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Our Blog

Relax with Sedation Dentistry

April 3rd, 2024

Dr. Rothstein and our team at A R Periodontics understand that many of our patients have a fear of dentistry. You may be concerned about experiencing pain from sensitive teeth or routine procedures. General anxiety is also common. Do not put off visiting our Livingston office; we offer various types of sedation to take the pain and fear out of your dental procedure.

Nitrous Oxide Sedation

For many patients, nitrous oxide, combined with local anesthetics, will both provide pain relief and reduce anxiety. Nitrous oxide is beneficial because the dosage can be regulated during treatment and patients are normally capable of driving shortly after the procedure is completed.

Oral or Injected Sedation

With oral sedation, you may be given a pill or liquid to consume several hours before your procedure. You will not be able to drive yourself to the appointment. An oral liquid is often given to children before any shots or intravenous anesthesia. An intramuscular injection may be given at the office that provides relaxation benefits for 20 to 30 minutes.

Nitrous Oxide with an Oral Sedative

If you experience higher levels of anxiety, an oral or injected sedative can be offered before nitrous oxide is started. This is also effective for reducing anxiety regarding the injection of local anesthetics. A liquid medication followed by nitrous oxide is beneficial for children. This combination can produce a deep sedation level.

General Anesthesia

This type of anesthesia can be offered as an inhaled gas or intravenous liquid. If no oral sedative is given before the general anesthesia is administered, you should wake up quickly after your procedure is complete. An injection, pill, or liquid medication can be offered to reduce anxiety before intravenous sedation begins. Intravenous sedation can also be used at moderate-to-deep sedation levels without complete loss of consciousness.

Do not hesitate to ask Dr. Rothstein about receiving sedation or pain prevention when you visit. We will be glad to explain the options we have available and answer all your questions to ensure that your exam is pleasant for you.

What makes a periodontist different from a dentist?

March 27th, 2024

“Dentists, periodontists … what’s the difference, anyway?” We hear our patients asking this question as they wonder about the difference between the two specialties. Periodontists like Dr. Rothstein are more than just oral health professionals. Unlike dentists, who act more like general practitioners, periodontists focus on treating the soft tissue (gums) and bones supporting the teeth, as well gum disorders. Sure, dentists can prevent the onset of gum disease through regular cleanings and prescribing medications. But it is periodontists who are required for more complex and advanced cases of gum disease called periodontitis, a gum infection that, if left untreated, can lead to tooth loss. Periodontitis is a condition that most dentists simply don’t treat. The most severe cases of periodontitis can even lead to serious health problems such as diabetes, heart disease, and cancers of the head, neck, and pancreas.

To make things simpler, we’ve come up reasons for when you should visit the dentist and when you should give us a call to book an appointment with Dr. Rothstein:

Visit your general dentist for:

  • Checkups and cleanings
  • X-rays
  • Filling cavities
  • Root canals
  • Tooth extractions
  • Crowns or bridges
  • Select cosmetic procedures such as veneers, bonding, and teeth whitening
  • Pediatric (children’s) care

Visit Dr. Rothstein for:

  • Deep pocket cleanings (to remove debris and infection-causing bacteria)
  • Bone grafts
  • Soft tissue removal
  • Scaling and root planing (deep cleaning)
  • Implant replacement
  • Crown lengthening
  • Osteoplasty (hard tissue recontouring)
  • Gingivoplasty (soft tissue recontouring)

To learn more about the differences between periodontists like Dr. Rothstein and your general dentist, or to schedule your next visit, please give us a call today! We look forward to seeing and treating you!

Is a Loose Tooth a Lost Tooth? Not Necessarily!

March 20th, 2024

When we were small, a loose tooth wasn’t a reason to be worried. On the contrary! It was a time to celebrate: A permanent tooth on the way. A sign that you were growing up. Perhaps even a lucrative visit from the Tooth Fairy. Losing a baby tooth had quite a few benefits.

Now that we’re grown, no such benefits are in store for us, because a lost adult tooth is gone for good. That’s why any time you notice a loose tooth you need to call your dentist immediately. With prompt dental care, that tooth might be saved.

But first, a word about how our teeth stay firmly rooted in the jaw.

  • The visible part (crown) of a tooth is protected by a layer of enamel. The root below is covered with a protective layer called cementum.
  • There is a socket for each tooth in the alveolar bone of the jaw, where each root is firmly attached within the socket by the periodontal ligament which surrounds it.
  • This ligament is made up of connective tissue, which attaches both to the cementum covering the root and to the alveolar bone. It not only holds the tooth in place, it cushions the tooth from the daily pressure of biting and chewing.
  • The gums surround the teeth and bone, protecting them from bacteria.

If the tooth, bone, ligament, or gums suffer damage, the result can be a loose tooth.

Treating a loose tooth

The treatment you receive will depend on the reason your tooth is loose. There are many situations which can lead to a loose tooth or teeth, and many treatment options available to you. Some of the common causes and potential treatments include:

  • Accident or Trauma

If you have suffered a tooth or jaw injury as a result of an accident or trauma, it’s very important to see Dr. Rothstein immediately. You should be carefully examined to determine whether there is damage to other teeth or the jaw.

In some cases of damage to the periodontal ligament or tooth, even if your tooth is loose or extruded (partially out of its socket), it can be stabilized in place so that the ligament and tissue around it has time to heal.

We’ll make sure the root, nerves, and blood vessels are still intact, position the tooth back in its socket, and then anchor it to the adjacent teeth with a flexible splint for several weeks. In the case of an alveolar or a root fracture, a rigid splint may be used.

Splinting gives the periodontal ligament and bone surrounding it time to heal while keeping your injured tooth from further displacement.

  • Bite problems & Bruxism

Your teeth are designed to withstand a lot of pressure—in fact, in some ways, pressure is essential for healthy teeth and bone. The normal pressure of chewing and biting stimulates bone tissue in the jaw. When a tooth is lost, that stimulation is gone and the result is gradual bone loss in the area underneath the lost tooth.

But sometimes, the pressure exerted by a malocclusion (bad bite) or bruxism (tooth grinding) is too forceful. The connective tissue which holds the teeth in place is damaged by these forces, and loose teeth can be the result.

If your bite problem is caused by a tooth or teeth which are a bit too high, the enamel can be carefully contoured and reshaped. In some cases, splints, either temporary or permanent, can also be used to stabilize several adjacent teeth so that any biting or chewing force is spread over the section as a whole.

If you grind your teeth, a night guard can be custom fitted to provide relief from the pressures and impact of tooth clenching and grinding. This special kind of mouth guard is known as an occlusal splint.

  • Osteoporosis

Osteoporosis causes a loss of bone density throughout the body. Studies suggest that this disease can affect bone in the jaw, leading to weaker bone and looser teeth. Your physician will provide your best medical alternatives, and be sure to let us now if you are taking medication for osteoporosis before we plan your dental treatment.

  • Periodontal Disease

Gum disease is one of the major causes of loose—and lost—teeth. Early gum disease, called gingivitis, should be treated promptly to avoid a more serious condition called periodontitis. Periodontitis can cause the gums to pull away from the teeth, creating pockets for bacterial growth and infection. Left untreated, this infection results in connective tissue and bone loss.

If you have serious gum disease, it’s always best to call a periodontist, a specialist trained in the treatment of the gums, periodontal ligaments, and bone surrounding the teeth.

Deep cleaning procedures such as scaling and root planing, topical and oral antibiotics, and oral surgeries such as flap surgery or bone and tissue grafting can help reverse the effects of periodontitis. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

  • Pregnancy

Hormonal changes can cause the ligaments and bone around your teeth to loosen, which can lead to loose teeth. While this might be an alarming development, it’s generally a temporary condition. Talk to your dentist about how to take care of your teeth and gums during your pregnancy.

Hormonal changes can also make your gums more vulnerable to irritation and infection. In fact, swollen and tender gums are often one of the first signs of pregnancy. That’s another reason it’s very important to keep up with dental hygiene during pregnancy. If your gums are red, swollen, bleeding, or tender, give our Livingston office a call. Dr. Rothstein can be especially helpful if gum problems persist.

What to do if you have a loose tooth?

  • Call your dentist immediately. Timely professional care can mean the difference between saving your tooth and losing it.
  • Avoid wiggling the tooth. This could loosen it further.
  • Protect your loose tooth. Eat soft foods, and try not to chew near the affected area. And while a liquid diet might sound like a good idea, no straws, please. Straws require suction, which can further dislodge your tooth.
  • Keep the area clean, gently.

What to do if a tooth can’t be saved

Baby teeth become loose and fall out because the permanent teeth coming in erode the smaller roots holding them in place. That’s why it’s so easy for parents to help their child’s wiggly baby tooth find its way from mouth to Tooth Fairy.

Adult roots, however, involve alveolar bone, ligaments, blood vessels, and nerves, so an extraction really needs to be done by a professional. You should also be examined to discover the reason for the tooth loss, and to prevent further damage with additional treatment as needed.

If you do lose a permanent tooth, there is still much that can be done to restore your smile. Modern implants are almost indistinguishable from natural teeth, and, what’s more, they function just like natural teeth to stimulate the bone beneath them. Periodontists are specialists in tooth implant procedures, so give us a call to discuss your options.

Finally, a loose tooth is never a cause for celebration, but, with proper dental care, a loose tooth doesn’t always lead to a lost tooth. Restoring a firm bite and a heathy, confident smile? That’s a reason to celebrate!

Five Reasons for Your Bad Breath

March 13th, 2024

Bad breath, or halitosis, is probably not a matter of life or death. But it can make you feel self-conscious and have a negative impact on your life. The majority of people suffering from bad breath are dealing with oral bacterial. However, there are other causes of this embarrassing problem. Learning more can help you fight this solvable problem.

Five Causes of Embarrassingly Bad Breath

  1. Dry Mouth. A decrease in saliva flow can be caused by several things. Most often, medication or mouth breathing are the culprits. As saliva helps wash away food particles from your mouth, it prevents bad breath. Dry mouth can be dealt with by stimulating salivation.
  2. Gum Disease and Poor Oral Hygiene. Not brushing and flossing well enough or with enough frequency can lead to gum disease, which leads to bad breath. Halitosis can be a sign that plaque is present on your teeth.
  3. Food-Related Bad Breath. Food particles that aren't brushed or flossed away attract bacteria that leads to bad breath. It's especially important to brush after eating strong-smelling foods, such as garlic or onions.
  4. Smoking and Tobacco. Tobacco is bad for your health, and that includes your oral health. Smoking or chewing tobacco can contribute toward the development of gum disease, as well as oral cancer.
  5. Mouth Infections and Other Medical Problems. A mouth infection, sinus infection or even the common cold can cause you to temporarily have bad breath. Even conditions such as diabetes and reflux can cause halitosis. It's always wise to see Dr. Rothstein to help determine the cause.

We are Your Ally

Even if you maintain good oral hygiene, it's important to see Dr. Rothstein at our Livingston office to deal with or avoid problems with bad breath. We can help you uncover the cause of halitosis, while also providing solutions that allow you to enjoy fresh breath without relying on mints and breath fresheners. As is the case with all things related to oral health, we are your number-one ally when it comes to eliminating the problem of bad breath.