My Blog

By Dr. Edward Portnoy and Dr. Grace D'oria
January 23, 2020
Category: Dental Procedures
LadyGagaWasntBornThisWay

Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"

"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.

The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.

Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.

Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).

The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.

Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.

So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”

By Dr. Edward Portnoy and Dr. Grace D'oria
January 13, 2020
Category: Oral Health
Tags: oral health  
NoMatterWhentheNewDecadeBeginsBeSureYourePartneredWithUsforYourDentalCare

The 2020s are here, so throw those “new decade” parties! Well, maybe. Some of your party guests might insist the Twenties won't begin until January 1, 2021. For some reason, feelings can run hot on both sides of this “debate,” enough to warm up everyone's eggnog. Instead, steer the conversation to something a little less controversial: how to achieve the best possible dental health in the upcoming decade (whenever it comes!).

Sadly, many folks don't pay attention to their dental health until it's in dire need of attention. The better approach is to be proactive, not reactive: doing things now to ensure healthy teeth and gums years, and decades, later.

If you say brush and floss daily, you're already ahead of the game. Nothing you do personally promotes a healthy mouth more than dedicated oral hygiene. But there's one more critical piece to proactive dental care—a solid partnership with us, your dental professionals. Working together, we can help ensure you remain healthy dental-wise for the long term.

To understand the value of this partnership, it helps to think of dental care as a four-phased cycle:

Identifying your individual dental risks. Because of our individual physical and genetic makeup, each of us faces different sets of risks to our dental health. Over the course of regular dental visits, we can identify and assess those weaknesses, such as a propensity for gum disease or structural tooth problems due to past tooth decay.

Designing your personal care program. Depending on your risk profile assessment, we can develop an ongoing personal care program to minimize those risks. Part of this risk-lowering plan will be identifying recommended prevention measures like enhanced fluoride applications or areas that need correction or treatment.

Treating dental problems promptly. The key to the best possible dental health is treating any arising problems as soon as possible. Diseases like tooth decay or gum disease only get worse with time and cause more damage the longer they go untreated. Treatment, though, can also extend to less urgent matters: Straightening crooked teeth, for example, can make it easier to keep them clean.

Maintaining your optimum level of health. Through comprehensive treatment and care, we can help you reach “a good place” in your dental health. But we can't stop there: We'll continue to monitor for health changes and maintain the good practices we've already established through regular care. And with any new developments, we begin the cycle again to keep you focused on optimum dental health.

No one knows what their life will be like passing through the next decade. But one thing's for certain: A dental care partnership with us can help you achieve the health you desire for your teeth and gums.

If you would like more information about ongoing dental care, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Successful Dental Treatment” and “Cost-Saving Treatment Alternatives.”

By Dr. Edward Portnoy and Dr. Grace D'oria
January 03, 2020
Category: Oral Health
Tags: nutrition   oral health  
FollowtheFast-FoodLeadCutBackSodasinYourChildsDiet

You can find some version of the ever popular kids’ meal at most major fast-food restaurants. It’s a neat little package: child’s size portions of burgers, chicken nuggets or sides—and often a small toy or treat to boot—all tucked into its own colorful cardboard container.

The drive-thru menu board at your favorite fast-food joint gives you plenty of choices to fill out your child’s meal. But you may notice something missing on many major chains’ kids’ menus—the mention of soft drinks as a beverage choice. You can still get one for your child’s meal, but the visual cue is no more on the menu board.

None of the “Big Three”—Burger King, McDonald’s or Wendy’s—post soft drinks as a menu item for their kid’s meals. It’s the result of an effort by health advocates promoting less soda consumption by children, the leading source of calories in the average child’s diet. With its high sugar content, it’s believed to be a major factor in the steep rise in child obesity over the last few years.

Sodas and similar beverages are also prime suspects in the prevalence of tooth decay among children. Besides sugar, these beverages are also high in acid, which can erode tooth enamel. These two ingredients combined in soda can drastically increase your child’s risk of tooth decay if they have a regular soda habit.

You can minimize this threat to their dental health by reducing their soda consumption. It’s important not to create a habit of automatically including sodas with every meal, especially when dining out. Instead, choose other beverages: Water by far is the best choice, followed by regular milk. Chocolate milk and juice are high in sugar, but they’re still a healthier choice than sodas due to their nutrient content.

Keeping sodas to a minimum could help benefit your child later in life by reducing their risk for heart disease, diabetes and other major health problems. It will also help them avoid tooth decay and the problems that that could cause for their current and future dental health.

If you would like more information on these and other effective practices for protecting your child against tooth decay, please contact us or schedule an appointment for a consultation.

By Dr. Edward Portnoy and Dr. Grace D'oria
December 24, 2019
Category: Dental Procedures
Tags: dental treatment  
TreatingaYoungPermanentToothRequiresaDifferentApproach

Soon after the primary (baby) teeth begin to give way, the teeth a child will have the rest of their lives start erupting into the mouth. But while they’re permanent, they’re not as strong and developed as they will be in adulthood.

That’s why we treat young permanent teeth differently from older adult teeth. For example, a decayed adult tooth may need a root canal treatment; but this standard treatment would often be the wrong choice for a child’s tooth.

The reason why involves the pulp, the innermost layer of a tooth, which plays a critical role in early development. Young permanent teeth continue to grow in sync with the jaws and facial structure. Most of this growth is in the dentin, the layer between the enamel and pulp, which increases proportionally to the other layers as the tooth matures. The pulp generates this new dentin.

A root canal treatment completely removes the diseased tissue of the pulp. This isn’t a major issue for a mature tooth because it no longer needs to generate more dentin. But it can have long-term consequences for an immature tooth whose growth may become stunted and the roots not fully formed. The tooth may thus become brittle and darkened, and might eventually require removal.

Because of these potential consequences, a root canal treatment is a last resort for a young permanent tooth. But there are modified alternatives, depending on the degree of pulp exposure or infection. For example, if the pulp is intact, we may be able to remove as much soft decayed dentin as we can, place an antibacterial agent and then fill the tooth to seal it without disturbing the pulp. If the pulp is partially affected, we can remove that part and place substances that encourage dentin growth and repair.

Our main goal is to treat a young tooth with as little contact with the pulp as possible, so as not to diminish its capacity to generate new dentin. Avoiding a full root canal treatment if at all possible by using these and other techniques will help ensure the tooth continues to develop to full maturity.

If you would like more information on dental care for children, 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 “Saving New Permanent Teeth after Injury.”

By Dr. Edward Portnoy and Dr. Grace D'oria
December 14, 2019
Category: Dental Procedures
Tags: celebrity smiles   veneers  
HowVeneersRestoredHowieMandelsWinningSmile

You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.

The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.

But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.

Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.

His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.

One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.

In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.

Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.

If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”





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.