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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
November 28, 2015
Category: Oral Health
Tags: oral health   pregnancy  

Pregnancy is an exciting time in a woman’s life — but it can also generate a lot of questions about both the mother’s and the baby’s health. The realm of dental care is no exception.

Here are a few of the questions we frequently hear from expectant mothers, along with our answers.

Does the baby’s tooth calcium come from my teeth?
This question is frequently asked by mothers who may have had dental issues and are worried they’ll pass on these problems to their baby. Simply put, no — a baby developing in the womb derives minerals like calcium for their teeth and bones from the mother’s diet, not her teeth. What an expectant mother can do is be sure to eat a healthy, balanced diet rich in nutrients and minerals like calcium.

Am I at heightened risk for dental disease during pregnancy?
Pregnancy does cause significant increases in your body’s hormones, particularly estrogen. This can cause changes in the gum tissue’s blood vessels that may make you more susceptible to periodontal (gum) disease (commonly called “pregnancy gingivitis”). It’s also possible later in pregnancy to develop non-cancerous overgrowths of gum tissues called “pregnancy tumors.” The heightened risk for gum disease during pregnancy calls for increased vigilance in monitoring gum health.

What should I do to take care of my teeth?
It’s important to brush your teeth thoroughly twice a day with ADA-approved fluoridated toothpaste to remove plaque, a thin layer of bacteria and food remnants that adhere to teeth. You should also floss daily and consider using an anti-plaque/anti-gingivitis mouthrinse. And, of course, you should see us for regular office cleanings and checkups, or if you notice swollen, tender or bleeding gums, or other abnormalities.

Should I take prenatal fluoride supplements?
This sounds appealing as a way to give your baby a head start on strong tooth development. Studies on its effectiveness, however, remain slim and somewhat inconclusive — we simply don’t have enough data to make a recommendation. What does have a solid research record is the application of fluoride to teeth in young children just after they appear in the mouth — studies involving over a thousand teeth have shown 99% cavity-free results using topical fluoride applications with sealants.

If you would like more information on dental care during pregnancy, 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 “Expectant Mothers.”

By Drs. Jeff DiMariano & Shaina DiMariano
November 20, 2015
Category: Dental Procedures
Tags: dental implants   dentures  

It’s a common problem for denture wearers: after years of a comfortable fit, your dentures now seem to be uncomfortably loose. The reason, though, may have more to do with bone loss than the dentures.

Bone is a living tissue with a life cycle — it forms, it ages, and it eventually dies and dissolves (resorbs). It’s replaced with new bone and the cycle repeats. Additionally, the forces generated when we bite or chew are transmitted from the teeth to the jaw, which helps stimulate new bone growth. When the natural teeth are missing, however, the bone no longer receives this stimulus. Resorbed bone isn’t replaced at a healthy rate, which leads over time to bone loss.

Denture construction can also contribute to bone loss. The denture palate rests for support on the bony ridges that once held the teeth. Over time the compressive forces of the dentures apply damages and reduces the volume of gum tissue and eventually does the same to the bone. Combining all these factors, the reduced gum and bone volume will eventually alter the denture fit.

There are a few alternatives for correcting loose dentures. One is to reline them with new plastic, as either a temporary fix performed during an office visit or a more permanent relining that requires sending your dentures to a dental lab. Depending on the rate of bone loss, a patient could go through several denture relinings to accommodate ongoing changes in the jaw. At some point, though, it may be necessary to create a new set of dentures.

A third alternative that’s becoming increasingly useful is to incorporate dental implants into the denture design. Implants can of course be used to replace individual teeth, but a few strategically placed implants (usually of smaller dimension) can serve as a support platform for a removable denture. This relieves some of the compression force of a traditionally worn denture and can slow bone loss.

If you’re having problems with your denture fit, call us for an appointment. We’ll help you decide on the best alternative to improving the fit and making your dentures more comfortable and secure.

If you would like more information on refitting loose dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Dentures.”

By Drs. Jeff DiMariano & Shaina DiMariano
November 12, 2015
Category: Oral Health
Tags: gum disease   birth control  

One of the health issues pregnant women should be concerned about is a higher risk of periodontal (gum) disease. But you don’t have to be pregnant to have an increased risk — you also may be more susceptible to dental disease if you’re taking certain birth control pills.

Gum disease is a bacterial infection caused by plaque, food debris that builds up on tooth and gum surfaces due to poor oral hygiene. If left untreated gum disease can eventually lead to the breakdown of connective gum tissue and cause tooth loss.

Pregnant women are at greater risk because of an increased level of female hormones (estrogen) in their blood stream. This causes a change in the blood vessels that supply the gums, making them more susceptible to the effects of bacteria. A number of birth control options also increase estrogen levels, causing much of the same effect. To heighten the effect, you may also have a predisposition toward gum disease by your genetics or a high stress level.

There are some things you can do, however, to help lower your risk if you’re taking birth control medication. First and foremost, practice a consistent, daily habit of brushing and flossing. If you’re unsure if your technique is effective, we can provide guidance and training to make sure you’re performing these tasks properly. You should also visit us at least twice a year for office cleanings and checkups: no matter how effective you are with brushing and flossing, plaque can still accumulate in hard to reach places and form hardened deposits known as calculus.

You should also be on the lookout for signs of disease like gum redness, swelling or bleeding. If you see any of these signs, contact us as soon as possible for a thorough examination. As with many other issues involving health, the sooner we begin treatment for gum disease the better your chances of stopping it before it does too much harm.

If you would like more information on the relationship between gum disease and pregnancy or birth control, 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 “Pregnancy & Birth Control.”

By Drs. Jeff DiMariano & Shaina DiMariano
November 04, 2015
Category: Oral Health

As is the case with most celebs today, Beyonce is no stranger to sharing on social media… but she really got our attention with a video she recently posted on instagram. The clip shows the superstar songstress — along with her adorable three-year old daughter Blue Ivy — flossing their teeth! In the background, a vocalist (sounding remarkably like her husband Jay-Z) repeats the phrase “flossin’…flossin’…” as mom and daughter appear to take care of their dental hygiene in time with the beat:

We’re happy that this clip highlights the importance of helping kids get an early start on good oral hygiene. And, according to authorities like the American Dental Association and the American Academy of Pediatric Dentistry, age 3 is about the right time for kids to begin getting involved in the care of their own teeth.

Of course, parents should start paying attention to their kids’ oral hygiene long before age three. In fact, as soon as baby’s tiny teeth make their first appearance, the teeth and gums can be cleaned with a soft brush or cloth and a smear of fluoride toothpaste, about the size of a grain of rice. Around age 3, kids will develop the ability to spit out toothpaste. That’s when you can increase the amount of toothpaste a little, and start explaining to them how you clean all around the teeth on the top and bottom of the mouth. Depending on your child’s dexterity, age 3 might be a good time to let them have a try at brushing by themselves.

Ready to help your kids take the first steps to a lifetime of good dental checkups? Place a pea-sized dab of fluoride toothpaste on a soft-bristled brush, and gently guide them as they clean in front, in back, on all surfaces of each tooth. At first, it’s a good idea to take turns brushing. That way, you can be sure they’re learning the right techniques and keeping their teeth plaque-free, while making the experience challenging and fun.

Most kids will need parental supervision and help with brushing until around age 6. As they develop better hand-eye coordination and the ability to follow through with the cleaning regimen, they can be left on their own more. But even the best may need some “brushing up” on their tooth-cleaning techniques from time to time.

What about flossing? While it’s an essential part of good oral hygiene, it does take a little more dexterity to do it properly. Flossing the gaps between teeth should be started when the teeth begin growing close to one another. Depending on how a child’s teeth are spaced, perhaps only the back ones will need to be flossed at first. Even after they learn to brush, kids may still need help flossing — but a floss holder (like the one Beyonce is using in the clip) can make the job a lot easier.

If you would like more information about maintaining your children’s oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”

By Drs. Jeff DiMariano & Shaina DiMariano
October 27, 2015
Category: Dental Procedures
Tags: wisdom teeth  

Teeth damaged by decay, periodontal (gum) disease or trauma are often removed (extracted) if they’re deemed beyond repair. But there’s another reason we may recommend an extraction: a tooth is causing or has the potential to cause problems for other teeth and your overall oral health.

Some of the most frequent cases of “preventive extraction” involve the third molars, or wisdom teeth, located in the very back of the mouth. They’re usually the last permanent teeth to come in, which is related to some of the problems they can cause. Because they’re trying to come in among teeth that have already erupted they don’t always erupt properly, often at abnormal angles or not fully erupting through the gums, a condition called impaction.

Impacted or misaligned wisdom teeth can put pressure on adjacent teeth and their roots, which can cause root resorption that damages the second molar. They can also increase the risk of periodontal (gum) disease in the gum tissues of the second molars, which if untreated can ultimately cause teeth and bone loss.

Because of current or possible future problems with wisdom teeth, we often consider removing them at some early point in the person’s dental development. Such a consideration shouldn’t be undertaken lightly, since wisdom teeth extraction is often complex and fraught with complications, and it usually requires a surgical procedure.

That’s why we first conduct a comprehensive examination (including x-ray or other imaging to determine exact location and possible complications) before we recommend an extraction. If after careful analysis an extraction appears to be the best course, we must then consider other factors like planned orthodontics to determine the best time for the procedure.

Once performed, a wisdom tooth extraction can resolve existing problems now and reduce the risks of gum disease or malocclusions in the future. When it comes to wisdom teeth, removing them may be in your or your family member’s best interest for optimal dental health.

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

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