My Blog

By Mark J. Schwartz, DMD
December 05, 2017
Category: Dental Procedures
Tags: gum disease   loose tooth  
HaveaLooseToothYoullNeedThisTwo-PhaseTreatmenttoSaveIt

Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.

One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.

Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.

Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.

The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.

Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.

The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.

Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.

If you would like more information on loose teeth and gum disease, 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 “Treatment for Loose Teeth.”

By Mark J. Schwartz, DMD
November 20, 2017
Category: Oral Health
AnyTimeAnyPlaceCamNewtonsGuidetoFlossing

When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?

For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.

Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.

Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:

  • It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
  • A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
  • Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
  • Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!

Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!

If you would like more information about flossing and oral hygiene, contact us or schedule an appointment for a consultation.

By Mark J. Schwartz, DMD
November 12, 2017
Category: Oral Health
Tags: nutrition   tmj disorders  
UseTheseTechniquestoEnjoyHealthyFoodsEvenwithaJawJointDisorder

We don’t often think about it, but eating is a multi-staged process. It starts, of course, with food that’s hopefully high in nutritional value. But you also need coordinated jaw action to chew and shred your food that when combined with the enzymes in saliva can then be effectively digested in the stomach.

But what if you’re unable to chew some foods because you suffer from chronic jaw pain and dysfunction? This is the situation for millions of people who suffer from problems associated with the jaw joints—temporomandibular joint disorders (TMD). It’s not just the chronic pain and discomfort TMD can cause that’s a real issue—it may also be preventing you from eating foods that are healthy for you.

Because TMD can make it difficult to open your jaws wide or causes pain when you bite down, you might especially have trouble with certain fruits and vegetables as well as many meats. Many people opt to skip otherwise healthy foods because they’re too difficult to eat. That, however, could lead to lack of proper nutrition in the long run.

But with a few techniques and modifications, you can still include many of these foods in your diet even when TMD discomfort flares up. For one, be sure to cut all your food portions (including toast) into small, bite-sized pieces. These should be small enough to limit the amount of jaw opening required to comfortably place the bite in your mouth and chew. When preparing your food, be sure to peel fruits and vegetables that have skin, which is often hard to chew.

You should also try cooking crisper fruits and vegetables to a soft, moist texture. Choose meat cuts, poultry or seafood that can be cooked to a tender, moist consistency—you can also use gravies and sauces to further moisten them.

And don’t forget to chew slowly. Not only does slower eating aid in digestion, it will help you avoid overworking your jaw joints.

With a few adjustments you can have a normal, nutritious diet and minimize the discomfort of your TMD symptoms. Continual healthy eating is a must for overall health and quality of life.

If you would like more information on reducing the impact of TMD on your life and health, 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 “What to Eat When TMJ Pain Flares Up.”

By Mark J. Schwartz, DMD
October 28, 2017
Category: Oral Health
GumDiseaseCouldAffectMorethanYourTeethandGums

If you have periodontal (gum) disease, it's important for you to know its effects aren't limited to your mouth. A number of studies demonstrate gum disease can affect the rest of your body — and what may be going on elsewhere could likewise stimulate gum disease.

Here are 3 diseases or conditions that seem to share a link with gum disease.

Diabetes. This chronic disease results from the body's inability to interact properly with insulin, the hormone necessary for turning glucose (sugar) into energy, or producing enough of it. There's clear evidence that having diabetes increases your risk of gum disease and vice-versa. If you have diabetes, it's important that you keep it under control for your gum's sake as much as for your overall health.

Cardiovascular disease. Like diabetes, this group of heart and blood vessel diseases has a related characteristic with gum disease: inflammation. This natural function of the immune system limits tissue damage caused by disease or injury. But in both CVD and gum disease, inflammation can become chronic and itself cause damage. Further, some types of bacteria associated with gum disease can contribute to a higher risk of CVD. Minimizing gum disease occurrence with good oral hygiene could positively impact your risk of CVD.

Pregnancy. While certainly not a disease, pregnancy does trigger hormonal changes in the mother that in turn could elevate her risk of gum disease, particularly pregnancy gingivitis. Not only does this pose problems for the mother's teeth and gums, some studies connect gum disease to the increased possibility of early, pre-term birth. A sharper focus on dental care during pregnancy not only benefits the mother but may also be important for the health of the baby.

These aren't the only conditions that can be affected by gum disease: others like osteoporosis, respiratory disease or rheumatoid arthritis also share links with the disease. If you have any systemic condition like these, it pays to be extra vigilant in preventing and treating gum disease.

If you would like more information on periodontal (gum) disease, 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 “Good Oral Health Leads to Better Health Overall.”

By Mark J. Schwartz, DMD
October 13, 2017
Category: Oral Health
OralHealthConcernsforPreteens

As if the preteen years didn’t give kids and their parents enough to think about, new oral health concerns loom on the horizon. Along with major changes to the body, brain and emotions, additional risk factors for tooth decay and gum disease appear during adolescence — the period of development starting around age 10 and extending through the teen years that marks the transition from childhood to adulthood.

Even with declining rates of tooth decay across the nation, the cavity rate remains high during adolescence. According to the American Academy of Pediatrics, 1 in every 5 adolescents has untreated tooth decay. What’s more, the onset of puberty — usually beginning around age 10-11 in girls and 11-12 in boys — brings changes in hormone levels that can affect gum health.

We all have millions of microorganisms in our mouth, representing hundreds of different species of mostly helpful, but some harmful, bacteria. Research has shown that total oral bacteria increases between ages 11 and 14, and new types of bacteria are introduced, including some that are not friendly to teeth and gums. Some unfamiliar microbes trigger an exaggerated inflammatory response to dental plaque, so gum bleeding and sensitivity are experienced by many children in this age group. In fact, “puberty gingivitis,” which peaks around age 11-13, is the most common type of gum disease found during childhood.

A combination of hormones, lifestyle changes and poor oral hygiene habits raises the risk of oral health problems among adolescents. A more independent social life may be accompanied by a change in eating habits and easier access to snacks and beverages that are sugary, acidic (like sports drinks and soda) or full of refined carbohydrates — none of which are tooth-healthy choices. And as children move toward greater independence, parents are less likely to micromanage their children’s personal care, including their oral hygiene routines. Good oral hygiene can keep dental plaque at bay, lowering the chance of having gingivitis and cavities. But let’s face it: Adolescents have a lot to think about, and keeping up with their oral health may not be a priority.

To help your preteen stay on top of their oral health, keep healthy snacks at home for your children and their friends and make sure you are well stocked with supplies such as new toothbrushes, floss and toothpaste. In addition, most preteens (and teens) can benefit from gentle reminders about oral hygiene routines.

For optimal oral health through all stages of life, make sure your preteen keeps up with professional teeth cleanings and exams, and talk with us about whether fluoride treatments or sealants may be appropriate for your child.

For more on your child’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Dentistry & Oral Health For Children” in Dear Doctor magazine.





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