Cosmetic Dentistry and Skin Care Blog

If you or a family member has rheumatic heart disease, bicuspid valve disease, aortic stenosis or a mitral valve prolapse, you’re probably used to taking prophylactic antibiotics prior to dental procedures. However, you may not be aware that the American Heart Association recently revised its antibiotic guidelines following their review of benefits vs. potential risks. After reading this valuable update regarding precautionary antibiotics, feel free to contact the Smile and Skin team with questions about your specific health condition. 

1. While antibiotics were previously recommended for a variety of heart conditions, the AHA now recommends the following: “Patients at the greatest risk of bad outcomes from infective endocarditis (IE) – an infection of the heart’s inner lining or the heart valves – should receive short-term preventative antibiotics before common, routine dental procedures.” This means that only patients who have received heart transplants or have artificial heart valves, serious congenital heart conditions or a history of serious endocarditis should receive prophylactic antibiotic prescriptions before going to the dentist. Remember to discuss your health history with Dr. Meola and his staff so they can make an educated recommendation about your need for antibiotics.
2. While there is limited evidence that prophylaxis works, the primary reason for the AHA recommendation change is due to the potential risks involved with some antibiotic doses. First, overprescribing of these prophylactic medications makes IE bacteria progressively more resistant to antibiotics. Second, some patients can have severe allergic reactions to antibiotics. At this point, physicians believe that antibiotics are best reserved for those with severe heart conditions, only.     
3. Finally, the AHA’s recommendations are based on evidence that infective endocarditis is far more likely to begin from bacteria entering the bloodstream through everyday activities, rather than through sterile dental procedures. According to Mayo Clinic physician, Walter R. Wilson, “…maintaining good oral health and hygiene appears to be more protective than the prophylactic antibiotics. This changes the whole philosophy of how we have constructed these recommendations for the last 50 years.”

If you’re concerned about IE or another serious health problem that may be impacted by secondary infection, ask the Smile and Skin team about the use of prophylactic antibiotics. Using the most updated guidelines and dental research, Dr. Meola and his team will assess your concerns and make recommendations that protect your health and address your specific medical condition.  

The Fluoride Solution

Up until now, you may have thought of fluoride as only a toothpaste additive. But did you know that fluoride is often present in water and many kinds of food? And when used properly, it's also a big part of the tooth decay solution. Fluoride helps with tooth development in children, and it hardens the surface of existing teeth in adults and older kids. The proper amount of fluoride prevents demineralization-and makes teeth more resistant to enamel breakdown and decay.

So how do you get fluoride? In addition to the fluoride present in food and water, fluoride is available in toothpastes, over-the-counter and prescription mouthwashes, and gel or foam treatments. If you're at risk for tooth decay, your dentist may apply gel or foam fluoride directly to your teeth or place it in a mouth guard to ensure adequate coverage.

Who Needs Fluoride Treatments?

Fluoride intake is critical for infants, toddlers and children between six months and 16 years as teeth are developing and erupting. But fluoride intake should not stop after adolescence. Older teens and adults can also prevent tooth decay with regular, topical fluoride treatments.

If you have any of the following health concerns, your dentist may recommend additional, more intensive fluoride applications.

• Frequent tooth decay: If you have a high rate of tooth decay (1-2+ cavities a year), it could be an indication that you need regular fluoride treatments.
• Gingival recession (a form of gum disease): Gingival recession exposes tooth roots, making teeth more susceptible to decay.
• Dry mouth: Certain types of diseases, allergies, or medications can cause excessive dry mouth. Saliva is important to the breakdown of acids and food, and its absence may cause frequent cavities and enamel softening.
• Corrective hardware: Braces, retainers, crowns and bridges can keep teeth from receiving the fluoride they need through daily exposure. Your dentist may need to apply fluoride directly to brackets and appliances to prevent underlying tooth decay.

Improve Your Smile with Smile and Skin

If you're concerned about excessive tooth decay, ask the Smile and Skin team if you could benefit from fluoride treatments. Schedule a consultation with Dr. Meola today, and ask about our variety of dental maintenance and cosmetic procedures. We'll help you protect your teeth-and enjoy your smile!

Advantages of Veneers

Smile and Skin veneers are a permanent solution to chipping, cracking, staining and unwanted tooth gaps. Porcelain veneers can transform your smile in as little as two appointments-and at competitive pricing. During your veneer visits, we will prepare your teeth, make detailed tooth impressions and carefully bond the porcelain laminates to your teeth, sometimes without any drilling or needles. We will use a special light to "cure" the bonding cement, so your veneer will be both permanent and durable.

Placing cosmetic veneers requires skill and artistry-and the Smile and Skin team has years of experience in transforming smiles of all ages. Benefits of our restorative veneers include:

• Texture, look and shine that mimics natural tooth enamel
• Stain and decay resistant design
• Simultaneous reversal of staining and tooth shape corrections
• Little to no discomfort; infrequent need for anesthesia

Advantages of Ceramic Crowns

For years, dentists have been repairing badly damaged teeth with crowns. Traditionally, these crowns were made of metal-which is an undesirable look for visible teeth. However, thanks to ceramic (porcelain) crown technology, Smile and Skin can apply natural-looking crowns that not only look attractive and mimic natural tooth structure, but also strengthen and protect your teeth.

If you are considering implant treatment or have extensive structural tooth damage, ceramic crowns are an aesthetic way of restoring your smile-and improving tooth functionality. During your crown visit, we will prepare the tooth and make an impression so our partner lab can manufacture a custom-fitted crown. After we receive the crown, it is permanently cemented in place and you are provided with a comprehensive review of how to care for it. Proper maintenance allows cosmetic crowns to last years and years, or even up to a lifetime.

Schedule Your Cosmetic Consultation Today!

If you've been putting off smile repairs, it's time to visit Dr. Meola's team of smile experts. Our staff of trained cosmetic dentists can use veneers and ceramic crowns to improve existing enamel defects, remove unsightly gaps and repair crooked teeth-and our three-dimensional models allow a glimpse of your new smile before we even begin. Call or email today to schedule your no-obligation cosmetic consultation, or to inquire about Zoom tooth whitening and other Smile and Skin cosmetic services.

Benefits of Invisalign

Coined the "invisible alternative to braces," Invisalign treatments consist of a progressive series of clear, thin aligners designed to adjust the position of your teeth, one step at a time. This simple, attractive aligner system offers a range of indisputable benefits, including:

1. Bracket and wire-free design: Invisalign inserts are virtually invisible, so you'll never have to worry about braces getting in the way of showing off your smile. In addition, the aligners are easily removed for eating, flossing and brushing-so there's no need to work around brackets and wires while maintaining your teeth health. Invisalign also eliminates the bracket staining that may go along with brace removal-so there's no need to tack a teeth whitening expense on to your alignment costs.

2. Reduced treatment time: Many teens and adults commit to wearing braces for years before their teeth are straight. And, while Invisalign plans differ based upon the individual patient, total treatment time averages nine to 15 months-which is much shorter than the average brace treatment of two years or more. In addition, Invisalign technology allows you to view "virtual straightening results" based on your specialist's recommended treatment plan-so you can look forward to your post-Invisalign look.

3. No speech changes: Unlike metal braces, headgear and traditional retainers, the slim, concealed design of Invisalign aligners won't impact your speech. You'll articulate speech clearly-without the lengthy adjustment period that comes with bulky wires, brackets and rubber bands.

Thinking about a smile transformation? There are summer specials and complementary bleaching available with your Invisalign treatment.

Call Dr. Meola's team today to schedule your no-obligation Invisalign consulation. When you're ready to begin, we'll use Invisalign's precision, three-dimensional analysis of your mouth to custom craft your aligners-and develop your ideal treatment plan.

Types of Sedation Dentistry

Nitrous Oxide Sedation
Use of a combination of inhaled nitrous oxide and oxygen is a very safe and effective way to achieve a relaxed state. Nitrous oxide, or commonly known as "laughing gas," has been used in dentistry for over one hundred years. The effects of nitrous oxide are to reduce fear and the perception of pain while still maintaining consciousness. One of the main benefits is that the onset and recovery is immediate, which allows patients to resume normal activity following their appointment.

Conscious Sedation
For patients with high levels of fear and anxiety, nitrous oxide sedation may not be enough. In these cases, conscious sedation is a much better option. Conscious sedation provides a reduced state of consciousness through the use of medications provided by the dentist. These medications are administered by mouth (oral conscious sedation) or via intravenous methods (IV sedation). Patients undergoing conscious sedation are able to speak and respond to verbal cues throughout the procedure, communicating any discomfort they experience to the dentist. Nitrous oxide sedation can also be used as an adjunct to conscious sedation, synergizing with the effect of local anesthetic and the sedative medications. One of the other benefits of conscious sedation is temporary amnesia that may erase any memory of the procedure. Most patients experience minimal post-operative discomfort; however, due to residual effects of the sedatives, it is important for a trusted companion to escort the patient home to ensure safe transportation and recovery.

General Anesthesia
The majority of dental procedures can be completed with conscious sedation. However, in rare cases in which a patient has extreme anxiety, requires extensive treatment to be done, or has a complex medical condition, general anesthesia may be the best option. General anesthesia is the state produced when a patient receives medications for purposes of amnesia, pain control and to induce sleep. An anesthetized patient can be thought of as being in a controlled, reversible state of unconsciousness. The medications are administered either intravenously or inhaled. Your dentist must work with an anesthesiologist to administer the medications and carefully monitor vital functions such as breathing and heart rate. Due to the complex nature of providing general anesthesia, it is usually performed in a hospital outpatient setting.

There is no need to be fearful of the dentist's office. You can receive the highest quality dental care in a painless and anxiety-free setting. To find out if sedation dentistry is an option for you, or if you would like more information about sedation dentistry, contact your dentist or a qualified sedation dentist.

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Smile & Skin Aesthetics is featured on SpaWeek.com:

Visit Smile & Skin Aesthetics at the office of Damian D. Meola DMD and Associates to experience the future of skincare. Along with all aspects of General and Cosmetic Dentistry, we offer the ultimate in skincare treatments to enhance any smile.

Begin your relaxing visit with the sound of water flowing from the waterfall, soothing music and soft scented candles. Choose from one of your many facials as well as Microdermabrasion and gentle exfoliating peels. We us an advanced product line called Environ. These professional, result oriented products can assist all skin types to help protect, restore and rejuvenate.

Available Treatments

• 75 Min Collagen Hydration Facial with Microdermabrasion
• 80 Min Resurfacing Facial with Intense Retinol Infusion
• 70 Min Chocolate Antioxidant Facial

To schedule your special Spa Week Spa Treatment, use the form to the right or call (781) 893-7500.