Latex Allergies

Natural rubber latex is made from the milky substance found in rubber trees. Latex is found in many medical and dental products such as gloves, masks, syringes, tape and bandages. Some people are hypersensitive to natural rubber latex which can cause an allergic reaction.

An allergy to latex can develop after repeated exposure to products made of natural rubber latex. Healthcare workers are particularly suseptible since they are constantly exposed to latex products. Symptoms of a latex allergy can vary in severity from hives or nasal congestion to anaphylaxis, a potentially life threatening condition if left untreated.

If you have had an adverse reaction to latex, consult your physician to determine the best way to deal with the allergy. Inform your dentist and his/her staff so they can put an alert on your chart and take the proper precautions.

Fun Facts!

Abraham Lincoln issued a 'Thanksgiving Proclamation' on October 3, 1863 and officially designated the last Thursday of November as the national day for Thanksgiving.

Prior to that date, Presidents made an annual proclamation to specify the day when Thanksgiving was to be held.

The above information is for general information and educational purposes only and does not constitute health or medical advice. Consult a qualified dentist or physician to determine an individualized treatment plan and for an accurate medical diagnosis and advice. Although every reasonable effort has been made to ensure the contents of this educational piece is current, accurate and complete, neither David A Dersh, D.M.D., PA nor any other party involved in the publication of this paper make guarantees of any kind to it's accuarcy, merchantability or fitness for a particular purpose and are not responsible for errors or omissions of any kind.

Sleep Apnea and Dental Care

We are hearing more and more about sleep apnea, which is a very serious sleep disorder. This disorder involves breathing that stops and starts repeatedly while one is sleeping. This can happen hundreds of times per night.

There are 3 types of Sleep Apnea

• Obstructive- Most common form that happens when throat muscles relax
• Central- happens when the brain doesn't send correct signals to the muscles that control breathing
• Complex- not as common and is a combination of Obstructive & Central

According to the National Institute of Health, sleep apnea affects more than 12 million Americans, mainly obese males over the age of 40. Sleep Apnea untreated can affect blood pressure, depression, erectile function and memory. It can lead to concentration impairment and cardiovascular diseaase. Fatigue is common since the disorder disrupts sleep. Interestingly, sleep apnea is the leading cause of car accidents both during the day and at night.

Symptoms

• Loud snoring
• Gasping for air or choking while sleeping
• Headaches each morning
• Poor memory
• Difficulty concentrating
• Waking up with a sore throat or dry mouth
• Frequent urination during the night
• Restless moving
• Waking yourself up from snoring or lack of air

Treatment

• Sleep Study to determine is sleep apnea is the correct diagnosis
• CPAP- Continuous Positive Airway Pressure machine that delivers air pressure through a mask that is placed over your nose while you sleep.
• Adjustable Airway Pressure Device- this may help if there continues to be a problem with the CPAP . It adjusts the pressure automatically while you sleep.
• Oral Appliance- Appliances work when other methods don't. These appliances bring your jaw forward and keep the throat open.
• Surgery-Surgery is done to remove excess tissue from the nose and throat that may be causing vibrations, which causes snoring and blockage of the upper air passages.

If you feel you or someone you know may be suffering from sleep apnea, we recommend you make an appointment with your medical doctor or a sleep specialist for a proper diagnosis.

The above information is for general information and educational purposes only and does not constitute health or medical advice. Consult a qualified dentist or physician to determine an individualized treatment plan and for an accurate medical diagnosis and advice. Although every reasonable effort has been made to ensure the contents of this educational piece is current, accurate and complete, neither David A Dersh, D.M.D., PA nor any other party involved in the publication of this paper make guarantees of any kind to it's accuarcy, merchantability or fitness for a particular purpose and are not responsible for errors or omissions of any kind.

Dental Trauma

Dental trauma may be inflicted by sports related accidents, car accidents, falls, fights, or eating hard foods.  The trauma that may occur can be a tooth that is knocked out, cracked or fractured, pushed out of position, or loosened by impact.  Because oral tissues are sensitive, injuries to the mouth are typically very painful.  These type of injuries should receive prompt treatment from a dentist.

A permanent tooth that has been knocked out is a dental emergency.  If possible, the tooth should be reinserted in the socket and held there until a dentist can be seen.  If it's not possible to replace the tooth in the socket, the tooth should be placed in milk, saliva, or cool water with a pinch of saline solution. 

For lesser dental trauma, soft tissue injuries may only require cold compresses or ice to reduce swelling.  Bleeding can be controlled with direct pressure with a clean gauze pad.  Pain may be managed with aspirin or acetaminophen. 

Treatment of a broken tooth will vary depending on severity of the fracture.

Since many of the dental emergencies we see are sports related, it is wise for children to wear a mouth guard when playing contact sports.

Please be aware that each individual is different and that the above does not apply to everyone. Only a qualified dentist in consultation with you can determine what may or may not be beneficial to your conditions. 

Flouride and Bottled Water

Communities have been fluoridating their water supply since 1945.  The American Dental Association continues to endorse this practice. Fluoridated water has been proven to reduce tooth decay by 20 to 40% and improve the oral health of millions of Americans.  Many of the brands of bottled water on the market do not contain the optimum levels of fluoride(0.7-1.2 ppm).  Some home water filtration systems also remove naturally occuring and enhanced levels of fluoride from the water.

The ADA recommends that patients investigate the level of flouride in their community water supply.  If you use a home filtration system, check to see how much fluoride is filtered out.  If bottled water is your primary source of drinking water, discuss fluoride supplementation with your child's pediatrician.  You can also contact the bottled water company for the levels of fluoride contained in their product.

The above information is for general education purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Mouthwashes - Should I Use One?

Mouthwashes are used as an adjunct to brushing & flossing. Most mouthwashes are effective oral antiseptics that freshen & reduce bad breath; however, other mouthwashes are targeted to specific needs.

The type of mouthwash one should use depends on their specific needs which can include the following:

Anticavity/Fluoride - These mouthwashes contain fluoride. This is a simple, effective, and clinically proven way to prevent tooth decay. Anticavity/fluoride rinses on the market include:

• ACT
• Fluorigard
• Tom's of Maine
• Listerine Total Care

Antiplaque - These are designed to be used as a pre-brushing rinse to help loosen plaque. Studies show only a 20-25% effectiveness in plaque reduction. However, if rinsing, along with brushing & flossing, make you more diligent about your home care, then by all means, rinse away. Plax & Viadent are two OTC pre brushing rinses.

Antimicrobial - Listerine products reduce the bacteria found in plaque, therefore, they help combat gingivitis. Peridex is a prescription strength antimicrobial rinse often prescribed by periodontists and oral surgeons post surgery.

CoQ10 rinses - Helps to prevent and recerse the beginning symptoms of gum disease. One brand name is JASON and can be found online, in health food stores and at Wegmans.

Fun Facts!

Did you know that tooth enamel is the hardest substance in the body?

Snacking on carrots, celery and apples helps clean away food debris!!

Toothbrushes should be changed every 2-3 months and after an illness such as a cold or flu.

(Source- American Dental Hygiene Association)

The above information is for general education purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Which toothpaste is right for you?

Just take a walk down the toothpaste aisle in the supermarket and you are presented with numerous choices. The following information will answer some questions you may have. Characteristics of today's toothpaste include:

• Fluoride- Fluoride can help in the prevention of cavities. Most toothpaste contains fluoride. Studies show that the most effective concentration of fluoride is around .1%.
• Treatment of sensitivity- Sensodyne is the brand widely recognized for the relief of sensitivity. The main ingredients are Strontium Chloride, found in original Sensodyne, and Potassium Nitrate.
• Abrasiveness- We do not recommend a highly abrasive toothpaste.
• Ph level- Toothpastes are mainly base and that is what you want.
• Whitening formulas- These contain tiny mildly abrasive particles that help to remove stain, thus making your teeth look whiter.
• Flavor- Use any that appeals to you.
• Plaque prevention- Colgate Total contains Triclosan to help fight plaque buildup.
• Pronamel- This toothpaste fights sensitivity and erosion or recession. Erosion can be caused by acidic foods. Recession can be caused by over aggressive brushing or periodontal disease. Pronamel helps to strengthen the enamel. It contains Potassium Nitrate and fluoride.

The most important thing to remember is that frequent and effective brushing and flossing along with your toothpaste will help you to maintain good oral health.

The above information is for general education purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Remineralization

Demineralization occurs when acid from bacteria, food, drinks, and our body dissolves the tooth enamel & reduces important minerals from the tooth surface. Remineralization is when important minerals are added back into the teeth where the acid has eroded.

Over the past 10-20 years, there has definitely been a shift in our understanding and management of cavities. Now, rather than focusing on the end result (the cavity), the focus has started to shift to the status of the bacterial plaque and its effects on the demineralization-remineralization process at the tooth surface and subsurface.

What we know for sure is that the tooth can be remineralized. While our body helps to remineralize teeth, there are products available to aid the natural processes. Currently, there are a number of calcium-phosphate-based remineralizing toothpastes, mouth rinses, foams, gels, gum, and more. These products will help patients fight cavities and reverse others that have not progressed beyond the enamel.

There are other ways to treat and prevent tooth decay:

• Increase more arginine in the diet. Eat more spinach, soy, seafood, and nuts.
• Brush with baking soda, or apply your regular toothpaste and then dip it in baking soda.
• Xylitol is a great preventive aid. Look for gum that has xylitol in it.
• Combat dry mouth with hydration and an at home fluoride rinse or gel
  
  

If you have any additional questions or concerns regarding this suject, please feel free to contact us. Our email address is dentalinfo@drdaviddersh.com.

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Teeth Bleaching (Whitening)

A child's baby teeth are generally whiter than the adult teeth that follow. As a person ages, the adult teeth often become darker due to changes in the mineral structure of the tooth and the enamel becoming less porous. Teeth can become stained from bacteria, tobacco, and foods and drinks, i.e. red wine, tea, coffee, soda, and berries. Certain antibiotic medications (esp. tetracycline) can also cause teeth stains or a reduction in the brilliance of the enamel. Excessive fluoride can also cause tooth discoloration or mottled enamel.

There are several methods to whiten teeth.

• Bleaching Strips
  
• Bleaching Pens
  
• Bleaching Gels
• Laser bleaching

The degree of whiteness will vary from patient to patient, depending on the individual, the shade and type of staining. Intrinsic staining (stain within the the tooth) is much harder to bleach, and may not achieve the results one is expecting. Tooth mottling from excessive fluoride is also tricky when it comes to whitening because sometimes the mottled spots only become whiter.

Bleaching can be done with over-the-counter (OTC) products or in office at a dental office.

If you're thinking about (OTC) bleaching, we would advise sticking with a reputable brand of a bleaching product, such as Crest, Colgate, or Rembrandt. We advise staying with these companies because they have been around for years and have a long standing reputation to maintain. Therefore, their bleaching products are safe to use. We cannot be sure of the efficacy and side effects of the many other brands that are available.

If you're thinking of using an OTC bleaching product, do not use more than once in a 6 month period. Also, generally, we do not recommend bleaching, whether OTC or in office, for individuals under 18 years of age. It depends on the bone growth completion of the adolescent. This is due to eruption not fully completed or additional jaw growth not yet completed. If done too early, an area not bleached could show up later,on the exposed tooth , making it difficult to match.

Professional dental whitening is performed in a dental office and monitored by a licensed dentist. In office bleaching can be done two ways:

• Gel in trays performed at home (monitored by a dentist)
• Gel and light combination performed at the dental office
  

When performed under the supervision of a dentist, whitening is safe.

The side effects of any bleaching procedure, at home or in office, may include sensitivity and minor tingling sensations. These side effects always dissipate.

If you have any additional questions regarding dental whitening or are thinking about having your teeth whitened, please feel free to discuss it with us at your next visit or call us at (908)-232-8455!

We hope you found this information helpful!

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Gingival Recession

Receding gums is a condition found most common in adults over the age of 40. Therefore, we felt it would be a topic well received by many of our patients. We hope you find this article beneficial.

Recession refers to the roots of the teeth being exposed caused by a loss of gum tissue or retraction of the gingival margin from the crown of the teeth. Although it is a common problem in adults over the age of 40, it can occur starting in the teens.


There are several possible causes of gingival recession:
* Abnormal tooth position
* Thin, fragile or insufficient gingival tissue
* Overaggressive brushing
* Periodontal disease
* Inadequate brushing or flossing (allows bacteria to build up between the teeth)
* Eating disorders (self inducing vomiting)
* Dipping tobacco (it affects the mucus membrane lining in the mouth and cause receding
gums over time)
* Adult orthodontic movement of teeth
* Piercings in the lip or tongue (wears away the gum by rubbing against it)
* Sensitivity to Sodium Lauryl Sulfate (SLS), an ingredient in most commercial toothpastes

The following signs and symptoms may indicate gum recession:

* Sensitive teeth
* Teeth may appear longer than normal (if gums are receded, a larger part of the crown in visible)
* The roots of the teeth are exposed and visible
* The tooth feels notched at the gumline
* Change in the tooth's color (color difference between enamel and the root)
* Larger spaces between teeth (gums don't fill in between anymore)
* Cavities below the gum line (roots are more susceptible to decay due to the softness of the
root surface)

If gum recession is caused by gingivitis, the following symptoms may also be present:

* Puffy, red, or inflamed gums
* Gums bleeding while brushing or flossing
* Bad breath (halitosis)

The first step to treatment is the address the problem which has caused the recession.

Some advice to arrest the recession or prevent it is:

* Use a soft toothbrush
* Gentle brushing technique
* Improved oral hygiene
* Regular dental check ups and cleanings

For more advanced cases, treatment may include:
* Soft tissue graft surgery which uses tissue from another site in the patients' mouth to replace receded gums
* New research is focusing on using stem cells to culture the patients' own gums to replace receded gums

Most cases of recession can be monitored, coupled with changes in technique or hygiene, and may never require invasive treatment. If you have any questions regarding recession, please feel free to talk to us about it on your next visit, or email us at dentalinfo@drdaviddersh.com.

- Dr. David A. Dersh, Tracy, & Phyllis

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.