My Blog

By John P. Ducar, DDS, Inc
January 21, 2021
Category: Dental Procedures
Tags: tooth decay  
3ReasonsForPreservingaDecayedBabyTooth

Tooth decay can be a big problem for children's primary (baby) teeth. It doesn't take long for a tooth to become infected and the infection spread to their neighbors.

But since it will eventually give way to a permanent tooth, why not just pull a diseased primary tooth? Although that sounds sensible, there are important reasons for helping a troubled primary tooth survive to its natural end.

Current usefulness. They may not be around for long, but primary teeth serve children well while they have them. They enable a child to eat solid foods to further their physical development. They also figure prominently in speech development, which could be stunted by lost teeth.

The smile factor. Young children are also honing their social skills, and smiling is an important part of learning to fit in with family and friends. A tooth that's missing for some time, especially in the “smile zone,” could affect their smile and have an adverse effect on their social development.

Future teeth health. A primary tooth reserves the space intended for the future permanent tooth, helping to ensure the incoming tooth erupts in the right position. If it's not there, however, other teeth can drift into the space, crowding the incoming tooth out of its proper alignment.

That last reason could have the most long-term effect, causing the development of a poor bite that could require extensive orthodontic treatment. To avoid this and any other physical or social consequences accompanying its premature loss, it's worth the effort to try to protect and save a primary tooth.

Preventively, we can apply sealants on biting surfaces more prone to plaque buildup (the main cause of decay) and topical fluoride to strengthen enamel. When decay does occur, we may be able to remove it and fill the tooth, cap a tooth with a steel crown, or even use a modified root canal procedure in the case of advanced tooth decay.

The best way, however, to protect your child's primary teeth is to brush and floss them every day. Removing harmful plaque vastly reduces the risk of tooth decay. Coupled with professional dental care, your child can avoid tooth decay and get the most out of their primary teeth.

If you would like more information on children's dental care, 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 “Importance of Baby Teeth.”

WhyKathyBatesChoseThisAlternativetoBracesandsoMightYou

Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.

Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.

Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.

Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.

While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.

That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.

Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.

With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.

The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.

If you would like more information about tooth straightening, please contact us or schedule a consultation.

By John P. Ducar, DDS, Inc
January 01, 2021
Category: Dental Procedures
Tags: dental implant   bridgework  
CouldaDentalBridgeBeaBetterChoiceThanImplants

What a difference forty years can make: Dental bridges once occupied the top spot for choices to replace missing teeth until the arrival of dental implants in the 1980s. Today, dental implants are the gold standard for dental restoration.

But although bridgework may have lost “first chair” in the orchestra of restorations, it's still a viable option. In fact, it can be the best option in certain situations.

Bridges consist of a series of porcelain crowns fused together like fence pickets. The center crowns, known as the pontics, “bridge” the gap left by a missing tooth or teeth. The crowns on each end, the abutment teeth, crown the natural teeth on either side of the gap to support the bridge.

Bridges are effective and durable, but with a major downside: To accommodate the abutment crowns, we must reduce the size of the natural teeth to which they'll be attached. This alteration can weaken those teeth's structure and require them from then on to have some form of restoration. They're also at higher risk for tooth decay.

Implants, on the other hand, don't require this alteration, and may also be more durable than bridges. Why then consider a bridge?

Price can be a factor: Implants may be more expensive, especially involving multiple teeth. Keep in mind, though, that this only compares the initial cost: Because implants have a 95% or more ten-year success rate, with further evidence they could potentially last for decades, they may actually cost less in the long-run than bridge restorations that have a higher chance of being replaced sooner.

But the prime reason is that some dental situations aren't suitable for dental implants. For instance, implants require a certain amount of bone for proper placement, so people with extensive bone loss may not be able to acquire them. Health conditions like uncontrolled diabetes or a compromised immune system can also complicate implant installation. A bridge in these cases may represent a better alternative.

With the help of your dentist, you'll need to consider your individual situation, dental and financial, in deciding between an implant or a bridge. And, if a dental bridge is your best option, it will be a solid choice for restoring your missing teeth and your smile.

If you would like more information on various dental restoration methods, 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 “Crowns & Bridgework.”

By John P. Ducar, DDS, Inc
December 22, 2020
Category: Dental Procedures
Tags: dental implant  
TalkWithYourDentistAboutAntibioticTherapyBeforeImplantSurgery

Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.

To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.

One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.

In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.

These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.

As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.

If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.

If you would like more information on getting 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 “Implants & Antibiotics.”

By John P. Ducar, DDS, Inc
December 12, 2020
Category: Oral Health
Tags: nutrition   oral health  
YourFoodsMicronutrientsMakeaDifferenceinYourDentalHealth

When you were a kid, a plate of green beans or carrots probably seemed less appealing than a handful of cookies or a bowl of ice cream. Mom or dad telling you to “eat your vegetables” was the last thing you wanted to hear.

Hopefully, you've made friends with fresh fruits and vegetables as you've grown up. But even if you're just acquaintances, these foods are nonetheless essential to good health, particularly your teeth and gums. Among other things, they're packed with vitamins and minerals that help prevent tooth decay, gum disease or even oral cancer.

Here's a sampling of dental health-boosting micronutrients and the foods you'll find them in.

Vitamin C. Found in a variety of fruits and vegetables, vitamin C boosts the immune system to fight infections like tooth decay or gum disease. It's also an antioxidant that lowers your risk of cancer.

Calcium. This mineral obtained through dairy products, bony fish, greens and legumes, strengthens teeth and bones. It can also improve nerve and muscle function.

Vitamin D. This vitamin helps teeth absorb calcium to make them less prone to decay. You can find this essential vitamin in dairy foods, eggs, fatty fish or sunlight.

Phosphorus. Like calcium, phosphorus also strengthens teeth and bones. You'll find it plentiful in dairy and meats, especially seafood and poultry.

Magnesium. This mineral helps teeth and bones absorb other minerals and can also help with enzyme function needed to avoid disease. You'll find it in nuts, legumes, whole grains, dark leafy greens, seafood and chocolate.

If you don't think you're getting enough of these and other nutrients, you can obtain them through dietary supplements. But do be careful: The Food and Drug Administration (FDA) can remove harmful supplements from the market, but only after consumer use has provided evidence that they're unsafe. And, you won't be getting fiber or other elements found in regular foods that your body needs to be healthy and function properly.

Still, if you think you need to supplement a nutritional deficiency, speak first with your doctor or dentist about it and what you should take. If at all possible, though, eat your veggies—your teeth and gums, as well as the rest of your body, will be the healthier for it.

If you would like more information on nutrition's role in dental health, 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 “Vitamins & Dietary Supplements.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.