How can cosmetic dentistry help improve the appearance of my smile?

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health. This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over. Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking. Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings. Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth. This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile. They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth. Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size. Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations. They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth. Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients. Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

How often should I have a dental exam and cleaning?

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities. Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health. These include:

• Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
• Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
• Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
• Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.

Are amalgam (silver) fillings safe?

Over the years there has been some concern as to the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.

According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth. The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.

The general consensus is that amalgam (silver) fillings are safe. Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective. The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling. The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of countless millions of silver fillings over the decades.

Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels. For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them. However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.

There are numerous options to silver fillings, including composite (tooth-colored), porcelain, and gold fillings. We encourage you to discuss these options with your dentist so you can determine which is the best option for you.

Dental Health for Pregnant Women

Image Source: Mouth Healthy

Many things go through a woman’s mind when she finds out that she is pregnant. When will she have her first ultrasound? What will she name the baby? Is it a boy or a girl?

Her dental health may well be one of the last things on her mind. However, a mother’s oral health can affect the health of her baby.

Mothers with gum disease have a higher instance of preterm birth. Preterm birth can cause serious problems for the infant, including low birth weight. Hormonal changes during pregnancy may also render a mother more susceptible to teeth and gum problems.

Preventing Pregnancy Gingivitis

In 2009, the American Academy of Pediatric Dentistry announced new oral health guidelines for pregnant women. These guidelines are designed to help pregnant women maintain healthy teeth and gums during their pregnancy and throughout the early stages of motherhood. These guidelines include:

1. Oral Hygiene: Correct brushing and flossing practices can help remove bacterial plaque, which is connected to preterm birth.
2. Fluoride: Pregnant women should continue to use fluoridated toothpaste. They should also use an over-the-counter alcohol-free fluoride rinse to reduce the amount of plaque in their mouths.
3. Treatment of Existing Tooth Decay: Existing tooth decay should be treated during pregnancy. Restoring decayed teeth will improve oral health by removing bacteria produced by the decay process.
4. Prevention of Transmission of Bacteria: Expectant mothers are discouraged from sharing utensils or food with others. Avoid sharing these items in order to prevent the transmission of bacteria that cause tooth decay.
5. Use of Xylitol Gum: When chewed four times a day, gum sweetened with xylitol has been shown to decrease the rate of tooth decay in children.

Pregnancy gingivitis develops in almost half of all pregnant women. It typically ends shortly after the birth, but it should be monitored throughout the pregnancy to ensure that it doesn’t progress into periodontitis. A more serious form of gum disease, periodontitis is irreversible. Pregnant mothers with periodontal disease are seven times more likely to go into preterm labor.

The Dangers of Preterm Birth

It may be hard for a pregnant mom to internalize the true danger that periodontitis poses for an unborn baby. The danger lies in prostaglandin, a chemical found in oral bacteria. High levels of prostaglandin have been found in the mouths of women with periodontitis. Prostaglandin may work to induce labor in pregnant women, causing preterm birth.

Babies born too early often have a low birth weight, which can cause significant health problems. Babies born prematurely have an increased risk of developing lung conditions, heart conditions and learning disorders. If you are pregnant or may become pregnant, consult your dentist about the state of your oral health.

FAQs about Bad Breath

What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue. Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

• Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
• Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
• Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
• Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
• Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
• Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products – Dry the mouth, causing bad breath.
• Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
• Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
• Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath. Also, review your current medications, recent surgeries, or illnesses with you dentist.

What can I do to prevent bad breath?

• Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
• See your dentist regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend more frequent visits.
• Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
• Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
• Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

Pass This Exam BEFORE School Starts

It's almost back to school time. This time of the year parents are starting to think about purchasing school supplies, backpacks and just the right pair of tennis shoes. Little do the kids know that there is one exam they need to take before the school bell rings -- a dental exam.

A good dental examination is an important part of maintaining a child's overall health. Additionally, oral pain can cause a host of problems in the classroom, making it hard for the student to concentrate. It may also be hard to eat lunch or speak properly. These symptoms can interfere with learning and even cause the student to miss school.

The American Academy of Pediatric Dentistry recommends that children get a dental exam every six months. So, if your child is due for a checkup schedule it now. Regular checkups can help discover and solve potential problems before there are even any symptoms - sparing you and your child precious time, money and pain!

Dining Out for Life 2014

For the 4th year in a row, I was honored to be part of Nashville CARES' Dining Out for Life this spring. We enjoyed the evening of April 22 at Nashville restaurant Virago. A portion of all sales that evening went to fund Nashville CARES' important HIV/AIDS resources and research. More than $150,000 was raised across all participating restaurants this year.

Dr. Dan and Sara Melamed, Dr. Warren Melamed, Alice Newgarden

Warren Melamed, Amy Rose, Dr. Randall Rose, Dr. Joel Veitschegger

Oral Cancer Walk 2014

Alice Newgarden, Warren Melamed, Pam McAteer

I was proud to once again be a part of the annual Oral Cancer Walk in Nashville, Tennessee, this year.

Oral Cancer is a devastating disease that affects more than 600,000 people worldwide. This year alone, more than 42,000 new cases of oral cancer will be diagnosed in the United States.

Risk factors for oral cancer include use of tobacco products, alcohol use, viruses and improper dental care. Early diagnosis is critical to ensuring the best possible outcome. The best way to prevent oral cancer is to avoid use of tobacco products and to be screened regularly. This is done at your regular dental exam. Yet another reason to get good, regular dental care.

For more information about oral cancer, visit the Oral Cancer Foundation online.

Best Wishes,
Warren Melamed

4 Tips for Selecting a Dental Professional

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Likeable Dentist

While a large percentage of Americans only think about going to the dentist whenever they experience pain in the mouth or teeth, Warren Melamed explains that is important for every individual to establish a solid relationship with a trusted dental professional. Locating a reliable, friendly and professional dentist is a great way to motivate yourself to visit a dentist on a regular basis—it can even make the experience much more enjoyable.

As a trusted and experienced dental professional, Warren Melamed offers the following tips to those who want to find a high quality dental care provider.

Tip #1 Find a Dentist that Offers Many Services

Most dental care professionals are able to assess and treat the immediate needs of oral health when they are certified as general dentists. However, those that want to locate a provider that offers comprehensive care should research professionals that offer a wide array of services. Having a dentist well-versed in various practices can provide trusted assistance in times where a person experiences an unexpected oral health emergency, rather than just routine dental care. In addition, some may benefit from enlisting the help of a dentist who also offers cosmetic services, such as whitening and veneer placement.

Tip #2 Choose a Dentist based on Your Location

When it comes to selecting a physician or dentist, it is often important to find one that is conveniently located near one’s home or place of work. While this close proximity can make going to appointments more convenient, the location of a dental office is also important for other reasons. For instance, if a person experiences sudden dental pain or emergency, he or she will not want to drive far in order to receive the medical attention that they require.

Tip #3 Investigate a Dentist’s Continuing Education Experience

Certification is one of the obvious requirements when selecting a trusted dentist; however, it is also important to examine the continuing education experience of a dental professional. Those who are considering a new dentist will often benefit from enlisting the services of one who is up-to-date on current practices and technologies used in the modern dental field. The more a dentist is aware of, in terms of modern dental practices, the more likely it is that his or her patients can access optimal care and greater treatment options.

Tip #4 Do Not Forget about Personality

Even is a dentist has all the skill necessary to treat patients, a winning personality can make the difference between an effective professional and a great one. Just like a doctor should have a great bedside manner, it is important for dentists to develop a formidable rapport with patients. If a dental professional is educated, experienced and friendly, it is more likely that a patient can have a better time when seeking consultation and openly discussing treatment options.

It is important for patients to remember that a dentist will generally spend more time with them than a general physician, especially if they are performing dental work in the patient’s mouth. Therefore, it is essential for patients to find a dental professional that aligns with their personality and can make the experience much more comfortable.