My Blog

Posts for: April, 2018

By John A. Pagliei, Jr., DMD
April 29, 2018
Category: Oral Health
ActorDavidRamseySaysDontForgettoFloss

Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.

“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.

Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.

“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.

Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?

Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.

Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a third to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.

Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”

Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.

If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”


By John A. Pagliei, Jr., DMD
April 19, 2018
Category: Dental Procedures
Tags: oral surgery  
SimpleProcedureCouldReduceBitingtheInsideofYourMouth

Somewhere between bites during a recent meal, the inside of your cheek found itself in the way of your teeth. You winced with pain at the resulting bite, and while it was sore for a day or two it seemed to heal over. Now, though, you’re noticing this same area of your cheek gets in the way of your teeth a lot more often, with more bites and sores.

What’s likely happened is that you have developed a traumatic fibroma. When the soft tissues of the inner cheek, lips or tongue heal after being injured, a small bit of fibrous tissue composed of the protein collagen forms like a callous over the bite wound to protect it after it heals. If, however, the process is interrupted by another bite, the fibrous tissue that subsequently forms may be thicker and thus more raised on the surface of the skin. This higher profile makes it more likely the site will be involved in repeated episodes of biting.

If the fibroma continues to be a problem, it can be solved with a simple surgical procedure. A surgically-trained dentist or oral surgeon will remove portions of the fibroma (usually with local anesthesia) to flatten the skin profile, and then close the resulting wound with a couple of stitches unless a laser was used. Any discomfort after the procedure can usually be managed with a mild anti-inflammatory drug like aspirin or ibuprofen, and the site should heal in just a few days to a week.

Although the vast majority of fibromas aren’t dangerous, it’s routine practice to have the excised tissue biopsied for abnormalities. More than likely the fibroma tissue will be normal; but by having the fibroma removed and examined, you’ll gain peace of mind about your oral health. In the process, you’ll also eliminate a bothersome and painful problem.

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


By John A. Pagliei, Jr., DMD
April 09, 2018
Category: Oral Health
Tags: oral health   bruxism   night guard  
LearnHowToProtectYourTeethDuringStressAwarenessMonth

Lots of people don’t know that April is National Stress Awareness Month; don’t fret if you’re one of them. For many, stress is already a common feature of everyday life. According to the American Psychological Association, 62% of Americans are stressed at their jobs, and stress has been estimated to cause the loss of some 275 million working days every year.

In addition to its other negative physical and mental consequences, stress can also spell trouble for your oral health. It may lead to the problems of teeth clenching and grinding, which dentists call bruxism. A habitual behavior that can occur in the daytime or at night, bruxism is thought to affect perhaps one in ten adults. While the evidence that stress causes bruxism is not conclusive, there’s a strong case for the linkage.

Bruxism sometimes causes symptoms like headaches, soreness or pain in the jaw muscles or joints, and problems with fully opening the mouth. It can be detected in the dental office by excessive tooth wear, and/or damage to tooth surfaces or dental work. Grinding or tapping noises heard at night may indicate that someone is grinding their teeth while sleeping. In children, nighttime bruxism is common and not necessarily a reason for concern; in adults, it may be more troubling.

So what can you do if you’re experiencing this problem? If you find yourself clenching and grinding during the daytime, simply becoming more aware of the behavior and trying to limit it can help. A bit of clenching during times of stress isn’t abnormal, but excessive grinding may be reason for concern. Many of the same techniques used to relieve stress in other situations—such as taking a step back, talking out your issues, and creating a calmer and more soothing environment—may prove helpful here as well.

Occasionally, prescription drugs may cause bruxism as an unwanted side effect; in this case, a medical professional may recommend changing your medication. The use of stimulants like coffee and mood altering substances like alcohol and illicit drugs have also been associated with teeth grinding—so if you’re having this issue, consider foregoing these substances and making healthier lifestyle choices.

There are also a number of dental treatments that can help protect your teeth from excessive grinding. The most common is an occlusal guard or “night guard.” This is a custom-fabricated appliance made of plastic that fits comfortably over your teeth. Usually worn at night, it keeps your teeth from actually coming into contact with each other and being damaged. Occasionally, additional treatments such as bite adjustment or orthodontics may be recommended to help solve the problem.

If you would like more information about teeth clenching and grinding, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”


ARetainer-LikeDevicecanPreservetheSpaceLeftbyaLostPrimaryTooth

Children losing their primary (“baby”) teeth is both natural and necessary. So, is it really that much of a concern if they lose one early?

The answer is yes — premature primary tooth loss could have long-term consequences for the permanent teeth as they develop within the jaw before eruption. Primary teeth play a crucial role in this development: as the permanent teeth form and grow the primary teeth serve as placeholders until they’re ready to erupt. A natural process then takes place in which the primary tooth’s roots dissolve (resorb) to allow them to fall out. Once they’re out of the way, the permanent teeth can then erupt.

If, however, they’re lost before the permanent teeth are ready, it leaves a space in the child’s bite. The dynamic mechanism between teeth and the periodontal ligament causes adjacent teeth to move or “drift” into the space. This can crowd out the permanent tooth intended for the space, causing it to come in improperly forming a malocclusion (bad bite), or it may become impacted and remain partially or fully below the surface of the gums.

This poor dental development could lead to extensive orthodontic treatment later in life, which is why we seek to preserve even decayed primary teeth for their entire natural lifespan. If the tooth is lost, however, we need to take action to preserve the space for the permanent tooth and avoid costly treatment later.

This usually calls for a “space maintenance” appliance — a type of orthodontic “retainer” — worn by the child to prevent other teeth from drifting into the space. Designed by your orthodontist, the appliance can also perform a cosmetic and social function by causing the space to appear unnoticeable.

Maintaining that space requires monitoring — especially by an orthodontist — and continued dental hygiene and care both at home and at the dentist’s office. The extra care preserving the space caused by premature tooth loss will help to ensure your child’s dental structure develops properly and their future smile will be an attractive one.

If you would like more information on the care and treatment of primary 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 articles “Early Loss of Baby Teeth” and “Losing a Baby Tooth.”