Colony Square Dental Associates

Use of Botox® in Dentistry

Use of Botox® in Dentistry

The first thing that pops into our heads when we hear the word BOTOX® is wrinkles. That is, getting rid of them, which is certainly one of the well-known uses of Botox since it was approved in 2002 for cosmetic use under the name BOTOX® cosmetic. It is considered minimally invasive and is widely utilized.

What is not as well known are other uses of this FDA approved therapeutic injectable as a tool for our dentists to assist our patients who experience numerous facial muscle disorders such as Temporomandibular Joint Dysfunction (TMJ), or disorder (TMD), migraine headaches and Bruxism (grinding or clenching teeth). And, while Botox is considered the most popular injectable to help us look more youthful by reducing the lines that appear as we age, or even lines caused by daily stresses, at Colony Square Dental Associates we consider it as another key component to assist in increasing patient comfort, all the while helping protect teeth from damage.

How does Botox work?

Botox, a botulinum toxin, the type of neurotoxin from which Botox is derived, relaxes muscles at the injection site. Think of tightening your jaw muscles and clenching your teeth consciously, or raising your eyebrows as a sign of surprise … you are controlling those muscles and can relax them. However, there are times when these muscles tighten, contract, spasm and the patient has no control over these muscle movements. Some patients, for whom stress causes them to contract muscles, it’s a habit, like biting ones nails. Habits, when the patient is aware and is trained to do so, can be broken. However, for many, muscle contractions, occurring while asleep or awake, cannot be controlled. Botox blocks the nerves that tell the muscles to contract at the injection site serving to reduce or eliminate the muscle pain.

When should I see a dentist for Botox?

While there are numerous Botox providers, seeking care for the administration of Botox from Dr. Mira Diora, a dentist specifically trained in accordance with the Georgia Board of Dentistry (GBD) requirements, offers patients a unique advantage. She is especially knowledgeable about the structure of your teeth, along with supporting and surrounding facial bones, the muscles that control your jaws, as well as all other facial muscles. Under her guidance you can be confident that all of these factors will be taken into consideration when she evaluates your needs and designs a custom treatment plan.

What are the benefits of Botox for oral healthcare?

  • As anyone who experiences migraine headaches, TMD / TMJ, or bruxism knows, these conditions can impact the quality of ones life. Once any underlying medical condition is ruled out, those with episodic migraines can suffer for hours to days. For some, oral medication for the rare migraine occurrence is sufficient. However, for others, who may suffer more frequently and find that the oral medication does not work quickly enough, or they do not want to take medication prophylactically or they experience side effects of oral medications, Botox can help prevent migraine symptoms for months at a time.
  • For those who experience jaw pain that does not resolve within a week or so of taking Acetaminophen, such as Tylenol or an Ibuprofen, eating soft foods, and applying warm compresses, ongoing TMD / TMJ can not only prevent you from eating favorite foods, but also can trigger a headache.
  • Botox injections also help prevent the symptoms caused by bruxism. When muscle contractions are minimized, you are applying less pressure to the teeth should you grind your teeth. Not only can Botox help alleviate the discomfort created in your TMJ, but also by lessening the force on ones teeth, it can help to protect your teeth from chipping, fracturing and the wear of the teeth’s chewing surfaces that increases the potential for decay to develop in weakened teeth.

Botox FAQs:

  • Is Botox FDA approved?

The FDA initially approved Botox in 1989 for therapeutic use to address muscle contractions that resulted in disorders of the eyes. By 2010, the FDA approved injectable Botox to treat migraines. And, in 2020, its approval was broadened to include treatment of Cervical Dystonia, muscle contractions of the neck and shoulders.

  • How is Botox administered

Botox is an injectable medication, utilizing a very thin needle

  • Is anesthesia utilized for Botox injections? 

As the needle is so thin, feeling like a small pinch, an injectable anesthetic is not necessary. If topical numbing is needed, an ice pack us used.  

  • How long does it take to have Botox injections?

           The actual injections take about 10 minutes

  • Will control of my facial expressions be impacted?

           No, the muscle(s) that relax are targeted and only at the site of the injection – Smile away!

  • Are there potential side effects of Botox? 

          As with all treatment procedures, there is the possibility of side effects that are typically transitory, resolving in a few hours to a few days after injection. Dr. Diora will review these with you and discuss any potential for allergic response.

  • Do I have to repeat Botox injections? 

          Yes, the results of injectable Botox do not last indefinitely. While each patient’s response will differ, typically, to maintain the result provided the patient will repeat the procedure every 3 to 4 months.

  • If I don’t return for follow up Botox injections, when it wears off will my face return to same appearance as prior to the injection?   

          Yes, Botox does not permanently change the facial muscles; once the medication is no longer active, all muscle function, and any lines created by that muscle function, such as wrinkles, will return.

At Colony Square Dental Associates we partner with each patient, providing diagnoses and treatment solutions based upon your unique needs. Whether it is routine dental hygiene care, restoration or replacement of teeth in need, cosmetic enhancements to improve the appearance of your smile or to help reduce areas of facial pain, our goal is to ensure you are offered the opportunities available to optimize your oral health, and to obtain the smile you desire, give us a call at 404-874-6464. We’d be happy to schedule a consultation.


Our Colony Square Dental Associates Dental Hygiene Team – Phyllis, Karen, Iliet & Trisha

Awards the Colony Square Dental Associates Seal of Approval to

Electric Toothbrushes

Sonicare® or Oral-B® Braun. Not only are they easy to use, have a timer – helping to brush for the 2 minutes that is recommended – they also minimize damage to the gum tissue that can occur from overzealous brushing and bristles that are harsh, both of which can lead to gum recession.

Water Flossers

The Waterpik® is our go-to. Combined with the use of an electric toothbrush, you can be sure to reach the areas that are most difficult to access, such as in-between posterior teeth and at the gum line. The potential for decay and for gum disease is reduced.

Dental Floss

Daily, preferably in the morning and before bedtime, use helps dislodge food particles and breaks up plaque, making it easier for your electric toothbrush and water flosser to thoroughly clean your teeth and gums. Oral-B® Glide is one product we suggest when the teeth are close together (called a tight contact), which is a common place for cavities to develop.


An ADA-approved brand, which requires the inclusion of fluoride, is always suggested. Most of the leading ADA-approved brands have numerous choices to assist in the reduction of sensitivity, whitening and brightening teeth, strengthening weakened enamel, and, of course, cavity prevention. Two of our ‘go-to’ products for patients with specific needs are:

  • Sensodyne®– for sensitivity
  • Paradontax ™– for bleeding gums


Selection of an ADA-approved product is the 1st criterion, again containing fluoride. Secondly, we prefer products without alcohol. Listerine® Purple Zero and Act® Zero Alcohol are two CSDA favorites.

Dry Mouth Products

There are numerous causes, such as medications and illness, which reduce the production of saliva. Biotene® offers various products that increase comfort and XyliMelts® help increase saliva production.

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September 2021 is Dental Implant Awareness Month

While the month of September is designated ‘Dental Implant Awareness Month’, every month of the year is one when awareness of the status of our health is important. Be it watching our diet, exercising, monitoring our blood pressure, having an annual physical, and getting needed rest and relaxation – all are components to keep us well. And we know that neglecting any piece of the puzzle can put us at risk. Maintaining our oral health is no less an important consideration; it’s part of overall wellness.

Our teeth, our gums and the supporting bone structure, work together as a team. Just as dieting without exercising or visa versa, omits an important tool to help our bodies stay well, so too, one cannot expect that leaving a space where a tooth is lost, will not impact our oral health. When one area is neglected, such as when a tooth or teeth are lost due to an accident or disease, overall oral health can be compromised. Why? The surrounding teeth, the gum tissue and the supporting bone oftentimes responds negatively to this loss.

When there is a void, nature wants to fill it. Spaces, left unrestored, can cause teeth on either side to drift towards the space, pulling away from the gum tissue, resulting in pockets (spaces) where bacteria resides, and is difficult to remove, and can cause both tooth decay and periodontal concerns. And the bone tissue, kept strong by being stimulated while chewing, is now met by a void; the stimulation is lacking. The bone can atrophy, or shrink, potentially impacting the supporting bone of adjacent teeth. Upper teeth can drift downwards when teeth are missing on the lower arch. And so on … the team is no longer playing at full strength.

Technological advances, as in many arenas, provide options. For generations missing teeth were restored with removable dentures, whether they were full or partial dentures, or non-removable dental bridges. However, today, and for over ½ of a century, dental implants have become the standard-of-care in order to replace one or more teeth. This is the closest to nature as we are able to come in order to replace the lost root of a tooth. Once a dental implant is ready for restoration, a dental crown is placed on the tooth, filling the void, the bone is, once again, stimulated when chewing and equally as important, the ability to eat and smile with confidence is restored

Since 1984, with advanced training in both the surgical placement and restoration dental implants, Dr. David G. Hochberg, a past president of the American Academy of Implant Dentistry (AAID), has been assisting referring dentists and his patient family – “Eat, Laugh, Live Again!” – this year’s theme for Dental Implant Awareness Month.  Call Colony Square Dental Associates to learn more about this exciting treatment option.

A renewed focus on Dental Health | 365 DAYS Later: A 1-YEAR ANNIVERSAY

We left our office, for what we expected to be a few weeks, last year in March 2020. And, over two months later on May 18th we returned to our Colony Square Dental Associates home. It’s now been over 365 days; we celebrate the end of a year working with patients during the most challenging of times as we continue ‘going strong’ providing for the oral healthcare needs of our patient family.


As has been our practice for over 35 years, long prior to COVID-19, our office has done its utmost to adhere to the health and safety standards and recommendations of the American Dental Association (the ADA) and the CDC. During the pandemic, we implemented new procedures, based on the guidelines of these healthcare organizations and have gone beyond to help ensure the safety of our patients and our team members. To read about our protocols, visit our website at:


Now, as we reenter the world, outside of our homes and closer to our everyday lives, as we knew them, patients are refocusing on a desire to look and feel their best. We know that excellent oral hygiene plays a role not only to maintain a bright, white smile but also, equally as important, professional dental care is essential in a program aimed at the prevention of tooth decay, gum disease, and bone loss. And, as all research has shown, there is a direct correlation between overall health and oral health. Many who have put off dental care are now seeking appointments. As was said recently on national news, obtaining an appointment with one’s hair salon and one’s dentist can be the two most difficult appointments to secure.


As we continue with our long-standing safety policies and procedures, and those newly implemented during COVID-19, we appreciate the patience of our existing patients and our new patients seeking to schedule care. We thank you for your support; we value you as a patient; and, for those not yet patients of

Drs. Hochberg & Diora, we’d be honored to welcome you as a new member of our patient family. Call us at 404-874-6464. We are on hand to answer questions you may have or to reserve an appointment.

How can my nutrition affect my dental health?

This question is not one we may typically think about, but it is very important. And, it’s especially true during the current pandemic we are all learning to navigate. With so many trying to recover from the quarantine binges, it’s more important than ever to question how our nutritional choices may have affected our oral health during the time that we were unable to visit the dentist and stuck at home watching tv. It is our hope that this article will serve as a great reminder to get back on track for our oral and overall health. And, as more and more people are able to get their vaccinations and the world begins to re-open up at a gradual rate, we definitely want everyone to feel and look their absolute best. Lets take a look at some good and not-so-good nutritional choices.

As many of us are familiar with the foods that cause damage to our dentition, let’s begin with those that are great for our teeth. Any foods that contain minerals are always good for aiding in strengthening our enamel. This is vital because as we know, the enamel is something that once it’s gone, we can’t get back. The foods that are enriched with calcium and phosphates, but low in sugar, truly work wonders for this cause. And, for those who may be allergic to dairy and need to turn to another alternative, nuts, fish, and eggs are all great replacements as well!

Now let’s take a look at some foods to avoid or to eat very sparingly and with moderation. Of course, the obvious answers are the first to come to mind like sugary foods, wine, excessive acidic foods like tomatoes or citrus, soft drinks, etc. However, there are some that might not “seem” so bad but really aren’t helping your pearly whites. These hidden foods include ice, chips, and dried fruits. It’s always a good rule that when you do enjoy these treats in moderation, you want to chew carefully and have a toothbrush close by.

So the main goal is to stray away from tooth decay and keep a healthy smile for years to come by monitoring your nutrition and staying diligent with your oral hygiene routines. Once you are comfortable to schedule, we certainly recommend a routine dental visit with your hygienist sooner rather than later. As many are behind due to Covid, office closures, and rescheduling to account for social distancing we want to see you in order to catch things early in the event that something unknowingly came up while you were away. And, as our staff here at Colony Square Dental Associates have all been vaccinated, we want to reassure all of our patients and make them feel as comfortable as possible in the dental chair. Our team is ready to tackle anything a lack of nutrition may have caused over the past year. We hope everyone has been brushing and flossing and look forward to seeing you very soon!

It’s Dental Hygiene Week | Learn Why Our Dental Hygienists Chose This Field of Study

The week of April 5th is when we recognize the dental hygiene profession across the world. We thought it would be unique to provide our patients with some insight as to why they chose to do what they do. This gave our team of superstar hygienists an opportunity to share their “why” with all of you! We hope that this helps our patients get to know them a bit more behind the mask and PPE coverings.

“As a dental hygienist, I pride myself on being a patient advocate. I love having the opportunity to meet patients from all walks of life and building rapport with them. There is great satisfaction as I work with patients to reach their optimal oral health goals. I am also very passionate about patient education, but also love what my patients teach and inspire me in return. It is so rewarding to witness the progress my patients make and knowing that I have helped to make a difference in their life.” – Laurie C. RDH (far left)


“I told my mom at the age of thirteen years old that I wanted to get braces. In my mind, I knew I wanted to be in dentistry, and if I was going to work with people’s teeth, mine needed to be pristine. So when my school’s guidance counselor asked me what my plans were for a career, I immediately responded that I wanted a 4-year degree in the field of Dental Hygiene. I was blessed early on with the gift of knowing how I wanted to mold my future and it has been my passion and occupation for thirty-eight years now. I am very happy to have spent the majority of my career with Dr. Hochberg and his team here at Colony Square Dental Associates. The relationships with my patients, my coworkers, my doctors make it even that much more enjoyable. I am beyond thankful to be back after an almost 6 ½ year hiatus. I work at the BEST dental office anywhere!” – Phyllis D. RDH (center)


“I try to lead a generally healthy lifestyle and have always enjoyed learning about science. So, I decided to merge the two passions, as well as working with my hands, and studied health science. Dental hygiene definitely fit the bill I was looking for. Not to mention, I love meeting new people and enjoy getting to know them. It’s a satisfying feeling to help people take care of their teeth and have a reason to smile. I have been very lucky to have seen literally generations of patients over my twenty-seven years in the dental field.” – Karen L. RDH (far right)


We are a little biased, but we have the very best dental hygienists in Atlanta. Each member of our hygiene team brings something special to the table all the while remaining fluid with the quality of care and bedside manners we are known for. While we all know to brush and floss, but these ladies go far beyond their call of duty. If you are in the market for a new dental expert, give us a call to schedule with Laurie, Phyllis, or Karen today!

How Much Do Dental Implants Cost? | Dental Implants and Beyond

Most of us like to consider ourselves savvy shoppers. We go online and research. We ask friends and family what products they like and how much the items should costs. We compare prices and do our best to make smart shopper decisions. Not so hard when we need AA Eveready batteries for a TV remote. Or we want a box of Honey Nut Cheerios. Or we need to replace our favorite jeans and know the size, color, and style number of the ones that are just too worn out to wear again. But, there are other purchases we make that are not as cut and dry and are not best explored by seeking the ‘best price around’. Our hairstylist may charge a bit more than another stylist for their haircuts; our gym membership may be more than the gym down the road. Oftentimes our decisions are based not merely on the dollar cost, but the value we place on the product or the value placed on the provider of the services we receive.


One of our most challenging decisions, and the most important, is how we invest in our health. We cannot compare our healthcare needs to another’s; we cannot compare our unique concerns, questions, and health-related issues to another’s, and we cannot compare what our expectations are in a healthcare provider to another’s. So, when it comes to making a decision that impacts our personal well-being and our day-to-day lives, it comes down to doing some homework and accepting the fact that the bottom line may not be the best or only factor to explore.


Patients frequently call and ask our Colony Square Dental Associates front office team: How much is a filling? A crown? A bridge? A dental implant? All good and fair questions. After all, one needs to know if the service is affordable based on their personal finances. But, unlike the AA Eveready batteries, how do you know that you need a filling? How many surfaces require restoration? What type of crown do you need and from what type of material will it be fabricated? Is a core buildup or a post & core needed? Is a bridge the best treatment option? Are extractions needed? Are you a candidate for a dental implant? Is there sufficient bone to support the implant? Is bone grafting or a sinus lift necessary? Not questions that can be answered in a phone call.


So, for example, you ask – How do I know how much dental treatment, such as dental implants, cost? And, of course, there is an answer; but one you can only obtain after a consultation with the treating dentist. Like your haircut, the answer will vary from office to office. Some differences will be due to the possibility that one dentist’s approach to the development of your treatment plan differs from another’s. Some differences will be due to different services incorporated in your plan of care and their associated fees. And other differences are related to each office’s determination of the fee structure that is developed to offer that office’s quality of care, as well as the healthcare provider’s training, experience, and expertise.




With the stipulation that an in-person visit to those dentists you’ve researched is imperative, there are several services you may see on your treatment plan that are in common from one office to another. Those may include fees related to: determining whether you are a candidate for dental implants, the fees for diagnostic workups prior to implant placement, dental implant placement – the surgical procedure and the associated dental implant abutments and dental implant crowns – the final restorations. While each patient’s situation is unique, treatment estimates could include:

  • Consultation
  • X-rays – pre and post-operative
  • CBCT Scan
  • Diagnostic imaging
  • Extraction(s)
  • Bone grafting / Healing membrane(s) / Sinus lift(s)
  • Dental implant placement or multiple implants
  • Custom Abutment(s)
  • Dental implant crowns
  • Post-operative evaluations


But, the caveat is that each treatment plan is based on the dentist’s determination of the patient’s needs. So, when attempting to compare costs, a phone call to ask for a ‘price on the phone’ will not provide you with the needed information. As a consumer, making a most important decision – related to one’s health, it is incumbent upon you to evaluate the dentist’s training and qualifications, schedule a consultation with the dentist to discuss their recommendations and associated fees, and a breakdown of the dentist’s plan of care that delineates the components of the plan. Ultimately, there will also be a value, though not one with an associated dollar amount that can be put on paper, on the trust and confidence inspired by the dentist when exploring your options.



Dr. David G. Hochberg has been providing his patients, as well as the patients of referring dentists, dental implant treatment options for over 35 years. Trained in both the surgical and restorative phases of dental implants, he also served as the past president of the American Academy Implant Dentistry. To learn more about your oral health investment, call us at 404-874-6464 to schedule a consultation.

National Children’s Dental Health Month | Celebrating 80 Years!

As many of you know, our office joins thousands of others each year in a national effort to celebrate Children’s Dental Health Month. The event is observed every February, and this year is no exception, despite the challenges of the ongoing global pandemic. It is exciting to be a part of an occasion that has been around for decades. In fact, this year National Children’s Dental Health Month is turning eighty!

Although we are unable to physically visit our local community as in years past, we are finding ways to connect with elementary school programs virtually. This year we will be donating toothbrushes, fun dental activity pages, and mystery “treasure box” items to the pre-kindergarten and kindergarten classes for The Primrose School of Midtown and The Haygood Pre-School of Atlanta. We have also included some informative literature for the parents. Dr. Mira Diora will present virtually via ZOOM video call to read a fan favorite, “Curious George Visits the Dentist.” She will also be answering all of the tough dental questions that the children have for her. It’s always surprising each year just how much they already know!

It is our goal to share the wealth with as many families as possible. That said, we’d love for you to visit the American Dental Association to access the activity pages and brushing calendar for the year 2021! These are all free to download. In addition to that, we’d love to broaden our reach for next year as well. If you have a child attending an elementary school in the Atlanta area and would like for us to add you to the list for 2022, please let us know! We are always looking to connect with new academic teams.

Dr. David Hochberg, Dr. Mira Diora, and the entire Colony Square Dental Associates team wish all of our small patients a Happy National Children’s Dental Health Month. We wish you a lifetime of healthy teeth!

2021 New Year, New Covid-19 Vaccine, & New Updates in Dentistry

2020 has definitely been one for the record books. From a temporary shutdown and a soft reopening months later to stockpiling PPE (personal protective equipment) and implementing new infection control protocols. It’s safe to say we are all ready for hope on the horizon! We continue to monitor updates provided by the American Dental Association (ADA), the Occupational Safety & Health Administration (OSHA), and the Environmental Protection Agency (EPA), as we do our utmost to protect the health and safety of our patients and the Colony Square Dental Associates’ team. In addition to the new procedures in place, we recently learned that oral healthcare providers are in the Phase 1A category, alongside medical healthcare personnel and those in long-term care facilities, to receive the approved vaccination for Covid-19. This will be an additional layer of protection for our front office and clinical staff. While we look forward to receipt of vaccinations, and this is a wonderful start, we understand that we have a long journey ahead of us. Our hope is that with each step forward we are able to reassure our patients they are in the best hands.

Like many, it is likely that you or a family member have missed a dental hygiene visit or two with us. While we understand your concerns, we would also like to encourage you to remember the importance of scheduling your dental hygiene visits to help you stay in good health. These visits are the cornerstones for diagnosing problems before more extensive treatment is needed, professionally removing decay-causing plaque and calculus and providing you with a bright, white smile for the New Year!

As more and more patients are receiving needed care, it’s more important now to call us as soon as possible to reserve a time and kick-off 2021 in excellent oral health. Dr. David Hochberg and Dr. Mira Diora, as well as our clinical and front office teams, are here, as always, to provide quality dental services, a safe environment, cutting edge technology, and knowledge of the ever-changing world we live in. We invite you to call us with any questions you may have.

Best wishes to our patient family, friends, neighbor a wonderful holiday season and a Happy, Healthy, New Year!

Fun Halloween Ideas for a Safe and Spooky celebration during Covid-19

The days are getting shorter and the temperatures are dropping, which can only mean one thing – Halloween is finally here! And it goes without saying that this year, Halloween will look very different for all of us. However, there are still tons of fun, spooky, and creative ideas for you to try! We have compiled a list of our unique favorites in hopes to inspire you for a safer way to celebrate with your family this weekend.

Spooky Movie Night

A movie night with a chilly twist could be the perfect alternative to restore traditions for those who typically visit the theatre after trick-or-treating. With some simple black-out curtains and battery-operated flicker candles, your living area can be inexpensively transformed into an eerie indoor cinema. In fact, many channels are releasing new movies on Halloween night! And what better to pair your piping hot apple cider with, than a creepy-crawly thriller.


Virtual Costume Party & Pumpkin Decorating Contest

There is nothing like face-to-face interactions with family members and close friends, but the reality is, most of us have attended a few (or more) virtual meetings since the beginning of the year. So why not drop some fun hand-made invitations in the mail and make this one memorable? You could even enclose a list of items needed to participate! A virtual costume party or a live pumpkin decorating contest can be a great way to make your elderly family members laugh and feel included, even from feet or miles apart.


Homemade Halloween Treats

Typically, Halloween night is known for the staggering mounds of candy dumped onto the kitchen table by young children in an effort to find the perfect sweet treat after a long trek around the neighborhood. And although you can still allow them to enjoy a piece of candy or two, (so long as they remember to brush well before bedtime), it’s nice to have some yummy themed foods and snacks on hand with a bit of a healthier twist. Tangerine pumpkins with a sliver of celery as a stem, a “boo-banana” with semi-sweet chocolates for eyes, strawberries dipped in Greek yogurt, and then frozen to resemble mini ghosts, or a cauliflower crusted pizza with a pepperoni jack-o-lantern face – are all great ideas to conceptualize!


Glow-In-The-Dark Piñata Party


Gathering outdoors in smaller groups is a great alternative to ensure everyone is able to properly social-distance. And what better way to spice up this year’s Halloween celebration than with an All Hallows Eve fiesta! And, a fiesta is just not complete without a traditional pinata. Papier-mâché pinatas have been around for ages and can be store-bought or made right at home! Do you remember covering a balloon with glue and bits of newspaper? – A creative way to make your pinata POP outdoors would be to cover it with glow-in-the-dark acrylic paint! Then, once dry, fill the pinata with individually wrapped Halloween candy, and have each participant take turns hitting it with a “witches” broom. With a few sanitizing wipes handy, you will be able to easily wipe-down between swings and enjoy a new way to trick-or-treat from the comfort of your backyard.


So, whether you are giving out pre-bagged goodies, visiting a local pumpkin patch, or going to an outdoor trunk-or-treat in your community, we sincerely hope you will safely enjoy some spooky festivities. After all, Halloween only comes around one time each year! And don’t forget to share your photos with us on Facebook, we would love to see what new ideas your family comes up with.