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(916) 929-3898
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900 E. Bidwell St. #400
Folsom, CA 95630
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By Drs. Jeff DiMariano & Shaina DiMariano
February 27, 2015
Category: Dental Procedures
HilaryDuffsChippedFrontTeethRepairedwithVeneers

Many Hollywood luminaries use porcelain veneers to enhance their smiles. Take actress and singer Hilary Duff, who, according to People magazine, had veneers placed on her two front teeth after chipping them on a microphone during what must have been an extremely energetic performance.

Well, you don't have to be a Hollywood star to benefit from a smile enhanced with porcelain veneers. If you have small chips, cracks, slight tooth rotations or minor spacing problems, veneers may be able to give you back your smile — or an even better one.

The word “veneer” refers to a super-thin covering, and in dentistry a veneer is a thin layer of porcelain that replaces your natural tooth enamel. Porcelain is the material of choice because of its strength, translucency, and ability to resist erosion.

In the right hands, dental porcelain can mimic tooth enamel perfectly. To make veneers, a skilled dental technician will mix porcelain powder (in a shade specified by the dentist) with water and then fire the material in an oven like pottery; the porcelain is built up in layers for a truly lifelike effect.

Before a veneer is bonded to a tooth, often we need to remove a tiny bit of the tooth's existing enamel so that the final effect will not be too bulky. The procedure is virtually painless and can be completed in as little as two visits. Because enamel is removed, this particular cosmetic treatment is not reversible. Sometimes veneers can be added directly onto the tooth surface without any tooth reduction and therefore are reversible if used in this way.

Once you have veneers, please keep in mind that while extremely strong, porcelain veneers are not indestructible; you won't want to do things like crunch ice or break nuts open with your teeth. And if you are a teeth-grinder, you should wear a nightguard to protect your beautiful new smile. With proper care, your veneers will last 20 years or more.

If you would like more information about porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced With Porcelain Veneers.” Dear Doctor also has more on “Cosmetic Dentistry: A Time For Change.”

By Drs. Jeff DiMariano & Shaina DiMariano
February 19, 2015
Category: Oral Health
Tags: oral hygiene   mouthrinse  
ChooseaMouthrinseCarefullyifyouwanttoEnhanceyourDentalHealth

Many people use a mouthrinse as part of their daily oral hygiene. If you’d also like to include a mouthrinse in your regimen, the kind you choose will depend on what you want it to do for you.

If your main desire is fresh breath, then a cosmetic rinse that imparts a minty smell to the mouth should fit the bill. That, however, is all they do — cosmetic mouthrinses don’t contribute to oral health beyond your personal satisfaction that your breath is free of bad odors. But, if you want more — added protection against dental disease, for example — then you’ll need to consider a therapeutic mouthrinse.

Therapeutic mouthrinses are usually described as anti-cariogenic (prevents decay) or anti-bacterial, and include both over-the-counter (OTC) and prescription rinses. Their purpose is to either strengthen teeth or reduce the mouth’s bacterial levels. Of the OTC variety, most contain a small amount of sodium fluoride, which can strengthen tooth enamel. They’ve proven highly effective: a number of studies show using a sodium fluoride mouthrinse in conjunction with brushing and flossing reduces the chances of new cavities forming.

A number of OTC rinses also have an anti-bacterial effect, usually provided by active ingredients such as triclosan, zinc or essential oils like menthol. Even a slight reduction in bacteria can help lessen the chances of gingivitis (gum inflammation), an early form of periodontal (gum) disease. Reducing bacteria levels may also help alleviate bad breath.

Some individuals, though, have higher than normal levels of bacteria, or a systemic weakness in fighting certain bacterial strains. If this is your case, you might benefit from a prescribed mouthrinse intended to lower bacterial levels. Most prescription mouthrinses contain chlorhexidine, which has been amply demonstrated as an effective anti-bacterial control of tooth decay and gum disease. Chlorhexidine prevents bacteria from adhering to the teeth and so disrupts plaque buildup, the main cause of dental disease. Its prolonged use will result in the dark staining of teeth in some people, but this can be removed during dental cleanings and teeth polishing. Long-term use is generally not preferred compared to getting the proper attention from regular cleanings and examinations.

If you would like more advice on adding a mouthrinse to your daily hygiene regimen, especially to help reduce your risk of dental disease, please feel free to discuss this with us at your next checkup. Regardless of which type of mouthrinse you choose, they should always be used as a complement to daily brushing and flossing, along with regular dental cleanings and checkups.

For more information on mouthrinses, 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 “Mouthrinses.”

By Drs. Jeff DiMariano & Shaina DiMariano
February 11, 2015
Category: Dental Procedures
Tags: smile makeover  
TeethMakeaPicture-PerfectSmile

When you’re posting a profile photo on LinkedIn, Facebook, Match.com and other social media sites, which shot is likely to make the best impression in terms of “likeability,” “competence” and “influence”? One in which you’re smiling and showing some teeth, for starters, according to PhotoFeeler.com, a crowdsourcing website that helps people evaluate their head shots. If something about your teeth is holding you back from parting your lips when you smile for the camera, here are some tried-and-true options for doing something about it!

Picture-Perfect Color, Shape and Alignment

Improving the color of your teeth may be as easy as getting regular professional cleanings, which are necessary for removal of calculus — dark-yellow hardened buildup of bacterial plaque — and can polish out superficial staining caused by certain beverages and foods.

Actually changing the color of your teeth entails whitening/bleaching. Professional whitening achieves the fastest results because it uses the highest concentration of peroxide solution and custom-fitted trays. In-home whitening kits take longer to work but are less expensive. Results last anywhere from six months to two years.

For permanent whitening results, consider veneers or crowns. In addition to changing tooth color, they can also alter tooth shape, hide wear and even minimize gaps between teeth. Veneers are affixed to the front of teeth, while crowns cover the entire tooth.

Teeth that are chipped, cracked or have noticeable areas of decay, can be restored with bonding, in which a composite resin material is applied that is colored to match your natural teeth.

You can straighten misaligned teeth and no one even has to know you’re doing it. Barely visible and entirely invisible orthodontic appliances include clear braces, lingual braces (attached to the tongue-facing side of teeth) and clear aligners, which are removable for tooth brushing/flossing, cleaning the appliance, eating, and special occasions.

If you would like more information about enhancing your smile, 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 “Beautiful Smiles by Design.”

By Drs. Jeff DiMariano & Shaina DiMariano
February 03, 2015
Category: Dental Procedures
Tags: dental implants  
IssuestoConsiderBeforeDentalImplants

With their durability, versatility and life-likeness, there’s no doubt dental implants have revolutionized teeth replacement. If you’re considering dental implants, however, there are some issues that could impact how and when you receive implants, or if you should consider another type of restoration.

Cost. Dental implants are initially more expensive than other tooth restorations, especially for multiple tooth replacement. However, be sure you consider the projected cost over the long-term, not just installation costs. Because of their durability, implants can last decades with little maintenance cost. In the long run, you may actually pay more for dental care with other types of restorations.

Bone health. Dental implants depend on a certain amount of bone to properly situate them for the best crown placement. If you’ve experienced extensive bone loss, however, there may not be enough to support the implant. This can often be overcome with grafting — immediately after extraction, at the time of implantation or a few months before implantation — to encourage bone growth. In some cases, though, bone loss may be so extensive you may need to consider an alternative restoration.

Gum Health. While implants themselves are impervious to infection, they’re supported by gum and bone tissues that can be affected. Infected tissues around an implant could eventually detach and lead to implant failure. If you have periodontal (gum) disease, we must first bring it under control and render your gums infection-free before installing implants. It’s also important to maintain effective oral hygiene and regular dental cleanings and checkups for optimum implant health.

Complications from osteoporosis. People with osteoporosis — in which the bones lose bone density and are more prone to fracture — are often treated with drugs known as bisphosphonates. In less than 1% of cases of long-term use, a patient may develop osteonecrosis in which the bone in the jaw may lose its vitality and die. As with bone loss, this condition could make implant placement difficult or impractical. Most dentists recommend stopping treatment of bisphosphonates for about three months before implant surgery.

If you have any of these issues or other complications with your oral health, be sure to discuss those with us before considering dental implants. With proper planning and care, most of these difficulties can be overcome for a successful outcome.

If you would like more information on pre-existing conditions that may affect implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Osteoporosis & Dental Implants” and “Infections around Implants.”

By Drs. Jeff DiMariano & Shaina DiMariano
January 26, 2015
Category: Oral Health
TVsNateBerkusDiscussesDentalSealantsFluorideTreatmentsandFlossing

Nate Berkus, author, interior designer and host of his own television program, The Nate Berkus Show, is a consummate professional who has always focused on “helping others love the way they live,” as he puts it. Berkus is known as one of America's most beloved go-to-guys for inspiration on the latest design trends. And then there is his captivating smile.

In an exclusive interview with Dear Doctor magazine, Berkus discusses his trademark smile. Unlike most people in Hollywood, his smile is totally natural — he never wore braces or had any cosmetic work. However, Berkus does give credit to his childhood dentist for the preventative healthcare he received as a young boy. Berkus states, “I'm grateful for having been given fluoride treatments and sealants as a child. Healthy habits should start at a young age.”

As for his oral hygiene routine today, Berkus says he brushes his teeth at least two times a day, and sometimes three times a day. Berkus is also an avid “flosser” and follows the important flossing advice he learned from his dentist: “Floss the ones you want to keep.”

In addition to his design expertise, Berkus is right on the mark with his opinions on oral hygiene. In fact, he inspired our office to put together the following list of facts and oral health tips:

  • The first step in improving your oral health is to learn good oral hygiene behavior. Simply put, to maintain optimal oral health, you must brush and floss properly so that you thoroughly remove the dental plaque.
  • The second step is a thorough evaluation system. We are a key part of this step. During your next office visit, we can conduct a thorough examination, review your brushing and flossing techniques, examine the health of your tongue and discuss any questions you have. We can also clean your teeth and ensure that you leave our offices confident with your new oral hygiene routine. And if you don't have an appointment, contact us today to schedule one.

To learn more about improving your oral hygiene, you can continue reading the Dear Doctor magazine article “Oral Hygiene Behavior - Dental Health For Life.” And to read the entire interview with Nate Berkus, please see the article “Nate Berkus.”





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