In the dental field there are many types of dentists, they can range from extremely conservative to extremely aggressive. And depending on where your dentist falls in that range you may find that accompanying your routine dental exam your dentist will say, ‘ok lets watch that spot’, or ‘its a small cavity but I recommend filling it before it becomes something bigger’. So what exactly does that mean? 
Teeth have different layers to them, the outer enamel layer, the softer inner dentin layer and the innermost layer where the nerve and blood supply to the tooth resides, the pulp chamber. When diagnosing a cavity we look at what damage has been done to these layers and from there decided what procedure needs to be done. A microcavity or incipient decay, is a cavity that is in the enamel layer but has not passed into the dentin layer. The question is, what are the risks of filling it vs. not filling it?
Recent studies have shown that filling microcavities may not help in preventing further decay or breakdown of the tooth. However, treating cavities at this stage has not shown any increase of decay or damage to the tooth either. It is our belief that when a microcavity is noted while we may not recommend placing a filling immediately, we do recommend treating the area by other means. Small cavities such as microcavities often times can be abated or avoided by maintaining a good home care regimen. This includes keeping the area clean as well creating a healthy oral environment to help stop the cavity from progressing. This can be done by stabilizing the pH in the mouth as well as using fluoride to help strengthen the enamel. To learn more about how to maintain great oral health follow this link.
The way it stands there are many viewpoints on how aggressive to be with decay. You as a patient may not want any decay in your mouth no matter how small. Or vice versa you may not want to begin removing tooth structure for something that may be maintained for a number or years. The best option for every patient is to find a dentist that feels the same way you do, whether it be conservative or aggressive.
Ever look on the back of the toothpaste box and wonder, what exactly is xanthan gum and why the heck is it in my toothpaste? Well wonder no more, as we go through how to decode the toothpaste label…
On every drug facts label you find a listing of active ingredients and inactive ingredients, as well as what its used for, any warnings for the product and directions for uses.
Active Ingredients: This is the part of the toothpaste that makes its use effective. In the case of most toothpastes the active ingredient is usually for anti-plaque, anti-cavity, anti-gingivitis as well as including ingredients to help prevent tooth sensitivity. So in this portion you will normally see your fluorides such as sodium fluoride, stannous fluoride or sodium monofluorophosphate. You may also see potassium nitrate, triclosan, pyrophosphates or zinc salts as well as a myriad of other ingredients.
Inactive Ingredients: This portion includes the ingredients that make the toothpaste standup to being on the shelf as well as completing the nuts and bolts function of general toothpaste use. So these ingredients stop the paste from drying out, keep it at a good pH, stop microbial growth, make them thick enough for use and help them become foamy when used. They also include flavoring agents, abrasives and whitening agents. So in this section, which in my opinion is the most confusing you’ll see these types of ingredients:
- Propylene glycol, glycerol, and polyethylene glycol to help keep toothpaste moist
- Carageenan, cellulose and xanthan gum to thicken and hold all the ingredients together
- Sodium benzoate and methyl paraben to keep toothpaste from decaying and to prevent microbial growth
- Sodium lauryl sulphate and cocoadmidopropyl betaine to make toothpaste foam thereby helping loosening and removing plaque from the tooth surface.
- sodium saccharin, xylitol, sorbitol, sodium cyclamate to flavor the toothpaste.
- Buffering agents to make it a pH favorable for the oral environment.
- And, you may see silicas, dicalcium phosphate dihydrate or aluminum oxide which are abrasives which help remove plaque and bacteria as well.
Crown, dental crown, cap or bridge, are common dental terms used often in our practice. If you’re not familar with these terms, this article should answer any questions you may have about what these procedures are and how they’re done, and why a patient would need them.
A crown or cap is a restoration that covers a broken down, root canaled or esthetically unpleasing tooth. They’re made from a variety of materials such as porcelain, metal or zirconia.
A bridge is a group of crowns linked together usually for the purpose of holding a fake tooth that will fill a space where a tooth is missing.
During a crown or bridge appointment, the area will initially be anesthetized, and the tooth, or in the case of a bridge, the teeth surrounding the space, will be shaved down. The tooth or teeth are shaved down into a cylindrical shape and and then an impression or mold is taken of the prepared area. The mold is sent to a dental lab and a bridge or a crown is fabricated. The lab generally returns the restoration in about 1.5 to 2 weeks so it can be tried in and cemented.]]>
what exactly a root canal is. A root canal is a routine dental procedure. Here is a summary of the root canal: what it is and what to expect with treatment:
Once it has been determined that root canal therapy is needed, a dentist will anesthetize the tooth and place a protective barrier around it in order to keep it clean. Then the dentist will clean out the nerve tissue with specially shaped instruments and may place a medicament. When the root canal is thoroughly cleaned and shaped, a sealing material is placed in the canal and a temporary filling material is placed in the tooth until the next visit when the final restoration of the tooth will take place. Root canal therapy, depending on the amount of canals in the tooth, can take between 1-2 visits ranging from an hour to an hour and fifteen minutes per visit. Root canal therapy is painless if the tooth is sufficiently numb. If a tooth is infected or has been irritated for a long time, there is a possibility that getting numb may take longer than normal. After treatment is completed, it is not uncommon to have some soreness when biting, similar to a bruised feeling. This sensitivity is normal and can be addressed with an over the counter pain reliever such as ibuprofen. It is important to note that the difficulty/ease of the procedure depends on various factors including severity of infection. Many of our patients report experiencing little or no pain at all. If fear of a root canal, or dental procedures in general, are preventing you from seeking dental treatment, speak to your dentist about conscious sedation.]]>
After years in the dental office, I can tell you that it’s very rare to find a patient who goes more than 3 years without a cavity.
Knowing that home care is one of the most important aspects of maintaining a healthy mouth, my partners and I set out on creating a home care regimen that’s relatively easy and will provide the results we are hoping to achieve, a decrease in cavities and improvement in overall oral health.
The final breakthrough of my home care routine recommendations came while reading Dr. Ellie Phillips book Kiss Your Dentist Goodbye. During our daily care routine, we are mainly focusing on removing and repairing the damage we’ve already done during the day. Removing plaque mostly and strengthening enamel. However, Dr. Ellie’s book brings up a great point, we aren’t focusing on improving the overall environment of the mouth, more specifically saliva makeup.
Combining both rationales, ours which focuses on mechanics and repair, and Dr. Ellie’s which focuses on reducing the saliva’s acidity and creating a healthier environment in the mouth, we created Frangella Dental’s basic home care regimen:
Part 1: Prepare & Clean
This portion of your home care focuses on the mechanical aspect of cleaning your mouth. The first step is to prepare the right oral environment. You can do this by using an oral rinse that creates a less acidic pH in your mouth. The product we recommend is CloSYS. We also recommend investing in a good electric tooth brush. Our favorite is the Sonicare tooth brush. Find floss that works best for you. I generally recommend unwaxed tape varieties of floss as opposed to the rope type. The brand I recommend the most is Glide.Part 2: Sanitize & Disinfect
Directly after brushing and flossing your teeth, the next step is to rinse with an antibacterial rinse. Our favorite product on the market is Listerine. After brushing your teeth, be sure to sanitize your tooth brush, you can do this by rinsing your brush in Listerine, then rinsing with water and allowing to air dry. Also, always store your toothbrush away from open toilets as well.Part 3: Strengthen & Repair
This portion of home care helps keep your enamel strong and healthy. At night, as the last step of your home care, you should rinse with a fluoride rinse. We recommend ACT Total Care fluoride rinse. After you have rinsed with the fluoride rinse, do not rinse with water. Also, throughout the day, to give added protection, you can chew xylitol gum or use other 100% xylitol products. You want to aim for about 6-10 grams a day of xylitol to get the best anticavity effects of this sugar substitute. To see all of Frangella Dental’s recommeded home care products, click here.]]>
Being in the dental field, I’ve noticed that about a month before the wedding, patients begin to panic and realize that the smile they’ve loved all their lives just isn’t wedding picture perfect. Unfortunately, the smile of most people’s dreams cannot be acheived in less than 3-4 weeks. If you’re recently engaged and not exactly sure where to start, here is Frangella Dental’s Wedding Countdown Guide:
- If you want to straighten your teeth, visit your dentist ASAP for an evaluation. Ortho or Invisalign cases typically take between 8 months and 1.5 years, so you’ll want to get started early in order to have your teeth perfect or at least almost perfect come wedding day.
- Crowns, bridges or veneers: These types of restorations usually require multiple visits, and the length of time between visits can be up to 2 weeks per visit. It’s best to have this treatment started as soon as possible but don’t wait any longer than 3-4 months before your wedding.
- No one wants a toothache on their wedding day so be sure to keep up with your 6-month check-ups to take care of any cavities.
- If you plan to whiten your teeth, we recommend one month before your wedding date. Whitening is the last dental procedure you should have done before big day.
Conscious sedation is a procedure that allows you to get the dental care you need while remaining stress free and comfortable.
Conscious sedation is defined as a minimally depressed state of consciousness that allows the retention of the ability to respond and react to physical stimulation and verbal command. During the sedated state most patients experience an amnesic effect that can erase any memory of the procedure.
It is a great tool that can help you achieve the smile you’ve always wanted but were kept from getting due to your fear of the dentist. If you are afraid to go to the dentist, or just anxious about certain aspects of your dental treatment, sedation may be a solution to your anxiety.
Unlike general anesthesia where the patient is unconscious or asleep, conscious sedation allows you to be awake but in a very relaxed state. Our certified IV conscious sedation dentist, Dr. Tina Frangella, can give you the ability to have your dental treatment completed while you are in a sedated and relaxed state.
Sedation Dentistry can give you the peace of mind you need in order to undergo dental work with no memory of the treatment that was done. It will allow you to receive the care necessary for you to enjoy better overall health, an improved self-image, and better quality of life with a healthy, beautiful smile.]]>
Being a dentist and being surrounded by a lot of dentists, I’ve had the opportunity to try a lot of dental products over the years and learn the opinions of my friends, family and colleagues about these same products.
I decided to compile a list of my absolute favorite, tried and true, dental products on the market. Of course I’m always open to try something new, so if you have any favorites, please let us know!
Toothbrush: Sonicare
This toothbrush’s sonic motion and handy timer really make a difference in your smile. It’s the best home care tool in my opinion.Floss: Glide
Whenever I buy floss, I tend to lean towards an unwaxed tape variety rather than a rope. Glide is great b/c its easy to manuever between teeth and doesn’t shred easily.Regular Toothpaste: Crest Original (with sodium fluoride)
Crest is a great product. I like the flavor of the paste and usually prefer sodium fluoride in my toothpaste as opposed to stannous fluoride. When I’m looking to buy a regular toothpaste I usually stick to the Crest Original.Toothpaste for Sensitive Teeth: Sensodyne Isoactive
For patients that are long time users of toothpaste for sensitive teeth, this new product is a great change from the dull chalky tasting toothpastes that have been on the market. I tried this product about 6 months ago and use it from time to time when my teeth become hot & cold sensitive. It forms a refreshing foam that leaves you with a great taste and more comfortable teeth as well.Whitening Toothpaste: Crest 3d White
When brushing your teeth in between whitenings to keep that beautiful fresh smile I like to use this Crest 3d White. It’s Crest, which has a great line of whitening products, and also has a great taste and is very effective in maintaining a bright smile.Antibacterial Mouthwash: Listerine and Closys
An antibacterial mouthwash is crucial to home care. The hard part is sorting through all the options and finding whats right for you. My top two picks are: CloSys and Listerine. I love CloSys because although it has a mild flavor, it is a great tool to kill bacteria that can lead to periodontal disease and also it is less acidic than many of the rinses on the market. My other top pick is Listerine. In my opinion Listerine is hands down the most effective antibacterial rinse on the market. My morning routine usually includes a quick rinse with CloSys then a thorough brushing & flossing followed by a rinse with Listerine.Fluoride Mouthwash: ACT Total Care
I always rinse with ACT right before bed. It has a great flavor (my favorite is the green one), probably the best tasting of all the mouthrinses I’ve tried, and is very effective in helping remineralize and strengthen enamel. Another great product worth trying.100% Xylitol Gum: Epic (epicdental.com)
Xylitol is a great sugarfree product that is important to home care. I usually opt for 100% Zylitol chewing gum (right now I’m addicted to Epic cinnamon flavor). The only downfall is the chewing gum doesn’t keep its flavor for that long. But on the upside, even after only chewing it for a short amount of time, my mouth feels really fresh and clean afterwards. And it’s a great way of delivering Xylitol, which is the only sugar substitute that studies have shown that has cavity fighting properties.]]>
Using both Invisalign and traditional braces, we’ve seen their smiles change over the years and sometimes even caught them in the process.
So who has had Invisalign and who has had braces?