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Friday, June 8, 2018

Not a Fan of Using CPAP for Your Sleep Apnea? Consider an Oral Appliance

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Do you wake up in the morning still feeling tired? Are you drowsy, irritable or have difficulty concentrating? And is your snoring habit a running joke around your household?

If you mostly answered yes, you may have obstructive sleep apnea (OSA). This condition is more than an irritation it could also have major health implications if not addressed.

OSA occurs when the airway becomes temporarily blocked during sleep. The tongue (or other mouth structures like tonsils or the uvula) is often the cause as it relaxes and covers the back of the throat. Although you’re asleep, the brain notices the drop in oxygen and initiates arousal to unblock the airway. As this action usually only takes a few seconds, you may not fully awake every time; but because it can occur several times a night, it can rob you of the deep sleep you need for well-being.

If you’re diagnosed with OSA, your doctor may recommend continuous positive airway pressure therapy (CPAP). This treatment uses a pump device to supply continuous pressurized air through a hose connected to a face mask worn during sleep. The elevated pressure helps keep the airway open.
While this approach is quite effective, many people find wearing the equipment uncomfortable or confining, and may choose not to use it. If that describes you, a qualified dentist may be able to provide you with an alternative called oral appliance therapy (OAT).

OAT uses a custom-made plastic oral appliance you wear while you sleep. The most common snaps over the teeth and uses a hinge mechanism to move the lower jaw (and the tongue with it) forward.

OAT is recommended for people with mild to moderate OSA, or those with severe symptoms who can’t tolerate CPAP. If you’d like to see if an OAT appliance could help you, contact us for a complete oral examination. Either treatment can improve your sleep and daily lifestyle, as well as help prevent certain health issues in the future.

If you would like more information on treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”

Thursday, May 31, 2018

Eden Sher and the Lost Retainer

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Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait it doesn’t fit, it’s not even hers!

If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.

If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?

As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed  and notify us immediately if it gets lost.

And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!

If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?

Tuesday, May 22, 2018

Bone Loss at the Roots can Put Your Tooth in Danger of Loss

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There’s more to teeth than meets the eye. Hidden beneath the visible crown are the tooth’s roots set within the jawbone, secured and protected by the gums from bacteria and infection. But if the gums shrink back (recede), the roots become exposed and susceptible to disease, especially at the points where multiple roots branch from each other, areas called furcations.

It all begins with periodontal (gum) disease caused by built-up bacterial plaque from insufficient brushing and flossing. The infection triggers inflammation that over time weakens gum tissues. They begin to detach from the teeth, which can eventually lead to gum recession and root exposure.

This also causes bone loss, especially at the furcations. We can detect any loss (known as a furcation invasion) and how far along it may be with x-ray imaging or by manually probing with an instrument called a periodontal probe.

There are three general classes measuring furcation invasions. In the earliest, Class I, we can feel the invasion as a slight groove; in Class II, it increases to two or more millimeters across. In Class III the bone loss extends from one side of the root all the way to the other (a “through and through”).

At this stage a patient is in danger of losing the tooth, so we’ll have to act promptly. This means first removing accumulated dental plaque and calculus (tartar) to stop the infection and allow the gums to heal. With severe damage, we may need to assist healing with bone and gum tissue grafting, in which we place donor grafts to serve as scaffolding for the appropriate tissue to grow upon.

You can help prevent this situation by practicing effective daily hygiene and visiting your dentist for thorough cleanings at least twice a year (or more if recommended). And at the first signs of a gum infection swollen, reddened or bleeding gums make an appointment as soon as possible to have it checked. The sooner we can detect and treat gum disease, the less likely a furcation invasion or worse will be in your future.

If you would like more information on gum disease diagnosis and treatment, please contact us or schedule an appointment for a consultation.

Tuesday, May 8, 2018

3 Situations for Seeing a Periodontist

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It’s likely you depend on your regular dentist for the lion’s share of your dental care. But in cases of advanced disease or trauma, you may need the services of a dental specialist.

This could be the case with periodontal (gum) disease, a bacterial infection triggered by a thin biofilm on tooth surfaces called dental plaque that isn’t adequately removed through daily oral hygiene practices. While your regular dentist can effectively treat many forms of gum disease, there are times when you should see a periodontist who specializes in the gum, supporting bone and connective tissues.

So, when should you see a periodontist for gum disease treatment? Here are 3 situations that may call for this important dental specialist.

If your dentist refers you. Your dentist may be quite proficient in treating gum disease, mainly by removing the dental plaque and tartar sustaining the infection. But if the infection has advanced deep within the gum tissues especially around the roots and bone, you may need more advanced measures, including surgery, performed by a periodontist.

If you’d like a second opinion. Of course, you don’t need a referral to see a periodontist. You can make an appointment with one for another opinion about your diagnosis and recommended treatment plan. If you choose to see a periodontist, make sure they have access to all your dental and medical records, as well as your past health history.

If you have other health issues. Gum disease often doesn’t occur in a vacuum – it may exist and even influence (or be influenced by) other inflammatory medical conditions. If you have such a condition like diabetes or cardiovascular disease, you may opt to see a periodontist first for a more comprehensive evaluation.

In the meantime, keep an eye out for the first signs of disease including red, swollen or bleeding gums (if you smoke, be aware smoking hides these signs of disease). And practice daily brushing and flossing as well as obtaining regular dental cleanings to keep plaque accumulation to minimum. Preventing gum disease and getting treatment as early as possible may help you avoid more invasive treatments later.

If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When to See a Periodontist.”

Monday, April 30, 2018

Are You Keeping Good Oral Hygiene Habits?

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Avoiding cavities doesn't have to be difficult. A good oral hygiene routine not only reduces your risk of tooth decay but also lowers the chance you'll develop gum disease. The Bergen County, NJ, dentists at Gentle Dentistry explain how you can improve your oral hygiene habits.

Less is definitely not more

When it comes to cleaning your teeth, a regular routine is particularly important. Failing to brush in the morning or evening can increase your risk of tooth decay. Plaque, the bacterial film that regularly forms on your teeth, can quickly grow out of control if you skip a single morning or evening brushing session. Although you can't see plaque, you may notice that it makes your teeth feel a little rough. Luckily brushing for two minutes in the morning and evening removes the coating from your teeth.

Daily flossing is very important, as plaque also forms between your teeth. If you're only an occasional flosser, you may be more likely to develop painful cavities between teeth. Flossing and brushing also help reduce tartar formation. Tartar is the hard brown or gray deposit that tends to form at the base of teeth. Tartar is very irritating and may cause gum disease if it's not removed during bi-annual cleanings in our Bergen County office.

Your tongue needs a little attention too

Brushing and flossing your teeth removes bacterial-laden plaque, but your efforts will be in vain if bacteria remains on your tongue. In fact, bacteria can move from your tongue to your teeth just minutes after you finish brushing. Brushing both sides of your tongue will help lower the amount of bacteria in your mouth and reduce your tooth decay risk. Do you avoid brushing your tongue because it makes you gag? Tongue scrapers, available in the oral care aisle of drugstores, can make the process more comfortable.

Choosing the right tools is important

Soft is the best choice when it comes to choosing a toothbrush. Medium bristles can damage your enamel and irritate your gums, particularly if you apply too much pressure when you brush. Replace your toothbrush at least every three months or when the bristles are splayed or flattened.

Thanks to the variety of dental floss and flossing tools available, there's never a good reason to skip flossing. String floss usually works best if your teeth are fairly close together, while tape floss makes flossing widely spaced teeth easier. Water flossers, flossing brushes, and other flossing tools make it easy to clean hard-to-reach spots.

Keep your smile healthy with good oral hygiene habits and regular dental checkups. Call the Bergen County, NJ, dentists at Gentle Dentistry at (201) 244-7070 to schedule your appointment.

Friday, April 6, 2018

Prompt Treatment for Gum Disease Could Ultimately Save Your Teeth

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Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.

Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.

Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.

As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.

But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.

While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.

And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.

If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation.

Friday, March 30, 2018

3 Questions You Should Ask before Undergoing Teeth Whitening

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There are a number of teeth whitening options to put the brightness back into your smile from professional dentist office applications to over-the-counter products for home use. But before you decide on an option, you should first consider whether whitening is right for you and to what extent.

Here are 3 questions to ask yourself — and us — before undergoing a whitening treatment.

Do I have any dental problems that make whitening problematic? The underlying cause of the staining may stem from decay, root canal problems or other dental issues; in these cases the underlying cause needs to be treated first, because whitening would only mask the actual problem. You also may not want to whiten your teeth for aesthetic reasons: people with certain features like short teeth or gummy smiles may find these features become more prominent after teeth whitening. It might be more advisable in these cases to consider other cosmetic options first.

How much whitening do I really need to improve my smile? One of the biggest myths about teeth whitening is the brighter the shade the more attractive the smile. A truly attractive tooth color, however, is more nuanced, and every person’s ideal color is different. The most attractive and natural color is one that matches the whites of your eyes.

What effect will whitening have on existing dental work I already have? In most cases, none — and that could be a problem. Composite resins or ceramic dental material have their color “baked in” and bleaching chemicals used in whitening have no effect on them. The concern then is whether whitening nearby natural teeth may produce a color mismatch between them and the dental restorations, resulting in an unattractive appearance.

Before you decide on teeth whitening, visit us first for a complete exam and consultation. We’ll discuss whether whitening is a good option for you, or whether there are other issues we should address first. We can also advise you on products and techniques, and how to get the most from your whitening experience.

If you would like more information on teeth whitening, please contact us or schedule an appointment for a consultation.