How does botox really work? Botox acts on the muscle its injected into by relaxing and reducing the strength of contractions. It is a highly refined purified protein with absolutely no live bacteria that lasts approximately 3-6 months. As the effects of Botox wear off, strength gradually returns to the contraction of the muscle affected.

Therapy with Botox for Grinding, Clenching, and TMJ Disorder

Many people grind and clench their teeth and/or suffer from TMJ Disorder. Your teeth should only touch together approximately 30 minutes a day, for chewing and swallowing. People that grind and clench put their teeth together more then 30 minutes a day. The hyper-function of the muscles used to move the jaw and put the teeth together can lead to: excessive wear to the teeth, broken teeth, inflammation/hypertrophy of muscles used to move jaw, TMJ Disorder, and headaches. Treating a patient with Botox in combination with a night guard can significantly reduce the symptoms from hyper-function of these muscles.

Gummy Smiles

Some patients have excessive gum tissue showing when they smile or talk. This could be due to excessive jaw growth, short upper lip, hyper-function of upper lip muscles, and/or altered gum tissue growth. Patients will sometimes go through gum or jaw surgery to reduce a “gummy smile.” An non-invasive alternative treatment option to treat “gummy smiles” is injecting botox into the upper lip muscles that produce a smile. By relaxing these muscles of facial expression with botox, the amount of gum tissue exposed when smiling is reduced.


Wrinkles are caused by muscles that fold the skin overlying. DSC_0265When the contraction of the muscles that cause facial expressions are reduced, wrinkles are reduced or go away completely by allowing the skin to recover. Dentists are experts in the anatomy of the head/neck region and are excellent sources for injections in the area. An added benefit is that patients typically see the dentist for routine cleanings every 6 months, the perfect time to have the Botox re-done. ]]>

fotolia_17582018_xs-resized-600 It’s hard to resist eating the candy intended for the big day before Halloween actually arrives. Then there’s the question of what do you do with all the left over candy that wasn’t given out, or the haul from “Trick-or-Treating!” Here’s our advice– Halloween is a fun time, so enjoy it. Just keep some of these tips in mind to help minimize the risk of getting cavities: -Try to avoid really sticky candies like caramels and taffies. These types of candies typically get into the nooks and crannies of your teeth that are hard to clean. -Give yourself or your child a set number of pieces of candy you can eat per day as to limit the sugar intake each day. – Try and limit the number of times you expose your teeth to candy in a day. It is better to eat multiple pieces at once, rather than one piece at time, multiple times during the day. – Try to brush and floss after snacking on candy. – If you’re unable to brush and floss, try and drink water. Although it won’t clean all of the sugar away from your teeth and is not a guarantee that you won’t get cavities, it will help cleanse your mouth, helping to reduce the possibily of cavities. Sugar-free gum is also another good trick. Like water, it helps to remove residual sugar from your mouth, while also stimulating saliva flow. Saliva is a natural protector against cavities. Happy Halloween!]]>

Fotolia_24195976_XS-resized-600Miles away from home and in unfamiliar surroundings and it hits you– your previously perfect tooth has just shattered and is now throbbing uncontrollably. Now what? Traveling in the US? – First step, call your dentist, they may have some words of advice for your particular problem. Also, depending on your circumstances they may be able to call in a prescription if necessary or direct you to a nearby facility to help you. – If your dentist is unavailable and you’re at a hotel, utilize your concierge or front desk staff. Often times they will have a list of people in the area that they have on call for emergency medical and dental situations. – If neither options are available, contact the local hospital. Mostly likely a dentist or oral surgeon will be on call to help you with your emergency. Traveling out of the Country? – As previously mentioned, contact your dentist immediately. Unfortunately, he/she will not be able to prescribe you any medications overseas but may be able to give you advice on how to proceed.  Also, check-in with your concierge for local resources as you would in the U.S. – If you don’t feel comfortable with your hotel’s concierge or don’t have a great grasp of the language and resources available to accomodate you, you may want to contact services at the U.S. Embassy.  They may be able to put you in touch with medical services and help with transferring funds from the U.S. – We also advise you contact your insurance company before a trip abroad to see if there are any policies about coverage outside of the country.]]>

Fotolia_15254500_XS-resized-600Have you ever wondered if the claims about certain sugar-free chewing gums are true and can in fact help prevent cavities? And, if so, why? Is it a special type of sugar, like xylitol, or is it from the process of just chewing gum? There is a lot of research about the benefits of chewing sugar-free gum that shows chewing sugar-free gum for 20 minutes following meals does in fact help with the reduction of cavities. Although many studies do say that xylitol can help in reducing cavities, the largest reason why chewing sugar-free gum can help is because of the role it plays in producing more saliva. When you chew sugar-free gum, there is no sugar present to be broken down in the mouth so there is no food for the bacteria that causes cavities to eat. The process of chewing gum increases the amount of saliva in your mouth. Saliva plays a huge role in keeping your mouth clean and healthy. By increasing the flow of saliva in your mouth, your teeth become more resistant to cavities by letting all the important ingredients to your saliva, such as calcium and phosphate, bathe your teeth and in turn strengthen tooth enamel. So, it is true! Chewing sugar-free gum can help reduce your risk for cavities. If you are able to chew gum and consume artificial sweeteners then remember, everything within moderation and be sure to look for chewing gum that has the ADA Seal of Acceptance on the back.

Source info: THE EFFECT OF CHEWING SUGAR-FREE GUM AFTER MEALS ON CLINICAL CARIES INCIDENCE BRADLEY B. BEISWANGER, D.D.S.; A. ELIAS BONETA, D.M.D., M.S.D.; MELISSA S. MAU, B.S.; BARRY P.KATZ, PH.D.; HOWARD M. PROSKIN, PH.D.; GEORGE K. STOOKEY, PH.D. September 12, 2011 Scientific Panel Issues Evidence-Based Clinical Recommendations: Sugar-Free Polyol Gum, Lozenges and Hard Candy, Nonfluoride Varnishes Help Prevent CavitiesRecommended in conjunction with fluoride for patients at high-risk for developing cavities Non-fluoride caries preventive agents Full report of a systematic review and evidence-based recommendations A Report of the Council on Scientific Affairs 5/24/2011

fotolia_28128322_xsIn today’s health conscious world, there is an increasing focus on maintaining a healthy mind as well as body. Studies now show just how complex our bodies are and how important daily maintenance is. One topic that I find very interesting and important is the link between periodontal disease and heart disease. Cardiovascular disease affects more than 80 million people in the United States alone. It can present itself in the form of high blood pressure, heart attacks, angina pectoris, strokes or even heart failure. Periodontal disease, in the dental world is also incredibly prevalent. Periodontal disease is the chronic inflammation and infection of the gums and surrounding tissues. Periodontal or gum disease can involve gingivitis (the inflammation of the gum tissue) or periodontitis (the loss or recession of bone aroud the teeth). So what’s the connection? Recent studies have found that the bacteria and inflammatory proteins that are present in gum disease are associated with an increase of blood vessel wall thickening, which is often found in cardiovascular disease. The theory is that the bacteria and inflammatory proteins found in the mouths of people with periodontal disease make their way to the blood stream where they begin to affect the cardiovascular system. How does this effect you? Having good oral health is something we should all strive for, however, if you are at risk for, or have a family history of cardiovascular disease then you should be even more diligent with your oral hygiene. That means flossing and brushing regularly and seeing your dentist at least every 6 months. If you have periodontal disease be sure to tell your physician as well.]]>

services_stock Even America’s taste in beauty has changed over the years. In general, we’ve moved away from the windswept and overprocessed looks of the 70’s, 80’s and 90’s as seen with Michelle Pfiefer, Cindy Crawford and Farrah Fawcett, to focus on fresh-faced, more natural looking women like Jennifer Aniston, Jessica Alba and Angelina Jolie. The New Vs. The Old Standards of Beauty:

  • Full natural faces vs. angular faces with high cheekbones
  • Round to almond shaped eyes with thicker less arched eyebrows vs. Cat eyes with skinny angular eybrows
  • Straight noses with longer bridges vs. perky, ski-slope noses
  • Full upper and lower lips vs. angular pouts w/ thinner upper lips and a fuller lower lip
  • Natural straight white teeth vs. Bright white ear to ear smile with large uniform flat edged smiles.
The old standards of beauty was a one-size fits all plasticized sense of beauty. Todays standards focus on the natural and enhancing an individuals unique features. This is heavily reflected in dentistry today. People have been retaining features about their smile that makes them unique and gives them character, like diastemas (or the gap between the front teeth). And, others have been opting for invisalign over veneering their teeth to retain the individuality that, to put it plainly, makes them… them.]]>

mall-whiteners Whitening kiosks usually promise results of achieving “at least four shades lighter in less than an hour.” In order to achieve these promised results in a limited amount of time, a professional strength whitening agent with a high hydrogen peroxide content must be used. At that high concentration, you are at a higher risk of chemical burn of the gums, sensitivy or damage to your teeth. Whitening procedures should always be done under the supervision of a dentist. Although the people at these kiosks may be wearing white coats, they are far from dental professionals. Usually they are unsupervised technicians working without the consultation of dental professionals. The way kiosks get around the legal implications of performing this procedure unsupervised is that they instruct the “patient” how to place the bleaching agent on their own teeth, rather than place it them themselves. Since they don’t actually do the procedure themselves, they’re absolved from the legal implications of any negative side effects that may result. It is Frangella Dental’s recommendation that whitening procedures be performed under a dentist’s supervision in a sterile environment. A dentist assesses each patient on an individual basis and predicts the outcome of treatment and any possible dangers.]]>

your questions about children’s oral health. Have additional questions for us? Visit Frangella Dental on Facebook or Twitter.

Is it okay to give children juice or is the sugar bad for their teeth?

Controlling a child’s diet is important for the prevention of cavities. You’ll want to make sure that your child is receiving the proper nutrition throughout the day but also keep their teeth in mind when doing so. If your child likes to sleep with a bottle, make sure that the bottle only has water in it. Sleeping with a bottle that contains sugary liquids can lead to baby bottle tooth decay. It is important that older children drink plenty of water and limit the amount of sugary beverages they drink including juice, energy drinks, and sodas. They are often full of sugar or can be acidic causing cavities, as well as acid erosion. Crunchy fruits and veggies can help clean a child’s teeth while supplying vitamins and nutrients that are good for your child’s overall health. After your child has a sugary drink, it is a good idea to brush their teeth. If that’s not possible, have them drink or rinse the mouth with water to cleanse the areas that the sugar that was deposited.

How many times a day should kids brush their teeth and with what equipment?

We recommend that children brush their teeth at least twice a day; in the morning and at night. Night time is one of the most important times to brush because all the sugary foods and drink that your child has had during the day are left to sit on the teeth, undisturbed all those hours if not brushed. Infants may not have all their teeth yet. They also don’t know not to swallow toothpaste so we recommend you use a warm towel to wipe gums & teeth rather than brush with a toothbrush. For toddlers and small children, you should brush for them with a soft bristle toothbrush appropriate for their age. Children’s toothbrushes will have age groups listed on them to help you pick the right one. When your child is at the point where he/she will not swallow toothpaste, you can begin having him/her brush with a fluoride toothpaste. As your child gets older, he/she will want to brush his/her own teeth but may not have the proper dexterity to reach all the areas of the mouth and often just do a back and forth motion on the front of the teeth. You should always follow up and brush for them when they’re done. This helps to make sure that the teeth are clean but also continues to reinforce the proper way to brush.

Should I floss my child’s teeth or is that not important until the permanent teeth come in?

We recommend that a parent floss a child’s teeth at least once a day. You may be wondering what there is to floss if there are spaces between the child’s teeth but the most important thing is to get below the gumline, to clean where the toothbrush doesn’t reach. You can pick up flossers specially made for children in local drugstores.

How much fluoride should I give my child? Can flouride be bad for teeth?

Fluorosis is something that can happen if a child is getting too much fluoride for their height and weight during tooth development. Your dentist or general physician will prescribe a fluoride vitamin during these years of development and account for fluoride that is already in your water.

How bad is a pacifier or thumb-sucking?

Children usually give up these habits before the age that adult teeth begin to come in so it has no long lasting dental result. If a child is engaging in these habits while the adult teeth are erupting it can cause them to be malpositioned and pushed forward. Adult teeth begin to erupt in a child around the ages of 5-6 years old, so it is a good idea to try and wean your child off of these habits before then.]]>

child-braces If it’s decided that your child needs orthodontic treatment, traditional braces are the most common way to straighten a child’s teeth from ages 8 to12 years old. For teenagers, there is an alternative to braces called Invisalign. Invisalign moves the teeth using clear aligners. The clear aligners are removable so that they can be taken out for eating, drinking, and social events. In order for your child to be considered for Invisalign, his/her mouth must have fully transitioned from baby teeth to permanent teeth, which is typically complete by 12 years old for most children. Because Invisalign is removable, teenagers may have compliance issues with the treatment. I often find teens with responsible personalities that truly do want to straighten their teeth to be the most successful with treatment. For additional information on treatment options or to schedule a consultation, call us at (212) 245-2888.]]>

  • Check and see if your child is due for his.her regular appointment. Ideally, they should be seeing a dentist every 6 months for regular cleanings and check-ups.
  • Teach your child good oral health habits! Children should be brushing their teeth at least twice a day for about 2-3 minutes each time. Kids from 6-9 years old can be the toughest as they don’t yet have the manual dexterity to clean their teeth properly on their own and typically focus solely on brushing the front teeth, yet they want to be independent and do it themselves. You should let them brush and once they’ve given it their best shot you should follow up and make sure they’ve done a good job, especially around those back molars. Electric toothbrushes are great for kids since they have timers that let them know exactly how long they should be brushing
  • Think through a healthy lunch and snack menu for when school begins. We know it’s easier said than done but since children don’t typically brush their teeth while at school, caretakers need to make sure their lunches and snacks contain healthy and sugar-free ingredients. Lunch bags filled with crunchy vegetables, sugar-free drinks and foods helps with keeping teeth clean and cavity free. Testing out drinks and snacks ahead of time to see which your children will actually enjoy will go a long way.
  • Get babies and toddlers on the same schedule and make sure if their teeth have erupted that you begin the process of selecting a dentist for them and scheduling their first appointment. The earlier you bring a child to the dentist, the sooner he/she will get accustomed to the environment and learn what to expect at the office and during a check-up.
  • ]]>