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Thank you for taking the time to visit the official Fiorentini Family Dentistry Blog!

An educated patient is our best patient, and accordingly we will provide you with updates on important information and advances in the dental profession and the latest news about our practice. Feel free to leave a comment or question for our doctors and staff.  Like us on Facebook to get office updates and be entered to win exciting prizes! – we hope this will be a valuable resource for our patients, families, and friends!

CUSTOM ATHLETIC MOUTHGUARD

We are a few weeks into the football season and just a few days from the start of hockey and the question on everyone’s mind is “How do these players protect their teeth?!”  Okay well maybe more people are wondering if the Giants can hold a 4^th quarter lead and if this will be the year the Rangers finally hoist the Stanley Cup, but a tooth-filled smile is nice too right?

While contact sports, like the ones mentioned above, are a prominent cause for trauma, dental injuries can also occur in non-contact activities and exercises such as basketball, baseball, and gymnastics.  The most effective way to protect the dentition and soft tissue is through use of a custom athletic mouthguard. ^1,2

Mouthguards provide a resilient, protective surface to distribute and dissipate forces on impact, thereby minimizing the severity of traumatic injury, such as fractured or knocked out teeth or laceration of the soft tissue.  While custom athletic mouthguards are considered by many to be the most protective option, other mouthguards can be effective if they fit well, are worn properly and stay in place.³

According to a 2007 meta-analysis of studies evaluating the effectiveness of mouthguards in reducing injuries, the overall injury risk was found to be 1.6-1.9 times greater when a mouthguard was not worn, relative to when mouthguards were used during athletic activity.²Another study of collegiate basketball teams found that athletes wearing custom athletic mouthguards sustained significantly fewer dental injuries than those who did not.⁴

Overall, if you or your child is participating in any athletic contest, especially those involving contact, a mouthguard should be considered a part of the uniform.  The best mouthguard is one that fits well and is comfortable so that it is worn at all times during competition.  It should be thick enough to protect the dentition, but not too big to impede normal breathing and swallowing.  A custom athletic mouthguard is the best solution to protect your smile.

Below are just a few more facts about dental injuries and mouthguards.  If you have any questions, please leave a comment or give our office a call.

A FEW ADDITIONAL FACTS ABOUT CUSTOM ATHLETIC MOUTHGUARDS ⁵

• Dental injuries are the most common type of orofacial injury sustained during participation in sports; the majority of these dental injuries are preventable.
• An athlete is more likely to sustain damage to the teeth when not wearing a protective mouthguard.
• The cost of a fractured tooth is many times greater than the cost of a dentist diagnosed and professionally made custom athletic mouthguard. Depending on the severity of the injury, the tooth may need a crown or be replaced with an implant
• Every athlete involved in contact sport has about a 10% chance per season of an orofacial injury, or a 33-56% chance during an athletic career.
• It is estimated that faceguards and mouthguards prevent approximately 200,000 injuries each year in high school and college football.
• The stock mouthguard which is bought at sports stores without any individual fitting, provide only a low level of protection, if any. If the wearer is rendered unconscious, there is a risk the mouthguard may lodge in the throat potentially causing an airway obstruction.  A custom athletic mouthguard is the most reliable option.

References

1. ADA Council on Access, Prevention and Interprofessional Relations; ADA Council on Scientific Affairs. Using mouthguards to reduce the incidence and severity of sports-related oral injuries. JADA 2006;137(12):1712-20.

2. Knapik JJ, Marshall SW, Lee RB, et al. Mouthguards in sport activities: history, physical properties and injury prevention effectiveness. Sports Medicine 2007;37(2):117-44.3. Kumamoto DP, Maeda Y. A literature review of sports-related orofacial trauma. Gen Dent 2004;52(3):270-80.

3. “Mouthguards.” Mouthguards. ADA Council on Access, Prevention and Interprofessional Relations

4. Labella CR, Smith BW, Sigurdsson A. Effect of mouthguards on dental injuries and concussions in college basketball. Med Sci Sports Exerc 2002;34(1):41-4.

5. “Sports Dentistry Facts.” Sports Dentistry Online – Sports Dentistry Facts. Sports Dentistry Online.

WHAT’S A GOOD AGE FOR YOUR CHILD’S FIRST VISIT TO THE DENTIST?

YOUR CHILD’S FIRST VISIT TO THE DENTIST?

A 2009 survey of American children’s oral health determined that a majority of children don’t see a dentist until they are over 2 years old.  Of those children who had visited a dentist, the average age of their first appointment was at 2.6 years. Even more concerning, the study also found that 34% of children up to age 11 had never seen a dentist!! So we ask again, what’s a good age for your child’s first visit to the dentist?

The American Academy of Pediatric Dentistry (AAPD) recommends that a child go to the dentist by age 1 or within six months after the first tooth erupts. Primary teeth typically begin erupting around 6 months of age and children can expect a full set of their primary teeth around 2 ½ years old.

PRIMARY TEETH ARE NOT JUST DISPOSABLE

As the permanent dentition erupts, the primary teeth loosen and eventually fall out.  This begins around age 6 with the lower incisors and continues through age 9-12 for the posterior teeth. The importance of keeping these teeth through proper oral hygiene and regular dental visits cannot be overstated.  Not only do the primary teeth help children eat properly and maintain proper nutrition, they also are important in speech development and help preserve the space for permanent teeth. Losing a tooth prematurely due to cavities can lead to improper eruption of the permanent dentition which may require extensive orthodontics.

A study found a statistically significant relationship in the prevalence of cavities in the primary and permanent dentition.  Of children who had a cavity in their primary teeth at 5 years old, 81.4% had at least one cavity in their permanent dentition!¹ Between the ages of 6 and 7, a child should have at least 6 permanent teeth and possibly up to 10!  This means that waiting to provide proper dental care to children can have consequences that will stay with them throughout their entire adult life!

WHAT’S THE SOLUTION

The best solution is to prevent the problem before it arises by scheduling your child’s first visit to the dentist as their first teeth begin to erupt.  The longer you wait, the more anxious a child can become about their visit, especially if they already have a tooth that is hurting them.  Familiarity with the office, the staff, and what to expect are the most important aspects of your child being comfortable at their first visit to the dentist.  What can you do to make their visit more comfortable?

• Bring them early.  Watching you or an older sibling have their teeth examined will show them that the dentist office is not a big deal.  Also visits prior to their own appointment will help them become familiar with the office and staff.
• Make it a game. Take turns examining each other’s teeth so that your child will be familiar with a dental exam.  Challenge them to see if they can brush as long as you or a sibling and see who has the whitest teeth afterwards.
• Educate them. Read a story book about a dentist, watch a video, or play a dental game online to teach them the importance of going to the dentist and keeping their teeth clean.

BRUXISM

Do you ever wake up in the morning with a headache or with the feeling that your jaw is tight?  You are probably one of the many people suffering from bruxism.

WHAT IS BRUXISM?

Bruxism is a parafunctional activity characterized by excessive clenching and grinding of the jaw.  Bruxism is a common problem, affecting up to 31% of the general population!¹ There are two main types of bruxism, one that occurs during sleep (sleep bruxism) and one that occurs when you are awake (awake bruxism).  While damage is done in both types, sleep bruxism can lead to more extensive damage and is associated with other medical concerns such as sleep apnea.

SYMPTOMS

• Worn down teeth
• Popping or clicking of the temporomandibular joint
• Headaches
• Tooth mobility
• Earaches
• Sore teeth, gums and muscles of the face
• Hypersentivity of teeth
• Restricted mouth opening (trismus)
• Tooth indentations on the edge of tongue

CAUSES

The cause of bruxism is largely unknown, but it is generally accepted to have multiple possible causes^2,3

• Stress and anxiety
• Anger
• Medications, especially those for treating depression and amphetamines
• Huntington’s disease and Parkinson’s disease
• Malocclusion
• Sleep apnea

DIAGNOSIS

The Internation Classification for Sleep Disorders listed diagnostic criteria for sleep bruxism.⁴ The minimal criteria include both of the following:

A. symptom of tooth-grinding or tooth-clenching during sleep, and

B. One or more of the following:

1. Abnormal tooth wear
2. Grinding sounds
3. Discomfort of the jaw muscles

WHAT CAN YOU DO?

People who grind their teeth may be unaware of the habit either because it occurs while sleeping or it is a habit during the day. Bruxism can have far-reaching effects on oral health, including tooth wear and the development of TMJ disorder.  Because of this, early diagnosis is key and can help prevent breakdown of your teeth.

If you are aware that you are an awake bruxer, try to break any habit that may cause you to clench your teeth during the day.  For instance if you clench your teeth when concentrating intently, try to loosen up or stick your tongue to the back of your teeth instead.

For a night bruxer, a custom nightguard can be fabricated to help protect your teeth.  This custom guard sits on one arch of your teeth and is only a few millimeters thick.  Call your dentist today and ask about bruxism and how to protect your teeth!

CITATIONS

1. Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F (2013). “Epidemiology of bruxism in adults: a systematic review of the literature”. Journal of Orofacial Pain 27 (2): 99–110.

2. Cawson RA, Odell EW, Porter S. (2002). Cawsonś essentials of oral pathology and oral medicine. (7th ed.). Edinburgh: Churchill Livingstone. pp. 6,566,364,366.

3. Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC (September 2010). “Bruxism: a literature review”. Journal of Indian Prosthodontic Society 10 (3): 141–8.

 4. “International classification of sleep disorders, revised: Diagnostic and coding manual.” Chicago, Illinois: American Academy of Sleep Medicine, 2001. Retrieved16 May2013.

PERIODONTAL RISK ASSESSMENT

If you have one or more of the above listed risk factors not only is it much more likely for gum disease to develop in your mouth, but it also makes it more difficult to eliminate periodontal disease once it has started.  Recent research has shown that periodontal disease increases your risk for serious chronic diseases such as heart disease, diabetes, Alzheimer’s disease, certain cancers, erectile dysfunction, and respiratory and kidney diseases.  Check off the boxes on this periodontal risk assessment and find out more information about how your specific health history can affect the condition of your mouth and entire body!

Inflammation anywhere in the body is harmful and is now identified as the root cause in many of the chronic diseases associated with aging.  It has been established that the mouth is a significant source of inflammation when periodontal disease is present.  These inflammatory mediators present in your mouth are the same as those associated with other inflammatory diseases.  Reducing the inflammatory burden in your mouth may help to reduce inflammation throughout the rest of the body!

TOBACCO USERS

You are already are at risk for heart disease, but tobacco use makes it more likely for periodontal  disease to develop as well.  Periodontal disease itself is also now recognized as a risk factor for heart disease.  Thus, it is especially important for you to do whatever is necessary to eliminate any periodontal disease.

DIABETES

If your blood sugar is not well controlled, you are at increased risk for serious complications associated with diabetes.  Research has suggested that the relationship between diabetes and periodontal disease goes both ways – gum disease may make it more difficult for people who have diabetes to control their blood sugar and that diabetes increases the risk of periodontal disease.  Eliminating periodontal disease can improve your blood sugar control and reduce the likelihood for serious complications.

OVERWEIGHT

When you are overweight, your body over-produces the same inflammatory mediators that cause periodontal disease.  In fact, obesity is now recognized as a risk factor for periodontal disease.  The latest research suggests that inflammatory mediators released when periodontal disease is present may affect appetite.

ARTHRITIS

A study showed that those who had moderate to severe periodontitis had more than twice the risk of arthritis compared to those with mild or no periodontitis!  Some bacteria associated with periodontal disease have been found to induce change in the immune system that causes rheumatoid arthritis.  Reducing periodontal disease can help lessen the crippling effects of arthritis.

FAMILY HISTORY OF GUM DISEASE

Periodontal disease has a strong genetic basis.  Research is suggesting that people with a family history of periodontal disease are not only at increased risk for periodontal disease, but also for other inflammatory diseases.

STRESS

The stress that results from life altering events (divorce, loss of job, moving to a new area, etc.) can make one more prone for periodontal disease to occur.

POST-MENOPAUSAL/OSTEOPOROSIS

The jaw bone is no different than other bones in your body.  If your bones are thinning due to osteoporosis you are at an increased risk for thinning bone in the jaw and associated periodontal disease.

THREE IMPORTANT STRATEGIES

1. Clean all bacteria from below the gum line
   1. Brushing only helps to break down what is above the gum line
   2. Requires ultrasonic and specialized instruments utilized at your dental hygiene visit
2. Boost your resistance!
   1. Accomplished through medication, diet, exercise
3. Partner with us to make sure gum disease does not return!
   1. It takes about 3 months for the bacteria to reform
   2. If you are at risk, increased frequency of visits may be required

If you have one or more of the factors for periodontal disease we may need to treat you more aggressively. Our goal is not just to help you avoid losing teeth, but to help you reduce the likelihood of promoting other more serious diseases of aging.  Even if you have insurance you may have to pay out of pocket for this care which is intended to reduce the disease causing inflammation in your mouth.  Rest assured, we will not recommend care unless we feel that it is worth it – the expected outcome will justify the necessary time, effort and cost.

NO MORE, “WELL IT DOESN’T HURT, CAN’T IT WAIT.”

Because of your risk factors we will be recommending recommend treatment at the earliest signs of disease since watching and waiting can be dangerous in your case – things can get worse in a hurry.  By the time periodontal disease hurts significant damage to your teeth and overall health may have already occurred.

MORE FREQUENT MONITORING

Periodontal disease is a silent disease.  You can have it and not even know it.  Often only a dentist or hygienist can tell if there is any inflammation of the gums in your mouth.  We will recommend seeing you more frequently than twice a year.  We know through solid research that it takes approximately 3 months for bacteria to reorganize and cause disease.  Since it is easier for bacteria to lead to problems in your case we may need to see you more frequently to make sure that we prevent any exacerbation before they turn into bigger issues.

MAY NEED MORE THAN JUST CLEANING

Typical cleaning may not be enough in your case.  Fortunately, there are adjunctive treatments that can really help eliminate gum inflammation and then keep it at bay.  Rest assured we will only recommend additional therapy when the expected benefit to your oral and overall health more than outweighs your out-of-pocket expense.

MAY REQUIRE REFERRAL TO A PERIODONTIST (GUM DISEASE SPECIALIST)

Because of the significant role that periodontal disease plays in overall health, we work closely with our Periodontist.  We’ll treat everything, but some areas may not fully respond.  You may need further treatment by a Periodontist.  If so, our treatment will minimize what the Periodontist needs to do and will allow them to get a better result.

WE ARE INNOVATIVE IN OUR TREATMENT PROTOCOLS.  OUR PERSONALIZED APPROACH WILL USE THE SPECIFIC TECHNIQUES FOR YOU THAT WILL MOST EFFICIENTLY ELIMINATE THE INFLAMMATION IN YOUR MOUTH. 

YOUR ORAL AND OVERALL HEALTH ARE AT STAKE!

h/t Dr. Tim Donley

ARE YOU A CANDIDATE FOR INVISALIGN?!

WHAT IS INVISALIGN?

Invisalign is a set of custom clear trays made from a strong plastic material that helps to guide your teeth into correct position over time.  There are no metal brackets and no wires to tighten!  Each case is customized using the latest technology to insure that each tooth is in its ideal position.  Every two weeks, a new aligner is worn as the teeth moved to their desired final position.  With Invisalign, you can achieve a great smile with little interference in your daily life.  The best part is that most people won’t even know that you are straightening your teeth!!

HOW DOES INVISALIGN WORK?

Invisalign works through the use of removable aligners instead of using the traditional metal braces.

After an inital consultation to determine if Invisalign is a good treatment for you, Dr. Fiorentini will take impressions and radiographs of your teeth so a treatment plan can be created for you.  A customized 3-D model of your teeth will be created and Dr. Fiorentini will show you how your teeth will move and shift as your treatment comes along. Depending on the severity of your case, treatment time is variable.

Once a finalized treatment plan is created, clear tray aligners will be created to custom fit your teeth. These tray aligners are removable and can be removed when eating, brushing and flossing so that they do not interfere with your everyday life. The aligners are also made of smooth plastic so they so they do not irritate your cheeks and you do not even notice that you are wearing them. These aligner trays are replaced every two weeks with a new aligner that will help shift your teeth into the next phase of treatment.

WHO CAN GET INVISALIGN?

Dr. Fiorentini is certified in both adult Invisalign and Invisalign teen.

These invisible braces are an appealing choice to many adults, especially those who wore braces as children and experienced teeth shifting in adult life and are now in need of some correction.

ADVANTAGES OF USING INVISALIGN

• Clear and invisible – no more traditional braces
• No tightening of metal wires
• Removable
• Smooth plastic – no cheek or gum irritation
• Straightens teeth in a comparable amount of time to traditional metal braces
• Helps with cases of gaps, overcrowding, crossbites, underbites, overbites

IF YOU HAVE ALWAYS WANTED A STRAIGHT, BEAUTIFUL SMILE, BUT ARE WORRIED ABOUT THE LOOK OF METAL BRACES, GIVE US A CALL TO LEARN MORE!

FIORENTINI FAMILY DENTISTRY IS ON FACEBOOK!

HAVE YOU CHECKED OUT OUR FACEBOOK PAGE?

LIKE US TO GET UPDATES ABOUT EXCITING INFORMATION IN THE FIELD OF DENTISTRY AND OUR PRACTICE.  AS AN ADDED BONUS, WE GIVE AWAY A FREE BLEACHING KIT TO ONE OF OUR FOLLOWERS EVERY QUARTER.  TELL ALL YOUR FRIENDS AND FAMILY TO LIKE US AS WELL AND GAIN AN EXTRA CHANCE FOR EVERY PERSON YOU REFER!!

APRIL IS ORAL CANCER AWARENESS MONTH

April is Nation Oral Cancer Awareness month, and the doctors and staff of Fiorentini Family Dentistry would like to invite you to our office for a complimentary oral cancer screening!

According to the National Cancer Institute, an estimated 35,000 new cases of oral cancer will be diagnosed this year and over 25% of these patients will have no known risk factors before diagnosis!!  On average, 60% will survive more than five years but oral cancer still claims 7,600 lives annually.

A comprehensive oral cancer screening takes less than 5 minutes.  Early detection can increase the chance for a cure and can decrease invasive treatment.  Oral cancer screenings are a routine part of the exam performed during your visit to the dentist so regular visits can help you stay a step ahead of oral cancer.

ARE YOU AT RISK?

• 25% have no known risk factors
• Alcohol and tobacco are the greatest risk factor
  • Using them in combination increases the risk 15 times!!
• Smokeless tobacco
  • Not a safe alternative to cigarettes with a 400% increased chance of oral cancer in users
• HPV virus
  • Historically, oral cancer has been a disease seen mostly in adults but the fastest growing population with oral cancer is in young, health, non-smoking individuals thanks to this sexually transmitted disease
• Leading cause of oropharyngeal cancer (the back part of the mouth)
• Prolonged sun or tanning bed exposure

SIGNS AND SYMPTOMS

• Patients may have no symptoms at all which is why routine dental exams, where we perform oral cancer screening, are vital to catching early signs of oral cancer.
• A sore that does not heal
• A red or white patch
• Bleeding, pain, or numbness
• Change in voice
• Loose teeth or dentures that no longer fit well
• Pain or trouble swallowing
• Consistent swelling of the jaw
• Consistent sore throat

WHAT CAN YOU DO?

• Early detection is the key!
• Regular self-examinations will help you become more vigilant and notice changes in the mouth early
•  If you do have risk factors, try to reduce your exposure and see your dentist for an oral examination

h/t aaoms.org

CONGRATULATIONS DR. CHRISTOPHER FIORENTINI

Congratulations to Dr. Chris Fiorentini for completing his residency at Robert Wood Johnson University Hospital Dental Clinic! We are so proud of you and all your accomplishments.  You have grown so much over the past year, taken countless middle of the night emergency calls, and now here you are.  We are excited to have you join our practice full time in just a few short days!!

GET A NEW SMILE IN ONE DAY WITH CEREC

At Fiorentini Family Dentistry, we offer same visit permanent crowns with CEREC!  Utilizing the latest in digital dentistry, we digitally scan in your teeth to our computer.  We then design your permanent crown to fit the ideal contours of your individual mouth.  One designed, we mill the crown in office with our specialized milling unit.  We then custom stain the crown to match your adjacent teeth so that you will never know the difference between your crown and natural tooth.  In one single appointment, you will go from broken down, discolored tooth to a strong, permanent, and aesthetic new crown.

Our composite restorations are another way to repair your teeth and achieve an aesthetic result.  Composite restorations are utilized in areas where the decay, or tooth fracture is less severe as they do not provide the overall strength that is gained with a full coverage crown.

Contact our office today to learn more about aesthetic dentistry and what CEREC and composite restorations can do for you!

(732) 545-1023