Wednesday, May 30, 2012

Is Nitrous Oxide a good choice for you?

At The Cosmetic Dentist, Nitrous Oxide is our first choice for helping calm our most fearful patient.  Nitrous is a gas that is mixed with oxygen and delivered to the patient through a nose piece.  The nose piece, which is usually scented, covers only the nose so the mouth can still be worked on.  The patient is instructed to breath through their nose to inhale the gas.  The patient will begin to feel the sedation between 30 seconds to 4 minutes after starting the gas.  After treatment is complete, the patient is given pure oxygen for 5 minutes to reverse the effects of the nitrous.  Unlike general or IV sedation, patients are able to drive themselves home after.

Nitrous Oxide has many benefits, and few side effects.  It is not effective if nasal passages are blocked, and can be difficult for patients with claustrophobia.  However, Nitrous Oxide is one of the safest forms of anesthetic available.  It works well on fearful patients as well as on children.  
If you are the type of patient that could stand to be a little calmer during dental treatment, Nitrous Oxide might be right for you.  Talk to your dental professional today about trying it during your next dental procedure. 

Information in this article from: and

Tuesday, May 29, 2012


Do you have facial pain?  A lot of people do.  At The Cosmetic Dentist, we see many patients every week that suffer from chronic facial pain.  Some common symptoms include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth, or headaches and neck pain.  Most of the time this pain can be associated with TMJ, the TemproMandibular Joint. 

Two joints and several jaw muscles make it possible to open and close the mouth. They work together when you chew, speak or swallow. They include muscles and ligaments, as well as the jaw bone--the mandible (lower jaw) with two joints called the temporomandibular joints or “TMJ.”

The TM joints are among the most complex joints in the body. Located on each side of the head, they work together to make many different movements, including a combination of rotating and gliding actions used when chewing and speaking.

Several muscles also help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side. Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and rotate or glide. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working properly may result in a painful TMJ disorder.

There are several treatments for TMJ disorders. They may include stress-reducing exercises, wearing a mouth protector to prevent teeth grinding, orthodontic treatment, medication or surgery. Treatment may involve a series of steps beginning with the most conservative options. In many cases, only minor, relatively non-invasive treatment may be needed to help reduce the pain.

Information in this article from:

Thursday, May 17, 2012

Gum Disease Illustrated

I just thought this was a great illustration.  It thoroughly explains the difference between a healthy tooth and a tooth with Gum Disease.  You can see, on the healthy side, the bone and gum level are normal.  On the disease side, you can see the tarter attached below the gum and the bone level reduced.  This is what we are talking about when we discuss bone loss with you.  It is this type of tooth that needs a deep cleaning.  We have to numb the area, and go under the gums to clean the tarter off the tooth.  This helps restore health to the tooth.  If you have questions about bone loss or Gum Disease talk to your dental health professional today!

Wednesday, May 16, 2012

Energy Drinks and Sports Drinks: Irreversable Damage

Dental Professionals are always telling patients to drink less soda and drink more water.  But did you know that Sports Drinks and Energy Drinks are so acidic they can do more damage than soda?  A lot of people will choose one of these drinks thinking it will improve their sports performance and give them energy.  What they don't understand is that levels of acid are so high in these drinks that they are permanently damaging the tooth enamel.  Once the enamel is compromised, the underlying tooth surface, dentin, is exposed.  This surface is not as strong as enamel and decays much more quickly.   This is becoming a wide spread problem, especially among the youth in our country.  The rate of decay among teenagers is growing and reseachers believe these types of drinks are to blame. 
The best way to manage this type of decay is to aviod these drinks all together.  If you must drink them, you should drink them down, DO NOT SIP ON THEM!!!!  Sipping on these drinks over time does not allow the teeth any time to recover from the acids.  This will cause more rapid decay.  Also, if you have a sports or energy drink you should wait at least an hour before you brush your teeth.  The acids from these drinks soften the enamel.  If brushing occurs before the enamel hardens up again, it can brush the enamel away.  Drinking or rinsing with water after comsuming a sports or energy drink will help stop the acids from attacking the teeth.  But remember, the best thing is to not drinks these drinks at all.  Water is the best choice!

Information in this article from: AAP: Kids should not consume energy drinks - American Dental Association - and

AAP: Kids should not consume energy drinks - American Dental Association -

Friday, May 11, 2012

Malocclusion and Orthodontics

What is malocclusion?

Malocclusion means having crooked teeth or a "poor bite."

Orthodontic treatment can correct the way teeth and jaws line up. Dentists who are specially trained to correct malocclusion are called orthodontists. They use a variety of treatment tools and techniques (including braces ) to move teeth, and sometimes the jaw, into the right places.

What causes malocclusion?

A common cause of malocclusion  is teeth that have too much or too little room in the jaw. If children have a small jaw, their teeth may grow into a space that is too small. As a result, teeth may grow or drift out of place.

Other causes of crooked teeth include thumb-sucking, pacifier use, and tooth loss.

What are the symptoms?

The most obvious sign is teeth that are crooked or stick out. Malocclusion can range from mild to severe. Most of the time, having crooked teeth is only a cosmetic problem, meaning people don't like the way their teeth look. But in severe cases, it can cause problems with eating or speaking.

How is malocclusion diagnosed?

A dentist usually checks for malocclusion in children during regular dental visits. If the jaw or teeth are out of line, the dentist may suggest a visit to an orthodontist. The American Association of Orthodontists recommends that all children get a checkup with an orthodontist by age 7.

An orthodontist will:

Ask questions about your or your child's past health problems.
Check the mouth and teeth.
Take X-rays of the face and teeth.
Take photographs of the face and teeth.
Make a plaster model of the teeth.
Start your child’s trips to the dentist at age 12 months. This will help your child get used to seeing a dentist. It will also catch any early problems. Keep up with regular dental checkups 2 times a year.

How is it treated?

In children and teens, the first step in treatment may be to take out certain teeth to make room for teeth that may still grow in.

The next step is to attach braces to teeth to straighten out the bite . In addition to straightening teeth, braces can help move a child’s jaw into the right position.

Teeth tend to move forward as you age, even after treatment with braces. Retainers  are devices you wear in your mouth to keep your teeth from moving. Some people need to use retainers for many years after treatment.

Adults can successfully straighten their teeth with braces. But the only way to straighten an adult’s jaw is with surgery.

Braces and other types of orthodontic treatment cost a lot. Most insurance plans don't pay for them. Before you start treatment, make sure you know how much it will cost and how you will pay for it.

Above article from:

Jeffrey Cohen, DMD
4324 Forest Hill Boulevard
West Palm Beach, FL 33406
Tel:(561) 967-8200

Wednesday, May 9, 2012

Dental Health and Dry Mouth

We all need saliva to moisten and cleanse our mouths and digest food. Saliva also prevents infection by controlling bacteria and fungi in the mouth. When we don't produce enough saliva, our mouth gets dry and uncomfortable. Fortunately, there are many effective treatments for dry mouth.

What Causes Dry Mouth?

There are several causes of dry mouth, also called xerostomia. These include:

Side effect of certain medications. Dry mouth is a common side effect of many prescription and nonprescription drugs, including drugs used to treat depression, anxiety, pain, allergies, and colds (antihistamines and decongestants), obesity, acne, epilepsy, hypertension (diuretics), diarrhea, nausea, psychotic disorders, urinary incontinence, asthma (certain bronchodilators), and Parkinson's disease. Dry mouth can also be a side effect of muscle relaxants and sedatives.

Side effect of certain diseases and infections. Dry mouth can be a side effect of medical conditions, including Sjögren's syndrome, HIV/AIDS, Alzheimer's disease, diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, Parkinson's disease, stroke, and mumps.

Side effect of certain medical treatments. Damage to the salivary glands, the glands that produce saliva, for example, from radiation to the head and neck and chemotherapy treatments for cancer, can reduce the amount of saliva produced.

Nerve damage . Dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery.

Dehydration . Conditions that lead to dehydration, such as fever, excessive sweating, vomiting, diarrhea, blood loss, and burns can cause dry mouth.

Surgical removal of the salivary glands.

Lifestyle. Smoking or chewing tobacco can affect saliva production and aggravate dry mouth. Continuously breathing with your mouth open can also contribute to the problem.

Above article from:

Jeffrey Cohen, DMD
4324 Forest Hill Boulevard
West Palm Beach, FL 33406
Tel:(561) 967-8200

Monday, May 7, 2012

Dental Crowns

A dental crown is a tooth-shaped "cap" that is placed over a tooth - covering the tooth to restore its shape and size, strength, and/or to improve its appearance.
The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

Why Is a Dental Crown Needed?
A dental crown may be needed in the following situations:
To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
To restore an already broken tooth or a tooth that has been severely worn down
To cover and support a tooth with a large filling when there isn't a lot of tooth left
To hold a dental bridge in place
To cover misshapened or severely discolored teeth
To cover a dental implant

What Types of Crowns Are Available?
Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic.

Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.

Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown's porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.

All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.

All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type and may be more suitable for people with metalallergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.

Temporary versus permanent. Temporary crowns can be made in your dentist's office whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by the dental laboratory.

Above article from:

Jeffrey Cohen, DMD
4324 Forest Hill Boulevard
West Palm Beach, FL 33406
Tel:(561) 967-8200