Archive for January, 2014

A Revolutionary New Find

Dentistry is changing so remarkably fast it’s scary.  But it’s also exciting to the core.  If I were let out of dental school today with what I learned when I graduated just 16 years ago, I’d be lost. Dental materials are ever changing and improving.   Computers have revolutionized things like endodontics (root canals) and numbing.  Even more difficult is keeping up-to-date with the new methods and procedures for restoring teeth.   One of the things we do to keep on the cutting edge is read… A LOT.   And thus, one of the gazillion dental journals I get a month had an article that I was particularly interested in.  It was about a new material that helps cure a devastating problem that dentists have struggled with for eons….

One of the most difficult decisions a dentist must make is when to restore widespread, broken down, pitted, soft enamel.  Usually the lesions start from childhood, specifically orthodontics.    Once the breakdown starts, it’s impossible to stop.  Dentists have to intervene with difficult, expensive, uncomfortable, unaesthetic restorations that, frankly, are very prone to recurrent decay.   Moreover, it’s especially unpleasant to acquiesce when its a young person that needs his or her teeth to last a lifetime.

So when I read about a new product called an “INFILTRANT” that is available to combat this problem, I was enthused but skeptical.  And I had a lot of questions that needed answered before I’d try it on a young person.  I called the manufacturer and spoke to one of the engineers.   Once my questions were addressed and I understood the limitations, I was ready.  Today, I tried it for the first time on a young man named Cameron.

The procedure was arduous, but the results were astounding.    It transformed Cameron’s weak enamel.    No, his teeth aren’t pearly white.  But these are his teeth; not bonding or porcelain.  The most revolutionary thing about it was that we were able to restore his teeth without removing any tooth structure first.  I didn’t even have to anesthetize him.  Once the teeth are “primed”, the INFILTRANT infuses into the tooth, rebuilding the tooth structure.  We took some before and after pictures and I am sharing them here.

So there is another leap forward in dentistry.  I see this product as a building block for wonderful new possibilities.   The future may be arresting decay and rebuilding tooth structure without having to numb and “drill” a tooth.  What a great time to be a dentist!




Add comment January 29, 2014

Through the Ages Missing / Avulsed / Lost Tooth

Avulsed Tooth


Losing a tooth can be especially traumatic.  It is physically but also emotionally trying, as the resulting empty site is not aesthetically pleasing and is difficult to replace.  The main cause in the permanent dentition is recreation/sports injuries and fighting.  If a tooth can be re-implanted within 15-30 min after the accident, there is a 90% chance the tooth will be retained for life.  However, this is not always practical.  The critical determining factors for successful re-implantation are time, transportation medium, how the tooth is handled, and condition of the socket.



Most important management is the time out of socket and the storage and transportation medium.


Missing tooth _ If tooth is not found, consider complete intrusion of the tooth into underlying bone.



  • Keep the person/child calm.
  • Find the tooth and pick it up by the crown (the white part). Avoid touching the root.
  • If the tooth is dirty, wash it briefly (10 seconds) under cold running water and reposition it. Try to encourage the patient / parent to replant the tooth. Bite on a handkerchief to hold it in position.  Do NOT reimplant Deciduous (Baby)teeth as they could damage the permanent tooth bud in formation.
  • If this is not possible, place the tooth in a suitable storage medium, e.g. a glass of milk, saline,  or a special storage media for avulsed teeth if available (Hanks Solution). The tooth can also be transported in the mouth, keeping it between the molars and the inside of the cheek. If the patient is very young, he/she could swallow the tooth- therefore it is advisable to get the patient to spit in a container and place the tooth in it. Avoid storage in water!
  • Seek emergency dental treatment immediately.

Add comment January 20, 2014

Through the Ages: Thumb Sucking & Pacifier Use


A concern all parents face is thumb sucking, finger sucking, or pacifier use.  Children learn this habit in the womb.   Thumb sucking is one of an infant’s natural reflexes.   It makes them feel secure and happy.   Since it is relaxing, it can also induce sleep.   My twin daughters who were born 2 months premature were introduced to pacifiers in the NICU.  Moreover, the pediatric doctors and nurses encouraged finger sucking for development and well-being.  They actually instructed us to place their little hands to their mouths.

 thumb sucking Alveolprog

However, prolonged thumb, finger, or pacifier sucking may cause improper growth of the mouth and misalignment of the teeth.  It can even trigger changes in the roof of the mouth.  Children who passively rest their thumbs in their mouths are less likely to develop problems than aggressive suckers.

Pacifiers can have the same effects on the teeth as finger sucking.  However, pacifier use is generally an easier habit to break.

Most children stop sucking their thumbs or fingers on their own between the ages of 2 and 4.  The behavior lessens during this period as children develop and interact with their environment.    Peer pressure is one of the most persuasive influences on getting children to break the habit.   Daycare and school are best at providing this opportunity.


Here are some tips to help:


  • Rather than scolding the child while thumb sucking, instead offer praise when not doing it.
  • Try to identify and correct any anxiety or insecurity that might me contributing to an episode.
  • Reward the child when they are overcoming the habit especially in times of stress.
  • Tricks like putting a sock over the hand or a bandage around the digit can help remind the child to stop.
  • In extreme situations, dentists can even make mouth appliances or recommend medications that coat the thumb to prevent the child from engaging the thumb.

1 comment January 9, 2014

Through the Ages

Throughout our lives, there are specific dental needs or situations that we might know are important

but never have the forethought for which to prepare ourselves or even ask about. I’m not talking about

the everyday dental disciplines like brushing and flossing. I’m talking about situations that are specific to

a particular point in life. So over the next weeks (maybe months), I am going to provide some facts and

pointers for different stages in our lives.

• Infants-Toddlers Thumb Sucking

• Toddlers-Teens Tooth Avulsion (Knocked out/Lost/Missing tooth)

• Teen-Adult New Trendy Beverages aka Sports & Energy Drinks, Mixers, etc.

• Adult – Senior How medications effect your oral health

So stay Tuned for a unique look at dental care for all ages, Through the Ages….dental_logo_by_labyr1nth-d2opsba

Add comment January 8, 2014