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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
August 20, 2014
Category: Oral Health
NewStudyShowsCustom-MadeMouthguardsCutConcussionInjuriesinHalf

Concussion in athletes is a topic that’s getting lots of attention recently — not only in professional leagues, but also at the level of high school, collegiate and amateur sports. Helmets are being increasingly used in both contact and non-contact sports, like skiing and biking. But when you’re looking for quality gear that gives you additional protection against head and facial injuries, do you think of getting it at the dental office?

According to some new research, you should. A study published in the journal of the Academy of General Dentistry shows that a custom-made mouthguard, obtained at a dentist’s office, is more than twice as effective against mild traumatic brain injures (MTBI) and concussions than the over-the-counter (OTC) mouthguards you can get at a sporting-goods store.

The randomized study followed six different high school football teams, with a total of 412 players. Half were assigned to wear custom-made mouthguards, while the other half used OTC types; all wore the same type of helmets. When the season ended, a total of 24 MBTI/concussion injuries were reported, for an overall rate of 5.8 percent.

But the study revealed that not all mouthguards are created equal: The incidence of concussion for players wearing OTC mouthguards was 8.3 percent, while the group with dentist-provided custom mouthguards had an incidence rate of just 3.6 percent — less than half the rate of the OTC group!

That’s a big difference — and there’s one more thing to consider: While they can give you additional protection against concussion, mouthguards are primarily designed to protect your teeth from serious injury. It is well established that athletes who wear mouthguards significantly reduce the risk of dental and facial injury. That’s why they are recommended by the American Dental Association, and why so many sports leagues and associations require their use at all levels of play.

A custom fabricated mouthguard, made from a model of your own teeth, fits you better than any generic type can; it’s also a better investment. The mouthguards we provide last much longer than the “boil-and-bite” or self-molded ones available in sporting-goods stores and big-box retailers. And if it prevents a single serious injury, a custom-made mouthguard can pay for itself many times over — not only in terms of medical bills, but also in time lost from school or work… and on the field, the trail or the slopes.

If you have questions about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

By Drs. Jeff DiMariano & Shaina DiMariano
August 15, 2014
Category: Dental Procedures
Tags: bridgework  
AFixedBridgeRemainsanEffectiveOptionforToothReplacement

If at all possible, we want to save a tooth — it’s the best outcome for your overall dental health. In many cases, we can achieve this by filling the tooth or installing a crown over it.

Unfortunately, preservation isn’t always possible if the natural tooth has been irreparably weakened by decay or trauma. Replacing the natural tooth with a life-like artificial one is the next best option: the replacement will help you regain lost function and reinvigorate your smile. Filling the missing tooth’s space also prevents neighboring teeth from drifting into it, causing further problems with function and appearance.

Dental implants are widely recognized as the best choice for tooth replacement because of their life-like qualities, durability and positive effect on bone health. Even their biggest drawback, their cost, isn’t that great an issue if you factor in their longevity — they may actually result in less dental expense over the long-term.

A dental implant, however, isn’t always a viable option. Some patients may not have enough bone mass to support an implant. Those with certain systemic diseases like uncontrolled diabetes or a weakened immune system may not be able to undergo dental implant surgery.

Fortunately, many of these patients can benefit from a fixed bridge, a restoration option that’s been used for decades. A bridge is a series of life-like crowns permanently joined like pickets in a fence. The middle crown known as the “pontic” fills the empty space left by the missing tooth. The crowns on either side of the pontic are permanently attached to the natural teeth that border the missing tooth space. Known also as “abutment” teeth, they serve as the support for the bridge.

Bridges do have one downside — the abutment teeth must be prepared by filing them down so the new crowns fit over them properly. This will permanently alter and possibly weaken the teeth. Dental implants, on the other hand, have little to no effect on adjacent teeth.

Still, a bridge remains an effective option for many people. Properly cared for, a bridge can restore function as well as enhance your smile for many years to come.

If you would like more information on bridgework as a restorative option, 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 “Crowns & Bridgework.”

By Drs. Jeff DiMariano & Shaina DiMariano
August 04, 2014
Category: Oral Health
VannaWhiteTalksDentistry

Vanna White has been a household name for the last 27+ years and is best known as the first female co-host of the game show, Wheel of Fortune. She radiates a warm, friendly, down-home appeal and says when describing herself, “what you see is what you get!” While this is quite true, there is so much more to her. She has received a star on the famous Hollywood Walk Of Fame, has starred in an NBC movie and written a book. She is even featured in The Guinness Book of World Records as TV's most frequent clapper, and most recently started her own line of yarn called Vanna's Choice with half of the proceeds going to St. Jude Children's Research Hospital. And while any one of these accolades could serve as the highlight of a lifetime for most, for Vanna they fall slightly short. Her favorite job is being mother to her son, Nicholas, and daughter, Giovanna.

The following are excerpts taken from an exclusive interview in Dear Doctor magazine, the premier oral healthcare resource for patients and consumers.

What is the secret to her dazzling smile?
Vanna's oral healthcare routine is the same today as it has been since her childhood — and one everyone can follow. She brushes her teeth at least twice a day (morning and at bedtime) and flosses her teeth daily. She also has strong feelings about flossing. “I think that flossing is the most important thing. I believe that dental floss helps a lot as it keeps your gums strong and looking younger.”

What about bleaching, has she done it?
Absolutely! Vanna bleaches her teeth once or twice a year to help retain her naturally white teeth and to offset any discoloration from coffee and an occasional glass of red wine. “I have done over-the-counter and professional bleaching, but I do like the trays my dentist made because they fit perfectly.” She also states, “Anything you can do professionally is probably better because I would assume that a dentist's ingredients are stronger than over-the-counter products.”

Has she had any cosmetic dentistry?
When it comes to answering a question about cosmetic dentistry, Vanna is just as open and honest as she is about everything else — a trait for which she is known. “I had a bridge put in probably 30 years ago, where I had a tooth pulled and there was a space. And I did have a little tiny chip on one of my front teeth years ago that my dentist fixed. But that is it. Again, I feel very fortunate to have good teeth. The braces [from her childhood] straightened them out and there has been no need for any cosmetics since then.”

Does she do anything to protect her teeth?
While she admits to occasionally forgetting to use her nightguard, a protective mouthguard worn during sleep, she firmly believes in their need. “I do sleep in a nightguard because I grind my teeth. I have a filling in the back that probably has been filled five times from grinding.” She added, “Both of my children do have mouthguards that they wear for their sports.”

Want a smile like Vanna's?
Contact us today to schedule an appointment or to discuss your questions about bleaching, cosmetic dentistry or mouthguards. You can also learn more about Vanna by reading the entire interview in the Dear Doctor article, “Vanna White — The Smile Defining America's Favorite Game Show — Wheel Of Fortune.”

By Drs. Jeff DiMariano & Shaina DiMariano
August 01, 2014
Category: Dental Procedures
Tags: fillings  
FrequentlyAskedQuestionsaboutInlaysandOnlays

Q: I’ve never heard these terms used in dentistry. What are they?
A: In the decorative arts, an inlay refers to a small piece of distinctive material that’s set into a larger matrix: a mother of pearl accent worked into the lid of a wooden box, for example. In dentistry, it means something similar: a filling (or restoration) that’s fabricated in a dental laboratory, and then set into a tooth in an area that has been damaged or lost.

Q: What’s the difference between inlays and onlays?
A: An inlay is made to fit in between the cusps (small points or ridges) of a back tooth (molar or premolar), and it covers only a small region of the biting surface of the tooth. If the restoration covers one or more of the cusps, it’s an onlay.

Q: Why would I need to have one of these restorations?
A: When a tooth has suffered damage (from decay or trauma, for example), and the affected area is too large to fill with a simple filling — but not large enough to need a full crown (cap) — then an inlay or onlay may be just right. Both of these procedures are considered “indirect fillings,” because the restoration itself is custom-fabricated in a laboratory and then bonded to the tooth in the dental office.

Q: What is the procedure for getting an inlay or onlay?
A: It’s similar to having a crown placed, in that it typically takes more than one office visit — yet an inlay or onlay involves less removal of tooth structure than a crown would require. On the first visit, after the area has been anesthetized (usually with a numbing shot), any decay is removed, and the tooth is shaped to receive the restoration. Next, a model of the tooth is made (either with putty or in digital form), and the tooth receives a temporary filling. The laboratory uses this model to create the actual inlay or onlay, which may take a few days; it is then permanently attached to the tooth on a second visit to the office. However, with today’s advances in CAD/CAM (computer aided design/ manufacturing) technology, some inlays or onlays can be made in the office and placed in the same visit.

Q: What else do I need to know about these tooth restorations?
A: Both inlays and onlays are strong and long-lasting restorations that need no more care than you would normally give your teeth: namely, regular brushing and flossing, and periodic checkups at our office. But because they don’t require the removal of a great deal of natural tooth material, they are considered relatively conservative treatments. After a thorough dental examination, we can recommend the type of tooth restoration that’s most appropriate in your individual circumstances.

If you’d like to find out more about inlays or onlays, please contact us or schedule an appointment for a consultation. You can also read the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “The Natural Beauty of Tooth Colored Fillings.”

By Drs. Jeff DiMariano & Shaina DiMariano
July 23, 2014
Category: Dental Procedures
Tags: crown  
CrownsPreservetheToothWhileOfferingGreaterProtectionThanaFilling

The preferred outcome when treating a tooth for decay is to preserve it. If the disease is still in its early stages, we can accomplish this effectively by removing diseased tissue and then restoring the remaining tooth with filling material.

There comes a point, however, when filling a tooth isn’t the best option. If it has already received several fillings, the tooth may have become too weak to receive another. Additionally, a filling may not be enough protection from further fracture or infection for teeth weakened from trauma or abnormal tooth wear or in the event a root canal treatment is necessary.

While a diseased tooth can be extracted and replaced with a durable and aesthetically pleasing dental implant, there may be another option to consider — installing a crown. Like a filling, a crown preserves what remains of a natural tooth, but with better protection, life expectancy and appearance than a filling.

Known also as a cap, a crown completely covers or “caps” a natural tooth. They’re produced in a variety of styles and materials to match the function and appearance of the capped tooth and adjacent teeth. Crowns made of porcelain are ideally suited for visible teeth because of their resemblance to tooth enamel. A less visible tooth that endures more biting force (like a back molar) may need the strength of a precious metal like gold or new-age porcelains that can also withstand significant biting forces. There are also hybrid crowns available that combine the strength of metal for biting surfaces and the life-like appearance of porcelain for the more visible areas of a tooth.

To prepare a tooth for a crown, we first remove any decayed structure and add bonding material to strengthen what remains. We then make a mold of the tooth and bite, which is typically sent to a dental technician as a guide for creating the permanent crown. Recent advances with digital technology have also made it possible to mill the permanent crown out of porcelain in the dental office while you wait.

After the permanent crown is received and permanently bonded to the tooth, you will have a protected and fully functional tooth. From this point on it’s important for you to clean and care for it as you would any other tooth since the underlying tooth is still at risk for decay. The good news is your tooth has been saved with a bonus — a long-term solution that’s also smile-transforming.

If you would like more information on crowns and other tooth restorations, 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 “Crowns & Bridgework.”





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Sacramento Office - 916-929-3898
Folsom Office - (916)-983-6655