My Blog
By Emanuel Kontos, DMD
December 11, 2021
Category: Oral Health
Tags: dental records  
WhyYourDentalRecordsShouldFollowYoutoYourNewDentist

Some things you hear at the dentist don't surprise you: You have more plaque buildup or (yuck!) you have a new cavity. On a more positive note, you might hear your teeth look fine. But what you might not expect to hear is that your dentist—your longtime dentist—is retiring.

Then again, it might be you telling your dentist you're moving to another city—or you just feel like it's time for a change. Whatever the reason, there could come a time when you must find a new dental care provider. And when you do, it's very important that your dental records go with you.

And, yes, your dentist does have such records on you. Just like medical physicians, they're obligated legally and professionally to maintain a formal record of all your visits and treatments (including all your x-ray films). They may also include notations on your other health conditions and medications that could impact your dental care.

Without those records, your new dentist essentially starts from scratch, depending on what you tell them and what they may ascertain from examining your mouth. It means new x-rays and new treatment plans that can take time to form. But with your old records in hand, dental care with your new dentist hardly misses a beat.

Technically, those records belong to your dentist. You are, however, legally entitled to view them and to obtain a copy, although you may have to reimburse the dentist for printing and mailing costs. Usually, though, you can simply request they be transmitted to your new dentist, which can often be done electronically.

But what if, for whatever reason, you're not comfortable asking for your records from your former dentist? In that case, you can ask your new dentist to request them. Even if you still have an outstanding balance with your former dentist's office, they can't refuse a transfer request.

HIPAA regulations require dental offices to retain adult patient records for at least six years. But don't wait that long! The sooner your dental records are in the hands of your new dentist, the less likely your dental care hits any speed bumps.

If you would like more information on the importance of your dental records, 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 “Why Your Dental Records Should Follow You.”

By Emanuel Kontos, DMD
December 01, 2021
Category: Dental Procedures
Tags: celebrity smiles   veneers  
HowMLBStarAaronJudgeChangedHisSmileandHowYouCanToo

Between the final game of the World Series in late October and spring training in February, major league baseball players work on their skills preparing for the new season. Reporters on a Zoom call to the New York Yankees' training camp wanted to know what star outfielder Aaron Judge had been doing along those lines. But when he smiled, their interest turned elsewhere: What had Aaron Judge done to his teeth?

Already with 120 homers after only five seasons, Judge is a top player with the Yankees. His smile, however, has been less than spectacular. Besides a noticeable gap between his top front teeth (which were also more prominent than the rest of his teeth), Judge also had a chipped tooth injury on a batting helmet in 2017 during a home plate celebration for a fellow player's walk-off home run.

But now Judge's teeth look even, with no chip and no gap. So, what did the Yankee slugger have done?

He hasn't quite said, but it looks as though he received a “smile makeover” with porcelain veneers, one of the best ways to turn dental “ugly ducklings” into “beautiful swans.” And what's even better is that veneers aren't limited to superstar athletes or performers—if you have teeth with a few moderate dental flaws, veneers could also change your smile.

As the name implies, veneers are thin shells of porcelain bonded to the front of teeth to mask chips, cracks, discolorations or slight gaps between teeth. They may even help even out disproportionately sized teeth. Veneers are custom-made by dental technicians based on a patient's particular tooth dimensions and color.

Like other cosmetic techniques, veneers are a blend of technology and artistry. They're made of a durable form of dental porcelain that can withstand biting forces (within reason, though—you'd want to avoid biting down on ice or a hard piece of food with veneered teeth). They're also carefully colored so that they blend seamlessly with your other teeth. With the right artistic touch, we can make them look as natural as possible.

Although porcelain veneers can accommodate a wide range of dental defects, they may not be suitable for more severe flaws. After examining your teeth, we'll let you know if you're a good candidate for veneers or if you should consider another restoration. Chances are, though, veneers could be your way to achieve what Aaron Judge did—a home run smile.

If you would like more information about porcelain veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers: Strength & Beauty As Never Before.”

By Emanuel Kontos, DMD
November 21, 2021
Category: Oral Health
Tags: tooth decay  
TheresMoreWeCanDoAboutToothDecayBesidesDrillandFill

Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.

Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.

At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.

One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.

Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.

Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.

Some of the elements of such a strategy might include:

  • Daily brushing and flossing, along with regular dental cleanings;
  • Fluoride dental products or treatments to strengthen enamel;
  • Changes in diet and excess snacking, and ceasing from any tobacco use;
  • Cleaning and maintaining appliances, as well as monitoring past dental work.

Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.

If you would like more information on tooth decay prevention and treatment, 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 “Tooth Decay: How to Assess Your Risk.”

By Emanuel Kontos, DMD
November 11, 2021
Category: Oral Health
Tags: tooth pain  
BothToothDecayorGumDiseaseCouldBecomeSomethingFarWorse

While mouth pain can certainly get your attention, what exactly hurts may be difficult to identify. It might seem to emanate from a single tooth, or a group of teeth. Then again, it might not be clear whether it's coming from teeth or from the gums.

Still, it's important to pinpoint the cause as much as possible to treat it correctly. One of the main questions we often want to answer is whether the cause originates from within a tooth or without.

In the first case, tooth decay may have entered the pulp at the center of the tooth. The pulp contains nerve bundles that can come under attack from decay and transmit pain signals. Incidentally, if the pain suddenly goes away, it may simply mean the nerves have died and not the infection.

The decay can also spread into the root canals leading to the root and supporting bone, and then make the jump into the gum tissues. One possible sign of this is the one mentioned earlier—you can't quite tell if the pain is from the tooth or the surrounding gums.

The root canals could also serve as a transportation medium for infection in the other direction. In that case, gum disease has advanced into the bone tissues around a tooth near its roots. The infection can then cross into the tooth. Again, both a tooth and the gum tissue around it can become diseased.

We have effective treatments for individual occurrences of interior tooth decay or gum disease: The former usually requires a root canal treatment to remove infected tissue and fill and seal the tooth from future infection; we alleviate gum disease by removing the dental plaque causing it and helping the gum tissues to heal. But combined tooth and gum infection scenarios are more difficult to treat, have a poorer prognosis and may require specialists.

To reduce the risk of either tooth decay or gum disease developing into this greater problem, it's best to take action at the first sign of trouble. So, see your dentist as soon as possible when you encounter oral pain or if you notice swollen or bleeding gums. The earlier we treat the initial outbreak of disease, be it tooth decay or gum disease, the better your chances of a successful and happy outcome.

If you would like more information on tooth pain, 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 “Confusing Tooth Pain.”

By Emanuel Kontos, DMD
November 01, 2021
Category: Oral Health
Tags: oral health  
AHealthyDietIsanImportantPartofYourDentalDiseasePreventionPlan

If you think brushing and flossing and regular dental visits are all you need to do to avoid dental disease, you're missing a key component in your prevention plan. What you eat could also help close the door on tooth decay or gum disease—or open it even wider if you're eating nutritionally deficient foods.

Let's look first at the latter scenario. Like us, the oral bacteria most responsible for dental disease also have to eat to survive and thrive. And, often like us, they have a favorite food—provide them ample amounts of that and they'll continue to multiply and raise your risk of disease.

That favorite bacterial food is simple carbohydrates, particularly refined sugar. A diet heavy in added sugar can increase oral bacteria, which in turn elevates your chances of a gum infection. Bacteria's main by-product, acid, may also increase. That's bad news for your teeth. At high levels, acid contact softens and erodes enamel, the precursor to tooth decay.

Obviously, then, a "tooth-friendly" diet should be low on sugar and other simple carbohydrates like refined breads, pasta or pastries. Soda, energy and sports drinks high in both sugar and acid should also be avoided or restricted to mealtimes. You should also be careful with how much fruit you're eating as their natural sugars can also feed bacteria.

A well-rounded diet, however, isn't simply about avoiding foods—you'll also want to include foods that help you build and maintain healthy teeth and gums. That includes:

  • Fiber-rich plant foods: Their fiber reduces the effects of any carbohydrates and they're packed with nutrients;
  • Whole grains: Whole grains don't promote decay as refined products do, and chewing them stimulates saliva flow for neutralizing acid;
  • Fresh fruits: Eaten in moderation, fruits can provide a bevy of vitamins and minerals. But avoid dried fruits as their sugars are more concentrated;
  • Dairy: Milk-based products, particularly cheese, contain nutrients like Vitamin D, calcium and phosphorus, which strengthen teeth against dental disease.

For the most part, a diet that promotes overall well-being will also provide optimum benefits for your dental health. Along with your dental hygiene efforts, eating the right foods can help protect your teeth and gums from both tooth decay and gum disease.

If you would like more information on how better nutrition can boost your dental health, 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 “Nutrition & Oral Health.”





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