Posts for: January, 2014

By Arnold Cutler, D.D.S.
January 28, 2014
Category: Oral Health
Tags: oral health  
ProteinInformationinSalivaCouldLeadtoBetterDiagnosticTests

You've probably never thought of the saliva swishing around in your mouth as amazing. The fact is, though, life would be a lot harder without it. Digestion would be quite unpleasant without its enzymes breaking down food during chewing; the soft tissues of our mouth would suffer more environmental abuse without its protective wash; and without its ability to neutralize acid, our tooth enamel would erode.

What's also amazing is what saliva can reveal about our health. As researchers discover more about this phenomenon, it's leading to better and less invasive ways to diagnose disease.

Similar to blood, saliva is composed of proteins containing RNA and DNA molecules which together hold the genetic instructions the human body needs to reproduce cells. We can therefore test saliva for health conditions as we do with blood, but with less invasive collection techniques and far less hazard to healthcare workers from blood-borne diseases. For example, doctors now have a saliva test that can detect the presence of HIV viruses that cause Acquired Immune Deficiency Syndrome (AIDS). Another saliva test will soon be available that can test for hepatitis.

Unfortunately, only a few such tests now exist. Researchers must first identify and then catalog saliva's biomarkers, protein molecules that correspond to specific health conditions — a daunting task since most are marked not by one but hundreds of proteins. Then it's a matter of developing diagnostic devices that can detect these biomarkers.

Although that too is a huge task, existing technology like mass spectrometry (already used to help detect early stages of oral cancer) could be a promising starting point. This process measures the portion of the light spectrum emitted by a molecule, a feature that could help identify a saliva protein by its emitted light signature.

Thanks to the work of these researchers, many of them in the dental profession, information about our bodies contained in saliva may soon be accessible. That accessibility may lead to earlier diagnoses and more successful treatment outcomes.

If you would like more information on saliva and your oral health, 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 “Secrets of Saliva.”


By Arnold Cutler, D.D.S.
January 24, 2014
Category: Dental Procedures
Tags: root canal  
RootCanalTreatmentAFirst-TimersGuide

It’s often said that thereĆ¢??s a first time for everything: Driving a car by yourself; getting your first “real” job; even… having a root canal?

Now don’t get us wrong — we’re not wishing that anyone should go through a medical procedure, no matter how minor. Yet the fact remains: A root canal procedure is one of the most common treatments performed in many dental offices… and, especially for first-timers, it’s one of the most misunderstood.

Let’s start off with the biggest misconception of all. Have you heard that a root canal is an exceptionally painful treatment? Get ready for some news: It just isn’t so. The fact is, in the vast majority of cases, having a root canal procedure is comparable to cavity treatment in terms of discomfort. Yet it brings immediate relief to the intense pain that can result from an infection in the pulp of the tooth. To understand how this works, we need to look a little closer at a tooth’s anatomy.

The hard outer surface of the tooth doesn’t have nerves, so it can’t “feel” any sensations. But deep inside of the tooth lies a bundle of nerves, blood vessels and connective tissue called the pulp. Safely sealed off from the outside world, pulp tissue is needed for proper tooth development, but has no essential function in adults. Sometimes, however, a deep cavity or a crack in the tooth allows bacteria to infect this soft tissue. That’s when the tooth’s pulp will let you know it’s still there — by causing the sensation of pain.

Pulp tissue fills a branching network of tiny canal-like passages, which can be compared to the roots of a plant. When infection develops in the root canals, the best treatment is to remove the diseased and dying tissue, clean out and disinfect the passageways, and seal up the area against further infection. This, in essence, is a root canal procedure. It is performed under local anesthesia, so you won’t feel any pain as it’s being done. When it’s over, a crown (cap) will be needed to restore the tooth’s appearance and function.

What happens if you need a root canal but don’t get one? If you can manage to ignore it, the pain may (or may not) eventually cease: This signals that the nerves have died — but the disease still persists. Eventually, it may lead to further infection… a pus-filled abscess… even tooth loss. And that’s a truly bad outcome.

It’s normal to feel a little apprehension before any medial procedure. But don’t let faded myths about the root canal procedure keep you from getting the treatment you need. Remember, root canal treatment doesn’t cause pain — it relieves it!

If you would like more information about root canal treatment, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “A Step-By-Step Guide To Root Canal Treatment” and “Tooth Pain? Don't Wait!


By Arnold Cutler, D.D.S.
January 16, 2014
Category: Dental Procedures
CosmeticGumSurgeryCanEnhanceaSmile

It's not just your teeth that are on display when you smile; it's also your gums. For a smile to look appealing, there needs to be a frame of healthy pink tissue to set off those pearly whites. But just as there can be cosmetic issues with teeth, the shape or condition of the gums, too, can create an aesthetic problem. If you feel the appearance of your gums is in any way detracting from the appeal of your smile, we can help with a variety of in-office surgical procedures.

Here are some common cosmetic gum problems — and possible solutions:

Problem: Too Much Gum Tissue. A smile can look “gummy” when excessive gum tissue covers more of the enamel surface of a tooth's crown (upper portion) than normal.
Solution: Crown Lengthening. This is a procedure in which gum tissue (and rarely but sometimes a small amount of bone tissue) is removed to expose more tooth surface.

Problem: Not Enough Gum Tissue. Sometimes your gums can shrink down (recede), exposing some of a tooth's root — which is more yellow than the enamel surface of the tooth.
Solution: Gum Grafting. There are various grafting procedures that can be used to cover exposed roots by moving gingival (gum) tissue from one site in the mouth to another. Sometimes laboratory-processed donor tissue can even be used to minimize the surgery.

Problem: Uneven Gum Line. This means that some teeth are covered by more gum tissue than others, which can make a smile seem off-kilter.
Solution: Gum tissue can be recontoured (reshaped) for a very pleasing effect with either conventional surgery or the newer dental laser technology.

All of the above procedures can be performed at the dental office — usually with only a local anesthetic (numbing shot). In fact, for laser surgery you may need only a topical anesthetic gel. An examination is required to determine whether conventional or laser treatment is in your best interests. Whatever your cosmetic gum surgery needs may be, the procedures are routine and predictable — and they can work wonders for your smile!

If you have any questions about cosmetic gum surgery, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Gummy Smiles” and “Periodontal Plastic Surgery.”


By Arnold Cutler, D.D.S.
January 08, 2014
Category: Oral Health
Tags: oral health   oral hygiene  
TechniqueJustasImportantWithPoweredToothbrushesasWithManual

Electric-powered toothbrushes have been in use for decades, and continue to enjoy wide popularity. But since their inception in the 1950s, there’s been a continuous debate not only about the best choice among powered toothbrushes, but whether powered toothbrushes are as effective in removing plaque as manual toothbrushes.

These debates are fueled by a large body of research over many years on powered toothbrushes. For instance, an independent research firm known as the Cochrane Collaboration has evaluated over 300 hundred studies of powered toothbrushes (over a thirty-year span) using international standards to analyze the data.

Surprisingly, they found only one type of powered toothbrush (using a rotation-oscillation action) that statistically outperformed manual toothbrushes in the reduction of plaque and gingivitis. Although from a statistical point of view the difference was significant, in practical terms it was only a modest increase in efficiency.

In all actuality, the most important aspect about toothbrushes in effective oral hygiene isn’t the brush, but how it’s used — or as we might say, “it’s not the brush so much as the hand that holds it.” The fact remains, after first flossing, a manual toothbrush can be quite effective in removing plaque if you brush once or twice a day with a soft-bristle brush using a gentle brushing motion.

Although a powered toothbrush does much of the work for you, it still requires training to be effective, just as with a manual toothbrush. We would encourage you, then, to bring your toothbrush, powered or manual, on your next cleaning visit: we would be happy to demonstrate proper technique and give you some useful tips on making your brushing experience more effective.

Remember too: brushing your teeth and flossing isn’t the whole of your oral hygiene. Although a critical part, brushing and flossing should also be accompanied with semi-annual professional cleanings to ensure the removal of as much disease-causing plaque as possible.

If you would like more information on types of toothbrushes, 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 “Manual vs. Powered Toothbrushes.”




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