Online Dental Guide

Dental Anesthesia

Before Intravenous Anesthesia Sedation

• You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
• No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
• A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
• The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
• Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
• Contact lenses, jewelry, and dentures must be removed at the time of surgery.
• Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
• If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.
• If you take routine oral medications, please check with Dr. Shah prior to your surgical date for instructions.

Baby Bottle Tooth Decay

What Is Baby Bottle Tooth Decay?

Babies who go to bed with a bottle of milk, formula, or juice are more likely to get tooth decay. Because the sugar in formula, milk, or juice stays in contact with the teeth for a long time during the night, the teeth can decay quickly.

Some Tips To Avoid Baby Bottle Tooth Decay

• Put your child to bed with a bottle of plain water, not milk or juice.
• Stop nursing when your child is asleep or has stopped sucking on the bottle.
• Try not to let your child walk around using a bottle of milk or juice as a pacifier.
• Start to teach your child to drink from a cup at about six months of age. Plan to stop using a bottle by 12 to 14 months at the latest.
• Don't dip your child's pacifier in honey or sugar.

Bleaching (Teeth Whitening)

TEETH-IN-AN-HOUR™ is a revolutionary concept providing patients with fully functioning teeth or dental implants in one single procedure that lasts about an hour.

The Right Time For Braces

How do braces straighten crooked teeth?

Braces use constant, gentle pressure, which over time, move teeth into their proper positions. Your braces are at work every moment of your orthodontic treatment. The two main components of your braces are:the brackets that are placed on your teeth and the main archwire that connects them. The bracket is a piece of shaped metal or ceramic that we affix to each tooth. The archwire is bent to reflect your ideal bite. In other words, it reflects the way we want you to look after treatment.

The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to move your teeth. Picture your tooth resting in your jaw bone. With pressure on one side from the archwire, the bone on the other side gives way. The tooth moves. New bone grows in behind.

Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth. In order for this force to remain constant, elastics must be worn all the time and changed every day.

Different Types of Braces

Metal braces are the most popular with kids and teenagers. They love using different colors of ligature ties. These braces are much smaller than ever before.

Gold braces are the newest addition to our line of brackets. They are stainless steel braces coated with 24 karat gold. They have the strength of metal, but blend in with the color of the teeth much better. That is because most teeth have a natural yellow tint. Quite often, we will put ceramic braces on the top teeth and gold braces on the bottom.

Translucent clear ceramic braces are the most popular with adults. You have to be very close to someone to be able to see them. Yet, because they are a ceramic material, they are more fragile.

Brushing

1. Place a pea size of toothpaste on the toothbrush.
2. Remember to angle the toothbrush at a 45 degree angle and brush each tooth. Starting on the outside of the lower teeth.
3. Brushing the inside of the teeth can be difficult because of the presence of the tongue. However, you must angle the toothbrush at a 45 degree angle at the gumline, and brush each tooth.
4. On the anterior teeth you must brush downward. Remember to brush each tooth.
5. After you have completed the outside and inside of the teeth then brush the chew surface of the teeth.
6. The top teeth start on the outside brushing at a 45 degree angle at the gumline.
7. Brush the inside of the teeth the same way as the lower teeth were brushed.
8. Remember to brush the inside of the front teeth downward.

BRUSHING MUST BE PERFORMED TWICE A DAY (MORNING AND NIGHT) FOR AT LEAST FIVE MINUTES

Bruxism (Teeth Grinding)

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Temporomandibular Disorders

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Composite Resins (White Fillings)

We are a mercury-free practice. However, many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and tooth-colored restorations (onlays) create fillings that are not only beautiful (or unnoticeable), but also add strength to weakened teeth. These restorations are aesthetically pleasing and very strong thanks to new bonding technologies.

Crowns

Crown and bridgework are a very reliable solutions for major dental problems caused by accidents, diseases, or wear and tear. Major problems can usually be corrected using these techniques. Materials used in these repairs are either high-grade porcelain or porcelain bonded to gold. A higher strength of the porcelain and gold materials is recommended to treat the most serious dental problems. In instances where damage has occurred resulting in the loss of teeth, where teeth have broken away through excessive wear, or tooth damage caused by old fillings breaking down, crowns and/or bridges can be used as a long-term solution.

What Is A Dental Implant?

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants are tiny titanium posts that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life.

Evaluation

If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your specific needs and considerations will be addressed by either Dr. Shah or by an oral and maxillofacial surgeon referred by our practice. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.

Procedure

Dental implants are metal anchors that act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are then attached to the implant that will protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums, gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. During this time, your restorative dentist designs the final bridgework or denture that will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. The surgeon will uncover the implants and attach a small healing collar. Dr. Shah can then start making your new teeth. An impression will be taken. Then posts or attachments can be connected to the implants. The replacement teeth are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life.

Dentures:Get Your Smile Back

A denture or a complete denture as it is often called, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips.

Diabetes and Oral Health

Individuals suffering from diabetes, especially uncontrolled diabetics, have a higher risk of developing bacterial infections of the mouth. These infections may impair your ability to process insulin, resulting in greater difficulty with controlling your diabetes. Periodontal diseases will be more severe than those of a non-diabetic and treatment more difficult. However, well-controlled diabetics have a lower incidence of cavities.

Steps to prevent periodontal disease include daily brushing and flossing to remove plaque from your teeth and gums, regular dental visits for professional cleaning, and regular periodontal evaluation. Your health professional must also be told of your history and the current status of your condition. And finally, you can help resist periodontal infection by maintaining control of your blood sugar levels.

Your Child's First Dental Visit

Your Child's First Visit

The first regular dental visit should be just after your child's third birthday. The first dental visit is usually short and involves very little treatment. We may ask the parent to sit in the dental chair and hold their child during the examination. The parent may also be asked to wait in the reception area during part of the visit so that a relationship can be built between your child and your dentist.

We will gently examine your child's teeth and gums. X-rays may be taken (to reveal decay and check on the progress of your child's permanent teeth under the gums). We may clean your child's teeth and apply topical fluoride to help protect the teeth against decay. We will make sure your child is receiving adequate fluoride at home. Most important of all, we will review with you how to clean and care for your child's teeth.

What Should I Tell My Child About Their First Dental Visit?

We are asked this question many times. We suggest you prepare your child the same way that you would before their first haircut or trip to the shoe store. Your child's reaction to his first visit to the dentist may surprise you.

Some First Visit Tips

• Take your child for a preview or online tour of the office.
• Read books with them about going to the dentist.
• Review with them what the dentist will be doing at the time of the first visit.
• Speak positively about your own dental experiences

What Will Happen During The First Visit With Your Dentist?

• Examination of your child’s mouth, teeth, and gums.
• Evaluate adverse habits like thumb sucking
• Check to see if your child need fluoride
• Teach you about cleaning your child’s teeth and gums.
• Suggest a schedule for regular dental visits.

What About Preventive Care?

Tooth decay and children no longer have to go hand-in-hand. At our office, we are most concerned with all aspects of preventive care. We use the latest in sealant technology to protect your child's teeth. Sealants are space-age plastics that are bonded to the chewing surfaces of decay prone back teeth. This is just one of the ways we will set the foundation for your child's lifetime of good oral health.

Cavity Prevention

Most of the time cavities are due to a diet high in sugary foods and a lack of brushing. Limiting sugar intake and brushing regularly, of course, can help. The longer it takes your child to chew their foods the longer the residue stays on their teeth, the greater the chances of getting cavities.

Every time someone eats, an acid reaction occurs inside their mouth as the bacteria digests the sugars. This reaction lasts approximately 20 minutes. During this time the acid environment can destroy the tooth structure, eventually leading to cavities.

Consistency of a person's saliva also makes a difference. Thinner saliva breaks up and washes away food more quickly. When a person eats diets high in carbohydrates and sugars, they tend to have thicker saliva that allows more acid-producing bacteria that can cause cavities.

Tips For Cavity Prevention

• Limit frequency of meals and snacks.
• Encourage brushing, flossing, and rinsing.
• Watch what you drink.
• Avoid sticky foods.
• Make treats part of meals.
• Choose nutritious snacks.

The first baby teeth that come into the mouth are the two bottom front teeth. You will notice this when your baby is about six to eight months old. Next to follow will be the four upper front teeth and the remainder of your baby's teeth will appear periodically. They will usually appear in pairs along the sides of the jaw until the child is about 2-1/2 years old.

At around 2-1/2 years old, your child should have all 20 teeth. Between the ages of five and six, the first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth and some don't. Don't worry if some teeth are a few months early or lat. All children are different.

Baby teeth are important as they not only hold space for permanent teeth, but they are important to chewing, biting, speech, and appearance. For this reason it is important to maintain a healthy diet and daily hygiene.

Fixed Bridges

Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.

Facts on Flossing

Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.

Start with a piece of floss (waxed is easier) about 18 long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.

To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.

To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the backside of the last tooth on both sides, upper and lower.

When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.

Fluoride & Your Health

Fluoride helps make teeth strong and prevents tooth decay. If the water where you live does not have enough fluoride, your doctor may prescribe fluoride supplements (fluoride drops or pills). You would give these drops or pills every day, starting when your child is about six months old. Only give as much as the directions say to use because too much fluoride can cause spots on your child's teeth. Also, be sure to call your local water authority and ask if your water is fluoridated. If it is, tell your dentist or pediatrician so that your child is not being over fluoridated. Children should take these drops or pills until they are 12 to 16 years old (or until you move to an area with fluoride in the water).

What Is A General Dentist?

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What is Gum Disease?

The best way to prevent gum disease is effective daily brushing and flossing as well as regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.

Halitosis (Bad Breath)

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Oral Health and Your Heart

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Oral Health For Seniors

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Mouthguards

What is a mouth guard?

A mouth guard is comprised of soft plastic. They come in standard or custom fit to adapt comfortably to the upper teeth.

Why is a mouth guard important?

A mouth guard protects the teeth from possible sport injuries. It does not only protect the teeth, but the lips, cheeks, tongue, and jaw bone as well. It can contribute to the protection of a child from head and neck injuries such as concussions. Most injuries occur to the mouth and head area when a child is not wearing a mouth guard.

When should my child wear a mouth guard?

It should be worn during any sport-based activity where there is risk of head, face, or neck injury. Such sports include hockey, soccer, karate, basketball, baseball, skating, skateboarding, as well as many other sports. Most oral injuries occur when children play basketball, baseball, and soccer.

How do I choose a mouth guard for my child?

Choose a mouth guard that your child feels is comfortable. If a mouth guard feels bulky or interferes with speech to any great degree, it is probably not appropriate for your child.

There are many options in mouth guards. Most guards are found in athletic stores. These vary in comfort, protection as well as cost. The least expensive tend to be the least effective in preventing oral injuries. Customized mouth guards can be provided through our practice. They may be a bit more expensive, but they are much more comfortable and shock absorbent.

Mouthrinses

Fluoride toothpastes and mouth rinses if used in conjunction with brushing and flossing can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gum line so these products have not been proven to reduce the early stage of gum disease.

Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing.

Nourishing Your Smile

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Oral Cancer

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

• Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
• A sore that fails to heal and bleeds easily
• A lump or thickening on the skin lining the inside of the mouth
• Chronic sore throat or hoarseness
• Difficulty in chewing or swallowing

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology and, curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer. We would recommend performing an oral cancer self-examination monthly and remember that your mouth is one of your body's most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we may help.

Porcelain Veneers:An Alternative to Crowns

Porcelain veneers are thin shells of ceramic that bond directly to the front surfaces of the teeth. They are an ideal choice for improving your smile and have become increasingly popular due to their simplicity and versatility. read more >>

Pregnancy and Gingivitis

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Pregnancy and Oral Health

Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may also swell, bleed and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear after pregnancy.

Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk.

The best way to prevent periodontic infections is to begin with healthy gums and continue to maintain your oral health with proper home care and careful periodontic monitoring.

Root Canal Therapy

A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges. read more >>

Dental Radiographs

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Dental Sealants

Sealants protect the depressions and grooves of your teeth from food particles and plaque that brushing and flossing can't reach. read more >>

Sensitive Teeth

Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive consult with your doctor. They may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth.

Spit Tobacco

You are probably familiar with the links between tobacco use and lung disease, cancer and heart disease.

Current studies have now linked periodontal disease with tobacco usage. These cases may be even more severe than those of non-users of tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth as well as greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of smokeless tobacco.

Chemicals in tobacco such as nicotine and tar, slow down healing and the predictability of success following periodontal treatment.

Problems caused by tobacco include:

Lung disease, heart disease, cancer, mouth sores, gum recession, loss of bone and teeth, bad breath, tooth staining, less success with periodontal treatment and with dental implants.

Quitting tobacco will reduce the chance of developing the above problems.

Toothbrushes

Automatic and high-tech electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with electric toothbrushes called Rotadent and Interplak.

Some toothbrushes have a rubber tip on the handle; this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with your doctor.

Tooth Decay:A Preventable Disease

The best way to prevent gum disease is effective daily brushing and flossing as well as regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.

Other important factors affecting the health of your gums include:

Toothpaste:Putting the Squeeze On Dentifrice

Fluoride toothpastes and mouth rinses if used in conjunction with brushing and flossing can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gum line so these products have not been proven to reduce the early stage of gum disease.

Wisdom Teeth Extractions

By the age of 18, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.

The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your third molars, also known as wisdom teeth.

Why Should I Have My Wisdom Teeth Removed?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result:swelling, stiffness, pain, and illness. The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Oral Examination

With an oral examination and x-rays of the mouth, Dr. Shah can evaluate the position of the wisdom teeth and predict if there are present or may be future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Shah has the training, license and experience to provide various types of anesthesia for patients to select the best alternative.

Removal

In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) or general anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your postoperative kit will include postoperative instructions, a prescription for pain medication, antibiotics, and a follow-up appointment in one week for suture removal. If you have any questions, please do not hesitate to call us at (973) 777-5353.

Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff who are experienced in anesthesia techniques.

Women's Dental Health

Throughout a woman’s life, hormonal changes affect tissue throughout the body.

Fluctuations in levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health.

Puberty

During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity and lead to greater irritations from plaque and food particles. The gums can become swollen, turn red and feel tender.

Menstruation

Similar symptoms occasionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek. The symptoms clear up once the period has started. As the amount of sex hormones decrease, so do these problems.

Oral contraceptives

Swelling, bleeding and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones.

You must mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate risk of drug interactions, such as antibiotics with oral contraceptives – where the effectiveness of the contraceptive can be lessened.

Menopause

Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. They include feeling pain and burning in your gum tissue and salty, peppery or sour tastes.

Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of “dry mouth.”

Dental Emergency

In case of any dental emergency, please call our office at (973) 777-5353.