My Blog

By Benjamin Goldberg, DMD
March 25, 2017
Category: Dental Procedures
ARootCanalCanStopToothDecayandSaveYourTooth

Tooth decay can wreak more havoc than just producing cavities. It can work its way into the innermost parts of the tooth — the pulp and tiny passageways called root canals that lead to the tooth's connection with the bone.

If that happens, you'll need more than “drilling and filling.” Without intervention, your tooth could be lost. That intervention is a root canal treatment, a procedure that removes the infection from within the tooth and preserves it from re-infection.

You've probably heard the old belief that root canal treatments are painful. With modern anesthetic techniques to deaden pain, that's not true. In fact, root canal treatments stop the pain caused by infected nerves within the pulp and root canals. More importantly, it saves your tooth.

Root canals can be performed by a general dentist. More extensive decay or complex root canal networks may require the services of an endodontist, a dentist who specializes in root canal anatomy and treatments. Endodontists have advanced techniques and equipment to handle even the most difficult case.

Regardless of who performs it, the basic procedure is the same, as is the goal: to completely remove all diseased tissue within the tooth and seal it with a special filling to prevent re-infection. To access the diseased pulp, we first drill an access hole, usually in the biting surface of a back tooth or the back of a front tooth. We then use specialized instruments to remove the infected tissue and flush out the space with antibacterial solutions.

We then insert a filling called gutta percha into the empty pulp chamber and root canals, seal off the filling with adhesive cement, and close the access hole with filling. These fillings and sealants prevent bacteria from reentering the tooth. For added protection against infection and fracturing, we also recommend placing a full-coverage dental crown. This also enhances the appearance of the tooth, which must be modified during the root canal procedure.

The end result: your once endangered tooth has been preserved for hopefully many years to come. So if we recommend you undergo a root canal treatment, don't wait — the tooth you save may be your own.

If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation.

By Benjamin Goldberg, DMD
March 10, 2017
Category: Dental Procedures
DentalMagicTransformsSmiles

Magician Michel Grandinetti can levitate a 500-pound motorcycle, melt into a 7-foot-tall wall of solid steel, and make borrowed rings vanish and reappear baked inside bread. Yet the master illusionist admits to being in awe of the magic that dentists perform when it comes to transforming smiles. In fact, he told an interviewer that it’s “way more important magic than walking through a steel wall because you’re affecting people’s health… people’s confidence, and you’re really allowing people to… feel good about themselves.”

Michael speaks from experience. As a teenager, his own smile was enhanced through orthodontic treatment. Considering the career path he chose for himself — performing for multitudes both live and on TV — he calls wearing an orthodontic device (braces) to align his crooked teeth “life-changing.” He relies on his welcoming, slightly mischievous smile to welcome audiences and make the initial human connection.

A beautiful smile is definitely an asset regardless of whether you’re performing for thousands, passing another individual on a sidewalk or even, research suggests, interviewing for a job. Like Michael, however, some of us need a little help creating ours. If something about your teeth or gums is making you self-conscious and preventing you from smiling as broadly as you could be, we have plenty of solutions up our sleeve. Some of the most popular include:

  • Tooth Whitening. Professional whitening in the dental office achieves faster results than doing it yourself at home, but either approach can noticeably brighten your smile.
  • Bonding. A tooth-colored composite resin can be bonded to a tooth to replace missing tooth structure, such a chip.
  • Veneers. This is a hard, thin shell of tooth-colored material bonded to the front surface of a tooth to change its color, shape, size and/or length; mask dental imperfections like stains, cracks, or chips, and compensating for excessive gum tissue.
  • Crowns. Sometimes too much of a tooth is lost due to decay or trauma to support a veneer. Instead, capping it with a natural-looking porcelain crown can achieve the same types of improvements. A crown covers the entire tooth replacing more of its natural structure than a veneer does.

If you would like more information about ways in which you can transform your smile, please contact us or schedule an appointment for a consultation. You can also learn more about the techniques mentioned above by reading the Dear Doctor magazine articles “Teeth Whitening,” “Repairing Chipped Teeth,” and “Porcelain Crowns & Veneers.”

By Benjamin Goldberg, DMD
February 23, 2017
Category: Oral Health
Tags: mouth sores  
WecanMinimizeDiscomfortfromCankerSoreswithafewBasicTreatments

They seemingly pop up out of the blue inside your mouth: tiny sores that are sometimes painful — and always annoying. Then, in about a week to ten days these small, irritating lesions are gone.

They're known as canker sores: the most common break out in the linings of the mouth, including the cheeks, lips, under the tongue or even the back of the throat. Medically known as aphthous ulcers, you'll recognize these round lesions by their yellow-gray center surrounded by a red “halo.”

You might feel a tingling sensation a couple of days before an outbreak. Once they appear they usually last a week to ten days; during that time they can cause discomfort especially while eating or drinking.

We don't know fully what causes canker sores, but it's believed they're related to abnormalities in the immune system, the processes in the body that fight infection and disease. High stress or anxiety and certain acidic or spicy foods like citrus fruit or tomato sauce also seem to trigger them.

Most people experience canker sores that range in intensity from slight discomfort to sometimes severe pain. But about 20-25% of people, mostly women, have an acute form known as recurrent aphthous stomatitis (RAS). Thought to be hereditary, RAS produces clusters of ulcers that are almost always painful, and which come and go on a regular basis.

Our main treatment goal with canker sores is to decrease discomfort while the outbreak runs its course and promote rapid healing. There are over-the-counter ointments that often prove effective. For more resistant symptoms we can also prescribe topical or injectable steroids or other medications.

Canker sores are rarely concerning as a significant health issue. You should, however, take an outbreak seriously if it hasn't healed within two weeks, if the outbreaks seem to be increasing in frequency or severity, or you're never without a sore in your mouth. In these cases, we may need to take a tissue sample of the lesion to biopsy for signs of cancer, pre-cancer or some other skin disease.

More than likely, though, the canker sore will be benign albeit annoying. With effective treatment, though, you can get through the outbreak with only a minimal amount of discomfort.

If you would like more information on treating canker sores, 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 “Mouth Sores.”

By Benjamin Goldberg, DMD
February 08, 2017
Category: Oral Health
ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”

By Benjamin Goldberg, DMD
January 24, 2017
Category: Oral Health
Tags: gummy smile  
TheTrueCauseofYourGummySmileDeterminesHowWeTreatit

What makes a beautiful smile? The teeth, of course: bright, evenly shaped and precisely aligned with each other. But your teeth can be as perfect as can be and your smile will still appear unattractive.

The reason? Your gums show more than they should when you smile.

What's considered a gummy smile is largely a matter of perception that can vary from person to person. As a rule of thumb, though, we consider a smile “gummy” if four millimeters (mm) or more of the gums show.

Fortunately, we can minimize the gums' prominence and make your smile more attractive. But what methods we use will depend on why your gums stand out. And it's not always because of the gums themselves.

It could be your teeth didn't erupt normally during dental development. Mature crown (the visible part of the tooth) length is normally about 10 mm with a width about 75-85% of that. But an abnormal eruption could result in teeth that appear too short, which can make the gums stand out more. We can correct this with a surgical procedure called crown lengthening in which we remove excess gum tissue and, if necessary, reshape the underlying bone to expose more of the tooth crown.

Another potential cause is how far your upper lip rises when you smile. Normally the lip rises only enough to reveal about 4 mm of teeth. In some cases, though, it may rise too high and show more of the gums. We can modify lip movement in a number of ways, including Botox injections to temporarily paralyze the lip. A more permanent solution is a lip stabilization procedure. It sounds bad, but it's a fairly simple procedure to surgically reposition the muscle attachments to restrict movement.

Your gummy smile may also result from an upper jaw too long for your facial structure. We can correct this with orthognathic (“ortho” – straighten, “gnathos” – jaw) surgery. During the procedure the surgeon permanently positions the jaw further up in the skull; this will reduce the amount of teeth and gums displayed when you smile.

Discovering the true cause of your gummy smile will determine how we treat it. After a complete oral examination, we can then discuss your options to transform your smile into a more attractive one.

If you would like more information on treating gummy smiles and other cosmetic problems, 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 “Gummy Smiles.”





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