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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
April 24, 2014
Category: Oral Health
MouthguardsareYourBestProtectionAgainstSports-RelatedDentalInjuries

Whether you are a serious or “weekend” athlete, you know the importance of protecting yourself against injury. While looking after your joints, ligaments and bones may garner most of your attention, you shouldn't neglect looking after your teeth and mouth as well. In fact, there are more than 600,000 emergency room visits each year for sports-related dental injuries. A knocked out tooth could eventually cost you $10,000 to $20,000 in dental treatment during your lifetime.

The best protection is really quite simple — wear a properly-fitted athletic mouthguard. Researchers estimate that mouthguards may prevent more than 200,000 dental injuries annually. Be aware, though — not all mouthguards are alike or provide the same level of protection.

Mouthguards generally fall into three types. Stock mouthguards are the least expensive of the three, and also the least effective at protection. They come in limited sizes and can't be customized to the wearer. “Bite and Boil” mouthguards are made of thermoplastic that becomes pliable when heated (as when boiled in water). In this state the mouthguard can be pressed into the wearer's teeth, which hardens to that fit once the thermoplastic cools. However, the fit isn't exact and they don't always cover the back teeth. Also during the heat of competition, the mouthguard softens and loses some of its stability and protection.

While more expensive than the other two types, a custom-fitted mouthguard made by a dentist provides the best level of protection. Made of a tear-resistant material, they are more comfortable to wear than the other types and cover more of the interior of the wearer's mouth.

A properly fitted and worn mouthguard protects the mouth and jaw area in a number of ways. It cushions the soft tissue of the lips and gums from cuts and abrasions caused by contact with sharp teeth surfaces after an impact. It absorbs and distributes forces generated in an impact that can cause tooth loss or even jaw fracture, and also cushions the jaw joint (TMJ) to reduce the likelihood of dislocation or other trauma.

A custom-fitted mouthguard can cost hundreds of dollars, but that price is relatively small compared with the physical, emotional and financial price you'll pay for an injury. This investment in your oral health is well worth it.

If you would like more information on the use of athletic mouthguards, contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Athletic Mouthguards.”

By Drs. Jeff DiMariano & Shaina DiMariano
April 09, 2014
Category: Oral Health
DoYouHabituallyClenchorGrindYourTeeth

Clenching, or grinding of your teeth (also known as bruxing) are common habits. Biting forces are normally small, gentle, fleeting and very frequent throughout the day. In fact, it's the normal stimulus necessary to keep your teeth and jawbone healthy. When you clench or grind your teeth you apply forces up to ten times normal (in the 200 lb range). And it's not just the force, it's the duration and frequency with which they're applied. High forces lasting for seconds or minutes, frequently exerted, can affect some or all of the masticatory system. This includes the teeth, jaws, jaw joints and muscles, causing aching jaws, headaches, earaches, neck and even backaches; and the teeth themselves causing excessive wear, fractures, or even loose teeth.

Why does grinding occur? Habitual grinding is most frequently a reaction to stress. Sometimes abnormalities in your bite or malocclusion (“mal” – bad; “occlusion” – bite) can trigger clenching or grinding. It is normal for children to sometimes grind their teeth when new teeth are coming in, but it may be indications of stress too. You may be grinding your teeth subconsciously in your sleep, but it may be so loud as to awaken your sleeping partner. Or our office may be the first to suspect it during a dental exam because of the apparent signs of change to muscles, joints and teeth especially abnormal tooth wear.

What can be done about teeth grinding or bruxing? If you are symptomatic, having pain, muscle, joint or tooth soreness, the first step is to get you comfortable. Generally, a mild non-steroidal anti-inflammatory medication (aspirin, ibuprofen) and muscle relaxants will help in addition to moist heat and mild jaw exercises. Stress management is also helpful. To prevent further damage, we may recommend a bite guard made of wear-resistant plastic that fits over the biting surfaces of your upper teeth. These customized unobtrusive appliances when properly fitted and adjusted stop clenching and grinding activity, or at least the damage they can do. A bite guard can be worn day or night especially during stressful periods.

Contact us today to schedule an appointment to discuss your questions about stress and tooth grinding. You can also learn more by reading the Dear Doctor magazine article “Stress & Tooth Habits.”

By Drs. Jeff DiMariano & Shaina DiMariano
April 01, 2014
Category: Dental Procedures
Tags: dental implants  
ReplaceaLostToothforLooksandforHealth

Lose a baby tooth when you're a young kid, no big deal — you'll grow another. Lose a permanent one and there's cause for concern. For one thing, tooth loss is often a symptom of an underlying oral health problem, such as tooth decay or gum disease, so it's important to identify the cause and treat it to prevent it from progressing. It is equally important to replace the tooth — not simply for the immediate impact it can have on your smile or bite, but for long-term function, esthetics and the health of the bone that supports your teeth.

The primary options for tooth replacement are fixed bridgework and dental implants. Both result in esthetically pleasing outcomes; the main difference is how each is attached. With a bridge, the replacement tooth, referred to as a “pontic,” uses the two natural teeth on either side of the gap — referred to as “abutments” — for support. The pontic is sandwiched between two other crowns, which fit over and are bonded or cemented to the teeth on either side of the gap. To ensure the companion crowns fit properly, the enamel must be removed from each abutment.

Placing dental implants, by contrast, involves working only on the affected area. The “implant” is actually a small titanium rod with spiraling threads just like a miniature screw that is carefully inserted into the jawbone as though it were a natural root. The replacement tooth, a customized crown, is secured to the end portion of the implant by way of an intermediary referred to as an abutment, which firmly anchors it in place.

Both bridges and implants are natural looking, functional, predictable, and reliable. Each has its advantages and disadvantages, and based on your oral health, one may be more appropriate than the other.

If you would like more information on tooth loss and replacement, 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 “The Hidden Consequences of Losing Teeth” and “Dental Implants vs. Bridgework.”

By Drs. Jeff DiMariano & Shaina DiMariano
March 24, 2014
Category: Oral Health
IronChefCatCoraProtectingYourChildrensTeethStartsEarly

When Cat Cora is not doing battle as the first female chef on the Food Network's hit series Iron Chef America, she is busy caring for the needs of her four active young sons. This includes monitoring the food they eat and their oral hygiene habits.

The busy chef, restaurateur, author, philanthropist and television personality recently revealed in an interview with Dear Doctor magazine that it all started when her four sons were little. She got rid of bottles and sippy cups as soon as possible to prevent tooth decay. She also started exposing her boys to a wide variety of spices and foods when they were infants — for example, by putting cinnamon in their baby cereal. Cat limits the amount of sugar in their diet by using fruit puree in baked goods and BBQ sauces, or the natural sugar substitute Stevia. Furthermore, Cat reports, “my kids have never had fast food.”

Cat is right on target with her approach to her children's oral health. In fact, we are often asked, when is the right time to schedule a child's first dental appointment? Our answer surprises some people — especially those expecting their first child.

The ideal time to take your child to the dentist is around age 1. Why so young? A baby's first visit to the dentist sets the stage for lifelong oral health. Besides, tooth decay can start very early. Baby Bottle Tooth Decay (BBTD), as the name suggests, impacts children who often go to sleep sipping a bottle filled with a liquid containing natural or added sugars, such as formula, fruit juice or a fruity drink mix. Another condition, Early Childhood Caries (ECC), is often found in children who continuously use sippy cups (again, filled with sugary liquids), children who breast feed at will throughout the night, children who use a sweetened pacifier, and children who regularly take sugar-based oral medicine to treat chronic illness.

To learn more about this topic, continue reading the Dear Doctor magazine article “Age One Dental Visit.” Or you can contact us today to schedule an appointment. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”

By Drs. Jeff DiMariano & Shaina DiMariano
March 21, 2014
Category: Oral Health
Tags: bad breath  
BanishBadBreath

Treating bad breath is big business. Just check your local drug store or supermarket and you'll find a mind-numbing array of mints, gums, mouthwashes, sprays, strips and other products that promise to sweeten your breath and make you (or your mouth at least) irresistible. But most of these products only mask halitosis (from the Latin “halitus” – exhalation, and Greek “osis” – disease) and some even contain ingredients, like sugar, that contribute to tooth decay and gum disease. In most cases, for enduring, healthful results, nothing beats a trusty toothbrush, toothpaste and floss, used faithfully and correctly, along with periodic dental checks and cleanings.

Oral bacteria are the number one reason for noxious breath. More than 600 types inhabit our mouth, and some of them emit awful odors — predominantly volatile sulfur compounds characterized by a “rotten egg” smell) — as they consume remnants of food trapped in our mouth. Brushing and flossing regularly, especially after eating, can dislodge food trapped between teeth (interdental) and under the gums (subgingival), depriving microbes of a ready-made meal. It also disrupts the buildup of sticky plaque (microbial “biofilms”) where odor-causing germs can flourish.

When cleaning your mouth, pay special attention to the back of the tongue. It is the primary location for generating halitosis because it is drier and less efficiently cleansed by saliva and normal oral activity than the front. Our office can instruct you on proper oral hygiene including the gentle use of a tongue scraper or brush.

Sometimes more involved periodontal techniques such as scaling and root planing (deep cleaning) are called for; antibiotics may be useful in targeting the offending microbes. If tooth decay and/or periodontal (or gum) disease is contributing to halitosis appropriate treatment is necessary.

Remember that foul breath is just a symptom of some underlying condition. If diligent oral care at home doesn't do the trick, our office can help you get to the root of the problem and determine the appropriate therapy.

If you would like more information about halitosis and ways to prevent or treat it, 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 “Bad Breath.”





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