My Blog

By Dominick P Agostin, DDS
November 14, 2019
Category: Oral Health
Tags: oral health  
ShareTheseTimelyDentalCareTipsWithYourCollege-BoundSonorDaughter

It's a “change” moment when your child leaves home to attend college for the first time. For many, it's the first time to truly be on their own. While that new autonomy can be exhilarating, it does require self-responsibility to avoid some nasty pitfalls that might snare them.

So, before you bid them adieu at the dorm, be sure to give them some good, old-fashioned parental advice. And that includes teeth and gum care: While it may not seem as urgent as other potential issues, failing to maintain oral health could eventually affect the rest of their health.

The most important thing they can do mouth-wise is to brush and floss every day—and see a dentist at least twice a year. Daily oral hygiene keeps plaque, a thin bacterial film on teeth most responsible for dental disease, from accumulating.

There are other habits that foster good oral health—like eating a well-balanced diet. Encourage them to eat “real” food: less on processed items and more on fresh fruits and vegetables. That includes keeping added sugar to a minimum—not only for good overall health, but to also deprive disease-causing oral bacteria of a favorite food source. And tell them to go easy on the sodas, sports and energy drinks loaded with acid that can damage enamel.

Don't forget to mention lifestyle practices that are best avoided. Tobacco use and excessive alcohol consumption can make the mouth more susceptible to diseases like tooth decay and periodontal (gum) disease. And even if oral piercings are all the rage on campus, any hardware worn in the mouth could cause chipped teeth and contribute to gum recession.

And if you've already had the “talk” with them, you should still review the facts of life one more time. There just happens to be a connection with this particular subject and their mouth—unsafe sexual practices could leave them vulnerable to the human papilloma virus (HPV16) that could increase their oral cancer risk.

College is both an exciting and challenging time. If your new student follows these timely oral care tips, they can avoid teeth and gum problems that could linger for years to come.

If you would like more information helping your college-bound student maintain good oral 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 “10 Health Tips for College Students.”

By Dominick P Agostin, DDS
November 04, 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.”

By Dominick P Agostin, DDS
October 25, 2019
Category: Dental Procedures
Tags: dental implant  
YourQuestforaDentalImplantMightBeInterruptedbyBoneLoss

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

If you would like more information on 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 After Previous Tooth Loss.”

By Dominick P Agostin, DDS
October 15, 2019
Category: Oral Health
Tags: tooth decay   nutrition  
ThesePopularDrinksCouldPutYourEnamelinDangerofErosion

Tooth enamel, to play on a phrase from Shakespeare, is made of “sterner stuff.” The strongest substance in the body, enamel can take years of biting and chewing and keep on going.

It does have one nemesis, though—mouth acid, which can soften and erode enamel’s mineral content. This is less of a concern if you have healthy saliva flow, because saliva neutralizes acid in thirty minutes to an hour after an acid attack and can also help re-mineralize the enamel. Daily brushing and flossing also help curb mouth acid by reducing the bacteria that produces it.

But as effective as saliva is at neutralizing mouth acidity, it can be overwhelmed by outside acid derived through certain foods and beverages. In the past couple of decades, at least two of these acid sources have grown in prominence: energy drinks and, believe it or not, sports drinks.

Just how acidic are they? The pH scale runs from 1 to 14, with acidity on the low end and alkalinity on the higher (7 is neutral). Tooth enamel begins dissolving below 5.5. Laboratory tests have pegged the average pH of energy drinks at 3.05 and sports drinks, 2.91.

Because of their acidity, frequent energy or sports drink consumption will bring mouth pH into the danger zone for tooth enamel. It’s even more likely if these beverages are sipped over an extended period, which can prevent saliva from getting ahead of any newly introduced acid.

Keeping your distance from these beverages is probably the safest bet. But if you do imbibe occasionally, follow these common sense tips:

  • Avoid sipping the beverage over long periods—and try to limit drinking them to meal times;
  • After drinking a beverage, wash your mouth out with water and wait an hour to brush to give your saliva time to neutralize any acid.
  • Practice consistent, daily brushing and flossing.

Above all, keep a healthy respect for acidic foods and beverages like energy and sports drinks and don’t overuse them. Your tooth enamel will appreciate it.

If you would like more information on the effect of sports and energy drinks on dental 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 “Think Before You Drink Sports and Energy Beverages.”

By Dominick P Agostin, DDS
October 05, 2019
Category: Oral Health
Tags: oral health  
TheTriplePartnershipThatCouldSaveaCancerPatientsOralHealth

While the effectiveness of chemotherapy and radiation have contributed to rising cancer survival rates, they can still have an adverse effect on the rest of the body. That includes the mouth: these treatments can damage healthy tissues like the salivary glands. The decrease in saliva flow increases the risk of tooth decay or periodontal (gum) disease.

While overcoming cancer is certainly the patient’s main health priority, it’s important for them to tend to their oral health. The best approach often involves a three-way partnership between patient, dentist and family caregivers all doing their part to keep the patient’s teeth, gums and mouth healthy during cancer treatment.

Here’s what each “partner” can do to protect a cancer patient’s oral health during treatment.

The dentist. To minimize dental disease odds, patients should enter cancer treatment with their teeth and gums in the best shape possible. Before beginning treatment, then, the dentist can assess their oral health status and recommend a treatment plan for any existing disease or condition. The dentist can also monitor a patient’s oral health during the treatment period.

The patient. Patients can do the most to protect their oral health by removing disease-causing plaque buildup with daily brushing and flossing, as well as maintaining their regular schedule of dental cleanings (if possible). They should also attempt to reduce dry mouth, a potential consequence of cancer treatment, by consuming more water and using saliva boosters like Xylitol-sweetened gums and mints. A nutritious diet is also important for protecting oral health.

The caregiver. Many cancer patients depend on family or friends to aid them during treatment. One of the best things a caregiver can do is act as a liaison between the patient and their medical and dental providers. When it comes to oral health, caregivers should be on the alert for any mouth changes including tooth pain, gum swelling or bleeding, foul breath and other signs of disease.

Focusing on oral health can be a daunting challenge for patients during their fight with cancer. But with help from their other partners, they can come out of this fight with their teeth, gums and mouth in good health.

If you would like more information on oral care during cancer treatment, 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.”





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