My Blog

Posts for: July, 2011

By Steven R. Gluck, D.D.S.
July 24, 2011
Category: Oral Health

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”


By Steven R. Gluck, D.D.S.
July 17, 2011
Category: Dental Procedures
Tags: oral health   tooth decay   root canal  

While some people associate the need for root canal treatment with an injury or trauma to a tooth (which is a valid cause), it can also most commonly be caused by tooth decay that is left untreated. This is the reason why we have put together this brief guide to explain the three common stages of tooth decay that lead up to the need for a root canal.

Stage 1: During this stage, decay begins to form in the tiny grooves on the biting surface of a tooth or where the teeth contact each other. The result is loss of the surface enamel of the tooth.

Stage 2: Left untreated, the disease progresses through the enamel and into the dentin, which forms the body of the tooth. Once in the dentin, it progresses more rapidly until it reaches the pulp — the living tissue within the root canals of the tooth. The decay infects the pulp tissues, which contain the nerves of the teeth, causing pain. The end result of inflammation and infection of the pulp is that it dies.

Stage 3: As the nerve dies an infection results, which causes pain and swelling. For some people who do not regularly visit our office, this may be the first physical sign that they have a problem. But all is not lost, a successful root canal treatment, whereby the infected pulpal tissue is removed and the root canals are cleaned and sealed will not only relieve the pain, but save your tooth. So the good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, the tooth can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our office as soon as you feel you have a problem with a tooth.

If you are having pain or symptoms from a tooth or teeth, check it out with us — you may or may not need a root canal treatment. Contact our office to schedule an appointment and find out. Don't wait until it's too late. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “I'd Rather Have A Root Canal....”


By Steven R. Gluck, D.D.S.
July 10, 2011
Category: Oral Health
Tags: oral health   oral hygiene  

Tongue and lip piercing is a growing popular trend for some young people and adults; however, did you know that they could wreak havoc on oral health? In fact, some people soon discover that before they can even enjoy their new piercing they are faced with issues ranging from bleeding and infection to nerve damage. Tongues and lips are highly vascular — that means they have lots of blood vessels that can bleed easily and are not always easy to stop once they start bleeding. Many tongue and lip bolts can initiate problems such as tooth sensitivity, gum disease and recession, chipped teeth and more. In addition, not all tattoo parlors and tattooists are properly licensed to do piercings. Therefore, sterile techniques are not always guaranteed if they do not come under the scrutiny government agencies. Unfortunately, these potential concerns are rarely discussed prior to receiving a piercing.

So what can be done if you already have a tongue or lip piercing?

If you already have piercings, it is critical that they are closely monitored by your health professionals to make sure they are not doing damage. It is also important that you have routine dental exams to ensure that you do not have any silent problems causing issues that you haven't noticed. However, your best option is to consider removing these oral piercings. The good news is that most often the hole in your tongue or lip may heal itself; otherwise, a minor corrective surgery may be required.

A note of warning: Before you contemplate a piercing, get as much information as you can about them and the person who will do them. This includes asking about their risks, benefits and better alternatives. And then think twice to make sure they will not become permanent and negative reminders of temporary emotions!


The best method for permanently replacing a missing tooth is with a dental implant. But did you know that there are two main techniques for placing implants? Implants can be placed either using a one stage or a two stage surgical technique, and as their names suggests, one is performed in one step while the other requires a second surgery.

With a one-stage procedure, a healing abutment is placed at the time of surgery. An abutment is a connector that attaches the implant from the bone into the mouth and which protrudes through the gum tissues. Following a 3 to 6 month healing period in which the implant fuses to the bone, a crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good, guaranteeing good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.

Under special conditions an implant can be placed and a crown placed on top of it at the same time. However, this is a very special circumstance requiring ideal conditions and surgical experience as well as crown fabrication know-how. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone.

A two-stage procedure is typically used for replacing teeth where there is no immediate need for a cosmetic solution and when more of a margin of safety is required. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. They are not exposed to the mouth, but stay buried and left to heal. Once healed, a second surgery is performed to attach an abutment for securing the crown in place. This approach is used when there is poorer bone quality or quantity. This may make it necessary to regenerate bone around the implant at the time of its placement. There may also be other health considerations dictating that a two-stage approach may be indicated.

Depending on your individual situation and medical status, our implant team will determine which approach is best for you. To learn more about these two procedures, read the Dear Doctor article, “Staging Surgery In Implant Dentistry.” You are also welcome to contact us to discuss your questions or to schedule an appointment.