My Blog

By Scott A. Allegretti, DDS Provincetown Dental Arts
June 27, 2020
Category: Dental Procedures
WhyKathyBatesChoseThisAlternativetoBracesandsoMightYou

Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.

Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.

Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.

Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.

While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.

That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.

Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.

With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.

The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.

If you would like more information about tooth straightening, please contact us or schedule a consultation.

By Scott A. Allegretti, DDS Provincetown Dental Arts
June 17, 2020
Category: Oral Health
Tags: dental care  
EffectiveDentalCareDependsFirstonGettingtheBigPicture

You might see your teeth and gums as separate parts of your mouth. But we dentists see them as a unified biological system, each of them contributing to your mouth's various functions: eating, speaking and, of course, smiling.

The teeth-gum-mouth relationship is also a factor when things aren't going well. Tooth decay, for example, doesn't suddenly appear — conditions have to be present in the mouth to cause it. The same can be said for periodontal (gum) disease or bite problems.

So the best approach in dental care is to consider the whole — to first learn all we can about your mouth. We need to understand not only your current problems but also your health history and the unique features of your mouth. With this deeper understanding we can formulate a long-term plan that addresses all your individual needs.

We specifically want to identify your individual oral health risks, from your genetic makeup to any past problems with dental disease or the bite. We then want to assess your current state of health: do you have any presence of dental disease? Is any past dental work failing or in need of updating? Are there any biomechanical issues with the bite or bone loss that need to be addressed?

With this more complete picture, we can then prioritize your care and treatment. Some things like gum disease require immediate attention. Other areas such as bite problems or cosmetic issues may require planning and time to fully address. Our aim, though, is to eventually bring you to as high a level of health as your individual situation will permit.

Once we've achieved an acceptable level of health, our aim is to then maintain that level. This includes monitoring for changes in your oral health and intervening when necessary.

As you can see, establishing a care strategy is only the beginning — and care will always be ongoing. In fact, we'll need to modify your care as new issues arise or you experience the effects of aging. Our end goal, however, always remains the same — to help you achieve and keep the most healthy and attractive mouth possible.

If you would like more information on getting the most from your dental care, 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 “Successful Dental Treatment: Getting the Best Possible Results.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
June 07, 2020
Category: Oral Health
Tags: nutrition   oral cancer  
DietandLifestyleChangesCouldLowerYourRiskofOralCancer

Oral cancer is one of the more dangerous malignancies people face. But there are ways you can reduce your risk of this deadly disease through changes in lifestyle habits and behaviors.

Two of the better known behaviors for increased oral cancer risk are immoderate consumption of alcohol and the use of tobacco, particularly chewing tobacco and snuff. Eliminating these, especially the latter, can vastly improve your odds of avoiding cancer. Another factor is a strain of the human papilloma virus (HPV 16) that's transmitted sexually, which you can avoid through safe sex practices.

In addition to these lifestyle changes, there's one more you should make to lower your oral cancer risk: adjustments to your diet. Research over the last half century has provided ample evidence of a link between the foods we eat and our risk of all types of cancers, including oral.

The biggest concern is over certain elements in some foods that can damage DNA, the molecular “operating instructions” that regulate the formation and function of our bodies' cells. These elements are collectively known as carcinogens because of their role in cancer formation.

An example of a carcinogen is a group of chemicals called nitrosamines. These form during preservation processes using nitrites in meats like bacon or ham. They're also found in beer or certain preserved fish. To limit your consumption of nitrosamines, you should reduce these and other processed products and replace them with fresh fruits and vegetables, or organic meats and dairy products.

Our DNA can also be damaged by unstable molecules called free radicals that arise during normal cellular function. But there are also substances known as antioxidants that help protect the cells from free radical damage. Many plant-based foods contain nutrients like vitamins C and E that have antioxidant properties, so including them in your diet could help reduce your oral cancer risk.

Several clinical studies over the years have been consistent in their findings that a diet rich in fresh fruits and vegetables can reduce the risk of oral or throat cancers, as well as other forms of cancer. Making changes to your diet in that direction, plus other lifestyle changes, could help you avoid this devastating oral disease.

If you would like more information on preventing oral cancer, 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 “Diet and Prevention of Oral Cancer.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
May 28, 2020
Category: Oral Health
Tags: oral health  
TheGraduationSeasonisthePerfectTimetoReviewDentalHealth

The month of May blossoms annually with commencement ceremonies honoring students graduating from high schools, colleges and universities. For each graduate, the occasion represents a major milestone along their road to adulthood. It's also an appropriate time to assess their dental development.

Although our teeth and gums continue to change as we age, the greatest change occurs during the first two decades of life. In that time, humans gain one set of teeth, lose it, and then gain another in relatively rapid succession. The new permanent teeth continue to mature, as do the jaws, up through the time many are graduating from college.

Of course, you don't have to be in the process of receiving a diploma to “graduate” from adolescent to adult. If you are in that season, here are a few things regarding your dental health that may deserve your attention.

Wisdom teeth. According to folklore, the back third molars are called wisdom teeth because they usually erupt during the transition from a “learning” child to a “wise” adult. Folklore aside, though, wisdom teeth are often a source for dental problems: The last to come in (typically between ages 17 and 25), wisdom teeth often erupt out of alignment in an already crowded jaw, or are impacted and remain hidden below the gums. To avoid the cascade of problems these issues can cause, it may be necessary to remove the teeth.

Permanent restorations. Though not as often as in adults, children and teens can lose teeth to disease, injury or deliberate removal. Because the jaw is still in development, dental implants are not generally advisable. Instead, patients under twenty often have temporary restorations like partial dentures or bonded bridges. As the jaws reach full maturity in a young adult's early 20s, it's often a good time to consider a permanent implant restoration.

Smile makeovers. An upcoming graduation is also a great reason to consider cosmetic smile upgrades. When it comes to improving a smile, the sky's the limit—from professional teeth whitening for dull teeth to porcelain veneers or crowns to mask dental imperfections. It's also not too late to consider orthodontics: Braces or the increasingly popular clear aligners can straighten almost anyone's teeth at any age, as long as the person is in reasonably good health.

This may also be a good time to update your own personal care. Regular dental visits, along with daily brushing and flossing, are the foundation stones for keeping your teeth and gums healthy throughout your life. So, as you “commence” with this new chapter in your life, make a dental appointment now to “commence” with a renewed commitment to your dental health.

If you would like more information about adult dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Wisdom Teeth” and “Teenagers & Dental Implants.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
May 18, 2020
Category: Dental Procedures
HughJackmanIsAllSmilesforHisNewBroadway-InspiredShow

To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.

With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.

The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…

Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.

A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.

And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.

One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.

If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”





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