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Dental appliance therapy, part II

April 24, 2013 By

submitted by Dr. Michael Spadafora, D.D.S.

Last month I discussed the subject of night guards (also called appliance therapy or splints) because patients will often question the necessity or importance of this much-used dental tool. 

You may remember that patients who have very significant wear patterns on the surface of their teeth present a special problem for the dental practitioner. The night guard is a solution to preparing the mouth for restorative work.

There are some patients who get to the dental office “in the nick of time.” They have the condition of bruxism (teeth grinding), but it has not yet developed into a major problem.

Perhaps the wear patterns are beginning to appear or the patient is complaining about a sore jaw or even headaches. In these cases, an appliance is the logical and cost effective solution.

The night guard will protect the mouth from the ravages of bruxism, while also protecting any dental work that has been completed. 

Patients are sometimes skeptical that something as simple as a custom-made appliance can be so effective and comfortable, but it is true. A well-fitted mouth guard will become comfortable to wear (sometimes is takes a little time to get used to it) and is a very good dental value.

One of the reasons that dental work can fail is the pressure put on the teeth by the jaw, even when the patient is not aware of it. The night guard assists in stabilizing the new work and allows the jaw to adapt.

These mouth guards are usually fabricated in a dental lab and must not be confused with the mouth guards that are worn for sports or are purchased in a drug store.

Clearly, I am a strong proponent of appliance therapy, which I believe is one of the best values that dentistry has to offer.

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Time for a spring cleaning

April 24, 2013 By

submitted by Gary Selleck, Owner, C and C Family Roofing

The snow has melted, the groundhog has come out of his hole and the sun doesn’t set till later in the day. All of these things are signs that spring is upon us.

This is the time when we tune up the lawn mower, clean off the patio furniture and break out the grill.

But the effects of winter (and Hurricane Sandy) may have left a lasting impression on the home. Now is the time to have some preventative repairs done to your home so that additional damage can be avoided.

Here are some things that should be considered in getting your house ready for the spring rain.

  1. Take a walk around your house and look for any signs of damage (shingles laying on the ground, loose or misaligned shingles on the roof, loose siding, overflowing gutter due to leaves and debris, etc.
  2. Have a licensed roofing and siding contractor come a give you an evaluation on your exterior. Have them give you a free estimate on any necessary repairs to be done so that you can prevent possible interior damage to drywall, paint, insulation or formation of mold.
  3. Have a thorough gutter tune-up performed so that the spring rains will be collected by the gutters and channeled away from the foundation of your house. Excessive water against the foundation may cause flooding in your basement or crawl space.
  4. Have your roof or siding replaced if you know that it is close to its life expectancy. The price for petroleum-based products is constantly going up and you may save a significant amount of money by not waiting. Also, spring is the busiest time of the year for roofing and siding contractors and some companies may still be running winter deals. Price breaks and scheduling of work will be harder to arrange the longer you wait.

Don’t let winter “rain” on your spring. Call a licensed roofing and siding contractor today for an appointment.

Be sure to ask for any specials or discounts. Don’t wait till it’s too late.

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Appliance therapy is important part of dental work

March 20, 2013 By

submitted by Dr. Michael Spadafora, D.D.S.

Did you ever leave your dental office with the recommendation for a night guard (also called an appliance or splint), only to get home and wonder if this was a way for your doctor to pad his bill?  Unfortunately, this happens because we, as dental professionals, don’t spend enough time explaining, and you, as patients, are too anxious, nervous or in a hurry to really listen and understand.

This misunderstanding happens more with night guards than other procedures, because you can’t feel the problem early on and it seems like an “add-on,” not as important as the actual “work.”  Nothing can be further from the truth.

For serious restorative cases, the occlusal guard is the very foundation for the entire case. Without appliance therapy, the chance of discomfort, or even failure, significantly increases.

Normal wear on the tooth is about 10 microns a year. A micron is 1/1000 of a millimeter. If you have a one- or two-millimeter loss of tooth structure (enamel) it is the equivalent of 100-200 years of “normal wear!” There is approximately two millimeters of enamel on the biting surface of a tooth (a millimeter is approximately 1/25 of an inch) and when you wear through that enamel surface the tooth can deteriorate quickly.

You would be surprised at how many patients come through my door with significant wear, possibly a sign of the stressful lives we live. The patient who has already lost a lot of tooth surface (one or more millimeters) is a special case.

Believe it or not, the jaw has a “memory.” It becomes accustomed to the shorter teeth.

Before I can begin the restorative case and lengthen the teeth to a normal vertical dimension, I have to make sure that the jaw will accommodate to the change. This is done through the night guard (appliance therapy). 

The occlusal (night) guard is a hard plastic appliance fabricated at a lab. It requires multiple adjustments to perfect the patient’s bite, and has a life expectancy of 10-15 years.

It is easy to wear and easily maintained by yearly visits to the office. It is a worthy investment for your dental health.

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Cosmetic dental bonding

February 19, 2013 By

submitted by Dr. Michael Spadafora, D.D.S.

In this era of cosmetic dentistry much emphasis has been placed on porcelain veneers, which are thin pieces of porcelain chemically bonded to the tooth surface. In today’s economy, however, the cost of porcelain veneers (generally ranging from $750 -$2000 a tooth) may be prohibitive for a significant segment of the population.

While porcelain veneers are very popular, predictable and beautiful, other tried and true cosmetic procedures are also available to beautify your smile. An economic alternative is composite tooth bonding, which offers the dentist many options to update your smile.

Unlike porcelain veneers, which are pieces of porcelain baked in an oven by a dental laboratory, composite tooth bonding is applied directly to the tooth and cured to its final hardness, using a special light. Usually the dentist will lightly roughen the surface of the tooth, chemically etch that surface, apply a thin layer of liquid bonding agent and then apply the appropriate shade of composite material.

The dental composite is then shaped, smoothed and polished to a bright luster that, if done artfully, will blend in to the remaining tooth structures.

Dental composites are made of acrylic resins impregnated with inorganic (glass, quartz) fillers. They are made to paste-like consistency so they can be sculpted to the appropriate size and shape.

A skillful dentist can use these materials to close gaps, fix broken edges, repair cavities, or replace silver fillings.

Cosmetic bonding costs, which vary according to a number of factors including the skill of the dentist, generally are one-half to one-third the cost of a porcelain veneer.

The average life expectancy of cosmetic bonding can be three to 15 years, depending on the patient’s oral hygiene. Usually after a few years, the composite may lose some of its original luster but it can be repolished to look almost new in a few minutes.

Ask your dentist if you are a candidate for cosmetic bonding. You may be pleasantly surprised with the answer.

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Four New Years dental resolutions

December 14, 2012 By

submitted by Dr. Michael Spadafora, D.D.S.

Christmas is upon us and we know that New Years Day is just around the corner.

Many people make the standard New Years resolutions (lose weight, exercise more) so I thought I would suggest a few resolutions to add to the list. These dental resolutions are not difficult or expensive – but they can really improve the health of your teeth and gums.

1. If you do not floss your teeth, start now. The saying that “you should only floss the teeth you want to keep” holds a lot of truth.  If you floss occasionally, try to make it a part of your regular routine. Your dental hygienist will see a difference in the health of your mouth.

2. Change your toothbrush regularly. When you see that the bristles are wearing or become splayed, it is time for a new brush.  Always get a new toothbrush after a cold or illness. Germs can linger on the brush causing re-infections.

3. Purchase and use an over the counter antiseptic mouth rinse (do not confuse these mouth rinses with regular mouth wash). The antiseptic mouth rinse will fight infection in the mouth, as well as promote the longevity of existing dental work. Your dental hygienist can tell you more about these products and recommend a brand for you.

4. Make an appointment to have your teeth cleaned and checked.  Most dental problems begin small and, if treated early, can be resolved in a cost effective manner. In these difficult economic times, many dental offices (including mine) are finding ways to make dentistry more affordable.

Adding these four resolutions to your New Years list can help you greatly in the management of your oral health.

I encourage you to use your dental hygienist as a resource. I am privileged to share my love of dentistry with you through these articles.

I wish you all a wonderful holiday season and a happy and healthy 2013.

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Tooth restorations 101

November 6, 2012 By

submitted by Dr. Michael Spadafora, D.D.S.

Last month I wrote about when decay in a tooth becomes so pervasive that a crown is necessary instead of a filling. This month I want to talk about the basic types of fillings, and when each is used.

Fillings (or tooth restorations) are usually done with amalgam or composite material. Amalgam restorations are what we commonly call silver fillings.

Amalgam is an alloy, usually consisting of mercury, silver, tin, copper and other trace elements. Its use in dentistry has been widespread since the mid 1800’s. 

Amalgam restorations are popular and have been around for so many years for several reasons. Amalgam is a good material for restoring teeth because it is strong, durable, and relatively inexpensive. The drawbacks, however, have made the use of amalgam materials much less popular in some offices today.

First, amalgams are less appealing cosmetically than the newer composite materials. Patients often want their silver fillings replaced with white composite fillings. Also, the strength of the amalgam, which is normally a positive, can have a negative affect on the tooth.

When the patient bites, particularly in the case of larger fillings, the amalgam works as a wedge, sometimes causing the tooth to fracture. And finally, through the years, studies have come out about the toxicity of amalgam restorations.

While I am not convinced that this is an issue (there are probably more studies disputing it than promoting amalgam as toxic), I do acknowledge that some patients are concerned about it and do not want silver fillings.

I generally use the newer white composite restorations. Unless money is such an issue that amalgam is the only option, the composite restoration is my recommendation.

Composite restorations are not noticeable in the mouth. A well-done composite filling looks just like a tooth. This is a huge positive for most people and often offsets the increase in expense.

The material of the composite adheres to the tooth structure and binds it together, instead of acting as a wedge. So, although the composite material is not as strong as amalgam, it does serve to strengthen the tooth.

The quality of the composite restoration can vary widely from dentist to dentist. If you do opt for a composite restoration (and I hope you do), make sure you choose a dentist with a good cosmetic touch, willing to spend the time to do a beautiful restoration.

You will be happy with the results.

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Options for restoring teeth

October 9, 2012 By

submitted by Dr. Michael Spadafora, D.D.S.

Most general dental offices are in the business of restoring teeth.  The reason for restoring a tooth is basic – the tooth has decay in it, sometimes around an existing (old) filling. Tooth decay will worsen in time, so it must be handled.

Tooth restorations are usually done by one of three methods – a filling (either amalgam or white composite), an onlay, or a crown.  An amalgam filling is the least expensive, but also the least esthetic, option.

The white composite filling is more expensive than amalgam, but is very natural looking. The gold or porcelain onlay and the gold or porcelain crown are fairly close in price and are the most expensive.

So when does a filling become a crown? What is the dentist considering when he determines that a filling is not the correct solution to the decay problem?

The answer is simple – it is a judgment call.

In dental school we were taught parameters, based on the width of the decay on the top surface of the tooth, to determine when an onlay or crown is needed. Additionally, years of experience suggest to me when decay in the tooth is too large to be handled with a filling.

When a tooth which has too much decay is filled, the structure of the tooth is compromised. It becomes more likely to develop fractures, causing many problems, sometimes including root canal or extraction with the necessity of an implant.

Occasionally, the dentist will begin to fill a tooth, only to determine that the decay is too extensive and a crown is in order.  While this can be upsetting to the patient, it can be blamed on the nature of radiography.

Since the x-ray is a two dimensional view of the tooth, and the tooth is actually three dimensional, more extensive decay than expected is sometimes found.

In future articles I will discuss the differences between onlays and crowns and also the pros and cons of amalgam versus composite restorations.

For now, however, be assured that when your doctor recommends a crown, it is not a cavalier decision based on his bottom line. It is an assessment of the current condition of the tooth, with an eye to the future.

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Millennium Salon & Spa: Your neighborhood full service salon and spa

October 9, 2012 By

Millenium Profile by June Portnoy

You don’t have to travel far to receive a day of beauty, relaxation and rejuvenation. The professional, experienced staff at Millennium Salon & Spa in Holland is here to indulge your every need right in your own community.

Millennium might appear small from the outside, but once inside, you’ll discover the large diversity of services, products and even clothing it has to offer.

Lucy Shursky, born in the Ukraine, brings 39 years of experience to Millennium, which she established 11 years ago. She and her professional hair stylists offer contemporary, traditional and European hair styling for men and women.

“We’ll provide you with any hair style, colors or highlights you request,” says Lucy. 

Millennium also offers Brazilian Keratin hair treatment, hair extensions and updos for special occasions. 

The salon welcomes Ariella to its staff this month. She’s an up-and-coming stylist specializing in permanent hair extensions, a new technique in this industry. She’s also available for color, cuts, highlights and updos.

Come to Millennium to have your hair done, or stay and be pampered from head to toe. Mila, a licensed cosmetologist, masseuse and manicurist, provides European and Swedish massages, as well as reflexology.

She also does full body waxing, including Brazilian waxing, for both men and women.

All waxing is done in a private room. Manicures and pedicures are also done in a private area for your comfort.

Also, come to Millennium to have your eyebrows colored, your eyelashes tinted or eyelash extensions added. Makeup artists Veronica and Irene are on-staff to show you which makeup colors work best for you.

In addition to traditional makeup, they also apply airbrush makeup. You can purchase their makeup at Millennium.

“Veronica and Irene use Shira Skin Care from Israel because it offers product lines for every kind of skin, and we’ve had nothing but positive results from these products,” says Lucy.

Schedule an appointment with Veronica or Irene to do your makeup for weddings, proms or any other special events.

Still another service offered at Millennium is European facials. Plus, this spa is currently running a Fall Skincare Special, consisting of Microdermabrasion for just $57, as opposed to its regular price of $120.

It’s being offered by Valentina, a facial aesthetician with 40 years experience.

“Microdermabrasion is the accelerated removal of the top layer of skin,” explains Lucy. “It’s ideal for eliminating fine lines, sun damaged skin, age spots and acne scarring.”

Millennium also sells clothing, shoes, wigs, hair extensions, plus custom made and sterling silver jewelry.

“We import almost all of our clothing and accessories from Europe because we want to provide you with the highest quality and most unusual, fashionable merchandise,” says Lucy.

Ask about Millennium’s prices for a Day of Beauty, consisting of a facial, manicure, pedicure, massage, haircut and makeup consultant, plus a complimentary lunch. It makes a great gift for the holidays.

In addition, gift certificates for various amounts are also available.

Despite the many luxurious services offered at Millennium, it is run as a friendly, welcoming salon and spa where you can come and be yourself in a comfortable atmosphere.

Millennium, located at 295 Buck Road in the Pheasant Valley Shopping Center in Holland, offers flexible scheduling, open seven days a week.

Appointments are required Sundays, Mondays and Tuesdays, but walk-ins are welcome the rest of the week.

For more information or to schedule an appointment, call Millennium Salon & Spa at 215-953-9300.

PHOTO CAP: Lucy Shursky, owner of Millenium Salon & Spa

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It’s back to school – How is your teen’s self-esteem?

September 7, 2012 By

submitted by Vicky Rappaport, LMA of Lifestyle Med Spa

Many teens and young adults suffer with significant acne. They walk with their heads down because they are ashamed of their skin. When school starts, they just want to fit in.

Did you know:

  • Approximately 85% of the U.S. population between ages 12 and 25 develops some form of acne;
  • Acne most often starts at around age 11 for girls and age 13 for boys;
  • 25% will have permanent scars;
  • Some studies have shown that up to 70% of women notice their acne worsening the week before their period;
  • Teens with acne are perceived less favorably than teens without acne by their peers. This reflects upon a teen’s self-esteem, as well as their ability to advance academically and socially;
  • Acne tends to run in the family.

If your teen is experiencing more pimples under their bangs or wherever their hair touches their skin, it might be a good idea to change hair care products.

In addition, excessive cleansing with harsh irritants may lead to dryness, skin sensitivity, redness, and other problems. Avoid washing with hot water as this serves to irritate the skin as well.

A good skin care professional should work with clients to help them to understand the causes for their acne, or any other skin care problems, and how to calm their skin down.

They should also teach them how to care for their skin so that the acne does not come back and healthy skin is maintained. 

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Now is a good time for a dental check-up

September 7, 2012 By

submitted by Dr. Michael Spadafora, D.D.S.

It’s a busy time right now.

Moms and Dads are getting the kids ready to start a new school year, college students are packing up to go back to the books, and everyone is trying to grab that last little bit of summer.

With all this going on, it is hard to think about your kids’ dental health, but that is exactly what I am encouraging you to do.

In addition to getting a prophylaxis (teeth cleaning) and a fluoride treatment to help prevent cavities, the twice a year dental appointment gives the doctor a chance to check for potential problems.

My philosophy is to treat the very small cavities in such a way as to prohibit future cavities on the tooth. If the cavity is large, I am not able to be as conservative in the treatment.

The check up appointment also gives the dentist an opportunity to determine if new teeth are coming in correctly. I am often able to refer a child to the orthodontist at a young age for early intervention. This can save the family aggravation, time and money.

One of the most frustrating experiences for a parent is when a child is away at college and has dental issues. The child can be miles from home, parents, and the doctors who know him.

Through the years, I have dealt with patients who have experienced this stressful situation. It’s one of the reasons that I urge teenagers and college kids to get checked out before heading back to school.

Another point for teens and young adults – a dental check-up is the chance for the doctor to evaluate the wisdom teeth. If these teeth are going to become an issue, it is better to know in advance and select a convenient time for removal instead of rolling the dice and letting the teeth decide for you.

If your book bag is packed and you haven’t seen your dentist this summer, give the office a call. If your dental team can’t get you in before going back to school, schedule for the fall or winter break.

It’s the smart thing to do.

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