Colony Square Dental Associates

New Baby & Dental Care

New Baby & Dental Care
A guide to kick start your baby’s first years of dental hygiene

Knowing how to approach oral healthcare for your new baby can be challenging. The first 3-12 months will be comprised of swollen/bulging gums, drooling, and irritability as your little one begins teething. As new mom herself, Dr. Mira Diora will soon be experiencing the same obstacles that many of our patients, as new parents, face. Our goal is to simplify the process and provide parents and caregivers with the basics to ensure their child’s smile remains both happy and healthy.

Beginning a healthy diet during pregnancy is vital. The food you consume can directly affect the growth in your unborn child. As teeth begin to develop between the third and sixth month of pregnancy, it is important you are ingesting enough nutrients. This includes calcium, protein, phosphorous, and vitamins A, C, and D. Regular dental visits for oral examinations and teeth cleanings are also very important during this time. Pregnancy hormones can make gum tissue increasingly sensitive to plaque and in many cases can develop into gingivitis. It is estimated that 30-80% of women will experience symptoms such as red, bleeding, or inflamed gums, sensitive teeth, or difficulty chewing. Given the prevalence of this condition, it is significantly important to pay close attention when brushing and flossing. This will become your best defense against bacteria.

Once your bundle of joy arrives, the work has just begun. Developing a habit of home dental care at an early age, promotes a lifetime of good dental hygiene. You may even start stimulating the gums prior to the first tooth appearing. This can be done with a clean wet washcloth after each feeding. Continuing this practice until the first tooth appears is preferable.

As soon as you detect a hard knot, or the first sightings of a tooth breaking through, it is time to begin brushing! Keep in mind your baby may have sore or tender gums during this time. It’s best to use a children’s soft-bristled toothbrush and a fluoride toothpaste. Begin brushing his or her teeth twice per day (morning and night). No more than a tiny smear of toothpaste is needed until the child turns three years old. It is important to be aware that your baby’s first dental visit may only entail reviewing their tooth and jaw development. We sometimes refer to it as their first ride in the dental chair. Dr. Hochberg and Dr. Diora will let you know when the first cleaning should be scheduled.

By three years of age, most children will have a full set of 20 baby teeth. Baby teeth hold a very important role in your child’s development. They assist with chewing, speaking, smiling, and holding space in the jaw for their permanent teeth to grow. Essentially, they serve as natural braces. At this age you may increase the amount of fluoride toothpaste from a smear to a pea-sized amount. Remember to always supervise brushing and ensure that no toothpaste is swallowed. By this time, your child will be visiting the dentist regularly for dental check-ups.

At Colony Square Dental Associates, we are here to help you answer any questions about your growing youngster. And we are sure Dr. Diora will soon be sharing stories of her personal experiences with her new baby boy, Shailen!

Diabetes and Dental Health
What is the connection?

Diabetes and Dental Health
Does Diabetes affect Dental Health?

According to the CDC’s study in 2014, it is estimated that almost 29 million people in the United States have some form of diabetes. Those who battle this disease know that it can impact many areas of the body – it’s commonly associated with diseases of the kidneys, eyes, nerves and cardiovascular system. Drs. Hochberg and Diora remind us that what is often overlooked is the effect that diabetes can have on one’s dental health. Whether type 1 or type 2, when diabetes becomes a chronic condition, research has confirmed a link between it and the oral cavity. And, this year, according to the American Dental Association, one in five people who experience total tooth loss has diabetes.

To best understand the connection between diabetes and oral health, let’s take a moment to review some basic dental facts, answering the question – What is periodontal disease? It’s an infection of the structures that support and surround our teeth. The first sign is gums that are swollen or bleed when brushing, called gingivitis. Left untreated the infection can progress into the bone that supports your teeth. Once the infection has spread to this point, periodontitis, the risk for tooth mobility and possible loss is increased. Periodontal disease is of great concern to patients otherwise in good health – everyone wants to keep their teeth for a lifetime! But, it’s even more challenging for those with diabetes. According to an article from the American Diabetes Association on Oct 10, 2014,

“…emerging research also suggests that the relationship between serious gum        disease and diabetes is two-way. Not only are people with diabetes more   susceptible to serious gum disease, but serious gum disease may have the   potential to affect blood glucose control and contribute to the progression of             diabetes”.

It sounds like circular reasoning but it’s true. Those with poorly controlled diabetes are at a higher risk for periodontal disease. And those with diabetes who have periodontal disease find it more difficult to control their diabetes. How and why is there this correlation? Those with diabetes are shown to be at a higher risk of thickening of blood vessels, which carry nutrients and oxygen to tissues and carry away waste products. This includes the gum tissue as well, leaving it more exposed the to risk of infection – periodontal disease. And, on the other end of the ‘two-way street’, patients with periodontal disease have an infection, no different than any other bodily infection. And, like any infection, periodontal disease can cause an increase in blood sugar levels, making glucose levels more difficult to control.

Other concerns we note with our diabetic patients are …

  • Xerostomia (dry – mouth) many medications inhibit the body’s production of saliva, which keeps your mouth moist, and comfortable. But this also occurs when blood sugar levels are not controlled. The glucose level in one’s saliva increases while at the same time there is a reduction in the body’s production of this natural tooth protector. The result? Dry-mouth and teeth that are more susceptible to decay.
  • Thrush – either on your tongue, or on the inside of your mouth, red or white patches are symptoms of this oral fungal infection.
  • Children’s cavities – children with IDDM (insulin–dependent diabetes mellitus) are shown to have more cavities.
  • Longer healing times – when undergoing oral surgery, such as an extraction. If it’s not an emergency, we will consider your blood glucose levels before scheduling dental surgery.
  • Changes in the taste of foods – a frequent complaint. What is important is to find healthy substitutes to enhance taste, avoiding adding extra sugar.

It goes without saying that the goal for our patients with diabetes is to control their glycemic levels. At Colony Square Dental Associates our role is partner with you to keep your mouth healthy. Ensuring that you maintain excellent periodontal health not only keeps your smile intact, but also healthier gums translate to a healthier you. What can you do to help out?

  • Brush and floss twice a day
  • Exercise and eat healthy
  • If you are a denture wearer – be sure to keep it clean
  • Call when you note any changes that occur in your mouth
  • Visit us periodically for your regular dental visits

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Teeth Whitening

Teeth Whitening
Do Natural Products Work?

First impressions are extremely important and we at Colony Square Dental Associates understand when the need arises to enhance your smile. However, many individuals may try to brighten at home before visiting their oral healthcare provider. Drs. Hochberg and Diora are here to research the latest DIY crazes and offer their expertise on which products are safe for your enamel and effective to whiten your teeth.

Among the newest trends is an oxidized charcoal powder. It is advertised to be used as a paste. This involves brushing for approximately two minutes prior to rinsing. Although it has grabbed attention online by way of social media, the American Dental Association has currently not approved any charcoal teeth whitening products. In fact, many dentists are warning that using this method may lead to both enamel deterioration and tooth erosion, as it is comprised of a harsh abrasive material. As your enamel cannot replenish itself, once lost it must be covered with a restoration by your dentist.

Another trend that many people are trying is “coconut oil pulling.” This entails involves gently swishing 1-2 tablespoons of coconut oil in your mouth, and in-between your teeth, for approximately 10-20 minutes, and while making certain not to swallow any of the oil. However, not only is this process very time consuming, there is no reliable scientific proof that shows it is effective in brightening or whitening teeth. The best rule of thumb for oils is to save them for your dinner table.

If whitening is a priority for your ideal smile we have suggestions for keeping a bright and white smile at home.

            Brush your teeth twice daily for approximately two minutes
            Use a whitening toothpaste that has the ADA Seal of Acceptance
>             Clean interproximally at least once daily with a proxy brush or dental floss
>             Limit foods and drinks that may stain your teeth or drink them sparingly through a straw
            Visit your dentist regularly for check-ups and cleanings

Remember a white smile is attainable. Both Dr. Hochberg and Dr. Diora are happy to discuss the many tooth whitening treatment options and determine which method is best for you. From our in-office ZOOM! ® Whitening procedure, to bleaching a single tooth internally, there are many beneficial ways to approach a whiter smile.  Please give us a call and we’d be happy to schedule a consultation for you.

Team Fun Day at CSDA

Team Fun Day at CSDA
An eventful day full of fun for the team and a few surprises for Dr. Diora too

The opportunity to enjoy some downtime with co-workers, outside of the hustle and bustle of the office, is always a treat. Being able to mingle and have personal conversations allows for a great ambiance and spirit that we bring back to our workspace. Last week we were surprised with a fun “Team Day”. With a lot of details left unknown, our only hint was that we needed to prepare to relax, sing, and wear our new fun teeth socks to help us get Footloose! Our first clue led us to Caribou Coffee, a unique coffee shop in Buckhead. While waiting for our next hint to unravel the mystery of the day, we grabbed a bite to eat and a warm cup of joe. Dr. Diora arrived soon after to join the breakfast brunch party. She passed out the next set of sealed envelopes, and we eagerly opened them.

And there it was, a shiny New Balance gift card, just waiting for us to splurge on a new pair of sneakers! Working on our feet all day can be taxing, and to have the opportunity to consult with a shoe specialist one on one was an awesome experience. From measuring our feet, finding custom supportive inserts, and informing us of the latest fashion trends, New Balance of Buckhead went above and beyond to ensure we secured the perfect pair of shoes. Not to mention, they even opened the store an hour early to accommodate us! We quickly snagged a few photos, checked out, and opened yet another sealed envelope.

A short walking distance from the shoe store, was a massage spa called “Treat Your Feet”. Since our initial hint told us to prepare for relaxation and to get “Footloose” some of us began to guess that we were getting foot massages. We were right of course, but that wasn’t all. Calming music played and we reclined in the most comfortable chairs while technicians treated us to the ultimate foot experience. Hot stones, soothing lotions, and warm towels were just a few methods used to help us unwind. Just when we thought it was over they massaged our face, head, and neck too. With that we were given our final envelope and proceeded to the last destination.

The location of our lunch was at Season’s 52. This restaurant is known for their sophisticated atmosphere, seasonal menu, and offering fresh ingredients that are naturally lighter. Turning the corner to our private room, it was decorated with all things baby. Surprising Dr. Diora was a delight. As many of you may already know, she is expecting to have a baby in June. Singing a CSDA version of the song “Footloose”, we lightened the room and begin the baby shower festivities. Games were played, presents opened, and a few happy tears were shed. It was the perfect way to end a great time with co-workers that truly feel like family. Thank you to Dr. Hochberg, Congratulations to Dr. Diora, and Happy Team Day from CSDA!

April is Oral Cancer Awareness Month

April is Oral Cancer Awareness Month

Encouraging a widespread conversation on the importance of routine oral cancer screenings – not only in April, but every day!

Oral Cancer, when detected in an early stage, is oftentimes treatable and has a better prognosis. With nearly 50,000 people in the U.S. diagnosed with oral cancer each year, it is imperative that we check for abnormalities when patients are seen at Colony Square Dental Associates. You may have noticed during your hygiene examination that Drs. Hochberg & Diora will feel, see, & verbalize their oral cancer screening findings, or a lack thereof, as they perform your examination. Our goal is to raise your awareness, not only in the month of April, but all year round.

The American Dental Association (ADA) encourages both dentists and clinicians alike to provide their patients with a complete hard-tissue and soft-tissue examination. This includes inspecting lymph nodes, touching floor of mouth, palate, checking tongue, lips, and rear of throat. The dentist is looking for a number of signs including red or white patches, a lump, or a rough spot. The examination is completed when the doctor reviews your health history form and risk assessment.

As early detection and treatment is often the key to survival, periodic dental visits can improve the chances of identifying any suspicious changes. And, in between routine dental visits, it is equally important for patients to be aware of the signs and symptoms of oral cancer. If you notice a persistent sore, irritation, trouble chewing, swallowing, or moving your jaw or tongue that exceeds two weeks, it is time to call.  Dr. Hochberg or Dr. Diora will be able to determine if the area should be further examined or biopsied. Being vigilant, and working together as a team, our goal is not only maximize your dental health, but also to detect concerns that impact your overall health.

CSDA Attends the HINMAN Dental Meeting

We all know when it’s springtime – we ‘spring ahead’ by resetting our clocks, welcoming the abundance of Atlanta’s colorful blooming flowers, and preparing for warmer weather.
At Colony Square Dental Associates, springtime is also hallmarked by our attendance at the annual Hinman Dental Meeting.

Continuing our dental education is essential in order for us to provide you with state-of-the-art dental care. We learn about new techniques, including new dental materials that provide superior aesthetic results, along with improved dental technology. The result? By regularly attending continuing education courses, Drs. Hochberg, Diora, and the entire treatment team, are able to offer you the latest options in order to not only maintain and restore your oral health, but to also provide you with an esthetically pleasing smile.

If you have any questions about the advancements in dentistry, just ask us. We would be delighted to share our knowledge with you. And, don’t forget to set some time aside for your Spring Dental Cleaning for a healthier, whiter, and brighter smile.

Healthy Nutrition | Healthy Teeth

Pinpointing how what you consume can directly affect your oral health

Healthy teeth and gums are essential for eating, chewing, and swallowing. Therefore the nutrients you consume, will directly affect your oral and overall health. Although many feel they are practicing perfect oral hygiene by brushing and flossing regularly, tooth decay and gum disease remain to be two of the most widespread diseases in the world. Drs. Hochberg & Diora promote a healthy diet and have tips on how you can properly choose foods that will in-turn positively impact your dental health.

Foods that are great for your tooth enamel are those comprised of minerals. Various acidic foods and drinks, when not consumed in moderation, may cause erosion of the enamel. Calcium and phosphorous are wonderful in aiding to replace minerals in areas they may have been lost. Calcium enriched foods that are low in sugar include yogurt, hard or aged cheese, seafood, low-fat milk, almonds, etc. Whereas some great phosphorous sources include pumpkin seeds, fish, Brazil nuts, red meat, eggs, and broth. These foods will help to strengthen your teeth and contain valuable protein.

Crunchy foods that are naturally hard usually contain high contents of water. The chewing required to eat these foods produces more saliva, which is the best way to counteract the bacteria that causes cavities. Also, the texture of these crunchy foods makes them naturally abrasive. In turn, this helps to gently scrub tooth surfaces freeing them of plaque and food debris. The best options to choose when looking for a high water content snack are celery, apples, cucumbers, and carrots.

It is also good to keep in mind the foods that can harm your dental health if not eaten with self-discipline. Beware of ‘empty calorie’ foods. These include candy, cookies, muffins, and snack foods such as potato chips. In addition to no nutritional value, these foods also contain high contents of sugar that tend to adhere to your teeth. The result is bacteria in your mouth will feed on these sugar spots, releasing acids, and then leading to eventual tooth decay. If you must enjoy a drink  with a high sugar content, try sipping on it through a straw, so that you’re not bathing your teeth in these acids and sugars directly.


You may reduce your risk of cavities by following the doctor’s guidance such as:

  • Always remember to brush your teeth twice daily for at least two minutes.
  • Limit your between-meal snacking.
  • Include dairy, a variety of fruits and vegetables, and fluoride filled water to your diet.

Remembering that brushing after eating should always be your first choice, however if it is not a viable option, try at least chewing sugar-free gum or rinsing with some water.





At one time or another, drinking or eating something hot or cold can elicit an ‘ouch’ moment. Which leads to frequently asked questions of Drs. Hochberg & Diora: When is tooth sensitivity a problem? What causes it? How can I decrease tooth sensitivity?

Our teeth’s protectors

To understand why sensitivity occurs, it’s helpful to learn a bit about the structure of our teeth. Nerves, blood supply and connective tissues in the center portion of the tooth, called the pulp, are our teeth’s lifeline. Protecting these vital structures from exposure keeps us comfortable when biting into an apple, drinking coffee or even just breathing air. The first layer protecting the pulp is dentin. But that’s not enough – dentin has tiny tubules that transmit hot, cold and pain sensation into the tooth’s ‘inner sanctum’.  When teeth are healthy, the enamel, a substance harder than our bones, covers and protects the portion of the tooth’s dentin that is above the gum line. Similarly, the dentin of our tooth’s root, located below the gum line, is covered by its protective covering called cementum.  It’s when these structures are damaged either from the outside inwards or from an internal disruption that the nerve is alerted. And so are we!


Our teeth’s adversaries (enemies, foes ….)

Dental disease, including cavities, abscesses, internal fractures and periodontal concerns are some of the well-known causes for tooth sensitivity.

  • When a tooth is exposed to hot, cold or even a sugar treat, and there is an internal root fracture, or decay extends into the tooth’s pulp – containing the tooth’s nerves – the nerves respond and let’s us know that there is a problem.
  • When the tooth’s root is exposed, due to recession of the gum tissue, bacteria can develop in the spaces (pockets) where the gums have pulled away from the tooth’s root. Ultimately, the disease process can destroy the bone that supports the root of the tooth.

But, there are other reasons that sensitivity, impacting one or more teeth, occurs.

  • Brushing, flossing & rinsing – In our efforts to maintain oral health we can be contributing to, and even creating, a problem. Hard toothbrushes, or overzealous brushing at the gum line, could not only damage the gum tissue, but also can also cause our gums to to pull away from our teeth, exposing the tooth’s sensitive roots. The solution? Change to a soft toothbrush and use a lighter touch. And, while we all like whiter teeth, there are times we need to use caution when making a toothpaste selection. Some whitening toothpastes are abrasive, which can wear down the enamel, or may contain ingredients that contribute to sensitivity. Then there are our mouthwashes. Though they leave us with a fresh feeling, some contain acids, another potential agent for increased discomfort. Ask Drs. Hochberg and Diora for their recommendations. You may be benefit from the many enamel protecting or desensitizing toothpastes and neutral fluoride rinses.
  • Grinding or clenching – Be it a habit that’s hard to break or a nighttime occurrence, both grinding or clenching place additional stresses and undo pressure the enamel of our teeth. Even though it’s extremely strong, enamel can chip or even wear with these additional forces. Oftentimes, a night guard, also called a mouth guard, or behavioral therapy is recommended.
  • Eating and Drinking Even some healthy choices! – Oranges, pickles, tomatoes, coffee, wine, and sodas– even diet sodas – and the list goes on. Why? Foods that are high in acid can erode the tooth’s enamel. This is why some patients notice a change in their tooth’s color. Wearing away the enamel exposes the dentin, which is a yellowish color, and furnishes a pathway for sensation to reach the nerves. This doesn’t mean we have to give up all of our favorite foods, especially those that are good for us, but we do have to take care. There are a few ways to consume wisely:
  • Avoid sipping acidic drinks throughout the day
  • Eat foods that are high in acid along with foods that are low in acid content, such as: cheeses, whole grains, fish, nuts, vegetables, bananas and many more. These foods are not only healthy, but also they help balance the acid intake along with changing the acid content in our saliva – working to provide protection to the tooth’s enamel.
  • Yes, brush your teeth, but NOT right after eating or drinking acidic foods. Why? While the enamel is exposed to the acid it has a tendency to become softer, and more susceptible to enamel wear from brushing. Drink water and wait – just a bit.


Reducing tooth sensitivity

As you can see, the answers to the questions relating to an ‘ouch’ moment are not always clear-cut. It’s important to advise Drs. Hochberg & Diora of your symptoms, when you notice sensitivity and if the pain or discomfort is localized. Absent dental disease that requires attention, they will review your daily routines and help you answer the question:  Why are my teeth so sensitive?



A toast to Tap Water!

The month of February is set aside as National Children’s Dental Health Month by the American Dental Association (ADA). But everyday, helping our children maintain bright happy smiles for their lifetime is our goal at Colony Square Dental Associates. This year’s ADA theme, “Choose Tap Water for a Sparkling Smile”, was the focus for our visit to Primrose, a neighborhood school. We asked the class of Kindergarten students, if they knew that a simple glass of tap water is a super ally in our fight against dental decay. Dr. Mira Diora, accompanied by Ms. Toothbrush and Ms. Toothpaste (aka Karren, Dr. Diora’s dental assistant, and Candice, with our front office team), were on hand to explain how the fluoride in our tap water helps fight against cavities.


How does this work? Simply put, the outer portion of our teeth, called enamel, is comprised of both phosphate and calcium, combining to form a structure that is actually stronger than our bones. And our salvia, which is composed of both elements, is constantly flowing in our mouths, keeping the tooth surface strong. But, some of carbohydrate rich foods that we eat combine with natural occurring bacteria in our mouth creating an acid. This acid becomes the enemy of the phosphate and calcium protection. The result? An opportunity for the tooth to become susceptible to decay.

Over 70 years ago, the surgeon general stated that fluoride, a chemical substance formed by joining fluorine and sodium, was shown to reduce cavities. It helps our young children even before their adult teeth erupt. Fluorides found in foods and our water help teeth develop with stronger enamel. And the fluoride added into our toothpastes and our tap water, combines with our saliva forming fluoroapatite, which has been found to help prevent the formation of cavities.


All good news! Watching diets, teaching how to floss & brush (with an ADA approved toothpaste), regular dental visits and a glass of tap water will help to keep our children’s teeth healthy. Just ask – Dr. David Hochberg, Dr. Mira Diora and our clinical team are on hand to answer any questions and provide you and your children the tips and tools needed for a lifetime of healthy smiles.



You know – Smoking is not good for you! While generations grew up smoking, some beginning as youngsters, it wasn’t until 1964 that the Surgeon General published their official report on the dangers of smoking. Over the past 50 plus years, increasing scientific evidence has been presented to the public on the consequences of both inhaled and chewing tobacco use.

These studies have shown the direct link between tobacco and a significant number of disease processes besides the more known ones such as lung cancer, cardiovascular disease and diabetes. For example, did you know that besides causing ‘smokers breath’ and stained teeth, smoking is detrimental to your oral health?


Smoking and chewing tobacco are shown to have direct links to:


  • Oral Cancer – of the mouth, throat, tongue and lips
  • Loss of bone structure in the oral cavity
  • An inability for bone to heal, which can impact the success rate of dental implant placement
  • Slowed healing after periodontal treatment or tooth removal
  • Periodontal disease – smoking is linked to the bone’s ability to attach to the gum tissue creating an increased risk of infection with eventual loss of a tooth/teeth
  • Greater propensity for the development of  plaque and calculus
  • A decrease in the ability to taste foods


So, with all compelling reasons to avoid the use of nicotine products, why does anyone continue to smoke? Nicotine is an addictive drug. And, like all addictions, breaking the habit is quite challenging. But, smoking cessation programs, and there are many, have been proven to greatly reduce risks even if you have smoked for some time. The right program can help save your life! Talk to your internist or Drs. Hochberg and Diora to learn more about the oral health connections. We want you to stay healthy and SMILE!