My Blog

Posts for: April, 2021

By Dr. Rosanne M. Palermo
April 28, 2021
Category: Oral Health
Tags: sensitive teeth  
TreatingToothSensitivityDependsonItsCause

A scoop of ice cream is one of life's little pleasures.┬áBut for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.

A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.

This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.

This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.

Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.

If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.

If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”


PorcelainVeneersTransformRealHousewivesStarsSmileSpoiledbyTeethGrinding

Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.

Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).

Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.

So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.

There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.

And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.

Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.

If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.

If you would like more information on teeth grinding habits and their effects, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”


By Dr. Rosanne M. Palermo
April 08, 2021
Category: Dental Procedures
Tags: x-rays  
HeresWhyX-RaysareaSafePracticeWithChildren

X-rays are so interwoven into dental care that we often don't think twice about them. Even so, we shouldn't take this invisible form of radiation lightly—regular exposure at high levels can affect the human body, especially in children.

The ability of x-rays to pass through tissue greatly improves our ability to diagnose tooth decay and other dental diseases. But x-rays can also potentially harm those same tissues. Because children are more sensitive to x-ray energy, they run a greater risk for cellular damage that could lead to cancer later in life.

In reality, though, these potential risks from x-rays are extremely low—so low, in fact, dental professionals regard their use as altogether safe for children. Here's why.

The ALARA principle. Dentists and other healthcare providers perform x-ray diagnostics based on a principle known as ALARA (“As low as reasonably achievable”). This means dentists only utilize x-rays to gain the most diagnostic benefit at the lowest amounts of radiation exposure. As such, ALARA guides both the development of x-ray equipment and the protocols involved in using them.

Equipment advances. Today's x-ray devices are safer and more efficient, restricting x-ray emissions to a single beam without scattering radiation into the environment. A child's radiation exposure is further lowered with the use of digital x-rays, which produce images in less time than conventional film. Because of these and other advances, children are exposed to less radiation during x-rays than what they typically receive in a day from the outside environment.

Safe practices. Following the ALARA principle, dentists are quite conservative in their use of x-rays in children. The most common means of x-ray is the bitewing, which captures images primarily of the back teeth that are more prone to decay. Bitewings, which require a lower x-ray dosage than a full mouth x-ray, are usually spaced at least six months apart or longer depending on a child's risk for dental disease.

The efficiency of modern radiographic equipment coupled with their judicious use has drastically reduced the amount of x-ray radiation to which a child may be exposed, thus lowering their risk of future health issues. The benefit for saving a child's teeth from disease is well worth their use.

If you would like more information on x-ray safety, 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 “X-Ray Safety for Children.”