ThereAreaLotofBacteriainYourMouthbutOnlyaFewMeanYouHarm

Say “bacteria,” especially in the same sentence with “disease” or “infection,” and you may trigger an immediate stampede for the hand sanitizer. The last thing most people want is to come in contact with these “menacing” microorganisms.

If that describes you, however, you’re too late. If you’re of adult age, there are already 100 trillion of these single-celled organisms in and on your body, outnumbering your own cells 10 to 1. But don’t panic: Of these 10,000-plus species only a handful can cause you harm—most are either harmless or beneficial, including in your mouth.

Thanks to recent research, we know quite a bit about the different kinds of bacteria in the mouth and what they’re doing. We’ve also learned that the mouth’s microbiome (the interactive environment of microscopic organisms in a particular location) develops over time, especially during our formative years. New mothers, for example, pass on hundreds of beneficial species of bacteria to their babies via their breast milk.

As our exposure to different bacteria grows, our immune system is also developing—not only fighting bacteria that pose a threat, but also learning to recognize benevolent species. All these factors over time result in a sophisticated, interrelated bacterial environment unique to every individual.

Of course, it isn’t all sweetness and light in this microscopic world. The few harmful oral bacteria, especially those that trigger tooth decay or periodontal (gum) disease, can cause enormous, irreparable damage to the teeth and gums. It’s our goal as dentists to treat these diseases and, when necessary, fight against harmful microorganisms with antibacterial agents and antibiotics.

But our growing knowledge of this “secret world” of bacteria is now influencing how we approach dental treatment. A generalized application of antibiotics, for example, could harm beneficial bacteria as well as harmful ones. In trying to do good we may run the risk of disrupting the mouth’s microbiome balance—with adverse results on a patient’s long-term oral health.

The treatment strategies of the future will take this into account. While stopping dental disease will remain the top priority, the treatments of the future will seek to do it without harming the delicate balance of the mouth’s microbiome.

If you would like more information on the role of bacteria in oral 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 “New Research Show Bacteria Essential to Health.”

By Peter Brusco DMD
October 05, 2019
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

By Peter Brusco DMD
September 25, 2019
Category: Oral Health
Tags: tmj disorders   jaw pain  
TwoMouthandFacePainDisordersandWhatYouCanDoAboutThem

Chronic pain affects the quality of life for an estimated 50 million adults in the U.S. alone. The American Chronic Pain Association designates September as “Pain Awareness Month” to highlight the many conditions that cause chronic pain and strategies to manage them. Among these are conditions that can involve your oral or facial health. Here are two painful mouth and face disorders and what you can do about them.

Temporomandibular Joint Disorder (TMD). TMD is a common condition often seen in the dental office. The temporomandibular joints connect the lower jaw to the skull and facilitate activities like eating or speaking that require jaw movement. If they and their associated muscles become inflamed, this can trigger debilitating chronic pain. If you suffer from TMD symptoms, make sure we know about it so we can make your dental visits as comfortable as possible.

When possible, avoid irreversible and invasive treatments for TMD that may permanently change your bite, such as surgery or having teeth ground down. Instead, most healthcare professionals recommend a more conservative approach. Try the following tips to alleviate TMD pain:

  • Eat soft foods so you do not aggravate the jaw joint.
  • Avoid extreme jaw movements like suddenly opening your mouth very wide.
  • Use ice packs and moist heat to relieve discomfort.
  • Ask us about jaw exercises to stretch and relax the jaw.
  • Practice stress-reduction techniques, such as meditation, yoga, tai chi or taking short walks to clear your mind.

Burning Mouth Syndrome. The sensation that the mouth has been burned or scalded without an obvious cause is most common among women during menopause. While researchers can’t yet pinpoint clear causes for it, the list of suspects includes hormonal changes, neurological or rare autoimmune disorders or medication-induced dry mouth.

The first step to treatment is an oral exam along with a complete medical history to identify any possible contributing factors. Depending on the results, we can offer recommendations to manage your symptoms. The following tips often help:

  • Keep your mouth moist. We can recommend an artificial saliva product or medication to increase saliva flow if needed.
  • Change your toothpaste if it contains irritating ingredients.
  • Identify and avoid foods and beverages that seem to precede an episode. These may include spicy foods, coffee and alcoholic beverages.
  • Quit smoking, as this is often linked to burning mouth episodes.

The pain and discomfort caused by these and other oral conditions can put a dent in your life. A visit to your dentist, though, could be the first step to finding relief.

If you would like more information about oral conditions that produce chronic pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Seeking Relief From TMD” and “Burning Mouth Syndrome.”

By Peter Brusco DMD
September 15, 2019
Category: Dental Procedures
OrthodonticsMoreThanStraighteningaCrookedSmile

Braces are a common experience among teens and pre-teens. And although the treatment can be a major financial undertaking, more and more families pursue it to help their child attain a straighter, more attractive smile.

But orthodontics isn’t first and foremost a cosmetic treatment. Although an improved appearance is a benefit, the main reason for treatment is therapeutic—it can improve your child’s current and future dental health.

The teeth’s relationship to the jaws and gums makes moving them possible. Rather than simply being fixed within their jawbone socket, teeth are actually held in place by a strong, elastic tissue called the periodontal ligament. The ligament lies between the teeth and jawbone and attaches to both with tiny extending fibers. This attachment secures the teeth in place.

But the ligament also has a dynamic quality—it can reshape itself when necessary and allow teeth to move gradually into new positions. This is most necessary during the early years of mouth and jaw development, but it can also occur throughout life. Orthodontics takes advantage of this mechanism by applying precise pressure to the teeth in the direction of desired movement. The periodontal ligament does the rest by reshaping and allowing the teeth to move in response to this pressure.

The result is straighter teeth and a more normal bite. With the teeth now where they should be, it’s also easier to clean them of disease-causing dental plaque, whereas misaligned teeth are more prone to plaque accumulation that can be difficult to remove. And because the whole mouth including teeth are involved when we talk, teeth positioned in a more normal bite will improve speech.

Orthodontics is a long-term process, often encompassing more than the actual time wearing braces. Both orthodontists and pediatric dentists recommend a bite evaluation by an orthodontist around the age of 6. If it does appear an abnormal bite is forming, it may be possible to intervene and stop or at least slow the development. This could have a more positive impact on any future treatment.

Braces and other treatments can make a difference in your child’s self-image and social relationships. But the main beneficiary will be their dental health.

If you would like more information on orthodontic 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 “Moving Teeth With Orthodontics.”

YourQuestforaDentalImplantMightBeInterruptedbyBoneLoss

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

If you would like more information on dental implants, 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 After Previous Tooth Loss.”





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Kinnelon, NJ Dentist
Peter Brusco DMD
170 Kinnelon Rd # 29A
Kinnelon, NJ 07405
(973) 838-5862
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