Schweitzer & Schweitzer, PC
Education & Photos

Amalgam (silver) Fillings:

Amalgam fillings have been used for tooth restorations with great efficacy in dentistry for over 150 years. More commonly known as "silver fillings", these restorations, in the correct clinical situation, offer a relatively inexpensive and excellent long-term solution to filling a cavity.

Mercury is a component of amalgam fillings along with silver, tin, copper and zinc. When mixed together and condensed to form a dental filling, these elements form a very strong and stable substance. Mercury is a room temperature liquid metal which acts as a medium for mixture of the amalgam elements during the creation of this restorative substance. According to the American Dental Association (ADA), studies have failed to find any link between amalgam restorations and any medical disorder. Additionally, the National Institutes of Health in 1991 created an expert panel to review the current state of amalgam safety.1 The panel concluded that there were no identifiable health hazards from the placement of dental amalgams and that they were an effective and safe restorative dental material. More current scientific literature also supports the safety of dental amalgam fillings. 2,3 For more information on amalgam fillings, click here to visit the ADA website.

1. National Institutes of Health. Effects and side-effects of dental restorative materials. An NIH Technology Assessment Conference. National Institute of Dental Research. Bethesda, MD. August 26-28, 1991. Adv Dent Res 1992;6:3-144
2. Kingman A, et a. Amalgam exposure and neurologic function. Neurotoxicology. 2005:26(2);241-255
3. Pam Factor-Litvak, et al. Mercury derived from dental amalgams and neuropsychologic function. Environ Health Perspect. 2003:111;719-723
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Antibiotic Pre-medication:

Some patients have pre-existing health conditions which, according to the American Heart Association (AHA), require antibiotic pre-medication before invasive dental procedures. This involves taking a dose of antibiotics 1 hour before dental treatment as a precautionary measure to help prevent bacterial endocarditis: a serious health risk caused by bacterial colonization of the lining and/or valves of the heart. If, upon assessment of your health history, it is discovered that you have a condition that requires antibiotic pre-medication, our doctors will consult with your physician on how to best manage your particular situation. For more information on bacterial endocarditis, click here to visit the AHA website.
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Avulsed (displaced) Tooth:

An avulsed tooth is one that has been knocked out of the mouth usually do to some type of trauma. Please follow the subsequent guidelines if this occurs:
  1. If the socket where the tooth was lost is actively bleeding, get a clean handkerchief or tissue, fold it up, and then hold it over the socket and bite down to apply pressure.
  2. If you need medicine for pain, don't take any medication containing aspirin as this can encourage further bleeding. Tylenol is a good substitute.
  3. If the tooth is whole, it needs to be replaced in the socket as soon as possible: ideally in less than 30 minutes, but teeth have been successfully re-implanted up to 60 minutes after being knocked out. It is not a good idea to try re-implanting the tooth back into the socket if it seems broken.
  4. It is important to avoid handling the root. If it is dirty, rinse the root with milk and wipe it with a clean tissue. Do not clean the root with disinfectant or water or let it dry out. Holding the tooth by the crown, place it back into the socket firmly, root first. Bite gently on a clean handkerchief to keep it in place. Then call our office and see one of our doctors as soon as possible for an emergency appointment.
  5. If you have trouble placing the tooth back into its socket, it will have a better chance of survival if you keep it in in your mouth between your cheek and gums until you see your doctor. If this is not possible, keep it in milk. Then call our office and see one of our doctors as soon as possible for an emergency appointment.
  6. If a tooth is successfully re-implanted, additional therapy to help increase the chance of survival will likely be necessary. Your doctor will inform you of any potential further treatment that may be required.
  7. It is not recommend to re-implant a baby tooth because it may damage the forming adult tooth underneath.
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Bonding:

Bonding is a procedure that uses chemical adhesives to "bond" a restoration to a prepared tooth surface. In the bonding process, a dilute acid is applied to the tooth structure to produce a visibly frosted surface which microscopically consists of a roughened topography containing an array of peaks and valleys. This treated surface is coated with a liquid composite resin that, when hardened with an applied light or laser, mechanically interlocks into the rough surface. When used in the proper clinical situation, bonding can provide strong, long term adherence of a restoration, such as composites, to a tooth. Furthermore, bonding can help in minimizing the amount of tooth structure needed to be removed in order to place a successful restoration.
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Bridges:

Also known as fixed partial dentures (FPD), bridges offer a definitive solution to replacing missing teeth that stays fixed in the mouth. When one or more teeth are missing, a FPD can be used to suspend replacement teeth while being supported by implants or teeth adjacent to the toothless area. FPDs are usually made of porcelain fused to a noble metal, such as gold or silver/palladium, and are cemented into place. This allows the dentist to create a restoration that is both strong and esthetic and should last for many years.
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Brushing:

Proper brushing is essential for cleaning teeth and gums (gingiva) effectively. Brush twice a day. Use a toothbrush with soft, nylon, round-ended bristles that will not scratch and irritate teeth or damage the gingival tissue.

  • Place bristles along the gingival margin at a 45-degree angle. Bristles should contact both the tooth surface and the gingival margin.
  • Gently brush the outer tooth surfaces of 2-3 teeth using a vibrating back and forth rolling motion. Move brush to the next group of 2-3 teeth and repeat. When you have completed brushing all the outer surfaces of your teeth, repeat the same brushing technique to clean all the inner tooth surfaces.
  • Tilt brush vertically behind the front teeth. Make several up and down strokes using the front half of the brush.
  • Place the brush against the biting surface of the teeth and use a gentle back and fourth scrubbing motion.
  • Brush the tongue from back to front to remove odor-producing bacteria.

Use only a moderate amount of toothpaste on your toothbrush, about the size of a pea. Too much toothpaste creates an abundance of foam or lather which will make you think that you are being thorough. You should brush your teeth for at least 2 minutes and can use a timer for assistance, or better yet, get an electric toothbrush with a built-in timer.

Remember to replace your toothbrush every three to four months. Researchers have established that thousands of microbes grow on toothbrush bristles and handles. Most are harmless, but some may be cold and flu viruses, the herpes virus that causes cold sores, and bacteria that can cause periodontal infections. If you have any questions about proper brushing technique, ask one of our hygienists or dentists.
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Composites:

Composites are tooth-colored resin restorative materials used to repair teeth. They are applied to teeth in a soft plastic state, shaped to the proper dimension and then hardened with a light or laser. Composite restorations are retained in teeth through mechanical interlocking and/or bonding. The hardened composite restoration can then be polished to a highly esthetic finish. Composites can be used to eliminate decay, correct small chips and fractures, fix discolorations, or close spaces between teeth.
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Cosmetic Dentistry:

Cosmetic, or esthetic, dentistry is the name applied to a group of clinical procedures that are performed to create a more esthetically pleasing smile. As Prosthodontists, our dentists are specialized in this type of dentistry and can correct discolorations, whiten teeth, replace missing teeth, close unsightly spaces, and repair chipped or fractured teeth through a variety of esthetic dentistry options. These include tooth whitening, porcelain veneers, dental implants, composites, crowns, and fixed bridges. If you have any questions regarding cosmetic dentistry, don't hesitate to ask one of our doctors.
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Crowns:

A dental crown is a tooth-shaped restoration that covers an entire tooth that has been badly decayed or damaged by, for example, fracture or severe wear. Crowns are generally used when the damage or decay is so extensive that filling materials, such as composites or amalgams, cannot offer a good long-term restorative solution. Crowns can also be used in esthetic situations to change the shape and color of teeth. Crowns are made from noble metals (e.g. gold), porcelain fused to metal, or even all-ceramic materials. The dentist and patient together will make the decision on which type of crown is best for a given clinical situation.
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DDS:

Doctor of Dental Surgery: the degree awarded upon graduation from dental school. DDS is analogous to DMD: Doctor of Dental Medicine. DDS and DMD use the same curriculum requirements as set by the American Dental Association's Commission on Dental Accreditation. Three to 4 years of undergraduate education plus 4 years of dental school is required to graduate and become a general dentist. Both degrees allow licensed individuals to practice the same scope of general dentistry. To become a dental specialist, such as a Prosthodontist, additional post-graduate training is required.
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Decay:

Also known as caries, dental decay is one of the most common of all human pathologic processes, second only to the common cold. Bacteria that are normally present in the mouth will convert all foods, especially sugars and starch, into destructive acids. These acids can breakdown tooth enamel and dentin. Caries will, if left untreated, eventually destroy tooth structure and potentially lead to infection and/or tooth loss.
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Dental Cleaning (prophylaxis):

Dental cleaning or prophylaxis is the first line of defense against dental disease. It is a procedure designed to preserve health and prevent the spread of dental pathology such as periodontal disease and decay. This procedure includes tooth scaling, ultrasonic and polishing procedures to remove coronal plaque, calculus and stain that can potentially afflict your dentition. It is done on a regular recall schedule, along with a periodic exam by your doctor, every 3 to 6 months to ensure your dental health. Frequency of dental cleanings is decided on by your doctor and hygienist to maximize your dental health.
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Dentures:

Dentures are removable devices that are used to replace teeth. The replacement teeth are held in an acrylic or metal/acrylic base that covers the gums. Complete dentures replace all the teeth on either your upper or lower jaw. A partial denture replaces some of the teeth on a given jaw, and often relies on clasps the grip a few of the remaining teeth for stability and retention. You should not sleep with your denture, unless otherwise directed by your doctor. Furthermore, it is important that dentures be removed and cleaned at least once a day as instructed by your doctor. If you are not satisfied with your denture, ask your doctor about the possibility of getting dental implants make you denture more secure.
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Extractions:

A dental extraction is the surgical removal of a tooth from your mouth. This procedure is usually done under local anesthetic. A tooth may be removed for a variety of reasons: it may have extensive decay, or advanced periodontal disease, rendering it non-restorable; it may be a source of chronic infections; or it may be impacted and potentially damaging to other teeth. After the tooth is removed, the initial phase of healing will result in the formation of a blood clot. Occasionally this clot can become dislodged, resulting in a condition called dry socket. This is localized inflammation of the tooth socket , also known as, osteitis. This will lengthen the healing process and cause additional pain and discomfort.

The following are reminders of your doctor's post-extraction instructions:
  1. DO NOT RINSE THE DAY OF YOUR PROCEDURE. Starting the following day, use ½ teaspoon of salt in a glass of warm water to gently rise you mouth after each meal. Continue this for the next five to seven days. This allows for proper cleansing and promotes healing of the operative site.
  2. Eat only soft, mild foods (e.g. Jell-O, yogurt, soup) for the first 24 hours. Subsequently, you may return to your regular diet.
  3. Do not smoke or drink alcoholic beverages following surgery, and refrain from doing so for as long as possible. Both are irritants to the operative site.
  4. Avoid spitting or drinking from a straw. Both will disturb the operative site.
  5. Oozing from the surgical area creating a little blood-tainted saliva is normal. If active bleeding occurs, place a sterile gauze pad over the site, bite down and hold firmly. After 15 minutes, remove the gauze and throw it away. Repeat the procedure with a new sterile gauze pad if necessary. If bleeding persists for 45 minutes, call the office.
  6. Swelling is normal after surgery, and may be at its worst within 48 hours post-op. To help reduce swelling, you can hold a cold compress or bag of ice to your face on the side of the extraction: 20 minutes on, 20 minutes off. If swelling continues to worsen after 48 hours, call the office.
  7. If antibiotics have been prescribed, TAKE THEM AS DIRECTED UNTIL COMPLETELY FINISHED.
  8. Mild post-surgical discomfort is normal after the local anesthesia wears off, and may last for up to 2 - 3 days. Take pain medication as prescribed by your doctor.
SIGNS OF INFECTION may include the following and must be reported to you doctor:

    • Fever above 101ºf
    • Persistent pain not relieved by pain medication
    • Increased swelling after 48 hours

For more information on dental extractions, click here to visit the ADA website.
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Flossing:

Daily flossing is an essential part of your daily oral hygiene regimen. Flossing effectively removes plaque from in between your teeth. There are many different types of floss on the market, but usually waxed is the best.

  • Take 18" of floss and, if you are right handed, wrap it around the middle finger of your left hand and the index finger of your right hand. Leave two inches between your hands. If you are left handed do the opposite.
  • Slide the floss between your teeth and wrap it in a "C" shape around the base of the tooth and then gently slide it under the gum line.
  • Wipe the tooth 3-4 times from the base to tip. Make sure you floss both sides of every tooth.
  • Brush after you floss.

If you have any questions about proper flossing technique, don't hesitate to ask one of our hygienists or doctors.
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Fluoride:

On January 25th, 1945, Grand Rapids, Michigan became the first city in the world to include therapeutic fluoridation in its public water supply. Since then water fluoridation in order to prevent tooth decay has been hailed by the Centers for Disease Control and Prevention as one of 10 great public health achievements of the 20th century. Fluoridation of a community is simply an adjustment of the naturally occurring fluoride levels in the water supply to an ideal concentration to prevent dental decay (0.7-1.2 parts per million). According to the ADA, fluoridation can reduce the decay rate in teeth by 20-40%. Our doctors and hygienists can administer fluoride treatment in the office or prescribe fluoride for home use if necessary. There are many studies in scientific journals supporting the use of fluoride to prevent decay.4-7 Careful control of fluoride levels is essential, however, as large doses can cause a condition called Fluorosis- a mineralization disorder which can discolor and potentially create porosities in teeth.

Weakening of a tooth's surface through demineralization occurs when bacteria found in plaque produce acids that attack enamel. Minerals such as fluoride, calcium and phosphate can be redeposited, through remineralization, into the enamel layer from the foods and waters consumed. If too much demineralization occurs without sufficent remineralization to repair the enamel layer, the tooth can begin to decay. Fluoride helps prevent tooth decay by making the tooth more resistant to acid attack by re-inforcing the remineralization process.

Even though New York City and most of the surrounding areas have closely regulated, fluoridated water supplies, there are areas of Long Island, New Jersey, and Connecticut that do not. In order to check whether your home is receiving fluoridated water you can call your local water supply company, or check the following Centers for Disease Control and Prevention Web links: Click here for New York counties; click here for Connecticut counties; and click here for New Jersey counties.

4. Moberg Skold U, et al. Approximal caries development in adolescents with low to moderate caries risk after different 3-year school-based supervised fluoride mouth rinsing programmes. Caries Res. 2005 Nov-Dec;39(6):529-535
5. Marthaler TM. Increasing the public health effectiveness of fluoridated salt. Schweiz Monatsschr Zahnmed. 2005;115(9):785-792
6. Hopcraft M, Morgan M. Dental caries experience in a young adult military population. Aust Dent J. 2003 Jun;48(2):125-129
7. Dohnke-Hohrmann S, Zimmer S. Change in caries prevalence after implementation of a fluoride varnish program. J Public Health Dent. 2004 Spring;64(2):96-100
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Gingivitis:

The bacteria in dental plaque can irritate the gums (gingiva) and eventually cause infection. When your body launches an immune response against these bacterial pathogens, the gingiva becomes inflamed. Patients with gingivitis usually experience little or no discomfort. Hence, it is important to recognize the symptoms, such as gingival tissue that is red, swollen or bleeds easily, in order to take the appropriate steps to remedy this clinical situation. Gingivitis is reversible with professional treatment and good home oral care. However, if gingivitis is left untreated, it can progress to more serious forms of periodontal disease. If you think you suffer from gingivitis, don't hesitate to ask our hygienists or doctors what you can do to treat it.
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Halitosis (bad breath):

The word halitosis is derived from the Latin word "halitus", which means breath, and the Greek suffix "osis", which means condition. This condition, in most cases, will originate from the gums and tongue. The odor is usually caused by bacteria and retained food debris due to poor oral hygiene. Proper brushing including brushing the cheeks, tongue, and palate will aid in the removal bacteria and food particles. Flossing aids in removing accumulated bacteria, plaque and food that may be trapped between your teeth. Mouth rinses, such as Listerine (© Pfizer Ltd.), are effective in the relief of bad breath, but only as a temporary measure. Bad breath can also occur in people who have periodontal disease, diabetes, kidney failure, or a liver malfunction. Xerostomia (dry mouth) and tobacco use also contribute to halitosis. Foods with onion, garlic and coffee can often be detected on a person's breath for up to 48 hours after digestion. It is extremely rare to have bad breath originating from the stomach.

Visiting your dentist on a regular basis will allow for removal of plaque and bacteria that build up on your teeth over time. If you believe that you suffer from halitosis, your dentist and hygienist can help determine its source. For more information on halitosis, click here to visit the ADA website.
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Implants:

Dental implants are titanium screw-like fixtures which are surgically placed into the jaw bone to provide support for dental restorations ranging from a single crown to dentures to bridges. A titanium dental implant is analogous to the root of a tooth. After surgical placement of the implant fixture, it is usually allowed 3 to 6 months to heal so that it can osseointegrate, or fuse, with the bone. Once osseointegration is complete, our doctors can restore the implant(s) with the restoration that is best for your situation. Current scientific literature has indicated that success rates for dental implants are over 90%.8-11 In some clinical situations, bone grafting may be necessary in order to create enough bone to support the implant fixture and ultimately the restoration. This will increase the overall treatment time for implant supported restorations. For more information on dental implants, click here for the ACP website.
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8. Lekholm U, et al. Survival of the Branemark implant in partially edentulous jaws: a 10-year prospective multicenter study. Int j Oral Maxillofac Implants 1999;14:639-645
9. Schwart-Arad D. A long-term study of implants supporting overdentures as a model for implant success. J Periodontol 2005 Sep;76:1431-1435
10. Johansson LA, Ekfeldt A. Implant supported fixed partial prostheses: a retrospective study. Int J Prosthodont 2003;16:172-176
11. Ferrigno N, Laureti M, Fanali S, Grippaudo G. A long-term follow-up study of non-submerged ITI implants in the treatment of totally edentulous jaws. Part I: Ten-year life table analysis of a prospective multicenter study with 1286 implants. Clin Oral Implants Res. 2002 Jun;13(3):260-73.
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Inlays and Onlays:

Inlays and onlays are used when a restoration is needed for a tooth, but the remaining tooth structure is insufficient to properly support an amalgam or composite filling. Instead of circumferential bulk reduction of a healthy tooth to fit a crown, inlays and onlays are fabricated as an alternative. These restorations are cemented into place and are usually made from either gold alloys or porcelain-based ceramics. An inlay is placed in a prepared space within the confines of the tooth. An onlay is placed on the tooth to help build up its shape. The dentist and patient together will make the decision on which type of inlay or onlay is best for a given clinical situation.
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Invisalign®:

Invisalign® is a simple, comfortable and very effective therapy for straightening your teeth. The treatment uses a series of clear aligners that are custom-molded to fit you. Your doctor will not need to use traditional metal wires or bands that can irritate your mouth, and best of all, most people won't notice you're in treatment. The virtually invisible aligners gradually reposition your teeth into a smile you'll be proud of. Key elements of Invisalign® treatment are as follows:

  • Remove your aligners to eat, brush and floss
  • Change aligners every two weeks
  • Your teeth move little by little
  • Regular progress checks with your dentist or orthodontist
  • Results often in 6 months to 1 year
  • Most people won't notice you're in treatment
  • Won't disrupt your lifestyle
  • Free initial consultation

If you are interested in Invisalign® please do not hesitate to contact our office for a free consultation. For more information on Invisalign®, click here to visit the Invisalign® website.
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Nightguards:

Nightguards are fabricated primarily for patients that suffer from bruxism: the medical term for grinding or clenching your teeth. When left untreated, bruxism can cause severe destruction of the teeth, pain in the temporomandibular (TMJ) joint(s), soreness and/or spasm of the muscles involved with jaw movement, and headache. The etiology of bruxism is ill-defined and considered to be multi-factorial, although psychological stress and anxiety are thought to be primary factors in causing this condition. Nightguards are custom clear acrylic devices that are worn between the upper or lower teeth. These devices absorb the wear and damage caused by any grinding or clenching at night. In addition, they also often have a relaxing effect on the jaw muscles and the TMJ. If you are concerned that you may be grinding or clenching your teeth, don't hesitate to consult one of our doctors.
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Obstructive Sleep Apnea:

Obstructive sleep apnea (OSA) is a potentially serious condition characterized by episodes of breathing cessation, often more than 10 seconds, during sleep. This is most commonly caused by closing of the upper airway while asleep when the muscles of the mouth and throat relax. The most common symptoms of OSA are loud snoring and drowsiness during the day. Other symptoms may include morning headaches, dry mouth, cognitive dysfunction, and depression. Men who are overweight and older than 40 are at a greater risk for OSA, although this condition can affect anyone. Untreated severe OSA can lead to serious health conditions such as hypertension, heart disease, and stroke.12,13 Weight management and avoiding use of alcohol and sedatives before bed may relieve OSA in some people. Additionally, mechanical dental devices inserted into the mouth at night to keep the jaw forward may help in mild to moderate cases of OSA. In severe cases, referral to a sleep disorder specialist may be necessary. If you believe you may be suffering from sleep apnea, don't hesitate to consult with one of our doctors.

12. Yaggi HK, et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005 Nov 10;353(19):2034-41
13. Narkiewicz K, et al. Obstructive sleep apnea and hypertension. Curr Cardiol Rep. 2005 Nov;7(6):435-40
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Oral Cancer:

As is the case with all cancers, oral cancer is an extremely serious condition. Presently, only about 50% of patients diagnosed with oral cancer survive more than five years. Oral cancers are particularly dangerous because most have a high risk of recurrence after treatment. There are several types of oral cancers, but about 90% are squamous cell carcinomas. It is important to detect oral cancer early and therefore see your dentist on a regular basis for check-ups. Oral cancer often begins as small white or red discolorations or sores anywhere in the mouth including the lips, gum tissue, tongue, palate or cheek lining.

Other signs of oral cancer include:

  • Sores that bleed easily and never heal.
  • Changes in the color of tissues in and around the mouth.
  • Any growth, thickening of the tissues of the mouth, persistent rough spots, or eroding areas.
  • Numbness anywhere in the mouth or on the lips.
  • Unexplained difficulty chewing, swallowing, speaking or moving the jaw or tongue.

Smoking, particularly with the use of alcohol, can increase your risk of developing oral cancer 10-fold or greater compared to people that don't drink alcohol or smoke.14,15 Additionally, prolonged exposure to the sun can increases the risk of lip cancer.16 Studies have suggested that a diet high in fruits and vegetables may prevent the development of oral cancer.17 Our doctors screen all new patients for oral cancer, and would be happy at any time to answer your questions or address any concerns you may have regarding this subject.  Click here to visit the Oral Cancer Foundation website.

14. Chandran R, et al. Scientific. Risk of intraoral cancer associated with tobacco and alcohol--a case-control study. SADJ. 2005 Sep;60(8):326-8
15. Rodriguez T, et al. Risk factors for oral and pharyngeal cancer in young adults. Oral Oncol. 2004 Feb;40(2):207-13
16. Pogoda JM, Preston-Martin S. Solar radiation, lip protection, and lip cancer risk in Los Angeles County women (California, United States). Cancer Causes Control. 1996 Jul;7(4):458-63
17. De Stefani E, et al. Dietary patterns and risk of cancer of the oral cavity and pharynx in Uruguay. Nutr Cancer. 2005;51(2):132-9
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Periodontal Disease:

Periodontal disease is a progressive destructive condition affecting the tissues surrounding and supporting the teeth (gum and bone) that can eventually lead to tooth loss. Moreover, recent scientific studies have indicated that periodontal disease appears to be associated with an increase in risk for cardiovascular disease.18-20 Even in healthy mouths, the tooth sulcus, or collar of gum tissue around each tooth, is teeming with bacteria, though they tend to be harmless varieties. Periodontal disease can develop because of two reasons:
  1. the bacteria increase in quantity
  2. the balance of bacterial types tilts from harmless to disease-causing bacteria
The best defense against periodontal disease is good oral hygiene, including proper brushing and flossing techniques, and regular dental cleanings with your hygienist and check-ups with your doctor. If you are diagnosed with active periodontal disease, you may be referred to a Periodontist, a dentist who specializes in treating this condition, for evaluation and potential treatment.

18. Cueto A, et al. Periodontitis as risk factor for acute myocardial infarction. A case control study of Spanish adults. J Periodontal Res. 2005 Feb;40(1):36-42
19. Geerts SO, et al. Further evidence of the association between periodontal conditions and coronary artery disease. J Periodontol. 2004 Sep;75(9):1274-80
20. Janket SJ, et al. Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 May;95(5):559-69
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Plaque:

Dental plaque is a sticky, yellow-whitish, substance, composed of many potentially pathogenic bacteria and food debris, which collects around and between teeth. It must be mechanically removed either by brushing, flossing, or dental cleaning. It is a primary etiological factor of decay, gingivitis, and periodontal disease.
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Porcelain Veneers:

Porcelain laminate veneers are one of the most esthetic means in dentistry of creating a more beautiful and pleasing smile. They usually require a minimal amount of tooth reduction (approximately 0.5 mm on the lip side and 1.0mm on the biting edge) and, hence, conserve more natural tooth structure compared to preparation for a crown. Veneers are fabricated from porcelain based all-ceramic materials and are bonded onto the prepared tooth surface. With proper treatment planning between you and your doctor, porcelain veneer therapy will allow your doctor to change the shape, size and color of your teeth in the manner which is most appropriate and satisfying for you. As Prosthodontists, our doctors are specialized in this type of dentistry, and would be more than happy to answer any questions you may have regarding porcelain veneers.
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Post and Cores:

Also known as dowel and cores, these are cemented restorations used to support a crown or a bridge when there is not enough natural tooth structure to do so. The use of a dowel and core is determined as per the presenting clinical situation based upon the support and structural requirements the restoration being fabricated for you. The dowel is the post-like portion of this restoration. It is a metal structure that is inserted within the body of the root of a tooth that has had a previous root canal therapy. It can only be inserted in a tooth that has already had root canal therapy because the space previously occupied by the tooth pulp is now being occupied by the dowel. The core portion of this restoration is the part that supports then crown or bridge. It is either made of metal or composite and is the part that can be seen after cementation of a dowel and core. There are different types of dowel and cores: they can be either pre-fabricated or cast with noble metal (e.g. gold) in our dental lab. Your doctor will choose the best type of dowel and core for your particular situation.
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Pregnancy and Dental Care:

The American Dental Association (ADA) recommends that pregnant women eat a balanced diet, continue to practice good oral hygiene (brushing twice a day and flossing once a day), and visit the dentist for regularly scheduled dental cleanings. All elective dental treatment, such as routine dental X-rays, teeth whitening and other cosmetic dental procedures, should be avoided, especially during the first trimester and second half of the third trimester: these are critical time periods in the baby's growth and development. However, if you are experiencing dental pain, emergency treatment should not be delayed. Minimal use of X-rays for emergency can be completed with proper shielding of the abdomen to protect the baby. Local anesthetic can also be used conservatively, preferably without the use of epinephrine. Antibiotics such as penicillin, amoxicillin, and azithromycin are safe to use during pregnancy. Tetracycline should be avoided because it can permanently discolor your unborn child's developing teeth.

It is recommended that all adults have a dental cleaning at least every six months. If you are pregnant, it is very important to receive your regularly scheduled cleaning because pregnancy causes increased harmone levels that put you at a greater risk for periodontal disease and especially inflammed, sometimes swollen gums that bleed easily - a condition called pregnancy gingivitis. Recent studies have indicated that pregnant women suffering from periodontal disease may be at a greater risk for pre-term delivery, which, subsequently, increases the risk of having a low-birth weight baby.21,22 For more information on dental care during pregnancy, click here to visit the ADA website pregnancy fact page.

21. Lopez NJ, et al. Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol. 2005 Nov;76(11-s):2144-2153
22. Marin C, et al. Correlation between infant birth weight and mother's periodontal status. J Clin Periodontol. 2005 Mar;32(3):299-304
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Prosthodontics:

There are 9 dental specialties recognized by the American Dental Association (ADA):
  1. Dental Public Health
  2. Endodontics
  3. Oral and Maxillofacial Pathology
  4. Oral and Maxillofacial Radiology
  5. Oral and Maxillofacial Surgery
  6. Orthodontics and Dentofacial Orthopedics
  7. Pediatric Dentistry
  8. Periodontics
  9. Prosthodontics
Specialty training in Prosthodontics requires 3 additional full-time years of didactic and clinical education after graduating from a 4-year dental school. Prosthodontists receive specialized post-graduate training in the restoration and replacement of teeth. This includes intense instruction in partial and full-mouth reconstructive techniques, dental esthetics, and restorative implant dentistry. Prosthodontists are specialized in restorative treatment procedures such as dentures, bridges, crowns, porcelain veneers, inlays and onlays, post and cores, implants and cosmetic dentistry. The American College of Prosthodonists (ACP) is the official sponsoring organization for the specialty of prosthodontics. For more information on the ADA recognized dental specialties, click here.
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Root Canal Therapy:

If the pulp (nerves and blood vessels) of a tooth has been irreparably damaged, either from decay, fracture or trauma, your doctor may suggest referral to an endodontist for root canal therapy in order to save the tooth. Endodontics is the American Dental Association's recognized specialty in the diagnosis, prevention and treatment of diseases and injuries of the pulp. During the course of treatment for root canal therapy, the endodontist will first drill a small hole through the top of the tooth and remove the infected pulp tissue. The pulp chamber and root canals are then cleaned out and disinfected to remove all pathogenic bacteria. If there is evidence of an abscess, the endodontist will likely place a temporary seal on the tooth, provide you with antibiotics to fight the infection, and schedule a follow-up appointment. Once the infection has cleared, the canals are packed and sealed with an inert rubber-like material called gutta percha. Once the root canal therapy is completed, you will be informed by the endodontist when it is time to return to our office for restoration of the tooth. Depending on the condition of the tooth, the access opening is either filled with an amalgam or composite filling, or restored with a post and core and then crown.
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Tartar (calculus):

Also know as calculus, tartar is formed by the deposition of calcium and phosphate salts in bacterial plaque. These salts are naturally present in saliva. Plaque mineralization can begin within 24-72 hours and takes approximately 2 weeks mature. Calculus contributes to dental disease by providing a porous foci for further plaque accumulation. Calculus is not the causative agent in dental disease, plaque is. Calculus is only effectively removed by dental cleanings.
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Temporomandibular Disorder (TMD):

The temporomandibular joints (TMJ) are the joints that connect the mandible (lower jaw) to the temporal bone (part of the skull). This joint is located just in front of each ear and allows the mandible to rotate and slide. When the TMJs are properly aligned, a smooth muscle action, such as chewing or speaking, can take place. When these components are not properly aligned and poorly synchronized difficulties may arise. Temporomandibular disorder (TMD) is a general description for any disorder of the jaw muscles, TMJs and/or the nerves associated with chronic or acute facial pain. The exact etiology of TMD is often multi-factorial and difficult to diagnose. Often it is due to physical trauma of, or strain due to, bruxism (the grinding or clenching of teeth) on the jaw muscles and/or TMJ(s).  Symptoms of TMD may include the following:

  • Jaw discomfort or soreness
  • Headaches
  • Earaches
  • Radiating pain behind the eyes, in the face, shoulder, and/or neck
  • Clicking, popping, or locking of the jaw
  • Limited mouth movement
  • Dizziness
  • Sensitivity of the teeth in the absence of dental disease

Treatment for TMD may include the following:

  • Resting the TMJ
  • Pain and anti-inflammatory medication
  • Behavioral relaxation techniques and stress management
  • Physical therapy
  • Nightguard therapy
  • Diet modification (soft diet to rest jaw muscles)
  • Cold or warm compresses
  • Surgery

TMD is often a very difficult disorder to fully cure, and effective treatment may require a combination of therapies over an extended period of time. If you think you are suffering from TMD don't hesitate to consult with one of our doctors. For more information on TMD click here for the ADA website.
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Tooth Whitening (bleaching):

Bleaching is an effective and safe method to lighten the color of teeth. Our practice offers both in-office and at-home tooth whitening procedures which utilize ADA accepted peroxide-based bleaching agents to whiten teeth.

During in-office or chair-side bleaching, our doctors and staff will apply a protective gel to your gums and the oral soft tissues. A bleaching agent is then applied to the surfaces of teeth, and a special light is used to enhance the whitening action of the agent. This procedure usually takes about 1 hour of in office chair time.

At home whitening procedures involve taking molds of your teeth that are used to fabricate custom bleaching trays. Our doctors will then instruct you on how to use these trays in conjunction with the bleaching gel in order to maximize whitening results.

These bleaching procedures may not correct all types of tooth discoloration. Likewise, bleaching may not enhance your smile if you have had bonding, tooth-colored fillings, or other restorations placed in your front teeth. The whitening process will not affect the color of these materials, and they may stand out in your newly whitened smile. In situations such as this, you may want discuss other esthetic whitening options with our doctors like porcelain veneers. For more information on tooth whitening click here for the ADA website.
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X-rays (digital radiography):

Dental X-rays, also known as radiographs, are a critical and indispensable tool for your doctor to properly assess the condition of your mouth. Dental radiographs can aid in the diagnosis of pathologies such as decay, infectious abscesses, cysts or oral cancers, or bone loss due to periodontal disease. Additionally, radiographs are important for detecting impacted or supernumerary teeth and can help determine the condition of existing amalgam or composite fillings, inlays and onlays, crowns, bridges, and root canals. Radiographs are also necessary in determining whether there is sufficient volume of bone for the surgical placement of dental implants.

The frequency of how often radiographs should be taken will be decided on by your doctor according to your individual health needs. If you are a new patient, your doctor will likely recommend radiographs be taken to properly determine the present health status of your mouth and to serve as a potential baseline for future diagnoses. On the average, a 4 film bite-wing series of radiographs is taken every 18 - 24 months and an 18 film full-mouth series about every 3 - 4 years. Larger single Panoramic radiographs and/or Computed Tomography Imaging (CT Scans) are taken for special diagnostic situations or frequently for dental implant surgery.

Our office uses only digital radiographic imaging. Studies have indicated that digital radiographs produce diagnostic images equal or better than that of conventional radiographs.23-25 Furthermore, according to a study cited by the American Dental Association, the yearly average radiation exposure in the U.S. from natural sources is 20x that of a conventional full mouth series of radiographs.26 When a digital system is used there is approximately a 65-70% reduction in the amount of radiation needed for diagnostic quality radiographs. Also, digital radiographs also allow for instantaneous imaging, greatly reducing procedure time. If you have any question regarding radiographs don't hesitate to ask one of our doctors or hygienists. For more information on dental radiology click here for the ADA website.

23. Sanden E, et al. Reliability of digital radiography of interproximal dental caries. Am J Dent. 2003 Jun;16(3):170-176
24. de Almeida SM, et al. Image quality in digital radiographic systems. Braz Dent J. 2003;14(2):136-141
25. Molander B, Quality of film-based and digital panoramic radiography. Dentomaxillofac Radiol. 2004 Jan;33(1):32-36
26. Frederiksen NL. X-Rays: What is the Risk? Tex Dent J. 1995;112(2):68-72.
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Schweitzer & Poole, PC
133 East 58th Street, Suite 803
New York, NY 10022

Tel: 212-759-4969
Fax: 646-735-1843

Copyright © Daniel M. Schweitzer, 2008

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