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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
September 29, 2014
Category: Dental Procedures
ChippedTeethHarmoniouslyMadeGoodasNew

“Break a leg” is a well-known theatrical expression for wishing good luck to an actor about to go on stage. Singers should have one of their own…“Chip a tooth”! Apparently collisions between microphones and pearly whites are an occupational hazard for crooners. Taylor Swift became one of the latest casualties during a concert in Pittsburgh while belting out her hit “I Knew You Were Trouble.” The consummate professional, she didn’t miss a beat and kept on singing despite seeing a tooth chip hit the floor.

After all, while chipping a tooth is an inconvenience, it’s not a permanent smile wrecker. Modern dentistry offers several options for restoring a damaged tooth to its original symmetry and luster, or even better!

Bonding
Dental cosmetic bonding is the quickest and lowest-cost option to repair a chip. This involves application of a composite filling material that is colored and shaped to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed.

Veneers
A veneer can be used for slightly larger areas or discolored teeth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface may be necessary to fit a veneer so it is flush with the surfaces of surrounding intact teeth.

Crowns
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.

If you would like more information about repairing a chipped tooth, 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 “Artistic Repair of Front Teeth With Composite Resin.”

By Drs. Jeff DiMariano & Shaina DiMariano
September 26, 2014
Category: Dental Procedures
Tags: dental implants  
FrequentlyAskedQuestionsaboutFixedDentures

Q: Is there much of a difference between fixed and removable dentures?
A: There’s a BIG difference! Removable dentures are the type your grandparents might have had — and possibly their grandparents, too. They work well enough after you get used to them, but there’s always the issue of slippage, poor fit, limited function… and potential embarrassment. Modern fixed dentures, however, get their stability from today’s state-of-the-art system for tooth replacement: dental implants. They won’t loosen or slip, they function and “feel” like your own natural teeth, and they can last for years and years to come.

Q: How are fixed dentures supported?
A: Each arch (set of teeth comprising the top or bottom jaw) of a fixed denture is anchored into the jaw bone by four or more dental implants. These small screw-like devices, made of titanium metal, are placed into the jawbone in a minor surgical procedure. Once set in place, they remain permanently attached by both mechanical forces and osseointegration — the process in which living bone cells actually become fused with the metal implants themselves.

Q: What is the procedure for getting dental implants like?
A: Before having any work done, you will receive a thorough examination and have a set of diagnostic images made. Implant surgery is normally performed in the dental office, using local anesthesia or conscious sedation. If any failing teeth must be extracted (removed), that will be done first. Next, small openings are made in the gums and the jawbone, and the implants are placed in precise locations. Sometimes, a set of temporary teeth can be attached to the implants immediately; other times, the implants will be allowed to heal for a period of time.

Q: Besides added stability, are there other advantages to fixed dentures?
A: Yes! As they become integrated in the jaw, dental implants actually help preserve the quantity and quality of bone in the jaw; removable dentures, on the other hand, decrease bone quantity and quality. This is important because the jawbone plays a vital role in supporting facial features like lips and cheeks. When the facial features lose support, it can make a person look prematurely aged. Also, people who wear removable dentures often have trouble eating “challenging” foods like raw fruits and vegetables (which are highly nutritious), and opt for softer, more processed (and less nutritious) foods. With fixed dentures, however, you can eat the foods you like.

Q: Aren't fixed dentures with dental implants more expensive?
A: Initially, the answer is yes — but in the long run, they may not be. Unlike removable dentures, which inevitably need to be re-lined or remade as the jawbone shrinks, fixed dentures can last for the rest of your life. They don’t require adhesives or creams, and you will never have to take them out at night and clean them. In fact, you can think of them as a long-term investment in yourself that pays off with a better quality of life!

If you’d like more information on fixed dentures, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Dental Implants: Your Best Option for Replacing Missing Teeth.”

By Drs. Jeff DiMariano & Shaina DiMariano
September 18, 2014
Category: Oral Health
Tags: dental anxiety  
EncounteringPositiveExperiencestheKeytoOvercomingDentalAnxiety

If you’re apprehensive about visiting the dentist, you’re not alone. Studies show a majority of us — as high as 75% — have experienced some form of anxiety about dental treatment. Between 10% and 15% of those have a high degree of anxiety that may cause them to avoid visiting the dentist altogether.

If you’ve experienced this level of anxiety, you weren’t born with it. Such fears develop from early experiences with dentistry, or from stories or attitudes relayed to us by others. While this undue emotional stress could adversely affect your general health, the greater threat is to your oral health, if it causes you to avoid dental care altogether.

Fortunately, anxiety from the thought of dentistry can be overcome. The best approach is relatively simple — counteract the bad experiences of the past with new, more positive experiences. Moderate dentistry should be able to completely eliminate any discomfort during treatment. And with each new good experience, your feelings and attitudes will gradually change over time for the better.

The first step is to discuss your anxiety about dental care with us. It’s important to establish trust with your care provider from the outset if you want to successfully overcome your anxiety. We will listen and not discount or diminish the reality of your fears and their emotional and physical effect; instead, we will work with you to include overcoming anxiety as a part of your treatment plan.

The next step is to proceed with treatments and procedures you feel you can easily undergo, so that at the end of each visit you’ll have a more positive view of that particular treatment (and that you could undergo it again). We won’t rush to complete treatments until you’re ready for them. Although this may extend the duration needed to complete a procedure, it’s important for us to proceed at a pace more conducive to creating and reinforcing new positive feelings and attitudes about dental visits.

In the end, we want to do more than treat an immediate or emergency-related dental condition. We want to help you overcome the anxiety that has kept you from seeking long-term dental care — and thus better dental health — a part of your life.

If you would like more information on overcoming dental treatment anxiety, 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 “Overcoming Dental Fear & Anxiety.”

By Drs. Jeff DiMariano & Shaina DiMariano
September 10, 2014
Category: Oral Health
Tags: oral health  
OralPiercingsFiveThingsYouShouldKnow

Whether you think they're the height of fashion or the depth of “ice,” oral piercings like tongue bolts are a sign of our times. But along with these bodily adornments come a host of questions about risks to the wearer's health, both immediate and long-term. To help sort out these concerns, here are five facts everyone ought to know about oral piercings.

Oral piercings can cause acute health problems.

Rarely, nerve problems may result from an oral piercing. In at least one case, a teenager who had just gotten a tongue bolt developed severe facial pain and the feeling of electrical shocks. A neurologist traced these symptoms to an irritated nerve in the tongue, and the bolt's removal made the pain go away. More commonly, however, the immediate problems are soreness in the area of the piercing, bleeding in the mouth, and the risk of infection.

Oral piercings can lead to gum disease.

Periodontal problems associated with oral piercings include gum recession, inflammation, and even infection. Long-term bone loss may also be an issue. Over time, all of these conditions may affect a person's general health.

Oral piercings can lead to tooth problems.

Tooth pain and sensitivity are sometimes reported after the installation of an oral piercing. Chipping of the teeth is also a possibility, due to repeated contact with the metal of the ornament. People who decide to wear oral piercings should consult with us about increasing the frequency of their dental checkups.

Closing the hole left by a tongue piercing may require minor surgery.

As is the case with an ear piercing, the hole made for a tongue bolt often closes on its own. If it doesn't, a little surgery may be required to help it. In some cases, the tissue around the piercing may need to be removed before the hole itself can be sewn closed. Carried out under local anesthesia (a numbing shot), however, the procedure is usually simple and quick to heal.

Removing an oral piercing improves your oral health.

Losing the piercing reduces your risk factors, and thus improves your oral health. It's as simple as that. But any decision about oral piercings is ultimately yours to make. You should have a frank conversation about its risks and benefits with a knowledgeable health professional.

If you would like more information about oral piercings, 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 “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”

By Drs. Jeff DiMariano & Shaina DiMariano
September 02, 2014
Category: Dental Procedures
PadmaLakshmisSmileARecipeforBeauty

Before she began hosting the long-running TV competition Top Chef, Padma Lakshmi was a well-known model and successful cookbook author. (Appropriately, she is said to have been “discovered” by a modeling agent while sitting in a café in Madrid.) Yet the Indian-born beauty's striking look — at once exotic and familiar — doesn't come from any cookie-cutter mold.

So when Lakshmi had cosmetic work done on her teeth, early in her career, her dentist didn't use a cookie-cutter approach either: Instead, her smile was carefully designed, using small amounts of bonding material to brighten her teeth and to bring their shape and spacing into harmony with her facial features.

Dentistry by Design
What exactly is smile design — and what could it do for you? Essentially, it's the process of evaluating your smile in concert with the appearance of your entire face, and visualizing the changes — some dramatic and some subtle — that will make it really shine. Some aspects we consider include the face's shape, the proportion or “balance” of facial features, the complexion, eye and lip color and form, and the overall dimensions of the smile.

Based on dental aesthetics and clinical experience, we will probably have a number of suggestions to make on how you can improve your smile. Your input will also be very important; while some individuals prefer perfectly even teeth and a sparkling “Hollywood white” smile, others are looking for a result that's more in keeping with a “natural” look: slight irregularities in tooth shape, spacing, and even color.

There's no right or wrong answer here: Having a “perfect” smile means what's perfect for you, so it's very important for dentists and patients to communicate openly during the smile design process. But sometimes, words alone just aren't enough to convey the subtle dimensions of beauty.

The Trial Smile
Fortunately, it's now possible to preview your “perfect” smile using a number of different techniques. Advances in computer imaging make this the first step in previewing your new smile — you can see the changes before a single tooth is touched! Still, many people find that having a more concrete picture is helpful. The next step is to make a 3-D mock-up the proposed dental work on an actual model of your mouth. That way, you can see a physical representation of the final results — and even turn it around and hold it in your hands.

There's still one more way to really experience the difference cosmetic treatments can make without committing to a permanent change: the provisional restoration. Here, tooth-colored bonding material and other techniques are used to actually create the new smile — temporarily. This gives you time to “live with it,” and see if the proposed changes work for you. If everything goes well with the provisional work, the permanent restoration is guaranteed to please.

So if you want holiday treats, get out the cookie cutter — but if you're looking for a smile that's uniquely yours, and one that enhances your own individual appearance… call our office and ask about a smile design consultation. You can learn more in the Dear Doctor magazine articles “Great Expectations — Perceptions in Smile Design” and “Beautiful Smiles by Design.”





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