My Blog
By Emanuel Kontos, DMD
June 25, 2019
Category: Dental Procedures
Tags: dental implant   smoking  
SmokingCouldShortenYourImplantsLongevity

Although costly in the beginning, dental implants often turn out to be the least expensive tooth replacement option. That's because their enviable record for longevity often outpaces dentures or bridges. Over the long-term you might spend less for implants than these other restorations.

But even with the high success rate of dental implants (greater than 95% survive the ten-year mark), we can't guarantee they won't fail. And if you're a tobacco smoker, the risk of failure might be even higher. One study, for example, found early implant failures were twice the rate for smokers over non-smokers. Although implant failures overall are low, smoking seems to be a factor in those that do.

There are a number of reasons to account for this. For one thing, inhaled smoke can damage salivary glands, reducing the flow of this important fluid. Saliva helps control bacterial growth and neutralize mouth acid, so without it you're more susceptible to tooth decay or periodontal (gum) disease. Either infection could ultimately weaken implant-supporting bone.

The nicotine in tobacco can also restrict oral blood vessels and lower their ability to supply antibodies and nutrients to the teeth and gums. This slows healing, which could have one particular effect on implant durability.

During the intervening weeks between implant placement and crown attachment, the implant's titanium post attracts bone cells that grow and adhere to its surface. The effects of nicotine on healing, especially right after implant surgery, can interfere with this integration process so that the implant doesn't anchor in the bone as well as it should.

If you're a smoker, you can increase your chances of implant success—and have a healthier mouth overall—by quitting smoking beforehand with the help of a cessation program. Or at the least, consider stopping smoking for one week before implant surgery and for two weeks afterward.

And be sure to brush and floss your teeth daily and visit your dentist regularly to keep your teeth and gums as healthy as possible. Stopping smoking and practicing effective oral hygiene could make a big difference in the success or failure of your implant.

If you would like more information on smoking and 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 “Dental Implants & Smoking.”

By Emanuel Kontos, DMD
June 15, 2019
Category: Oral Health
Tags: oral health   saliva  
SixWaysSalivaHelpsYourMouthandBodyStayHealthy

While it doesn’t garner the star power of blood, saliva is still an important bodily fluid. A true multi-tasker, saliva contributes in many ways to the function and health of the body, from stronger teeth to more efficient digestion.

Here are six ways saliva helps your mouth and body function properly and stay healthy.

The mouth’s natural cleanser. Bacteria are responsible for much of the dental disease that plagues us, particularly tooth decay and gum disease. Saliva clears the mouth of food remnants, bacteria’s primary feeding source, after we eat. This leaves a cleaner mouth and fewer bacteria to cause infection.

The immune system’s partner. Saliva contains an antibody called Immunoglobulin A (IgA) that attacks disease-causing microorganisms. Along with secreting other antibacterial agents like lactoferrin and lyzozyme that curb the growth and development of bacteria, saliva serves as the body’s first line of defense against pathogens entering through the mouth.

Acid neutralizer. The optimal oral environment is a neutral pH of 7. Many of our foods and beverages, though, are highly acidic, which can raise the mouth’s acid level. The acidic environment causes the minerals in tooth enamel to soften and dissolve (a process called de-mineralization). Saliva restores the balance by neutralizing any remaining acid after we eat (a process that takes about 30 to 60 minutes).

Mineral replacer. Even under normal conditions, enamel will de-mineralize to some extent whenever the mouth becomes acidic. Saliva restores some of the enamel’s lost minerals like calcium and phosphate while it’s neutralizing acid. If fluoride is also present in saliva from fluoridated drinking water or toothpaste, it too is absorbed by the enamel making it stronger and more resistant to acid attacks.

Digestion enhancer. Saliva lubricates the mouth while we eat, making it easier for us to chew (and taste) our food. Saliva also releases the enzyme amylase as we chew to break down starches before the food enters our stomach. The end result is more efficient and comfortable digestion.

The wave of the future in diagnostics. Like blood and urine, saliva contains genetic and disease markers that could tell a physician if a patient has a certain condition. Since collecting a saliva sample is much easier than with these other bodily fluids, diagnosing disease with saliva will become more prevalent as more calibrated devices reach the market.

If you would like more information on the role of saliva in the body, 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 “Saliva.”

By Emanuel Kontos, DMD
June 05, 2019
Category: Dental Procedures
Tags: chipped tooth  
YourOptionsforRestoringaChippedTooth

A tooth that's been chipped doesn't mean it's no longer healthy. The same, unfortunately, can't be said about the attractiveness of your smile, especially if it's one of your front teeth. A chipped tooth can be quite noticeable and make you self-conscious.

The good news is a chipped tooth can be restored cosmetically to look just as normal and attractive as your other teeth. Depending on the application there are two different materials we commonly use: porcelains, a type of oven-fired ceramic most often found in veneers or crowns; or composite resins, a mixture of glass and plastic substances we apply in liquid form that hardens in built-up layers on the tooth's surface to ultimately resemble normal tooth shape and color.

So, which of these two materials is the best option for your tooth? That depends on the extent and location of the tooth damage. Composite resins are most often used for mild to moderate chipping or breaks in the enamel (and somewhat for the underlying dentin) or decayed areas in the front teeth. Porcelain veneers or crowns are better for more extensive damage or discoloration.

Both materials have their advantages and disadvantages. Composite resins can be applied in one office visit, but they require a skillful technique and an artistic eye to achieve a life-like appearance; although their strength has improved over the years, they're also limited in their durability and longevity compared to porcelain. Porcelain, on the other hand, is quite durable and has an excellent tooth-like appearance; they do, however, require removal of more tooth material than a composite resin to accommodate the new veneer or crown, along with more than one visit and the services of a dental lab to create the restoration.

The best way to find out which option is best for you is to visit us for a thorough dental examination. From there we can review with you our findings, our recommendations and the costs associated with each option. But whichever material we use, porcelain or composite resins, you can look forward to a new smile you'll be proud to display.

If you would like more information on cosmetic treatments for 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 “Artistic Repair of Front Teeth with Composite Resin.”

By Emanuel Kontos, DMD
May 26, 2019
Category: Oral Health
PopStarDemiLovatoPopsOutJayGlazersTooth

Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.

Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.

Would you know what to do in a dental emergency? Here are some guidelines:

  • If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
  • If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
  • If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
  • If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.

What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues.¬†And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!

To learn more, read the Dear Doctor articles “Trauma & Nerve Damage to Teeth” and “Saving New Permanent Teeth After Injury.”

TakeProactiveStepstoProtectYourOralHealthDuringCancerTreatment

Cancer treatment can consume all of your focus to the exclusion of other health issues. But these other issues still need attention, especially how treating cancer could affect other parts of your body. That definitely includes your teeth and gums.

Treatments like radiation or chemotherapy eradicate cancer cells disrupting their growth. Unfortunately, they may do the same to benign cells — “collateral damage,” so to speak. This could cause a ripple effect throughout the body, including in the mouth. Radiation, for example, could damage the salivary glands and result in reduced salivary flow. Because saliva neutralizes acid and diminishes bacterial growth, your risk for tooth decay as well as periodontal (gum) disease could increase.

While you may be able to recover from reduced salivary flow after treatment, your health could suffer in the meantime, even to the point of tooth and bone loss. Fortunately, there are some things we can do before and during your treatment.

If you can, have any necessary dental work performed well before you begin cancer treatment. You’ll be more resistant to side effects if you can start treatment with as healthy a mouth as possible.

Keep up your regular dental visits if at all possible, or see us if you begin seeing signs of dental disease. By staying on schedule, we’ll have a better chance of detecting and treating problems before they advance too far; we may also be able to provide preventive measures like topical fluoride applications to help keep your teeth resistant to disease. If you need more extensive treatment like tooth extraction or surgery we may need to coordinate with your cancer treatment provider.

Above all, continue to practice daily brushing and flossing to remove plaque, the main cause of dental disease. Drink plenty of water or take substances that boost salivation. And be sure to eat a nutritious diet while also reducing or eliminating tobacco or alcohol from your lifestyle.

Taking these steps will help protect your teeth and gums during cancer treatment. As a result, you have a better chance for maintaining your dental health during this critical time in your life.

If you would like more information on dental care during cancer 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 “Oral Health During Cancer Treatment.”





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