These are the people that help give our practice the friendly, warm feeling we strive for, while giving you the best possible dental care.
1610 Arden Way #157
Sacramento, CA 95815
(917) 646-6315 fax
900 E. Bidwell St. #400
Folsom, CA 95630
(916) 983-1079 fax
Find helpful information in our digital library.
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DiMariano Family Dentistry
Sometimes, we all need a bit of prompting to do what's good for us. When Serena Girardi, the 10-year-old daughter of New York Yankees manager Joe Girardi, needed to have orthodontic treatment, she was a little nervous. To help lessen her anxiety, Girardi, then 45 years old, made a deal: if she got braces, then he would too.
“What I didn't realize,” said Girardi in an interview with ESPN, “is that she only had to get four on her front teeth and I got the full mouthful.”
But that didn't stop the baseball great from keeping up his end of the bargain. In a separate deal with his son Dante, who also needed braces, Girardi agreed to wear blue rubber bands. “It's a good look,” he said. What will he do if his third child needs braces? Stay tuned...
Whether it starts as a bargain with your kids or as a promise to yourself, orthodontic treatment can offer real benefits at any age. In fact, about one out of five orthodontic patients today is an adult. Studies have shown that up to three-quarters of all adults have some form of orthodontic problem, like drifting or crowding of teeth. And having a great-looking smile not only improves self-confidence, but can also boost an adult's social life, and even enhance his or her career opportunities.
If you or your child may need braces, but you're put off by the dreary metal hardware you remember from back in the day, take heart! Plenty has changed in the field of orthodontics since you were a teenager — and it's not just the color of the rubber bands.
In many cases, clear or colorless ceramic braces can be used instead of metal ones. These stain-resistant orthodontic appliances blend in well with your own teeth, making them much less evident. It may be possible for them to be placed on the lingual (tongue) side of the teeth, where they're even less visible.
Clear aligners offer an alternative to braces that's appropriate for some people. Aligners are a series of precision-made “trays” composed of polyurethane plastic. Worn 20-22 hours per day for a period of months, these appliances gradually move teeth into an improved position. Besides being virtually invisible, another advantage of these trays is that they may be removed for eating and for important occasions. Once recommended only for adults, they have recently become available to teenagers as well.
What's the best way to find out whether you or someone in your family could benefit from orthodontics, and which treatment option best suits your individual needs? Come in to our office for a consultation! After a thorough examination, we would be happy to recommend the most appropriate treatment methods for your particular situation.
If you have questions about orthodontic treatment, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Clear Aligners for Teenagers.”
While periodontal disease can take on a variety of forms, most are caused by a thin layer of bacterial plaque called biofilm. This layer of plaque will form every 8-12 hours and sticks like glue to your teeth near the gum line. With time, tartar formation occurs at and below the gum line.
If left unchecked, biofilm can give rise to a very unhealthy progression. It first triggers an infection that leads to painful inflammation, progressive bone loss and the gum tissue losing attachment with a tooth. Void spaces (or pockets) form where the gum and bone tissue once adhered; infectious plaque and tartar moves into these pockets and advances deeper to the root. Overcome by disease, the tooth is in danger of being lost.
It's imperative then to remove as much of this entrenched plaque and tartar as possible. Renewed oral hygiene is not enough — removing plaque and tartar from the root surfaces requires a treatment known as root planing.
Root planing is a meticulous, labor-intensive process. We first clear away larger portions of plaque around the teeth and gums with hand instruments or an ultrasonic device and then flush out the pockets with water. After administering a local anesthetic for pain, we would then turn to a number of small hand instruments known as curettes to probe and scrape away as much remaining plaque below the gum line as we can get to.
Root planing requires experience and a good sense of touch to work in areas that can't be clearly seen. Observing the gum line, though, can give us a good indication of progress as these tissues will actually change color once the biofilm and tartar deposits have been removed.
Being so deeply entrenched, not all the deposits might be removed during one session. However, as plaque and tartar are removed, the gum tissues will begin to heal and become less inflamed. This will make it easier to remove plaque in subsequent sessions.
Root planing takes time, but the effort is well worth it. In the short term you'll notice less inflammation and pain around your teeth and gums. In the long-term, it just may save your teeth.
If you would like more information on root planing and periodontal disease, 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 “Root Planing.”
If your infant is extra cranky and seems to want to chew everything in sight, it's a good bet that the first tooth is on the way! For parents, this is cause for both celebration and concern. After all, no parent wants to see a child suffer even a little bit. Decades ago, when a teething infant showed signs of discomfort, a parent might have rubbed some whisky or other strong liquor on the child's gums — a misguided and dangerous practice. There are far safer, more effective ways to help your child through this exciting yet sometimes uncomfortable phase of development. Here are our top five teething remedies:
Chilled rubber teething rings or pacifiers. Cold can be very soothing, but be careful not to freeze teething rings or pacifiers; ice can actually burn the sensitive tissues of the mouth if left in place too long.
Cold, wet washcloths. These are great for gnawing on. Make sure the washcloth is clean and that you leave part of it dry to make it more comfortable to hold.
Cold foods. When your child is old enough, cold foods such as popsicles may soothe sore gums. However, make sure you confine them to mealtimes because sugars can cause tooth decay — even in very young children.
Gum massage. Massaging inflamed gums with your clean finger can help counteract the pressure from an erupting tooth.
Over-the-counter medicine. If teething pain persists, you can give your baby acetaminophen or ibuprofen, but check with a pharmacist or this office for the correct dosage. The medicine should be swallowed and not massaged into the sore areas, as this, too, can burn.
So when does it all begin? Some babies start teething as early as three months or as late as twelve months, but the typical time frame is between six and nine months. Usually the two lower front teeth erupt first, followed by the two upper front teeth. The first molars come in next, followed by the canines (eyeteeth). Most children have all 20 of their baby teeth by age 3.
If you have any questions about teething or the development of your child's teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Teething Troubles.”
Is it a root canal problem, a gum infection, or both?
Sometimes it's difficult to pinpoint the source of tooth pain; it can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Identifying the origin of a toothache is important, however, so we can choose the right treatment and do all that we can to save the tooth.
When a tooth becomes decayed, bacteria can infect the sensitive, living nerve tissue deep inside the tooth known as the root canal. This condition is called an endodontic (“endo” – inside; “dont” – tooth) problem. The infection inside the tooth can spread to the periodontal ligament (“peri” – around; “dont” – tooth) that encases the tooth and attaches it to the jawbone. Occasionally, infection of endodontic (root canal) origin can spread out from the end of the tooth root all the way up the periodontal ligament, and into the gum.
The reverse can also happen: dental pain can originate from periodontal (gum) tissues that have become diseased. Gum disease is caused by a buildup of bacterial biofilm (plaque) along the gum line. It results in detachment of the gums along the tooth surface. In advanced cases, this bacterial infection can travel into the nerve tissues of the dental pulp through accessory canals or at the end of a tooth.
To figure out where pain is coming from when the source is not obvious, we need to take a detailed history of the symptoms, test how the tooth reacts to temperature and pressure, and evaluate radiographs (x-ray pictures).
Unfortunately, once dental disease becomes a combined periodontal-endodontic problem, the long-term survival of the tooth is jeopardized. The chances for saving the tooth are better if the infection started in the root canal and then spread to the gums, rather than if it started as gum disease that spread into the root canal of the tooth. That's because in the latter case, there is usually a lot of bone loss from the gum disease. Effectively removing plaque from your teeth on a daily basis with routine brushing and flossing is your best defense against developing gum disease in the first place.
If you would like more information about tooth pain, gum disease or root canal problems, please contact us or schedule an appointment for a consultation. You can also learn more about this diagnostic dilemma by reading Dear Doctor magazine's article “Confusing Tooth Pain.”
Fans of the classic bumbling-buddies comic film “Dumb and Dumber” will surely remember the chipped front tooth that Jim Carrey sported as simpleminded former limo driver Lloyd Christmas. Carrey reportedly came up with the idea for this look when considering ways to make his character appear more “deranged.” He didn't need help from the make-up department, however… He simply had his dentist remove the dental bonding material on his left front tooth to reveal the chip he sustained in grade school!
Creating a Bond
A dental cosmetic bonding involves application of a composite filling material that our office can color and shape 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. This is the quickest and lowest-cost option to repair a chip.
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.
A veneer can be used to hide smaller areas of missing tooth. 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 also may be necessary to fit a veneer.
A chipped tooth makes an impression, but generally not a flattering one. Nearly 20 years after “Dumb and Dumber” hit the theaters, the only thing Jim Carrey had to do recently to hint at a sequel for his nitwitted character was tweet a photo of that goofy grin!
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.”
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