My Blog
By Dr. James Merlo and Dr. Mary A. Merlo-Murison
December 15, 2021
Category: Oral Health
KeeptheImplantsSupportingYourBridgeCleanofDentalPlaque

Dental implants have revolutionized restorative dentistry. Not only are they the top choice for individual tooth replacement, implants also improve upon traditional dental work.

Dental bridges are a case in point. A few well-placed implants can support a fixed bridge instead of natural teeth, as with a traditional bridge. Furthermore, a fixed, implant-supported bridge can replace all the teeth on a jaw.

But although convenient, we can't simply install an implant-supported bridge and forget about it. We must also protect it from what might seem at first an unlikely threat—periodontal (gum) disease.

Although the bridge materials themselves are impervious to infection, the natural tissues that underly the implants—the gums and bone—are not. An infection plaguing the gums around an implant can eventually reach the bone, weakening it to the point that it can no longer support the imbedded implants. As the implants fail, so does the bridge.

To guard against this, patients must regularly remove any buildup of plaque, a thin biofilm that feeds disease-causing bacteria, adhering to the implant surfaces in the space between the bridge and the gums. To do this, you'll need to floss—but not in the traditional way. You'll need some form of tool to accomplish the job.

One such tool is a floss threader. Similar to a large needle, the threader has an eye opening at one end through which you insert a section of floss. You then gently pass the threader between the bridge and the gums toward the tongue.

Once through, you release the floss from the threader, and holding each end, you work the floss along the implant surfaces within reach. You then repeat the threading process for other sections until you've flossed around all the implants.

You might also use a water flosser, a device that directs a spray of water between the bridge and gums. The pressure from the spray loosens and flushes away any plaque around the implants.

Whatever the method, it's important to use it every day to reduce the threat of gum disease. You should also see your dentist regularly for further cleanings and checkups. Keeping your implants clean helps ensure gum disease won't ruin your fixed bridge—or your attractive smile.

If you would like more information on keeping your dental work clean, 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 Hygiene for Fixed Bridgework.”

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
December 05, 2021
Category: Oral Health
Tags: oral health   osteoporosis  
SomeOsteoporosisTreatmentsCouldImpactDentalCare

Millions of Americans live with osteoporosis, a degenerative bone disease that can turn a minor fall into a potential bone fracture. Literally meaning "porous bone," osteoporosis causes the natural marrow spaces in bone tissue to progressively grow larger and weaken the remaining bone.

Many osteoporosis patients take medication to slow the disease's process. But due to the dynamic nature of bone, some of these drugs can have unintended consequences—consequences that could affect dental care.

As living tissue, bone is literally "coming and going." Certain cells called osteoblasts continuously produce new bone, while others called osteoclasts remove older tissue to make way for the new. Drugs like bisphosphonates and RANKL inhibitors interrupt this process by destroying some of the osteoclasts.

As a result, more of the older bone remains past its normal lifespan, helping the bone overall to retain strength. But ongoing research is beginning to hint that this may only be a short-term gain. The older, longer lasting bone is more fragile than newer bone, and tends to become more brittle and prone to fracture the longer a patient takes the drug. This tissue can also die but still remain intact, a condition known as osteonecrosis.

The femur (the large upper leg bone) and the jawbone are the bones of the body most susceptible to osteonecrosis. Dentists are most concerned when this happens in the latter: Its occurrence could lead to complications during invasive procedures like oral surgery or implant placement.

Because of this possibility, you should keep your dentist informed regarding any treatments you're undergoing for osteoporosis, especially when planning upcoming dental procedures like oral surgery or implant placement. You might be able to lower your risk by taking a "drug holiday," coming off of certain medications for about three months before your dental work.

As always, you shouldn't stop medication without your doctor's guidance. But research has shown drug holidays of short duration won't worsen your osteoporosis. If you're already showing signs of osteonecrosis in the jaw, a short absence from your prescription along with antiseptic mouthrinses and heightened oral hygiene could help reverse it.

Fortunately, the risk for dental complications related to osteoporosis medication remains low. And, by working closely with both your dentist and your physician, you can ensure it stays that way.

If you would like more information on osteoporosis and your dental care, 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 “Osteoporosis Drugs & Dental Treatment.”

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
November 25, 2021
Category: Dental Procedures
MAFSStarJakeEdwardsUndergoesaSmileMakeoverAndHelpsOthersAlongtheWay

A year ago, former Australian footballer Jake Edwards got married. On television. To a woman he'd just met. No, not in a Vegas wedding chapel—it was all part of a reality TV series called Married At First Sight. Unfortunately, the marriage didn't last, which led to Edwards reevaluating his life. And one area in particular that came under his inward scrutiny was his smile.

Although otherwise possessing movie star looks, Edwards' teeth were anything but handsome: Besides a few that were chipped and cracked, his teeth overall looked small. His less-than-perfect smile was no secret, and he had plenty of offers from dentists to transform his smile.

He finally decided to do so, but with a twist: In addition to his own, he offered a full smile makeover to two other people for free (each valued at $30,000). The impetus for his makeover contest undoubtedly stems from his own lifelong experience: After years of being teased and bullied about his teeth, he knew firsthand how an unattractive smile can affect your personal and social confidence.

You too might feel the same confidence drain every time you look in the mirror. The problem, though, is that a full-scale makeover may seem out of reach financially and there aren't many Jake Edwards-style contests around to enter. But not to worry! There are a few ways to change your smile for the better without taking out a second mortgage on your house.

Teeth whitening. Even a smile with straight and perfectly formed teeth can be unattractive if those teeth are stained and dull. A professional teeth-whitening procedure can change that: Using a bleaching solution, we can turn drab and dingy teeth into a bright and dazzling smile in one sitting. With a little care and occasional touchups, your whiter smile could last for quite a while.

Bonding. We can repair mild to moderate chips and other tooth deformities simply and affordably with dental bonding. We gradually apply a resin dental material color-matched to your tooth, building it up and sculpting it to look natural. In just one sitting, a chipped tooth that once stood out like a sore thumb can regain its attractiveness.

Veneers. Many people like Edwards suffer from teeth that appear overly small or have slightly widened gaps. Problems like these and other deformities can be overcome with dental veneers, thin layers of porcelain bonded to the surfaces of teeth. Veneers can mask all manner of dental defects and truly transform a smile.

These and other affordable cosmetic procedures can truly change your smile, and many only take one visit. To learn more about your personal options, see us for a complete dental exam and consultation.

If you would like more information about other cosmetic dental procedures, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Repairing Chipped Teeth.”

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
November 15, 2021
Category: Oral Health
Tags: oral hygiene  
4TipsForImprovingYourOralHygieneTechnique

Although we've advanced leaps and bounds over the years treating dental disease, our strategy for preventing them hasn't changed much. That's because these prevention basics are quite effective—and as the old saying goes, "If it ain't broke, don't fix it."

The core of an effective dental disease prevention strategy is mind-numbingly simple—brush and floss every day. These twin cleaning tasks remove accumulated dental plaque, a thin, bacterial film on tooth surfaces that's the primary oral disease driver.

True, there have been innovations concerning the "tools of the trade," i.e., toothbrushes, toothpastes and flossing devices. But what really makes this prevention strategy work is a consistent daily habit of oral hygiene.

In a way, simply "showing up" for daily oral hygiene goes a long way. But you can go even farther if you perform these tasks with greater proficiency—becoming a hygiene "ninja," of sorts.

Here, then, are 4 tips to improve your brushing and flossing prowess.

Be thorough when you brush. Try to cover all of your tooth surfaces when you brush, being sure to work the bristles into all the nooks and crannies and around the gum lines. A thorough brushing should take about 2 minutes.

Easy does it. Hard scrubbing may work on floors, but not your teeth—aggressive brushing can damage your enamel and gums. Brush gently and let the mild abrasives in your toothpaste do the heavy work of plaque removal.

Don't forget to floss. Although you may not like this "other hygiene task," flossing is necessary to remove plaque between teeth that your brush can't reach. Be sure, then, that you floss at least once a day.

Take the "tongue test." Wondering how well you're doing with your oral hygiene? A quick way to find out is by swiping your tongue across your teeth: If they feel gritty rather than smooth, you may have left some plaque behind.

Be sure to also ask your dentist for additional tips on better brushing and flossing. Improving your technique can help you put even more distance between you and dental disease.

If you would like more information on daily care for teeth and gums, 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 “Daily Oral Hygiene.”

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
November 05, 2021
Category: Oral Health
Tags: oral hygiene  
5TipsForKeepingYourToothEnamelHealthy

You know what people say: "Protect your tooth enamel, and it will protect your teeth." Then again, maybe you've never heard anyone say that—but it's still true. Super strong enamel protects teeth from oral threats that have the potential to do them in.

Unfortunately, holding the title of "Hardest substance in the human body" doesn't make enamel indestructible. It's especially threatened by oral acid, which can soften its mineral content and lead to erosion.

That doesn't have to happen. Here are 5 things you can do to protect your enamel—and your teeth.

Don't brush too often. Brushing is essential for removing bacterial plaque, the main cause for dental disease. But more isn't always good—brushing too frequently can wear down enamel (and damage your gums, too). So, limit daily brushing to no more than twice a day.

Don't brush too soon. Oral acid normally peaks at mealtime, which can put your enamel into a softer than normal state. No worries, though, because saliva neutralizes acid within about an hour. But brushing before saliva finishes rebuffering could cause tiny bits of softened enamel to flake off—so, wait an hour after eating to brush.

Stop eating—right before turning in for the night, that is. Because saliva flow drops significantly during sleep, the decreased saliva may struggle to buffer acid from that late night snack. To avoid this situation, end your eating or snacking at least an hour before bedtime.

Increase your calcium. This essential mineral that helps us maintain strong bones and teeth can also help our enamel remineralize faster after acid contact. Be sure, then, to include calcium-rich foods and calcium-fortified beverages in your diet.

Limit acidic beverages. Many sodas, sports and energy drinks are high in acid, which can skew your mouth's normal pH. Go with low-acidic beverages like milk or water, or limit acidic drinks to mealtimes when saliva flows more freely. Also, consider using a straw while drinking acidic beverages to lessen their contact with teeth.

Remember, enamel isn't a renewable resource—once it's gone, it's gone. Take care of your enamel, then, so it will continue to take care of you!

If you would like more information on caring for your tooth enamel, 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 “6 Tips to Help Prevent the Erosion of Tooth Enamel.”





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Dr. Mary A. Merlo-Murison

312-726-2553
30 N Michigan Ave Ste 808Chicago, IL 60602-4803