My Blog

Posts for: December, 2017

By Dr. Edward Portnoy and Dr. Grace D'oria
December 20, 2017
Category: Dental Procedures
LasersareMakinganImpactinTreatingGumDisease

Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.

To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.

 While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.

The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter. It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.

 Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.

Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.

If you would like more information on your treatment options for 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”


By Dr. Edward Portnoy and Dr. Grace D'oria
December 05, 2017
Category: Dental Procedures
Tags: orthodontics   adult braces  
YourAgeWontNecessarilyDecideAgainstStraighteningYourSmile

It’s something you think about often—especially when you look in a mirror or at a photo of yourself. You wish something could have been done about it a long time ago. But now you think you’re too old to correct your misaligned teeth—your “crooked” smile.

Actually, you can transform your smile through orthodontics, whatever your age. Millions of your peers have done just that—currently, an estimated one in five orthodontic patients is an adult.

If orthodontics isn’t right for you it won’t be because of age, but most likely the condition of your gums and underlying bone or your overall health. That first factor is extremely important: if you’ve lost a significant amount of bone due to periodontal (gum) disease, there may not be enough to support the force of moving the teeth during orthodontics.

Health conditions like severe heart-valve disease, uncontrolled diabetes or drugs to treat arthritis or osteoporosis can also make tooth movement difficult. And, if you have restricted saliva flow (dry mouth), wearing orthodontic devices could be uncomfortable and increase your risk of tooth decay.

If, however, your mouth and body are reasonably healthy (and you don’t have a difficult bite problem to correct), there’s no reason why you can’t undergo orthodontic treatment. The only other thing that might hold you back is concern over your appearance during treatment. Many adults balk at the possible embarrassment of wearing metal braces “at their age.”

If this is a concern, you may have an alternative: clear aligners. These are a series of computer-generated clear plastic trays that conform to the individual contours of your teeth. Each tray is slightly different—you wear one for a short period of time (usually two weeks) before moving on to the next tray to successively and gradually move your teeth. They’re nearly invisible to others and, unlike fixed metal braces, you can take them out for a rare special occasion.

The only way you’ll know whether correcting your misaligned teeth is a viable option is to undergo a full orthodontic evaluation. From there we can help you decide if and how you want to gain a straighter, more attractive smile.

If you would like more information on adult orthodontics, 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 “Orthodontics for the Older Adult.”