My Blog
By Lawrence Marini, D.D.S.,PC
July 22, 2017
Category: Oral Health
Tags: dental injuries  
HowtoHandle3CommonInjuriestoYourChildsMouth

Once they learn to walk, there's no stopping most children. Sometimes it can be a little jarring, as when you discover your toddler on top of the kitchen counter reaching in the cupboard on tip-toes for a snack!

Fortunately, children are fairly resilient. Unfortunately, they're not invincible — some of their adventures could result in physical injuries, especially to the highly vulnerable area of the mouth.

Even if you've carefully “child-proofed” your home, it's still best to be prepared for mishaps. Here are 3 common dental injuries and how to handle them.

Soft tissue injuries. Making contact with the ground or hard objects like furniture can injure the lips, tongue, cheeks or gums and cause bleeding, cuts or bruising. First, clean the area with clean water and a cloth or gauze as best you can, making sure there aren't any trapped pieces of tooth or dirt. Apply gentle, continuous pressure with a clean cloth to control bleeding, and apply ice packs or cold compresses for swelling. Don't apply bleach, aspirin or similar medications to open wounds. If the bleeding won't stop or the wounds look serious or deep, go to an emergency room.

Chipped or displaced tooth. A blunt force mouth injury can chip or push (displace) teeth out of position. In this case try to save any chipped pieces you find — your dentist may be able to re-bond them to the tooth. A displaced tooth is a dental emergency, so contact your dentist immediately. Don't try to re-position the tooth yourself unless it's completely knocked out.

Knocked-out tooth. Actions to take with a knocked-out tooth depend on whether it's a permanent or primary (baby) tooth. If permanent, rinse the tooth with clean water. Handle it by the crown (never by the root) and gently place it back in the empty socket. If that's not possible, place the tooth between your child's cheek and gum (if the child is old enough not to swallow it by mistake. You can also place it in a glass of cold milk. Get to a dentist or an emergency room as soon as possible — minutes count for a successful reattachment. Conversely, don't try to put a primary tooth back in its socket — you could damage the developing permanent tooth beneath the gum line. But do see a dentist as soon as possible for an examination.

If you would like more information on responding to mouth injuries in children, please contact us or schedule an appointment for a consultation.

By Lawrence Marini, D.D.S.,PC
July 07, 2017
Category: Dental Procedures
ArianaGrandeBreaksFree-ofHerWisdomTeeth

Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”

With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.

Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.

But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.

In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.

So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Lawrence Marini, D.D.S.,PC
June 22, 2017
Category: Dental Procedures
Tags: gum disease  
GumInfectionAroundToothRootsCallsforImmediateAction

Many people learn they have periodontal (gum) disease after noticing gum swelling, soreness or bleeding. But what you can see or feel may be only the tip of the iceberg — the damage may extend much deeper.

Gum disease is caused mainly by dental plaque, a thin film of bacteria and food particles built up on teeth due to ineffective brushing and flossing. Infection of the visible gums is only the beginning — left untreated, it can advance well below the gum line and even infect supporting bone.

One critical concern in this regard is the areas where the roots of a tooth separate from each other, known as furcations. Here an infection known as a furcation invasion can cause the bone to weaken and dissolve.

This usually occurs in stages (or classes) we can detect through manual probing and/or with x-rays. In the earliest stage, Class I, we might only notice a slight pocket in the gums with no significant bone loss. In Class II, though, the pocket between the roots has become a horizontal opening of two or more millimeters, indicating definite bone loss with increased pocket depth getting “under” the crown of the tooth. Class III, the last and most serious stage, describes an opening we can probe under the crown all the way to the other side of the tooth; the bone loss now extends “through and through” the furcation.

The basic goal of gum disease treatment is to remove plaque and calculus (tartar) from all tooth and gum surfaces. But removing plaque below the gum line, especially “into” the furcations, can be challenging. We will need instruments called scalers to clean root surfaces, assisted sometimes by ultrasonic equipment to vibrate plaque loose. With furcations we may also need to employ surgery to aid gum or bone tissue regeneration or to make the area easier to access for future cleaning.

Of course, the best way to protect against furcation invasions is to prevent gum disease in the first place. Be sure to brush and floss daily and visit us for thorough dental cleanings and checkups at least every six months.

And don’t delay contacting us if you see any signs of teeth or gum problems. The sooner we can identify gum disease, the more likely we’ll be able to prevent it from doing serious damage to your gums, bone and teeth.

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 “What are Furcations?

By Lawrence Marini, D.D.S.,PC
June 07, 2017
Category: Dental Procedures
MasterIllusionistBenefitsfromtheMagicofOrthodontics

Magician Michael Grandinetti mystifies and astonishes audiences with his sleight of hand and mastery of illusion. But when he initially steps onto the stage, it’s his smile that grabs the attention. “The first thing… that an audience notices is your smile; it’s what really connects you as a person to them,” Michael told an interviewer.

He attributes his audience-pleasing smile to several years of orthodontic treatment as a teenager to straighten misaligned teeth, plus a lifetime of good oral care. “I’m so thankful that I did it,” he said about wearing orthodontic braces. “It was so beneficial. And… looking at the path I’ve chosen, it was life-changing.”

Orthodontics — the dental subspecialty focused on treating malocclusions (literally “bad bites”) — can indeed make life-changing improvements. Properly positioned teeth are integral to the aesthetics of any smile, and a smile that’s pleasing to look at boosts confidence and self-esteem and makes a terrific first impression. Studies have even linked having an attractive smile with greater professional success.

There can also be functional benefits such as improved biting/chewing and speech, and reduced strain on jaw muscles and joints. Additionally, well-aligned teeth are easier to clean and less likely to trap food particles that can lead to decay.

The Science Behind the Magic

There are more options than ever for correcting bites, but all capitalize on the fact that teeth are suspended in individual jawbone sockets by elastic periodontal ligaments that enable them to move. Orthodontic appliances (commonly called braces or clear aligners) place light, controlled forces on teeth in a calculated fashion to move them into their new desired alignment.

The “gold standard” in orthodontic treatment remains the orthodontic band for posterior (back) teeth and the bonded bracket for front teeth. Thin, flexible wires threaded through the brackets create the light forces needed for repositioning. Traditionally the brackets have been made of metal, but for those concerned about the aesthetics, they can also be made out of a clear material. Lingual braces, which are bonded to the back of teeth instead of the front, are another less visible option. The most discrete appliance is the removable clear aligner, which consists of a progression of custom-made clear trays that reposition teeth incrementally.

How’s that for a disappearing act?!

If you would like more information about orthodontic treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “The Magic of Orthodontics.”

By Lawrence Marini, D.D.S.,PC
May 23, 2017
Category: Dental Procedures
ConsiderClearAlignersInsteadofBracesforYourTeen

Your teenager is about to take a big step toward better health and a more attractive appearance — orthodontic treatment. You both know the benefits: better chewing function, lower risk of dental disease, and, of course, a straighter and more beautiful smile.

But your teen might also dread the next couple of years of wearing braces. And it's hard to blame them: although they're effective, wearing braces restricts eating certain snacks and foods, they require extra time and effort for brushing and flossing, and they're often uncomfortable to wear. And of high importance to a teenager, they may feel embarrassed to wear them.

But over the last couple of decades a braces alternative has emerged: clear aligners. This form of bite correction requires fewer food restrictions, allows greater ease in hygiene, and is considered more attractive than braces. In fact, most observers won't notice them when a wearer smiles.

Clear aligners are a series of clear plastic trays created by computer that are worn in a certain sequence. During wear each tray exerts pressure on the teeth to gradually move them in the desired direction. The patient wears a single tray for two weeks and then changes to the next tray in the sequence, which will be slightly different than the previous tray. At the end of the process, the teeth will have been moved to their new positions.

Clear aligners aren't appropriate for all bite problems. When they are, though, they offer a couple of advantages over braces. Unlike braces, a wearer can remove the aligner to brush and floss their teeth or for rare, special or important social occasions. And, of course, their appearance makes them less likely to cause embarrassment while wearing them.

In recent years, design improvements have increased the kinds of bites aligners can be used to correct. For example, they now often include “power ridges,” tiny features that precisely control the amount and direction of pressure applied to the teeth. They've also become thinner and more comfortable to wear.

If you're interested in clear aligners as a treatment option, talk with your orthodontist about whether your teen is a good candidate. If so, they could make orthodontic treatment for achieving a more attractive and healthy smile less of an ordeal.

If you would like more information on clear aligners as an orthodontic option, 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 “Clear Aligners for Teens.”





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