Cavities tend to plague the young; gum disease gets us when we’re older.

Sure, most of us brush our teeth at least once a day (maybe lackadaisically, but we still brush). And since we aren’t getting cavities any more (we’re brushing, after all!) we assume that we’re home free.

Hardly. If we don’t take care of our gums as we get older we very likely will lose at least one tooth after 65 – if not sooner.

What’s more, gum disease – its clinical term is periodontal disease – can also lead to other health risks such as heart attack and stroke.

Periodontal disease starts out as gingivitis – the least severe form of the disease. Symptoms can include swelling, redness, and bleeding gums (often when you brush your teeth). You’ll probably feel no pain with gingivitis, but if left untreated (and most people can take care of gingivitis with better oral care under the direction of their Keller dentist), it can develop into periodontitis.

This happens because plaque spreads beneath your gum line and the toxins produced by plaque cause irritation. Your body responds with inflammation, causing the tissue and bone beneath your teeth to degrade, with your teeth and gums growing more and more separate from each other. Infection can set in and the cycle continues, with the destruction of more supporting tissue and bone. Given enough time, your teeth can loosen and need to be removed.

But wait! There’s more: there are multiple types of periodontitis. What’s known as aggressive periodontitis usually shows up in healthy people. This type of periodontitis is characterized by rapid destruction of bone and loss of attachment. Chronic periodontitis is the most common type and it’s known for the inflammation of supporting tissue and a slow progression of attachment loss.

As hinted at above, periodontitis can also be a product of another disease (respiratory disease is common), diabetes, heart ailments, and so on.

Finally, a particularly bad form of the disease is necrotizing periodontal disease. This is where the periodontal ligaments, gum tissues and bone die. This type of periodontal disease is most common in patients who have suppressed immune systems.

The treatment for periodontal disease depends on how severe it is. As mentioned above, gingivitis can be tamed with good oral hygiene habits (flossing regularly, brushing for at least one minute each time, regular dental checkups with tooth cleaning and plaque and tartar buildup removed from your teeth).

Scaling and root planning are other non-surgical treatments. Treatments that require surgery include flap surgery/pocket reduction surgery, bone grafts, soft tissue grafts, guided tissue regeneration, and bone surgery.

Most gum disease can be treated non-surgically; the surgical procedures listed above are almost always necessary when the tissue around the teeth is unhealthy and can’t be repaired otherwise.

As serious as periodontal disease is, it’s relatively easy to prevent: take care of your teeth and gums!

For more information about Dr. Brent Cornelius please visit www.brentcornelius.com

Biomimetic dentistry

Introduction

• Biomimetic dentistry is based on the philosophy that the intact tooth in its ideal hues and shades and, more importantly, its intracoronal anatomy, mechanics and location in the arch, is the guide to reconstruction and the determinant of success.
• This approach is conservative and biologically sound and in sharp contrast to the porcelain fused- to-metal technique in which the metal casting with its high elastic modulus makes the underlying dentin hypo functional.
• The goal of biomimetics in restorative dentistry is to return all of the prepared dental tissues to full function by the creation of a-tissue bond that allows functional stresses to pass through the tooth, drawing the entire crown into the final functional biologic and esthetic result.
• Bio: meaning life and mimesis meaning imitation are from Greek.
•  Biomimetics is the field of scientific endeavor which attempts to design system and synthesize materials through biomimicry.
• It’s the concept of taking ideas from nature and implementing them in another technology such as engineering design computing etc.
• The subject matter of biomimetics is known by several names bionics, biognosis etc .
• Biomimectics is an emerging inter disciplinary field that combines information from the study of  biological structures and their function with physics mathematics chemistry and engineering in the development of principles that are important for the generation of novel synthetic materials and organs.

History

• The name biomimeitcs was coined by Ottoschmit in the 1950s. The term bionics coined by JackE.Steele in 1960 at continence in Dayton.
• The foundation of this broad new field has ancient roots. Replacing body parts goes back at least 2,500 years when bridges made them artificial teeth carved them the bones or oxen.
• Evidence of crude dental implants dates back to roman population of the first or second century AD and to pre-Columbian cultures of central and south America.
•  The first use of dental amalgam to repair decayed teeth was recorded in the Chinese literature in the year 659.
• The middle of 20^th century same sophisticated inventions in the heart pacemaker the artificial heart valve and hip and knee joint replacement historically organ and tissue loss have been treated by surgical reconstruction and more recently the use of mechanical devices such as kidney dialyzers and the transplantations of organs from one individual to another.

REGENERATION OF DENTAL STRUCTURES

Regeneration of the dentin pulp complex :-

• The recombinant human BMP2 and BMP4 can induce new dentin .
• Recombinant BMP delivered in a scaffold of demineralized dentin matrix induces classic tubular dentin in amputated pulp where as BMP delivered using reconstituted type I collagen matrix induces instead osteodentin .
• Reparative dentin is also induced on freshly cut healthy pulp tissue in nonhuman primate using recombinant human BMP7 with an insoluble type I collagen matrix.
• The size and shape of the inductive material controls the size and shaped of the reparative dentin.
• The reparative dentin appears initially with cellularand soft tissue inclusions a portion of which (comprising only about 20% of the reparative dentin ) subsequently changes into a more tubular form of matrix with associated odontablast like cells attached to the mass of a tubular matrix.
• Therefore the extra cellular matrix scaffolding is a critical component and a prerequisite to odontoblast differentiation and tubular dentin formation.

Periodontal regeneration :-

• The periodontium which consist of cementum PDL and alveolar bone functions to anchor the teeth to the jaws.
• The morphogenetic potential of BMPs makes them ideal candidates for use in periodontal regeneration o p t i m i z i n g  t h e r e s p o n s e o f s t e m cells to BMP induction requires the use of a delivery system that is conducive to the migration and attachment of the responding stem cells on to the scaffolding using a baboon model recombinant BMP7 and baboon type I collagen has been used as a biomimetic scaffold to regenerate surgically created function defects in molars.
•  The formation of alveolar bone and the creation of cementum and sharpey’s fibers inserted at the optimal orientation into the root surface.
• Platelet rich plasma (PRP) used in different surgical procedures.
• It consists of thrombocyte concentrates and high amounts of growth factors (GFs) especially platelet desired growth factor (PDGF), insulin like growth factor (IGF -I) and transforming growth factor (TGF- beta ) which are important in wound healing and regeneration combination of PRP and tricalcium phosphate can be used in the treatment of periapical inflammatory lesion.
• Platelet gel biotechnology a method which has all the components of “tissue engineering” techniques with healing process of guided tissue regeneration procedures (GTR) by multiplying the number of molecules that activate the healing response and by grafting in the host site various cell types among which stem cell host is applied to regenerative surgery of intrabony defects in patients with refractory g e n e r a l i z e d a g g r e s s i v e p e r i d o n t i t i s .

THE BIOMIMETIC PRINCIPLE IN RESTORATIVE DENTISTRY

• There are two major perspectives to which the term “biomimetic” is applied: a purist perspective that focuses on recreating biological tissues and a descriptive perspective that focuses on using materials that result in a mimicked biological effect.
• Although different, both share a common goal of mimicking biology in restoration. This has been an increasingly common goal for dentists and patients alike in achieving esthetic and functional dentistry.
•  The goal of biomimetics in restorative dentistry is to return all of the prepared dental tissues to full function by the creation of a hard tissue bond that allows functional stresses to pass through the tooth drawing the entire crown into the final functional biologic and esthetic result .
•  Bonded porcelain restorations are recommended to treat the most perilous situation ( non vital or fractured teeth) thus avoiding the use of intraradiucular parts or full coverage crowns e.g.- inlay onlay laminates cemented with the adhesive resins .
• Biomimetic dentistry techniques provide the patient with minimally invasive options that conserve sound tooth structure as a clinical imperative.
•  Biomimetics is essentially described as a mimicking of natural life, which can be accomplished using contemporary composite resins and adhesive dental procedures.
• Conservation and biological mimicry make up the foundation of a biomimetic philosophy and together produce the effect that today’s patients expect.
• From an esthetic/restorative perspective, biomimetics or biomimicry is the application of methods and systems to artificially replace biologic elements in order to recreate optimal oral health.
•  Practicing interdisciplinary esthetic restorative dentistry enables dentists to achieve biomimetic results with cosmetic dentistry.
•  These techniques and materials are crucial to modern dentistry in that they combine a focus on dental health and appearance.
• A biomimetic material should match the part of the tooth that it’s replacing in several important ways, including the modulus of elasticity and function of the respective areas (e.g., pulp, dentin, enamel, dentoenamel junction)
• The low elastic modules of most composites can never fully compensate for the loss of strong proximal enamel ridges especially in extremely large class II restorations .
• In these situations including those with cusp coverage indirect ceramic inlays onlays seem to be best alternative .
•  In case of total occlusal coverage in vital teeth with a short clinical crown ceramic indirect overlays are indicated. .
• With the development of improved adhesives and immediate dentin sealing the use and indications for base lines have decreased.
• This group of materials traditionally performs many different function including the partial lining as a biologic protection for deep preparation areas the total lining for the dentin insulation against chemical or thermal injuries and the dentin replacement as a base prior to further restoration procedures.
• The indication for placing a linear under on adhesive restoration is mainly for pulp protection in the form of a partial lining using Ca (OH2) cements.
• Modern adhesives are capable replacing the total living function of former varnishes and cements.
•  Base materials are mainly indicated to reduce the volume of the inlay/ onlay (e.g.- excessive depth ) and to create an adequate preparation geometry by providing an even cavity floor and filling up internal undercuts .
• Endodontically treated teeth are more susceptible to fracture not because of pulp removal but due to the increased strain resulting them tooth substance loss.
• For posterior teeth total cuspal coverage with porcelain is recommended as it will significantly stiffen the crown and increase cusp stabilization for vital teeth
• .A composite resin base in indicated to reduce the volume of the inlay/onlay and to create an adequate preparation geometry (by providing an even cavity floor and filling up internal undercuts)

DEVELOPMENT OFARTIFICIAL SALIVARY GLAND

• Many people suffer a loss of salivary gland function as a result of radiation treatment for head and neck cancer, and also many people affected for sjogren’s syndrome an autoimmune disease whose symptoms include dry mouth and dry eyes without adequate saliva patient may experience difficulty in speaking, chewing and swallowing.
• The application of state – of – the- art methodologies include the use of adult and embryonic stem cells for the regeneration of the salivary glands, parenchyma and restorations of its secretary functions.
• Efforts have focused on creating a rather simple device a “blind- endtube” suitable to graft in the buccal mucosa of patients whose salivary parenchyma has been destroyed.
• The lumen of these tubes would be lined with compatible epithelial cells and be physiologically capable of unidirectional water movement. A realistic opportunity to develop a first generation artificial salivary gland suitable for clinical testing is believed to exists.

BIOMATERIALS

• According to Douglas A. Terry, DDS, in dentistry there is no one biomaterial that has the same physical, mechanical and optical  properties as tooth structure (i.e., dentin, enamel, cementum) and possesses the physiological characteristics of intact teeth in function.
•  By utilizing biomimetic therapeutic approaches, dentists can improve and become closer to natural biological structures and their function
• Synthetic Polymer: The polymer can be biodegradable or non degradable .biodegradable polymers include polylactic acid and polyglycolic acid and co polymers.
•  These polymers are used as suture materials but are also being examined for usage such as bone ,skin and liver substitutes.
• These polymers are broken down in the body hydrolytically to produce lactic acid and glycolic acid.
• Newer biomaterials are polyanhydrites, Polyphosphazenes. Polymethyl Methacrylate(PMMA),Polytetrafluoroethylene(PTFE)andPMMA, polyhydroxyethylmethacrylate (PHEMA) may be described as alloplastic , synthetic, Nonbiodegradable polymers.
• PMMA used for dentures and as a cement for many orthopedic prosthesis. PTFE used for augmentation and guided bone regeneration.

CERAMICS

• It is used in dental applications and are being examined for bone tissue engineering application.
• Two common ceramics used in dentistry and hip prosthesis are alumina and hydroxyapatite.
• Alumina has excellent corrosion resistance, high strength, high wear resistance.
• Hydroxyapatite is a calcium phosphate based ceramic and it is a major component of inorganic compartment of bone.
• Advantages of a BioMimetic crown

• Less healthy tooth structure is removed.

• Less potential chances of damaging the nerve inside the tooth.

• T he visual look of the restoration is identical to the natural tooth structure.

• Chances of decay getting under the restoration are small compared to a conventional crown.

• Disadvantages of a BioMimetic crown

• There is the possibility that the porcelain crown could fracture.

• T here is the possibility that the porcelain crown could de-bond (fall off) the tooth. This would require a new crown to be made.

BIOMIMETIC PRINCIPLES IN DENTAL IMPLANT

• Biomimetic dental implants may be the next development in the field.
• A variety of biomimetic coatings may prove helpful for application in individual patients.
•  For example, coating implants with factors known to induce endothelial cell differentiation and proliferation may promote greater vascularity in highly cortical bone, thereby improving conditions for early and long-term (in response to functional loading) bone remodelling.
• Ceramics such as the calcium phosphate hydroxyappatite and various types of aluminum oxides are proved to be bio compatible and they are coated to implant which increases osteointegration.
• Coating implants with pharmacological agents such as bisphosphonates6 may be a way of locally improving bone density in highly cancellous bone.
• Coating implants with BMPs may also accelerate initial healing times during integration of the dental implant, thereby reducing overall treatment times and improving implant success rates.
• Experimental investigations with a BMP known as recombinant human BMP-2 (rhBMP-2) in animal models have shown that it promotes initial integration of dental implants and “rescues” implants affected by experimentally induced peri-implant bone loss.
•  Modifying the surface characteristics of the implant can promote migration of mesenchymal cells to the implant surface, enhance attachment and proliferation of these cells, and, in some instances, stimulate osteoblastic differentiation.

SCOPE

• Biologist study biomimetics not only for an understanding of the biological processes but also to trace the evolution of various classes of organism biochemist have interest in the field due to the complexities associated with the interaction of biopolymers with ions of metal leading to the mineralization in living organisms.
• On the whole the field of biomimetics addresses more than one issue those engaged in this field of research activity try to mimic natural method of manufacture of chemicals in order to create new ones, learn new principles from phenomenon observed in nature, reproduce mechanism found in nature and copy the principles of synthesizing materials under ambient conditions and with easily available raw materials.
•  Design of biodegradable scaffolds to serve as platforms for cells to organize tissues for repair and regeneration of teeth and periodontal tissues.
• Develop biodegradable synthetic polymers for gene therapy identify isolate culture and characterize multipotent stem cells for adult tissues type for repair of TMJ associated structures.

CONCLUSION

• There is a need for a firmer scientific and technical basis in order to develop the next generation of medical implants that are safe reliable smart and long lasting integrated and multidisciplinary research should advance our understanding of biological system and provide the basis for the design and development of normal synthetic medical materials that are compatible with the environment of the host and significantly increase the functional life time of implants.
• Future advances in this field will require materials and computer scientist, physicists, bioengineers, clinicians, biologist and industries working together towards a shared vision rather than pursuing their separate objectives

STEM CELLS

TERMINOLOGIES

Tissue Stem cells :

• Potten and Loeffler, 1990 definition
• Stem cells of a particular tissue are undifferentiated cells (relative to a functional tissue) capable of

 1.proliferation;

2. production of a large number of differentiated functional progeny;

3.self-maintenance of their population;

4. regeneration of the tissue after injury;

5.flexibility in the use of these options

• Amended Definition of Tissue Stem Cells

Stem cells of a particular tissue are:

1. a potentially heterogeneous population of functionally undifferentiated cells, capable of:

2. homing to an appropriate growth environment;

3.proliferation;

4. production of a large number of differentiated progeny;

5.self-renewing or self-maintaining their population;

6.regenerating the functional tissue after injury with

7. flexibility and reversibility in the use of these options

• Potency -differentiation potential (the potential to differentiate into different cell types) of the stem cell.

1.Totipotent /omnipotent stem cells –

• differentiate into embryonic and extraembryonic cell types. –
• a complete, viable organism.
• produced from the fusion of an egg and sperm cell.
•  Cells produced by the first few divisions of the fertilized egg are also totipotent.

2.Pluripotent stem cells –

• descendants of totipotent cells
• can differentiate into nearly all cells,  i.e. cells derived from any of the three germ layers.

3. Multipotent stem cells

•  -can differentiate into a number of cells,
• - but only those of a closely related family of cells.

4.Oligopotent stem cells

• can differentiate into only a few cells, such as lymphoid or myeloid stem cells.

5.Unipotent cells

• can produce only one cell type, their own,but have the property of self-renewal,
• - distinguishes them from non-stem cells (e.g., muscle stem cells)

Introduction

• Russian histologist Alexander Maksimov in 1908
• Stem cells grew out of findings by Canadian scientists in the 1960s
• Dental exfoliation-genetically regulated event
• Lost- donot regenerate
• Stem cells-divide to produce one stem cell and one cell capable of differentation .
• Stem Cells in Dentistry
• 2000- Discovery of adult Stem-cells in dental pulp cells, the living tissue at the centre of tooth.
• 2003- Stem-cells found in baby teeth.
• 2004- Stem-cells found in periodontal ligament, which holds the teeth in place in gums.
• 2007- Researchers learn how to reprogram some adult cells from mice to assume a State like Embryonic Stem-cells called induced pluripotent Stem-cells.
• 2008- Cells in dental pulp identified as adult Stemcells.
• 2003 Dr. Songtao Shi - baby tooth Stem-cells by using the deciduous teeth of his six year old daughter-  isolate, grow and preserve these Stem cells with regenerative ability, and he named them as SHED (Stemcells from Human ExfoliateD Deciduous teeth)
• CLASSIFICATION
• two broad types of Stem-cells
• Embryonic stem- cells
•  Adult Stem-cells.
• Embryonic Stem cells
• Pluripotent-differentiate into all types of somatic cells and theoretically divide an unlimited number of times
• Embryoblast cells –part of blastocyst –interest for stem cell research
• Ability to self regenerate
• Adult-Stem cells
• cells are also called as somatic Stem-cells because they refer to body cells
• can only proliferate a limited number of times.
• Distinguished according to their developmental potential. There are uni- and bipotent progenitor cells-only be differentiated into mature cells of their parent tissue
• Multipotent adult stem cells-are not identical to the parent tissue
• Sources Of Stem-Cells
• Bone marrow -from the long bones. The best sources are pelvic bones, femur and sheen bone.
•  Umbilical cord blood -collected just after the birth of the baby.
•  Embryonic cells -from the blastocyst phase of the embryo.
• Placental Stem-cells
•  Menstrual Stem-cells -extra-ordinary improvement over the umbilical cord blood cells-  have a rapid growth rate.
•  Dental Stem-cells -from the pulp of deciduous or wisdom teeth. - has been found to produce bones, cartilage, and muscle cells if cultured.
•  Present in natal teeth, mesiodense or supernumerary teeth.
• Applications- Parkinson’s diseases,paraplegia, leukemia, and brain tumors
• therapeutic use in dentistry - to regenerate individual tissue types- such as bone,periodontal tissue
• Someday even entire teeth
• 2 means of regenerating teeth
• 1.conventional tissue engineering-the application of cells in a carrier material in vitro under the influence of a stimulus leads to tissue regeneration.
• 2. using dental epithelium and mesenchymal cells in vivo after direct implantation
• - Based on knowledge of general embryogenesis and physiological tooth development during childhood
• CLINICAL APPLICATIONS
• Craniofacial applications.
•  Dental pulp applications.
• Creation of artificial embryonic teeth primordia fromcultured cells.
• Cementoblast like cells applications.
• Periodontal regeneration.
• Over 200 regulatory genes-odontogenesis
• Growth factors from four families
• 1. fibroblast growth factor (FGF),
• 2.Hedgehog,
• 3.wingless (WNT)
• 4. transforming growth factor- (TGF-), to which the bone
• morphogenic proteins (BMPs) belong
• The basis for the regeneration of teeth or individual dental tissues –
• is the acquisition of suitable stem cells and
•  a suitable environment in which these cells can
•  differentiate into the target tissues
• Carrier materials
• collagen sponges
• HA/TCP (hydroxyapatite tricalcium phosphate
• calcium phosphate
• fibrin polymer ceramic
• alginate
• or polymers
•  PCL gelatin scaffolds
• the use of growth factors such as fibroblast growth factors
• and some of the transforming growth factor  family, e. g. bone morphogenic proteins

Dental epithelial stem cells

• The embryonic oral epithelium induces odontogenesis
• Ameloblasts- arise from epithelial stem cells
• the only cells of ectodermal origin which play a role in odontogenesis.
• Lost after tooth eruption- leaving no adult human ectodermal stem cells available for cell therapy.
• Dental epithelial stem cells –obtained from third molars of newborn or juvenile, still developing animals
• A source of epithelial stem cells,
• -the apical bud cells (ABCs), in the apical epithelium is responsible for continuous enamel production
• Dental mesenchymal stem cells
• With the exception of ameloblast progenitor cells,all stem cells involved in odontogenesis originate in mesenchyme
• Mesenchymal stem cells - differentiate into nerve, muscle, vascular, fat, cartilage or bone cells

• Dental pulp stem cells
• isolated from the dental pulp
• Depending on specific signals from their environment, DPSCs can either regenerate new stem cells or undergo  a differentiation process.
• Dental pulp acquired from third molars or pulpectomized teeth left in situ.
• Even after temporary storage in liquid nitrogen- the DPSCs do not lose their multipotent ability to differentiate
• In vitro, DPSCs - differentiate to odontoblasts, osteoblasts, endothelocytes, smooth muscle cells, adipocytes, chondrocytes, and neurons.
• DPSCs differentiate in vitro to osteoblast progenitor cells and mature into osteoblasts which produce LAB (living autologous fibrous bone tissue
• DPSCs in vivo can form calcified bone tissue with Haversian canals and osteocytes and dentin/pulp-like tissue complexes
• odontogenic, myogenic, adipogenic, and osteogenic differentiation.
•  DPSCs influence angiogenesis
• Regeneration potential of adult stem cells in human dental pulp - tertiary dentin
• therapeutically employed for direct and indirect pulp capping after caries excavation near the pulp
• Stem cells from human exfoliated deciduous teeth (SHEDs
• relatively easily accessible source of adult stem cells
• coronal pulp of exfoliated deciduous teeth
• Role
• in the eruption of permanent teeth
• influence the osteogenesis
• In vitro-odontogenically, osteogenically, adipogenically, chondrogenically, or neurally
• In vivo- neurons, adipocytes, odontoblasts, and osteoinductive and endothelioid cells
• Periodontal ligament stem cells (PDLSCs)
• Periodontal ligament - contains stem cells which have the potential to form periodontal structures such as cementum and ligament
• from the roots of extracted teeth
• In vitro-differentiate into osteoblasts, cementoblasts,
• and adipocytes.
• In vivo, after transplantation into mice, structures resembling bone, cementum, cartilage, and PDL have been found.
• Dental follicle stem cells (DFSCs)
• The dental follicle plays a major role in the genesis of cementum, periodontal ligament, and alveolar bone.
• isolated from the follicles of impacted third molars
• in vitro exhibit characteristics of cementoblasts and osteoblasts-can differentiate neurally.
• In vivo, tissue similar to dental cementum and differentiation into PDL progenitor cells
• Stem cells from the dental apical papilla (SCAPs)
• SCAPs - stem cells from the apical part of the papilla,
• a precursor tissue of the dental pulp.
•  Impacted third molars
• In vitro, SCAPs -differentiate osteogenically, odontogenically, and adipogenically.
• In vivo, SCAPs -differentiate into odontonblasts and osteoblasts.
• Non-dental stem cells
• Human bone marrow-bone marrow derived mesenchymal stem cells (BMSCs) can replicate themselves and, in experiments, be differentiated into osteoblasts, myoblasts, adipocytes, and neuron-like cells
• In humans, BMSCs -used therapeutically in bone augmentation by sinus lifts
• -minimally invasively harvested from the iliac crest and inserted into the maxillary sinus on a carrier.
• MBMSCs -(mandibular bone marrow stem cells)
• -possess a high osteogenic potency
• Mesenchymal cells can be isolated from odontomas and differentiated into dental hard tissue, such as dentin
• Other sources :
• From umbilical cord blood
• cartilage
• the cornea
• mammary glands
• adipose tissue
• Renal stem cells
• Medical research- multipotent neural stem cells
•  from areas such as the hippocampus and subventricular zone
• Dermal multipotent cells -differentiated to odontoblasts in embryonic tooth-bud medium
• Dental Stem cell markers
• Identify,characterize, and isolate stem cells.
• STRO-1, a trypsin-resistant cell-surface antigen- most common-early surface markers of mesenchymal stem cells
• STRO-4, binds to heat shock protein–90 beta of multipotent MSCs
• The osteoblast marker osteocalcin -a stem cell marker of DPSCs
• The neural marker nestin on dental stem cells
• Conclusion
• For dentistry, stem cell biology and tissue engineering are of great interest.
• A great deal of research must be done before it is possible to cultivat eentire teeth as natural, autologous tooth replacements

Are you in a cash crunch? Need to consolidate a business or personal debt? We are healthcare specialists; we will succeed when banks have failed; funding in as little as 7-10 business days; funds can be used at your discretion.

If you’d like to hear more about our programs or even take a look at some figures so you can quickly evaluate whether this would be worth your time feel free to send me an email at kasandra@imsfinancial.net and/or call me anytime at (818) 762-6611.

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Web Dentists are those who come to know your teeth problems then provide suggestions and prescribe methods over internet. Many dentists and oral hygiene experts are associated with Webdentist. Patients can communicate via emails and also register to connect with doctors of their choices.

Cavities are the prime reason which develop bacteria and cause tooth ache. Tooth ache is also caused by tooth decay, tooth fracture, infected gums and damaged filling. When the toothache becomes severe and lasts for more than two days then one should immediately seek doctor’s help.

Many first aid treatments and emergencies are prescribed over the webdentist and some of the treatments include:

• One should have a clean mouth by rinsing mouth with warm water and flossing also removes the food particles. Salt and warm water solution also happens.
• To subside the pain a cool compressor is used outside of the mouth or cheek, some pain killers should also be given but some pain killers like Aspirin should not be given to any one below the age of 18 and such pain killers should not be taken on the gum area which will make it burn with sensation.
• If the pain does not subside one should visit a dentist.
• There are some natural remedies by which one can get rid of toothache like rubbing clove oil on the affected tooth can bring relief to the toothache since clove oil has properties which kill bacteria and it also acts as a local anesthetic. A paste of ginger powder and red pepper can be applied on the affected tooth for a quick relief. Rinsing one’s mouth with a drop of myrrh acts as an astringent. Peppermint tea also has a numbing power. To kill bacteria a solution of hydrogen peroxide solution can also be taken for a temporary relief. Ice cubes, tea bags also bring relief.
• Better toothpaste for sensitive tooth is the usual norm. Apple Cedar vinegar, vanilla extract, garlic and oil of oregano al help to bring down the pain.
• A softened chewing gum, soft bristle brush and acupressure techniques should be taken care of.

Toothache has many treatments depending on the type of toothache. If cavity is the reason for toothache the dentist will fill the cavity or extract the tooth. If the toothache causes infection on the nerve’s end then the dentist may also go for root canal and for reducing the pain phototherapy is done along with a cold laser which gives relief. The dentist also prescribes antibiotics. Toothaches can be prevented by following simple daily care routine like maintaining a good oral hygiene which consists of brushing regularly with a fluoride based toothpaste, regularly going to the dentist for proper clean ups, less consumption of sugar based foods.

Read more on Tooth Decay and Cavity at www.webdentist.in

A beautiful smile breaks many barriers between two people. A fight or an argument dissolves immediately when a person receives the warm smile by another person. It is estimated that around 99.7 percent of Americans think that smile is an important social asset. A smile is a timeless asset, with 45 percent of the people thinking that smile is the most attractive feature in a personality.

A smile not only breaks the barriers but makes one attractive to the opposite sex. People with a beautiful smile turn many heads and gather more attention. On the other hand, it is believed that people who sport an unattractive smile have fewer chances of career success. A smile brings many benefits, from friendships to long term relationships have all started with a beautiful smile. So, if you want to benefit from a beautiful smile, maintain it by keeping its straightness, whiteness, cleanliness and sincerity most of all.

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Hello All, my name is Kasandra Bell I am an Executive Accountant for IMS Financial.

I would like to introduce myself and share with you a little bit about IMS Financial and what it is that I do.

“IMS financial” operates as a financial resource servicing areas throughout the US. With 40+ years of expertise, we’ll bring to you and your practice unmatched resources in fulfilling your commercial or private loan, financing and refinancing needs.

Our team focuses on providing Dental Professionals of all specialties with the most competitive rates, while removing the hassle of dealing with traditional lenders and finding the right financial solution for our clients, which will ultimately help them achieve greater financial satisfaction, security and success. We will use our expert up-to-date knowledge and banking network connectivity to achieve the most unique packages possible for our Dental Professionals all over the country.

“IMS Financial” provides growth opportunities for our healthcare professionals who provide jobs in our community, quality of life for their patients and preservation for their families. Our medical working capital loan programs are available to both startups and well established practices.

Here are just a few programs we provide:

• Dental Working Capital
• Working Capital
• Practice Acquisition
• Practice Expansion
• Practice Refinance
• Commercial Mortgage  

• Residential Mortgage

If you’d like to hear more about our programs so you can quickly evaluate whether this would be worth your time, feel free to send me an email at kasandra@imsfinancial.net and/or call me anytime at (818) 762-6611.

Looking forward to connecting with all of you, and have a wonderful day!!!

All the best,

Kasandra

Tooth decay is a serious problem and some of us don't realize that there are solutions out there that will help prevent tooth decay. Sometimes tooth decay pain can be so bad that it's difficult to work or do your daily routine chores. Here are some causes for tooth decay, which one can know and prevent from happening:

For more information visit SedationConsulting.com

With a considerable growth observed in the overall healthcare industry, there is also an increase in the number of dental clinics across the world. These clinics need different categories of Dental Lab Equipments that will help them perform their duty with ease. These equipments are categorized depending on the task they are used for. Let us go, through each of these categories to know what are the exact requirements that would be required in a dental clinic.

The first category of lab equipments includes the Amalgams and the Accessories. These deal with the filling materials and application tools that the dentist uses to dig and clean the holes made in the teeth in order to treat cavities.

The second category of equipments is the collection of lab instruments. The equipments included here deal mainly with diagnosing dental problems or creating dental products. Some of the equipments that can be listed here are the lab scrappers, lab, knives, lab scissors and many more.

The equipments required for performing administrative tasks are placed in the third category of equipments required for dental clinics. They include items that can be used for billing, record keeping or registration formalities. Items such as a registration form, files, insurance forms and many more are counted under this category.

The final, i.e. the fourth category consists of equipments that are used to perform the main dental work. Items here include air and water syringes, nitrous oxide, diamonds and curing lights and many more. These are the equipments that are required for major treatments conducted in the dental clinics.

There are a lot of tools that a dental clinic would need in order to ensure proper working. These tools and equipments need to be of good quality and should match the needs of the dentists. There are many suppliers who provide Dental Lab Equipments of good quality. As these equipments are used for a medical purpose to manage the oral health of people, it should be made sure that they are of the highest quality. In order to get a good deal on these items, one should know what are the products available in the market and at what cost. As mentioned above, it is important to check the quality and cost ratio. This will help select the best among all those that are available.

Crooked teeth (also called malocclusion) can affect almost 75% of all American adults. Malocclusion can significantly affect oral health over the course of a lifetime, leaving you with increased chances of developing periodontal disease and increased wear and trauma to teeth.

Types Of Malocclusion

-Crossbite – A crossbite is when the lower teeth overlap or come out even with the upper teeth. In a normal occlusion the upper teeth overlap the lower ones but when a crossbite (can occur on either side or both) is present, the opposite is true. This can lead to premature wear, increased risk of chipping or fracturing your teeth, development of abfraction (small notch in tooth at the gumline), and periodontal disease.

-Excessive Overjet – This occurs when the upper front teeth are too far out in front of the lower teeth. This can lead to increased trauma as well as an increase to chipping or fracturing of teeth (especially the front ones).

-Edge To Edge Bite – This occurs when the teeth touch one another edge to edge (or cusp to cusp). The teeth do not fit together propely allowing the biting surfaces to touch. This will lead to increased risk of chipping and fracturing, Temperomandibular Joint (TMJ) pain, as well as short, worn down teeth.

-Open Bite – This is a common occurence from thumb sucking or can be genetic. It is when there is a space between the front upper teeth and the front lower teeth upon closing. Not only is this an unesthetic option but it can lead to abfraction, is difficult to bite and tear food ,and causes excessive, premature wear of the back teeth.

-Over Bite- This is when the upper front teeth completely cover the lower front teeth. Often, the lower teeth hit into the backs of the upper teeth and sometimes into the roof of the mouth.

-Under Bite- This occurs when the lower jaw has grown more quickly than the upper jaw. The lower front teeth and jaw have grown in front of the upper teeth.

-Tooth Size Arch Length Discrepency- When your teeth are too large for your jaw space and cause extreme crowding or when your teeth are too small for your mouth. Crowding can lead to decay, fracture, and periodontal disease. Small teeth are generally a major cosmetic issue.

The General Health Danger

Gum disease is commonly found along with malocclusion, due to difficulty in maintaining good oral hygiene when teeth are not in proper position.

Periodontal disease has been linked to many systemic diseases through various studies. Some of these diseases include heart disease, diabetes, and alzheimer’s. Periodontal disease generally takes years of neglect to develop. There are various stages of periodontal disease progression, they include:

-Gingivitis – The earliest stage. The only stage that is reversible with proper dental care. This stage is characterized by swollen, red gum tissues, bleeding upon brushing, as well as bad breath (halitosis). If treated before it progresses, it can be reversed back to a normal, healthy, gingival state.

-Periodontitis – This is the stage that develops following ginigvitis. It is not reversible but can be controlled. Damage to teeth, bone, and gums can be limited with proper dental care. During this stage, the supporting tissues around the teeth may break down leading to gum recession and bone loss around the teeth.

-Advanced Periodontitis – This stage increases the bone loss and gum recession leading to loosening of teeth with the real possibility of losing one or more teeth.

How Do Crooked Teeth Affect Our Mouths?

When teeth are crowded and not aligned properly, the plaque and bacteria that forms on our teeth during everyday food consumption  becomes much more difficult to remove. This makes it difficult to  maintain a good state of health. Many times, flossing and brushing areas of overcrowded teeth will become very difficult. These areas are generally called a “plaque trap” for their ability to constantly trap food and debris.  As mentioned earlier, without proper care, plaque traps can lead to bone loss, gum recession, and even tooth loss.

Another cause for concern is wear and trauma to the teeth. Poorly aligned teeth can create unnatural stresses on the teeth and the jaws. Teeth subjected to excessive pressures can develop chipping, fracturing, and abfractions. Premature wear can also lead to lost teeth, loose teeth and even root canal therapy.

Finally, crowded teeth affect your systemic health by allowing bacteria to grow and flourish unabated in these crowded areas. Over time, this can lead to devastating life threatening effects like heart disease and stroke.

What Can Be Done To Combat Crooked Teeth?

Fortunately, in many cases the simple solution is increased visits to the dentist for professional cleanings as well as diligent  home care.  When there is undue stress placed on the teeth that can cause trauma and wear over time, Orthodontics is the answer in most cases. Orthodontics is a type of dentistry dealing with crowded or misaligned teeth. Proper orthodontic treatment can, in many cases, restore your smile and make it easier to maintain it.

Orthodontics Conclusion

Orthodontics is not just for cosmetic reasons. We are not all born with perfectly straight teeth and sometimes we need a little help to get there. The bottom line is to have beautiful teeth and gums that make you feel confident and healthy. Your smile should  last you a lifetime!

© 2013, Marielaina Perrone DDS. All rights reserved. Henderson Orthodontist

Obstructive sleep apnea (OSA) occurs when the tongue, tonsils, or other throat tissue blocks the airway, stopping breathing.Sleep apnea is often misunderstood regarding its risks and possible treatments. Below we will sort out some of the common myths and give you the facts to better understand this misunderstood affliction.

Myth – Sleep Apnea Is Just Snoring.

This is probably the most common myth regarding sleep apnea. In many individuals sleep apnea can be the cause of snoring while sleeping. The real issue with sleep apnea is that it actually causes a person to stop breathing while sleeping up to 400-500 times a night for a duration of 10-20 seconds each time.

Myth – I Snore So I Must Have Sleep Apnea.

In the United States alone anywhere between 25-50% of the population snores at one time or another. Snoring can be caused by a cold, being overweight, or even alcohol use.

Myth – Sleep Apnea Is Not Dangerous.

If left untreated sleep apnea can be life threatening. It affects a person’s sleep as well as their daily activites. Not being fully rested can lead to accidents and injuries. It has also been shown to be linked to heart attacks, stroke, high blood pressure, and decreased sex drive.

Myth – Sleep Apnea Is Only For Old People.

It is true that sleep apnea is more common in people over age 40 but it can develop at any age. It is estimated that about 22 million Americans suffer from sleep apnea. It can also affect children. The groups most at risk include people over 40 years of age, men, African Americans, Latino’s, and those with a family history.

Myth – Sleeping Pills And Alcohol Will Help You Sleep.

Many try to solve their sleep apnea problem using medications or alcohol. These methods can actually make things worse because the muscles will relax further making it far easier for the airway to become blocked.

Sleep Apnea Conclusion

There are various treatments for sleep apnea including use of  TAP III dental appliance, a CPAP machine (machine that blows a stream of air into the person’s airway in order to keep it open while sleeping), and weight loss programs. The treatment depends on the severity of the sleep apnea which can be assessed during a sleep study. Consult your dentist or physician for the best course of action if you suspect you have sleep apnea.

© 2014, Marielaina Perrone DDS. All rights reserved. Sleep Apnea Causes

Classification

1. 1.    Veau classification

Classification system proposed in 1938.

Group I (A)

• Defects of the soft palate alone

Group II (B)

• Defects involving the hard and soft palates (not extending anterior to the incisive foramen)

Group III (C)

• Defects involving the palate through to the alveolus

Group IV (D)

• Complete bilateral clefts.

2,Kernahan and Stark classification [2]

Embryology-based classification system proposed in 1958 that designates the incisive foramen as the dividing line between the primary and secondary palates.

The incisive foramen is a funnel-shaped opening through which neurovascular bundles pass. It is located in the hard palate behind the middle upper teeth (incisors). This structure is an important embryological landmark, which is used to define the boundary between the primary and secondary palate.

• Primary palate includes those structures anterior to the incisive foramen (lip, pre-maxilla, anterior septum).
• Secondary palate includes those structures posterior to the incisive foramen (lateral palatine shelves, soft palate, and uvula).

3.Kernahan classification [3]

Classification system based on the resemblance of an intra-oral view of a cleft lip and palate to the letter 'Y', proposed in 1971.

The area affected by the cleft is marked on the 'Y' and labelled from 1 to 9, each of which represents a different anatomical structure. Combinations of the numeric values represent the appearance of the cleft lip, alveolus, or palate. View image

• Areas 1 and 4 represent the right and left side of the nasal floor, respectively.
• Areas 2 and 5 represent the right and left side of the lip, respectively.
• Areas 3 and 6 represent the right and left side of the paired alveolar segment, respectively.
• Area 7 represents the primary palate.
• Areas 8 and 9 represent the secondary palate.

4.Harkins' classification [4]

Classification system proposed in 1962.

1. Cleft of primary palate

• Cleft lip
• Alveolar cleft

1. Cleft of secondary palate

• Soft palate
• Hard palate

1. Mandibular process clefts
2. Naso-ocular clefts: involving the nose towards the medial canthal region
3. Oro-ocular clefts: extending from the oral commissure towards the palpebral fissure
4. Oro-aural clefts: extending from the oral commissure towards the auricle.

5.Spina classification [5]

Classification system proposed in 1974.

1. Pre-incisive foramen clefts (lip ± alveolus)

• Unilateral
• Bilateral
• Median

1. Trans-incisive foramen cleft (lip, alveolus, palate)

• Unilateral
• Bilateral

1. Post-incisive foramen clefts (secondary cleft palate)
2. Atypical (rare) facial clefts.

6.Tessier's classification [6]

Tessier described a classification scheme that is universally utilised, in a landmark article of 1976. View imageView image

Oro-facial clefts can manifest as:

• Unilateral or bilateral
• Complete, incomplete, or microform (e.g., sub-mucous cleft palate)
• Clefting of the lip with or without the palate, or of the palate in isolation
• Atypical cranio-facial clefts.

7.DAVIS AND RITCHIE CLASSIFICATION:

• The following classification was proposed by
• Davis and Ritchie in 1922.
•  This system broadly categorized the clefts into three groups according to position of cleft in relation to alveolar process.
• Group I – Pre alveolar clefts:
• • Unilateral cleft lip
• • Bilateral cleft lip
• • Median cleft lip
• Group II - Post alveolar clefts:
• • Cleft hard palate alone
• • Cleft soft palate alone
• • Cleft soft palate and hard palate
• • Sub mucous cleft
• Group III-Alveolar clefts:
• • Unilateral alveolar cleft
• • Bilateral alveolar cleft
• • Median alveolar cleft

8.ARTURO SANTIAGO CLASSIFICATION:

Santiago A8 proposed a classification in 1969 in which he used four digits to indicate presence of cleft and its location. Each digit is followed by letter to indicate condition of cleft (complete, incomplete or

sub mucous). Four digits represent the following four structures

affected by cleft.

• The first digit refers to the lip.

• The second digit refers to the alveolus.

• The third digit refers to the hard palate.

• The fourth digit refers to the soft palate.

The numbers used as digits represents the condition of cleft.

• 0= No cleft

• 1= Midline cleft

• 2= Cleft on right side

• 3= Cleft on left side

• 4= Bilateral cleft

The letters indicate more specifically the type of cleft.

• A = An incomplete midline cleft

• B = An incomplete cleft of right side

• C = An incomplete cleft of left side

• D = Bilateral incomplete cleft

• • E = Sub mucous cleft

1. LAHSAL CLASSIFICATION OF CLEFT LIP AND PALATE:

Kreins O (cited by Hodgkinson et al)9 proposed

LAHSHAL system for classification of cleft lip and

palate patients which was modified on the recommendation

of Royal College of Surgeons Britain in 2005

by omitting one “H” from the acronym “LAHSHAL”. LAHSAL system is a diagrammatic classification

of cleft lip and palate. According to this classification,

mouth is divided into six parts.

• Right lip

• Right alveolus

• Hard palate

• Soft palate (LAHSAL)

• Left alveolus

• Left lip

• The first character is for patient’s right lip and

last character for patient’s left lip.

• LAHSAL code indicates complete cleft with

capital letter and an incomplete cleft with small

letter.

 No cleft is represented with a dot.

1. 10.                       ELNASSRY CLASSIFICATION:

Elnassry10 proposed following classification in

2007. He divided cleft lip and palate patients in to

seven classes.

Class I: Unilateral cleft lip

Class II: Unilateral cleft lip and alveolus

Class III: Bilateral cleft lip and alveolus

Class IV: Unilateral complete cleft lip and palate

Class V: Bilateral complete cleft lip and palate

Class VI: Cleft hard palate

Class VII: Bifid uvula

Classification

1. 1.    Veau classification

Classification system proposed in 1938.

Group I (A)

• Defects of the soft palate alone

Group II (B)

• Defects involving the hard and soft palates (not extending anterior to the incisive foramen)

Group III (C)

• Defects involving the palate through to the alveolus

Group IV (D)

• Complete bilateral clefts.

2,Kernahan and Stark classification [2]

Embryology-based classification system proposed in 1958 that designates the incisive foramen as the dividing line between the primary and secondary palates.

The incisive foramen is a funnel-shaped opening through which neurovascular bundles pass. It is located in the hard palate behind the middle upper teeth (incisors). This structure is an important embryological landmark, which is used to define the boundary between the primary and secondary palate.

• Primary palate includes those structures anterior to the incisive foramen (lip, pre-maxilla, anterior septum).
• Secondary palate includes those structures posterior to the incisive foramen (lateral palatine shelves, soft palate, and uvula).

3.Kernahan classification [3]

Classification system based on the resemblance of an intra-oral view of a cleft lip and palate to the letter 'Y', proposed in 1971.

The area affected by the cleft is marked on the 'Y' and labelled from 1 to 9, each of which represents a different anatomical structure. Combinations of the numeric values represent the appearance of the cleft lip, alveolus, or palate. View image

• Areas 1 and 4 represent the right and left side of the nasal floor, respectively.
• Areas 2 and 5 represent the right and left side of the lip, respectively.
• Areas 3 and 6 represent the right and left side of the paired alveolar segment, respectively.
• Area 7 represents the primary palate.
• Areas 8 and 9 represent the secondary palate.

4.Harkins' classification [4]

Classification system proposed in 1962.

1. Cleft of primary palate

• Cleft lip
• Alveolar cleft

1. Cleft of secondary palate

• Soft palate
• Hard palate

1. Mandibular process clefts
2. Naso-ocular clefts: involving the nose towards the medial canthal region
3. Oro-ocular clefts: extending from the oral commissure towards the palpebral fissure
4. Oro-aural clefts: extending from the oral commissure towards the auricle.

5.Spina classification [5]

Classification system proposed in 1974.

1. Pre-incisive foramen clefts (lip ± alveolus)

• Unilateral
• Bilateral
• Median

1. Trans-incisive foramen cleft (lip, alveolus, palate)

• Unilateral
• Bilateral

1. Post-incisive foramen clefts (secondary cleft palate)
2. Atypical (rare) facial clefts.

6.Tessier's classification [6]

Tessier described a classification scheme that is universally utilised, in a landmark article of 1976. View imageView image

Oro-facial clefts can manifest as:

• Unilateral or bilateral
• Complete, incomplete, or microform (e.g., sub-mucous cleft palate)
• Clefting of the lip with or without the palate, or of the palate in isolation
• Atypical cranio-facial clefts.

7.DAVIS AND RITCHIE CLASSIFICATION:

• The following classification was proposed by
• Davis and Ritchie in 1922.
•  This system broadly categorized the clefts into three groups according to position of cleft in relation to alveolar process.
• Group I – Pre alveolar clefts:
• • Unilateral cleft lip
• • Bilateral cleft lip
• • Median cleft lip
• Group II - Post alveolar clefts:
• • Cleft hard palate alone
• • Cleft soft palate alone
• • Cleft soft palate and hard palate
• • Sub mucous cleft
• Group III-Alveolar clefts:
• • Unilateral alveolar cleft
• • Bilateral alveolar cleft
• • Median alveolar cleft

8.ARTURO SANTIAGO CLASSIFICATION:

Santiago A8 proposed a classification in 1969 in which he used four digits to indicate presence of cleft and its location. Each digit is followed by letter to indicate condition of cleft (complete, incomplete or

sub mucous). Four digits represent the following four structures

affected by cleft.

• The first digit refers to the lip.

• The second digit refers to the alveolus.

• The third digit refers to the hard palate.

• The fourth digit refers to the soft palate.

The numbers used as digits represents the condition of cleft.

• 0= No cleft

• 1= Midline cleft

• 2= Cleft on right side

• 3= Cleft on left side

• 4= Bilateral cleft

The letters indicate more specifically the type of cleft.

• A = An incomplete midline cleft

• B = An incomplete cleft of right side

• C = An incomplete cleft of left side

• D = Bilateral incomplete cleft

• • E = Sub mucous cleft

1. LAHSAL CLASSIFICATION OF CLEFT LIP AND PALATE:

Kreins O (cited by Hodgkinson et al)9 proposed

LAHSHAL system for classification of cleft lip and

palate patients which was modified on the recommendation

of Royal College of Surgeons Britain in 2005

by omitting one “H” from the acronym “LAHSHAL”. LAHSAL system is a diagrammatic classification

of cleft lip and palate. According to this classification,

mouth is divided into six parts.

• Right lip

• Right alveolus

• Hard palate

• Soft palate (LAHSAL)

• Left alveolus

• Left lip

• The first character is for patient’s right lip and

last character for patient’s left lip.

• LAHSAL code indicates complete cleft with

capital letter and an incomplete cleft with small

letter.

 No cleft is represented with a dot.

1. 10.                       ELNASSRY CLASSIFICATION:

Elnassry10 proposed following classification in

2007. He divided cleft lip and palate patients in to

seven classes.

Class I: Unilateral cleft lip

Class II: Unilateral cleft lip and alveolus

Class III: Bilateral cleft lip and alveolus

Class IV: Unilateral complete cleft lip and palate

Class V: Bilateral complete cleft lip and palate

Class VI: Cleft hard palate

Class VII: Bifid uvula

It is important to remember first impressions last and one of the first things people notice upon meeting is a smile. You should feel good about your smile, and smile often. When we think of a perfect smile we have to remember that we all have our own idea of what that may be. It may be whiter teeth, straighter teeth, or even just healthier teeth. Each individual can look in the mirror and find what they want changed about their smile.

How Can Cosmetic Dentistry Help?

A well trained experienced cosmetic dentist can help remove or diminish those flaws using various procedures ranging from porcelain veneers to teeth whitening. Your cosmetic dentist can change the shape of your teeth, alter your gum tissue (for those with a gummy smile), or even fix chips on your teeth. Luckily, for the consumer not all of these cosmetic dentistryprocedures are very expensive. While a complete smile makeover would be cost prohibitive for many, there are still many changes your cosmetic dentist can provide that will not break the bank. And while many may desire a complete smile makeover, it is not recommended for everyone. Cosmetic dentistry is very much an art, focusing on each individuals existing smile and needs.

Cost Effective Cosmetic Dentistry Procedures

-Teeth Whitening. This has become a billion dollar cosmetic dentistry business with products ranging from in office whitening to at home whitening with customized dental trays, whitening strips,  paint on gels and even whitening toothpastes. The differences between the types has to do with speed and depth of whitening. Teeth whitening can have a dramatic effect on almost anyone’s smile for a relatively low cost and minimal time involved.

-Gum Contouring. For those with a gummy smile, this can be a real confidence booster. This cosmetic dentistry procedure is generally done in one visit and can give incredible results for many with an overly gummy smile. Gum contouring simply removes the excess gum tissue and reshapes the gums to ensure you obtain the desired look. for some, this may require reduction of bone also, in this case it is recommended that you see a periodontal surgeon .

-Dental Bonding. This cosmetic dentistry procedure involves using tooth colored materials that can be bonded to teeth to change shape, color, and length. This same material can also be used a full face veneer (called a composite veneer). Dental bonding can generally be completed in one visit.

-Snap On Smile. This is a way to improve your smile without any permanent dental work. All that is required is having your dentist take impressions of your teeth, choosing a color, and the dentist sending them to a lab to have your snap on smile fabricated. Once the snap on smile is made, you simply clean your teeth, apply a fluoride gel inside, and slip it on over your teeth. You can talk, eat and smile with it all day long.

-Porcelain Veneers. While the initial cost is higher than the other options, this may be cost effective if extensive changes need to be made. Porcelain veneers can change shape, color, length, and even correct minor misalignments of teeth. This will last a long time, will not stain, and is a very strong, natural looking material.

-Tooth Recontouring. Changing the shape or alignment of teeth in a minor way can have a dramatic effect on a persons smile. Tooth recontouring involves removing small amounts of tooth structure from edges of teeth to correct a tooth that might be misshapen or slightly misaligned.

-Minor Tooth Movement. Sometimes the only thing making you uncomfortable to smile may be a small misalignment of one or a few teeth. A simple orthodontic appliance may be able to move your teeth into a more favorable position in a few months.

Cosmetic Dentistry Conclusion

While cosmetic dentistry may not be for everyone, it is good to know the options available to you. Having a perfect smile is not a goal of everyone, but if you are looking to improve your smile, seek out the help of an experienced, well trained cosmetic dentist for a full evaluation. This cosmetic dentistry evaluation can give you valuable information to make an informed decision about possible treatment options available to you. Smile with confidence, it not only makes you feel good, it makes others smile too.

© 2014, Marielaina Perrone DDS. All rights reserved. Cosmetic Dentistry

BPA? What is it? BPA is short for Bisphenol A. BPA is an organic compound  that is used throughout the manufacture of many consumer plastic products, and has been found in some dental composites and sealants.

BPA has been shown to have hormone-like (estrogen) properties that raise concern about its suitability in consumer products and food containers. Some laboratory testing has suggested that BPA may effect reproduction and development in animals by mimicking the effects of the female hormone estrogen. This testing is raising concerns about its safety. Recent scientific research has found links between BPA and serious health problems, from heart disease, diabetes and liver abnormalities in adults to developmental problems in the brains and hormonal systems of children.

BPA and Dentistry

There are three ways BPA can become a part of dental materials:

1. As a direct ingredient in dental composites or dental sealants.

2. As a by-product of degrading dental composites or dental sealants in saliva. Composite resins are formulated from a mixture of monomers that are commonly based on bisphenol A glycidyl methacrylate (bis-GMA). Some composite resins may contain other monomers, in addition to bis-GMA, that are added to modify the properties of the resin. An example is bisphenol A dimethacrylate (bis-DMA). Bis-GMA and Bis-DMA-containing materials can release  BPA because both  bis-DMA and Bis-GMA are subject to degradation by salivary enzymes. Bis-DMA releases more BPA than Bis-GMA.

3. As a trace material during manufacture of dental materials. BPA may be used in the production of other ingredients found in some dental composites and sealants. Bis-DMA and bis-GMA are both produced using BPA as a starting ingredient, so residual trace amounts of BPA may be present in the final product.

There are many products utilized for “white” fillings. You can ask if your dentist is BPA free. The products utilized should not contain BPA, and even better if there is also no Bis DMA.

What Can Be Done To Limit Dental Exposure To BPA?

The big concern first was the use of traditional dental materials like dental amalgam. Amalgam contains mercury and there has been vigorous debate regarding its health effects. While all dental amalgam fillings contain mercury, not all dental composites and dental sealants contain Bisphenol-A (BPA). It is important to choose a dentist who carefully selects dental composites and dental sealants that are BPA free.

What if you already have dental composites or dental sealants? Should you be concerned?

It is important to remember the amount of BPA released in dental composites and dental sealants is very small. Although, the effect of BPA accumulation may be small it is important to note that it is a cumulative effect. Over the course of a lifetime the BPA will build up like most environmental toxins. Still, if the dental work in question is not causing any immediate health problems that you experience, removing the dental composite can do more harm than good. The trauma each tooth would undergo through the removal process may do more substantial harm to the teeth.

Common Items Containing BPA

-Baby Bottle

-Water Bottles

-Sports Equipment

-Medical and Dental Devices

-Dental composite filling

-Dental Sealants

-Cd’s and DVD’s

-Lining of Water Pipes

-Lining of Soda cans

How To Reduce Overall Exposure To BPA?

Choosing products that are BPA free  is important. Make good choices in everyday products as well as dental materials. Below are some tips to reduce overall BPA exposure for you and your loved ones.

-Choose Cardboard Or Glass Containers Over Cans. Most cans used in food preparation today are lined with BPA. The food in these cans are in contact with this lining allowing the food to leach BPA from the lining. Highly acidic foods (like tomato sauce) tend to leach more BPA than lower acidic foods. Choosing cardboard or glass will be safer in the long run.

-Avoid Microwaving Plastic Food Containers. The packaging in many microwaveable foods can break down under the high temperatures of the microwave. This will release BPA into your food from the lining of the container. It is not required to report whether a container contains BPA but plastic containers that do are usually marked with a #7 recycling code on the bottom of the package.

-Choose BPA Free Baby Bottles. The general rule for plastics is hard and clear contains BPA while soft or cloudy does not. Luckily, most major manufacturers now tout BPA free bottles for our children.

-Use Powdered Infant Formula. Recent research has shown that liquid formulas contain more BPA than the powdered version.

Bisphenol-A (BPA) Conclusion

Research continues to mount regarding the health hazards of Bisphenol-A (BPA) so it would be wise to protect your family and be educated. While we can probably never live a BPA free life we can limit exposure by making smart choices in dental care as well as our lifestyle. Manufacturers are making their own choices, and moving towards many BPA free products. Hopefully, future research will continue with the evolution of even better products to keep us all healthier.

© 2014, Marielaina Perrone DDS. All rights reserved. BPA Free

Dental anxiety affects a large portion of the population. While many have such anxiety, some are so fearful that they can not even get themselves through the dentist’s front door.Statistics show that  15-20% of all Americans avoid the dentist due to fears or anxiety about the dentist. The reasons for anxiety are different for everyone. These can include fear about feeling rushed by the dentist, possible pain, or even just the smells and sounds of the dental office. Dental anxiety and dental phobia, when stopping someone from receiving dental care,  lead to unnecessary oral and general health problems.

Tips To Calm Dental Anxiety

-Finding The Right Dentist And Dental Team. That’s right, it is not just about the dentist. The dental team is just as important in maintaining a calm, soothing atmosphere. A well trained dentist and team can make you feel at ease throughout your dental treatment and actually make it an enjoyable experience. Ask friends or relatives for recommendations. A good review about a dentist from someone you trust can significantly reduce anxiety. Also, in the internet age read online reviews. These can let you get a better understanding of the dentist and how they treat their patients. Last, make an appointment for a consultation so that you can meet the dentist and staff to see if they make you feel comfortable enough to schedule an exam and cleaning.

-Communication. One of the most important factors in overcoming dental anxiety is a good, open line of communication between dentist and patient. You must always feel comfortable expressing your feelings, fears, and concerns before, during, and after treatment is rendered. You must also feel that the dental team is listening to you and making adjustments as needed. Communication should never be compromised for any patient but it is even more important for a patient with dental anxiety. This will allow you to feel a sense of comfort that you may have never felt in a dental office before.

-Feeling Of Being In Control. This comes from the confidence to stop or start treatment whenever you need to. You should always feel comfortable controlling your treatment.  Making treatment decisions based upon options, how long your appointments should be, and how often you are comfortable coming in for treatment. Another aspect to being in control is to give yourself the power of knowledge about your dental care. This will give you the ability to understand the steps of treatment, and why it is important for you to follow through. Being in control will allow you to properly express your feelings about how much treatment you can handle.

-Own Your Emotions. For many who have neglected their dental care due to fear there can be a sense of embarrassment. Express your feelings and allow your dentist to understand your feelings so they can be addressed properly. Panic, tears, needing your hand held, etc. are coping mechanisms to fear. It is ok to get emotional at the dental office. You can and should be able to express your emotions without embarrassment.

-Utilize Relaxation Techniques.  These can include:

1. Proper Breathing. Focus on breathing regularly and slowly during dental work. When people are feeling anxiety or nervousness we tend to hold our breaths, or breathe in short rapid breaths. This decreases oxygen levels in the body, or hyperventilation, further increasing our feelings of panic.

2. Wear Headphones. For many, the sound of the dental office is a trigger for dental anxiety. Using an ipod or mp3 player with headphones can drown out the noises and relax you.

3. Avoid Caffeine. Caffeine can raise your heart rate and blood pressure, This can trigger panic attacks, make you feel dizzy, lightheaded, or give you the feeling of a fast beating heart. Caffeine before a dental appointment should be avoided.

4. Choose Pre Dental Meals Carefully. Eating high-protein foods have the ability to produce a calming effect.

5. Timing Is Everything. The time of day for your dental appointment can be critical. Try to choose a time for your dental visit when you’ re least  likely to be rushed or feel under pressure.

-Repetition. The simple process of repeat appointments, will make you feel more comfortable and at ease. As you learn what to expect, and realize that you are in control of the appointment, you will be able to manage more time in the chair. Remember not to wait too long between appointments or to reschedule unless an emergency arises. Merely coming to the office and not having treatment that day is better than canceling.

-Predictable Pain Control. Every individual is slightly different. What may work for one may not work for another. Let your dentist know if you have a history of difficulty getting numb. Be sure to let your dentist know whether or not you still feel sensitivity, or lack of complete numbness. When you can trust that your comfort will be a priority, you will find that your anxiety rapidly diminishes.

Dental Anxiety Conclusion

Overcoming dental anxiety can be a trying experience. It is important to find the right dentist and dental team so that you can move forward and free yourself from dental anxiety once and for all. Know what you are looking for in a dentist, and be prepared with questions for your meeting. Remember, it is ok to shop around, you will know when you have found the right dentist for you!

© 2014, Marielaina Perrone DDS. All rights reserved. Dental Anxiety

Cosmetic Dentistry is not just about the outward appearance of a smile. There are many aspects that go into creating a beautiful and healthy smile. There are also many benefits to having a great smile that many of us do not really think about. Below are some of the effects cosmetic dentistry can have on your overall well being.

Cosmetic Dentistry More Than Meets The Eye

It may come as a surprise to some patients, but cosmetic dentistry procedures can actually help patients realize improvements in overall health. Specifically, patients who elect to have certain cosmetic procedures can significantly improve physical, mental, and emotional well being.

-Improved Physical Health. For patients who suffer with Temperomandibular Joint (TMJ) pain, bite alignment issues, and other craniofacial conditions, cosmetic dentistry can help to reshape affected areas in a way that is optimal for physical health. Examples include:

*Stronger teeth. Dental Bonding, dental implants, and porcelain crowns can be used to restore chipped, cracked, damaged, or missing teeth. The goal of any good cosmetic dentist is to preserve as much natural tooth enamel as possible while still developing a smile any patient can be proud of. When cosmetic dentistry treatment is complete, patients will experience a stronger, fuller, and more properly aligned smile that stays healthier, longer.

*Healthier gum tissues. A smile free of periodontal disease is important to maintaining optimal overall health. Recent research has linked periodontal disease to diabetes, heart disease, and stroke. Cosmetic dentistry should never be performed on a patient with progressive periodontal disease or poor at home maintenance. Without a proper foundation, any cosmetic dental care will be doomed to fail over time.

*Realignment of the jaw and/or TMJ, reducing joint pain and preventing teeth from becoming misaligned over time.

*Natural realignment of the airway and oral soft tissues, making it easier for the body to breath at night. Such procedures have been shown reduce snoring, curb sleep apnea, and improve overall quality of sleep.

-Increased Self Confidence. Cosmetic dentistry can improve how we perceive ourselves. An increase in self confidence and self esteem will give ourselves a greater self image. Research has shown that an increase in self esteem is vital to physical health.

-Increased Smiling. With a new-found smile, you will find yourself smiling more. This will make you more attractive to others whether in love or business. Research has also indicated that those who smile frequently often live longer and lead a higher quality of life.

Cosmetic Dentistry Procedures To Change Your Smile

-Teeth Whitening. This has become a billion dollar cosmetic dentistry business with products ranging from in office whitening to at home whitening with customized dental trays, whitening strips,  paint on gels and even whitening toothpastes. The differences between the types has to do with speed and depth of whitening. Teeth whitening can have a dramatic effect on almost anyone’s smile for a relatively low cost and minimal time involved.

-Dental Implants. Missing teeth can make you feel uncomfortable with smiling, socially awkward, or may make you look older than you are. Replacing lost teeth can be done with very natural results. Dental implants are a great way to achieve cosmetics, strength, and durability.  Dental implants can be used to replace a single tooth or multiple teeth. The best part is, once restored, the dental implants should last a lifetime.

-Dental Bonding. This cosmetic dentistry procedure involves using tooth colored materials that can be bonded to teeth to change shape, color, and length. This same material can also be used to fully cover the front surface, (called a composite veneer). Dental bonding can generally be completed in one visit.

-Porcelain Veneers. While the initial cost is higher than the other cosmetic dentistry options, this may be cost effective if extensive changes need to be made. Porcelain veneers can change shape, color, length, and even correct minor misalignments of teeth. This will last a long time, will not stain, and is a very strong, natural looking material.

-Porcelain and Zirconia Crowns. These types of crowns are the strongest and most cosmetic options available. They are made from modern dental porcelains that range in strength and esthetics. If done properly, no one should ever be able to tell a porcelain crown from a natural tooth. Modern porcelains possesses strength, color properties, and light reflection properties that very closely mimic our natural teeth. Porcelain crowns can be used to change bite alignment issues as well as change alignment of front teeth which are more extreme such as those issues that porcelain veneers alone cannot fix. More natural tooth structure needs to be removed in preparing a porcelain crown vs a porcelain veneer.

-Snap On Smile. This is a modern, conservative way to improve your smile without any permanent dental work. All that is required is having your dentist take impressions of your teeth, choosing a color, and the dentist sending them to a lab to have your snap on smile fabricated. Once the snap on smile is made, you simply clean your teeth, apply a fluoride gel inside, and slip it on over your teeth. You can talk, eat and smile with it all day long.

-Gum Contouring. For those with a gummy smile, this can be a real confidence booster. This cosmetic dentistry procedure is generally done in one visit and can give incredible results for many with an overly gummy smile. Gum contouring simply removes the excess gum tissue and reshapes the gums to ensure you obtain the desired look. For some, this may require reduction of bone, in this case, it is recommended that you see a periodontal surgeon.

-Tooth Recontouring. Changing the shape or alignment of teeth in a minor way can have a dramatic effect on a persons smile. Tooth recontouring involves removing small amounts of tooth structure from edges of teeth to correct a tooth that might be misshapen or slightly misaligned.

-Orthodontics. Minor tooth movement can be utilized by your cosmetic dentist to bring your smile in line and allow for a better harmony between your smile and function.

Cosmetic Dentistry Conclusion

 A well trained, experienced cosmetic dentist can not only transform your smile but your entire well being. Your cosmetic dentist can improve the outward appearance of your smile but also bring it back into balance.

© 2014, Marielaina Perrone DDS. All rights reserved. Family Cosmetic Dentistry