My Blog

Posts for: May, 2014

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
May 27, 2014
Category: Dental Procedures
EarlyOrthodonticCareHelpedChildStarNolanGouldGetReadyforPrimeTime

Nolan Gould, who plays Luke on the popular TV comedy Modern Family, has beautiful, straight teeth. But in an exclusive interview with Dear Doctor magazine, the young actor said it wasn't always that way.

“My teeth used to be pretty messed up,” Nolan said. “I had two extra teeth when I was born. They hadn't come out (erupted) yet. And all the other teeth that were already there were starting to point backwards because it was getting so crowded in my mouth. At about the age of 7, I started going to the orthodontist to get my teeth checked.”

Age 7 may sound early for a visit to the orthodontist, but in fact that's exactly the age we recommend for a first orthodontic evaluation. Malocclusions (bad bites) often become noticeable around this time, as the child's permanent (adult) teeth erupt. We might already be able to see evidence of the following problems: crowding, too much space between teeth, protruding teeth, extra or missing teeth, and sometimes problems with jaw growth. So even if your child is too young for braces, it is not necessarily too early for an orthodontic evaluation.

This type of exam can spot subtle problems with jaw growth and emerging teeth while some baby teeth are still present. Early detection of orthodontic problems makes it easier to correct those problems in the long run. Waiting until all of the permanent teeth are in, or until facial growth is nearly complete, may make correction more difficult or even impossible. That's why the American Association of Orthodontists recommends that all children get a check-up with an orthodontist no later than age 7.

Orthodontic treatment itself usually begins between ages 7 and 14. Therapy that begins while a child is still growing, often referred to as “interceptive orthodontics,” helps produce optimal results. In Nolan's case, an early orthodontic evaluation allowed his orthodontist enough time to plan the most effective treatment. Nolan's two extra teeth were removed before they had a chance to push his other teeth even further out of alignment, and he was given orthodontic appliances which fit behind the teeth.

“You can remove them, which is really good for acting, especially because you can't see them. I can wear them 24/7 and nobody will ever notice.”

One thing that is noticeable, however, is Nolan's perfectly aligned smile!

If you would like to learn more about improving tooth alignment with orthodontics, please contact us to schedule an appointment for a consultation. To read Dear Doctor's entire interview with Nolan Gould, please see “Nolan Gould.” Dear Doctor also has more on an “Early Orthodontic Evaluation.”


By Dr. James Merlo and Dr. Mary A. Merlo-Murison
May 12, 2014
Category: Dental Procedures
Tags: dental implants  
MaintainingyourDentalImplants

Once you receive your dental implants, you can have peace-of-mind in knowing that you have chosen a successful tooth replacement option, with long-term success rates of well over 95%. Your implant will look, feel and function just like the natural teeth that it has replaced.

However, despite the natural appearance, when you visit us for a regular cleaning, you may notice that we are using special instruments to clean around the implant. Cleaning around implants differs from the maintenance of your natural teeth for two reasons:

  1. Your implants attach to the surrounding bone and gums in a very different way from your natural teeth.
  2. The materials that comprise your implants are very different than those that make up your natural teeth.

Cleaning implants is just as important as cleaning natural teeth, because both depend on healthy surrounding tissues for support. Just as bacterial biofilm (plaque) collects on your natural teeth, it can also collect on your implant. That is why it is very important to brush and floss thoroughly on a daily basis at home. Without daily biofilm removal, the gums surrounding your implant can become infected, leading to bone loss and eventually loss of the implant.

Your regular dental cleanings will also play an important role in keeping dental implants infection-free, and we will select the right instruments for a professional cleaning. We will ensure that these instruments will not damage the crown, abutment, or the implant itself. If implants are scratched, they can attract and harbor bacteria. That's why the instruments we use, called scalers and curettes, are most often made of plastics and resins. Natural teeth don't scratch in the same way, and therefore metal instruments need to be used to clean them.

A number of power instruments have nylon or plastic sheaths or tips to minimize implant damage. They clean by using high-frequency vibration, which may be necessary if large quantities of debris have accumulated on your implant. We use these on a low power setting with a lot of water irrigation, and sometimes antibacterial solutions, to clean and flush material.

When it comes to keeping your implants infection-free, keep in mind that the most successful formula will be consistent oral hygiene at home mixed with regular dental cleanings.

If you would like more information about maintaining your dental implants, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”


By Dr. James Merlo and Dr. Mary A. Merlo-Murison
May 02, 2014
Category: Dental Procedures
PadmaLakshmisSmileARecipeforBeauty

Before she began hosting the long-running TV competition Top Chef, Padma Lakshmi was a well-known model and successful cookbook author. (Appropriately, she is said to have been “discovered” by a modeling agent while sitting in a café in Madrid.) Yet the Indian-born beauty's striking look — at once exotic and familiar — doesn't come from any cookie-cutter mold.

So when Lakshmi had cosmetic work done on her teeth, early in her career, her dentist didn't use a cookie-cutter approach either: Instead, her smile was carefully designed, using small amounts of bonding material to brighten her teeth and to bring their shape and spacing into harmony with her facial features.

Dentistry by Design
What exactly is smile design — and what could it do for you? Essentially, it's the process of evaluating your smile in concert with the appearance of your entire face, and visualizing the changes — some dramatic and some subtle — that will make it really shine. Some aspects we consider include the face's shape, the proportion or “balance” of facial features, the complexion, eye and lip color and form, and the overall dimensions of the smile.

Based on dental aesthetics and clinical experience, we will probably have a number of suggestions to make on how you can improve your smile. Your input will also be very important; while some individuals prefer perfectly even teeth and a sparkling “Hollywood white” smile, others are looking for a result that's more in keeping with a “natural” look: slight irregularities in tooth shape, spacing, and even color.

There's no right or wrong answer here: Having a “perfect” smile means what's perfect for you, so it's very important for dentists and patients to communicate openly during the smile design process. But sometimes, words alone just aren't enough to convey the subtle dimensions of beauty.

The Trial Smile
Fortunately, it's now possible to preview your “perfect” smile using a number of different techniques. Advances in computer imaging make this the first step in previewing your new smile — you can see the changes before a single tooth is touched! Still, many people find that having a more concrete picture is helpful. The next step is to make a 3-D mock-up the proposed dental work on an actual model of your mouth. That way, you can see a physical representation of the final results — and even turn it around and hold it in your hands.

There's still one more way to really experience the difference cosmetic treatments can make without committing to a permanent change: the provisional restoration. Here, tooth-colored bonding material and other techniques are used to actually create the new smile — temporarily. This gives you time to “live with it,” and see if the proposed changes work for you. If everything goes well with the provisional work, the permanent restoration is guaranteed to please.

So if you want holiday treats, get out the cookie cutter — but if you're looking for a smile that's uniquely yours, and one that enhances your own individual appearance… call our office and ask about a smile design consultation. You can learn more in the Dear Doctor magazine articles “Great Expectations — Perceptions in Smile Design” and “Beautiful Smiles by Design.”