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1610 Arden Way  #157
Sacramento, CA 95815
(916) 929-3898
(917) 646-6315 fax


900 E. Bidwell St. #400
Folsom, CA 95630
(916) 983-6655
(916) 983-1079 fax


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By Drs. Jeff DiMariano & Shaina DiMariano
December 19, 2014
Category: Dental Procedures
Tags: dental implants  
DentalImplantMaintenance5FactsYouShouldKnow

If you've recently had a dental implant placed, congratulations! You have made a good investment in your smile that should last for a lifetime — if you take proper care of it. This is easy to do with a good oral hygiene routine and regular professional cleanings. Here are some important things to keep in mind about implant care:

  1. Implants can last as long as teeth. A dental implant made of titanium will fuse to the bone surrounding it and function just like a natural tooth. It is a highly successful method of tooth replacement that succeeds more than 95% of the time.
  2. Implants and natural teeth attach to surrounding bone and gums very differently. A natural tooth does not actually fuse to the bone that surrounds it. Instead, it is held in place by a periodontal ligament (“peri” – around; “odont” – tooth) made up of tiny fibers that insert into the bone on one side and into the tooth on the other. Farther up, these collagen fibers attach the tooth to the gum tissue. Implants and the crowns that go on top of them are not anchored to the gum in this way. An understanding of this biology is important for maintaining good periodontal health when implants are present. We will go over this with you so can care for your implants correctly.
  3. Infection is the enemy. Bacterial infection is a concern with both natural teeth and implant-supported teeth. A bacterial biofilm (plaque) builds up daily on implant teeth, just as it does on natural teeth. If it is not regularly cleared away, various oral infections can develop. In the case of natural teeth, this might result in tooth decay, gum disease, and the loss of tooth-supporting bone. Implants can't decay, but they can be threatened by a rapidly progressing infection known as peri-implantits (“peri” – around; implant “itis” – inflammation), which can lead to a well-like or dish-shaped loss of bone around the implant. The implant can become loose as greater amounts of bone is lost.
  4. Good oral hygiene is as important as ever. Daily removal of bacterial biofilm is key to preventing peri-implantitis. You'll want to make sure you brush your teeth twice daily with a soft brush and fluoride toothpaste, and floss gently at least once per day.
  5. Your dental hygienist has an important role to play. Professional cleanings here at our dental office are also still as necessary as ever, if not more so. Dental hygienists have special instruments they use to clean areas around your implant that can't be reached by your brush or floss — without scratching the surfaces of your implant components.

If you would like more information about dental implants, please call us or schedule an appointment. You can also read more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”

By Drs. Jeff DiMariano & Shaina DiMariano
December 11, 2014
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and 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 “Removing Wisdom Teeth.”

By Drs. Jeff DiMariano & Shaina DiMariano
December 01, 2014
Category: Dental Procedures
AmericasDentistsGotTalent-forFixingDamagedorMissingTeeth

A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.

We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?

Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.

When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?

In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.

So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.

If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”

By Drs. Jeff DiMariano & Shaina DiMariano
November 19, 2014
Category: Oral Health
Tags: oral health   oral cancer   tobacco  
4ReasonswhyQuittingChewingTobaccoisGoodforYourOralHealth

Chewing tobacco is as much a part of our sports culture as the national anthem. What once began as an early 20th Century baseball player method for keeping their mouths moist on dusty fields has evolved into a virtual rite of passage for many young athletes.

But the persona of “cool” surrounding smokeless tobacco hides numerous health threats — including disfigurement and death. What isn’t as widely recognized is the degree to which chewing tobacco can adversely affect your teeth, mouth and gums.

Need more reasons to quit? Here are 4 oral health reasons why you should spit out smokeless tobacco for good.

Bad breath and teeth staining. Chewing tobacco is a prime cause of bad breath; it can also stain your teeth, leaving your smile dull and dingy, as well as unattractive from the unsightly bits of tobacco between your teeth. While these may seem like superficial reasons for quitting, a less-than-attractive smile can also have an impact on your self-confidence and adversely affect your social relationships.

The effects of nicotine. Nicotine, the active ingredient in all tobacco, absorbs into your oral tissues and causes a reduction in blood flow to them. This reduced blood flow inhibits the delivery of antibodies to areas of infection in your mouth. This can cause…

Greater susceptibility to dental disease. Tooth decay and gum disease both originate primarily from bacterial plaque that builds up on tooth surfaces (the result of poor oral hygiene). The use of any form of tobacco, but particularly smokeless, dramatically increases your risk of developing these diseases and can make treatment more difficult.

Higher risk of oral cancer. Besides nicotine, scientists have found more than 30 chemicals in tobacco known to cause cancer. While oral cancer constitutes only a small portion of all types of cancer, the occurrence is especially high among smokeless tobacco users. And because oral cancer is difficult to diagnose in its early stages, it has a poor survival rate compared with other cancers — only 58% after five years.

The good news is, you or someone you love can quit this dangerous habit — and we can help. Make an appointment today to learn how to send your chewing tobacco habit to the showers.

If you would like more information on the effects of chewing tobacco on general and 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 “Chewing Tobacco.”

By Drs. Jeff DiMariano & Shaina DiMariano
November 11, 2014
Category: Oral Health
Tags: oral health  
WhatAthletesHavetoTellUsAboutOralHealth

Considering all the intensive conditioning, practice and training they do, most people would expect elite athletes to be… well… healthy. And that’s generally true — except when it comes to their oral health. A major study of Olympic contenders in the 2012 London games showed that the oral health of athletes is far worse than that of the general population.

Or to put it more succinctly: “They have bodies of Adonis and a garbage mouth.”

That comment, from Dr. Paul Piccininni, a practicing dentist and member of the International Olympic Committee’s medical commission, sums up the study’s findings. In terms of the numbers, the report estimates that about one in five athletes fared worse in competition because of poor oral health, and almost half had not seen a dentist in the past year. It also found that 55 percent had cavities, 45 percent suffered from dental erosion (excessive tooth wear), and about 15 percent had moderate to severe periodontal (gum) disease.

Yet, according to Professor Ian Needleman of University College, London, lead author of the study, “Oral health could be an easy win for athletes, as the oral conditions that can affect performance are all easily preventable.”

Many of the factors that had a negative impact on the athletes are the same ones that can degrade your own oral health. A follow-up paper recently published in the British Journal of Sports Medicine identified several of these issues. One is a poor diet: The consumption of excessive carbohydrates and acidic foods and beverages (including sports drinks) can cause tooth decay and erosion of the protective enamel. Another is dehydration: Not drinking enough water can reduce the flow of healthy saliva, which can add to the damage caused by carbohydrates and acids. The effects of eating disorders (which are more commonly seen in certain sports, such as gymnastics) can also dramatically worsen an individual’s oral health.

Sound familiar? Maybe it’s because this brings up some issues that dentists have been talking about all along. While we don’t mean to nag, this study does point out that even world-class competitors have room for improvement with their oral hygiene. How about you? Whether you’re a triathlete in training, a weekend warrior or an armchair aficionado, good oral health can have a major effect on your well-being.

If you have additional questions about oral health, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”





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