My Blog
By George Debbaneh, DDS
September 17, 2020
Category: Dental Procedures
Tags: dental injury  
ActQuicklyWithaKnockedOutToothtoEnsureItsLong-TermSurvival

We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.

Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.

That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.

Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.

Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:

  1. Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
  2. Reinsert the root end into the empty socket with firm pressure;
  3. Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
  4. Seek dental or emergency medical care immediately;
  5. If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.

You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.

If you would like more information on what to do in a dental emergency, 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 “When a Tooth is Knocked Out.”

By George Debbaneh, DDS
September 07, 2020
Category: Dental Procedures
ImproveYourSmileWithTheseDentalEnhancements

In case you missed it, September is Self-Improvement Month. Don't fret if you weren't aware—we're not sure how the ninth month acquired this celebration of positive human development either. But as long as we're celebrating, do something good for yourself—like improving your smile.

If this doesn't seem like a lofty enough self-improvement goal, remember this: There's much more to a smile than its looks. Smiles “speak” a social language, allowing us to wordlessly communicate acceptance, happiness, or even sympathy. A smile is a valuable part of beginning and maintaining relationships, be they familial, social or professional.

So why not go all out and enhance your smile during Self-Improvement Month? To that end, here are a few options:

Teeth whitening. Maybe your teeth are a little yellowed. If you have mild to moderate enamel staining, consider undergoing a professional whitening procedure. We use a safe but effective solution to give you just the level of brightness you want. And with proper maintenance and occasional touch-ups, you can have a brighter smile for years.

Bonding, veneers or crowns. If your teeth have chips, heavy discolorations or other mild to moderate defects, we can offer a variety of solutions. We can bond special dental materials to repair slight defects that make a tooth look good as new. For moderate flaws, heavy staining or slight gaps, we can bond a custom-made veneer to the front of teeth to hide these imperfections. We can also cap teeth with natural-looking crowns to cover larger disfigurements.

Orthodontics. Misaligned teeth can detract from an otherwise attractive smile. Orthodontics can help—and as long as you're in good oral and general health, you can undergo bite correction at any age. Braces aren't your only option: Removable clear aligners are nearly invisible to others, and because they're removable, they make it easier to keep your teeth clean.

Dental implants. Missing teeth can definitely dim a smile. And while there are a number of restoration options, dental implants are one of the top choices. Implants not only look and feel lifelike, they're exceedingly durable. Although they may be more expensive up-front, they have been shown to last longer and tend to require less maintenance than other restorations. Dental implants are a worthwhile investment in a long-term smile.

Cosmetic enhancements like teeth whitening or bonding may require only one or two visits, while other options like orthodontics or implants can take much longer. But you can still get the ball rolling now. Make an appointment this month for a full dental exam and consultation to start your journey toward improving your smile.

If you would like more information about enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cosmetic Dentistry: A Time for Change.”

By George Debbaneh, DDS
August 28, 2020
Category: Oral Health
Tags: dry mouth  
TakeTheseStepstoAlleviateChronicDryMouth

You might be noticing some changes as you get older: You're getting winded easier and you're wondering why book or magazine print has suddenly shrunk (it didn't). Perhaps you've also noticed your mouth seems drier more often.

It could be a condition called xerostomia, in which your body isn't producing enough saliva. Older people are more prone to it because it's often a side effect of prescription drugs that can inhibit saliva production. Because seniors tend to take more medications than other age groups, xerostomia is a more common problem for them.

Xerostomia isn't a pleasant experience. More importantly, it's hazardous to your oral health. Saliva contains antibodies that fight bacterial infection, and it also neutralizes mouth acid that causes tooth decay. A lack of saliva puts you at greater risk for both tooth decay and gum disease.

Fortunately, there are things you can do to alleviate or ease the effects of xerostomia.

Cut back on spicy foods and caffeinated beverages. Spicy or salty foods can irritate your gum tissues and worsen dry mouth symptoms. Because it's a diuretic, caffeine causes you to lose more fluid, something you can't afford with xerostomia. Cutting back on both will improve your symptoms.

Drink more water. Increasing your daily water intake can help you produce more saliva. It also washes away food particles bacteria feed on and dilutes acid buildup, which can reduce your risk for dental disease.

Talk to your doctor and dentist. If you're taking medications with dry mouth side effects, ask your doctor about other alternatives. You can also ask your dentist about products you can use to boost saliva production.

Practice daily hygiene. Daily hygiene is important for everyone, but especially for those whose saliva flow is sub-par. Brushing and flossing clear away dental plaque, the top cause for dental disease. Along with regular dental visits, this practice can significantly reduce your risk for tooth decay and gum disease.

Taking these steps can help you avoid the discomfort that often accompanies xerostomia. It could also help you prevent diseases that could rob you of your dental health.

If you would like more information on dealing with dry mouth, 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 “10 Tips for Dealing With Dry Mouth.”

TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

By George Debbaneh, DDS
August 08, 2020
Category: Dental Procedures
Tags: dentures  
DenturesareStillaViableChoiceforToothReplacement

Edentulism, the loss of all of a person’s teeth, is more than an appearance problem. As one in four Americans over 65 can attest, total tooth loss can lead to emotional suffering, social embarrassment and a lack of nutrition caused by limited food choices.

But there are solutions like the removable denture, an effective dental restoration for more than a century. In its current advanced form, the removable denture is truly a functional, affordable and attractive way to restore lost teeth.

Creating an effective denture begins first by taking detailed impressions of a patient’s gum ridges. We use the measurements obtained from this process to create a plastic resin base colored to resemble the natural gums.  Using old photos and other resources documenting how the patient looked with teeth, we choose the best size and shape of porcelain teeth and then position them onto the base.

Finally, we fine-tune the dentures the first time they’re in the patient’s mouth to make sure they have a secure fit and a balanced bite when the jaws come together. We also want to be sure the dentures are attractive and blend well with other facial features. The result:  a new set of teeth that can do the job of the old ones and look nearly as real and attractive.

Dentures, though, do have one major drawback: they can’t stop bone loss, a common consequence of missing teeth. In fact, they may even accelerate bone loss due to the pressure they bring to bear on the gum ridges. Continuing bone loss could eventually cause their once secure fit to slacken, making them less functional and much more uncomfortable to wear.

But a recent innovation could put the brakes on bone loss for a denture wearer. By incorporating small implants imbedded at various places along the gums, a denture with compatible fittings connects securely with the implants to support the denture rather than the gum ridges. This not only relieves pressure on the gums, but the titanium within the implants attracts bone cells and stimulates their growth.

Thanks to this and other modern advances, dentures continue to be a solid choice for tooth replacement. Not only can they restore a lost smile, they can improve overall health and well-being too.

If you would like more information on dental restorations for missing teeth, 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 “Removable Full Dentures.”





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