Fluoride has been and continues to be a hot topic in the field of dentistry. Despite all the information available regarding the benefits and Fotolia_5327278_XS-resized-600risks of fluoride use there still seems to be a large amount of misinformation about this topic. Fluoridation of the water system has been recommended by numerous health organizations, most notably the CDC and WHO have long supported the dental benefits of fluoride.
The CDC has stated that:  “For 65 years, community water fluoridation has been a safe and healthy way to effectively prevent tooth decay. CDC has recognized water fluoridation as one of 10 great public health achievements of the 20th century.” And,  the World Health Organization explained that:  “Public health actions are needed to provide sufficient fluoride intake in areas where this is lacking, so as to minimize tooth decay.” As a dentist I do believe that fluoride is a great tool to use to help prevent tooth decay. In our practice we frequently recommend fluoride products for adults and children alike. And, with my recommendations I have encountered many questions about fluoride, such as where does it come from, how much am I getting and how much do I need?

  • Fluoride is a naturally occurring mineral and can be found naturally in all water sources.
  • There are two ways to receive fluoride.
    • Systemically such as in a supplement or in your drinking water.
    • Topically, such as in toothpastes, mouthrinses and topical foams or gels.
  • Fluoride, when applied to the teeth can cause the enamel, or outermost layer, to become stronger and more resistant to cavities.
  • Fluoride when applied to the teeth in addition to preventing new cavities, can help heal or re-calcify small cavities
  • Like any other supplement fluoride is most effective when used in moderation.
  • The American Dental Association only recommends fluoride supplements for children ages 6 months- 16 years old. And, only for children who live in an area without fluoridated water and are at high risk for cavities.
  • Although bottled water may contain fluoride they are not required to report the amount of fluoride present unless they have actively added it to their water.
  • By ingesting too much systemic fluoride (fluoride supplements, processed/manufactured foods high in fluoride, and fluoridated water) you are at risk for  fluorosis of the teeth, this means that the enamel on the teeth can appear mottled or patchy.
  • By ingesting topical fluoride (toothpaste, mouthrinse, foams or gels)  you can cause stomach upset and nausea
  • Topical fluoride, such as in toothpastes and rinses are not meant to be swallowed and should not be used on children that may ingest it during use.
  • To find out if your water is fluoridated visit this website
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conscious sedation is the surgical placement of dental implants.  With the surgical placement of dental implants it is crucial that a patient is anxiety free as to prevent any movement during the procedure.  There are certain parts during the procedure that may not cause pain, but can make a patient uncomfortable.  Conscious sedation removes this uncomfortable feeling because the patient is often At Dentist's Officeasleep or at the very least anxiety free and very calm. During the procedure I often have the patient perform tasks such as “open wide” or “bite down” or ask them questions in regards to how they are feeling.  With conscious sedation this is never a problem because the patient is able to maintain their own breathing and reflexes, they are also able to respond to different instructions. Also, most people would care not to remember the surgical procedure they have just experienced.  As an added benefit, 90% of the time the patient has amnesia towards the procedure just performed.    But, the biggest benefit to me as a practitioner is that conscious sedation is safe for the patient.  I cannot say the same about general anesthesia, the risks of complications are much higher.   As a practitioner who performs surgical placement of dental implants regularly, there is no other safe and comfortable way to have this procedure done then with conscious sedation.  ]]>

Professional dentist providing patient care

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Dental Myth 1:  Pregnancy steals calcium from your teeth causing you to have more cavities During pregnancy there are many changes that occur to your body as a result  in the influx of hormones. Also, there is typically a change in diet due to restrictions imposed to protect the baby. These two factors amid many others (most notably the exhaustion that most expecting mothers feel as well as symptoms of morning sickness) can lead to a change in the risk for cavities that they may face. For example, most pregnant women eat less artificial sugars than they may have previously and are forced to switch to regular sugar, this coupled with being more tired than usual and perhaps a lax in brushing and flossing can cause them to develop cavities during pregnancy. Although there may be other factors at play, such as a subtle change in the oral environment during pregnancy, we typically do not find that calcium is leeched from the teeth and in turn causing more cavities, but more often a series of subtle changes that make you more susceptible to developing cavities. Fotolia_10056459_XS-resized-600

Dental Myth 2:  Wisdom teeth push your teeth and make them crooked

Dental eruption is normally a passive process. In other words, with the exception of primary or baby teeth, we do not usually see an effect of adult teeth destroying or moving the teeth next to them during the eruption process. The correlation between teeth shifting, or appearing more crooked, and the eruption or presence of wisdom teeth can be attributed to several other factors which are still under debate.

Dental Myth 3:  You do not have to wear your retainer after a year

Some patients happen to be lucky and get away with not having to wear their retainers after completing orthodontics.  But the vast majority of us will see relapse and the teeth will shift back to where they were moved from.  The forces that put our teeth in the original position are still present.  Retainers fight these forces from pushing the teeth back to their original place.

Dental Myth 4:  Adults do not need to use fluoride

Fluoride bonds with enamel and makes it stronger, therefore preventing acids from penetrating teeth and causing cavities.   Adults will benefit from strong enamel just as a child would.

Dental Myth 5:  Cavities cause pain

If a cavity is causing you pain it is because it has penetrated the enamel and is now into the softer and more sensitive layer of the tooth called dentin.  If the cavity really hurts, it probably is now past the dentin layer and into the nerve.  That is when root canal therapy is necessary.  Many cavities do not penetrate through the enamel and therefore do not cause pain.  ]]>

Should I Go Electric? The high price tag that comes along with an electric toothbrush often gets people asking “Is it really worth it?” There are many benefits to using an electric toothbrush. Electric toothbrushes minimize technique errors that occur with manual toothbrushes. People often miss hard to reach areas because they are rushing or just don’t know proper brushing technique. Electric toothbrushes are designed so that all you have to do is position the toothbrush head in the proper areas and it will do all the work for you by performing the proper brushing motions on its own. When positioning the brush head, you want to feel it between the teeth and also along the gum line. Electric toothbrushes can help remove or prevent surface staining. Who doesn’t want whiter teeth? It also lowers your risk for toothbrush abrasion. People typically brush too hard and for too short of a period of time. With built in timers, the toothbrush will let you know when it’s time to move on to another area. And with the toothbrush doing all the work, you can stop all that forceful scrubbing.

 Philips Sonicare vs Oral-B Spinbrush

I am partial to the Philips Sonicare because of the toothbrush head shape and brushing motion, but this is really just a personal preference. Both work great. You just have to pick which better suits you. sonicareoral-b   ]]>

Dr. Frangella - dentist at Frangella Dental Manhattan NYC

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Often times I hear a patient refer to being “knocked out” for procedures such as extracting wisdom teeth or placement of implants.  Truth is, to “knock out” a patient we would have to perform General Anesthesia.  This is when a patient is intubated, and is done because he or she no longer has reflexes to breath on their own. Fotolia_35347877_XS-resized-600-300x200We rarely do this for routine dental procedures.  In fact, when a patient refers to being “knocked out”, they may be describing “twilight” or conscious sedation. Conscious sedation is a form of sedation in which patients still have their reflexes during the procedure.  What this means is they breathe and move on their own while being sedated.  In our office we use an intravenously delivered sedative,  90% of the time our patients do not remember the procedure performed. The level of sedation used allows our patients to remain comfortable through out the procedure, without anxiety, while remaining aware enough to respond to stimuli and questions if need be. This allows us to provide a variety of services with relative ease and comfort to the patient.]]>

Woman with toothache

1. Gum recession:

When the gum tissue around a tooth recedes, the root becomes exposed.  The root is a very sensitive part of the tooth that when exposed to cold, hot, or sweets it can create sensitivity.   Solution: An immediate answer to this problem is  the use of desensitizing products such as toothpaste (Sensodyne) and mouth rinse (ACT) which can help take the edge off the sharpness felt in the tooth.  These products take a few weeks to work.   A long term solution may be bonding or gingival graft (surgically placing gum tissue)  over the exposed root.  These are procedures  in which we simply cover the exposed root causing sensitivity.

2. Teeth Whitening Products:

These days teeth whitening products are in virtually every type of product we use to keep our teeth healthy.  They are in mouth rinses, toothpaste, gum, etc.  The active ingredients that whiten our teeth can leave us with sensitivity after use of these products.  Solution: Very simple, use products without the whitening additive or at least cut back.

3. Grinding/Clenching:

Grinding and clenching your teeth can lead to gum recession which can lead to sensitivity.  Grinding and clenching also causes trauma to the tooth and can make it hypersensitive to hot, cold, sweets, etc. This is because the nerve inside the tooth becomes inflamed from the trauma.    Solution: Wear a night guard when you sleep and be conscious of keeping your teeth apart during the day.

4. Rough Teeth Cleaning:

Some times a hygienist or dentist can be a little overzealous when cleaning a patients teeth.  If a protective layer (cementum) is scrapped off of the roots of your teeth, you may experience sensitivity for a few weeks until that protective layer is reformed.  Solution: Wait it out, it could take a few weeks to improve.  Also,  mention to the provider who cleaned your teeth what your experience was like afterwards. We hope these offered solutions help with that annoying tooth sensitivity that just will not go away.   But always remember to keep up with your regular dental check ups and if sensitivity persists for longer than 2 weeks let your dental provider know!]]>

01218_TS_iosBrand2_280 The Academy of General Dentistry just released a free interactive game: Toothsavers, available online as an app for Android and iOS devices. The game is for ages 3-6 and was designed to get kids in the routine of brushing twice a day for two minutes each time.   As many of you know well, it is a very daunting task at times to motivate children to take care of their own teeth.  Any feedback on the use of this app and how it is working with your kids would be greatly appreciated, just post your comments on our Facebook page.]]>

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