When should I take my child to the dentist?


Taking your child to the dentist at a young age is the best way to prevent problems such as tooth decay, and can help parents learn how to clean their child’s teeth and identify his or her fluoride needs. After all, decay can occur as soon as teeth appear. Bringing your child to the dentist early often leads to a lifetime of good oral care habits and acclimates your child to the dental office, thereby reducing anxiety and fear, which will make for plenty of stress-free visits in the future.

What is Bruxism?


Bruxism is a term for grinding and clenching that abrades teeth and may cause facial pain. People who grind and clench unintentionally bite down to hard at inappropriate times, such as in their sleep. These people also tend to bite their fingernails and their cheeks. Many people are completely unaware that they have the habit.

What are the signs?

When a person has bruxism, the tips of the teeth look flat. Sometimes the teeth are worn down so much that the enamel is rubbed off and the inner layer of the tooth is exposed. Many times these teeth become sensitive. Bruxers may experience TMJ (jaw joint) pain which may lead to popping and clicking as well as headaches and neck pain. Tongue indentations are another sign of clenching. Stress and certain personality types are prime candidates for bruxism. People who are aggressive, competitive and hurried also may be at a greater risk for bruxism.

What can be done about it?

During regular visits, the dentist automatically checks for physical signs of bruxism. If the dentist or patient notices signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy. Research has shown that there are 3 root causes of bruxism. 1) Central Nervous System reflex   2) Bad bite (unbalanced or over closed bite) 3) Habit.   Peoples whose root cause is due to a bad bite may benefit from neuromuscular TMD treatment. This involves having a computer assited bite splint fabricated. Patients with a unbalanced or over closed bite usually report having headaches or painful jaw joints. Those patients that have CNS reflex or habits are usually best treated with a custom fabricated nightguard made by a dentist. This protects the teeth from losing further tooth structure. It is very important that the night guard fits very snug and is very rigid. This is so that the forces generated by the clenching and grinding are dispersed over the surface of the night guard. Over the counter night guards do not meet this criteria and are therefore potentially harmful.

If you think you may be a bruxer make sure you discuss it with your dentist.

What Can I Do To Help Protect My Teeth?


The best way to combat cavities is to follow these 3 steps:

  1. Cut down on sweets and between-meal snacks. Remember, it’s these sugary and starchy treats that put your teeth at extra risk for cavities.
  2. Brush after every meal and floss daily. Cavities most often begin in hard-to-clean places between teeth and in the grooves and pits, edges around a crowned tooth and gaps between the teeth. Hold the toothbrush at a 45-degree angle and brush inside, outside and between your teeth and on top of your tongue. Replace your toothbrush about every 2 months or sooner if the bristles become bent. Rinse your toothbrush thoroughly after brushing. Try to brush for at least 3 minutes. Only buy toothpastes and rinses that contain fluoride. Children under 6 should only use a small pea-sized dab of toothpaste on the brush and should spit out as much as possible because swallowing toothpaste can result in a stomach ache. Finally, because the bacteria that causes caries is transmittable, toothbrushes should never be shared, especially with your children.
  3. See your dentist at least every 6 months for checkups and professional cleanings. Because cavities can be difficult to detect a thorough dental examination is very important. If you get a painful toothache, if your teeth are very sensitive to hot or cold foods, or if you notice signs of decay like white spots, tooth discolorations or cavities, make an appointment right away. The longer you wait to treat infected teeth the more intensive and lengthy the treatment will be. Left neglected, cavities can lead to root canal infection, permanent deterioration of decayed tooth substance and even loss of the tooth itself.

Burning Mouth Syndrome


Burning mouth syndrome (BMS) is a common, but complex problem that causes people to experience a burning or scalding pain on the lips and tongue (and sometimes throughout the mouth). There are often no visible signs of irritation, and the cause of the syndrome may be caused by the onset of menopause to vitamin deficiencies. Though members of both sexes are susceptible to BMS, it occurs more frequently in older women. BMS is not a form of nor can cause cancer.

There are many symptoms associated with BMS. The main symptom is a burning sensation , ranging from moderate to severe, in your mouth, throat, lips and tongue. Other symptoms include dry mouth, bitter or metallic tastes and other taste alterations. People with BMS often say the pain is gradual and spontaneous, intensifying as the day moves along. The discomfort and restlessness associated with BMS may cause mood changes, irritability, anxiety and depression.

The exact cause of BMS is difficult to determine. In 30% of the cases it is caused by existing conditions that affect the oral and systemic health. Some conditions include the onset of menopause, diabetes, nutrient deficiencies and complications to cancer therapy.

In a majority of cases, no specific diagnosis for the symptoms can be made. BMS symptoms may occur from dry mouth, tongue thrusting, teeth grinding, irritating or ill-fitting dentures, and thrush (a common fungal infection). Some research points to nerve disorders and damage; psychological factors, particularly depression and anxiety; allergies; acid reflux; and medications that cause dry mouth. It’s not unusual for a person suffering with BMS to have more than one cause attributed to the ailment or to have health care providers fail to find any cause at all.

Your dentist will begin by reviewing your medical history and asking you to describe the symptoms. Your dentist may look for oral causes by taking an oral swab or biopsy to check for thrush. But because BMS is caused by so many conditions, your dentist may refer you to a physician or specialist for other blood, allergy, liver or thyroid tests.

Treatment for BMS depends on the patient and the cause. For dry mouth, your dentist may prescribe a medicine that promotes the flow of saliva. Thrush may be treated with oral anti-fungal medications. If dentures are the culprit, your dentist can make adjustments sot they won’t irritate the mouth, or replace them with better fitting dentures. If your dentist determines that there are no oral conditions causing BMS he or she may refer you to your family physician or specialist.

Problems Solved by Porcelain Veneers


Porcelain veneers can solve numerous cosmetic dental problems in the same treatment, so you have fewer visits to the dentist’s office to get the results you want. You may be able to avoid undergoing a series of treatments, and have all of your problems solved in two office visits. Porcelain veneers can also be used in addition other procedures if you need work more extensive than what veneers alone can accomplish.

Stubborn Discoloration

Porcelain veneers can cover discoloration that is resistant to whitening, so anyone can have a bright beautiful smile. Even deep discoloration can be corrected. If you have always wanted a bright, white smile, but have been told that your discoloration cannot be treated with teeth whitening, porcelain veneers may be the answer.

Minor Crookedness

Often referred to as “instant orthodontics” porcelain veneers can be used to correct the appearance of minor crookedness and twisted teeth without the need for braces and the lengthy process of gradually moving your teeth into the right position.

If you have already gone the traditional orthodontics route, only to have your teeth shift out of place later, porcelain veneers can restore the look of all your hard work without the need to repeat the process.

Correcting Tooth Size

If your teeth are too short, it can create a gummy appearance. Teeth that are unevenly sized can appear crooked and unhealthy. Porcelain veneers can be used to give your teeth a more uniform size and shape, and they can be slightly longer than your natural teeth if your teeth are too short.

Chips, Cracks, and Holes

Chips, cracks, and small holes in your teeth can be covered and sealed with veneers. This puts an end to pain and sensitivity, stops damage from progressing, and corrects the appearance of small but serious dental flaws.

Gaps between Your Teeth

The appearance of small gaps can be corrected when the teeth on each side of the gap are covered with veneers that are slightly wider than the teeth, to close the gap.

What are Porcelain Veneers?


Porcelain veneers are a very popular choice in cosmetic dentistry because they are so versatile and can accomplish so much with so little time and effort. The concept is simple. A veneer is just a very thin shell of porcelain that is bonded to the front surface of your tooth. Because it is made of porcelain, it looks like real tooth enamel. Because it is bonded to your tooth, it is very strong and durable. Typically, veneers are used to cover anywhere from two or three to a group eight teeth.

Solving Multiple Issues in One Minimally Invasive Treatment

By choosing porcelain veneers, you may be able to avoid undergoing multiple procedures. Porcelain veneers can correct the appearance of chipped teeth, cracks, gaps, minor crookedness, unevenly sized teeth, and more. The procedure itself is minimally invasive, requiring only that the enamel be prepared to receive the veneers before they are placed. It is all done in just two office visits.

Beautiful Porcelain

Dental porcelain is the material most like natural tooth enamel that is available. It reacts with light in the same way as natural teeth, so you don’t get the flat that was common with older dental materials. It can be color-matched to your teeth, so it blends in perfectly with the surrounding teeth. We can whiten your teeth first so that your veneers are matched to your optimal shade. The veneers are stain resistant.

When you have porcelain veneers, you care for them just like your natural teeth. Because they are very thin, they will feel and function like your natural teeth, too.

Why are Porcelain Veneers referred to as “Instant Orthodontics”?


Porcelain veneers are sometimes referred to as instant orthodontics because they can be used to correct the appearance of minor crookedness. Veneers do not actually straighten your teeth, but they can make them look straight without the hassle and time commitment of wearing braces or using Invisalign. In addition, you get the benefit of correcting the appearance of other dental flaws such as discoloration and unevenly sized teeth.

Fast and Convenient

Porcelain veneers can give you a beautiful, straight smile in just two office visits. You don’t have to spend months or years waiting for your teeth to slowly move to the correct position, as you make multiple visits to the orthodontist for adjustments. You can skip the discomfort or straightening your teeth, and the inconvenience of caring for teeth with braces or wearing aligner trays.

Special Occasions

Want your teeth to be photo-ready in time for a wedding, graduation, or another special occasion? Porcelain veneers may be the solution for you. You have enough on your plate without having to commit the time and effort it takes to go through traditional orthodontics.

For Those Who Have Already Worn Braces

If you had your teeth straightened with traditional orthodontics when you were a teenager, only to have them shift out of place when your wisdom teeth came in later in life, you probably don’t want to go through the process all over again. The hard work has already been done.

Now you can correct the minor crookedness that came back in a quick and easy treatment. And, you can take care of multiple issues at once. If you have stains that do not respond to whitening, chipped teeth, or teeth that are unevenly sized, porcelain veneers will cover these flaws as well.

Maintaining the Results of Teeth Whitening


After teeth whitening, your teeth can quickly become stained again if you do not take some basic steps to maintain the results. Consuming staining foods and drinks, and tobacco use, all contribute to the discoloration of your teeth, so you will want to minimize these activities, but a few changes in your habits can help you extend the results without having to give up staining substances entirely.

Staining Foods and Beverages

You probably know the most obvious culprits, such as red wine, but there are some less obvious foods that can stain your teeth, too. Examples of staining foods and beverages include:

  • Red wine
  • Dark berries and fruit, such as blueberries, blackberries, cherries, and pomegranate
  • Fruit juice
  • Smoothies
  • Tomato sauce
  • Curry, and other sauces containing turmeric
  • Soy, tamari, and teriyaki sauce
  • Chocolate
  • Beets
  • Potatoes
  • Coffee
  • Tea
  • Soda
  • Sports drinks
  • Colored candies

Keeping Your Teeth White without a Deprivation Diet

Some of the substances that are staining are also very healthy, and you don’t want to trash your diet or give up your favorite foods and beverages just to keep your teeth white. Be mindful of what you are putting in your mouth and act accordingly. Here are some tips that can help you get away with indulging:

  • Use a straw when drinking staining beverages, to help bypass the front surfaces of your teeth
  • Brush immediately after consuming staining substances
  • When you can’t brush right away, at least rinse your mouth out
  • Use a whitening toothpaste
  • Touch-up your results periodically with a professional take-home kit from Dr. Patel.

Partial Dentures


A partial denture is an option for replacing a missing tooth or group of teeth. A partial contains artificial teeth made of dental porcelain. You take it out to clean it like full dentures. For some patients a partial is the best choice, but some patients may be happier with a fixed bridge or dental implants, because partials have some drawbacks. Your cosmetic dentist can help you decide which type of tooth replacement is best for you.

Partial vs. Fixed Bridge

A fixed bridge is similar to a partial, but it is permanent fixed in place. A partial must be removed and cleaned like dentures. It can slip and rub, causing discomfort, and you may not be able to eat all of your favorite foods. You will need to be refitted for your partial and have it replaced every few years.

A fixed bridge stays in place, and you clean and care for it like your natural teeth. It will not slip and rub, and you will not have to replace it on a regular basis. There is no risk of losing a fixed bridge, and it is more convenient than a partial.

A fixed bridge can be anchored to the adjacent teeth with crowns, or it can be anchored with dental implants.

Dental Implants

Dental implants are really the preferred choice for most patients. You can have a single implant to replace a single missing tooth, or you can have a fixed bridge anchored by dental implants to replace a group of teeth.

The implant itself helps prevent the bone loss that is so common with dentures and partials, because it replaces the tooth root. Anchoring with dental implants rather than crowns prevents stress on the adjacent teeth.

Professional Vs. Over the Counter Teeth Whitening at Home


If you are considering teeth whitening at home, you may be wondering if there is really a difference between the take home kits you can get from your dentist and the ones you can buy off the shelf. There is a big difference. Even the over-the-counter (OTC) whitening products that involve using trays and gels, that seem so similar to the kit you get from the dentist, does not deliver the same powerful and consistent results.

Take Home Whitening Kits from Your Dentist

When you get a take home kit from your dentist the whitening gel is a professional grade product with more whitening power than OTC gels.

The trays that come with OTC kits are not custom made for your teeth, and may not provide even coverage and even whitening, and the fit may be so poor that it hurts your gums.

Trays provided by a cosmetic dentist are custom made to fit your teeth so that each tooth gets full and even coverage, with no gaps in the whitening.


A professional kit comes with desensitizing gel. OTC products can be very uncomfortable or intolerable for people with sensitive teeth.


When you buy an OTC whitening kit, you are on your own. When you use a professional take-home kit provided by the highly trained dentists at The Center for Contemporary Dentistry in the Lakes Region of New Hampshire you have support of dentists Jay and Manisha Patel. You can call with any questions and concerns, and know that you are getting answers that are relevant to you and your mouth, not just generic information that a rep reads off the screen.

And, should you have a problem that you think needs attention, you can always come into the office to have it checked out.