Nashua, NH Dentist
Nashua Smile Makers
76 Allds Street
Nashua, NH 03060
(603) 882-3727
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By Nashua Smile Makers
October 12, 2021
Category: Dental Procedures
Tags: clear aligners  
ClearAlignersAnotherOptionBesidesBracesforMovingTeeth

Advances in technology often lead to greater choices for things like automobiles or smartphones. In recent decades, advances in orthodontics have given families another choice besides braces for straightening teeth: clear aligners.

Clear aligners are a series of computer-generated mouth trays of clear plastic that are custom made for an individual patient's teeth. Like braces, these trays worn in the mouth put pressure on the teeth to move in a desired direction. Patients wear an individual tray for about two weeks and then change it out for the next tray in the series. Each subsequent tray is designed to pick up where the former tray left off in the progress of tooth movement.

Although treatment takes about as along as braces, clear aligners have some distinct advantages. First and foremost, their clear plastic construction makes them nearly invisible to outside observers. This makes them ideal for appearance-conscious teens (or adults) who may be embarrassed by the look of metallic braces.

And unlike their fixed counterpart, clear aligners can be removed by the wearer for meals, hygiene and the rare special occasion. As a result, patients with aligners aren't as restricted with food items and have an easier time keeping their teeth clean and avoiding dental disease than braces wearers.

But although definitely a benefit, removability can be potentially problematic depending on the maturity level of the patient. To be effective, an aligner tray must remain in the mouth for the majority of the time—too much time out negates the effect. Patients, then, must be responsible with wearing aligners as directed.

Clear aligners may also not work for treating difficult bites, especially those that require targeted movement (or non-movement) of select teeth. In those cases, braces may be the necessary treatment. But this situation has changed in recent years with the development of new devices and techniques that increase the range of bite problems clear aligners can treat.

Depending then on the bite problem and a patient's level of personal responsibility, clear aligners can be a viable orthodontic choice. And just like braces, they too can improve both dental function and appearance.

If you would like more information on orthodontic options for teens, 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 “Clear Aligners for Teens.”

By Nashua Smile Makers
October 02, 2021
Category: Dental Procedures
Tags: tooth decay  
WereImprovingOurEffectivenessinTreatingToothDecay

For several decades, dentists have been saving teeth from tooth decay following a few basic guidelines: 1) Identify decay as soon as possible; 2) Thoroughly remove decayed tooth structure; and 3) Fill any cavities. With millions of diseased teeth rescued, observing these simple steps have proven a rousing success.

But as with most things, even this successful protocol isn't perfect. For one, some healthy tissue gets removed along with the diseased portions. The average percentage of "collateral damage" has dropped over the years, but it still happens—and a reduction in healthy tissue can make a tooth less structurally sound.

Another drawback, at least from the patient's perspective, is the dental drill used for removing decay and preparing cavities for filling. Many people find drilling unpleasant, whether from its vibrations in the mouth or its high-pitched whine. The drill's burr head design also contributes to greater healthy tissue loss.

But those weaknesses have lessened over the last few years, thanks to innovations on a number of fronts.

Better risk management. Tooth decay doesn't occur out of thin air—it arises out of risk factors unique to an individual patient like personal hygiene, bacterial load, saliva production or even genetics. Taking the time to identify a patient's "tooth decay risk score" can lead to customized treatments and practices that can minimize the occurrence of decay.

Earlier detection. Like other aspects of dental health, the sooner we detect decay, the less damage it causes and the more successful our treatment. X-rays remain the workhorse for detecting decay, but now with improvements like digital film and better equipment. We're also using newer technologies like laser fluorescence and infrared technology that can "see" decay that might otherwise go undetected.

Less invasive treatment. The dental drill is now being used less with the advent of air abrasion technology. Air abrasion utilizes a concentrated spray of particles to remove diseased tooth structure more precisely than drilling. That means less healthy tissue loss—and a more pleasant (and quieter!) experience for the patient.

In effect, "less is more" could describe these improvements to traditional decay treatment. They and other methods promise healthier teeth and happier patients.

If you would like more information on current treatments for tooth decay, 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 “Minimally Invasive Dentistry: When Less Care is More.”

PorcelainVeneersTransformRealHousewivesStarsSmileSpoiledbyTeethGrinding

Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.

Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).

Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.

So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.

There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.

And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.

Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.

If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.

If you would like more information on teeth grinding habits and their effects, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”

By Nashua Smile Makers
September 12, 2021
Category: Dental Procedures
Tags: gum recession  
GumRecessionDoesntHavetobePermanent

The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.

Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.

Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.

But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.

The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.

There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.

In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting.  The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.

Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.

If you would like more information on treating gum recession, 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 “Periodontal Plastic Surgery.”

By Nashua Smile Makers
September 02, 2021
Category: Oral Health
Tags: Oral Hygiene  
TakeCareofYourGums-AndYourGumsWillTakeCareofYourTeeth

Even masterpiece paintings need an appropriate frame. Likewise, our gums help bring out our teeth's beauty.

But gums are more than enhancements for our smile appearance—they're also critical to good oral health. In recognition of National Gum Care Month, there are a couple of reasons why you should look after your gums just like you do your teeth.

For one, the gums are primarily responsible for holding teeth in place. With healthy gums, the teeth won't budge even under chewing stress (although this attachment does allow for micro-movements). Diseased gums, however, are another story: Advancing gum disease weakens gum attachment, causing teeth to loosen and eventually give way.

The gums also protect the root end of teeth from pathogens and oral acid, just as enamel protects the crown. Gum disease can also foul up this protective mechanism as infected gums have a tendency to shrink away from the teeth (also known as gum recession). This exposes the roots to an increased risk for disease.

So, taking care of your gums is an essential part of taking care of your teeth. And, the basic care for them is the same as for your pearly whites: daily brushing and flossing and regular dental cleanings. These habits remove the buildup of dental plaque, a thin film of food and bacteria that cause gum disease.

It's also important to keep a watchful eye for any signs of gum abnormalities. Be on the alert for unusual gum redness, swelling and bleeding. Because these may be indicators of an infection already underway, you should see us for an examination as soon as possible.

If we find gum disease, we can begin immediate treatment in the form of comprehensive plaque removal. If the disease has advanced to the root, we may need to access this area surgically to remove any infection. So, the sooner we're able to diagnose and treat an infection, the less likely that scenario will occur.

Ironically, something meant to protect your gums could also damage them. You can do this with excessive and overly aggressive brushing. Putting too much "elbow grease" into brushing, as well as doing it more than a couple of times a day, could eventually cause the gums to recede. Instead, apply only the same degree of pressure to brushing as you would while writing with a pencil.

As we like to tell our patients, take care of your mouth, and your mouth will take care of you. Something similar could be said about your gums: Take care of these essential soft tissues, and they'll continue to support and protect your teeth.

If you would like more information about periodontal gum care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”





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