Posts for: April, 2014

By Arnold Cutler, D.D.S.
April 28, 2014
Category: Oral Health
WhatisPediatricConsciousSedation

In dentistry (as well as other branches of medicine) pediatric conscious sedation is becoming more widespread than ever — but some people aren’t yet familiar with this beneficial therapy. Conscious sedation can remove anxiety and produce a feeling of calm and relaxation during dental treatment; however, unlike general anesthesia, it doesn’t cause the loss of consciousness. That means patients can still breathe normally and can respond to certain stimuli, while feelings of pain and anxiety are blocked.

Conscious sedation is often employed for invasive procedures such as tooth extractions or root canals — which cause some people a great deal of apprehension, no matter what their age. It can be especially useful for children, however, who may have a more limited ability to understand (and cooperate with) their dental treatment. Because the medications are commonly administered orally (by mouth), there’s no needle to provoke fear. And when it’s over, there is usually little or no memory of the procedure that was done.

Pediatric conscious sedation is typically administered in an office setting by a dentist with special qualifications. The American Dental Association, the American Academy of Pediatric Dentistry, and the American Academy of Pediatrics have jointly established criteria for its use. Specialized training and continuing education are part of the qualification process; additionally, the dental office must be equipped with advanced life-support equipment and trained staff, who can help in the unlikely case of an emergency.

While your child is receiving conscious sedation, he or she will be monitored by a designated staff member who keeps a close watch on vital signs like blood pressure, oxygen levels, pulse rate and respiration. This helps to ensure that the level of sedation remains safe, yet effective. When the procedure is over, the medications wear off quickly; however, children will certainly need a ride home, and shouldn’t return to school until the next day.

As new medications are developed, more dentists receive special training, and the cost of associated equipment becomes more reasonable, the practice of pediatric conscious sedation is becoming more widespread. For many kids, it could mean the difference between having fearful childhood memories of the dental office that linger on through life — and remembering almost nothing at all.

If your child has dental anxiety or requires invasive procedures, pediatric conscious sedation may be a good option for you to consider. For more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Sedation Dentistry for Kids.”


By Arnold Cutler, D.D.S.
April 25, 2014
Category: Dental Procedures
HowDoILookAfterMyNewPorcelainVeneers

You've just had porcelain laminate veneers placed on your teeth to improve their appearance, color and shape. Now what? How do you maintain them and keep them looking their best?

A dental porcelain veneer is a thin layer of porcelain that is bonded to a tooth, replacing the enamel (the outermost layer of a tooth). Dental porcelain is a glass-like substance that can be used to mimic natural tooth enamel perfectly because of its bright, reflective and translucent (see-through) qualities.

To look after your veneers, it is important to maintain the health of the teeth on which they were placed, and of the surrounding gums.

  • About a week after your veneers have been placed, return to our office so that we can check them to make sure they are functioning well.
  • Brush and floss regularly using non-abrasive fluoride toothpaste; make sure you remove biofilm, the film of bacteria that collects on the teeth, every day. Flossing or brushing will not harm your veneers.
  • We recommend regular dental checkups to review the state of your veneers and your dental health in general.

Porcelain is a ceramic glass-like material, and like glass it is strong but brittle and can fracture when placed under too much stress.

  • You can eat almost all foods without harming your veneers, but avoid biting into hard things like candy apples.
  • Many people habitually grind or clench their teeth. If you are one of them, let us know. We can make a protective bite guard that you can wear to reduce stress placed on your teeth (and your veneers) while you sleep.

With good dental hygiene, and regular dental check-ups porcelain veneers can last from seven to twenty years or even longer. This makes them a good solution that will improve your smile for years to come.

Contact us today to schedule an appointment or to discuss your questions about porcelain laminate veneers. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”


By Arnold Cutler, D.D.S.
April 17, 2014
Category: Dental Procedures
Tags: cosmetic dentistry  
YouCanPutOnaGreatFacewithVeneersandCrowns

Smiling feels great and makes others feel good as well. But if you are self-conscious about exposing teeth that are showing imperfections or excessive wear, you may not be smiling as broadly as you should be. Fortunately, there are ways to correct the esthetic issues that might be holding you back. One involves covering the natural tooth partly or completely with a natural-looking but flawless “facade.”

Perhaps you've heard about dental veneers and crowns? Both can achieve similar, eye-pleasing results by changing the shape and color of your teeth and even helping to compensate for uneven spacing or alignment. And both are custom-designed for your teeth. So what's the difference and which is right for you?

One distinguishing feature is the amount of tooth each covers. A veneer is a wafer-thin layer of dental porcelain that bonds to the front of your tooth. A crown, also fashioned from dental porcelain, fits over and covers the entire existing tooth, like a hood, right down to the gum. With either approach, to ensure the best, most natural fit, some of the natural tooth structure must be reduced by a minimal amount. In the case of veneers, up to 1 mm of tooth enamel — about the thinness of a fingernail — is removed. Crowns are generally thicker than veneers, so in their case the removal of at least 2 mm of tooth is needed.

Another difference between veneers and crowns is the situations in which one might be more suitable than the other to achieve the desired results. For example, a crown may be necessary when too much tooth structure has been lost to decay or other problems, or for use on back teeth that have to withstand greater impact from biting and chewing. A dental professional can make a recommendation based on your goals, the condition of the tooth or teeth in question, and other factors.

Either way, both veneers and crowns are an excellent solution for a range of esthetic concerns — from poor tooth color/staining, chips and cracks, and excessive wear at the bottom of teeth (from bruxism, a term for teeth grinding) to making small teeth look larger, closing minor gaps between teeth, and making slight corrections in alignment.

If you would like more information about veneers and crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Porcelain Veneers: Strength & Beauty As Never Before.”


Xylitol-ThisNaturalSugarCouldHelpyouWintheBattleAgainstToothDecay

Refined table sugar (sucrose) has been in the health spotlight for some time now. While its effects on nutrition and general health are just now gaining attention, its effect on dental health, particularly as a food source for bacteria that cause tooth decay, has been known for decades.

In recent years, though, a different kind of natural sugar known as xylitol has come into popularity. Mutans Streptococci, the main bacteria responsible for tooth decay, is unable to break down and consume this alcohol-based sugar as it can with sucrose. What’s more, there’s evidence that xylitol can actually “starve” the offending bacteria and reduce its levels in the mouth. Xylitol also helps to reduce the level of acid in saliva and supports this vital fluid in its role of balancing the mouth’s pH level. By helping maintain a more pH neutral environment, xylitol can help prevent decay from even starting and promote the production of bacteria that doesn’t produce acid.

One of the most prevalent ways to include xylitol in your diet is through chewing gum. Researchers have found xylitol chewing gum can significantly reduce the risk of tooth decay, especially by inhibiting the decay process. Its reaction with saliva also contributes to the process of hardening the mineral content of enamel, a further inhibition to tooth decay.

Depending on your risk factors for dental disease, we might direct you to chew two pieces of xylitol gum for five minutes after meals and snacks, up to four times a day. Our target dose is about one to two teaspoons spread out during the day. If chewing gum is problematic or undesirable, it’s also possible to receive the recommended dosage of xylitol through hard candy, mints and oral products like toothpaste, mouthwash or sprays that contain the sugar.

Depending on your risk factors, a daily dosage of xylitol in chewing gum and other products can change the environment in your mouth for the better. A few minutes of gum chewing after meals and snacks might provide you the winning edge in the battle against tooth decay.

If you would like more information on the benefits and uses of xylitol, 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 “Xylitol in Chewing Gum.”


By Arnold Cutler, D.D.S.
April 01, 2014
Category: Oral Health
OralCareTipsforyourToddler

Caring for a young child can be overwhelming at times. Sometimes, it may feel like you can't read enough books to learn the correct way to do everything from potty training to feeding. It's also important to teach your child healthcare habits during these crucial years, so that they continue these habits for a lifetime!

Here are a few simple ways you can help your child to institute lifetime oral care habits.

  1. DO: Encourage your Child to Brush Every Day with Fluoride Toothpaste. Fluoride will help make your child's teeth more resistant to tooth decay. You should use a thin smear of fluoride toothpaste for children under age two and a pea-sized amount for older children. At age two, you can also begin empowering your child to brush, but make sure that you supervise and finish the job. Your child will probably need your help until around the age of six.
  2. DON'T: Share your Germs. Did you know that children are not born with the bacteria that cause tooth decay? In fact, the bacteria are transmitted to them from adults! You should never share a cup or spoon with your child. Also, next time you kiss your child, kiss him or her on the cheeks instead of the lips. Believe it or not, you can transmit harmful bacteria through this quick little kiss.
  3. DO: Limit your Child's Sugar Intake. When your child consumes sugar, the bacteria use the sugar to produce acids that dissolve tooth enamel, eventually leading to tooth decay. Saliva can neutralize those acids, but it needs enough time, 30 to 60 minutes, to work its magic. That is why it is important to limit sugar intake between meals.
  4. DON'T: Give Your Child a Bottle at Night. Juice, milk and even breast milk contain sugars that promote tooth decay, in particular during sleep, when less saliva is being produced. So, though it may be tempting, do not let your child go to bed with a bottle.
  5. DO: Take your Child to the Dentist Early. The American Academy of Pediatric Dentistry recommends that all children have their first dental visit by the age of one. Your toddler will benefit from regular dental visits, because we will monitor tooth decay, correct brushing techniques and also, most importantly, ensure that he or she is comfortable in the dental chair.
  6. DON'T: Allow your Child to Suck His or Her Thumb Past Age Three. Thumb sucking for comfort is a very normal behavior for babies and toddlers. However, if your child constantly sucks his or her thumb past the age of three, it can affect teeth alignment and jaw development.

If you would like more information about oral care for your child, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Dentistry and Oral Health for Children.”




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