My Blog
By Jay Freedman, DDS & Associates, PC
February 14, 2018
Category: Oral Health
Tags: dental emergency  
3ThingstodotoPrepareforDentalEmergenciesWhileTravelingAbroad

Vacationing abroad can be the trip of a lifetime — or a nightmare if you have a medical or dental emergency while traveling. Dental care in many locations around the world can be limited, expensive or even dangerous.

Here are 3 important things you should to do to prepare for a possible dental emergency during that dream vacation in a foreign country.

Have a complete checkup, cleaning and necessary dental work before you leave. Whoever said, “An ounce of prevention is worth a pound of cure,” must have been a traveler. Better to take care of problems beforehand than have them erupt into an emergency far from home. Be sure especially to have decayed or cracked teeth repaired, as well as any planned dental work like root canal treatments before you go. This is especially important if you’re flying — high altitudes can increase pressure and pain for many dental problems.

Research your destination’s available dental and medical care ahead of time. Standards and practices in other countries can differ from those in the United States, sometimes drastically. Knowing what’s available and what’s expected in terms of service and price will help immensely if you do encounter a health emergency while traveling. A good starting place is A Traveler’s Guide to Safe Dental Care, available at www.osap.org.

Know who to contact if you have a dental emergency. While it may be frightening having a dental issue in a strange place, you’re not alone — there are most likely a number of fellow Americans in your location who can help. Have contact information ready for people you know or military personnel living in your locale, as well as contacts to the American Embassy in that country. And if you’re staying in a hotel, be sure to make friends with the local concierge!

It’s always unsettling to have a dental emergency, but especially so when you’re far from home. Doing a little preparation for the possibility will help lessen the stress if it happens and get you the help you need.

If you would like more information on preparing for dental emergencies while traveling, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Traveling Abroad? Tips for Dealing with Dental Emergencies.”

By Jay Freedman, DDS & Associates, PC
January 30, 2018
Category: Dental Procedures
Tags: dental implants  
ImplantPlacementintheSmileZoneRequiresExtraAttention

Dental implants are popular with both patients and dentists for their durability and likeness to natural teeth. That natural look, though, can be difficult to attain, especially in what’s known as the “smile zone” — the area of the mouth where teeth are most visible when you smile.

Our biggest concern is the upper front teeth, where the gums are most visible, especially if you smile widely. It takes considerable skill, experience and artistry to position implants in this area so that they appear to naturally emerge from the gums and blend well with other teeth.

To obtain that natural look, we must first assess whether or not there’s enough bone present, which tends to dissolve (resorb) when a tooth is missing, to sufficiently anchor the implant in the right position. There also needs to be sufficient bone around adjacent teeth to support the tiny triangles of gum tissue between teeth called papillae. Without the papillae an unattractive black hole may result between the implant and an adjacent tooth or implant.

Another factor we must consider is the type of gum tissue you have. Everyone generally inherits one of two types of tissue from their parents: thin or thick. The type you have can influence the way the implant appears to emerge from the gums. If you have thick gums, they’re easier to work with and can cover more of the implant. Thinner tissues aren’t quite as easy and are less forgiving if an implant isn’t placed as precisely as possible.

In recent years, improvements in implant design have sought to provide greater stability around bone and gum tissues to offset some of the issues we’ve mentioned. A variation on the design of the top of the implant (where the crown is attached) changes the direction of growth for gum tissues from a horizontal orientation to a vertical one, which can help with the final appearance.

The first step, if you’re considering dental implants for a tooth in the smile zone, is to visit us for a complete examination to see if any of these factors may have an impact on your situation. We can then advise you on the best course of action to achieve the most attractive smile possible.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implant Aesthetics.”

By Jay Freedman, DDS & Associates, PC
January 15, 2018
Category: Dental Procedures
Tags: root canal  
SettingtheRecordStraightonRootCanalTreatments

If there was an “Unsung Hero” award for dental procedures, the root canal treatment would win hands-down. Much aligned in popular culture, today’s root canal treatment is actually a valuable tool for saving teeth that would otherwise be lost. And contrary to popular belief, root canal treatments don’t cause pain — they relieve it.

To help you understand its true worth, here are some common questions and answers about the root canal treatment.

What problem does a root canal treatment fix?
A root canal treatment stops a bacterial infection that has invaded the innermost part of a tooth — the pulp — and is advancing toward the end of the root through small passageways known as root canals. Most people first notice the problem as a sharp pain in the affected tooth that may suddenly dissipate in a few days. The infection has attacked the inner pulp tissue, rich in nerve fibers; when the nerve fibers die they stop sending pain signals. The infection, however, hasn’t died: as it advances, you may then begin to experience pain when you bite down or when you encounter hot foods. You may also notice tenderness and swelling in nearby gums.

How does the procedure stop the infection?
A root canal treatment removes all the infected or dead tissue and cleanses the pulp chamber. We enter the pulp chamber through a small access hole created in the tooth’s biting surface. After tissue removal, we then “shape” and prepare the empty chamber and root canals (often with the aid of microscopic equipment) to be filled with a special filling. After filling, the tooth is then sealed to prevent re-infection (most often, we need to install a permanent crown at a subsequent visit for maximum protection).

How much pain can I expect during and after the procedure?
During the procedure, none — the tooth and surrounding gums are fully anesthetized before we begin the procedure. Afterward, you may experience mild discomfort for a few days that can be relieved with over-the-counter medications like aspirin or ibuprofen.

What’s the ultimate value for a root canal treatment?
The procedure can save a tooth severely damaged by the infection. Even covered by an artificial crown, a living tooth continuing to exist and function normally within the mouth is usually more conducive for optimum oral health than an artificial tooth replacement.

If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”

By Jay Freedman, DDS & Associates, PC
January 07, 2018
Category: Dental Procedures
DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

By Jay Freedman, DDS & Associates, PC
December 30, 2017
Category: Oral Health
Tags: dry mouth  
GetControlofDryMouthtoProtectYourDentalHealth

As your mother used to say, “A moist mouth is a healthy mouth.” Well, maybe she didn't — but it's still true. Without the constant flow of saliva, your teeth and gums would be less healthy.

That's because among its many functions, saliva helps keep the mouth from becoming too acidic. Just after eating, your mouth's neutral pH level tips to the acidic side of the scale. Acid is enamel's number one enemy, and it takes little time for it to begin dissolving mineral content. But in thirty minutes to an hour, saliva neutralizes the acid; it also helps restore some of the enamel's minerals.

Without adequate saliva flow, acid quickly gets the upper hand. In time, this can greatly increase your risk for dental disease. And for many people, inadequate saliva — dry mouth — is a chronic problem.

There are a number of reasons why. Salivary glands may not produce as much in our later years. In addition, as we age, we may begin taking more medications, some of which can cause dry mouth. Treatments for certain kinds of systemic diseases, particularly cancer, can also inhibit saliva or even damage salivary glands.

If you feel your mouth is continuously dry, make an appointment to find out the cause, which will determine the best course of action to alleviate it. If it's related to your medication, we'll see if there's an alternative. If not, you may need to drink more water when you take your medication and more throughout the day.

There are other things you can do as well. Reduce your intake of acidic foods or caffeinated beverages. Run a cool-air humidifier at night to keep your mouth and nose membranes moist. And you can also try saliva stimulants available by prescription or even over the counter. Chewing gum with xylitol (an alcohol-based sugar) has also been shown to stimulate saliva flow.

Above all, be diligent about daily brushing and flossing and regular dental cleanings and checkups. Keeping a watchful eye will help ensure dental disease doesn't take advantage of your dry mouth.

If you would like more information on managing dry mouth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Mouth.”





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