My Blog

Posts for: March, 2014

By John G. Fisher, DMD
March 24, 2014
Category: Dental Procedures
5ReasonstoConsiderClearOrthodonticAligners

You've probably heard of the relatively new method of straightening teeth with thin, plastic orthodontic appliances (“ortho” – to straighten; “odont” – teeth) known as clear aligners. Here are some reasons you might want to consider them for your orthodontic treatment:

  1. Appearance. Looks aren't everything, as the saying goes. But it may be that metal-covered teeth will not give you a look you want to sport for perhaps a year or more. Adults in particular find that metal braces don't always fit in with their self-image. Because clear aligners are virtually invisible, your teeth will look as they always do and it will not be obvious that you are undergoing orthodontic treatment.
  2. Control. When you have traditional braces, you cannot take them out of your mouth yourself. They must be professionally removed when your treatment is completed. With clear aligners, however, you can take them out to eat and also for important social occasions. Of course, that means you are also responsible for wearing them as often as needed — a minimum of 22 hours a day. It's a good bargain if you can live up to it, and most find that they can.
  3. Hygiene. One of the challenges of traditional braces is to learn to clean around them so that your teeth and gums stay healthy throughout treatment. It's not always so easy to do. With clear aligners, you can maintain your usual oral hygiene routine — and also clean the aligners themselves.
  4. Comfort. Sometimes the rigid brackets and wires of traditional braces can press into sensitive tissues of the mouth. It's something that you will eventually get used to, but it can be uncomfortable temporarily. The material of clear aligners is flexible, so this type of irritation is not an issue.
  5. Versatility. In recent years, the clear alignment system has been improved to handle more serious malocclusions (“mal” – bad; “occlusion” – bite). Enhancements have also been made to accommodate additional growth of molar teeth in the case of teenagers.

While there are some cases in which traditional braces are still the best option, clear aligners have more applications than ever before. They also have some clear advantages that are worth considering.

If you would like more information about clear aligners, please contact us or schedule an appointment for a consultation. You can also learn more about clear aligners in general by reading the Dear Doctor magazine article “Clear Aligners For Teenagers.”


By John G. Fisher, DMD
March 21, 2014
Category: Oral Health
TVAnchorNancyODellDiscussesPregnancyandOralHealth

We've all heard of morning sickness, but did you know that it's also not unusual for pregnant women to experience oral discomfort? This is what Entertainment Tonight co-host Nancy O'Dell discovered when she was expecting her daughter, Ashby. In an exclusive interview with Dear Doctor magazine, Nancy described how her gums became extra-sensitive during pregnancy, leading her dentist to diagnose her with “pregnancy gingivitis” (“gingival” – gum tissue; “itis” – inflammation).

“While my dental health has always been relatively normal, pregnancy did cause me some concern about my teeth and gums,” Nancy said. “With my dentist's advice and treatment, the few problems I had were minimized,” she said.

It's especially important to maintain good oral hygiene during pregnancy with routine brushing and flossing, and regular professional cleanings. This will reduce the accumulation of the dental bacterial plaque that leads to gum disease. Both mother and child are particularly vulnerable to these bacteria during this sensitive time. Scientific studies have established a link between preterm delivery and the presence of periodontal (gum) disease in pregnant women. Also, the elevated hormone levels of pregnancy cause the tiny blood vessels of the gum tissues to become dilated (widened) and therefore more susceptible to the effects of plaque bacteria and their toxins. Gingivitis is especially common during the second to eighth months of pregnancy.

Excess bacterial plaque can occasionally lead to another pregnancy-related condition in the second trimester: an overgrowth of gum tissue called a “pregnancy tumor.” In this case, “tumor” means nothing more than a swelling or growth. Pregnancy tumors, usually found between the teeth, are completely benign but they do bleed easily and are characterized by a red, raw-looking mulberry-like surface. They can be surgically removed if they do not resolve themselves after the baby is born.

If you are experiencing any pregnancy-related oral health issues, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Nancy O'Dell, please see “Nancy O'Dell.” Dear Doctor also has more on “Pregnancy and Oral Health: Everything You Always Wanted To Know But Never Knew To Ask.”


PatientsonBloodThinnersRequirePrecautionsBeforeandDuringOralSurgery

The proliferation of drugs to treat all manner of diseases and conditions has heightened concerns not only about general side effects, but also how a particular drug may affect treatments for other conditions. There are indications, for example, that drugs classified as blood thinners could cause complications for patients undergoing oral surgery.

Blood thinners like Warfarin are typically prescribed to patients with artificial heart valves or who are at significant risk for stroke, heart attack, or the formation of clots that could potentially damage the heart and lungs. The drug reduces the coagulation (clotting) mechanism in blood; aspirin taken regularly should also be considered a blood thinner.

As with any invasive procedure, blood thinners can complicate oral surgery. Blood doesn’t clot normally and so bleeding during a procedure is more difficult to stop. This doesn’t necessarily mean the surgery can’t be performed. For one thing, many oral procedures like tooth removal involve little trauma to tissues and bleeding in the hands of a careful and experienced surgeon. The surgeon can also use hemostatic agents during surgery that will stabilize blood clotting, as well as suturing the incision in such a way as to reduce bleeding from surface capillaries. In the case of a tooth extraction, a bone graft placed within the empty socket not only reduces bone loss from a missing tooth, but can also enhance bleeding control.

In consultation with your medical doctor, it’s also possible to temporarily stop or reduce your medication dosage in anticipation of a pending oral surgery. While it may not be safe to stop the drug altogether, a reduced dosage can ease the anti-coagulant effect and reduce any complications from bleeding that might occur during the surgery. You can then resume normal dosage soon after the procedure.

During your pre-op examination, it’s important to let your surgeon know about any drugs you are currently taking, including over-the-counter drugs like aspirin. The oral surgeon will then be able to take the necessary steps, including working with your medical doctor, to ensure your surgical procedure is safe and uneventful.

If you would like more information on oral surgery precautions while taking blood thinners and other medication, 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 “Oral Surgery & Blood Thinners.”


By John G. Fisher, DMD
March 04, 2014
Category: Dental Procedures
Tags: dental implants  
UnderstandingtheProcessofDentalImplants

If you’ve been reviewing tooth replacement options, you probably already know the superior benefits of dental implants: their durability, functionality and life-like quality could provide you with years, even decades of satisfying service.

If you take this option, however, you should be prepared for a slightly longer process than a couple of office visits. From concept to permanent crown placement, it will require several months of preparation, expertise and teamwork. The more you know about this process, the better prepared you’ll be to handle it.

After careful preparation, which may include extracting the tooth being replaced, the process begins in earnest with the surgical placement of the implant’s titanium post into the jawbone. The surgeon uses a guide based on your bite and mouth structure to precisely implant the post in a pre-planned location: this ensures that the permanent crown will be affixed in the right location for best appearance and functionality.

While a temporary crown can sometimes be attached immediately after implantation, the permanent crown must wait until the bone grows and attaches around the titanium post (osseointegration). Once this has occurred, usually over several months, the implant can fully support the permanent crown and its function.

This last element, the permanent crown, is in many ways a work of art. Taking into consideration the patient’s facial features and shape, the type of tooth replaced and the tooth coloring natural to the patient which is transmitted this information to the dental technician who will manufacture the crown. The goal is to produce a life-like replica that will look natural and perform well.

It may seem quite involved, but all these stages are necessary for a successful outcome. Although dental implants take careful attention and time, the outcome is worth it. In the end you’ll not only recover lost function, you’ll also have a new, transformed smile.

If you would like more information on the procedures for placing 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 Implants: Evaluating Your Professional Options for Care.”