By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
April 11, 2021
Category: Oral Health
Tags: loose teeth  
SeeYourDentistASAPIfYouHaveaLoosePermanentTooth

Unless you're 6 years old and on speed dial with the Tooth Fairy, a loose tooth isn't a good feeling. It's also a sign something is wrong in your mouth. If you don't take prompt action, you may lose that tooth for good.

To begin with, teeth are held in place by an elastic tissue known as the periodontal ligament. The ligament lies between the tooth and bone and attaches to both through tiny fibers. The thing to note about the ligament is that it does allow for tooth movement, which serves as a “shock absorber” against the forces generated while biting and chewing.

But that movement is normally so slight, you won't perceive it. If you do, chances are there's a problem with the ligament attachment, which may have been damaged due to trauma or disease.

A hard blow to the face could certainly damage both the teeth and their attachments. But it can also happen if one tooth extends out farther than the rest and absorbs more stress during chewing. You could encounter similar damage if you attempt DIY orthodontics or wear tongue jewelry.

The more common source of ligament damage, though, is periodontal (gum) disease, usually caused by dental plaque, a thin film of bacteria and food particles left on tooth surfaces. If not treated, the infection can advance deeper into the gum tissues (and eventually the supporting bone), causing the ligaments to weaken and detach. In fact, a loose tooth is often a sign of well-advanced gum disease.

If you notice a loose tooth, you should make an appointment with us as soon as possible. Our first step is to ascertain the underlying cause and initiate any needed treatment. We may also want to splint a loose tooth to adjacent teeth to prevent excessive movement while the ligaments heal and reform their attachment to the tooth.

There will be times when a loose tooth is beyond repair. In that case, it may be best to remove the tooth and install a life-like replacement like a dental implant. But that's not inevitable. If at all possible and practical, we'll try to save your loose tooth.

If you would like more information on loose permanent teeth, 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 “When Permanent Teeth Become Loose.”

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
April 01, 2021
Category: Oral Health
Tags: gum disease   nutrition  
EatingtheRightKindofCarbsCanHelpYouAvoidGumDisease

There are great health benefits to eating better, including for your teeth and gums. But to determine your ideal diet, you'll have to come to terms with carbohydrates, the sugars, fiber and starches found in plants or dairy products that convert to glucose after digestion.

Carbohydrates (also known as carbs) are important because the glucose created from them supplies energy and regulates metabolism in the body's cells. But they can also create elevated spikes of glucose in the bloodstream that can cause chronic inflammation. Besides conditions like diabetes or heart disease, chronic inflammation also increases your risk of periodontal (gum) disease, a bacterial infection arising from dental plaque.

Many concerned about this effect choose either to severely restrict carbs in their diet or cut them out altogether. But these hardline approaches deprive you of the benefits of carbs in maintaining good health. There's a better way—and it starts with understanding that not all carbs are the same. And, one difference in particular can help you properly manage them in your diet.

Here's the key: Different carbs convert to glucose at different digestive rates of speed measured on a scale known as the glycemic index. Carbs that digest faster (and are more apt to cause glucose spikes in the bloodstream) are known as high glycemic. Those which are slower are known as low glycemic.

Your basic strategy then to avoid blood glucose spikes is to eat more low glycemic foods and less high glycemic. Foods low on the glycemic index contain complex, unrefined carbohydrates like most vegetables, greens, legumes, nuts or whole grains. High glycemic foods tend to be processed or refined with added sugar like pastries, white rice, or mashed potatoes.

Low glycemic foods also tend to have higher amounts of minerals and nutrients necessary for healthy mouths and bodies. And fresh vegetables in particular often contain high amounts of fiber, which slows down the digestion of the accompanying carbohydrates.

Eating mainly low glycemic foods can provide you the right kinds of carbs needed to keep your body healthy while avoiding glucose spikes that lead to inflammation. You're also much less likely to experience gum disease and maintain a healthy mouth.

If you would like more information on nutrition and 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 Dr David Kahn, DMD & Dr John Pergolizzi, DMD
March 22, 2021
Category: Oral Health
Tags: osteoporosis  
CertainDrugsforOsteoporosisCouldImpactYourDentalCare

Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.

From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.

Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.

These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.

Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.

Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.

If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown.  If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.

Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.

If you would like more information on osteoporosis and 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 “Osteoporosis Drugs & Dental Treatment.”

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
March 12, 2021
Category: Oral Health
AfteraDevastatingInjuryPromptActionSavedSingerCarlyPearcesSmile

Performing for an awards show is a quite a feather in an entertainer's cap. So, up-and-coming country music star Carly Pearce was obviously excited when she gained a slot on last November's Country Music Awards. But an accident a couple of weeks before the event almost derailed her opportunity when she fell and knocked out two of her front teeth.

Fortunately, Pearce took quick action and, thanks to a skilled dental and medical team, was able to put her mouth back together before the show. Those watching her perform her hit single, “I Hope You're Happy Now,” as she smiled broadly would never have known otherwise about her traumatic emergency if she hadn't spilled the beans.

Orofacial injuries can happen to anyone, not just entertainers. You or someone you love could face such an injury from a motor vehicle accident, hard sports contact or, like Pearce, a simple slip and fall. But if you also act quickly like Pearce, you may be able to minimize the injury's long-term impact on dental health and appearance.

Here are some guidelines if you suffer a dental injury:

Collect any tooth fragments. Dental injuries can result in parts of teeth—or even a whole tooth—coming out of the mouth. It may be possible, though, to use those fragments to repair the tooth. Try to retrieve and save what you can, and after rinsing off any debris with cold water, place the fragments in a container with milk.

Re-insert a knocked-out tooth. You can often save a knocked-out tooth by putting it back in its socket as soon as possible. After cleaning off any debris, hold the tooth by its crown (never the root) and place it back in the empty socket. Don't fret over getting it in perfectly—your dentist will assist its placement later. Place a piece of clean cloth or cotton over the tooth and have the injured person bite down gently but firmly to hold it in place.

See the dentist ASAP. You should immediately see a dentist if any tooth structure has been damaged, or if a tooth is loose or has been moved out of place. If you're not sure, call your dentist to see if you should come on in or if you can wait. If a dentist is not available, go immediately to an emergency room or clinic. With many dental injuries, the longer you wait, the more likely the teeth involved won't survive long-term.

A dental injury could happen in a flash, with consequences that last a lifetime. But if, like Carly Pearce, you take prompt action and obtain necessary dental care, you could save an injured tooth—and the smile that goes with it.

If you would like more information about dental injuries, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Field-Side Guide to Dental Injuries.”

By Dr David Kahn, DMD & Dr John Pergolizzi, DMD
March 02, 2021
Category: Oral Health
Tags: gum recession  
GumRecessionCanRobYouofYourSmileandYourDentalHealthToo

If it seems like your teeth are getting longer as you get older, it's unlikely they're magically growing. More likely, your gums are shrinking or receding from your teeth. Besides the negative effect on your appearance, gum recession exposes you and vulnerable tooth areas to harmful bacteria and painful sensitivity.

Although common among older adults, gum recession isn't necessarily a part of aging: It's primarily caused by periodontal (gum) disease, in which infected gum tissues can weaken and detach from the teeth. This, along with bone loss, leads to recession.

But gum disease isn't the only cause—ironically, brushing your teeth to prevent dental disease can also contribute to recession. By brushing too aggressively or too often (more than twice a day), you could eventually damage the gums and cause them to recede. Tobacco use and oral piercings can also lead to weakened or damaged gums susceptible to recession.

You can lower your risk of gum recession by abstaining from unhealthy habits and proper oral hygiene to prevent gum disease. For the latter, your primary defense is gentle but thorough brushing and flossing every day to remove harmful dental plaque. You should also see your dentist at least twice a year for professional dental cleanings and checkups.

If, however, you do experience gum recession, there are a number of ways to restore your gums or at least minimize the recession. To start with, we must treat any gum disease present by thoroughly removing all plaque and tartar (calcified plaque), which fuels the infection. This reduces inflammation and allows the gums to heal.

With mild recession, the gums may rejuvenate enough tissue to recover the teeth during healing. If not, we may be able to treat exposed areas with a tooth-colored material that protects the surface, relieves discomfort and improves appearance.

If the recession is more advanced, we may still be able to stimulate gum regeneration by attaching a tissue graft with a micro-surgical procedure. These types of periodontal surgeries, however, can require a high degree of technical and artistic skill for best results.

In any event, the sooner we detect gum disease or recession, the quicker we can act to minimize the damage. Doing so will ensure your gums are healthy enough to protect your teeth and preserve your smile.

If you would like more information on gum recession, 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 “Gum Recession.”





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To contact us, please call our office at (973) 835-3900.

Dr David Kahn, DMD & Dr John Pergolizzi, DMD

(973) 835-3900
Dentist in Ringwood, NJ
Dr. David Kahn, DMD & Dr. John Pergolizzi, DMD
10 Greenwood Lake Tpke
Ringwood, NJ 07456
(973) 835-3900
(973) 835-4631 Fax

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