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Posts for: January, 2014

By Forest Hills Dental
January 28, 2014
Category: Oral Health
Tags: oral health  
HealthRisksofOralPiercings

If you have to ask why anybody would voluntarily endure the pain of receiving a tongue piercing — then maybe you're just too old to understand. But seriously: no matter where you stand on the aesthetics of the issue, you shouldn't ignore the real health risks that go along with the installation of oral piercings.

According to the Journal of the American Dental Association, the most common sites for intraoral piercing are the tongue and the lip. In the case of the so-called “tongue bolt,” several significant short-term and long-term risks have been identified; most also apply to other types of oral piercings as well.

The tongue is primarily composed of muscle tissue, along with a rich supply of associated blood vessels and nerves. This explains why accidentally biting your tongue can be so painful — and bloody. Installing a tongue bolt involves piercing a small hole through the tongue, and attaching the ornament through the hole.

In rare instances — such as the case of a teenager who experienced severe pain and the sensation of electrical shocks — nerve irritation and damage may occur soon after a tongue bolt is installed. (Fortunately, her symptoms cleared up shortly after the bolt was removed.) More often, the symptoms are less severe, but the health issues are chronic.

Tongue bolts are known to cause problems with the teeth, including increased sensitivity and pain. Teeth are also prone to chipping due to contact with the ornament. These are among the reasons why you are likely to need more frequent dental checkups if you have an oral piercing.

Additionally, periodontal (gum) problems can develop in individuals with oral piercings. These frequently appear as gum recession, inflammation and infection. Eventually, bone loss may occur as well.

The good news: removing an oral piercing is generally easy, and the area is quick to heal. If it doesn't seal up by itself, the hole left behind can be closed with only minor surgery. And removing the piercing immediately reduces your health risk — thus instantly improving your overall oral health.

Thinking of getting — or removing — an oral piercing? Talk to us. No matter what you decide to do, you owe it to your health to become informed about the issues surrounding these body ornaments.

If you would like more information about oral piercings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”


ClearOrthodonticAlignersAreTheyRightForYou

If you are considering having your teeth straightened, for cosmetic or other reasons, the idea of using clear aligners rather than traditional braces may be appealing.

Here are the answers to some frequently asked questions about clear aligners.

What are clear aligners?
Clear aligners are clear removable custom fitted “trays” that gradually straighten teeth. Used sequentially, each individual tray is slightly different from the one before and is worn every day for two weeks before going on to the next one in the series. This slowly moves your teeth to a new position.

How are they made?
The trays are computer-generated, based on impressions and models of your mouth combined with the knowledge of growth, development of teeth and jaws, and most importantly how and why teeth move.

How long does this treatment take?
By wearing clear aligners for at least 20 hours per day for two weeks before changing to the next tray in the sequence, treatment time can range from six months to two years depending on your individual situation.

Can children wear clear aligners?
Clear aligners are generally used for adults who have all their teeth and when jaw growth is complete, but can be used for younger people depending upon the extent and severity of their situation.

What situations can clear aligners be used for?
Clear aligners can realign or straighten teeth, close mild spaces, treat elongated teeth and tip teeth into better position. They are usually recommended for correcting mild to moderate crowding of teeth, particularly if your back teeth already fit together properly.

When are clear aligners probably not the right choice?
If you have a bad bite (your back teeth do not fit together well), or if you have a severe overbite or underbite, traditional braces are probably a better choice for treatment. If your teeth are severely crowded, or if your situation is complex, clear aligners will probably not be the right treatment choice.

How do you decide whether clear aligners are right for you?
An orthodontic assessment of your individual situation must be performed by our office.

What is considered in the assessment?
The assessment includes specialized x-rays of your teeth, jaws and skull, along with photos, impressions, and models of your bite.

For more information about clear aligners vs. traditional braces, make an appointment with us for a consultation and an examination of your own situation. You can learn more by reading the Dear Doctor magazine article “Clear Orthodontic Aligners: An Alternative for Adult Orthodontics.”


AlthoughChallengingSmileZoneImplantscanAppearBeautifullyLife-Like

Dental implants have quickly become the restoration of choice for two basic reasons: they effectively restore the lost function of missing teeth and simultaneously rejuvenate the smile with their life-like appearance.

Achieving a life-like appearance, however, isn’t always a simple matter. A restoration in what we dentists call the “Smile Zone” (the upper front area that displays both teeth and the gum line when you smile) requires careful planning and technique to ensure they appear as life-like as possible.

Our first concern is whether there’s enough bone to fully anchor an implant. Bone is a living, dynamic tissue that goes through cycles of dissolving (resorption) and growth. The normal forces of biting and chewing transmit through healthy teeth and stimulate growth in the bone. When the teeth are missing and no longer transmit this pressure, the bone will eventually resorb only and not grow.

Adjacent teeth could also be affected with bone loss if the extraction was difficult and a bone graft was not placed into the extraction socket to preserve bone. This not only puts adjacent teeth at risk of gum and bone loss but can also have implications for the final smile appearance. This bone also supports the triangular tissue between teeth known as papillae which give teeth their arched appearance. If the bone isn’t adequate, there’s less hope that the papillae will regenerate.

With these concerns it’s very important to consider how the implant and crown emerges from the gums in the Smile Zone. Recent developments in implant design are helping in this regard. The design change of the top of the implant re-orients the gum tissues in relation to the implant from vertical to horizontal, which dentists call “platform switching.” This provides greater stabilization where bone mass is limited, and helps create a more aesthetically pleasing result. There are also other techniques, such as surgical tissue grafting of the papillae that can further enhance the final appearance.

Although creating a natural, life-like appearance in the Smile Zone is difficult, it’s not impossible. It’s important first to undergo a complete dental examination and profile, where we can advise you on your best options to achieve a beautiful smile.

If you would like more information on the relation of implants to the aesthetics of your smile, 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 “Implant Aesthetics.”


By Forest Hills Dental
January 08, 2014
Category: Oral Health
ThickorThinYourGumsNeedtobeProtected

While hygiene and regular dental care go a long way to reduce your risk of oral disease and disorders, you’re still subject to your heredity. Everything from tooth alignment to the shape of your jaws is determined by your genes.

So is the biological structure of your gum tissue. Aside from minute variations, gum tissue structure falls into two broad categories — “thin” or “thick,” which refer to the actual thickness of the tissue and the underlying bone. The tooth’s appearance is the best indicator of which type you may have: those with more triangular-shaped tooth (often called scalloped) have thin gum tissue; a person with a squarer appearance (flat) has thick gum tissue. People of Asian descent tend to have thin/scalloped tissue while those with European or African heritage tend to have thick/flat tissues.

Thick gum tissue isn’t superior to thin, or vice-versa. In fact, each type is susceptible to certain types of diseases or adverse conditions.

Thin tissues are more susceptible to the occurrence of receding gums. Caused mainly by periodontal disease and toothbrush abrasion, the gum tissue recedes and exposes more of the unprotected tooth surface that should be below the gum line. This increases the risk of decay and tooth loss. Patients with thick tissue, on the other hand, have a higher risk of developing a condition known as “pocketing.” As the thicker gum tissue becomes inflamed from dental plaque, it loses its attachment to the teeth and forms a small pocket. The end result is possible bone and tooth loss.

There’s not much you can do about which type of gum tissue you have, for which you can thank (or blame!) your ancestors. But there’s something you can do to reduce your risk of periodontal disease. First and foremost, you should practice good daily hygiene, brushing with a soft-bristled tooth brush and gentle flossing. It’s also important to maintain regular cleanings and checkups in our office; not only will this ensure complete plaque and tartar removal, but gives us a better chance to detect either receding gums or pocketing early. Earlier detection can mean better treatment outcomes — and a saved smile.

If you would like more information on genetic types of periodontal tissues, 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 “Genetics & Gum Tissue Types.”




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