By James C. Whiting, DDS, MAGD
September 12, 2018
Category: Oral Health
Tags: oral health  
CreateaStrategytoDealwithDentalProblemstoAvoidFutureExpenses

If you have limited financial resources, learning what it will cost to restore your teeth and gums to good health could be a shock. Dental care can be expensive, especially for treating advanced dental disease.

Properly managing your ongoing dental care can greatly reduce the chances for higher expenses in the future. Here are 3 tips for staying ahead of problems that might cost you dearly tomorrow.

Practice prevention now. Dental disease doesn’t come out of nowhere — it’s the product of a bacteria-rich environment and neglect. You can help eliminate that environment by removing plaque — a thin film of bacteria and food particles built up on tooth surfaces — with daily brushing and flossing. Twice-a-year dental cleanings remove plaque and calculus (hardened plaque deposits) you can’t reach with daily brushing. Reducing sugar (which bacteria feed on) in your diet and treating low saliva flow (which can increase decay-causing acid in the mouth) will round out your prevention practices.

Take care of emerging problems as soon as possible. Dental disease typically doesn’t go away by itself: more likely, it will get worse — and more costly — with time. Don’t wait to see us if you encounter tooth pain or bleeding, tender or swollen gums. In some cases, we can take temporary measures like resin-based fillings in decayed areas that can buy a little time while you prepare for the expense of a more permanent restoration.

Adopt a long-term care strategy. Our goal is for you to have as healthy a mouth as possible.  To that end, we’ll work with you on strategy and payment plans that address your individual needs. A good strategy puts a priority on treating emergencies or advanced disease first, followed by treating less affected teeth as you’re able to afford it. We may also be able to address your tooth and gum problems with fewer but longer sessions that can help ease pressure on your costs.

Adopting solid hygiene and dietary habits now, visiting us at least twice a year and following a plan to treat problems as they emerge is your best approach for keeping dental care from making a huge impact on your wallet.

If you would like more information on managing your 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 “Cost-Saving Treatment Alternatives.”

By James C. Whiting, DDS, MAGD
September 02, 2018
Category: Dental Procedures
Tags: dental implants   diabetes  
DentalImplantsandDiabetes

Today, dental implants are an increasingly popular option for replacing lost teeth — an issue faced by many older Americans. It’s not hard to see why these high-tech prosthetic teeth are preferred: They look, “feel” and function just like natural teeth… and with proper care they can last the rest of your life. Unfortunately, many people who could benefit from implants also face an additional health problem: diabetes, a metabolic disease that can affect many different parts of the body, sometimes severely.  Uncontrolled diabetes can lead to nerve and tissue damage, and may adversely impact your oral health. So if you have diabetes, does it mean you won’t be able to get dental implants? 

The short answer is no — but there are some considerations that diabetics (and their health care providers) need to keep in mind. For example, it has been demonstrated that wounds in diabetics tend to heal more slowly, and are more prone to infection than those in non-diabetics. Also, people with diabetes sometimes experience a chronic inflammatory response, which can eventually lead to tissue damage or other problems.

Because the placement of dental implants requires minor surgery, dentists and researchers have questioned whether people with diabetes are good candidates for implants. Now there’s encouraging news: Several recent studies have come to the conclusion that many diabetics can indeed undergo an implant procedure without undue risk.

One key consideration is how well an individual can control his or her blood glucose levels. Researchers have found that diabetics with good blood glucose control, those with poor glucose control, and non-diabetics all have similar implant success rates (above 95%). However, in diabetics with poor glucose control, more time may be needed for the jawbone to heal in the area where the implant procedure was done. That doesn’t by any means rule out the placement of a dental implant — but it does mean that special considerations apply to individuals in this situation.

So if you are considering an implant procedure but have trouble controlling your blood glucose levels, ask us how we can help. Just remember that in most cases, having diabetes doesn’t mean you won’t be able to enjoy the benefits of dental implants. If you have additional questions, contact us or schedule an appointment.

By James C. Whiting, DDS, MAGD
August 23, 2018
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.”

By James C. Whiting, DDS, MAGD
August 13, 2018
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By James C. Whiting, DDS, MAGD
August 03, 2018
Category: Oral Health
Tags: nutrition   oral cancer  
AHealthyDietCouldLowerYourRiskofOralCancer

Good nutrition is vital for maintaining health and preventing disease, especially for your mouth. A diet rich in whole foods — fresh fruits and vegetables, protein and dairy products — and low in sugar will not only promote strong teeth and gums, but lessen your chances of developing tooth decay or periodontal (gum) disease.

Diet is also a prominent factor in reducing the risk for another serious mouth disease — oral cancer. While oral cancer makes up only 3% of total cancer cases reported annually, the five-year survival rate is a sobering 50%, much lower than for other types of common cancers. While genetics plays a role in your susceptibility to oral cancer, lifestyle choices and practices present the greater risk factors for the disease.

Of these lifestyle factors, refraining from tobacco products, moderating your alcohol consumption and avoiding risky sexual behavior are of primary importance in reducing your cancer risk. With that said, you should also take into account the foods that are part of your daily diet — both what you should and shouldn’t eat. As an example of the latter, some foods contain a class of chemicals known as nitrosamines that are carcinogenic (cancer-causing). One such chemical, nitrite, is used as a preservative in meats like bacon or ham, and may also be found in beer, and seafood products.

On the positive side, your diet should be rich in foods that supply antioxidants, substances that protect the body’s cells from damaging, unstable molecules known as free radicals. The best sources for antioxidants (more so than dietary supplements) are plant foods rich in fiber and vitamins C and E. Eating more of these may also reduce your intake of nitrates, animal fat and saturated fat.

Adopting a moderate, nutritious diet, along with exercise, can have a huge positive impact on your general health and quality of life. Along with other lifestyle changes, better dietary choices can also help ensure a healthy mouth and reduce your risk of oral cancer.

If you would like more information on the role of nutrition in reducing your risk of oral cancer, 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 “Diet and Prevention of Oral Cancer.”





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James C. Whiting, DDS, MAGD

6701 Sunset Dr. Suite 205 South Miami, FL 33143