We Now Offer A Solution For Dental Anxiety


First, let me say that much has happened since our last newsletter back in August. We have welcomed Dr. Sagar Lunagaria to our practice, and as a result, we are offering new services and additional hours. In particular, Dr. Lunagaria provides sedation for those who have dental anxiety, he is experienced in placing dental implants and he performs gum procedures which previously required our patients to seek the care of a periodontist. For many minor surgical procedures our patients can now remain in our office. In addition, in the event that you need care for a dental emergency, you will find it much easier to be seen very promptly to have your problem addressed.

It has been an absolute pleasure working with Dr. Lunagaria, and he has been well received by not only our team but by the many patients who have met him during September. Dr. Lunagaria will be available in our office every day that we are open except Tuesdays. Please make sure that you have an opportunity to meet him the next time that you are in the office.


You can now truly relax in the dental chair while having your treatment. Nitrous oxide – commonly known as laughing gas is a mild sedative. It is one of the safest ways to relieve fear and anxiety related to dental appointments. This form of relaxation is also very helpful in eliminating or minimizing severe gagging. It does wonders for individuals who are highly fearful of needles or who have real difficulty getting numbed.

Is severe gagging preventing you from seeing a dentist?

Nitrous oxide is administered through the nose by simple inhalation while your dentist works on your teeth. The amount of gas is regulated by the dentist so he has full control over the amount of anxiety control which is needed for each individual patient.

Fear of needles?

Inhalation sedation is very safe and there is almost no side effect of it. The effects of the laughing gas wear off quickly as so that you can drive yourself home after finishing your procedure without the need of an escort.

Do you ever dread going to a dentist?

Depending on the severity of fear and anxiety, nitrous oxide (laughing gas) can be combined with oral medication which is taken before your treatment to help you relax even further. It is a great choice for people who fear needles. You will be awake and aware of your surroundings but relaxed and free of anxiety. It also helps create short term partial memory loss, so most patients do remember discomfort, smells or noises associated with the dental procedures performed.

Do you have difficulty getting numbed?


Again, our goal is for you to be comfortable and anxiety-free during your dental treatment. We are proud to offer this service in our office now. Call our office at 908-659-6655 to find out more or visit us online at www.DesignsForDentalHealth.com to book a complimentary consultation today!!

Top Five Dental Problems For People 50 +

Many of our patients have been visiting us for well over 20 years. As these patients reach 50 years of age and above, we see a significant shift in the risk factors whichj affect them from a dental standpoint.  There have been several instances of patients who have suddenly developed rather severe decay, gum disease, and general tooth attrition resulting from bite problems. These are patients who for years required only minimal and basic preventive and restorative care.

As a result, I decided to list and describe the top five dental problems which those of us who have reached age 50 and beyond are experiencing. In our next blog article, we will present the top treatments which have been successful at addressing these issues. As always, the best treatment and care which every dental patient needs is preventive care. Preventive care includes proper homecare and routine dental exams and cleanings. Those who are seen regularly in our office are much less likely to develop the major problems which some 50+ year olds experience.

The top five dental concerns are:

1. Dental decay especially around the gumline.

features-teeth-1Often, as we get older, our gums recede leaving root surfaces exposed and gaps between the teeth.   As the root surface is less smooth and softer than enamel, decay in these areas is quite common here. And between the teeth where spaces have developed, food and plaque become trapped and lead to decay as well.


 2. Dry mouth, also known as xerostomia.

The amount of saliva in our mouths can decrease as we age. In addition, many medications can cause a reduction in saliva production leading to dry mouth. The importance of saliva in protecting our teeth and gums cannot be overstated. Saliva acts as a buffer to help neutralize the acids which are the main cause of dental decay and gum disease. Acids are formed in our mouths when the bacteria in plaque ingest carbohydrates like sugars which we eat.

3.   Gum disease (periodontal disease)


It is not uncommon to see patients who have had mild to moderate cases of gingivitis in the past begin to develop more serious periodontal disease. Gingivitis is inflammation which is limited to the gums and results in redness, swelling and bleeding gums. If this problem progresses, the underlying bone may become involved and the attachments of the teeth becomes increasingly jeopardized. In its most severe form, teeth will become loosened and may eventually literally fall out.

4. Oral cancer

Traditionally, the use of tobacco and alcohol has been associated with oral cancer.   Today HPV  (Human papilloma virus) which is sexually transmitted has become the number one cause of oral cancer. In this case, the best offense is a good defense meaning regular dental checkups which include a proper oral cancer screening.

5. Crowded teeth

We have seen numerous examples of patients whose teeth have been slowly shifting over the years resulting in marked overlapping of especially the upper and lower front teeth. Teeth which are crowded tend to collect more debris and plaque than those which are straight. In addition, overlapping teeth are more difficult to keep clean. As a result, such teeth are more prone to both dental decay and gum disease. In addition, because crowded teeth do not meet the teeth in the opposing arch evenly, such teeth exhibit increased wear and chipping as they become more and more thin.









We will address possible solutions to each of these problems in our next blog. In the meantime, if you have any questions about any of these issues please feel free to contact us by telephone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com


Which Is Worse –Bad Gums Or Teeth?

This may sound like a trick question, but really it’s not. The “correct” answer, of course, is that both are equally important. But, I have a different view and will share it later in this article.

Both gums and teeth require good to excellent daily hygiene to remain healthy.   Prevention of both periodontal disease and dental decay is accomplished using the same techniques and products.  Both gum disease and dental decay are caused by the attack of bacteria which produce acid.  This acid causes damage to both hard and soft oral tissues including gums, enamel, dentin and bone. Both conditions if not properly and promptly addressed will result in the eventual loss of teeth as well as the inability to properly chew food.   And, both problems are a source of embarrassment and self consciousness due to missing teeth, bad breath, swollen and red gums, black holes, etc., etc.

Both teeth and gums are checked at every dental re-care appointment.   Commonly, both june3of these dental diseases go unnoticed by patients until more involved and expensive treatments are required. In the case of cavities, decay which has advanced to the point when a patient feels pain will generally require root canal therapy. And, in the case of gum disease, by the time a patient realizes that there is a problem, the solution often involves the services of a periodontist, possible gum surgery and / or loss of teeth.   Unrecognized and untreated periodontal disease will eventually lead to loose teeth as a result of the loss of bone and the attachment of the teeth.


Finally, both gum disease and tooth decay result in the existence of chronic infection and inflammation which has detrimental affects on the overall health of the body. A chronic infection which becomes acute, can result in serious illness which may require hospitalization. The hidden impact of such diseases, however, is that these chronic inflammations increase the risk of other health issues including heart disease, cancer, complicated births, etc.

As promised, my view whenever planning the treatment for patients and explaining its need is that once acute infection and pain are under control, the health of the gums is the number one priority.  Consider the gums and bone to be the foundation which supports the teeth.   Without a solid foundation, even the healthiest teeth can be lost. Once the periodontal condition is stable and healthy, then the teeth can be addressed as needed.

If you have any questions about gum disease or dental decay, please feel free to contact us by telephone @ 908.359.6655 or via our website www.DesignsForDentalHealth.com

Our 30th Anniversary Hillsborough High School Scholarship

The artwork which you see displayed in our office has been created by six Hillsborough High School Seniors who have applied for the Richard M. Nadler DMD, PA 30th Anniversary Scholarship.  One student will be selected to receive this scholarship based on their artwork submitted for display as well as letters of recommendation from two people who were influential in the selection of fine arts as their college path.  



This scholarship is our way of expressing thanks to the Township as well as the people of Hillsborough for having been hosts for our dental practice for the past 30 plus years.  You may ask why would a dentist sponsor a Fine Art scholarship? Wouldn’t a career in science or medicine make more sense? Well, you may already know that I originally began my working career as an architect. I actually practiced that profession for a period of some ten years before returning to school to become a dentist.  One of the reasons that I chose architecture as my original career was because of my love of drawing and art. I have always had tremendous respect and admiration for those creative individuals who have the ability to express their imagination through the visual arts – whether it is on paper, canvas, film or in three-dimensional sculpture. So, I decided to also encourage a potential, local, up-and-coming young artist to pursue his or her career in the arts.


I hope that in some small way this scholarship expresses the gratitude that our entire team has for the people of Hillsborough.   It is you wonderful people who have made coming to work each day our life’s fulfillment.



New Sleep And Snore Device Offers Improvements

A new sleep and snore device called a MicrO2 was introduced nearly a year ago and it offers several significant improvements over appliances which have been most commonly prescribed in the recent past. This appliance is used to treat patients who have mild to moderate obstructive sleep apnea (OSA) as well as primary snoring.  We have been offering this appliance for the past few months and feel very positive about several of its features.

sleep and snore device

This product is similar to its predecessors in that it repositions the lower jaw in a downward and forward direction in order to maintain an open airway. As the jaw moves down and forward, the tongue and soft tissue at the back of the throat are also pulled forward so that they cannot fall back into the airway thus blocking the flow of air.   One of the major improvements of this appliance is that its intrusion into the tongue space is minimized.  Older appliances are more bulky in areas adjacent to the tongue and have a tendency to force the tongue further back into the airway – a counterproductive byproduct of older appliances.  By minimizing encroachment into the tongue space, less forward movement of the jaw is required to gain the same benefits. As a result, the appliance is more comfortable to wear and potentially more efficient in treating the primary cause of snoring and sleep apnea.

sleep and snore device

Similarly, because this appliance is milled from a different material, its thickness or bulkiness, if you will, is much less than that of its predecessors making it more comfortable to wear while not compromising its durability.  In addition, it has no movable parts like the adjustment screws in other similar appliances. As a result, the possibility of improper adjustment by the patient is eliminated and the appliance is further streamlined.

Another benefit of being digitally milled is that replacements as well as additional appliances for different jaw positions can be milled without the need for additional impressions. If an appliance should break or be lost, a replacement can easily be ordered from the laboratory at a reasonable cost with just a phone call. These appliances have a two-year warranty and are approved by the FDA.  And, did I mention that its cost is slightly LESS than previous such appliances?

Side effects which may be experienced by wearing these appliances remain the same as previous models. There may be gum or tooth soreness, which is easily adjusted and resolved by the dentist.  There may be an increase or decrease in salivation during the first few weeks of wearing the new appliance. These symptoms usually resolve by themselves within a couple of weeks. There may be jaw soreness or tightness especially when first placing the appliance; and, again, this symptom is usually temporary. On awakening in the morning, the bite will have changed overnight and generally resolves within an hour by gently squeezing the back teeth together. As with all procedures, if there are any issues, a call to the dentist will generally resolve the problem.

If you have any questions about the MicrO2 device please feel free to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com.

Don’t Like Flossing? Here are Some Helpful Ideas

We know that some of you don’t like flossing. You may be surprised to hear us say, we understand!” Flossing each day can be difficult. Perhaps you have sensitive gums, your mouth is small, or you feel like floss wrapped around your fingers cuts off your circulation. There are lots of seemingly good reasons not to floss, and as you can imagine, we’ve heard them all.

What if we told you that there are several options available that can make flossing easier?

Many, Many Varieties Of Floss

flossingTry ribbon-style floss instead of thread-style. Try waxed versus unwaxed. Try one that’s specially designed to glide easily. Try a different thickness, or a different flavor. The type of floss you use doesn’t matter nearly as much as the fact you’re doing it!  Take a look at our post from October 3- These Are a Few of Our Favorite Things to see what our favorite floss is!

Consider Tools Like Flossers And Flossing Sticks

After trying several of the various options suggested above, if no brand or particular type of floss seems to be doing the trick for you, look into other tools that are designed to help.

flossingFlossers and floss sticks eliminate the need to wrap floss around your fingers. These tools can also make it easier to reach back teeth without having to stick your hands in your mouth. They can also help you more easily maneuver the floss for better coverage.


The are many different tools and many different brands available to try. The most important thing is that you floss!  Watch these two videos to show two different tools that can be used for flossing; one for everyone and one for kids!

For Everyone


For Kids

Never Underestimate The Value Of Flossing!

Flossing is an essential part of effective, daily oral hygiene care. Flossing helps guard against gum disease, the most common cause of tooth loss in adults. In addition to the woes of gum disease, studies suggest that gum health is linked to systemic health issues including diabetes and Alzheimer’s.

Make Flossing A Daily Priority

If you have questions about how to make flossing easier, please let us know at your next appointment. We want to help you maintain and improve your dental health!

Thanks for being our valued patients and friends!

Originally published on http://designsfordentalhealthblog.com/dont-like-to-floss-here-are-some-helpful-ideas/

Removing the Fear of Showing Your Teeth When You Smile

Showing your teeth when you smile makes a huge difference in your confidence and appearance. Beautiful teeth make us all feel more approachable, better prepared, accepting of others, younger, and more attractive. Studies show that 70% of people believe a beautiful smile can make someone appear more attractive than wearing makeup!

As We Age, Our Smiles Lose Their Luster

It’s an unavoidable part of life. As we get older, our teeth become worn, yellow, and misaligned. Micro cracks absorb stains easier and discolor teeth. Grinding and chewing can give our smiles a shortened appearance, making our faces look sunken.

Turning To Cosmetic Dentistry

People today turn to dentistry for anti-aging treatments! It’s amazing to see the difference smile improvements make in an entire look (and confidence)!

Basic Cosmetic Procedures Overview

Showing Your Teeth When You SmileVeneers – Veneers are typically made of porcelain, shaped and bonded to the front of, or over teeth. Veneers are a great way to change a tooth’s color and shape and provide extra volume that can give your entire face a fuller look.

Composites & Implants – If you’re missing a tooth or have unsightly dark fillings, we can help. There are many options.

Showing Your Teeth When You SmileWhitening – The safest, fastest, and most effective way to whiten your teeth is with professional whitening. Talk to us about whitening options.

Straightening – Straightening your smile not only improves your appearance, but also your health! Modern options have improved the aesthetics, speed, and comfort of teeth straightening.

Straightening Your Smile With Invisalign

In this video, Dr. Nadler describes Invisalign and answers some frequently asked questions.  Keep a look out for our Invisalign Special starting in April!

Removing The Fear Isn’t As Difficult As You May Think

We want you to feel like showing your teeth when you smile! Small improvements can make a big difference. Let’s visit soon about your particular concerns. We’re here to help!

Thanks for being wonderful patients!

Back to Normal Sooner with Oraverse


With today’s busy schedules, sometimes it’s difficult to make time for a dental appointment. The last thing you want is to have to spend several more hours after your appointment recovering from the numbing effects of the anesthetic.

Here at Designs for Dental Health, we believe that providing the best possible care also means minimizing your downtime! So, we use a “numbness reversal” product called OraVerse to get you back to your normal life, faster.

Resume Your Life In Half The Time

OraVerse brings patients who have received anesthesia back to normal sensation in half the time. Oraverse is a rather new product which we felt would offer a real benefit to some of our patients who really do not like that “numb” feeling or who need to be ready to get back to work fast. As always, feel free to let us know if you have any questions about this product.

Say Goodbye To Slurred Speech And Drooling!

After your appointment here, we know you may be headed back to work or school. We want to help get your sensations and speech back to normal as soon as possible.

In addition to helping you avoid embarrassment caused by slurred speech or drooling, OraVerse helps reduce the risk of injury caused by biting the inside of your cheek while you’re still numb.

Has Anything Funny Happened To YOU While Numb?

We feel like our relationship with you doesn’t end when you walk out our door.  Has anything funny happened to you when your mouth was numb? If so, share your story in our comments section below. We’d love to hear from you!

This article was originally featured on our secondary blog site.  You can find it by clicking on this link: http://designsfordentalhealthblog.com

Is Invisalign a Reasonable Option to Straighten Adult Teeth?

Invisalign is a system for straightening teeth and improving the bite which is an alternative to conventional metal orthodontic “braces”.  This system utilizes a series of clear plastic aligners, each of which is worn 22 hours per day for a period of 2 weeks. The company began in 1997 and has gone through a series of improvements which have made this method increasingly utilized and accepted by the dental community as well as patients.

There is no question that our practice is seeing more and more adult patients who  request Invisalign to improve their bite and appearance, as well as to help turn back the clock.

There are a number of conditions which can be addressed using this system:

  1. Those who had orthodontics as a child but have seen significant relapse over the years.
  2. Patients who are concerned about the shifting or increasing misalignment of their teeth.
  3. Those who have teeth which are wearing down unevenly.
  4. Patients with teeth that appear crowded or misaligned.
  5. Those who have an underbite, overbite or open bite.
  6. In some cases, those who have gaps between their teeth.
  7. Increasingly, those who desire to improve their appearance and look younger.

Click this image for a concise video on Invisalign.

There are significant benefits of Invisalign as compared to conventional metal orthodontics:

  1. InvisalignThere are no dietary restrictions because the aligners are removed before eating.
  2. There are no special dental hygiene requirements because the liners can be removed to brush and floss the teeth.
  3. Because the aligners are made from a clear plastic material, they are practically invisible.

As the system begins with a virtual treatment plan called a “ClinCheck”, both the dentist and the patient are provided a digital preview of the treatment.   This preview, if used properly, helps to determine how well the treatment will result.  In our experience, patients truly enjoy this preview and its use to track the progress of their case.  It’s important to note that In some severe cases, the use of Invisalign may not offer the best solution. Some cases may still require either surgical intervention, conventional metal braces or a combination of the two.

There are several long-term benefits of having straight teeth and a good bite:

  1. Straight teeth are easier to keep clean and food particles and plaque are not trapped in uneven spaces.  The result is a decreased likelihood of both dental decay and gum disease.
  2. Healthier teeth and gums contribute to a person’s overall systematic well-being and health.
  3. Uneven wear due to misaligned teeth is alleviated.
  4. Patients enjoy a more confident smile and an improved, more youthful appearance.

 If you have any questions about Invisalign, please feel free to call us at 908.359.6655 or via our website at www.DesignsForDentalHealth.com


The Best Way To Fill Your Tooth

Can You Just Fill It?

One question that dentists are asked all the time is: “Can you just fill it?” My goal with this particular article is to answer just that question.   And the answer is: That depends on several factors. First and foremost are the needs and desires of the particular patient.  Equally important is the condition of the tooth or teeth in question.


First, let me begin by explaining that nearly all of today’s tooth restorations are made of ceramic. Ceramic encompasses the materials most commonly used to restore teeth today. This includes porcelain in various forms as well as composite, commonly known as “plastic” fillings.  In our practice, metal is rarely used except in specific cases where achieving a quality bond is impossible (deep under the gum) or the strength of metal is mandatory.  Ceramic materials offer a beautiful, lifelike appearance and can be bonded to tooth structure for strength and longevity.

The choice of whether to use a composite filling or some type of porcelain restoration is dependent upon the following five conditions:

1. The size of the cavity

Composite fillings makes sense when the cavity – whether caused by decay or fracture – is less than one third the width of the tooth and takes up less than 50% of the biting surface. Larger cavities with inadequate tooth to support a filling are best restored using porcelain.

2. A cracked tooth

If the tooth is cracked, a porcelain restoration is needed to protect the tooth from fracturing.  We commonly see cracked teeth when silver fillings, especially large ones, have been in place for many years.

3. Worn teeth

Teeth which are worn can be restored with either material depending upon the extent and location of wear.   Surfaces which receive heavy biting forces require the strength of porcelain to last a reasonable length of time.

4. Root canal

Teeth which have had root canal therapy generally require porcelain crowns to protect them from breakage, as these teeth are brittle and somewhat hollow as a result of the root canal.

5. Tooth Modifications

Sometimes teeth are restored to alter their shape and or appearance. Examples are gaps between teeth, poorly aligned teeth and teeth which are restored to improve the bite.  Larger modifications require the use of porcelain.


Today’s porcelains are much different from those that were used only 10 to 15 years ago. Newer technology has produced ceramic materials with exceptional strength as well as a lifelike appearance.  In addition, these materials can be used to make crowns, commonly known as  “caps”, which cover the entire tooth.

fillThey can also be used as onlays or “partial caps” to preserve solid healthy tooth structure. These onlays are beautiful and long-lasting restorations which can be less costly than full crowns.

If you have any questions about which fillings are appropriate for you, please do not hesitate to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com