My Blog

Posts for: October, 2018

By Dr. Edward Portnoy and Dr. Grace D'oria
October 30, 2018
Category: Dental Procedures
Tags: dental implants   diabetes  
DiabetesDoesntHavetoStopYouFromAcquiringDentalImplants

One of the best and most successful tooth replacement choices available is the dental implant. No other restorative method is as similar in both form and function to a real tooth as an implant; and with a success rate of 95-plus percent after ten years, it’s one of the most durable.

But there can be extenuating circumstances that make obtaining an implant difficult or sometimes impossible. One possible problematic situation is the systemic disease diabetes.

Diabetes is a hormonal condition in which the body is unable to sufficiently regulate the amount of glucose (a basic sugar that provides energy to the body’s cells) within the blood stream. Normally, the pancreas produces the hormone insulin to reduce excess glucose. But diabetes interferes with this insulin production: if you have Type 1 diabetes, the pancreas has stopped producing insulin altogether; if you have the more common Type 2, the body doesn’t produce adequate insulin or it doesn’t respond sufficiently to the insulin produced.

Over time diabetes can affect other areas of health, especially wound healing. Because the condition gradually causes blood vessels to narrow and stiffen, the normal inflammatory response to disease or trauma can become prolonged. This in turn slows the rate of wound healing.

Slow wound healing can have a bearing on the recovery period just after implant surgery, especially the necessary integration process that takes place between the bone and the titanium metal implant that provides its signature strength. If that process is impeded by slow wound healing caused by diabetes, the risk increases dramatically for implant failure.

That’s the worst case scenario if you have diabetes, but only if your condition is out of control. If, however, you have your blood sugar levels well regulated through medication, diet and exercise, then your chances for implant success could easily be on par with someone without diabetes.

So if you’re diabetic and are considering dental implants for missing teeth, it’s important to discuss the possibility of obtaining them with both your dentist and the physician caring for your diabetes. With your overall healthcare team working together, there’s no reason why diabetes should stop you from enjoying this premiere restoration for missing teeth.

If you would like more information on obtaining dental implants, 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 “Dental Implants & Diabetes.”


By Dr. Edward Portnoy and Dr. Grace D'oria
October 20, 2018
Category: Oral Health
Tags: teeth grinding   tooth wear  
DontStressOverYourChildsTeethGrindingHabitUnlessitPersists

Along with thumb sucking, childhood teeth grinding is one of the top concerns anxious parents bring to their dentists. It’s so prevalent, though, many providers consider it normal behavior—the sleep-disturbing sound it can generate is often the worst consequence for the habit.

But that doesn’t mean you should brush aside all concern, especially if the habit continues into late childhood. Long-term teeth grinding could eventually damage the teeth and gums.

Teeth grinding (or clenching) is the involuntary movement of the jaws when not engaged in normal functions like chewing, speaking or swallowing. The action often produces higher than normal chewing forces, which over time can accelerate tooth wear, cause fractures, or contribute to loose teeth, all of which could increase the risk of dental disease. While it can occur at any time it’s most common among children during nighttime sleep.

While stress is the usual trigger for teeth grinding in adults, with young children the causes for the habit are more complex and less understood. Most doctors hold to the theory that most pediatric teeth grinding arises during shifts from lighter to heavier, rapid-eye-movement (REM) sleep. The child’s immature neuromuscular chewing control may engage involuntarily during this shift. Teeth grinding is also prevalent among children who snore or mouth-breathe, or who take anti-depressant medication.

But as mentioned before, there’s usually no cause for concern unless the habit persists beyond about age 11. If the habit isn’t fading, you should speak to your dentist about ways to reduce it or its effects. One way is with a custom-made night guard worn during sleep. The smooth, plastic surface of the appliance prevents teeth from making solid contact with each other during a grinding episode.

You might also seek treatment from an ear, nose and throat (ENT) specialist if your child is having issues with airway obstruction, which could also relieve teeth grinding. And children experiencing stressful situations or events may find relief both emotionally and physically from psychological therapy.

At younger ages, you can safely regard your child’s grinding habit as normal. But if it persists, it’s worth looking for ways to reduce it.

If you would like more information on your child’s teeth grinding habit, 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 “When Children Grind Their Teeth: Is the Habit of ‘Bruxism’ Harmful?


By Dr. Edward Portnoy and Dr. Grace D'oria
October 10, 2018
Category: Oral Health
Tags: tooth decay  
NewDentalAdvancesPromiseBetterOutcomesforTreatingDecay

Over the last century effectively treating a decayed tooth has often required removing any decayed structure with drilling and then filling the remaining cavity. While this approach does save teeth that might otherwise be lost, it can also result in a fair amount of healthy structure removed in the process.

But continuing advances in dentistry are now making possible a new approach to tooth decay treatment that preserves as much of the healthy portions of tooth as possible. This new way is often referred to as minimally invasive dentistry (MID).

The primary goal of MID treatment is to intercept and treat decay as early as possible to minimize tooth damage. It begins with helping patients identify their own individual risk factors for decay such as the presence of disease-causing bacteria, the adequacy of their saliva flow, or their lifestyle and dietary habits. We then recommend changes or preventive measures to reduce those risks.

The next step in MID is using various diagnostic technologies to find decay as early as possible. X-rays continue to play a major role, but dentists are also using dental microscopy to magnify the earliest forms of decay. Many also utilize laser fluorescence, infrared photography and optical scanning to further “see” decay difficult to detect with the naked eye.

In regard to treatments, MID adopts the adage “less is more.” If caught early enough, we can encourage the re-mineralization of enamel that acid has eroded with CPP-ACP, a substance acquired from milk, or strengthen teeth with topical fluoride applications. Instead of the dental drill, many dentists now turn to air abrasion for decay removal, equipment that emits a fine stream of abrasive particles that harms less healthy structure than a drill.

And if lasers continue to develop at their current pace, we’ll be able to use this technology to perform much more precise decay treatment than possible with manual instruments. As a result, we’ll be able to treat decayed teeth with less invasive means to preserve as much healthy structure as possible.

As these and other developments continue, MID promises a bright future for preventing and treating tooth decay. As a result, there’ll be less tooth structure loss and more attractive and healthy smiles.

If you would like more information on the latest techniques for treating tooth decay, 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 “Minimally Invasive Dentistry.”