By James J. Karam DDS, PC
September 21, 2018
Category: Oral Health
Tags: tooth decay   tooth erosion  
DontLettheAcidinSportsandEnergyDrinksRuinYourToothEnamel

Sports and energy drinks — two different types of popular beverages. But though different they have one thing in common: they can both wreak havoc on your tooth enamel.

That's because each contains high concentrations of acid. And acid is tooth enamel's mortal enemy — prolonged exposure with it causes the minerals in enamel to soften and erode, a process called de-mineralization.

Demineralization becomes even more pronounced when the mouth's pH levels fall below 4.0 into the acidic range. A sampling of various brands of sports and energy drinks reveal mean pH levels below even that threshold. Energy drinks are especially harmful to enamel because the type of acid they contain is more concentrated.

So, what can you do to minimize this threat to your dental health? The optimal thing to do is avoid such beverages altogether, especially energy drinks. If you currently re-hydrate after hard work or exercise with sports drinks, consider switching to water, nature's hydrator.

If you do, however, continue to drink these beverages, then follow a few precautions to lessen the acidic levels in your mouth:

Wait until mealtimes. Saliva is your body's way of neutralizing acid in your mouth, but it takes about 30 to 60 minutes for it to fully buffer acid. If you're sipping between meals on acidic beverages, saliva can't keep up. So, wait until you eat or limit your sipping time on a drink.

Rinse with water. Since water's pH is neutral, swishing some in your mouth right after drinking a sports or energy drink will help reduce acidity.

Wait an hour to brush. Your enamel will begin demineralizing as soon as it encounters acid. If you brush right away you could be sloughing off miniscule amounts of softened minerals. By waiting an hour you give your saliva time to buffer and help re-mineralize the enamel.

Although popular, especially among teenagers and young adults, overindulgence in sports and energy drinks could damage your teeth and increase your risk for tooth decay. With a little moderation and common sense, you can keep your enamel strong and healthy.

If you would like more information on the effects of sports and energy drinks on 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 “Think Before you Drink.”

By James J. Karam DDS, PC
September 11, 2018
Category: Oral Health
GoodOralHygieneJustasImportantforImplantsasforNaturalTeeth

Dental implants are known for their durability as well as life-like beauty. Thanks to their unique construction and ability to integrate with bone, they have a very high success rate and can last for decades.

But while they’re less problematic than other restorations, we still can’t “set them and forget them.” While the implants themselves aren’t susceptible to disease, the supporting gums, bone and adjacent teeth are. If you want them to last as long as possible, you’ll need to care for them and the rest of your mouth through daily oral hygiene and semi-annual office cleanings.

With that said, there are a few differences in how we perform hygiene tasks with implants. This is due to the way in which they attach to the jaw, as the titanium post is inserted directly into the bone. Natural teeth, on the other hand, are held in place by the periodontal ligament, a strong connective tissue that lies between the teeth and bone. The ligament holds the teeth firmly in place while also allowing minute tooth movement in response to changes in the mouth.

The ligament also has an ample blood supply that assists with fighting infection that may arise in the tooth and its supporting gums. Without this extra source of defense, infections that arise around an implant can grow quickly into a condition known as peri-implantitis and lead to rapid bone loss that could cause the implant to fail.

That’s why you and your hygienist must be ever vigilant to the buildup of plaque, the bacterial film that gives rise to dental disease, around implants and adjacent teeth. This includes removing plaque buildup from implant surfaces, although your hygienist will use tools (scalers or curettes) made of plastic or resin rather than traditional metal to avoid scratching the implant’s dental material. They’ll likewise use nylon or plastic tips with ultrasonic equipment (which uses high vibration to loosen plaque) and lower power settings with water irrigation devices.

Keeping infection at bay with effective hygiene is the number one maintenance goal with dental implants. Doing your part along with your hygienist will help you get the most of this investment in your smile.

If you would like more information on oral hygiene 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 “Dental Implant Maintenance.”

By James J. Karam DDS, PC
September 01, 2018
Category: Dental Procedures
ArianaGrandeBreaksFree-ofHerWisdomTeeth

Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”

With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.

Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.

But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.

In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.

So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By James J. Karam DDS, PC
August 22, 2018
Category: Dental Procedures
Tags: dental implants   dentures  
Implant-SupportedDenturesCouldHelpYouAvoidBoneLoss

Not long ago, the most affordable option for total tooth loss was a removable denture. Dentures, prosthetic (false) teeth set in gum-colored acrylic plastic bases, can effectively restore function and appearance. But the appliance continues to have one major drawback: it can accelerate bone loss in the jaw.

Like other living tissues, older bone cells die and become absorbed into the body (resorption). Normally they're replaced by newer cells. The forces generated when we chew our food travel through the teeth to stimulate this new growth. This stimulus ends when we lose our teeth, and so cell replacement can slow to an abnormal rate. Eventually, this causes bone loss.

Removable dentures can't provide this stimulation. In fact, the pressure generated as they compress the gums' bony ridges can even accelerate bone loss. That's why over time a denture's fit can become loose and uncomfortable — the bone has shrunk and no longer matches the contours of the dentures.

In recent years, though, a new development has been able to provide greater support to dentures while at the same time slowing or even stopping bone loss. We can now support dentures with dental implants.

Implants are best known as individual tooth replacements: a titanium metal post replaces the root, while a life-like porcelain crown attaches to the post to replace the visible tooth. In addition to providing a longer-lasting alternative to removable dentures, implants provide a very important health benefit: they improve bone density because they mimic the function of natural teeth. Bone cells are naturally attracted to the titanium; they adhere to the titanium post and are stimulated to grow through the action of chewing, increasing bone density and securing the implant's hold in the jaw.

Using the same technology we can support removable dentures, or even full fixed bridges. Rather than rest directly on the bony ridges, a denture can make a secure connection through a coupling system with just a few strategically placed implants. We can also permanently attach a full bridge by fastening it to a few implants with screws.

Not only do we eliminate the pressure from dentures compressing the gums and bone tissue, we can actually stimulate bone growth with the implants. Although more costly upfront than traditional dentures, unlike traditional dentures which must be replaced every five to seven years, long-lasting implants may be more cost-effective over the long-run.

If you would like more information on implant-supported tooth replacement, 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 “New Teeth in One Day.”

By James J. Karam DDS, PC
August 12, 2018
Category: Dental Procedures
Tags: dental implants  
GettingDentalImplantsRequiresMinorSurgery

Dental implants are best known as restorations for single missing teeth. But there’s more to them than that—they can also be used to support and secure removable dentures or fixed bridges.

That’s because a dental implant is actually a root replacement. A threaded titanium post is inserted directly into the jawbone where, over time, bone cells grow and adhere to it. This accumulated bone growth gives the implant its signature durability and contributes to its long-term success rate (95%-plus after ten years). It can support a single attached crown, or serve as an attachment point for a dental bridge or a connector for a removable denture.

The method and design of implants differentiates it from other restoration options. And there’s one other difference—implants require a minor surgical procedure to insert them into the jawbone.

While this might give you pause, implant surgery is no more complicated than a surgical tooth extraction. In most cases we can perform the procedure using local anesthesia (you’ll be awake the entire time) coupled with sedatives (if you have bouts of anxiety) to help you relax.

We first access the bone through small incisions in the gums and then create a small channel or hole in it. A surgical guide that fits over the teeth may be used to help pinpoint the exact location for the implant.

We then use a drilling sequence to progressively increase the size of the channel until it matches the implant size and shape. We’re then ready to insert the implant, which we remove at this time from its sterile packaging. We may then take a few x-rays to ensure the implant is in the right position, followed by closing the gums with sutures.

There may be a little discomfort for that day, but most patients can manage it with over-the-counter pain relievers like aspirin or ibuprofen. It’s what goes on over the next few weeks that’s of prime importance as the bone grows and adheres to the implant. Once they’re fully integrated, we’re ready to move to the next step of affixing your crown, bridge or denture to gain what you’ve waited so long for—your new implant-supported smile.

If you would like more information on 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 Surgery: What to Expect Before, During and After.”





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