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Daniel W. Salvatore, DDS

Daniel W. Salvatore, D.D.S.   

Newsfile Archive

January 2008





Articles from past issues of SmileLink

January 2008



Office News

An introduction...

We know that regardless of our individual experiences, we all have something we can learn today that we did not know about yesterday. The same holds true for dental health as for every other aspect of our lives. Our goal with this newsletter is to assist us in develop an ever-strengthening  partnership with each of our patients. We believe the more our patients understand about the importance of dental health, the better we can help them maintain a healthy mouth, as well as treat the causes and symptoms of any dental condition.

We invite you to look through our introductory release of the SmileLink newsletter. This newsletter is one of the many resources being made available to you through our Learning Center. And more will become available over time. We hope you will take the time to check out our website on a regular basis for this new, and changing information. We also remind you to contact our office with any questions or concerns you may have that are left unanswered or worry you. Working together, we can help you achieve a lifetime of healthy and attractive teeth and gums.

Your Great Smiles Family Dental Team 


Wisecrackers Needn't Apply

The 'tween/teen years can be challenging. It takes a lot of energy and patience making the transition to young adulthood. Taking a driver's test. Dating. Applying for a job. Trying out "adult" wisdom. This is no place for wisecracking. Believe-it-or-not, inside your mouth is no place for "wisecracking" either.

During late teen-hood and into your early 20s, the third molars, better known as wisdom teeth, are erupting. Don't be fooled by their name. They are not wise. Sometimes they don't erupt in a timely manner. They only partially erupt, or don't erupt at all. The result of those three situations plagues people of all ages, not just 'tweens and teens. [Image is a partially-erupted wisdom tooth]

Some time after you should have had your wisdom teeth, you might have noticed swollen lymph nodes in your neck. You may have had a bad taste in your mouth and pain in the gum tissue around one of your wisdom teeth.

Ahhhh, likely those symptoms were telltale signs that you had a condition called "pericoronitis." "Peri" means "around," "coron(a)" means "crown," and "itis" means "inflammation." You had an infection in the soft tissues that surrounded a partially-erupted wisdom tooth.

When a wisdom tooth partially pushes up through the gingiva (soft gum tissue), it leaves a small flap of gum covering an area on the top of the tooth. When you eat, tiny food particles slip under that tissue flap. Bacteria feed on the trapped food particles and cause an infection. [Image shows a gum tissue flap]

If you notice soreness at the site of a partially-erupted wisdom tooth, we suggest that you brush and floss several times a day and rinse with warm salt water, an antimicrobial mouth rinse, or use an oral irrigator.

There is only so much you can do from home once the infection gets roiled up. Unfortunately, you might think your infection will go away by itself, and you don't call us. Pain means something is wrong. Please, don't ignore your symptoms and let them get to a serious state.

If the infection doesn't go away in 3–5 days, come to our office! We need to intervene so that the infection won't travel to other areas of your head and neck and cause serious issues.

When you come into the office, we'll examine the infected site and maybe take x-rays to see if there is anything else sinister going on. We can thoroughly clean the area to get rid of some of that smelly pus and flush out the food particles and bacteria. Depending on the amount of infection and severity of pain, we might also prescribe an antibiotic to help the recovery process.

Once we have done those steps, it will be up to you to keep the area clean. We can show you how to properly clean around your wisdom tooth to help prevent another infection. Brushing, flossing and rinsing will be key to your recovery and ongoing health routine.

We can recommend a style and kind of toothbrush, floss and mouth rinse, as well as perhaps an oral irrigator. An oral irrigator is an effective method to rinse because it delivers a stream of liquid to the area where you point the wand. [Image shows an oral irrigator wand.]

If pericoronitis has been a recurring problem or if you get another infection or infections, we likely will consider removing the tissue flap. We could also determine that extracting the problem tooth is our only option to keep you and your oral tissues healthy.

If you are experiencing any of the symptoms of pericoronitis, or anything out of the ordinary, please call our office right away so that we can get you scheduled for an examination. The earlier we can intervene, the better chance you have of recovering quickly and fending off any future recurrences with those unwise teeth.


Father Knew Best

Many of the wonders of modern medicine trace their roots to people and events thousands of years ago. One of those ingenious people was Hippocrates, the father of clinical medicine. Hippocrates discovered that a certain willow tree bark contained "salicin," which he gave to his father to ease his father's pain.

Much later, in the early 1800s, a simple academic research project resulted in a product known as "acetylsalicylic acid," the main ingredient in today's aspirin. Over 2000 years earlier, Hippocrates had given "aspirin" to his father.

We sometimes have patients tell us that they use aspirin to ease a toothache. That is a reasonable, short-term treatment. However, when we ask more questions, we discover that they do not swallow the aspirin; they hold it against the tooth, or they crush it between their teeth and let it sit on the tooth. When we examine the tooth, we can see the result: tooth erosion and damage to the gum.

When aspirin lies against the gum, it burns the tender gum tissue and causes the top layer of the gum to slough off. Underneath is a red ulcer or lesion that can cause you to experience severe pain. This may prompt you to use even more aspirin, which only makes the condition worse.

When aspirin comes in contact with a tooth, the acid in aspirin "eats" into the tooth's enamel, which can expose the tooth to an infection or decay. Once the enamel is eaten away, it cannot be put back. Some teeth are so severely damaged that they have to be restored with crowns.

We know of patients who give aspirin to their children and tell the child to hold the chewed aspirin between the teeth. When the teeth were examined, the grains of aspirin were wedged into the pits and fissures on the biting surface of their molars and pre-molars. Their teeth suffered severe damage. [Bottom image—pits and fissures]

It is so very important to take proper care of primary teeth so that they can prepare the child's jawbones for their permanent teeth.

The father of modern medicine did know best. Little could Hippocrates have realized then that his discovery is the most popular non-prescription pain-relief drug in history!

Because aspirin is so common in your daily life, you may forget it is a powerful drug that has potential harmful effects when incorrectly used. Holding aspirin in the mouth does not speed up its pain-relieving ability. Please use aspirin cautiously and according to directions so that it doesn't harm your precious teeth and oral tissues.

If you are experiencing oral pain or are having another dental issue, please call our office and schedule an appointment. We will do an exam and determine its cause. We can recommend a treatment plan to get you back on the road to health!


Rub a Dub Dub

I'm not sure if the three tub occupants in the nursery rhyme "Rub-a-Dub-Dub" had a spotless tub, but I do know how important it is to have spotless teeth.

Your teeth can become stained from an infection, a fever, fluoride, and a mishap when the enamel on your teeth was developing, for example. We often see stain or discoloration in children's permanent teeth, but adults, too, sometimes have teeth that need a little intervention to make them dazzling white.

We can approach stain and discoloration removal three ways, depending on the severity. If the stain is on the surface, the dental hygienist can often just polish it off using a pumice paste. Most stains are like that. If, on the other hand, your stain is built into the enamel or is a result of poor oral care during your time with braces, we can bring out the big guns.

The first procedure we can try is whitening your teeth by applying a bleaching solution to them. We can either brush the solution onto your teeth or pour it into a special bleaching tray that covers your teeth. We may also use a high-intensity light or laser to help the bleaching solution do its job.

If the stain remains after the whitening treatment, we can use microabrasion. Microabrasion is considered a minimal intervention treatment and is a good option to remove stain or discoloration. According to a 2007 study, microabrasion is still considered an effective method to remove tooth stains.

A microabrasion technique developed in the late 1980s is pretty much the same procedure used today.

Microabrasion simply means that we carefully rub a mild abrasive substance (grit) onto the stained teeth, much like you may use a household cleanser to remove water and soap stains from your bathtub. Typically, the abrasive substance is pumice, which is a soft, porous stone produced by a volcanic eruption. Pumice is a common ingredient in many cleaning agents including some hand soaps.

Microabrasion treatment takes about 30 minutes. This is a little longer than it takes you to clean your tub, but your teeth and tub will sparkle.

Our third option is to use microabrasion and an at-home whitening treatment if the first two options don't produce satisfactory results. After your microabrasion treatment, we'll send a custom-fitted bleaching tray and solution with you to be used at home. The tray may need to be kept on your teeth over night.

More recently, remineralization products have been marketed and can really make an astounding difference. These products are beneficial to someone whose braces have just been removed. Remineralization products help whiten stains that resulted from inadequate oral care while the braces were in place.

It's not all done in the office though; you'll have to do a little at home. You would wear the remineralization paste in a custom-fitted tray for about five minutes each day for up to a month.

If your teeth don't respond satisfactorily to microabrasion, the home bleaching follow-up, or the remineralization product, then we may consider other options such as veneers or porcelain crowns. These procedures take more time and effort, and there is quite a difference in cost.

If you or your child has stains or discolorations on your teeth, please call and schedule an appointment. We can decide the best option for you and return your teeth to their shiny white best.


Share and Share Alike

Someone may have shared their special warm and fuzzy feeling with you when you were a child. You may have shared your special warm and fuzzy feeling with someone else.

You could be one of the 85 percent of the world population who has experienced a warm and fuzzy feeling. Once you have that special warm and fuzzy feeling, you will get it again and again.

This isn't an ordinary warm and fuzzy feeling. This warm and fuzzy feeling has a special zing to it. First, this feeling turns into tingling sensation. A couple days later it turns into a nasty red blister on your lip. You have a herpes simplex 1 virus, commonly known as a cold sore or fever blister. And it's very contagious.

When you were 6 months to 7 years old, that first herpes outbreak (gingivostomatitis) caused tiny gray or yellowish blisters with red edges on the inside of your cheeks, your gums, tongue, tonsils, or soft palate. You may have had trouble swallowing because your throat swelled. But after a week or so, the blisters went away by themselves.

The adult version of a cold sore is a little different than the juvenile outbreak. As an adult, the outbreaks will appear on the outside of your mouth. Only in rare instances do the blisters occur on the gums or roof of the mouth.

Sometimes cold sores are confused with canker sores. A canker sore occurs only on the soft tissues inside your mouth, and it's not contagious.

You might have cold sores 2–6 times every year. The initial warm and fuzzy, tingling sensation usually lasts no longer than 2 days. Next, is the blister phase that lasts another 1–2 days. The blisters contain fluid that can spread the virus to other parts of your body and to other people.

The blisters weep during the third stage. Weeping usually lasts 1 day. It is extremely important not to touch the fluid with your bare hands. If you do, immediately wash your hands because the virus can attack your fingers. If you were to touch your eye, you could spread the virus to your eye.

If you use a towel, tissue or wash cloth to blot or wipe the fluid, do not put the cloth or tissue where anyone else can come in contact with it. The virus can also be transmitted if someone uses your coffee cup, toothbrush, lipstick or eating utensil, for example.

Once the fluid has seeped out of the blisters, the sore will form a crust. The crust usually comes off in about 4 days.

Finally, as each crust gets smaller and smaller and falls off over a 3–4 days time span, the outbreak is done.

While the cold sores are active and painful you could offer your child acetaminophen or ibuprofen (never give aspirin to someone under 20 years of age!). For yourself, you could use aspirin, acetaminophen or ibuprofen. We may also prescribe an antiviral medication.

When you have a cold sore outbreak, it's important to maintain your oral health care routine. Brush and floss as usual, being careful not to brush against a sore. Be sure to thoroughly wash your hands before and after handling your toothbrush or any object you use during your oral care routine.

If you experience any unusual pain in your mouth while you are in the throes of an outbreak, please call our office and schedule an appointment so that we can examine your teeth and gums and rule out any other issue. The earlier we can intervene, the better chance you will have an uncomplicated recovery and maintaining your healthy teeth.


Are We There Yet?

Your bags are packed and in the trunk of your car. You made a list and checked it twice. Swimsuits—check. Extra socks—check. Toothbrushes—check. Newspaper carrier—check. Everyone excitedly piles into the family auto and you are on your way to get a few days R&R.

As you get out of the car at your destination, you stub your toe and stumble headlong onto the pavement. Ouch! Your lip feels pulverized and your front tooth hurts. Checking in the mirror you see that you chipped your front tooth and it's wiggling.

What to do now so far from home? It's then you realize our phone number isn't programmed into your cell phone or on your emergency number list!

When you plan a trip away from home, even for a couple of days, it's a good idea to include dental health need items, as well as that swimsuit, in your list.

To help you keep your R&R relaxing and stress-free, consider these tips:

  • Call and schedule a check-up in advance of your vacation so we can make sure your teeth are in good health or take care of any issues before you leave.
  • Ask us for a list of temporary treatments for different types of tooth injuries.
  • Write down our office and emergency phone numbers in case you have questions or need a referral.
  • If we are unable to offer a referral, call the local or state dental society, or ask a local hospital to recommend a dentist.
  • If you are traveling internationally, the hotel concierge will be able to help you locate a dentist. Or call the U.S. Embassy or consulate.
  • Review your dental health plan before you leave. You might need supplemental dental coverage for travelers.

Then, pack a few just-in-case items in your bag:

  • aspirin or other anti-inflammatory for a toothache
  • a temporary filling material that can be purchased at your local pharmacy
  • gauze in case you stub your toe and chip a tooth
  • cotton wool if a brace or retainer wire becomes misshapen. Cotton wool refers to a flat "sheet" of cotton rather than a cotton ball.
  • nail file to file off rough edges of a broken tooth in case you can't get medical attention right away
  • sugarless chewing gum, which will help cover misshapen dental wire or be a temporary filler if absolutely necessary.

A vacation is a great time to relax and unwind. To help you be worry-free, call and make an appointment so we can give you a clean bill of health and send you on your way. And don't forget to send me a postcard!








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Last Updated: April 08, 2010