The eruption of your child's first permanent teeth is a milestone in his or her development. As parents, you want to help your child preserve and protect their new permanent teeth so that they can last a lifetime. Dental sealants are one easy, simple, and inexpensive way to protect them from decay.

How do cavities develop?

The back teeth (premolars and molars) are formed with deep grooves on their biting surfaces that we call “pits and fissures.” These crevices are too deep for toothbrush bristles to reach. Bacteria can therefore grow and thrive inside them. The acid produced by these bacteria begins to dissolve the tooth enamel, starting the decay process.

Are new teeth more vulnerable?

Yes, the enamel surface of newly erupted teeth is more permeable and less resistant to tooth decay. As the enamel matures, it becomes more resistant.

How can you prevent decay in these new teeth?

Good oral hygiene habits, nutrition (including low sugar consumption), together with fluoride, sealants, and regular dental visits strengthen the teeth and can dramatically reduce tooth decay.

How does fluoride protect these teeth?

Fluoride makes the enamel surface harder and more impermeable and, therefore, less susceptible to acid attack and decay. Fluoride adds some protection to the deep pits and fissures of the teeth but they are still at high risk because of their shape and they often need further protection.

What are sealants and how do they work?

Sealants are protective coatings placed in the tiny pits and fissures to seal them from the bacteria and acids that promote decay. They actually “seal” the pits and fissures to prevent decay and can be used in the treatment of very early decay by arresting it. Greater use of sealants could reduce the need for subsequent treatment and prolong the time until treatment may become necessary.

Contact us today to schedule an appointment or to discuss your questions about dental sealants for your children. You can learn more about them by reading the Dear Doctor magazine article “Sealants for Children.”

When you say “ahhhhh,” are you worried about all your unsightly metal fillings? If so, did you know that your dentist can resolve your concerns through the use of tooth-colored fillings?

The public's demand for aesthetic tooth-colored (metal free) restorations (fillings) together with the dental profession's desire to preserve as much natural tooth structure as possible has led to the development of special adhesive tooth-colored restorations. And the demand is not limited to just the front teeth. In fact, many people are opting to replace all of their metal fillings — not just those in the front teeth — so that all of their teeth appear younger, fresher and as if they have never had any cavities.

Can you really mimic natural teeth? Proper tooth restoration is a lot more than just filling holes. It is a unique art applied with scientific understanding. Each tooth's internal shape and structure is the guide to how it must be rebuilt to successfully restore it. However, choosing which material to use to restore or rebuild teeth is a critical one based on scientific understanding, experience and clinical judgment — expertise we use daily in our office. The most popular options include composite resins and porcelains, as they allow us to mimic natural tooth colors and shapes. But for the most life-like, natural tooth-colored filling, your best option is porcelain. Porcelain, which is built up in layers, can be made to mimic the natural translucency and contours of tooth enamel.

But what about matching the color? Will it really match? Absolutely! Whether we use resins or porcelain, through our artistry we will create absolute tooth-like replicas. You will never know your teeth have fillings! And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, thus stabilizing and strengthening them. These techniques are even suitable for children's teeth and can incorporate fluoride to reduce decay.

Still undecided? If so, we understand. Feel free to contact us today to schedule an appointment to discuss your questions about tooth-colored restorations. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”

Thanks to technological advances, today there are more than 40 types of traditional or standard implants. A traditional dental implant actually replaces the root of a tooth, upon which a crown is built — the part you see in the mouth. There are 2 others types that are quite similar to standard implants. Mini implants are most like traditional implants except they are smaller in diameter. Micro-mini implants are an even smaller variation with an even narrower, more screw-like appearance. Micro-mini implants are also designed to be used on a temporary basis, thus can easily be removed. Together all of these types of implants provide us with a wide variety of options for permanently replacing missing teeth.

The following list details the types of implant restorations:

• Single tooth replacements: As the name suggests, these implants are used to replace single teeth.
• Multiple tooth replacements: Implants can be used to replace multiple teeth in a variety of ways. This includes acting as bridge supports to permanently replace missing teeth.
• Combinations of fixed and removable bridgework: Dental implants can be used to support permanently fixed in teeth, bridgework or removable bridges or dentures. Their biggest advantage over dentures alone is that they stabilize the dentures and preserve the jawbone to which they attach, thus preventing the jawbone from melting away under the pressure of dentures.
• Over-dentures: These restorations are now considered the new gold standard. In this application two or more standard implants (or multiple mini-implants) are used to attach and stabilize full dentures. Over-dentures are especially useful for tooth replacement in the lower jaw, where denture stability is often problematic.
• Temporary Anchorage Devices (TADS): These special implants are a tool that orthodontists can use to obtain a stable, non-movable anchor for moving teeth more quickly and easily. They are small, easy to place and easy to remove once their job is done.
• Temporary bridgework: In this case, mini-implants are used to support temporary bridgework. They are placed between permanent implants and later removed when the permanent implants have healed and teeth are permanently placed on them. Mini-implants ensure that a person is never without teeth during the process of teeth replacement.

To learn more on this topic, read the Dear Doctor article, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

We'd like to take a moment to clarify why it is so important to wear the retainer(s) given to you after your orthodontic treatment. These devices, which literally “retain” your teeth in their new and improved positions, are not just for kids. Anyone who has recently had their teeth moved through orthodontics needs to wear them for the prescribed length of time. Here's why:

Though your teeth may now look perfectly aligned, research has shown that there is no “right” position for your teeth to be in that can assure they don't move again — no matter what age you are when treated for malocclusion (“mal” – bad; “occlusion” – bite). In fact, most people will see changes to their bite and tooth alignment as they get older, with or without orthodontic treatment.

For one thing, there is a natural tendency for bottom front teeth to undergo a gradual “uprighting” with age. This can cause them to crowd as they move toward the tongue. And it happens regardless of whether wisdom teeth are present.

In the case of teeth that have been straightened recently, a type of “memory” of their original position may cause them to drift back to it. This tendency gradually lessens, but it may be a problem for up to 18 months.

That's why it's crucial to follow our instructions for wearing retainers. Keep in mind that the plan we have given you is designed to achieve the best possible results in your individual case. Some people will need to wear retainers 24 hours per day, some just at night, and still others on an as-needed basis. You may have received a removable retainer or one that is secured to the back of your teeth. The important thing is to secure the results you've worked so hard to achieve.

If you have any questions about orthodontic retainers, please contact us, or schedule an appointment for an orthodontic consultation.

You can read more about this topic in the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

How much do you know about dental implants? Test yourself with this quiz.

1. Earliest recorded attempts at using dental implants were from
1. Medieval England
2. The ancient Mayans
3. U.S.A. in the 1950s
2. Dental implants are called endosseous. What does this mean?
1. They fuse with the bone
2. They are inside the mouth
3. They are not real teeth
3. What are most dental implants made of?
1. Aluminum
2. Titanium
3. Steel
4. What part of the tooth does an implant replace?
1. The implant is the root replacement
2. The implant is the root plus the crown
3. The implant is the crown
5. What is the success rate of dental implants?
1. 50 percent or less
2. 75 percent
3. 95 percent or more
6. What could cause an implant to fail?
1. Smoking or drug use
2. Poor bone quality and quantity at the implant site
3. Both of the above
7. What is a tooth's emergence profile?
1. The implant and crown's shape as it emerges from beneath the gum line
2. A measure of the urgency of the tooth replacement
3. A measure of the time it takes for you to be able to chew on the new implant
8. What are some of the factors that go into the aesthetics of designing the crown?
1. Choice of materials
2. Color matching
3. Both of the above

1. b. The concept of dental implants goes back to the Mayan civilization in 600 AD.
2. a. The word endosseous (from endo meaning within and osseo meaning bone) refers to the implant's ability to fuse with or integrate with the bone in which it is placed.
3. b. Most implants are made of a titanium alloy, a metallic substance that is not rejected by the body and is able to fuse with the bone.
4. a. The term “implant” refers to the root replacement, which is anchored in the gum and bone. A crown is put around the implant where it emerges from the gumline.
5. c. The majority of studies have shown long term success rates of over 95 percent.
6. c. Factors that could cause an implant to fail include general health concerns such as smoking and drug use, osteoporosis, or a compromised immune system; poor bone quality or quantity; and poor maintenance such as lack of proper brushing and flossing.
7. a. The emergence profile has a lot to do with the implant's natural appearance. It involves the way the crown, which attaches to the implant, seemingly emerges through the gum tissue like a natural tooth.
8. c. Choices such as materials, color, and position can be worked out in the design of a customized temporary crown, which acts as a template or blueprint for a final crown.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”