By Michael Wolfgram, DDS
March 16, 2018
Category: Dental Procedures
Tags: celebrity smiles   braces  

Have you started orthodontic treatment recently? Are you having a little trouble getting used to your braces? If so, you are not alone: Everybody goes through an adjustment period during which they momentarily wonder if they’ll really ever get used to this. Don’t worry — you will! And we’ve never heard anyone say, on the day their braces come off and their new smile is revealed, that they aren’t glad they went the distance. Just ask Houston Rockets all-star center Dwight Howard, who discussed his own orthodontic treatment in a recent interview.

“I’m sure I was no different than anyone else who has ever had braces,” he told Mediaplanet. “At first I hated them so much… That changed once I got used to them and I actually grew to love them.” What’s Howard’s advice? “Do exactly what your orthodontist says and know that the outcome is well worth it in the end.” We couldn’t agree more! Here are some tips for wearing braces comfortably:

  • Hard & Chewy Foods: If you love fresh fruits and vegetables, that’s great; there’s no reason to give them up, just the really hard ones. You don’t want to bite into an apple or carrot or any other hard foods like bagels and pizza that have any “size” to them. Small pieces may be ok as long as they can’t bend your wires. Chewy, sticky candy should really be avoided completely. Same with soda, sports drinks and so-called energy drinks because they contain acids that promote tooth decay and can cause a lot of damage around the braces.
  • Effective Oral Hygiene: Keeping your teeth clean is more important than ever, but also more challenging than ever. It’s easy for food to get stuck under wires and around brackets, but failing to remove it can cause tooth decay, gum irritation and soreness. Therefore, the cleaner your teeth and your braces are, the healthier you will be. Use interdental cleaning brushes and/or a floss-threader to get behind your wires. A mouthrinse can also help strengthen teeth and keep bacteria in check. If you have any questions about how to clean between your teeth, please ask for a demonstration at your next visit.
  • Pain Relief: Some soreness at the beginning of orthodontic treatment is normal. To relieve it, you can use an over-the-counter pain reliever and/or a warm washcloth or heating pad placed on the outside of the jaw. If brackets or wires are rubbing against the inside of your cheeks or lips, try applying wax to these areas of your braces. If this does not offer enough relief, we may be able to trim the end of a poking wire. Call us if you need help with this.

Our goal is to make your orthodontic treatment as comfortable as possible on the way to achieving your all-star smile. If you have questions about adjusting to braces, contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”


Due to financial circumstances, people often have a lost tooth restored with a removable partial denture, an effective appliance that restores function and a degree of aesthetic appearance. Later, though, they may want to improve both function and appearance with a dental implant.

If this describes you, you’re making a great choice. Dental implants are the closest technology we have to a natural tooth. But there may be a roadblock to your implant, especially if a long time has passed since your tooth loss—there may not be enough bone at the site to place an implant.

The heart of an implant is a titanium metal post surgically imbedded in the jawbone. The titanium naturally attracts bone cells, which grow and adhere to it to form a solid hold that can support a porcelain crown or other restorations like bridges or dentures. But to achieve a natural appearance it’s important that the implant is placed in the right location. To achieve that requires adequate bone.

But there may not be adequate bone if the tooth has been missing for a while. The forces generated when we chew travel through the teeth to the jawbone, which stimulates bone growth. If that stimulus is absent because of a missing tooth, new bone cells may not replace older ones at a healthy rate and the total bone volume begins to diminish. A denture can’t compensate and, in fact, accelerates bone loss.

But there may be a solution: bone grafting. With this procedure we place a donor bone graft into the area of bone deficiency some time before implant surgery. The graft serves as a scaffold for new bone cells to grow upon. Hopefully, this will produce enough healthy bone to support an implant. If the bone deficiency is minor, we may place the implant and the bone graft at the same time.

If you have experienced bone loss, we must first determine the amount of bone at the missing tooth site and whether grafting is a viable option. Bone grafting postpones your implant, but the delay will be worth the wait if we’re successful. With increased bone volume you’ll be able to obtain a new tooth that’s superior to your current restoration.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.

By Michael Wolfgram, DDS
February 14, 2018
Category: Oral Health
Tags: gum disease   nutrition  

If you’ve had issues with periodontal (gum) disease, no doubt a few things have changed for you. You may be seeing us for dental cleanings and checkups more frequently and you have to be extra diligent about your daily brushing and flossing.

There’s one other thing you may need to do: change your diet. Some of the foods you may be eating could work against you in your fight against gum disease. At the same time, increasing your intake of certain foods could boost your overall oral health.

The biggest culprits in the first category are carbohydrates, which make up almost half the average diet in the Western world, mainly as added sugar. Although carbohydrates help fuel the body, too much can increase inflammation—which also happens to be a primary cause of tissue damage related to gum disease.

Of course, we can’t paint too broad a brush because not all carbohydrates have the same effect on the body. Carbohydrates like sugar or processed items like bakery goods, white rice or mashed potatoes quickly convert to glucose (the actual sugar used by the body for energy) in the bloodstream and increase insulin levels, which can then lead to chronic inflammation. Complex or unprocessed carbohydrates like vegetables, nuts or whole grains take longer to digest and so convert to glucose slowly—a process which can actually hinder inflammation.  

Eating less of the higher glycemic (the rate of glucose conversion entering the bloodstream) carbohydrates and more low glycemic foods will help reduce inflammation. And that’s good news for your gums. You should also add foods rich in vitamins C and D (cheese and other dairy products, for instance) and antioxidants to further protect your oral health.

Studies have shown that changing to a low-carbohydrate, anti-inflammatory diet can significantly reduce chronic inflammation in the body and improve gum health. Coupled with your other efforts at prevention, a better diet can go a long way in keeping gum disease at bay.

If you would like more information on the role of diet in dental health, 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 “Carbohydrates Linked to Gum Disease.”

By Michael Wolfgram, DDS
January 30, 2018
Category: Dental Procedures
Tags: dental care  

While some aspects of regular dental visits are much the same for everyone, they can be more involved for an older adult. That’s because people later in life face an increased risk of dental disease and other age-related issues.

If you’re a caregiver for an older adult, you’ll want to be aware of these heightened risks. Here are 4 areas of concern we may check during their next regular dental visit.

Oral cancer. While it can occur at any age, cancer is more prevalent among older adults. Although rarer than other cancers, oral cancer’s survival rate is a dismal 50% after five years. This is because the disease is difficult to detect early or is misidentified as other conditions. To increase the odds of early detection (and better survival chances) we may perform a cancer screening during the visit.

Dental disease. The risks for tooth decay and periodontal (gum) disease also increase with age. A primary risk factor for older people is a lack of adequate saliva (the mouth’s natural disease fighter) often caused by medications or systemic conditions. We’ll watch carefully for any signs of disease, as well as assess their individual risk factors (including medications) for decreased oral health.

Dentures. If they wear dentures, we’ll check the appliance’s fit. While dentures can wear with use, the fit may also grow loose due to continuing bone loss in the jaw, a downside of denture wearing. We’ll make sure they still fit comfortably and aren’t stressing the gums or supporting teeth. It may be necessary to reline them or consider replacing them with a new set.

Oral hygiene. Brushing and flossing are just as important for older adults as for younger people for preventing dental disease, but often more difficult due to mental or physical impairment. We can note areas of bacterial plaque buildup and recommend ways to improve their hygiene efforts.

Depending on how well your older adult can care for themselves, it may be advisable for you to come with them when they visit us. Our dental team can provide valuable information and advice to help you help them have a healthier mouth.

If you would like more information on dental care for older adults, 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 “Aging & Dental Health.”

By Michael Wolfgram, DDS
January 15, 2018
Category: Dental Procedures

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”

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