By Vincent J Castellano DMD
September 08, 2021
Category: Oral Health
Tags: tooth decay  
StopToothDecayBeforeItDerailsYourChildsDentalDevelopment

From birth to early adulthood, your child's teeth, gums and jaws develop at a rapid pace. And, for the most part, nature takes its course without our help.

But tooth decay can derail that development. The result of bacterial acid eroding enamel, tooth decay is the top cause for premature primary tooth loss in children. One particular form, early childhood caries (ECC), can rapidly spread from one tooth to another.

Many parents assume prematurely losing teeth that are destined to fall out soon anyway is inconsequential. But primary teeth play a critical role in the proper eruption of permanent teeth, serving as both placeholders and guides for those teeth developing just below them in the gums. A permanent tooth without this guidance can erupt out of alignment to create a poor bite that may require future orthodontics.

Being proactive about tooth decay lessens that risk—and the best time to start is when the first teeth begin to erupt. That's when you should begin their regular dental visits sometime around their first birthday.

Dental visits are an important defense against tooth decay. Besides routine dental cleanings, your child's dentist can offer various preventive treatments like sealants to stop decay from forming in the biting surfaces of back molars or topically applied fluoride to strengthen tooth enamel.

Daily home care is just as important in the fight against tooth decay. Oral hygiene should be a part of your child's daily life even before teeth: It's a good habit to wipe an infant's gums with a clean cloth after nursing. As teeth arrive, oral hygiene turns to brushing and flossing—perhaps the best defense of all against dental disease.

It's also important to watch their intake of sugar, a prime food source for bacteria that produce harmful acid. Instead, encourage a "tooth-friendly" diet of whole foods to keep teeth and gums healthy.

Even if they do develop tooth decay, there are effective treatments to minimize any damage and preserve affected primary teeth until they've served their purpose. By adopting these prevention strategies and prompt treatment, you can stay ahead of this destructive disease.

If you would like more information on preventive dental care for children, please contact us or schedule an appointment for a consultation.

By Vincent J Castellano DMD
August 29, 2021
Category: Oral Health
Tags: oral hygiene   gum disease  
PlaqueRemovalistheTopPriorityforPreventingorTreatingGumDisease

Tooth loss is often the unfortunate conclusion to a case of untreated periodontal (gum) disease—incentive enough to try either to prevent it or aggressively treat an infection should it occur. In either case, the objective is the same: to remove all plaque from dental surfaces.

Dental plaque (and its hardened form, tartar) is a thin buildup of bacteria and food particles on tooth surfaces. It's a ready food source for sustaining the bacteria that cause gum disease. Removing it can prevent an infection or “starve” one that has already begun.

Your first line of prevention is brushing and flossing your teeth daily to remove any accumulated plaque. Next in line are dental cleanings at least twice a year: This removes plaque and tartar that may have survived your daily hygiene.

Plaque removal is also necessary to stop an infection should it occur. Think of it as a more intense dental cleaning: We use many of the same tools and techniques, including scalers (or curettes) or ultrasonic devices to loosen plaque that is then flushed away. But we must often go deeper, to find and remove plaque deposits below the gums and around tooth roots.

This can be challenging, especially if the infection has already caused damage to these areas. For example, the junctures where tooth roots separate from the main body of the tooth, called furcations, are especially vulnerable to disease.

The results of infection around furcations (known as furcation involvements or furcation invasions) can weaken the tooth's stability. These involvements can begin as a slight groove and ultimately progress to an actual hole that passes from one end to the other (“through and through”).

To stop or attempt to reverse this damage, we must access the roots, sometimes surgically. Once we reach the area, we must remove any plaque deposits and try to stimulate regrowth of gum tissue and attachments around the tooth, as well as new bone to fill in the damage caused by the furcation involvement.

Extensive and aggressive treatment when a furcation involvement occurs—and the earlier, the better—can help save an affected tooth. But the best strategy is preventing gum disease altogether with dedicated oral hygiene and regular dental visits.

If you would like more information on preventing and treating gum disease, 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 “What are Furcations?

By Vincent J Castellano DMD
August 19, 2021
Category: Dental Procedures
Tags: braces  
CorrectingaPoorBiteWithBraces-aTrueWonder

Braces are so common that we often view them as "ho-hum." But there are aspects about braces that make them remarkable. For one, the fact that we can move teeth at all is a wonder of nature.

We normally experience our teeth as firmly set in the jaw, which can easily lead to assuming they're permanently fixed to the bone. They're not. Teeth are actually held in place by a fibrous gum tissue called the periodontal ligament that lies between them and the jawbone. The ligament anchors to both with tiny fibers, which on the tooth side affixes within a thin substance called cementum deposited on the tooth root.

As we said, we don't normally notice teeth moving. But the periodontal ligament does allow movement on a miniscule scale as a response to normal pressures that accompany biting and chewing. Although we're unaware of it, this movement takes place as the bone and cementum ahead of the direction of movement begin to dissolve. Simultaneously, new bone and cementum develops on the other side of the tooth to stabilize the movement.

Orthodontic treatment takes advantage of this natural process. The anchored wires of braces through attached brackets place pressure on the teeth in the intended direction for tooth movement. The natural mechanism described earlier does the rest. Over time, orthodontists have developed an amazing amount of precision working within this mechanism.

Another aspect about braces and other methods we may take for granted is our motive for even trying to move teeth in the first place. It may seem we're only realigning teeth to produce a more attractive smile—which they can do and why we often refer to braces as the "original smile makeover." But there's an even greater desire—straightening teeth can improve dental health.

Poor bites in turn cause other problems. Misaligned teeth are more difficult to keep clean of bacterial plaque, which increases the risk of disease. A poor bite can also accelerate teeth wear and contribute to gum problems like recession. We can eliminate or minimize these problems through bite correction.

Whatever your age, braces or other means can vastly benefit your health and your appearance. They may not always seem so, but braces are one of the true wonders of dental care.

If you would like more information on bite correction through orthodontics, 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 “Moving Teeth With Orthodontics.”

HowYouTooCouldHaveLindseyVonnsViralVideoSmileMakeover

Instagram, America's humongous digital photo and video album, is chock-full of the silly, mundane, and poignant moments of people's everyday lives. That includes celebrities: Tom Hanks buying a used car; Ryan Reynolds sporting tiny sunglasses; Taylor Swift and Ed Sheeran taking a hike. And then there's former Olympic alpine skier, Lindsey Vonn—posting a video of her recent dental visit.

Winner of several World Cup competitions and the first woman to gain the gold for downhill racing at the 2010 Winter Olympics, Vonn broke her two front teeth during a—you guessed it—skiing competition a few years ago. This past September, she went to the dentist to update her restoration and gave her followers a fascinating firsthand look at dental bonding, a technique for repairing a chipped or broken tooth.

Although dental bonding has been around for decades, it's taken a leap forward in the last few years because of improvements in bonding material. A mixture of plastic and glass components, composite resins can produce a strong and durable result when bonded to teeth. To begin the technique, the tooth's surface is prepared so that the composite resin can better adhere. Along with an adhesive agent, the bonding material is applied as a paste, which makes it easier to shape and sculpt for the most realistic look. This is usually done layer by layer, with each individual layer hardened with a curing light.

The technique allows us not only to achieve the right tooth shape, but also to incorporate your natural tooth color. We can tint the composite resin as we work so that your restored tooth blends seamlessly with the rest of your natural teeth. The result: A “new” tooth that's both beautiful and natural-looking.

What's more, dental bonding is more affordable than veneers or crowns and can often be done in a single visit. You will, however, need to exercise care with your new restoration. Although highly durable, it can be damaged if you bite into something hard. You'll also need to watch foods and beverages like tea or coffee that can stain the dental material.

Even so, we can help you regain the smile you once had before you took your teeth skiing—Lindsey Vonn-style—or whatever you were doing that resulted in a “whoopsie.” All it takes is a call for an appointment to start you on the path to a more attractive smile.

If you would like more information about cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Artistic Repair of Front Teeth With Composite Resin.”

By Vincent J Castellano DMD
July 30, 2021
Category: Oral Health
Tags: oral hygiene  
BrushorFlossFirstHeresWhatYouNeedtoKnowtoDecide

If you like conundrums like "Which came first? The chicken or the egg?", then you may enjoy this one: "Which should you do first, brush or floss?"

Both of these oral hygiene tasks are equally important for removing dental plaque, a thin bacterial film that forms on teeth after eating. Removing plaque on a daily basis minimizes your risk for developing tooth decay or periodontal (gum) disease, the top causes for tooth loss. Brushing removes plaque from broad tooth surfaces, while flossing removes it from between teeth where brushing can't reach.

There is wide consensus that you need both brushing and flossing to thoroughly remove plaque. But there is a debate over which of these two tasks you should do first for the most effective outcome. Those debates are more or less good-natured, but there are proponents on both sides on which task should come first.

Those on the "Brush First" side say brushing initially gets the bulk of accumulated plaque out of the way. If you floss first, you may be plowing through a lot of soft plaque, which can quickly turn your floss into a gunky mess. More importantly, you may only be moving plaque around with the floss, not actually removing it. By brushing first, there's less plaque to deal with when flossing.

"Floss First" folks, though, say flossing before you brush loosens plaque stuck between teeth that can be more easily brushed away. But perhaps a more important reason is psychological: People don't really like flossing as much as brushing. Because of this, putting it off to the end may mean it doesn't happen; doing it first will help ensure it actually gets done.

In the end, though, the order you perform these tasks comes down to personal preference. You can try both ways to see which one suits you best. The important thing, however, is that you do both tasks—if you do, you can greatly lower your risk of dental disease that could rob you of your teeth.

If you would like more information on effective oral hygiene, 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 “Brushing and flossing: Which Should Be Done First?





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