My Blog

By Dr. Mark C. Pothitakis
November 18, 2019
Category: Dental Procedures
Tags: dental implant  
GettingaNewToothinOneDayWillDependonYourBoneHealth

If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.

The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.

Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.

The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.

If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.

The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.

Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.

If you would like more information on restoring missing teeth with dental implants, 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 Timelines for Replacing Missing Teeth.”

By Dr. Mark C. Pothitakis
November 13, 2019
Category: Oral Health
MakeYourBabyasComfortableasPossibleDuringTeething

Your sweet, good-natured baby has seemingly gone from zero to grumpy overnight. The reason is simple: They’re teething.

Teething is a natural process in which a baby’s first teeth (primary teeth) begin to break through the gums, usually between six and nine months of age. This process continues intermittently until all twenty of the primary teeth erupt, sometime around age 3.

This uncomfortable and sometimes painful experience can cause gum swelling, biting and gnawing, chin rash and drooling. Your child may become irritable not only from this physical discomfort but also from disrupted sleep patterns and decreased appetite that often accompanies teething.

While you may have an unhappy baby while they’re teething, there’s usually no cause for concern. This is a natural process all children encounter, and the best thing you can do is make them as comfortable as possible. An exception would be accompanying diarrhea, fever or lingering crankiness—these could be symptoms of a more serious condition. If you begin to notice these, consult your doctor as soon as possible.

During teething there are a number of things you can do to reduce irritation. For one, allow your child to chew on clean, chilled (not frozen) teething rings, or a cold wet washcloth. The cold will help numb their irritated gum tissues. Massaging their gums with a clean finger can also help counteract the pressure caused by the incoming tooth.

If your doctor advises, you can also give your child over-the-counter pain relievers like acetaminophen or ibuprofen in an age-appropriate dosage. But be sure you give these medications orally and not rub them on the gums—some ingredients in them could burn the tissues. You should also not apply rubbing alcohol to the gums for the same reason. And avoid products with the numbing agent Benzocaine┬« in children less than two years of age unless your doctor advises otherwise.

Teething isn’t always a pleasant time for your baby or you, but it’s necessary—and temporary. In no time at all this discomfort will pass, and in its place will be their first set of teeth.

If you would like more information on teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”

By Dr. Mark C. Pothitakis
November 08, 2019
Category: Oral Health
Tags: oral health   vaping  
VapingCouldBeJustasHarmfultoYourTeethandGumsasSmoking

The electronic cigarette (e-cig), the much-acclaimed smoking alternative, has recently been linked to hundreds of lung-related illnesses and deaths among otherwise healthy young adults. But dentists were actually among the first to sound alarm bells on the potential harm of “vaping,” particularly to dental health.

If you're vaping as a substitute for smoking, you may be trading one set of oral health risks for another. Many dentists believe vaping may be no safer for your mouth than traditional tobacco.

An e-cig is a small, handheld device that holds a mixture of water, flavoring and chemicals. The device heats the liquid until it becomes a gaseous aerosol the user inhales into their lungs. Proponents say it's a safer and cleaner alternative to smoking. But, like cigarettes, vaping mixtures can contain nicotine. This chemical constricts blood vessels, decreasing nutrients and infection-fighting agents to the gums and increasing the risk of gum disease.

And although vaping flavorings are FDA-approved as a food additive, there's some evidence as an aerosol they irritate the mouth's inner membranes and cause mouth dryness similar to smoking. Vaping liquids also contain propylene glycol for moisture preservation, which some studies have shown increases a buildup of plaque, the bacterial film most responsible for dental disease.

All of these different effects from vaping can create a perfect storm in the mouth for disease. So, rather than switch to vaping, consider quitting the tobacco habit altogether. It's a solid thing to do for your teeth and gums, not to mention the rest of the body.

As we commemorate the Great American Smokeout on November 21, this month is the perfect time to take action. Here are some tips to help you kick the habit.

Don't try to quit all at once. Your body has developed a physical connection with nicotine, so quitting “cold turkey” can be extremely difficult and unpleasant. Although different approaches work for different people, you may find it easier to overcome your habit by gradually reducing the number of cigarettes you smoke each day.

Enroll in a cessation program. There are a number of step-by-step programs, some involving medication, that can help you quit smoking. Talk to us or your doctor about using a cessation program to end your tobacco habit.

Seek support from others. Beating the smoking habit can be tough if you're trying to do it solo. Instead, enlist the help of family and friends to support you and keep you on track. Consider also joining a supervised support group for quitting smoking near you or online.

Smoking can harm your dental health and vaping may be just as harmful. Distancing yourself from both habits will help you maintain a healthier smile and a healthier life.

If you would like more information about the effects of vaping and tobacco use, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Vaping and Oral Health” and “Smoking and Gum Disease.”

By Dr. Mark C. Pothitakis
November 03, 2019
Category: Oral Health
Tags: tmj disorders  
SeekCoordinatedTreatmentIfYouHaveBothTMDandFibromyalgia

Fibromyalgia is a chronic condition that produces widespread pain and stiffness in the muscles and joints. The pain, muscle spasms and tingling it causes can disrupt sleep, alter moods and impair memory function.

Dealing with just this one condition can be overwhelming. But did you know 3 out 4 fibromyalgia patients also develop chronic pain and dysfunction involving their jaw joints? Known collectively as temporomandibular joint disorders (TMD), these jaw joint problems cause pain, muscle spasms and difficulty moving the jaws that can interfere with eating and speaking. TMD can also contribute to headaches and earaches.

Many researchers believe this prevalence of TMD among fibromyalgia patients stems from both conditions originating from the same primary cause—a malfunction within the central nervous system. In both cases, the brain and spinal cord may not be able to process pain signals in a normal fashion. This malfunction could also be generating and amplifying pain signals even when nerves are receiving no stimulation.

For decades now, the most effective treatment strategy for TMD has been to manage the symptoms with physical therapy and exercises, thermal therapy or medications. Relief for fibromyalgia has depended on medication and relaxation techniques like biofeedback therapy. But with the evidence of some connection between the two conditions, it may be helpful to coordinate treatment for both with a team approach involving all your healthcare providers, rather than treat them separately.

To that end, make sure both your dentist or physician treating you for TMD and your physician treating your fibromyalgia each know about the other condition. Consulting together, your healthcare team may find treatments (like certain drugs that counteract neurotransmitter imbalances) that might help reduce symptoms in both conditions. And cognitive-behavioral therapy, meditation and other therapeutic pain management techniques can help you cope with the pain.

Continued research into these two debilitating conditions and the possible links between them may have an effect on how we treat both. A holistic approach to treating them could be the wave of the future.

If you would like more information on the links between TMD and other chronic pain conditions, 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 “Fibromyalgia and Temporomandibular Disorders.”

By Dr. Mark C. Pothitakis
October 29, 2019
Category: Dental Procedures
Tags: dental implant  
CleanYourImplantsJustLikeYourOtherTeeth

You feel great about your new smile, thanks to dental implants! And you may also be feeling relief as the problems with your former teeth fade into the past.

But that doesn’t mean you can drop your guard on periodontal (gum) disease. Even though implants are impervious to decay, the natural tissues supporting them are vulnerable to periodontal (gum) disease. If they become diseased, your implants could lose their bone support and eventually fail.

And that failure could happen quickly. That’s because, as life-like as they are, implants don’t have one important advantage of real teeth: an attachment to a connective tissue called the periodontal ligament. This tough but elastic ligament lies between the teeth and the bone, attaching to both with tiny extending fibers and holding the teeth in place.

And that’s not all: Because the periodontal ligament contains an abundance of blood vessels, it can supply antibodies to help fight infection. The body’s defenses may not be able to stop disease, but they can certainly inhibit its progress.

Implants can’t benefit from this infection-fighting mechanism. So, when an infection arises in the gums surrounding an implant, it can spread rapidly through a form of gum disease known as peri-implantitis (literally “inflammation around an implant”). If we don’t stop it with prompt treatment, you could lose bone support from your implant and eventually lose it, sometimes in quick fashion.

That’s why you should clean your implants everyday like you do the rest of your teeth with brushing and flossing. You should also visit us regularly for dental cleanings. A dental cleaning involving implants is similar to one with natural teeth, except the hygienist won’t use metal instruments on the implants—this could create tiny scratches on their surface. Instead, they’ll use nylon or plastic instruments or ultrasonic equipment to clean them.

You should also make a dental appointment as soon as you notice swollen, reddened or bleeding gums. If you have gum disease, we can stop the infection through treatment and restore your gums to health. This can be a long and involved process, but it’s necessary to preserve your implants.

It’s true that implants can change your life. If you want to enjoy that change for a long time, take care of your implants and the natural tissues that support them.

If you would like more information on caring for dental implants, 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 “Dental Implant Maintenance.”





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