My Blog

Posts for: November, 2016

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
November 29, 2016
Category: Oral Health
Tags: oral hygiene   tooth decay  
5QuestionstoAskYourselfAboutYourRiskforToothDecay

Among our most common diseases, tooth decay can be a big problem at any age: in the U.S., one in four children 5 and under has some form of the disease, as well as ninety percent of those 60 and older — and a quarter of those have suffered complete tooth loss.

Fortunately, we now know what needs to be done on a regular basis to prevent tooth decay. Unfortunately, many are uninformed about all they need to do to lower their risk.

Here, then, are 5 questions to ask yourself to see if you’re on the right prevention path or not.

Do I brush and floss daily? If not, you’re aiding and abetting the “enemy” — bacteria that cause tooth decay. Bacteria that make up plaque feed on any food remnants that adhere to tooth surfaces. Brushing at least once daily (twice is better) removes plaque, while flossing removes plaque between teeth that can’t be reached with a brush. Removing plaque will lower your mouth’s acid levels that cause a loss of minerals to the enamel surface.

Do I use the proper techniques for brushing and flossing? While it’s important to establish daily hygiene habits, if you’re not performing them properly you won’t realize the full benefit from your efforts. But don’t dismay — we can train you in the proper techniques for brushing and flossing your teeth.

Do I use fluoride toothpaste? This naturally-occurring chemical strengthens tooth enamel and makes it more resistant to decay. You can increase fluoride’s absorption rate into enamel by using hygiene products that contain it.

Do I constantly snack between meals? Saliva neutralizes acid remaining in the mouth after eating in about 30 to 60 minutes. If you’re constantly snacking or sipping acidic beverages, however, saliva can’t do this effectively. It’s best to limit snacking to a few, specific times and restrict acidic beverages to meal time only.

Do I visit the dentist for cleanings and checkups? While brushing and flossing reduce plaque, it can’t remove it from hard-to-reach places below the gums or harder deposits (calculus) that have developed. A professional cleaning twice a year removes the plaque and calculus left from daily hygiene. We can also gauge the health of your teeth and determine if tooth decay or gum disease may be developing.

If you would like more information on tooth decay prevention, 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 Dr. James Merlo and Dr. Mary A. Merlo-Murison
November 14, 2016
Category: Dental Procedures
ArianaGrandeBreaksFree-ofHerWisdomTeeth

Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”

With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.

Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.

But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.

In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.

So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


By Dr. James Merlo and Dr. Mary A. Merlo-Murison
November 06, 2016
Category: Dental Procedures
TeensMayNeedaTemporaryReplacementforMissingTeeth

Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.

The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.

Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.

Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.

All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.

If you would like more information on temporary tooth replacements for teens, please contact us or schedule an appointment for a consultation.