Just one article – gtg

Your teeth don’t have to show your age!

We can’t stop aging, but we can make the best of what we already have. Looking after your skin and general appearance is one step. But what about your teeth? They are a revealing sign of aging – yet surprising things can be done today to reverse this process.

Staying young-looking

Teeth are one of the first features that people look at. Our teeth deteriorate over the years, gradually taking on more and more imperfections that betray our age – or make us look even older than we really are. In Western society, where one in six people will soon be over 65, everybody wants to stay as young-looking as possible. So how can a 50-year old stay young-looking? Well, maybe he/she has fortunate genes, looks after their skin regularly (often in addition to great genes) and has had excellent cosmetic facial surgery. To look at them, you wouldn’t be able to guess their true age – until they smile. Then their mouth gives the game away. How? Because of the state of their teeth.

Signs of aging – your teeth

So how do your teeth betray your age? Their color changes over time, losing brightness and luminosity, and becoming darker. Dental wear will shorten teeth, making them look ‘stubby’. Years of food, nicotine and fluid stains can also stain teeth permanently.

Tooth shape: The natural smile line is a gentle convex. But extensive wear on our front teeth can change this to a straight or even concave line (reversed curve). Tooth grinding (prompted by stress), accelerates this dental erosion. Chipped tooth edges are another sign, creating an unbalanced and disharmonious look.

Tooth surface: The fine ridges on young teeth get smoothed away as we get older. While in early adulthood such smoothing can produce attractive teeth that reflect light more uniformly, too much smoothing will show age.

Tooth crack lines: Over time, micro-fractures can appear on the enamel surface. While perhaps superficial, they can show up as little crack lines, which will downgrade the attractiveness of teeth

Filled front teeth: White fillings in front teeth need to be regularly replaced or they change color and start to look obvious. They may even show dark lines between the edge of the filling and the natural tooth.

Smile color: White reflects light and dark absorbs it. A mouth with silver-mercury (amalgam) fillings in many of the teeth will present an overall dull grey color that absorbs light and therefore looks dark. It’s another sign of aging.

Signs of aging – your lips

Over time the lips lose muscle tone and become thinner and narrower. The top lip can sag, covering more of the upper teeth. The lower lip may also drop, showing more of the lower teeth. If you had fairly thin lips when young, then they will become even more so. Also thin vertical lines appear in the lips, which are accentuated and hastened by smoking. Crease lines can also appear at the corners of the lips, often with a more significant, deeper crease line, angled downward, which can make you look permanently unhappy.

What can you do restore youthful looks?

Your smile is the key to your facial appearance. So you need to do something about any old, worn, chipped and discolored teeth you have and remove these obvious clues of aging. The essence in good cosmetic/ aesthetic dentistry is to combine modern techniques with artistic flair – so that nobody can guess what’s been done.

Ways of improving your teeth

Re-contouring: A little bleaching whitens the teeth and slight reshaping restores the edges of the teeth to what they were in youth

Replacing fillings: Using modern materials for the front and most prominent teeth can cause the dental restoration work to blend in with the general color of the tooth.

Bonding: A synthetic material that looks like natural tooth enamel is bonded to the enamel tooth surface. Because it can be shaped and polished, this material can alter the color, texture, size, shape and even, to an extent, the position of the teeth. The treatment can be applied to the eight to twelve upper front teeth. It lasts from three to six years.

Veneering: A technique similar to bonding – only more permanent. A thin, hard porcelain veneer is individually made for each tooth to the correct color, size and shape. Porcelain is as durable as the original tooth enamel so the restored tooth will last for decades rather than years. Veneering is often done on front incisor teeth that have been damaged.

Improving your lips

Thin lips can be treated by using fillers to accentuate the lip line (vermillion border) between the red part of the lips and the normal skin. These fillers are, for example, bovine collagen, or natural hyaluronic acid (Restylane). The effect lasts up to twelve months. The substance of the lip can also be increased by injecting Restylane or even fat from another part of the body into the lip itself. The result, of course, depends on how much and where it is placed.

So how can your smile make you look younger?

Look in the mirror for a few minutes. Decide what parts of your face, and particularly your smile, you would like to rejuvenate using the techniques mentioned above. Then consult with a cosmetic dental surgeon, who can show you an accurate simulation of how treatment would look on your face. It is advisable to do this before going ahead with any cosmetic surgery on your face.

Most cosmetic medical surgeons are still not orientated or even knowledgeable enough about what cosmetic dentists are able to achieve with teeth. A few short dental treatments can take years off your looks, helping you evaluate whether other surgery is necessary.


orthodontics 3/18/2019 – gtg

Orthodontics FAQS
What is orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention, and treatment of dental and facial irregularities.

What is an orthodontist?
An orthodontist is a specialist who has completed an advanced education program following dental school to learn the special skills required to manage tooth movement and guide facial development.

What are some possible benefits of orthodontics?
• A more attractive smile
• Reduced appearance-consciousness during critical development years
• Better function of the teeth
• Possible increase in self-confidence
• Increased ability to clean the teeth
• Improved force distribution and wear patterns of the teeth
• Better long term health of teeth and gums
• Guide permanent teeth into more favorable positions
• Reduce the risk of injury to protruded front teeth
• Aids in optimizing other dental treatment

What are some signs that braces may be needed?
• Upper front teeth protrude excessively over the lower teeth, or are bucked
• Upper front teeth cover the majority of the lower teeth when biting together (deep bite)
• Upper front teeth are behind or inside the lower front teeth (underbite)
• The upper and lower front teeth do not touch when biting together (open bite)
• Crowded or overlapped teeth
• The center of the upper and lower teeth do not line up
• Finger or thumb sucking habits which continue after six or seven years old
• Difficulty chewing
• Teeth wearing unevenly or excessively
• The lower jaw shifts to one side or the other when biting together
• Spaces between the teeth

At what age should orthodontic treatment occur?
Orthodontic treatment can be started at any age. Many orthodontic problems are easier to correct if detected at an early age before jaw growth has slowed. Early treatment may mean that a patient can avoid surgery and more serious complications. The American Association of Orthodontists recommends that every child first visit an orthodontist by age 7 or earlier if a problem is detected by parents, the family dentist, or the child’s physician.

What is Phase I and Phase II treatment?
Phase I, or early interceptive treatment, is limited orthodontic treatment (i.e. expander or partial braces) before all of the permanent teeth have erupted. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correction of cross bites, overbites, and underbites, or harmful oral habits. Phase II treatment is also called comprehensive treatment because it involves full braces when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen.

Would an adult patient benefit from orthodontics?
Orthodontic treatment can be successful at any age. Everyone wants a beautiful and healthy smile. Twenty to twenty five percent of orthodontic patients today are adults.

How does orthodontic treatment work?
Braces use steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on your teeth and the arch wire that connects them are the main components. When the arch wire is placed into the brackets, it tries to return to its original shape. As it does so, it applies pressure to move your teeth to their new, more ideal positions.

How long does orthodontic treatment take?
Treatment times vary on a case-by-case basis, but the average time is from one to two years. Actual treatment time can be affected by rate of growth and severity of the correction necessary. Treatment length is also dependent upon patient compliance. Maintaining good oral hygiene and keeping regular appointments are important in keeping treatment time on schedule.

Do braces hurt?
The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the arch wires you may feel some soreness of your teeth for one to four days. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth.

Will braces interfere with playing sports?
No. It is recommended, however, that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. Mouth guards are inexpensive, comfortable, and come in a variety of colors and patterns.

Will braces interfere with playing musical instruments?
No. However, there may be an initial period of adjustment. In addition, brace covers can be provided to prevent discomfort.

Should I see my general dentist while I have braces?
Yes, you should continue to see your general dentist every six months for cleanings and dental checkups.

Your First Visit
Your initial visit to our office is very important to us. It gives us the opportunity to get to know each other and determine what you hope to accomplish with your smile. During this visit, the doctor will answer questions that you may have such as the type of treatment needed, when it should start, and the estimated treatment time. If treatment is needed, you will be able to discuss fees and payment options before treatment begins.

We offer the following financial options for your convenience:
• Interest free monthly payments
• Discount for paying in full
• Family discounts
• Most major credit cards accepted
• Insurance billing
We are also happy to work with Cafeteria accounts and Flex and HSA accounts.

If you are excited to get your treatment started, diagnostic records can be taken at the conclusion of this appointment so you can begin your treatment as soon as possible.

Call to schedule your complimentary exam today.

Regular Appointments
The appointment when you get your appliances (braces, expanders, etc.) usually takes from one to one and a half hours. You’ll then see us at regular intervals 4 to 8 weeks apart for an adjustment, which takes 20 to 40 minutes.  We make every effort to be on time for our patients and ask that you extend the same courtesy to us. If you cannot keep an appointment, please notify us immediately. Cancel only if it is an emergency. It is difficult to reschedule you since most appointments are made 4 to 8 weeks in advance.

If you have insurance, we will help you to determine the coverage you have available. We ask that you assign your insurance benefit to us. The balance will be arranged for you to pay (see above). Professional care is provided to you, our patient, and not to an insurance company. Thus, the insurance company is responsible to the patient and the patient is responsible to the doctor. We will help in every way we can in filing your claim and handling insurance questions from our office on your behalf.

Regular Appointments
In order to properly place brackets and fit bands, the first few appointments will be frequent, requiring your patience and flexibility. After the appliances are placed, adjustment appointments will then occur approximately every six weeks and for shorter time intervals, approximately 20-40 minutes.

Cooperation is requested in making and keeping all appointments. As most of our patients are school age, we will make every effort to give each patient their share of after-school appointments; however, please be aware that many appointments, especially those of longer duration, will be during school hours. We are happy to provide a school excuse, if needed.

It is difficult to reschedule you since most appointments are made 4 to 8 weeks in advance. If an appointment must be broken, please notify us immediately so another appointment can be reserved. Whenever possible, advance notice of 24 hours is appreciated if an appointment must be changed.

Other Dental Treatment and Records
Extractions (if necessary), x-rays, and the restoration of decayed teeth will usually be done before orthodontic treatment is started. After treatment, a complete set of orthodontic records will be taken. It is recommended that a dental checkup be scheduled with your dentist shortly after braces are removed.

Braces Care
Oral Hygiene
Orthodontic bands and wires are food-catchers. It is therefore important that the teeth be carefully brushed after each meal and snack. After brushing, the appliances should be checked to see if they appear clean and shiny with no food particles or plaque. Failure to keep the mouth clean increases the likelihood of dental decay and etching of the enamel around the edges of the brackets and bands. Patients who keep their teeth clean and use fluoride gels usually have a minimum of decay, if any.

Regular Dental Check-ups
It is recommended that regular 6-month dental check-ups and cleanings be continued by your dentist during treatment.

Foods which are hard or chewy should be avoided during orthodontic treatment in order to prevent appliance breakages. Appliance breakages will complicate and thus prolong treatment.

Loose or Broken Appliances
Any breakage of the appliances (loose bands or brackets, broken wires, etc.) should be reported immediately to the office and an appointment made to repair the appliance. Do not wait until your next scheduled adjustment, as there is insufficient time during this appointment to repair appliances and make an adjustment. If a repair must be made during an adjustment appointment, you may be rescheduled at a later date in order to make an adjustment. If breakages become excessive, there may be an additional charge made for repairs.

Ceramic Brackets
Although ceramic brackets have several advantages, they also require special attention and care. In order to maintain their aesthetic appearance, these brackets must be kept clean. Any foods which have a tendency to stain (such as mustard, tea, and coffee) will turn the clear elastics around the brackets yellow over several weeks and therefore should be avoided, if possible. Ceramic brackets are more brittle than those made of metal and thus require special attention to the types of foods eaten in order to avoid breakage. Finally, ceramic brackets are much harder than the enamel on teeth. For this reason, it is important that the patient contact the doctor’s office immediately if he or she is biting on a bracket any time during treatment, as this may cause significant wear on the patient’s teeth

Ortho Dictionary
Parts of Braces
Anything your orthodontist attaches to your teeth which moves your teeth or changes the shape of your jaw.

Arch wire
The metal wire that acts as a track to guide your teeth along as they move. It is changed periodically throughout treatment as your teeth move to their new positions.

A metal ring that is cemented to your tooth, going completely around it. Bands provide a way to attach brackets to your teeth.

The seal created by orthodontic cement that holds your appliances in place.

A metal or ceramic part cemented (“bonded”) to your tooth that holds your arch wire in place.

Coil Spring
A spring that fits between your brackets and over your arch wire to open space between your teeth.

Elastic (Rubber Band)
A small rubber band that is hooked between different points on your appliance to provide pressure to move your teeth to their new position.

Elastic Tie
The tiny rubber band that fits around your bracket to hold the arch wire in place. They come in a variety of colors.

Headgear uses an external wire apparatus known as a facebow to gently guide the growth of your face and jaw by moving your teeth into proper position. The force is applied to the facebow by a spring-loaded neck strap or head strap. The straps have a safety release that disconnects if the facebow is pulled or snagged.

Headgear Tube
A round, hollow attachment on your back bands. The inner bow of your headgear fits into it.

A welded or removable arm to which elastics are attached.

A thin wire that holds your arch wire into your bracket.

Lip Bumper
A lip bumper is an arch wire attached to a molded piece of plastic. The lip bumper holds back the molars on your lower jaw to provide more space for your other teeth.

A device that protects your mouth from injury when you participate in sports or rigorous activities.

Palatal Expander
A device that makes your upper jaw wider.

An appliance that is worn after your braces are removed, the retainer attaches to your upper and/or lower teeth to hold them in place. Some retainers are removable, while others are bonded to the tongue-side of several teeth.

Separator or Spacer
A small rubber ring that creates space between your teeth before the bands are attached.

Tie Wire
A fine wire that is twisted around your bracket to hold the arch wire in place.

Wax is used to stop your braces from irritating your lips.

Orthodontic Procedures
The process of fitting and cementing orthodontic bands to your teeth.

The process of attaching brackets to your teeth using special orthodontic cement.

Cephalometic X-ray
An x-ray of your head which shows the relative positions and growth of the face, jaws, and teeth.

A meeting with your orthodontist to discuss a treatment plan.

The process of removing cemented orthodontic bands from your teeth.

The process of removing cemented orthodontic brackets from your teeth.

The process of making a model of your teeth by biting into a soft material that hardens into a mold of your teeth. Your orthodontist will use these impressions to prepare your treatment plan.

An alternative to traditional braces, Invisalign straightens your teeth with a series of clear custom-molded aligners. Invisalign can correct some, but not all, orthodontic problems.

The process of attaching an arch wire to the brackets on your teeth.

Panoramic X-ray
An x-ray that rotates around your head to take pictures of your teeth, jaw, and other facial areas.



ortho 2/18/19 – gtg



Orthodontics can be successful at any age. However there is an ideal time when the best improvement can be achieved. Contrary to popular belief, orthodontics is not something to postpone until a child is older. In fact the American Association of Orthodontists recommend, that all children have an orthodontic screening by a specialist orthodontist by age 8.

For some patient timely orthodontic treatment may prevent the need for jaw surgery, extraction of teeth, or fracture of protruded upper incisors. Early treatment may also help your child’s self esteem. A complete evaluation will determine if your child will benefit from early orthodontic treatment.

You are never too old to smile, meaning you are never too old to improve the appearance or health of your teeth. In fact 35% of patients are adults. With the latest advancement in orthodontics, wearing of braces has become easier and more effective than before. If the thought of wearing braces has held you back from having the smile you have always wanted, consider our clear, invisible braces or Invisalign.


A customized treatment plan is developed which is tailored specifically for that individual and an estimate of treatment time is provided. Our investment in continuing education is to keep us current with state of the art procedures including Invisalign.

Come and see the difference at a place where perfection is the ultimate goal, and excellence is the least you can expect. Quality makes the difference, and we believe you are worth the highest efforts and attention. We are committed to providing the highest quality of care in the most friendly manner.







Gum/Periodontal Disease
Gum disease (periodontal disease) can occur at any age. Many people think of periodontal disease as an adult problem. However, studies indicate that nearly all children and adolescents have gingivitis, the first stage of periodontal disease. Advanced forms of periodontal disease are more rare in children than adults, but can occur. Periodontal disease is an inflammatory infection of your gums and bone caused by the bacteria that adhere to your teeth. The bacteria often congregate in invisible colonies called biofilm. The bacteria produce toxins or poisons that irritate your gums. The toxins also stimulate a chronic inflammatory response in which your body in essence turns on itself. Your body produces protein hormones called cytokines. They allow the tissues and bone that support the teeth to be broken down and destroyed. These cytokines act as a form of communication between other inflammatory cells not only in the gums and bone but also in other body organs far from the mouth and can have serious consequences. Additionally, physicians are beginning to measure the blood level of C-reactive protein (CRP) which is produced by the liver. The level of CRP rises when there is inflammation throughout the body and may be associated with the following:

* Cancer
* Connective tissue disease
* Heart attack
* Infections (such as gum disease)
* Inflammatory bowel disease (IBD)
* Lupus
* Pneumococcal pneumonia
* Rheumatoid arthritis
* Rheumatic fever
* Tuberculosis

In the early stage of the disease, called gingivitis, gums may swell, turn red and bleed easily. Eventually, these toxins cause the tissues to separate from the tooth and form deepened spaces called pockets. If left untreated, the disease can progress to the bone. Because gum inflammation and bone destruction are largely painless, people may wrongly assume that the painless bleeding after teeth cleaning is insignificant.

Basic signs will alert you to periodontal disease:

Bleeding Gums – Puffy, Tender, Bright Red Gums – Receding Gums

In later stages of the disease called periodontitis, the bone and the soft tissues that support the teeth can be destroyed. This can cause the teeth to become loose, fall out, or have to be removed by your dentist. Periodontitis is the most frequent cause of tooth removal for people over 40 years of age.

An article in the Journal of Periodontology states that cigarette smoking may be responsible for more than half the gum disease in US adults. Current smokers are four times more likely to have gum disease than those who have never smoked.. The more cigarettes you smoke each day, the greater the odds you’ll get gum disease. Quitting smoking seems to gradually reduce the harmful effects of tobacco on your gums.

Periodontal (gum) disease may be passed from parents to children and between couples, according to an article in the Journal of the American Dental Association. Researchers suggest that the bacteria that cause periodontal disease pass though saliva. This means that the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member. If one family member has periodontal disease, all family members should see a dental professional for a periodontal evaluation.

In addition, it’s well documented that women who are pregnant and have periodontal disease are far more likely to give birth earlier (prematurely) and give birth to low birth weight babies than women with healthy gums. The mouth is the portal to the body, it should be no surprise that an infected mouth can affect your unborn baby. Premature babies are born with serious health complications that last throughout life, from cerebral palsy to mental disabilities to blindness. Prematurity is also the leading cause of neonatal death in this country. The American Dental Association is working with the March of Dimes Prematurity Campaign to raise awareness of the link between gum disease and premature births.

Diabetics with gum disease have a harder time controlling their blood sugar as measured by their A1c.

Obese patients are 8 times more likely to have periodontal disease.

Recently, a link between gum disease and gastric ulcers has been established. Gastric ulcers are caused by a particular type of bacteria. That same bacteria is also found in periodontal pockets. It is theorized that this type of bacteria can be swallowed from the mouth to the stomach where it contributes to gastric ulcer formation.

Harvard researchers reported that men with a history of gum disease were at a 64% higher risk for pancreatic cancer compared with those with healthy mouths. This study’s lead author said, “People think of gum disease as being in their mouth. But when it gets severe, it’s not just in the mouth. It’s probably in the entire body.”

A study published in the Journal of Periodontology concluded that controlling gum disease may reduce the incidence and progression of chronic kidney disease.

Are you starting to see the connection, an unhealthy mouth may lead to an unhealthy body.

Be aware that Biophosphate drugs (Fosamax, Boniva, Actonel and Reclast) that fight osteoporosis and prevent broken bones can make fighting gum disease more difficult because these drugs make bone more dense. This makes it difficult for gum disease fighting antibiotics to reach the gum infection and slows down the rate of bony repair. Please tell your dentist about all drugs that you are taking.

Your periodontal risk factors as determined by your history, x-rays and probing will dictate how aggressively and quickly your dentist work to eliminate your inflammation. Because periodontal disease can cycle up and down in intensity over time, your dentist will also set up a monitoring program based on your risk factors and your body’s response to your initial therapy.

If you are at low risk, simple physical removal of the bacteria called debridement may eliminate the inflammation. Dentists used to scrape the bacteria off by hand, but now many use ultrasonic devices that disable the bacteria by a combination mechanical chipping at their colonies, cavitation shock waves similar to mini tornados with turbulence that strips the bacteria of their hair like feet/flagella and the forceful flushing of the loosened and bombarded colonies by the water stream at the ultrasonic device tip. The elimination of bleeding at previous bleeding sites is the measure of successful periodontal therapy. If you are a medium to high risk patient, your dentist will work to neutralize the bacteria by debridement and may place high dose localized antibiotics next to your teeth in the more severe areas. In addition to neutralizing the bacteria, if you are at medium to high risk, your dentist may prescribe a low dose systemic antibiotic such as doxycycline to reduce the harmful production of inflammatory mediators by your body. The highest risk patients and those lower risk patients who show little inflammatory improvement as measured at original bleeding sites, will need to be referred to a periodontal specialist. The periodontal specialist may need to do outpatient surgery to temporarily move the gum tissue out of the way so bacteria in the hardest to reach places can be removed and the healing process can begin. Some gum and bone damage cannot be restored by the best of therapy. This finding makes it essential to see your dentist for an inflammation evaluation on a regular basis before damage is irreversible.