Which Is Worse –Bad Gums Or Teeth?

Posted on June 9, 2015 by DrRichardNadler

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 of 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

Don’t Like Flossing? Here are Some Helpful Ideas

Posted on April 10, 2015 by DrRichardNadler

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

Try 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.

Flossers 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/

Back to Normal Sooner with Oraverse

Posted on March 17, 2015 by DrRichardNadler

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?

Posted on February 24, 2015 by DrRichardNadler

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:

Those who had orthodontics as a child but have seen significant relapse over the years.
Patients who are concerned about the shifting or increasing misalignment of their teeth.
Those who have teeth which are wearing down unevenly.
Patients with teeth that appear crowded or misaligned.
Those who have an underbite, overbite or open bite.
In some cases, those who have gaps between their teeth.
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:

There are no dietary restrictions because the aligners are removed before eating.
There are no special dental hygiene requirements because the liners can be removed to brush and floss the teeth.
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:

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.
Healthier teeth and gums contribute to a person’s overall systematic well-being and health.
Uneven wear due to misaligned teeth is alleviated.
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

Posted on February 10, 2015 by DrRichardNadler

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.

fill

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.

They 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

Celebrating 30 Years- Thank You, Maria and Our Hygienists

Posted on December 2, 2014 by DrRichardNadler

In today’s installment of our Thirty Days of Thanks, I have the pleasure of expressing my gratitude to Maria Slavinsky and all of our dental hygienists. Maria has been an important member of our team for the last eleven years! During that time, anyone who has been a “regular” in our office knows that Maria was married, had a baby and has become a most caring and involved mother. One reason that patients like her so much is that she begins every visit by “catching up” on the past six months and sharing the most recent pictures of her family. She has that natural gift of being able to bond with people and show her true interest in everyone for whom she provides care, not to mention her coworkers, friends and family.

Patients also appreciate the fact that she is gentle and yet very thorough in her treatment. She provides a complete explanation of what is happening in each patient’s mouth, and has the knowledge to offer solutions for patients’ various issues and concerns.

As a team member, all of us appreciate Maria’s dependability, enthusiasm and cooperation. She has only missed being in the office on two extended occasions. One of those occurred six years ago just after one of our office holiday parties. Apparently, Italian food jump started Maria’s contractions and she gave birth to her daughter Veronica within a day or so. The other occasion followed an incident in Maria’s kitchen when she was attempting to remove an avocado pit. Without getting into too much detail, that incident resulted in surgery to properly reattach one of Maria’s fingers. She is no longer allowed to carve up avocados! I guess the only other time she regularly places herself in jeopardy is when she and her husband Dmitri and daughter Veronica go skiing, which I believe is as often as possible.

There is one trait which Maria has that you may not be aware of. It is a trait which I have come to share with her. We have both become rather germophobic over the years, so none of our patients needs to be too concerned about cleanliness around Maria. She and I wash our hands constantly after any questionable contact, and she is always cleaning up to get rid of any potential hazard.

I would be remiss if I didn’t mention Karen Cummins I have known Karen for as long as I have been in Hillsborough, as her son Marty and my daughter Meredith were an item at one time. More importantly, Karen has been a part time hygienist in our office for many, many years; and, has a very loyal following of patients who want to be seen only by her. She has been a good friend to us over the years and we truly appreciate all her help.

Similarly, there have been other hygienists in our first two decades who were wonderful members of our team and provided excellent care for our patients. The work that hygienists do is not easy and requires dedication and skill to be done with proficiency.

Thank you to Maria, Karen and all the hygienists for your professionalism and friendship over the past thirty years.

Celebrating 30 Years- Thank You Technology

Posted on November 25, 2014 by DrRichardNadler

Before I begin today’s topic, I must correct a glaring omission from the thank you letter I wrote to April and all of our dental assistants. There is a woman who was our second dental assistant after Liz back in the mid 80’s and describing this person provides a perfect segue into today’s subject. The person to whom I refer is Remi, a very attractive young woman, who would come to the office dressed in popular clothing of the time, which were stretch pants and high heels with the top of her choice. Naturally, Remi was very popular among my male patients as well as being a top-notch dental assistant. I had the pleasure of working with her for a couple of years until her family moved to North Carolina but Remi and I stayed in touch. Then, during the 90’s, we became quite good friends socially. When April began her first maternity leave, Remi stepped in to help us and remained on a part-time basis until she left for a new full-time position. Remi is owed a big thank you for both her friendship and her contributions to our dental practice. Remi, please forgive me for not having included you in the first article!!

But what does Remi have to do with today’s topic? Today, I will express thanks for the amazing progress that we have made in dentistry owing to the development of various technological advancements. At the same time, I’ll have an opportunity to describe how the practice of dentistry has changed in the last thirty years. So, if you can picture Remi wearing stretch pants and high heels, you will realize that what we wear today is far different from the “uniform” of thirty years ago. Better yet, if you can picture what Remi was not wearing at the time, you will understand the first major change that occurred in dentistry in the last thirty years.

What Remi was not wearing back then was gloves, a mask and all the other outer protective garments, which are mandatory today. What changed was the AIDS epidemic had begun and the use of all protective clothing and shields became mandated. After having practiced “wet fingered” dentistry for several years, wearing gloves was initially quite a challenge due to the loss of tactile sensation that resulted. But we all adapted and have since incorporated a multitude of protocols and protective items to protect not only those who work in the dental office but also every patient.

The next major change for dental practices was the use of computers which began in the mid to late 1980’s. I remember buying my first computer, an IBM with a whopping 50 MB of memory! Bear in mind that is megabytes and I’m not referring to RAM. This computer took some getting used to, but relieved us of hours upon hours of paperwork every day as all appointments and transactions had been done by hand up to that time. As you can imagine, the computers kept getting bigger and doing more for us every year. Now, the practice of dentistry and the use of computers are totally integrated and amazing.

Today, the world of dentistry is becoming more and more digital. By now, most of my patients have seen the digital x-rays which we employ. These x-rays are so large and easy to read that patients can easily see what we see with minimum coaching. These x-rays can be manipulated in terms of contrast, size and various other features. Similarly, in the future, impressions will be taken digitally using a small intraoral camera rather than all of that impression gook which many patients are not fond of.

If you’ve been in our office for the last dozen years or so, you’ll note that we also use a digital camera to record photos of your teeth. In addition, we have an intraoral camera which takes close-up images of the teeth. The use of these photographs helps us to better diagnose what is going on in a given patient’s mouth as well as the ability to easily explain conditions and options to patients.

One of my favorite newer pieces of equipment is called the K7. We have been using this system for the past five years or so to help us better diagnose and treat patients who have Temporomandibular Joint Disorders. This piece of equipment allows us to evaluate the jaw muscles, jaw movement and joint sounds. Using this piece of equipment, we can determine in an objective way the best position for an individual patient’s jaw. Since using the K7, we have been able to help many patients who were suffering with a variety of TMD symptoms. If you have any interest in the subject, you may find additional information on the website www.myotronics.com .

Other technological advances which assist us in our day to day treatment of patients include the use of the diode laser, the Wave One root canal system, and the Diagnodent cavity detection device.

The diode laser has a multitude of uses including preparing teeth for impressions, cosmetic re-contouring of the gums, the treatment of periodontal or gum disease and the speed healing of canker sores and fever blisters just to name a few. This is a marvelous piece of equipment which is kind to patients for its healing properties, its gentleness not requiring the need for anesthesia in many cases, as well as its ability to work without creating bleeding.

The Wave One root canal system is an equally wonderful system which helps us to perform root canal therapy for patients in less time than in the past while being more thorough at the same time.

The Diagnodent cavity detection device uses a laser to detect the presence of decay in an extremely accurate manner. We had even seen that it finds decay which is not visible either on x-ray or in the mouth but serves to help patients avoid more extensive treatment due to lack of prompt care.

The descriptions provided above of the technological advances which we have seen the last 30 years is by no means a complete list. Suffice it to say, the practice of dentistry is far more enjoyable, accurate and just plain better than it was in the 80’s.

Thank you to all the pioneers who helped to develop the technology that we use today. It will be fascinating to watch dentistry continue to evolve in the next thirty years!

30 Days of Thanks- Dental Technicians and Laboratories

Posted on November 13, 2014 by DrRichardNadler

I have had the pleasure of working with several wonderful dental technicians and laboratories and during the past three decades. Since it has always been our goal to provide excellent dental care for our patients, selecting the right dental laboratories to be our partners was critical. In the process of advancing our dental techniques and treatment planning, it was incumbent upon us to find dental laboratories and technicians who shared the same philosophy and passion to do great work. In that regard, to find a good fit, we depended upon word of mouth from our peers. Such has been the case since the late 1980’s and several labs with whom we have worked deserve our sincere thanks.

dental technicians and laboratories

Back in the late 80’s and early 90’s, the use of gold for fine dental restorations was still common. So, to learn how to provide excellent gold inlays and onlays, I took advantage of an opportunity to become a member of the exclusive Richard Tucker Gold Study Club. Members of this club met in dental offices and brought actual patients on whom to practice their technique. These doctors were very particular; Tucker trained doctors used only Tucker trained technicians. As a result, I was fortunate to have met a man named Dale Jones who handmade the finest gold restorations I had ever seen. Times have changed, and patients no longer wished to have gold visible in their mouths. So we began doing a similar service using modern dental ceramics for beautiful restorations. The problem was that Dale did not work with porcelain, but I asked him if he knew someone who was as good with porcelain as he was with gold. That is how I was introduced to Krisann Shaler and her lab called Porcelain Designs.

Kris and I began working together in the early 90’s and we still work together today. Her lab is in California, but we were able to spend some quality time together around the year 2000. We arranged to meet while I was taking a course at the Las Vegas Institute and it was then that Kris, Dale and I, along with our spouses, went to dinner and got to know each other on a personal level. Kris actually made the restorations for my wife, Liz, that were being prepared while I was attending courses at the Las Vegas Institute. When I inserted these restorations, the other doctors with whom I attended classes and the teaching doctors commented on how beautiful the porcelain work was. Kris is still providing beautiful restorations like those for my patients today.

As I learned more about restoring patients with major bite problems, the need arose for more complex restorations using increasingly difficult techniques. As a result, I was introduced to larger laboratories that had both the necessary equipment and knowledge to produce these complex cases. The two labs which have provided this fine service deserve to be thanked as well and their names are Aurum Ceramic Dental Laboratories and Microdental Laboratory. Each of these labs have several outstanding technicians, but I’d like to call out Ulf from Aurum and Gloria from Microdental who have acted as integral members of our team during the production of many of our larger cases.

There are several other laboratories with which we have worked over the years and they deserve our gratitude as well. Many times, it is these laboratories who make us look good because they allow us to provide excellent care and service for our deserving patients. So in closing, I’d like to give a huge Thank You to Dale, Krisann and all of the lab technicians who have taken such great care of us for the last 30 years.

Celebrating 30 Years With 30 Days of Thanks Kicks Off

Posted on November 4, 2014 by DrRichardNadler

This year, we commemorate the 30th anniversary of the opening of our dental practice in Hillsborough. To accomplish this, we have designated the month of November as Celebrating 30 years With 30 Days of Thanks. To that end, we have created a list of 30 different ways to express our gratitude to the many people and business partners who have contributed to the evolution and success of our dental practice. It is all these people who provided the support, fun, excitement, challenge and fulfillment which have made this last 30 years such an amazing adventure.

Each day this month, we will find a different way to express our thanks. Among those who will be honored are my mentors, significant teaching institutions, wonderful doctors and dentists to whom we refer, those who refer patients to us, our partner dental labs, our IT partners, our wonderful team, friends, family and last, but certainly not least, our amazing patients.

We will express our thanks in a number of different ways. Many will receive public letters of appreciation, which will be posted on our blog and social media pages. You may find many of these letters to be interesting as we plan to share stories about the practice and the people involved with it. There will be at least three of these each week during the month. In addition, there will be giveaways each week for our patients and we have ordered special commemorative gifts for that purpose.

Before our dental assistant, April, begins her maternity leave at the end of this month, we will enjoy a luncheon to honor of our fabulous team. Finally, we are working to complete our gift of appreciation to the town and people of Hillsborough. Details will be announced at the end of the month.

To kick off these 30 Days of Thanks, the entire list of people and entities to be thanked was reviewed in order to decide who should come first. Without hesitation, it is our wonderful patients who deserve to be celebrated first. Without these people, we would not be able to do the work that we love. Over the years, we have shared each other’s happy times, sad times, difficulties and joys. Many, if not most, of the patients who began coming to our office in the 1980’s were around the same age as me. So our families have grown up at the same time and we have shared similar experiences.

I will never forget that my team and I hosted a “VIP” (Very Important Patient) party way back in the late 80’s and it was held at my home. Our family of patients was still intimate enough to invite every one of them to this event. It was a summer party and was attended by many families who had children about the same age as my own. I still fondly remember the wonderful afternoon that was enjoyed by our team and patients alike. Many of those patients remain in our practice to this day.

Not too many years later, I turned 40 and a surprise 40th birthday party was thrown for me again at my home. Our entire dental team at that time attended that party and provided some of the “entertainment.” Specifically, an exotic dancer presented herself at my front door and proceeded to engage in a most provocative dance with yours truly – I believe her name was ”Katja”. Talk about embarrassing… That same night, my dental assistant – not Liz – came out of her shell and made quite a hit with some of the guys in attendance culminating in one of them sipping champagne out of her shoe. What a crazy, fun night.

But enough reminiscing; how shall we thank our patients? Every person who has been a regular patient for at least five years will receive a gift certificate. That certificate increases in value with every five-year period that they have been our patient. Look for yours to arrive by mail. We are still checking, but I believe that there is one person who has been a continuous patient for the last 30 years! Naturally he will receive a special certificate!

In addition, any patient who is seen on a Friday this month will receive a commemorative gift. Also, every Monday, one random patient will receive a special gift. We’ll try to keep you posted on who wins what. These will most likely be featured on our Facebook Page.

Most importantly, Thank You to all of our patients, both current and past. We are extremely grateful for the pleasure of having cared for you for the past 30 years. You provided us with friendship, laughter, challenges, happiness and fulfillment, which has made our lives meaningful. We Love you all!

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