My Blog
By David J. Adams, DMD, MS, PA
July 27, 2020
Category: Oral Health
Tags: oral hygiene  
FlossFirstorBrushFirstYouBetheJudge

Brushing and flossing are two of the best things you can do to fight dental disease and maintain healthy teeth and gums.

Or is it flossing and brushing? What we mean is, should you floss first or brush first?

There's virtually no debate among dental professionals about whether or not to perform both hygiene tasks. While brushing removes disease-causing plaque from the broad surfaces of teeth, flossing gets to deposits of this disease-causing, bacterial film lodged between the teeth that brushing can't reach. You don't want to neglect one task over the other if you want to fully minimize your risk of tooth decay or gum disease (and don't forget semi-annual dental cleanings too).

But where there is some debate—good-natured, of course—among dentists is over whether it's better hygiene-wise to brush before flossing or vice-versa. For those on Team Brush, you should pick up your toothbrush first for the best results.

By brushing before you floss, you'll remove most of the plaque that has accumulated since your last cleaning session. If you floss first, the flossing thread has to plow through a lot of the plaque that otherwise might be removed by brushing. For many, this can lead to an unpleasant sticky mess. By removing most of the plaque first via brushing, you can focus your flossing on the small amount left between teeth.

Team Floss, on the other hand, believes giving flossing first crack at loosening the plaque between teeth will make it easier for the detergent in the toothpaste to remove it out of the way during brushing. It may also better expose these in-between areas of teeth to the fluoride in your toothpaste while brushing. And because flossing is generally considered a bit more toilsome to do than brushing, tackling it first could increase the likelihood you'll actually floss and not neglect it after brushing.

So, which task should you perform first? Actually, it's up to you: Weighing both sides, it usually comes down to which way is the most comfortable for you and will give you the greatest impetus for flossing. Because no matter which “team” you're on, the important thing is this: Don't forget to floss.

If you would like more information on personal dental care, 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 “Daily Oral Hygiene.”

By David J. Adams, DMD, MS, PA
July 17, 2020
Category: Dental Procedures
Tags: dental implant  
TheseDigitalToolsIncreasetheSuccessRateofDentalImplants

Nothing beats the form and function of a real tooth—but dental implants come pretty close. That's why they're tops among both dentists and patients for replacing missing teeth.

Much of an implant's functionality and durability can be credited to its material construction, from the titanium metal post imbedded in the jawbone to the lifelike porcelain crown attached at its other end. But an implant's “nuts and bolts” isn't the only reason why this premier dental restoration is so popular: A good portion of their success comes from the adjunct support provided by digital technology.

Without this varied array of computer-based applications used in planning, designing and installing them, implants couldn't produce the level of satisfactory outcomes they currently do. Here then are a few of the high-tech tools dentists use to make sure your implants result in a winning smile.

CBCT scanning. Implant placement requires a high degree of precision often complicated by various anatomical structures like nerves, blood vessels and sinuses within the gums and jaws. Cone Beam Computer Tomography (CBCT) scanners rotate around a patient's head, taking hundreds of digital x-ray images that are then assembled into a 3-D model image. Dentists can view this model from various angles to identify obstacles and better pinpoint the best implant locations.

Digital impressions. Dentists can also create a 3-D digital impression model of the inside of a patient's mouth that can give them views of their current teeth and gums from any angle. This aids in determining the size and type of implant so that it blends seamlessly with remaining teeth. A digital impression can also provide both the dentist and patient a preview appearance of their future smile after treatment.

3-D printed surgical guides. To accurately drill the implant site during surgery, dentists often create a custom-made device called a surgical guide that fits into the patient's mouth during the procedure. Using results from scanning and digital impressions, highly accurate guides can be created with a 3-D printer. This further ensures that the implant will be in the exact best location for the most attractive and functional outcome.

Implantology is as much art as it is science in achieving a beautiful smile. These and other digital tools help make that desirable end a reality.

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

By David J. Adams, DMD, MS, PA
July 07, 2020
Category: Oral Health
Tags: missing teeth  
ComplicationsfromMissingTeethCouldLimitYourReplacementOptions

There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.

The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.

Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.

If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.

It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.

If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.

Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.

Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.

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

MileyCyrussLittleSecretStraighteningHerSmileWithLingualBraces

Miley Cyrus's rise to fame began when she was cast in the Disney series Hannah Montana. She played the title character, Hannah Montana, a famous singing star hiding her true identity, ordinary girl, Miley Stewart. In her real life at the time, Miley Cyrus had her own little secret—she was undergoing orthodontic treatment to straighten her smile.

Like many teenagers (as well as many adults), Cyrus's dental bite wasn't in proper alignment. She could have gone the traditional way by straightening her smile with braces fixed to the front of her teeth. It's an effective treatment, but the metallic hardware can overwhelm a person's appearance.

With her various roles in the public spotlight, Cyrus and her family wanted an effective but out-of-sight method for moving her teeth. They chose a relatively new one called lingual braces. Unlike traditional braces, the hardware for lingual braces is fixed on the back of the teeth (or the tongue side, hence the term “lingual”).

Lingual braces can correct any bite problem labial (“lip”) braces can, just through different mechanics of movement. Its main appeal is that the hardware is hidden behind the teeth, so only you and your orthodontist need know you're wearing braces.

There is also less risk of damage to the mouth or the braces themselves if you're in a sport or profession where you're at high risk for facial blows. And unlike patients with traditional braces, you'll have an unobstructed view of your progress over the course of treatment.

Lingual braces do tend to cost more than traditional braces. Some patients also have difficulty at first with speaking and tongue comfort, though most grow accustomed to the braces within a couple of weeks. Because lingual braces are relatively new, there's been a limited number of orthodontists offering it.

But lingual braces are just one of the ways to straighten teeth. Modern dentistry offers several ways to give you your dream smile. If you have dental problems or would like to improve the look of your smile, please contact us or schedule a consultation, and we can discuss your options. To learn more, read the Dear Doctor magazine articles “Lingual Braces” and “The Magic of Orthodontics.”

By David J. Adams, DMD, MS, PA
June 17, 2020
Category: Oral Health
Tags: antibiotics  
ExcitingNewDiscoveryCouldHelpintheFightAgainstAntibioticResistance

Like the rest of healthcare, antibiotics have transformed dentistry. Advanced oral infections that once eluded successful treatment are routinely stopped with the use of these “wonder drugs.” But their overuse over the years has given rise to dangerous “superbugs” resistant to many antibiotics.

Antibiotics are one of the 20th Century's most significant healthcare achievements. Drugs like penicillin played a major role ending the global threat of tuberculosis, cholera and bacterial meningitis. Over the last few decades, more antibiotics have been developed to defend against an even wider array of bacterial dangers.

But along the way doctors and dentists began prescribing antibiotics for all manner of illnesses including viral infections like colds or flu for which they're less effective. They've also been increasingly used as a preventive measure, including inclusion in animal feed to fight disease.

But our tiny biological nemeses are adaptable. As bacterial strains come in contact with greater amounts of antibiotics, individual bacterium that survive transmit their resistance to subsequent generations. This can produce new strains like Staphylococcus aureus (MRSA) that are resistant to methicillin and other common antibiotics that once contained them.

There's deep concern that these new resistant strains, often recent incarnations of old diseases once thought defeated, will lead to higher rates of sickness and death. Increasing resistance could also make common procedures like those performed by dentists and oral surgeons, much riskier to undertake.

To combat this, pharmaceutical companies are racing to create new drugs to compensate. Recently, they've received an encouraging sign of hope in this battle from an unlikely source: viruses. Researchers in Tel Aviv, Israel have discovered an antagonistic protein to bacteria among a group of viruses called bacteriophages. The protein, injected into a bacterium, commandeers the cell's DNA function to aid virus reproduction, which kills the host.

In the words of one researcher, this makes these particular “enemy of our enemy” viruses our “friend.” Although the discovery is still a long way from practical use in antibiotics, harnessing it in future drug versions could help pack a greater punch against resistant bacteria.

In the meantime, providers and patients alike must practice and advocate for stricter protocols regarding the use of antibiotics. The viability of tomorrow's healthcare is on the line.

If you would like more information on the use of antibiotics in dentistry, please contact us or schedule an appointment for a consultation.





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