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By Mark J. Schwartz, DMD
October 10, 2018
Category: Dental Procedures
SingerDuaLipaSeestheWisdominPostponingTourDates

When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.

“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”

The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”

A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.

It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.

So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

EarlyInterventioncanCorrectAbnormalUpperJawandPalateGrowth

Poor bites, also known as “malocclusions,” can have a dramatic impact on mouth function and appearance. Moving teeth to better positions will solve most of these bite problems — but not all.

A case in point is a malformed maxilla, the skeletal structure formed by the union of the upper jaw and the roof of the mouth (the palate). If the rear portion of the maxilla develops too narrowly, the back teeth will bite abnormally inside the lower teeth while the front teeth bite normally, creating what’s known as a crossbite. People with this kind of malocclusion often shift their lower jaw to one side to bite down completely.

This can be corrected without too much intervention if the problem is diagnosed while the person is young. This is because the maxilla is actually formed from two bones that don’t completely fuse together in the center of the palate until just after puberty. An orthodontic appliance known as a palatal expander takes advantage of this slight gap. The metal appliance is placed along the narrowed portion of the palate in the rear of the mouth: four metal “arms,” two on each side, attach to the inside of the back teeth with a tension device between them that extends the arms outward to put pressure against the teeth.

Every day the patient or a parent uses a special key to turn the tension device and cause it to expand slightly, placing additional outward pressure on the jaw. This will widen the gap in the center of the palate and new bone will grow to fill in the increased space. Over time this will cause the rear portion of maxilla to widen.

While effective, a palatal expander may not work in every case, and it must be done before the two bones fuse permanently. When it can be used, though, it’s a proven treatment that can restore proper bite function, as well as improve your child’s smile.

If you would like more information on palatal expanders to correct certain bite problems, 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 “Palatal Expanders.”

By Mark J. Schwartz, DMD
September 20, 2018
Category: Dental Procedures
Tags: teeth whitening  
WeighingtheProsandConsofTeethWhitening

Transforming your smile doesn’t necessarily require complex treatments like orthodontics, dental implants or porcelain veneers. Sometimes a little brightness can mean all the difference in the world.

Bleaching (or teeth whitening) is a proven method for dealing with tooth discoloration and staining. Nearly all whitening products, whether home or professional, contain the bleaching agent carbamide peroxide or its breakdown product hydrogen peroxide. These agents effectively diminish staining deep within a tooth (intrinsic) or on the enamel surface (extrinsic), although intrinsic staining will require a more invasive office procedure.

If you have extrinsic staining you have three basic options: dental office bleaching, a retail home kit or a kit purchased from a dentist. Again, you’ll find the same basic bleaching agents in each of these versions. The difference will be the concentration: home kits contain about 10% agent by volume, while the office application will be a much higher range of 15% to 35% (which may also employ specialized lights or lasers to increase the bleaching effect). As a result, an office bleaching may take only a visit or two to achieve the desired brightness while a home kit about two or three weeks.

Whitening is a more economical route for smile enhancement of otherwise sound teeth than other measures. But there are other considerations you should weigh before undergoing a procedure. Whitening isn’t a permanent fix — the brightness will diminish over time, optimally six months to a year in what dentists call the “fade rate.” You can slow this process by avoiding or limiting foods and habits that cause staining.

If you have other dental work — crowns, bridgework or fillings — it may be difficult to achieve a tint level that matches these restorations, especially at home. And while whitening is relatively safe (as long as you’re using your kit as directed), you may experience tooth sensitivity, gum irritation or other minor oral side effects.

Before you decide on whitening, visit us first for a complete dental examination. From there we can advise you on whether whitening is a good smile enhancement choice for you.

If you would like more information on teeth whitening, 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 “Teeth Whitening.”

By Mark J. Schwartz, DMD
September 10, 2018
Category: Oral Health
Tags: oral health   cancer  
LookAfterYourTeethDuringCancerTreatmenttoAvoidDentalDisease

Cancer treatment can be an all-out battle with intense side effects for your entire body. One particular area that can suffer is your mouth.

Chemotherapy and radiation target and destroy cancer cells, which can lead to non-cancerous cells caught in the crossfire and also destroyed. The salivary glands in the mouth are prone to such damage, which could greatly impact your ability to ward off dental disease.

Saliva, what salivary glands produce, plays a major role in oral health. The bodily fluid disseminates antibodies throughout the mouth that fight disease-causing bacteria. It also neutralizes acid, which can erode tooth enamel, and helps restore lost minerals to the enamel.

If the salivary glands become damaged, however, they may produce less saliva and create a condition called xerostomia or “dry mouth.” This is a common occurrence for cancer patients, which can rob them of saliva’s benefits and make them more susceptible to tooth decay or periodontal (gum) disease. The end result could be tooth loss.

There are things you and your dentist can do to prevent this. First, have a complete dental checkup before undergoing cancer treatment. If at all possible have any necessary dental work undertaken (with adequate recovery time afterward) before beginning chemo or radiation. Your dentist and oncologist (cancer specialist) may need to coordinate any planned dental work.

You should also practice daily oral hygiene with brushing and flossing, along with keeping up your regular dental cleanings. This will prevent the buildup on teeth of bacterial plaque, which in turn will reduce your chances for dental disease. Your dentist may also prescribe antibacterial as well as fluoride mouth rinses to help limit the growth of oral bacteria.

To minimize dry mouth, increase your water consumption as much as possible. You may also use saliva boosters like xylitol, an alcohol-based sweetener found in many gums or mints that promotes salivation (it also deters oral bacterial growth).

And don’t forget to maintain a healthy diet, which will not only benefit your stamina during cancer treatment but can also help you maintain better dental health. Providing good care for your mouth during this trying time will help ensure your teeth and gums stay as healthy as possible.

If you would like more information on oral 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 “Oral Health During Cancer Treatment.”

ADifferentKindofChipShotforProGolferDanielleKang

While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.

“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.

Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.

Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).

For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.

Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.

If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”





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