My Blog

By Paul A. Guidi, DMD, PA
January 25, 2020
Category: Oral Health
NHLIronManKeithYandleSuffersDentalTraumaonIce

Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”

We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.

As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:

  • If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
  • If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
  • If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
  • If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.

Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.

And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.

If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”

By Paul A. Guidi, DMD, PA
January 15, 2020
Category: Dental Procedures
Tags: dentures  
WearingDentures247MayNotBeaGoodIdea-HeresWhy

Today’s technologically advanced dentures aren’t your grandparents’ “false teeth.” Now made with superior materials and processes, you could almost forget you’re wearing them. But don’t let that cause you to leave them in for the night: While it may seem like a harmless thing to do, wearing dentures 24/7 may not be good for them or your health.

For one thing, around the clock denture wearing could worsen bone loss, already a concern with dentures and missing teeth. The forces generated when we chew on natural teeth stimulate new bone growth to replace older bone cells. When teeth go missing, though, so does this stimulus. Even the best dentures can’t restore this stimulation, so bone loss remains a risk.

And, dentures can accelerate bone loss because of the added pressure they bring to the bony gum ridges that support them. Wearing them all the time deprives the gums of any rest, further speeding up the pace of bone loss. Losing bone volume not only affects your overall oral health, it will gradually loosen your dentures’ fit and make them uncomfortable to wear.

Another problem: You may clean your dentures less frequently if you don’t take them out at night. Lack of cleaning can encourage bacterial growth and lead to disease. Studies show that people who don’t take their dentures out at night have more dental plaque accumulation, gum inflammation and higher blood counts of the protein interleukin 6, indicating the body is fighting infection.

And that’s not just a problem for your mouth. Continuous denture wearing could make you twice as likely to develop life-threatening pneumonia as someone who routinely takes their dentures out.

These and other concerns make nightly denture removal a good practice for your health’s sake. While they’re out, it’s also a good time to clean them: Manually brush them for best results (be sure you’re only using regular soap or denture cleanser—toothpaste is too abrasive for them). You can then store them in clean water or a solution designed for dentures.

Having said all that, though, there may be one reason why wearing dentures at night might be beneficial—it may help prevent obstructive sleep apnea. If you have this condition, talk to your dentist about whether wearing your dentures at night has more advantages than disadvantages. And, if bone loss created by wearing dentures is a concern, it could be resolved by having implants support your dentures. Again, discuss this with your dentist.

Taking care of your dentures will help increase their life and fit, and protect your health. And part of that may be taking them out to give your gums a rest while you’re resting.

If you would like more information on denture 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 “Sleeping in Dentures.”

By Paul A. Guidi, DMD, PA
January 05, 2020
Category: Dental Procedures
Tags: veneers  
AvoidPermanentToothAlterationWithNoPrepVeneers

Looking for an affordable way to beautify your smile? The answer could be dental veneers, thin wafers of porcelain bonded to the front of teeth to hide stains, chips or other deformities. Custom-made veneers can look so much like natural teeth in color and shape, it’s hard to tell they’re there.

To achieve this realism, though, it’s usually necessary to alter the tooth first. That’s because a veneer can look unnaturally bulky when bonded to an unprepared tooth. To compensate, we often remove a slight amount of surface enamel so that the veneer’s width won’t be unattractive.

This alteration doesn’t harm a tooth as long as it has a veneer or some other restoration to protect any exposed underlayer of dentin. And because the alteration is permanent, the tooth will need a veneer or other protective covering from then on.

In recent years, though, two new options called no-prep or minimal-prep veneers make it possible to avoid or at least decrease the amount of enamel reduction needed. This is possible thanks mainly to improvements in the strength composition of the dental material used in them.

As a result, these veneers are as thin as contact lenses and may only require slight enamel reshaping to smooth out the sides of the teeth for a better fit. And, unlike traditional veneers, you can have them removed and return to your original look without the need for another restoration.

Low prep veneers are best suited for patients with teeth that are small (or appear small), worn, narrow or only slightly stained or misshapen. Someone with oversized teeth, on the other hand, or that jut forward may still need extensive tooth preparation or even orthodontic work beforehand.

If you do meet the criteria, though, you may be able to benefit from low prep veneers. Because there’s no tooth preparation, you may not even need local anesthesia. And you can reverse the restoration if you desire without harm to your teeth.

To find out if you might benefit from these new kinds of veneers, see us for an initial dental examination to see if you qualify. It’s your first step toward a more beautiful and confident smile.

If you would like more information on no-prep or minimal-prep veneers, 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 “No-Prep Porcelain Veneers.”

By Paul A. Guidi, DMD, PA
December 26, 2019
Category: Oral Health
Tags: dental exam  
YouMayNeedSomethingOtherThanOintmenttoClearupThisFacialRash

During your latest dental cleaning and checkup, your dentist notices a skin rash around your mouth. You sigh—it’s been going on for some time. And every ointment you’ve tried doesn’t help.

You may have peri-oral dermatitis, a type of skin rash dentists sometime notice during dental treatment. It doesn’t occur often—usually in only 1% of the population—but when it does, it can be resistant to common over-the-counter ointments.

That’s because peri-oral dermatitis is somewhat different from other facial rashes. Often mistaken as acne, the rash can appear as small red bumps, blisters or pus-filled pimples most often around the mouth (but not on the lips), nostrils or even the eyes. Sometimes the rash can sting, itch or burn.

People with peri-oral dermatitis often try medicated ointments to treat it. Many of these contain steroids that work well on other skin conditions; however, they can have an opposite effect on peri-oral dermatitis.

Because the steroids cause a constriction in the tiny blood vessels of the skin, the rash may first appear to be fading. This is short-lived, though, as the rash soon returns with a vengeance. Prolonged steroid applications can also thin the affected skin, making it more susceptible to infection and resistant to healing.

Peri-oral dermatitis requires a different treatment approach. The first step is to stop using any kind of steroidal cream, as well as moisturizers, ointments and both prescription and non-prescription medications. Instead, you should only use a mild soap to wash your face.

You may find the rash looking worse for a few days but be patient and continue to avoid ointments or creams. Your healthcare provider may also prescribe oral antibiotics, usually of the tetracycline family. It may take several weeks of antibiotic treatment until the skin noticeably clears up.

For most people, this approach puts their rash into permanent remission. Some, though, may see a reoccurrence, in which case it’s usually best to repeat treatment. With a little patience and care, though, you’ll finally see this persistent rash fade away.

If you would like more information on peri-oral dermatitis, 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.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.