possible link with bottled water. Some articles have suggested that the increase in bottled water over tap water has decreased the amount of fluoride intake thereby increasing the rate of cavities in children. This statement is not entirely true. Although decreased fluoride intake can increase your susceptibility to cavities it is only one factor in a complex scenario. Also, keep in mind that many bottled water companies do offer water with fluoride in it and also many communities do not have fluoride in their tap water.
Over the years dentistry has focused on preventative care with pediatric patients. We do this by recommending good home care, fluoride use, dental sealants and regular check ups. This is only one piece of the puzzle though. One portion of care that dentists do not get to address thoroughly is a child’s diet. With an increase in high sugar and carbohydrate intake, processed foods, and children with little opportunity to brush their teeth during the day, we are seeing more and more children with cavities at a young age.
Bottled water is not the enemy, as the International Bottled Water Association stated in a recent article, bottled water does not have sugar in it and is a great and healthy alternative to other bottled drinks on the market. Fluoride is just one step to help our children achieve great oral health. We also have to focus on good nutrition, home care, and regular hygiene visits to help keep our kids healthy!]]>
effort to keep our patients informed on the most recent dental information we assembled the facts about this study and its findings and our views on dental x-rays.
The study suggests that dental x-rays, particularly when obtained frequently and at a young age, may be associated with an increased risk of an intracranial meningioma. The study compared dental and therapeutic radiation histories in 1433 patients against a control group of 1350 subjects. The study was conducted via telephone interviews with patients and information accrued via patients memory. Due to dental records being held at various offices, researchers were unable to validate the samples history due to time and financial considerations.
- The study states that: “No studies have reported on the association between use of computed tomography (CT) and meningioma risk” as well as: ” The studies that report on dental x-ray exposure are suggestive but are limited by sample size and by the inclusion of cases from time periods with higher dosing regimes than the current era”
- Meningioma’s are common benign brain tumors originating in the meninges. As reported by the Cancer Brain Tumor Registry of the United States, “Primary brain tumors represent only 2% of all cancers, with 35,000 new cases diagnosed each year in the United States,” “Meningioma’s occur at a rate of 7.8 per 100,000 per year, but only 25% are believed to be symptomatic, with the others being found incidentally.” Because the overall prognosis for this type of tumor is good and the tumors are commonly asymptomatic, only being found incidentally, many doctors do not recommend treating them and opt to observe the tumors instead.
- Dr. Elizabeth Claus, the lead author of the study reported is quoted as saying: “Our take home message is don’t panic. Don’t stop going to the dentist” and ” Our study refers to exposures in the past rather than exposures that people are receiving in this day and age”
- The American Dental Association’s position on dental x-rays is that dentists should order dental x-rays for patients only when necessary for diagnosis and treatment.
Dental x-rays and risk of meningioma; Elizabeth B. Claus MD, PhD1,2,§,*, Lisa Calvocoressi PhD1, Melissa L. Bondy PhD3, Joellen M. Schildkraut PhD4, Joseph L. Wiemels PhD5, Margaret Wrensch PhD5,6
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this 2012 baseball season, baseball players, managers, and coaches can not carry tobacco tins or packages in their uniforms any time that patrons are in the ballpark. They also have been restricted from use of smokeless tobacco during any televised interviews or any events where they are in contact with fans. This includes team-sponsored events and autograph signings. This was accomplished by much lobbying by various senators and health groups. Although, they have not banned the use of chewing tobacco during games and events they have been able to make a step in the right direction by eliminating tins and packages.
Smokeless tobacco can have many detrimental dental and overall health effects. Studies have found that between 60-78% of smokeless tobacco users have lesions in their mouths which may or may not be precancerous or cancerous. Besides the risk for oral cancer smokeless tobacco users often have an increased risk of cavities, receding gums and root surface exposure which can increase sensitivity to hot and cold.
According to statistics provided by the organizations lobbying to remove chewing tobacco use in front of baseball fans, they found that “There has been a 36% increase in the use of smokeless tobacco by high school boys since 2003, with 15% of all high school boys using it. The major leaguers who use it during games “are providing a celebrity endorsement for these products” . By decreasing the exposure of our youths to smokeless tobacco, whether it be by the media or by their family and peers, we can help reduce their chances of beginning a harmful habit that can increase their risk for oral cancer. To learn more about this topic please follow this link]]>
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.
Early treatment of incipient carious lesions: A two-year clinical evaluation; JAMES C. HAMILTON, D.D.S., JOSEPH B. DENNISON, D.D.S., M.S., KENNETH W. STOFFERS, D.M.D., M.S., WILLIAM A. GREGORY, D.D.S., M.S. and KATHLEEN B. WELCH, M.P.H., M.S
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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.]]>
