Colony Square Dental Associates

Snoring and Sleep Apnea | Getting a good night’s sleep

It is estimated that almost 100 million people, just in the United States, snore. It’s a staggering number. And, as any bed partner of a snorer can attest to – it’s annoying! Maybe not overtly to the person who snores, but to the person listening to an unwelcome nightly concert. Drs. Hochberg and Diora are frequently asked if there is anything they can do help. Before delving into possible solutions, it’s important to understand that while there are some crossover treatment options for those suffering from sleep apnea and for those who snore, they are not the same conditions.

If I snore, do I have sleep apnea?

The terms sleep apnea and snoring are not interchangeable. One can snore and not have sleep apnea; and even though most with sleep apnea do snore, one can have sleep apnea without snoring. It is important to understand that there are differences and, while snoring is bothersome and can leave the snorer tired during the day, sleep apnea can be life threatening. Snoring occurs when there is a relaxation of the intra-oral tissue(s) causing a partial blockage or a partial obstruction. Whether it’s the uvula, a nasal obstruction, a tongue that is large in relation to the oral cavity or an elongated soft palate, there is a constriction as air moves, causing a vibration – the sound of snoring. For some, lifestyle changes such as loosing weight or reducing alcohol consumptions helps.

 

While loud and frequent snoring oftentimes is a symptom of sleep apnea, termed Obstructive Sleep Apnea (OSA), those with OSA have periods of time during sleep when breathing actually stops or is greatly slowed. Be it an apnea, an abnormal pause in breathing, and/or a hypopnea, a reduction in the amount of breathing, oxygen flow, the sleeper may wake gasping for air or they may be completely unaware that this is occurring. It can occur infrequently each evening or repeatedly. There may be a physical blockage or, less common, central sleep apnea – a reduction in the body’s ability to maintain adequate respiratory effort during sleep – the brain is failing to send adequate signals to breathe.

 

So, while snoring is annoying to sleep partners, both conditions can impact the quality of the patient’s life and overall health. Patients may go to bed at a reasonable hour and arise after an 8-hour sleep cycle, but the quality of their body’s ability to fully rest is diminished. A general feeling of fatigue may persist. And evidence-based research findings have found that those with OSA are not only feel sleep, they may actually fall asleep during the day and often report difficulty in cognitive processes. This illness is linked to an increased risk of heart diseases, diabetes, certain types of cancer and dementia. Some deaths have even been attributed to OSA.

 

How do I know if I have sleep apnea?

You may know you snore … because you were told. Or you may have been told that you seem to stop breathing or gasp for air. Or you may find that after a full night ‘sleeping’, you are still tired. However, to determine if you have OSA, and its severity, a visit to a physician with specialized training in sleep medicine is recommended. Testing may be indicated, which takes place in a medical ‘sleep center’ for a sleep study or at home with equipment provided by the specialist. These studies are designed to measure patterns that occur while sleeping, to see if there are disruptions, how many and how often, oxygen levels and brain activity.

 

How do I get a better night’s sleep if I snore or have sleep apnea?

While snoring and sleep apnea are different, the goal – an even and adequate supply of oxygen, is the same. As long as the problem is not related to missed signals from the brain, an airway that stays open and clear throughout the night helps both those who snore or have sleep apnea.

 

A CPAP – Continuous Positive Airway Pressure – has been considered the gold standard, especially for those with OSA. There are many types of CPACs, but in general a machine is used at nighttime and continuously pushes air, keeping the airway from closing when sleeping and providing sufficient oxygen to oxygenate the blood. If the results of testing by your physician indicate that this is needed, you will be given a prescription. And new technologies, such as Provent® Sleep Apnea Therapy (also available by prescription for mild cases of OSA – an Expiratory Positive Airway Pressure (EPAPs) product), come onto the market, your physician will discuss your options.

 

How does a dentist assist in treating snoring or OSA?

One alternative frequently recommended, especially for those who do not have sleep apnea or cannot adapt to the CPAP (termed ‘CPAP intolerant)’ and fall into the mild or moderate category, are oral appliances provided by a dentist. Just ask Drs. Hochberg and Diora; they are available to discuss Oral Appliance Therapy (OAT). These Mandibular Advancement Devices (MADs) are custom fabricated mouth-guards. They look similar to guards worn to protect teeth while playing sports. However, they actually reposition the lower jaw by easing it forward slightly to help keep the airway open. There is an upper guard that snaps over the top teeth and a lower guard that snaps over the bottom teeth. These guards are joined together by connectors that adjust. This allows the dentist to adjust as necessary to optimize your care and help ease discomfort that may arise in your TMJ as you adapt to the appliance.

Sleep Well!

From parents insisting that their children go to bed on time to medical professionals advising us that a good night’s sleep is the foundation for health, we know that waking up refreshed helps start our day reinvigorated. When sleep is disrupted, deep sleep cycles are shortened, tossing and turning occurs, or the body undergoes the stressors when breathing is impaired, if only for seconds, our day and our health is negatively impacted. When you are told that you snore frequently, when you are not rested, if you wake gasping for air, don’t ignore the symptoms. Seek care! We, at Colony Square Dental Associates are available to discuss your concerns.

New Year | New Baby

As the end of the year draws near, we are all looking forward to spending time with close family and friends. This year, our office has a little something extra to celebrate. Our very own, Dr. Mira Diora, and her husband are expecting baby boy number two!

 

If you or someone you know is expecting a bundle of joy this holiday season, keep in mind the following:

  • You should let your dental office know you are pregnant.
  • Yes, it is safe to have an x-ray taken and your clinician will cover your abdomen with a lead apron to minimize exposure. Keep in mind radiation from dental x-rays are extremely low.
  • If you need a composite, root canal treatment, or an extraction, it is safe to use a numbing medication for both you and your baby.
  • Your dentist may recommend cleanings more frequently as some women can develop pregnancy gingivitis. This is inflammation that can cause both swelling and tenderness when brushing or flossing.

 

Dental care when pregnant is a crucial. Drs. Hochberg and Diora are here to help with any questions and wish both you and your little one a healthy New Year!

The 12 Days of Dental | Good Oral Hygiene Should Never Take a Holiday

The holiday season is here once again. And no matter the celebration, whether it be a traditional Christmas, Hanukkah, Kwanzaa, Yule, Festivus, or otherwise, we want you to enjoy this important time of year with your close family and friends, who matter the most. All the while, we want to ensure your oral health isn’t forgotten. Therefore, we have made a 12 days of “dental” checklist. These fun reminders and tips will ensure you remember to treat your teeth as well as your tummy this year.

  1. Honor existing dental appointments
    We understand the holidays are a busy time of year, with traveling plans and family coming into town, many unexpected factors arise that clutter your already tight schedule. This is why we encourage you to proactively plan your day, to allow time for your reserved dental appointment. Also, maximizing your dental insurance benefits prior to the end of the year is another added factor that can assist with cutting your overall out-of-pocket costs. And we want to ensure your appointment isn’t postponed, as our schedule tends to book in advance for dental hygiene sessions, especially around this time of year.
  2. Stop smoking
    Shopping for the perfect gift, making sure you have all the ingredients for grandma’s special recipe, and decorating your home for the holidays are all additional stresses. And key triggers, such as stress, have proven to be the reason smokers oftentimes increase their nicotine intake during these months. Smoking is a direct link to gum disease, the leading cause in tooth-loss. What better gift to give your family this year, than a smoke free environment?
  3. Avoid using your teeth as a gift wrapping tool
    It is so easy to misplace the scissors with all the extra hands scrambling to wrap presents, not to mention the mail and packages to open as well. Take caution to avoid chips, fractures, or emergency based visits to the dentist by avoiding the use of your teeth as a tool for cutting. It might be tempting, but we assure you that is not the way you want to spend the holiday.
  4. Purchase a Travel-size Hygiene Kit
    An inexpensive way to keep your teeth looking their best at all your family gatherings is to purchase a small travel-size hygiene kit. Complete with a travel toothbrush, toothpaste, dental floss, and toothpicks, it is the perfect solution for touching up between house to house visits. The conveniently sized pouch can easily be placed in your car or purse for easy access.
  5. Stock your Stockings Well
    Stockings by the fireplace are filled with wonderful goodies enjoyed by people of all ages. This year when shopping for those miniature treats, be sure to purchase stuffers that offer more than an oral sugary bath for the recipient. Many gift ideas, such as playing cards, socks, and bath essentials are great alternatives to candy.
  6. Avoid Excessive Hard Candy
    Although it’s tempting, ensure that hard candy such as lollipops, hard mints, and candy canes are kept to a healthy minimum. These sugary treats tend to linger on the surface of your teeth and can cause chipping if you are biting down on them. It’s in best practice to allow the candy to dissolve and then brush afterward.
  7. Rinse after Holiday Beverages
    Eggnog, hot chocolate, sparkling juices, and alcoholic beverages are always readily available at dinner and office parties this time of year. After enjoying these tasty drinks discretely swish with water until you are able to brush your teeth properly. This will help to avoid decay. If you can locate a straw to use, even better!
  8. Let your kids “carol while they clean”
    The golden rule, as recommended by the American Dental Association, is to brush for at least 2 minutes. However, for those with small children, it can be a challenge to achieve. This year make it a game! Let your child choose their favorite carol, and have them hum while they are brushing. By the time a verse or two and a chorus has gone by the two minutes will be up and it will have been fun and painless for both adult and child.
  9. Watch-out for Wine
    A glass of wine while the turkey finishes up in the oven, sounds like a nice way to relax before the guests begin to arrive. However, it is important to remember that wine, especially those that are red or dark in color, can cause staining. Choose your beverage carefully and be sure to only enjoy in moderation to avoid dulling the appearance of your teeth. Ask our doctors about both in office and at home whitening treatments to keep them bright all year long.
  10. Choose cheese & veggies
    Broccoli and carrots are terrific treats for your teeth as they are rich in Vitamin A, which strengthens your enamel. And if you are choosing to indulge in alcoholic beverages, snacking on cheese cubes are a great way to balance the acid that’s in those drinks and doubles as a great source of calcium. So if you don’t know what covered dish to bring, a veggie and cheese tray might just be the perfect (and healthier) option to go for.
  11. Make the holidays more meaningful
    Grazing on food throughout the day is not an uncommon practice on big holidays. After dining with your family this year, maybe try a new practice centered more on activity and games. By avoiding a constant state of eating, you can monitor your waist as well as your oral health.
  12. When in doubt, give the gift of dental care
    Practical gifts always give the recipient something to smile about. So when in doubt, give the gift of dental products. Whether a small stocking stuffer or a last minute teacher gift, toothbrush, floss, and a little lip gloss will always be a fan favorite.

We hope this helps with putting your holiday dental woes at ease. Drs. Hochberg and Diora wish you a wonder-filled holiday season.

Canker Sores and Cold Sores | Something hurts!

You woke up and noticed, and felt, something sore on your face or lips or inside your mouth. Should you be concerned? Usually, the answer is no. Most often that lesion, is a canker sore or a cold sore caused by a fungal or viral infection. Though quite different, they both typically resolve in a few weeks with or without attention.

 

How do I know if I have a problem?

The first step is to raise awareness. After all, we take time to brush and floss our teeth, do our hair, and apply makeup. We look at ourselves in the mirror numerous times each day. But, are we only looking to see if our clothes and hair are in place as we go out in public? It’s important to really look. Do we notice changes? Does something look or feel different around your mouth? Inside your mouth? Do we know what to look for? Use an illuminated magnifying mirror. Look inside at the surface of your cheeks, the top of your tongue and under your tongue. Does the area feel sore? Is there a different texture or color in one area? Is there swelling? Are there patches that are white, red, gray or yellow?

Canker Sores / Mouth Ulcers

Canker sores are not contagious. They look like an ulcer with a red border and a white or yellowish center and a center depression. They can pop up inside your mouth or on your tongue. And they usually cause discomfort. The most common canker sore, called a Minor Aphthous Ulcer, is small, under .4”, and is round or oval and typically heals in less than two weeks. Less common are Major Aphthous Ulcers; they are larger, deeper, more painful, take longer to resolve and can scar. When canker sores appear in clusters, from 10 to 100, they are called Herpetiform Ulcers. Not to be confused with herpes, they too are not contagious and heal quickly.

 

Cold Sores / Fever Blisters

Caused by Herpes Simplex Virus 1, cold sores, also called fever blisters, are contagious. They are seen in clusters of red, fluid-filled raised blisters around lips or underneath the nose or chin. For many patients there is awareness, before the breakout. There may be a tingling feeling, itching, or even a burning sensation before the blisters are visible.

 

What causes Canker & Cold Sores?

As mentioned, cold sores are manifestations of the Herpes Simplex Virus 1 (HSV-1 – oral herpes) a person-to-person transmitted viral infection that, once contracted, remains in the body. It is so easily contracted – by kissing, sharing utensils, and even using someone’s chapstick – it is estimated that around two-thirds of adults have this virus even though they may remain symptom free. For others cold sores may erupt infrequently with years between outbreaks or they may be frequent occurrences.

 

Canker sores, on the other hand, result from a variety of causes such as:

  • Daytime habits: chewing on the inside of your cheeks
  • Nighttime habits: biting the cheeks while sleeping
  • Prosthesis, dentures and partials, and retainers that are ill-fitting and cause irritations
  • Teeth that have fractured that have sharp edges or fillings that are not smooth
  • Brushing too aggressively or using a toothbrush with hard bristles that irritate the gums
  • Spicy foods, acidic foods, and hot foods can irritate or burn delicate tissues; hard foods such as chips or pretzels have sharp edges can catch on the tissue
  • Sensitivity to toothpastes with sodium lauryl sulphate (SLS toothpastes)
  • Side effect of medications
  • B12 or iron vitamin deficiencies
  • GI diseases such as Crohn’s and Coeliac Disease
  • Weakened immune systems
  • Smoking
  • Heredity

 

And stress! With a list this long it can be challenging to determine which, if any, of these caused your canker sore. And, if it resolves in a short time, under 2 weeks, and occurs infrequently, there’s no need to determine causality. However, if the sore does not resolve, or you frequently have canker sores, it is time to see Dr. Hochberg or Dr. Diora to determine if there is an identifiable and resolvable contributing factor or an underlying medical problem that requires attention.

 

How to reduce the discomfort from canker sores and cold sores?

If you have a cold sore, there are topical, medicated lip balms specifically formulated to help reduce the discomfort of those with HSV-1. When persistent or frequently reoccurring, Drs. Hochberg and Diora can provide prescriptions, including anti-viral medications and rinses, once a diagnosis has been confirmed. If you have a canker sore, watch irritants (the spicy, acidic, or hot liquids and foods) that can aggravate the sore. A saltwater rinse with lukewarm water helps as well. Corticosteroids and cauterization of canker sores are also options that your dentist may offer.

 

Beyond Canker Sores & Cold Sores

However, canker sores or cold sores are not the only causes for lesions or changes around or inside the mouth. There are manifestations of other diseases that are seen intra-orally and are not to be taken lightly. If there are gray patches, white patches, red patches, a mixture of red and white, or changes in the appearance of the tissue, there is the possibility that a serious problem could be the cause. Most often, pre-cancerous tissue does not cause pain as do canker or cold sores, lulling patients a false sense of being okay and ignoring the visual changes. But, don’t discount warning signs. When a symptom, or change, does not resolve in a short time frame – seek a professional’s opinion. And remember, your periodic visit to your dental hygienist at Colony Square Dental Associates not only results in clean teeth, it’s an opportunity for your dentist and hygienist to provide an oral cancer screening and see if any changes in the intra-oral tissue has occurred.

 

Hope You Had a Tooth-Healthy Halloween | Your Sweet Tooth – And the truth about candy

We hope you had a Happy Halloween, a time to give in a bit to our sweet tooth. Between Trick-or-Treating and Halloween parties, sweets abound. Though processed sugars are full of dietary pitfalls, it doesn’t mean that, every now and then, we can’t indulge in a treat. Good home healthcare, which includes brushing twice a day as well as flossing, helps protect us from damage if we, on occasion, splurge.  That said it’s still important to know that all sugar-laden treats are not created equal when it comes to our teeth.

You’ve heard for years that processed sugar is linked to tooth decay. But, how and why? Dr. Hochberg and Dr. Diora tell us that the reason is that when the bacteria, ever-present in the oral cavity, interacts with sugar, cavity-causing acid is produced. Over time these acids can become a strong contributor to dental decay – cavities.  But, what is less known is that when we indulge in those treats determines how well our bodies are able to remove the sugar, lessening the teeth’s exposure to potential harm. When eating a meal more saliva is produced. Saliva is our body’s natural oral cavity ‘bath’, washing away not only the small bits of food that are not immediately swallowed, but also the acids produced by bacteria present in the oral cavity. So, it makes sense that if a sweet is ingested as part of the meal, or immediately following the meal, the saliva present during mealtimes helps. Those who snack on sugary sweets throughout the day, causing the teeth to remain in a ‘sugar bath’ are at a greater risk of dental decay.

 

What about those yummy gummies and small hard candies?

Unless they are sugar free, gummies, or any sticky candy, leave residue that sticks to the teeth, which cannot be rinsed off by saliva. And hard candy, again, unless sugar-free, may appear to be lower in calories, but, nonetheless, the sugar present in the hard candy mixes with the salvia and sits in your mouth longer than a piece of chocolate. And don’t be surprised to learn that even those ‘sourballs’, that are not sweet in taste, can be even more harmful; sour candies have a tendency to be higher in acidic content attacking the health of the enamel. Drs. Hochberg & Diora have seen countless patients present with teeth that have been compromised by the habit of sucking on hard candy throughout the day or making the mistake of biting down on the candy and fracturing a tooth.

Choose chocolate!

Did you know that this is the best choice? The nature of chocolate, just a plain old-fashioned chocolate bar, makes it a more tooth-friendly treat. It is not as sticky and washes off of our teeth more quickly than other choices. And, if you choose a dark chocolate, which has lower sugar content, it’s an even a better choice and has some health benefits as well.

 

Keep your teeth health during Halloween and throughout the year by:

  • Eating treats immediately following a meal
  • Choose treats that are quickly washed away; avoid hard or sticky candies that remain in the mouth
  • Chew ADA approved gum that is sugar-free after eating; it helps to maintain the increased saliva flow, removing more residue
  • Flush out the sugar residue and small food particles by increasing water intake
  • BRUSH & FLOSS

 

We hope you continue to enjoy those Halloween goodies as well as treats throughout the upcoming holidays!

CSDA visits Dallas, Texas

It is always a privilege to travel with Dr. David G. Hochberg. Our annual team trips have become somewhat of a tradition to say the least. This year, however, was even more special. We had the opportunity to travel to Dallas, Texas for the annual conference of the American Academy of Implant Dentistry (AAID.) With Dr. Hochberg finishing up his year as president for the 2017-2018 term, we proudly attended his farewell speech at the Gala hosted in the ballroom of the stunning Hyatt Regency Hotel. We of course had a few continuing educational classes while we were there, but had some free time to visit the Stockyards and The Texas State Fair as well. To enjoy our complete album, please visit our Facebook page www.facebook.com/ColonySquareDental.

Dental Implant Awareness Month | Why CBCT Scanning, Bone Grafting, and other related procedures are necessary

The American Academy of Implant Dentistry (AAID) has designated the month of September as Dental Implant Month. This organization has provided educational opportunities for thousands of dentists desiring to learn and become credentialed in implant dentistry. The training provided enables dentists in this country, and worldwide, to gain expertise in this field. The quality of life for countless patients such as, improving their ability to eat in comfort, speak naturally, and smile with confidence, has been enhanced. Whether a patient is missing one tooth, or many, dental implants have become the treatment of choice.

And the dentists at Colony Square Dental Associates are especially familiar with all aspects of implant dentistry. After years of continued education and rigorous examination, Dr. David G. Hochberg became a Fellow of the American Academy of Implant Dentistry (AAID) and a Diplomate of the American Board of Oral Implantology (ABOI). He has also served as an examiner for other dentists seeking advanced credentials. This past year, Dr. Hochberg was honored to serve as the 66th president of the AAID.

Inasmuch as dental implants have become the standard-of-care, and are frequently advertised on television, many are familiar with the basic concept of dental implants. However, less known are other services, and the terminology, that oftentimes are provided to maximize the potential for success.

Cone beam computed tomography (CBCT)

One of the tools made available by today’s advancements in digital dentistry, is a CBCT scan. This is a 3-dimensional image of the jaw. Why is this a useful diagnostic tool? Seeing the entire jaw and interrelationship between the bone, the teeth, the nerves and the sinus cavity provides the dentist with a unique window in order to optimize the plan of care. The scan helps to answer questions such as:

  • Is the bone volume adequate to support a dental implant?
  • Has the bone resorbed causing the sinus cavity to drop – potentially being too close to the area where the implant will be placed?
  • Is the location of the sinus membrane in close proximity to the implant site?
  • What size implant is appropriate?
  • What is the appropriate angle to anchor the implant?

BONE GRAFTING

When all is healthy – the teeth, the gums and the supporting bone, the tooth’s root is firmly held in place. And like other cells and tissue in our bodies, the bone in our jaw is always continuously repairing itself – replacing damaged cells with new ones. However, the following are some oral health concerns that can negatively impact the body’s ability to heal itself.

  • Periodontal (gum) disease is a major cause for tooth loss. Left untreated, infected gum tissue pulls away from the bone, the bone is damaged, and the weakened bone no longer can support the tooth’s root. If the bone was not adequate to support the natural tooth, it cannot support an implant.
  • The body continues both the formation of new cells and the replacement of damaged cells throughout our bodies as needed. In the jaw, it is the root of the tooth stimulating the bone tissue when we chew that signals the body that it is viable tissue that needs to remain strong and healthy. However, when a tooth, or teeth were lost some time ago, whether they have had replacement teeth fabricated or have not, the root of the tooth is no longer there. The signal is lost. New cells and replacement cells do not keep the bone healthy and the bone resorbs. More often than not, the tissue atrophies.
  • When a tooth requires removal, be it due to trauma or dental disease, the extraction site is at risk. There is no longer a root in place; there is a void. And there is no longer a root to stimulate bone growth.

 

To maintain bone, to prevent atrophy, to minimize the risk for bone resorption, to augment sites without adequate bone volumes – bone grafting can be the difference between bone that can or cannot support an implant. It provides an extra measure of insurance to help increase the predictability of a positive outcome.

Bone grafts, which are comprised of different materials, are selected based upon the patient’s needs. Once in place, the stage is set to stimulate new bone growth. And once in place new tissue grows around the dental implant and bonds to it in a process called osseous integration. The newly formed bone becomes the solid foundation to support the implant.

SINUS LIFT

Everyone has heard of the sinus cavity. After all, who hasn’t had a cold? But you may wonder why they are of importance in dentistry. The sinuses sit right above the jaw; and the dental implant, like the tooth’s root, is placed in the jaw. When our adult teeth form within the natural structure of the jaw; the root has adequate space to fit and the sinus cavity is not of concern. But whether due to trauma or disease, if a tooth or teeth are lost, factors may preclude the replacement of the tooth’s root with a dental implant without consideration of the sinus cavity. Over time, the jaw atrophies when the roots of the teeth are no longer present. The maxillary sinus drops down reducing the bone height necessary to place an implant; a sinus lift is indicated. This procedure, sometimes called a sinus augmentation, involves moving the sinus membrane upwards to provide space for the placement of additional bone between the maxillary sinuses and the jaw.

A FOLLOW UP Periapical (PA)

A PA (digital image/x-ray) is taken to examine the root of a tooth; similarly, it is taken to examine the dental implant. Drs. Hochberg and Diora are able to evaluate the implant placement within the bone. It’s a quick and cost-effective measure to ensure that there are no abscesses or infection noted and that the bone tissue has sufficiently matured around the dental implant. A PA is taken routinely during the treatment phases and then is recommended annually.

Dental implants offer patients excellent alternatives to bridges and dentures. As in all areas of healthcare, technology, techniques, and materials are improving daily, giving the clinicians at Colony Square Dental Associates the tools to provide optimal patient care. And as with all advancements, there are new words for new treatment options. These are but a few. Ask Drs. Hochberg and Diora to explain all the details and all the terminology. They would be happy to answer all your questions.

The Tooth Fairy

The history behind the myth and today’s more modern traditions.

 

The Tooth Fairy is often a fond memory of one’s childhood, similar to the way we remember Santa Clause, or the Easter Bunny. But where did this mythical creature originate, and how can Drs. Hochberg and Diora use the Tooth Fairy as a tool to encourage dental health in young children?

There are many traditions around the world commemorating the loss of a child’s tooth. In Italy, the Tooth Fairy is thought to be a mouse, named Topolino. In fact, many countries, portray the Tooth Fairy character as a mouse.  In Asian countries, tradition has been to have the child throw his or her tooth onto the rooftop of their house. And in Japan, the lost tooth is often thrown straight down to the ground if an upper tooth and straight into the air if it is a lower tooth, symbolizing that the teeth are to grow in straight.

The Tooth Fairy legend as we know it to be, a tiny fairy in a tutu with fairy wings, is believed to have originated in the United States. And although it began in the early part of the 1900’s, the custom has remained popular even today. The folklore states that when children lose one of their baby teeth, it should be placed under their pillow. Once they are fast asleep, the Tooth Fairy will visit and replace the tooth with a small payment.

According to a survey conducted by VISA INC., an American child will receive $3.70 per tooth on average. However, in recent years with influences like mommy blogs and Pinterest, many parents choose to get a bit more creative when rewarding their child for losing a tooth. With ideas like hand written notes from the Tooth Fairy, dental fairy dust (glitter) sprinkled on a pillow or bedding, or even incentives like eluding that a perfect tooth receives a greater reward than a decayed one, the possibilities are endless.

In the event a baby tooth may need a little extra help by the dentist to “wiggle” it out, the Tooth Fairy can oftentimes be the voice to praise the child for their bravery. A colorful note accompanied by a small treat, encourages the child at his or her level of understanding.

By the time all 32 permanent teeth have come in, your child will have lost a total of 20 primary teeth. The expectations of each lost tooth vary from family to family, but the goal is to encourage your child to brush, floss, and keep their teeth healthy for a lifetime. The Tooth Fairy is always watching.

Dental Temporaries

While you are “Under Construction”

At Colony Square Dental Associates we are quite familiar with the term “Under Construction”, especially as Colony Square undergoes a transformation. However, we are appreciably more knowledgeable about dental reconstruction. Whether the patient’s goal is to enhance the esthetics of their smile with porcelain dental veneers or ceramic dental crowns, or a tooth or teeth are damaged due to an accidental injury or dental disease, Drs. Hochberg and Diora and their treatment team are on hand to guide patients throughout the process.

Oftentimes, constructing or reconstructing teeth entails treatment over a period of time. There may be decayed or fractured teeth that require the fabrication of one or more crowns, onlays, or inlays. In other cases the teeth are non-restorable and must be removed; dental implants or a bridge are necessary to replace the missing teeth. Most often there is a healing period after extraction or dental implant placement; an ‘in-between’ time prior to the final restoration. Even root canal therapy can present conditions when our dentists want to ensure that the tooth has settled down prior to permanently sealing the tooth’s canal; the tooth is temporized. Irrespective of the plan of care, it is essential that patients leave Colony Square Dental Associates able to chew in comfort and with their smiles intact. To achieve this end, the patient will leave with an interim filling, crown, partial, or denture – ‘in temps’.

 

The type of interim solution, until the permanent restoration can be placed, is dependent upon the treatment planned. Will there be porcelain veneers on the upper anterior teeth to enhance a smile? A crown on a posterior molar? An anterior bridge? One or more dental implants to support a new tooth or teeth. Or a partial or fully implant-supported denture? Either Dr. Hochberg or Dr. Diora will discuss the temporary or provisional interim measures designed to carry you through from the initiation of care to the final restoration.

While oftentimes the terms temporary or provisional are used interchangeably, there is a difference. The treatment planned, the number of teeth involved, the location of the teeth (in the front or the back of your mouth) will dictate the nature and purpose of the interim that is fabricated. For example, when treatment entails the esthetics of anterior teeth or there are a series of teeth that will be replaced with dental implants, a waxup is fabricated by the laboratory from which the interim is designed. This detailed measure provides the patient with the opportunity to have a glimpse of the shape and size of the final restoration(s). Modifications can be made before the final prosthesis is fabricated. In other instances the patient’s occlusion (bite) will benefit from modification; a provisional interim allows the patient to speak and eat for a period of time to determine that they are comfortable with the changes. If there are not anterior esthetic concerns or a change in occlusion – perhaps it’s a single crown or a 3-tooth bridge in the posterior area – these type of restorations typically do not require a waxup and an in-office fabricated temporary to protect the tooth or teeth pending the cementation of the permanent crown(s) is sufficient. However, there are commonalities between the terms for the interims. Temporary or provisional restorations serve to:

  • Minimize the tooth’s sensitivity.
  • Approximate the final restoration. A provisional interim offers a glimpse at the final result.
  • Maintain the space that was occupied by the full sized tooth or teeth, ensuring that the adjacent teeth do not shift and the opposing tooth above or below the temp does not drift downward or upward.
  • Cover and protect the exposed dentin, which is the softer material and via the tubules could allow bacteria to enter once a tooth has been reshaped.
  • Keep the gum in its original position.

We hope that you bear with us during the modernization of the Colony Square complex; and we will to do our utmost to work with you during the reconstruction of your smile. And just like any construction project, there is a period of time during which we await the desired end result and abide a bit of inconvenience … on a temporary basis!

Teeth Whitening | How to determine which shade of white is right for you!

The number one requested service in most dental offices is tooth whitening. Perhaps this is driven by the fact that wherever we look, be it the movies or magazines, we see models and movie stars with whiter than white teeth. Whether they are young … or in their mature years … oftentimes their smile is not only the first thing you see, but sometimes it’s the main thing you see. Why? With today’s over-the-counter products and the advanced technology and skilled ceramists, dentists are able to offer designer smiles. But, actors and models may have goals that are different from yours. As the patient, it’s important to communicate your preferences. Before you decide whether a Hollywood neon smile is what you want, take some time to think and discuss options with your dentist. Answer the question – What’s right for me? Then talk with Drs. Hochberg and Diora as to determine the best way to meet those expectations.

 

Of course, we all agree that an attractive smile boosts self-confidence. We want to smile proudly, without embarrassment, and share our good feelings with others. If you are displeased with the esthetics of your smile, the first step is to identify what it is that you don’t like. Is it discoloration? Coffee, tea, wine, and many foods can contribute to surface discoloration. Or yellowing and darkening can occur from smoking. Maybe your home health dental hygiene regime is a bit underwhelming. Remember that the outer portion of the tooth, the enamel, can be damaged or thinned due to many factors, revealing the yellower dentin, which is underneath this layer.

 

If tooth color is the only concern, after a professional cleaning by a dental hygienist and once any areas of active decay are treated, in-office procedures, such as Zoom! Tooth Whitening, can lighten natural teeth shades whiter. There are also trays that can be fabricated and worn at home as well as over-the-counter products. However, how many shades whiter these treatment options can take your teeth is dependent on the thickness of the natural tooth’s enamel and the darkness of the dentin that is showing through. Expectations must be realistic. And excessive use of OTC whitening products can actually cause damage to the teeth – the teeth develop an excessive translucency at the edges and appear to be see through and appear unnatural.

 

When topical applications will not meet the desired results or modification of the size and shape of the teeth is also indicated, porcelain veneers are often the answer. Many of the Hollywood stars’ smiles are the result of cosmetic dentistry and the fabrication of veneers or dental crowns. They can be any shade that you want. They can be ‘whiter than white’. Or the shade selected can be more natural. This is a your decision, one that needs to be discussed prior to selecting a shade for your veneers or crowns, as you will be sporting your new smile for quite some time. While it’s tempting to ask for teeth that are as white as possible, before you choose the brightest white, as they say ‘similar to our porcelain toilet’, consider the full picture. When tooth color becomes excessively white the teeth can actually appear fake – similar to the dentures from years ago that were Chiclet white; they were obviously false teeth. And when teeth are too white, they become the sole focal point of your face, diminishing the rest of your facial features and taking away the warmth that comes from your eyes. Balancing the decision between an unnaturally white smile and ‘wow’ than can comes from a bright, white smile that is a bit more natural will let your personality shine through. For years, the typical rule of thumb was that your teeth should approximate the shade of white in your eyes. Of course, tooth shade is not the only factor that contributes to a natural smile. The size, shaping, and translucency of the veneers and crowns help to make your smile unique to you. A combination of the artistic skills of your dentist and the ceramist are the tools to create a smile designed just for you.

 

The wonderful news is that with in-office or at-home whitening or with porcelain veneers and ceramic crowns, we at Colony Square Dental Associates can work with you to evaluate the numerous treatment options available. Today’s cosmetic dentistry and tooth whitening products enhance the smiles of countless patients. Just remember, take the time to discuss with your dentist your specific expectations and goals and answer this question for yourself, “How white is white enough”? We are here to help you look your fantastic best!