3ReasonsWhyYourNewDentistNeedsYourTreatmentRecords

Like other healthcare providers, your dentist keeps records of your ongoing care. These include not only their written notes but also x-ray imaging, frequency of visits and cleanings, and any medical information that could affect your care. What’s more, they have a legal obligation to maintain these records.

Your dental records help guide decisions about your care. In that regard, you should consider something else—you may need to change providers: your dentist retires or you move; your dentist isn’t in your new insurance network; or, unfortunately, you have an “irreconcilable” difference with your provider.

If that happens, it’s very important your dental records find their way to your new provider. Here are 3 reasons why.

Your individual dental history. Each person’s dental situation and needs are unique. Your past records help clue in your new dentist about your past history and current needs, which will help guide how they treat you.

Time and money. Your dental records contain x-rays or other diagnostic information about your oral condition, including preparations for any upcoming dental work. If you change dentists before completing that treatment, your new dentist may have to start over with new diagnostic tests if they don’t have this previous data. It could cost you more money and make you wait longer for a needed procedure.

Coordinating dental care with your general health. Your mouth isn’t isolated from the rest of your body, and some dental treatment measures could affect other health conditions (and vice-versa). If your new dentist knows other health issues you may have from your previous records, it can help ensure you’re getting dental treatment appropriate to your overall health.

For the most streamlined transition between providers, it’s important your dental records follow you. You’re entitled to having those records transferred, and, if you’re uncomfortable asking yourself, your new provider can obtain them for you. Just be sure to ask.

If you would like more information on your rights regarding your dental care records, 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 “Why Your Dental Records Should Follow You.”

StainingWithinaToothRequiresaClinicalWhiteningApproach

Home whitening kits are a popular way to turn a dull smile into a dazzling one. But these self-applied products only work for teeth with outer enamel stains — if the discoloration originates inside a tooth, you’ll need professional treatment.

Known as “intrinsic staining,” this type of discoloration most often occurs within a tooth’s pulp or dentin layers. There are a number of causes like tooth trauma or tetracycline use at an early age. A root canal treatment used to remove infection from deep within a tooth can also cause discoloration: sometimes blood pigments left after tissue removal or the filling materials themselves can stain a tooth’s interior.

Intrinsic staining can often be treated by placing a bleaching agent, usually sodium perborate, into the tooth’s pulp chamber. But before undertaking this procedure on a tooth that’s undergone a root canal treatment, we want to first ensure the filling is intact and still adequately sealing the tooth from infection. We also want to make sure the supporting bone is also healthy.

If all’s well, we access the pulp in the same way as the root canal treatment, and preferably through the same access hole. We then clean out the pulp chamber of any stained matter and then ensure the root canals remain filled and sealed off from the pulp chamber.

We can then place the bleaching agent into the pulp, a process that will need to be repeated every three or four days to achieve the desired level of brightness. After each session we place a cotton pellet over the opening and held in place with a temporary adhesive; we can easily remove and re-apply this covering during subsequent sessions. Once we’ve achieved the desired color change, we seal the tooth with a permanent filling and restore the access cavity with a tooth-colored composite resin material bonded to the enamel and dentin.

There are other options for an intrinsically stained tooth like veneers or crowns that outwardly cover the discoloration. Internal bleaching, however, is a more conservative approach that causes less alteration of the tooth. If successful, it can restore a stained tooth to a brighter, more attractive shade.

If you would like more information on internal bleaching, 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 “Whitening Traumatized Teeth.”

NBCStarDeliversaMessageaboutthePerfectSmile

Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.

Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.

Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”

Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.

There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.

So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.

Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”

If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”

StopSmokingtoReduceYourRiskofGumDisease

Your risk for periodontal (gum) disease increases if you’re not brushing or flossing effectively. You can also have a higher risk if you’ve inherited thinner gum tissues from your parents. But there’s one other risk factor for gum disease that’s just as significant: if you have a smoking habit.

According to research from the U.S. Centers for Disease Control (CDC), a little more than sixty percent of smokers develop gum disease in their lifetime at double the risk of non-smokers. And it’s not just cigarettes—any form of tobacco use (including smokeless) or even e-cigarettes increases the risk for gum disease.

Smoking alters the oral environment to make it friendlier for disease-causing bacteria. Some chemicals released in tobacco can damage gum tissues, which can cause them to gradually detach from the teeth. This can lead to tooth loss, which smokers are three times more likely to experience than non-smokers.

Smoking may also hide the early signs of gum disease like red, swollen or bleeding gums. But because the nicotine in tobacco restricts the blood supply to gum tissue, the gums of a smoker with gum disease may look healthy. But it’s a camouflage, which could delay prompt treatment that could prevent further damage.

Finally because tobacco can inhibit the body’s production of antibodies to fight infection, smoking may slow the healing process after gum disease treatment.  This also means tobacco users have a higher risk of a repeat infection, something known as refractory periodontitis. This can create a cycle of treatment and re-infection that can significantly increase dental care costs.

It doesn’t have to be this way. You can substantially lower your risk of gum disease and its complications by quitting any kind of tobacco habit. As it leaves your system, your body will respond much quicker to heal itself. And quitting will definitely increase your chances of preventing gum disease in the first place.

Quitting, though, can be difficult, so it’s best not to go it alone. Talk with your doctor about ways to kick the habit; you may also benefit from the encouragement of family and friends, as well as support groups of others trying to quit too. To learn more about quitting tobacco visit www.smokefree.gov or call 1-800-QUIT-NOW.

If you would like more information on how smoking can affect your 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 “Smoking and Gum Disease.”

TakeCareofYourDentalAppliancetoExtenditsLongevity

What do dentures, retainers and nightguards have in common? Along with orthodontic aligners and athletic mouthguards, they’re all types of removable dental appliances. They also share another commonality: each one depends on the wearer caring for it to ensure its longevity.

The most important thing you can do for your appliance is to clean it regularly. Don’t use toothpaste, though, even with dentures: while your natural tooth enamel can handle the abrasive particles in toothpaste, your appliance’s materials may not. Toothpaste can create tiny scratches that can harbor disease-causing bacteria. Instead, use liquid dish detergent or hand soap with warm water.

Although boiling water may disinfect your appliance, it’s not advisable to use. Even hot water can distort plastic components and warp the appliance’s fit in your mouth. Likewise, don’t use bleach, which can fade the plastic color used to resemble gum tissue and break down the material’s composition. When you clean your appliance, use a brush — but not the one you use for your natural teeth. Use a soft toothbrush, a nail brush or a specialized brush for appliances like dentures.

You should also protect your appliance from damage. Some appliances like dentures have parts that can break if they’re dropped on a hard surface — like the porcelain in your sink. To prevent this, place a towel in the sink to cushion the appliance if it accidentally slips from your hand during cleaning. And when the appliance isn’t in your mouth, don’t keep it on a low table or night stand where small children or pets can easily get their hands (or paws) on it.

And one more thing: don’t wear your denture appliance around the clock — take it out, for instance, while you sleep. Leaving dentures in interferes with the acid-neutralizing and antibacterial function of your mouth’s saliva, which could increase your risk of disease (and bad breath).

Appliances can be an expensive investment in your dental health. By following these guidelines you’ll help protect that investment for years to come.

If you would like more information on caring for your dental appliance, 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 “10 Tips for Cleaning Your Oral Appliance.”





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Dr. George Salem and Associates, P.C.

Braintree, MA Dentist
Dr. George Salem and Associates, PC
60 Adams Street
Braintree, MA 02184
(781) 843-0660
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