My Blog

Posts for: January, 2019

By Paul D. Nifong, Jr, DDS, PA
January 30, 2019
Category: Dental Procedures
BobbyBonesDancesHisWaytoDentalDamage

The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.

Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”

Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?

It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.

If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.

For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.

It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.

If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”


By Paul D. Nifong, Jr, DDS, PA
January 20, 2019
Category: Oral Health
Tags: dental care  
DentistryisChangingtoMeetDentalCaresEmergingChallenges

Today’s dentist can not only treat most dental diseases and conditions, but can almost prevent disease completely. Our true needs as a society, however, go beyond the dentist’s chair — to the lack of availability and affordability of care for every American.

That’s of grave concern to dentists — so much so that dentistry itself is already changing to meet these challenges.

In one of the most visible changes, we’re seeing accelerated technological advancement that could lower costs and extend our range of care. Advances in 3-D digital imaging are giving dentists amazingly detailed views of patients’ mouths that surpass the accuracy of traditional imaging. Telecommunications and the internet are enabling dentists in distant locations to examine patients and even review dental x-rays to guide treatment, providing a new level of care access for patients.

The means for delivering that care are also changing as the traditional paradigm of the solo practice becomes more difficult for new dentists to achieve. With educational debt and practice setup costs reaching as high as $1 million — before earning their first dollar — many dentists are joining larger groups or dental corporations. In these arrangements, practitioners don’t have the burden of overhead expenses and can concentrate mainly on their clinical work. On the downside, patients seeing multiple providers may not easily build that all important dentist-patient relationship that’s the hallmark of a solo practice. This alternative model could, however, increase the number of practicing dentists over time, making dental care more widely available.

Finally, we’re beginning to see greater collaboration between physicians and dentists. There’s an emerging understanding of the true interconnection of the body’s various systems: diseases of the mouth can affect other diseases of the body, and vice-versa. We’re also experiencing a growing development in salivary diagnosis, using this vital oral fluid to detect conditions and disease in other parts of the body. Dentists and physicians will be working more closely than ever to treat the whole person, not just individual systems — a collaboration that will improve patient care all around.

As these changes continue to emerge in dentistry, you may soon see their effects during your visits. One thing, however, won’t change — the commitment of dentists to provide the highest level of care, for both your oral and general health.

If you would like more information on how changes in dentistry could affect your care, please contact us or schedule an appointment for a consultation.


By Paul D. Nifong, Jr, DDS, PA
January 10, 2019
Category: Oral Health
FlossingDailyAroundImplantswillHelpPreventLosingYourBridge

Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.

Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.

To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.

This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.

To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.

You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.

You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.

Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.

If you would like more information on implant-supported bridges, 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.”