Please Join Us in Welcoming Dr. Casey DePauw

To Our Dental Family,

We are pleased to announce the addition of Dr. Casey DePauw to our dental team.

Dr. Casey DePauw was born and raised in Canandaigua, NY and then moved to Buffalo where she completed her undergraduate degree in Biology from Canisius College.  At Canisius, she was a student-athlete, playing division one lacrosse for four years.  After graduating from Canisius, Dr. DePauw received her dental degree from the University of Pennsylvania School of Dental Medicine where she graduated in the top of her class with honors in Clinical Dentistry.

After dental school, Dr. DePauw completed her Advanced Education in General Dentistry residency from University of Buffalo where she continued to teach for two years after completion.  She is a member of the American Dental Association, 8th District Dental Society, International Team of Implantology and Omicron Kappa Upsilon Eta (OKU) National Honor Society Chapter.  Dr. DePauw is always learning and taking continuing education courses.

Dr. DePauw is passionate about providing high-quality dental care to her patients, while building long-lasting relationships.  She currently resides in South Buffalo with her husband, Jake and greater swiss mountain dog, Griffin.  Dr. DePauw loves spending her summers at Canandaigua Lake and Crystal Beach with her friends and family.  She was raised an avid Buffalo Bills fan and loves to run, snowboard, cook and hike.

As Aurora Dental Care continues to grow, it is very important for us to find that “someone” that will deliver the personalized, high quality, hometown care that our patients value and appreciate. We strongly feel Dr. DePauw is the right fit and will begin seeing patients on April 7, 2022. Dr. Moore and Dr. Petronio will be working with Dr. DePauw to ensure a seamless introduction. 

Dr. Moore will be in the office Mondays, Wednesdays and Fridays. Dr. Petronio will be in the office Mondays and Tuesdays. Dr. DePauw Wednesdays and Thursdays. Dr. Zunner on Fridays.

Thank you for entrusting us with your dental care. Please join us in welcoming Dr. DePauw to our dental family!

 Aurora Dental Care

American Dental Association Responds to World Health Organization Recommendation: Dentistry is Essential Health Care

CHICAGO, August 12, 2020 —The American Dental Association (ADA) respectfully yet strongly disagrees with the World Health Organization’s (WHO) recommendation to delay “routine” dental care in certain situations due to COVID-19.

“Oral health is integral to overall health. Dentistry is essential health care,” states ADA President Chad P. Gehani, D.D.S. “Dentistry is essential health care because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can affect systemic health.”

Dr. Gehani added that in March, when COVID-19 cases began to rise in the U.S., the ADA called for dentists to postpone all but urgent and emergency care in order to understand the disease, consider its effect on dental patients, dental professionals and the greater community.

Both the ADA and the U.S. Centers for Disease Control and Prevention (CDC) then issued interim guidance for dental professionals related to COVID-19. The ADA’s guidance calls for the highest level of PPE available—masks, goggles and face shields. The ADA’s interim guidance also calls for the use of rubber dams and high velocity suction whenever possible and hand scaling when cleaning teeth rather than using ultrasonic scaling to minimize aerosols.

Dr. Gehani concludes, “Millions of patients have safely visited their dentists in the past few months for the full range of dental services. With appropriate PPE, dental care should continue to be delivered during global pandemics or other disaster situations.”

We are taking every safety measure to be open

Dear Patient:

We hope that this letter finds you in good health. Our community has been through a lot over the last few months, and all of us are looking forward to resuming our normal habits and routines. While many things have changed, one thing has remained the same:  our commitment to your safety.

Infection control has always been a top priority for our practice and you may have seen this during your visits to the office. Our infection control processes are made so that when you receive care, it’s both safe and comfortable. We want to tell you about the infection control procedures we follow at Aurora Dental Care to keep our patients and team safe.

Aurora Dental Care follows infection control recommendations made by the American Dental Association (ADA), the U.S. Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA). We follow the activities of these agencies so we are up-to-date on any new rulings or guidance that may be issued. We do this to make sure that our infection control procedures are current and adhere to each agencies recommendations.

You will see some changes when it is time for your next appointment. We made these changes to help protect our patients and our team.  For example:

Our office will communicate with you beforehand to ask some screening questions.You’ll be asked those same questions again when you come in the office.
We will take your temperature upon entering the office.
We have hand sanitizer that we will ask you to use when you enter the office. You will also find some in the reception area and other places in the office for you to use as needed.
You will see our reception room will no longer offer magazines, our coffee station, children’s books and so forth, since those items are difficult to disinfect. We will continue to provide bottled water for our patients.
Appointments will be managed to allow social distancing between patients.
We will do our best to allow greater time between patients to reduce waiting times for you, as well as to reduce the number of patients in the reception area at any one time.

We look forward to seeing you again and are happy to answer any questions you may have about the steps we take to keep you and every patient safe in our practice. To make an appointment, please call our office at (716)652-0190 or visit our website at www.auroradentalcare.com.

Thank you for your being our patient and for your patience and understanding as we navigate this unchartered water together. We value your trust and loyalty and look forward to welcoming back our patients, neighbors and friends.

Sincerely,

Deborah A. Petronio, DDS and our Aurora Dental Care Team

We are open!

As of June 5, 2020 our office opened for all our patients needs. Please call us at 652-0190 to schedule an appointment or email us at info@auroradentalcare.com. Thank you and it feels great to be back.

Q: I have a dental appointment coming up. Can I keep it?

A: The short answer to your question for now is no. No non emergency dental care is being provided. According to the New York State Health Department, dental offices are among the list of non-essential services put on pause until at least April 29. Of course this date is subject to change. This does not mean however that you cannot contact your dentist about any dental problem you are experiencing. Most dentists have not completely closed their offices and are open for emergency care. Some dental questions may even be able to be handled through “teledentistry”. It is up to your dentist to decide if an actual in person visit should take place.

The dental setting is one in which there is a high potential contact with saliva and aerosols. In light is this the dental industry together with agencies like the American Dental Association, the CDC, OSHA, and other regulatory bodies have continuously worked to make infection control guidelines to ensure that patients as well as dental healthcare workers are kept safe in the dental setting. The last very large paradigm shift in the dental setting happened in the 1980’s with the AIDS epidemic and the institution of disposable gloves and masks for each patient. With the onset of COVID-19, another shift may be in the works. Be prepared to see more personal protective gear being worn by your dental health care providers as well as more equipment specifically intended to contain aerosols. In the dental setting, aerosols are the very fine “spatter” arising from using ultrasonic tooth cleaning tools, high speed drills and the like.

Be assured that dentists are prepared to do what is necessary to make sure that dental visits are safe. As you wait for your dentist to get up and running again, remember that prevention is the best thing you can do to avoid dental emergencies. Be sure to keep up with brushing and flossing twice a day! 

Why should I take care of my teeth as I get older?

A:   I have been practicing dentistry for over 20 years now. As a result, I have seen many of my patients advancing in years (but not me!). I see people in all stages of health, but a common denominator is that everyone still wants to be able to eat comfortably and enjoy their food. Whether gathering for a meal, having a steak, or eating healthy vegetables, thinking about your teeth can be a big issue for some people.

As we age, certain things may cause oral health to deteriorate. The first of these obviously is that a person has been using their teeth for many years. The permanent dentition is usually complete by age 12. That means that a person who is 80 has been using their teeth for 68 years to chew, tear open bags, bite threads, take out stress by grinding and clenching and so on.  It is quite amazing that teeth can stand that kind of abuse and in many instances, be in great shape. Much of long term dental health depends on the amount and extent of dental work the patient has received over their lifetime. I have patients that are over 100 years old with beautiful teeth. I also see patients struggle with teeth issue many decades before becoming a centenarian. So taking care of your teeth from the start will reap lasting benefits.

Health issues may also affect the health of your teeth as you get older. Medications and treatments associated with diabetes, high blood pressure, and cancer to name a few, can cause a decrease in saliva. In turn, loosing the lubricating and cleansing affects of saliva can lead to tooth decay- especially decay on the roots of teeth. This can be devastating to the teeth if not properly managed. Diabetes itself is linked to loss of bone around the teeth and tooth loss if not kept under control. Having regular visits to the dentist can help you make a plan to keep your teeth and gums healthy, and spot problems when they are easier to manage.

Those who have not maintained good oral health may find themselves with problems if their health deteriorates to the point when they are not able to care for themselves. Having to rely on a caregiver for teeth brushing (and flossing!) they may find that another person is not going to do an adequate job of caring for their teeth. Compound that with already existing poor oral health and it is a recipe for disaster. It is a difficult decision when a patient is in poor health to take on extensive dental work, but sometimes the choices are limited. It is a much better scenario to keep things as healthy as possible before entering into this situation.

Some tips for senior oral care are to use an electric toothbrush. These take less manual dexterity to do a decent job cleaning the teeth. Make sure you are using a fluoride toothpaste twice a day. Also limit the amount of sugary or refined carbohydrate foods. These can lead to increased tooth decay if teeth are not cleaned regularly. Fluoride rinses may also help to prevent cavities. Your dentist and hygienist are trained to combat diminishing oral health so visiting regularly can be one of the most important steps in keeping your teeth and gums healthy for your whole life.

Why should I take care of my teeth as I get older?

A:   I have been practicing dentistry for over 20 years now. As a result, I have seen many of my patients advancing in years (but not me!). I see people in all stages of health, but a common denominator is that everyone still wants to be able to eat comfortably and enjoy their food. Whether gathering for a meal, having a steak, or eating healthy vegetables, thinking about your teeth can be a big issue for some people.

As we age, certain things may cause oral health to deteriorate. The first of these obviously is that a person has been using their teeth for many years. The permanent dentition is usually complete by age 12. That means that a person who is 80 has been using their teeth for 68 years to chew, tear open bags, bite threads, take out stress by grinding and clenching and so on.  It is quite amazing that teeth can stand that kind of abuse and in many instances, be in great shape. Much of long term dental health depends on the amount and extent of dental work the patient has received over their lifetime. I have patients that are over 100 years old with beautiful teeth. I also see patients struggle with teeth issue many decades before becoming a centenarian. So taking care of your teeth from the start will reap lasting benefits.

Health issues may also affect the health of your teeth as you get older. Medications and treatments associated with diabetes, high blood pressure, and cancer to name a few, can cause a decrease in saliva. In turn, loosing the lubricating and cleansing affects of saliva can lead to tooth decay- especially decay on the roots of teeth. This can be devastating to the teeth if not properly managed. Diabetes itself is linked to loss of bone around the teeth and tooth loss if not kept under control. Having regular visits to the dentist can help you make a plan to keep your teeth and gums healthy, and spot problems when they are easier to manage.

Those who have not maintained good oral health may find themselves with problems if their health deteriorates to the point when they are not able to care for themselves. Having to rely on a caregiver for teeth brushing (and flossing!) they may find that another person is not going to do an adequate job of caring for their teeth. Compound that with already existing poor oral health and it is a recipe for disaster. It is a difficult decision when a patient is in poor health to take on extensive dental work, but sometimes the choices are limited. It is a much better scenario to keep things as healthy as possible before entering into this situation.

Some tips for senior oral care are to use an electric toothbrush. These take less manual dexterity to do a decent job cleaning the teeth. Make sure you are using a fluoride toothpaste twice a day. Also limit the amount of sugary or refined carbohydrate foods. These can lead to increased tooth decay if teeth are not cleaned regularly. Fluoride rinses may also help to prevent cavities. Your dentist and hygienist are trained to combat diminishing oral health so visiting regularly can be one of the most important steps in keeping your teeth and gums healthy for your whole life.

Q: What can you tell me about anti-snoring appliances? Do they really work?

A: Great question! The whole area of sleep medicine and dentistry is growing rapidly. Physicians and dentists are more aware of the serious consequences of untreated sleep disorders. These may range from snoring to restless leg syndrome to obstructive sleep apnea (OSA) as well as other less common health concerns.

Dentists are the only health professionals that are able to make an oral appliance to treat snoring or sleep apnea. The dental appliance, when properly fitted and managed, is a very effective treatment and may be used as a replacement for the continuous positive airway pressure (CPAP) mask and equipment. It is most often used for milder cases of OSA or when CPAP equipment can’t be tolerated by a patient.

A dentist cannot make a diagnosis of OSA. This needs to be done by a medical doctor. Many times a patient’s primary care physician will refer a patient for a sleep study to be done by a board certified sleep physician. That doctor will make the diagnosis and recommend treatment.

CPAP is still the gold standard for treatment of OSA, but oral appliances are growing in popularity as a viable option in many cases. Oral appliances are more convenient to wear; there is no bulky equipment, nothing covering your face, or pressurized air involved.

The oral appliance works by holding the lower jaw forward. This positions the tongue forward and the airway is opened. The amount that the lower jaw is held forward is calibrated by the dentist to balance comfort and effectiveness.

It is important that you do not diagnose yourself. There are very serious consequences for untreated sleep apnea, including daytime sleepiness, drowsy driving, low energy and cardiovascular disease. If you think you may have a sleep disorder, please talk to your dentist or physician so you can get a proper diagnosis and treatment.

If you have any further questions about oral appliances for sleep apnea, please feel free to contact Dr. Petronio at info@auroradentalcare.com, call our office at 716.652.0190, or go to AADSM.org to find a dentist in your area.

Q: I read on the internet that I can use baking soda instead of toothpaste. Is that a good idea?

 A: I seem to be encountering patients using alternative ways to clean their teeth on a regular basis more than ever before. I attribute this to social media and other internet forms of information. I have even seen ads for “dirt” toothpaste! Over the years various forms of toothpaste have come and gone. My best advice is this. Commercially available toothpaste like Crest or Sensodyne are made to be mild sudsing agents to clean teeth using the mechanical action of your toothbrush. ( By the way, I only recommend soft toothbrushes.) Many “alternative toothpastes tend to be more abrasive, with ingredients like baking soda, mica, diatomaceous earth, and charcoal. These can clean your teeth well, but can also lead to abrasion, discoloration from thinning enamel, and sensitivity.

 Also, fluoride is an important ingredient put into toothpaste to help prevent cavities. You would not get that if you were only using baking soda. The fluoride in toothpaste is a topical form that strengthens your teeth in your mouth, as opposed to the fluoride we give to children to help strengthen the developing permanent teeth.

If you have great hygiene habits, which include daily flossing and brushing twice a day for two minutes, and also have a low sugar diet, you may be able to get away with brushing with an alternative toothpaste which does not have fluoride. For everyone else, just use the regular toothpaste and strive for great oral hygiene. There are no shortcuts.

Q: I have heard that survival rate for Oral Cancer is a frightening 50% – is that true?

A good habit for the New Year!

A:  Yes it is. Because two-thirds of oral cancers are not detected until the later stages of the disease, the prognosis poor. The five year survival rate really is only about 50%.  This is particularly heartbreaking because oral cancer is one of the most curable forms of cancerwhen detected early, and your dentist has a simple, inexpensive way to detect it!

 As with all types of cancer, oral lesions that are detected early offer a much better chance for successful treatment, but 67% of people diagnosed with oral cancer are already in stage three or four which are much more difficult to treat.  Patients with oral cancer may have no pain or obvious symptoms.  The first sign of trouble may be abnormal-looking cells or lesions on the surface of the mouth or tongue which could go unnoticed for a long time, especially if you are not having regular dental check-ups.

 When we think of oral cancer, we think of old people who have been smoking for years, but alarmingly, more that 25% of oral cancers occur in people who don’t smoke and who have no other lifestyle risk factors.  

The medical profession has made huge strides in reducing the mortality rate from other cancers; breast cancer, cervical and prostate cancers.  Much of this improvement has come from more effective methods for screening the healthy population to detect abnormalities earlier and earlier in the disease process.  

 Recent developments in dentistry have made a reliable screening method available to patients as part of their routine dental visits.  The screening is quick (about ten minutes), painless and involves the use of stains and a special incandescent light which illuminates suspicious cells.  It is inexpensive (currently less than $30 or less than the cost of a decent haircut) and is (should be) performed annually as part of a routine hygiene visit (in adults over the age of.....?). 

Oral health is intimately linked to overall health and this is one more reason why people should have regular, six-monthly dental check-ups.  Ask your Dentist about oral cancer screening at your next visit.  

If you would like to know more about oral cancer, oral cancer screenings or any other matters linked to your oral health, please email Dr. Petronio at info@auroradentalcare.com

With each recall appointment you have – we always keep a keen eye for telltale signs like lumps and discoloration, and for suspicious areas or roughness or of any change whatsoever. We check your whole mouth (the top of the tongue and underneath, your lips, cheek lining, and gums).  To help us out, make sure you play an active role in early detection too.  Make it a habit to “know your mouth” and regularly examine it for any changes.  

1)    Lift your upper lip and check for discoloration or sores on your lips and gums.  The repeat for your lower lip.

2)    Check your inner cheeks for white, red or dark patches.  Use your finger to feel the cheek surface for lumps or roughness.  

3)    Look at the roof of your mouth.  Any changes?

4)    Check your tongue – top, side and bottom – for any color changes or swelling.

 If you find an area of concern, call us right away.  And always remember, like we do....the first step in prevention and successful treatment is awareness.

Q: I’m having a baby and was wondering what I can do to make sure she has good teeth?

A: Having your first baby is a wonderful, exciting, life changing, and maybe a little intimidating time. All of a sudden you are responsible for so many more things! One of those things is your child’s oral health. Two good things are that the teeth do not start appearing until your baby is about 6 months old, and of course any book or google search will give you lots of information. I have included a chart that shows when you can expect teething as well as when the primary teeth should fall out later. I got this from a google search!

What I may be able to help you with is my experience. There are some things to look out for that you may not come across in your reading, but are interesting and may be helpful. The first thing to remember is that as soon as a tooth appears, it is susceptible to decay. The normal rules apply here. Limit refined sugar and brush and floss twice a day. If there are spaces between the teeth, brushing only is fine. If a toddler comes into the office and has tooth decay, I look at several possible causes. The first is diet. Please never put your baby to sleep with a bottle of anything but water. Milk, formula, juice or soda will cause cavities if your baby falls asleep with that in their mouth. It can cause rampant and devastating tooth decay and loss. The second thing is called “lip tie”. There is a small muscle attachment that connects the middle of the upper lip to the gums above the two front teeth. If the muscle attaches too close to the teeth the lip will be held tight against the teeth. After nursing or a bottle, be sure to wipe the area clean or brush since food could be stuck against the teeth. It is an easy surgical procedure with a laser to move this attachment to a more appropriate area. Your pediatrician or dentist can advise you. The other possible cause of early tooth decay is a problem with the development of the teeth. Rarely teeth can form with thin or missing enamel. This makes the teeth more susceptible to decay.

Dental visits ideal should start around one year of age. Even if we can just get a look at the teeth it is helpful. A small problem detected early may head off a complicated problem later. We look for abnormalities like I mentioned above, but also we will just get to know your child. Your child can become comfortable at the office, and hopefully develop a routine of regular dental visits. Starting out right with dental care for your baby can reap a lifetime of healthy teeth.

Question: I heard that a cavity can heal itself?

Answer:

A cavity in a tooth can heal itself! If a cavity is small and only into the first layer of the tooth ( the enamel) the tooth may be able to heal and become solid again. For this to happen certain factors must take place though. First, the patient must commit to a daily home care routine. This includes thoroughly cleaning all surfaces of the teeth. We recommend brushing with a fluoride containing toothpaste for two minutes each time twice a day. Flossing once a day is also recommended. If you can brush and floss right before going to bed, that is the best time since saliva flow decreases at night, therefore creating an ideal environment for cavities to form or grow if there is plaque or food left on the teeth all night. The important thing is to clean ALL surfaces of ALL teeth daily

Secondly, we recommend a low sugar diet. Food containing sugar or carbohydrates provides food for cavity causing bacteria. Limiting sugar to mealtimes and limiting snacking on sugary foods and drinks can help control cavities. Some people don’t realize that foods like bread or pretzels break down to sugar when we eat them. It’s not just candy that leads to cavities.

Lastly, you must have adequate saliva to help wash away food particles from your teeth. Saliva flow can be affected by many common medications, radiation therapy, auto immune diseases, or inadequate fluid intake. Your dentist and primary care doctor can help with managing your saliva flow. People with reduced saliva flow can benefit from everything I mentioned above, and also more frequent dental visits, topical fluoride treatments, prescription strength toothpaste, and even medication. Everyone can make sure they drink lots of water every day.

When a cavity starts, bacteria will demineralize an area of tooth enamel. At this point, if the patient adheres to the suggestions above, there is still a chance that the cavity will remineralize. If caught early enough it is possible for the tooth to return to perfect condition. More often though, even if remineralized, the area will be a weak spot. As soon as poor oral hygiene or poor diet return, that remineralized area will be the first place to be attacked.

Scientists and researchers are working in these areas to develop better strategies to combat tooth decay and remineralize teeth. Unfortunately no amount of science can overcome poor hygiene habits and a high sugar diet! So keep up the brushing and flossing and don’t let cavities start.

Q: I want to whiten my teeth. I am confused about all the options. Can you advise me?

A:  A whiter smile can make you look younger, more vibrant, and more confident. Teeth whitening is an easy way to improve your smile. There are some things to consider though. Firstly, why are the teeth dark? For some people the natural color of their teeth is darker than they would like. Some other reasons for dark teeth are staining from food and drinks like tea and coffee. Decayed or decalcified teeth will appear dark. Problems with the formation of tooth enamel can make teeth stained gray, white or brown. Smoking causes a lot of tenacious stain to adhere to the teeth. Old dental restorations can stain or turn color. Some medications, especially those given to young children, can lead to dark internal tooth stain when the permanent teeth are forming. And also trauma can make a tooth turn dark. 

It is important to know why your teeth are dark. If it is any of the reasons above except stain or the natural shade of your teeth, simply whitening may not give you the result you are looking for. That is why I always recommend talking to your dentist about whitening your teeth. If there are dental problems or dental restorations like fillings or crowns, the whitening will not work.

Whitening works by using one of two products. One is hydrogen peroxide and the other is carbamine peroxide. These agents break down the stains to make your teeth appear brighter.

Secondly, there are several options to choose to whiten your teeth. The whitening that a dentist can offer is stronger than you can get from over the counter products. A dentist usually offers two types of whitening. In Office Whitening is done  by a dentist or hygienist directly on your teeth and takes about an hour. Alternatively, Custom Whitening Trays can be made from impressions and you can use them at home for an hour a day for a week or two and get similar results. Over The Counter products are not as strong, but for brightening up your smile, these work well and are cost effective.

Lastly, there are some precautions to take when whitening your teeth. In the dental office, care is taken to not get the strong whitening gel on your gums because that can be irritating. Also any type of whitening can cause mild to moderate temporary tooth sensitivity. Overuse of whitening trays or over the counter products can damage the enamel and even make the teeth appear gray.

It is always best to consult your dentist or hygienist. When used properly teeth whitening is safe and effective and give you a bright smile. 

Q: My child brushes his teeth every day. We just went to the dentist and he has 5 cavities. How can this be? We use Tom’s of Maine toothpaste. I am a big believer in all natural products.

A: As a parent we always try to do the best thing for our children’s health. It sounds like you have been diligent in caring for your child’s teeth. Teaching him to brush every day and visiting the dentist for regular checkups is exactly what you should be doing. It is so frustrating when you do things right and your child still gets cavities. You are not alone in this. I frequently see parents who are in this situation. Let’s look at some reasons why your child is still getting cavities in spite of his and your efforts.

Firstly, let me say that I do not usually recommend toothpaste brands. I do however have to say that I see problems when children do not use a toothpaste containing fluoride (like Tom’s). I have written this column several times about the safety and effectiveness of fluoride when used properly. As long as a child can rinse and spit, there is no reason why he will get too much fluoride from toothpaste. Especially now that you know that your child is prone to cavities, I would switch to a fluoride containing brand.

Secondly I would recommend that you choose smart snacks. Kids love sticky gummy fruit snacks like gummy bears , fruit rollups and raisins, but these sticky foods are big cavity producers! Likewise sugary drinks like soda and orange juice have high sugar content as well as acid which helps cavities form. So what is a smart snack? Cut up veggies and dip, cheese that is not artificial, and popcorn are all smart snacks. You can find lists of good snack ideas on the internet.

Lastly, timing is important. Brushing after breakfast is a great way to start the day. Teeth are clean before school starts and usually stay clean until lunch. If you can do a quick brush after other meals it is great, but sometimes just not practical. Before bed is the most important time to thoroughly clean your teeth. Depending on the child’s age this may mean brushing for them, checking their brushing, or monitoring their brushing. The same goes for flossing. We all spend lots of time sleeping, so having clean teeth during that time will help keep them free of decay.

Of course regular dental cleanings and exams will provide education and help to spot dental problems early. It’s a great idea to have an open conversation with your dentist and hygienist about this subject.

Q: My child brushes his teeth every day. We just went to the dentist and he has 5 cavities. How can this be? We use Tom’s of Maine toothpaste. I am a big believer in all natural products.

A: As a parent we always try to do the best thing for our children’s health. It sounds like you have been diligent in caring for your child’s teeth. Teaching him to brush every day and visiting the dentist for regular checkups is exactly what you should be doing. It is so frustrating when you do things right and your child still gets cavities. You are not alone in this. I frequently see parents who are in this situation. Let’s look at some reasons why your child is still getting cavities in spite of his and your efforts.

Firstly, let me say that I do not usually recommend toothpaste brands. I do however have to say that I see problems when children do not use a toothpaste containing fluoride (like Tom’s). I have written this column several times about the safety and effectiveness of fluoride when used properly. As long as a child can rinse and spit, there is no reason why he will get too much fluoride from toothpaste. Especially now that you know that your child is prone to cavities, I would switch to a fluoride-containing brand.

Secondly I would recommend that you choose smart snacks. Kids love sticky gummy fruit snacks like gummy bears , fruit rollups and raisins, but these sticky foods are big cavity producers! Likewise sugary drinks like soda and orange juice have high sugar content as well as acid, which helps cavities, form. So what is a smart snack? Cut up veggies and dip, cheese that is not artificial, and popcorn are all smart snacks. You can find lists of good snack ideas on the Internet.

Lastly, timing is important. Brushing after breakfast is a great way to start the day. Teeth are clean before school starts and usually stay clean until lunch. If you can do a quick brush after other meals it is great, but sometimes just not practical. Before bed is the most important time to thoroughly clean your teeth. Depending on the child’s age this may mean brushing for them, checking their brushing, or monitoring their brushing. The same goes for flossing. We all spend lots of time sleeping, so having clean teeth during that time will help keep them free of decay.

Of course regular dental cleanings and exams will provide education and help to spot dental problems early. It’s a great idea to have an open conversation with your dentist and hygienist about this subject.

Q: Why do I get cavities? I brush my teeth!

A:  Very often I see patients who are surprised that they have one or more cavities when they come in for their dental checkup.  The surprise comes because these people who go to the dentist regularly and brush their teeth every day. Sometimes that person hasn’t had a new cavity in many years. So why does a person get a cavity?

Well, the answer is multifaceted. A cavity in a tooth is formed by the combination a certain bacteria and an environment that causes the bacteria to be able to eat away at the tooth. To get rid of the bacteria, our first defense is brushing, as well as flossing. Cleaning the area in between the teeth is important because most adult cavities are formed in between the teeth, where they touch each other. Flossing or using some other dental device like a dental pick or proxy brush can clean this area of food and plaque. While brushing, concentrate on cleaning the area of the tooth that touches the gumline. Sometimes we get in a hurry and miss spots! I recommend that you spend a couple of minutes brushing. Divide your teeth up into four sections and spend 30 seconds on each section.

Getting rid of bacteria is the first thing to prevent tooth decay. Making your mouth a healthy environment is the second area of defense. What I mean by this is, number one, making sure that you do what you can to limit sugary foods. Sugar is food to bacteria. When they eat the sugar they release acid. Acid is what eats away at the tooth to cause a cavity. So limiting not only the amount of sugar, but the number of times each day you eat sugar is vital to preventing cavities. Remember that foods like bread, crackers, juice and fruit contain sugar! Secondly, having an adequate amount of saliva ensures that food can be washed down and swallowed while you eat. If you have an inadequate amount of saliva, mainly due to a medical condition or medications you want to be sure to supplement with a saliva substitute or special prescription medication to make up for it. Drinking more water can also help.

In closing, I must note that sometimes it seems like some people tend to get more cavities than others. Sometimes this is because there is a lot of dental work already existing. The problem may not necessarily be new decay, but rather failing dental restorations. Also some people have habits that will lead to tooth decay and they are not even aware of the problem. I had a patient once that had large cavities on the sides of her back teeth. After discussing what had changed she revealed that she had been falling asleep with a cough drop in her mouth right in that area every night for months. No amount of brushing and flossing will counteract that!

So be aware of your habits and make sure you are creating conditions for good dental health. Talk to your dentist and hygienist about better techniques you can use to keep your teeth decay free.

Q: Is Invisalign a Good Option For Busy Professionals?

“Invisalign has become a very popular option for professionals who want straighter teeth without having all the wires and brackets that go along with traditional braces”, says Dr. Deborah Petronio. Dr. Petronio is the owner of Aurora Dental Care, which offers Invisalign for adults and teens in the Western New York area.

Although Invisalign is popular with children, teens and adults as well, the treatment is especially gaining traction among the professional crowd. “People like Invisalign because you can remove the aligners if you have a big meeting, an important presentation, or a big date,” says Dr. Petronio. Obviously, this is not an option for people who choose to go with regular metal braces instead.

Like traditional braces, Invisalign is a way of moving teeth for patients who want straighter smiles. The main difference, however is that Invisalign does not rely on brackets or wires to get the job done. The Invisalign system uses a series of clear, comfortable aligners that are custom modeled to fit your teeth, which gradually reposition your teeth into a smile you’ll be proud of. The virtually invisible aligners allow you to smile both during treatment and after. In fact, no one will know you are wearing it unless you tell.

Another reason professionals favor Invisalign is because they don’t need to take as much time off of work to come in for follow-up appointments as they would with regular braces. “The frequency with which a patient needs to come into the office with Invisalign all depends on the case, but most patients only need to see us once every 6 weeks”, says Dr. Petronio.

The addition of new technology is another great reason that people are happy with Invisalign. A device called Acceledent is now available that shortens the treatment time by half! It uses vibrations to help move the teeth, and the results are amazing.

 Invisalign has become popular because many professionals appreciate not having to go through treatment as long as they would with regular braces. At Dr. Petronio’s practice, patients average 3-15 months of treatment time. Regular braces, by contrast, require an average treatment of 24 months. For this reason, professionals who don’t have the time to spend going to frequent appointments, or the desire to look younger than they already are in business settings, are increasingly choosing Invisalign to straighten their smiles.

Q: I brush my teeth, so why do I still get cavities?

A: I love this question. It’s one I explain over and over to my patients. I find that the process of getting cavities is not well understood by the general public, hence people are unsure how to really prevent cavities. The answer is both simple and complex. There are many factors that contribute to tooth decay including genetics, salivary flow, diet, tooth cleansing, tooth anatomy, etc.

Simply put though, to make a cavity you need to understand that it is caused by bacteria in your mouth. There is one type of bacteria that causes most tooth decay. It is called Streptococcus Mutans. It is passed around though saliva, so most people get the bacteria early in life through their parents. After that, cavities need only two things to develop, sugar and acid. So any “carb” you eat, from candy to crackers to soda pop turns to sugar. This allows the bacteria to do their dirty work. As they eat the sugar they expel acid. This acid  is what eats through your tooth.

A few decades ago in this country researchers did some human experiments that would no longer be allowed in this day and age. The lessons we learned from them are taught to all dental students. They grouped institutionalized children into various groups. One group was only allowed meat, fruits and vegetables at regular mealtimes. Another group was given the same meals, but was given as many caramels as they wanted for dessert. The third group was given the same meals, but they were given their bag of caramels each morning to eat whenever they wanted during the day or night. Who had the most cavities? The group that had access to their caramels anytime had way more cavities than the other two groups. The reason for this is that they had more “acid attacks” during each day. Surprisingly, the group that ate their caramels with their meals did not have many more cavities than the group who had no candy.

The point of this is to explain that it is the frequency of “acid attacks” that caused the cavities. Using this knowledge, it would make sense to limit between meal snacking, or at least make sure it is not sugar or carbs. Cheese is one snack that is “dentist approved”. I know it has cholesterol, but it also contains an enzyme that inhibits tooth decay. This may come as a blow to all those “grazers” out there. If you do snack, it is best to brush and floss afterwards. If that is not possible, rinsing with water or even chewing sugarless gum can lower your risk of cavities.

So now you know why just brushing your teeth every day is not enough to prevent cavities. The more knowledge you have, they better health you can achieve. If you have any questions, feel free to contact me at (716) 652-0190 or email me at info@auroradentalcare.com.

“I Got Gaps, You Got Gaps”

Q: Can you tell me what My options are for closing a gap between my front teeth?

A: There are a few options to fill in a gap between teeth. In Dentistry the term for a gap is a diastema. It is very common to have a gap between the two front teeth- think Lauren Bacall. Many people find this an attractive quality in a smile, but if the gap is large, or the teeth start to shift, some people opt to have the space closed.

In my office, the first thing I do is a “mock up” of how the patient would look with the space closed. I do this with my tooth colored filling material right in the patients mouth. It gives them a good idea of the final result. Then we can discuss what the options are. Basically there are two options. The first is direct bonding which uses matching tooth colored resin sculpted to the two teeth to create two wider teeth, thus filling the space. I have to say that this is the option that I do most of the time. It is relatively inexpensive, looks great, last a long time and it is easy, needing no numbing.

Sometimes though, the size of the restoration would be too large to support a simple bonding, so a lab created porcelain restoration is needed. To close very large spaces or to create more length a crown or veneer is necessary. Although these are much more costly than bonding, they are beautiful and very long lasting. Crowns are also indicated if the teeth already have large fillings because they will strengthen the teeth.

Another option to close spaces is orthodontics. Using traditional braces or a new product like Invisalign you can close spaces by moving the teeth back. This would eliminate the need for any bonding. This would be a very conservative and low maintenance way to close spaces. It might be the best option if there were a lot of spaces to close.

In childhood there is a muscle that attaches between the top front teeth. In some people this attachment is large enough to keep the front teeth separated. If you see this situation with your child you can talk to your dentist and see if she thinks it will lead to any future orthodontic issues. Sometimes that muscle (the frenum) needs to be “clipped” so that the front teeth will move together and there will be enough room for all the adult teeth to erupt normally.

As you can see, there are options to close spaces between teeth. It is best to make an appointment with your dentist for a consultation to see what the best option is for your smile.

Deborah Petronio, D.D.S.

Aurora Dental Care

92 Grey St.

East Aurora, NY 14052

716-652-0190

www.auroradentalcare.com

Q: Is Invisalign a Good Option For Busy Professionals?

A: “Invisalign has become a very popular option for professionals who want straighter teeth without having all the wires and brackets that go along with traditional braces”, says Dr. Deborah Petronio. Dr. Petronio is the owner of Aurora Dental Care, which offers Invisalign for adults and teens in the Western New York area.

Although Invisalign is popular with children, teens and adults as well, the treatment is especially gaining traction among the professional crowd. “People like Invisalign because you can remove the aligners if you have a big meeting, an important presentation, or a big date,” says Dr. Petronio. Obviously, this is not an option for people who choose to go with regular metal braces instead.

Like traditional braces, Invisalign is a way of moving teeth for patients who want straighter smiles. The main difference, however is that Invisalign does not rely on brackets or wires to get the job done. The Invisalign system uses a series of clear, comfortable aligners that are custom modeled to fit your teeth, which gradually reposition your teeth into a smile you’ll be proud of. The virtually invisible aligners allow you to smile both during treatment and after. In fact, no one will know you are wearing it unless you tell.

Another reason professionals favor Invisalign is because they don’t need to take as much time off of work to come in for follow-up appointments as they would with regular braces. “The frequency with which a patient needs to come into the office with Invisalign all depends on the case, but most patients only need to see us once every 6 weeks”, says Dr. Petronio.

The addition of new technology is another great reason that people are happy with Invisalign. A device called Acceledent is now available that shortens the treatment time by half! It uses vibrations to help move the teeth, and the results are amazing.

Invisalign has become popular because many professionals appreciate not having to go through treatment as long as they would with regular braces. At Dr. Petronio’s practice, patients average 3-15 months of treatment time. Regular braces, by contrast, require an average treatment of 24 months. For this reason, professionals who don’t have the time to spend going to frequent appointments, or the desire to look younger than they already are in business settings, are increasingly choosing Invisalign to straighten their smiles.