My Blog

Posts for: April, 2018

By David Mayer, DDS
April 29, 2018
Category: Dental Procedures
Tags: celebrity smiles   braces  
DwightHowardABrightNBAStarWithaSmiletoMatch

Have you started orthodontic treatment recently? Are you having a little trouble getting used to your braces? If so, you are not alone: Everybody goes through an adjustment period during which they momentarily wonder if they’ll really ever get used to this. Don’t worry — you will! And we’ve never heard anyone say, on the day their braces come off and their new smile is revealed, that they aren’t glad they went the distance. Just ask Houston Rockets all-star center Dwight Howard, who discussed his own orthodontic treatment in a recent interview.

“I’m sure I was no different than anyone else who has ever had braces,” he told Mediaplanet. “At first I hated them so much… That changed once I got used to them and I actually grew to love them.” What’s Howard’s advice? “Do exactly what your orthodontist says and know that the outcome is well worth it in the end.” We couldn’t agree more! Here are some tips for wearing braces comfortably:

  • Hard & Chewy Foods: If you love fresh fruits and vegetables, that’s great; there’s no reason to give them up, just the really hard ones. You don’t want to bite into an apple or carrot or any other hard foods like bagels and pizza that have any “size” to them. Small pieces may be ok as long as they can’t bend your wires. Chewy, sticky candy should really be avoided completely. Same with soda, sports drinks and so-called energy drinks because they contain acids that promote tooth decay and can cause a lot of damage around the braces.
  • Effective Oral Hygiene: Keeping your teeth clean is more important than ever, but also more challenging than ever. It’s easy for food to get stuck under wires and around brackets, but failing to remove it can cause tooth decay, gum irritation and soreness. Therefore, the cleaner your teeth and your braces are, the healthier you will be. Use interdental cleaning brushes and/or a floss-threader to get behind your wires. A mouthrinse can also help strengthen teeth and keep bacteria in check. If you have any questions about how to clean between your teeth, please ask for a demonstration at your next visit.
  • Pain Relief: Some soreness at the beginning of orthodontic treatment is normal. To relieve it, you can use an over-the-counter pain reliever and/or a warm washcloth or heating pad placed on the outside of the jaw. If brackets or wires are rubbing against the inside of your cheeks or lips, try applying wax to these areas of your braces. If this does not offer enough relief, we may be able to trim the end of a poking wire. Call us if you need help with this.

Our goal is to make your orthodontic treatment as comfortable as possible on the way to achieving your all-star smile. If you have questions about adjusting to braces, contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”


By David Mayer, DDS
April 19, 2018
Category: Dental Procedures
Tags: porcelain veneers  
WhatYouShouldKnowAboutVeneersforTeenagers

Porcelain veneers are a great way to enhance an unattractive smile. But are they appropriate for teenagers? The answer usually depends on a patient’s current development stage and the type of veneer used.

Veneers are thin layers of porcelain bonded to the front of teeth. But even though quite thin, they can appear bulky if we don’t first remove some of the tooth’s enamel surface. This is irreversible, so the tooth may require a restoration from then on.

This could be a major issue for teens whose permanent teeth are still developing. During this period the tooth’s central pulp is relatively large and the dentin layer not fully developed. As a result, the pulp’s nerves are often closer to the surface than in an adult tooth. This increases risk of nerve damage during veneer preparation; if nerve damage occurs, the tooth could ultimately require a root canal treatment to save it.

On the other hand, some types of veneers don’t require tooth alteration (or only very little) beforehand. These “no-prep” or “minimal prep” veneers are best for certain situations like abnormally small teeth, so we must first determine if using such a veneer would be appropriate for your teen.

In effect, we’ll need to weigh these and other factors before determining if veneers are a safe choice for your teen. That being the case, it may be more advisable to consider more conservative cosmetic techniques first. For example, if enamel staining is the main issue, you could consider teeth whitening. Although the often amazing results eventually fade, whitening could still buy some time until the teeth have matured to safely apply veneers.

Slight deformities like chipping can often be corrected by bonding tooth-colored composite material to the tooth. In artistic hands it’s even possible to create a full veneer effect with very little if any tooth preparation. How much we can apply, though, depends on tooth size, and it won’t be as durable as a porcelain veneer.

With that said, veneers could be the right solution to enhance your teen’s smile. But, we’ll need to carefully consider their dental situation to ensure their new smile remains a healthy one.

If you would like more information on cosmetic solutions for smile appearance problems, please contact us or schedule an appointment for a consultation.


WhyweNeedtoCareforaYoungerPatientsBoneafteraToothLoss

In an instant, an accident could leave you or a loved one with a missing tooth. Thankfully, we can restore it with a dental implant that looks and functions like a real tooth—and the sooner the better.

But if the patient is a teenager or younger, sooner may have to be later. Because their jaws are still developing, an implant placed now could eventually look as if it's sinking into the gums as the jaw continues to grow and the implant doesn't move. It's best to wait until full jaw maturity around early adulthood and in the meantime use a temporary replacement.

But that wait could pose a problem with bone health. As living tissue, bone cells have a life cycle where they form, function and then dissolve (resorption) with new cells taking their place. This cycle continues at a healthy rate thanks to stimulation from forces generated by the teeth during chewing that travel through the roots to the bone.

When a tooth goes missing, however, so does this stimulation. Without it the bone's growth cycle can slow to an unhealthy rate, ultimately reducing bone volume.  Because implants require a certain amount of bone for proper placement and support, this could make it difficult if not impossible to install one.

We can help prevent this by placing a bone graft immediately after the removal of a tooth within the tooth's "socket." The graft serves as a scaffold for new bone cells to form and grow upon. The graft will eventually resorb leaving the newly formed bone in its place.

We can also fine-tune and slow the graft's resorption rate. This may be preferable for a younger patient with years to go before their permanent restoration. In the meantime, you can still proceed with other dental treatments including orthodontics.

By carefully monitoring a young patient's bone health and other aspects of their dental care, we can keep on course for an eventual permanent restoration. With the advances in implantology, the final smile result will be worth the wait.

If you would like more information on dental care for trauma injuries, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers: Factors Influencing Treatment Planning in Adolescents.”


OvercomingGumRecessionwillRestoreDentalHealthandyourSmile

Your gums not only help hold your teeth securely in place, they also help protect them. They're also part of your smile — when healthy and proportionally sized, they provide a beautiful frame for your teeth.

But if they become weakened by periodontal (gum) disease, they can detach and begin to shrink back or recede from the teeth. Not only will your smile be less attractive, but you could eventually lose teeth and some of the underlying bone.

Treating gum recession begins with treating the gum disease that caused it. The primary goal is to remove the source of the disease, a thin film of food particles and bacteria called dental plaque, from all tooth and gum surfaces. This may take several sessions, but eventually the infected gums should begin showing signs of health.

If the recession has been severe, however, we may have to assist their healing by grafting donor tissue to the recession site. Not only does this provide cover for exposed tooth surfaces, it also provides a “scaffold” for new tissue growth to build upon.

There are two basic surgical approaches to gum tissue grafting. One is called free gingival grafting in which we first completely remove a thin layer of surface skin from the mouth palate or a similar site with tissue similar to the gums. We then attach the removed skin to the recession site where it and the donor site will usually heal in a predictable manner.

The other approach is called connective tissue grafting and is often necessary when there's extensive root exposure. The tissue is usually taken from below the surface of the patient's own palate and then attached to the recession site where it's covered by the surrounding adjacent tissue. Called a pedicle or flap, this covering of tissue provides a blood supply that will continue to nourish the graft.

Both of these techniques, but especially the latter, require extensive training and micro-surgical experience. The end result is nothing less than stunning — the tissues further rejuvenate and re-attach to the teeth. The teeth regain their protection and health — and you'll regain your beautiful smile.

If you would like more information on treating gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Plastic Surgery.”