My Blog
By Sharon M. Verdinelli, DMD
August 16, 2019
Category: Oral Health
ActressEmmaStoneRevealsHowThumbSuckingAffectedHerTeeth

It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.

“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”

While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)

When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.

Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.

But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.

Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

By Sharon M. Verdinelli, DMD
August 06, 2019
Category: Dental Procedures
Tags: tooth replacement  
3WaystoCorrectMissingFrontTeeth

Roughly 75% of American adults are missing at least one tooth, mostly from disease, trauma or extraction for other dental reasons. A few missing teeth, though, never erupted in the first place.

It’s a rare occurrence, but sometimes people are born without certain teeth, usually back molars or premolars that may not be as visible. Occasionally, though, it’s the more visible upper lateral incisors positioned on either side of the central incisors (the two front teeth on either side of the midline of the face).

Missing incisors can lead to poor bites and create difficulties for speech development and nutrition. But these highly visible (or in this case, “invisible”) teeth can also detract from an otherwise attractive smile.

There are ways, however to correct a smile with missing lateral incisors. Here are 3 of those ways.

Canine substitution. We can fill the vacancy created by the missing incisors by orthodontically moving the canines (the “eyeteeth,” normally next to them) into the space. Braces can close the gap in a conservative way, while possibly correcting any existing bite problems. Because canines are larger than incisors, its often necessary to re-contour them and restore them with a crown, veneer or bonding material to look more natural.

Fixed bridge. A second way to fill the space is with a dental bridge. A bridge consists of a series of crowns fused together in a row. The middle crowns replace the missing teeth; the end crowns cap the natural teeth on either end of the gap, which establishes support for the bridge. Another variation is a cantilever bridge in which only one natural tooth is capped for support. With either type, though, the capped teeth will be permanently reduced in size to accommodate the crowns.

Dental implants. This popular restoration is also a favorite for correcting missing incisors. Implants provide a life-like and durable replacement for missing teeth, while not requiring any alterations to existing teeth as with a bridge. But they are more expensive than the other options, and they require adequate space between the adjacent teeth for insertion, as well as healthy bone for proper placement and anchorage. This is also an option that must wait until the jaw has fully matured in early adulthood.

If you would like more information on treating congenitally missing teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow: Treatment Options for Congenitally Missing Lateral Incisors.”

By Sharon M. Verdinelli, DMD
July 27, 2019
Category: Dental Procedures
Tags: root canal  
ThreeThingsYouMayNotKnowAboutRootCanalTreatments

The term “root canal” is a part of our social lexicon, and not always with a positive meaning. But contrary to its negative reputation, a root canal treatment can make all the difference in your dental health.

Here are 3 things you may not know about this important procedure.

A root canal treatment is a “tooth” saver. Decay deep inside the tooth pulp puts the entire tooth at risk. The infection not only destroys nerves and tissue in the pulp, it has a direct path to the root through tiny passageways known as root canals. By cleaning out this infected tissue, then filling the empty pulp chamber and the root canals with a special filling, the procedure stops the disease from further harm and seals the tooth from future infection. Without it, it’s highly likely the tooth will be lost and other teeth threatened by the infection.

A root canal doesn’t cause pain — it relieves it. The biggest misconception about root canal treatments is their supposed painfulness. That’s just not true, thanks to anesthetic techniques that numb the teeth and gums — and any discomfort afterward is quite manageable with mild anti-inflammatory drugs like ibuprofen. The procedure actually stops the real pain, caused by the infection damaging and finally killing the tooth’s nerves, when it stops the infection.

Root canal treatments are even more effective thanks to recent advancements. Not all infected tooth situations are the same: some teeth have smaller offset passageways called accessory canals that grow off a larger root canal that can be quite difficult to detect and access. Missing them can leave the door open for re-infection. In recent years, though, endodontists, specialists in root canal disorders, have improved the way we address these complications using advanced technologies like specialized microscopic equipment and new filling techniques. The result: a lower risk of re-infection and a higher chance of long-term success.

Hopefully, you’ll continue to enjoy good dental health and won’t need a root canal treatment. But if you do, rest assured it won’t be the unpleasant experience you might have thought — and will be a welcomed solution to pain and threatening tooth loss.

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

By Sharon M. Verdinelli, DMD
July 17, 2019
Category: Oral Health
Tags: ibuprofen   pain management  
NSAIDsforPainManagementisSafe-ifUsedProperly

Millions of Americans regularly use ibuprofen to manage minor pain and swelling. As with other fields in healthcare, the drug is a mainstay in dentistry especially for post-procedural discomfort. But ibuprofen and similar drugs also have side effects that can lead to serious health problems. So, should you be concerned about its safety?

For most people, ibuprofen is safe and effective — but only if used properly. Like aspirin, ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation by blocking the effect of substances called prostaglandins, released by injured or damaged tissues. NSAIDs differ in mechanism from pain relievers like steroids or narcotics and don’t have the same side effects, especially the addictive qualities and impaired consciousness potential of narcotics like morphine or codeine. While these more potent drugs are usually reserved for serious injuries or illnesses, NSAIDs like ibuprofen are ideal for mild to moderate pain following routine dental work.

The biggest concern for the use of an NSAID is its tendency to thin the blood, especially if used continuously over several weeks; this can make bleeding control more difficult after an injury. Prolonged overuse has also been linked to erosion of the stomach lining leading to ulcers or bleeding, kidney failure, early miscarriage and repeat heart attacks for patients with cardiovascular disease.

With this in mind, we recommend that adults take no more than 2,400 milligrams of ibuprofen during one twenty-four hour period for short-term pain relief unless otherwise recommended by a doctor. Research has shown that a single 400-milligram dose of ibuprofen is safe and effective for relieving even severe post-operative pain for about five hours in most people. On the other hand, we don’t recommend a NSAID during pregnancy or for people with a history of intestinal bleeding or heart attacks.

Taking into account your medical history and the procedure you’ll be undergoing, we will recommend the best pain management medication for your situation. In most cases, ibuprofen will be an effective means to reduce your discomfort level and, taken properly, will not pose a danger to your overall health.

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

By Sharon M. Verdinelli, DMD
July 07, 2019
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”





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