My Blog

By David R. Leonoff, DDS, PC
January 21, 2021
Category: Dental Procedures
Tags: bridge   partial denture  
TwoGoodOptionsforTemporarilyReplacingaTeenagersMissingTooth

While anyone can lose a permanent tooth, the cause often varies by age group. Adults usually lose their teeth to disease, while those under twenty lose a tooth to accidents.

For adults, a dental implant is usually the best way to replace a missing tooth. Teenagers and younger, on the other hand, must wait to get implants until their jaws fully develop. An implant placed on an immature jaw will eventually look and feel out of place.

For most, their jaws won't reach full maturity until their early twenties. Even so, they still have a couple of good options for restoring their smiles in the meantime, albeit temporarily.

One is a removable partial denture or RPD, a device with the replacement prosthetic (false) tooth or teeth set in a gum-colored acrylic base. Of the various types of RPDs, most teenagers do well with a rigid but lightweight version called a “flipper,” called so because it can be flipped in and out of place with the tongue.

These RPDs are affordable, their fit easily adjusted, and they make cleaning the rest of the teeth easier. But they can break while biting down hard and—because they're dentures—aren't always well accepted among teenagers.

The other option is a bonded bridge. Unlike a traditional bridge secured with crowns cemented to natural teeth, a bonded bridge uses a strip of dental material affixed to the back of the prosthetic tooth with the ends of the strip extending outward horizontally. With the prosthetic tooth inserted into the empty space, these extended ends are bonded to the backs of the natural teeth on either side.

Though not as secure as a traditional bridge, a bonded bridge is more aesthetic and comfortable than an RPG. On the other hand, patients who have a deep bite or a teeth-grinding habit, both of which can generate abnormally high biting forces, run a higher risk of damaging the bridge. A bridge can also make hygiene tasks difficult and time-consuming, requiring a high degree of self-discipline from the patient.

Whichever you choose, both options can effectively replace a teenager's missing tooth while waiting for dental implants. Although temporary, they can make the long wait time for a teenager more bearable.

If you would like more information on restorations for children and teens, please contact us or schedule an appointment for a consultation.

By David R. Leonoff, DDS, PC
January 11, 2021
Category: Dental Procedures
Tags: crowns  
HeresWhatYouNeedToKnowAboutDentalInsuranceandChoosingaCrown

Millions of Americans rely on dental insurance to help them better afford dental care. Depending on the benefit package, an insurance policy can be useful in restoring dental health compromised by disease or injury.

But how life-like that restoration may appear is often a secondary concern with many insurance plans. For example, dental insurance will pay for a crown restoration that restores function to a tooth, but not necessarily of the highest aesthetic quality for achieving a truly life-like appearance.

To be sure, not all dental crowns are the same. Some are all metal, usually gold or silver. Some are “hybrids,” made of an interior metal shell with an outer fused porcelain shell (porcelain-fused-to-metal or PFM). In recent years all -ceramic crowns made of stronger life-like ceramics have become the most popular.

The type of crown used will depend a great deal on the type and location of the tooth. Teeth on the back of the jaw that encounter greater biting forces and are not as noticeable in the smile may do better with a metal or PFM crown. Visible side and front teeth are more likely candidates for all-ceramic. Your dentist will give you your best options as it pertains to your dental needs and appearance.

There's also a difference in crown workmanship. Dental laboratories now use milling machinery that sculpts a crown from a single block of material. Although some final handwork by skilled technicians is still necessary, milling has streamlined the process—and the cost—for producing a crown of high functioning quality.

But crowns that achieve the most natural smile appearance require more in the way of artistic craftsmanship. This in turn can increase the crown's price—beyond what many dental policies agree to cover. You may then be faced with a decision: an insurance-covered functional crown with an acceptable level of life-likeness or a more life-like crown for which you may have to pay more out-of-pocket.

Your dentist can advise you on your best options for a crown restoration, also factoring in what your insurance will cover. Ultimately, though, you'll have to weigh the kind of smile you desire with your dental situation and finances.

If you would like more information on dental crown restorations, 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 “Porcelain Dental Crowns.”

By David R. Leonoff, DDS, PC
January 01, 2021
Category: Oral Health
Tags: oral health  
WhatYouShoulddoAboutThisBizarreDrugSideEffect

Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.

But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."

It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.

We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.

While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.

One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.

If you would like more information on reactions to medication that might affect your oral health, please contact us or schedule an appointment for a consultation.

KevinBaconsMango-SlicingTrickandOtherWaystoRidFoodBetweenYourTeeth

During the COVID-19 quarantines, stir-crazy celebrities have been creating some “unique” home videos—like Madonna singing about fried fish to the tune of “Vogue” in her bathroom or Cardi B busting through a human-sized Jenga tower. But an entertaining Instagram video from Kevin Bacon also came with a handy culinary tip: The just-awakened film and TV actor showed fans his morning technique for cutting a mango to avoid the stringy pulp that gets between your teeth. After cutting a mango in half, he scored it lengthwise and crosswise to create squares and then turned the mango inside out for easy eating.

With his mango-slicing video garnering over a quarter-million views, the City on a Hill star may have touched a nerve—the near universal annoyance we all have with food stuck between our teeth. Trapped food particles aren't only annoying, they can also contribute to a bacterial film called dental plaque that's the top cause for tooth decay and gum disease.

Unfortunately, it's nearly impossible to avoid stuck food if you love things like popcorn, poppy-seed muffins or barbecue ribs. It's helpful then to have a few go-to ways for removing food caught between teeth. First, though, let's talk about what NOT to use to loosen a piece of stuck food.

A recent survey of more than 1,000 adults found that when removing something caught between our teeth, we humans are a creative lot. The makeshift tools that survey respondents said they've used in a pinch included twigs, safety pins, screwdrivers and nails (both the hammer and finger/toe variety). Although clever, many such items are both unsanitary and harmful to your gums and tooth enamel, especially if they're metallic or abrasive.

If you want a safe way to remove unwanted food debris, try these methods instead:

Brush your teeth: The gentle abrasives in toothpaste plus the mechanical action of brushing can help dislodge trapped food.

Use dental floss: A little bit of dental floss usually does the trick to remove wedged-in food—and it's easy to carry a small floss container or a floss pick on you for emergencies.

Try a toothpick. A toothpick is also an appropriate food-removing tool, according the American Dental Association, as long as it is rounded and made of wood.

See your dentist. We have the tools to safely and effectively remove trapped food debris that you haven't been able to dislodge by other means—so before you get desperate, give us a call.

You can also minimize plaque buildup from food particles between teeth by both brushing and flossing every day. And for optimally clean teeth, be sure you have regular dental office cleanings at least twice a year.

Thanks to Kevin Bacon's little trick, you can have your “non-stringy” mango and eat it too. Still, you can't always avoid food getting wedged between your teeth, so be prepared.

If you would like more information about effective oral hygiene practices, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By David R. Leonoff, DDS, PC
December 12, 2020
Category: Oral Health
Tags: oral health   nutrition  
KeepaLidonSugarThisHolidayforHealthierTeethandGums

During this time of year, many of us dust off traditional family recipes and make our favorite holiday treats. There is, however, a small price to pay for all that nostalgic goodness in the shape of a few extra pounds to deal with in the new year. We may also be increasing the risk for something even more unpleasant: tooth decay.

The main cause, of course, is a certain carbohydrate integral to many holiday goodies: sugar.  We humans love it, but so do oral bacteria that readily devour any sugar lingering in our mouth after eating. This fuels bacterial reproduction, which in turn increases the production of acid that softens tooth enamel.

There are a number of strategies you can follow to reduce this effect. You can remove sugar completely from your holiday preparations—and risk family and friends “voting you off the island.” Or, you can try these tips for easing the impact of holiday sugar on your dental health.

Look for ways to reduce sugar. Just because you're not throwing the sugar bowl out the window doesn't mean you have to go all out using it. Instead, try to modify older recipes (or look for newer versions) to decrease the amount of sugar in candies and baked goods. You may also consider alternative sweeteners like sucralose that tolerate high baking temperatures.

Balance savory with sweet. Not all holiday treats need to be sweet—you can add items that take advantage of more savory seasonings. For example, try offering up popcorn with a sprinkling of cinnamon or other holiday spice, or a creative assortment of cheeses (which in turn promote saliva flow to neutralize acid).

Combine treats with mealtimes. Continuous snacking may be part of the holiday tradition, but it can also raise the risk for tooth decay. Acidity increases when we eat, but saliva normally neutralizes it within thirty minutes to an hour. However, saliva can get overwhelmed during continuous snacking, resulting in longer periods of high acidity that damages tooth enamel. Instead, try to combine snack times with mealtimes.

Don't neglect your oral hygiene. Even though things can get hectic during the holidays, make a point of keeping up daily brushing and flossing. Regular hygiene keeps dental plaque, a thin film of harmful bacteria and food particles (including sugar), from building up on your teeth. Reducing plaque lowers your overall decay risk. Attention to oral health through your day-to-day dental hygiene routine along with regular professional cleanings and checkups is the best thing you can do to avoid dental disease.

The holidays should be a joyous time for you and your family. They can also be a healthy time for your teeth and gums, if you minimize the role of sugar in your holiday treats.

If you would like more information about boosting your dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”





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