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Posts for category: Oral Health

By Scott A. Allegretti, DDS Provincetown Dental Arts
October 11, 2019
Category: Oral Health
Tags: oral health  
CelebrateWorldSmileDayWithMoreAttractiveTeeth

The smiley face: It’s been around forever. Except it hasn’t—someone created it. No, not Forrest Gump (but good guess!), but graphic artist Harvey Ball in 1963 to help boost employee morale at an insurance company. Do you know what else Harvey Ball came up with? World Smile Day: Beginning in 1999, Ball began promoting the first Friday in October as a day to encourage smiles and acts of kindness. But there’s no need to limit smiles to one day. We hope you treat every day as World Smile Day—to make your corner of the world a little brighter.

What can you do to show your support? Well to begin with, smile—a lot. And also do things to make other people smile. We don’t want you to hold back because you’re not completely satisfied with your smile. If you’d like to get that wonderful smile of yours in better shape, here are some ideas:

Have your teeth professionally cleaned. Having your teeth cleaned at the dental office is one of the best things you can do to prevent dental disease. Dental plaque makes your teeth look dull and dingy and can lead to gum disease and cavities. A professional cleaning to rid your teeth of any built-up plaque and tartar (hardened plaque) with a follow-up polish can help your teeth look great!

Brighten up your smile. You can turn up the brightness volume on your teeth with a tooth whitening application. There are whitening products you can buy over the counter, but for best results see your dentist for a professional whitening. Dentists can better control the degree of brightness and their professional-grade solutions often last longer.

Upgrade your teeth’s appearance. You may have a great looking smile—except for that chip, discoloration or slight gap between a couple of teeth. There are a number of ways, many quite affordable, to improve your teeth’s appearance. Your dentist can bond color-matched composite resin to your teeth to “fill in” chips or other blemishes. And a veneer, a thin layer of porcelain bonded to the face of a tooth, can mask mild to moderate dental blemishes.

There are other “smile changers” like orthodontics, crowns or dental implants that are a bit more extensive. Depending on your needs and expectations, these can give you a “smile makeover” that will get you ready for future World Smile Days.

In the meantime, talk to us about how you can perk up your smile. An attractive smile is much easier to share with the world.

If you would like more information about smile enhancements, please contact us to schedule a consultation.

By Scott A. Allegretti, DDS Provincetown Dental Arts
October 01, 2019
Category: Oral Health
Tags: gum disease  
DifficultorNotPlaqueRemovalisNecessaryforStoppingGumDisease

When we refer to periodontal (gum) disease, we’re actually talking about a family of progressive, infectious diseases that attack the gums and other tissues attached to the teeth. Caused primarily by bacterial plaque left on tooth surfaces from inefficient oral hygiene, gum disease can ultimately lead to tooth loss.

There’s only one way to stop the infection and restore health to diseased tissues — remove all of the offending plaque and calculus (hardened plaque deposits) possible from tooth and gum surfaces, including below the gum line at the roots. The basic tools for this task are specialized hand instruments called scalers or ultrasonic equipment that vibrates plaque loose. A series of cleaning sessions using these tools could stop the infection and promote healing if followed with a consistent, efficient daily hygiene habit.

There are times, however, when the infection has progressed so deeply below the gum line or into the tissues that it requires other procedures to remove the plaque and infected tissue. One such situation is the formation of an abscess within the gum tissues, a pus-filled sac that has developed in response to infection. After administering local anesthesia, the abscess must be treated to remove the cause and allow the infectious fluid to drain. The area is then thoroughly flushed with saline or an antibacterial solution.

The gum tissues are not completely attached to the tooth surface for a small distance creating a space. These spaces are called periodontal pockets when they are inflamed and continue to deepen as the disease progresses. These inflamed and sometimes pus-filled pockets form when tissues damaged by the infection detach from the teeth. If the pockets are located near the gum line, it may be possible to clean out the infectious material using scaling techniques. If, however, they’re located four or more millimeters below the gum line a technique known as root planing may be needed, where plaque and calculus are shaved or “planed” from the root surface. As the disease progresses and the pockets deepen, it may also be necessary for surgical intervention to gain access to the tooth roots.

To stop gum disease and promote soft tissue healing, we should use any or all treatment tools at our disposal to reach even the most difficult places for removing plaque and calculus. The end result — a saved tooth — is well worth the effort.

If you would like more information on treating periodontal 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 “Treating Difficult Areas of Periodontal Disease.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
September 21, 2019
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
September 11, 2019
Category: Oral Health
Tags: toothache  
ThatToothacheMightNotBeFromYourToothTheProblemofReferredPain

Pain is the body’s warning system: It tells us something is wrong. And depending on the location and intensity of the pain, it can give us vital clues about the problem.

Sometimes, though, it’s not so clear and direct—the pain could arise from any number of sources. Toothaches often fall into this category: Although it’s likely indicating a tooth or gum problem, it could be something else — or even somewhere else.

This is known as referred pain, in which you may feel pain in one location, like your mouth, but the actual source of the problem is somewhere else, like an infected and congested sinus passage. If we’re able to identify the true source and location of the pain, the better the chances of a successful treatment outcome.

Besides sinus infections, there are other conditions like trigeminal neuralgia that can refer pain to the mouth. This painful condition involves the trigeminal nerve, a large nerve running on either side of the face that can become inflamed. Depending on where the inflammation occurs, you might feel the pain at various points along the jaw, feeling much like a toothache.

There’s also the case of an earache mimicking a toothache, and vice-versa. Because of the proximity of the ears to the jaws, there is some nerve interconnectedness between them. For example, an infected or abscessed back tooth could feel a lot like an earache.

These and other possible problems (including jaw joint disorders or teeth grinding) can generate pain as if it were coming from the mouth or a single tooth. To be sure you’ll need to undergo a complete dental examination. If your dentist doesn’t find anything wrong with your mouth, he or she may refer you to a medical doctor to explore other possible causes.

Getting to the root cause of pain can help determine which treatment strategy to pursue to relieve it. Finding the actual source is the most efficient way to understand what a pain sensation is trying to tell us.

If you would like more information on dental pain, please contact us or schedule an appointment for a consultation.

By Scott A. Allegretti, DDS Provincetown Dental Arts
August 22, 2019
Category: Oral Health
Tags: dry mouth  
CurbingDryMouthCouldBoostYourOralHealthasyougetOlder

There is much to contend with as we grow older, including a higher risk for dental disease. One possible contributing factor: dry mouth from a lack of saliva.

Also known as xerostomia, dry mouth occurs when the salivary glands secrete less than the normal two to four pints a day. Saliva performs a number of functions, but perhaps the most important for dental health is as an acid neutralizer. Within a half hour to hour after eating, saliva can restore the mouth's normal pH level to prevent acid from softening tooth enamel. When there isn't enough saliva, acid levels stay high leading to erosion of the enamel. This vastly increases the chances for tooth decay.

Although there are several causes for dry mouth, one of the more common is as a side effect from certain medications. It's estimated over 500 drugs — many taken by seniors — can cause dry mouth, including diuretics for high blood pressure and heart failure, antidepressants, and antihistamines. Some diseases like diabetes or Parkinson's may also reduce saliva flow, as well as radiation and chemotherapy.

If you've developed chronic dry mouth, there are some things that may help restore adequate saliva flow. If medication is the cause you can talk to your doctor about an alternative medication or add a few sips of water before swallowing the pills and a full glass afterwards. You should also drink plenty of non-caffeinated beverages (water is the best) during the day and cut back on sugary or acidic foods. And a cool-air humidifier running while you sleep may also help keep your mouth moist.

We may further recommend an over-the-counter or prescription stimulant for saliva. For example, xylitol, a natural alcohol sugar that's found in many gums and mints, has been found to stimulate saliva and reduce the risk of tooth decay as an added benefit.

Last but not least, be sure to brush and floss daily to remove disease-causing plaque and see us at least twice a year for cleanings and checkups (if your mouth is very dry, three to four times a year is a better prevention program). Managing chronic dry mouth along with proper oral hygiene will help ensure your mouth continues to stay healthy as you grow older.

If you would like more information on the causes and treatment for dry mouth, 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 “Dry Mouth.”