My Blog

Posts for: July, 2016

By Paul David Epstein, D.M.D. & Associates, P.C.
July 25, 2016
Category: Dental Procedures
Tags: bridge   partial denture  
ATeensMissingToothMayRequireaTemporaryReplacement

Besides reduced biting and chewing function, a missing tooth can cause an embarrassing inhibition to healthy social interaction. This can be especially so for teens who greatly value peer relationships and acceptance.

Be that as it may, we typically discourage a permanent replacement for teens with a missing tooth, particularly dental implants. While we value a patient’s psychological needs, the long-term effect on dental health may be too great to advise otherwise.

The effect we’re concerned with involves jaw growth and development. Although a person’s permanent teeth have usually all erupted by early adolescence, the jaws continue to grow until the late teens or early twenties. Natural teeth can adapt to this growth because the periodontal ligament that holds them in place allows for incremental tooth movement. The teeth move in response to jaw growth and are thus able to maintain their proper relationship and alignment in the jaw as growth occurs.

Dental implants, on the other hand, are imbedded into the jaw bone: they, therefore, can’t move like natural teeth and thus can’t adjust their position with jaw growth, particularly the upper jaw as it grows forward and down. This can result in the implants appearing as though they are left behind or retreat into the jaw. It can also affect the position of the gums and inhibit their growth around the implants.

It’s best then to hold off implants and other permanent restorations until the jaw has finished developing. That, however, isn’t always easy to determine: specialized x-ray diagnostics may help, but it’s not an exact science. Your input as a parent will also be helpful, such as whether you’ve noticed the end of growth spurts (not changing clothes or shoe sizes as often) or your child’s recent similarity in appearance to other adult members of your family. It thus becomes a judgment call, based on examination and experience, as to whether it’s safe to proceed with implants — and may require erring on the side of caution.

In the meantime, there are temporary restorations that can improve appearance while you wait for the appropriate time to undertake a permanent restoration. Two of the most useful are removable partial dentures (RPDs) or a bonded bridge, a less invasive form of the traditional bridge. With a proper assessment we can advise you on which option is your best choice.

If you would like more information on tooth restorations for teenagers, 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 “Teenagers & Dental Implants.”


By Paul David Epstein, D.M.D. & Associates, P.C.
July 17, 2016
Category: Oral Health
ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavi­ties. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”


By Paul David Epstein, D.M.D., & Associates, P.C.
July 08, 2016
Category: Dental Procedures
Tags: dental implants  

Dental implants offer an excellent way to replace a missing tooth, but they also provide valuable dental health benefits. Dr. Paul Epstein, your Burlington, MA, dentist at Paul David Epstein, D.M.D., & Associates, P.C., explains how dental implants keep your smile healthy.Dental Implants

Dental implants replace your roots

Unlike other tooth replacement options, dental implants replace your entire tooth from the root to the crown. The loss of a tooth can be particularly devastating because the roots no longer provide the constant stimulation your jawbone needs to stay healthy. Without constant pressure from your roots, your jawbone begins to shrink and weaken. Eventually, facial sagging and further tooth loss can occur.

After your Burlington dentist places the implant in your jaw, it begins to bond to the bone. After three to six months, bonding is complete, and your implant takes over the role your roots once performed. Your new implant is now ready to provide a stable foundation for the crown, the artificial tooth that replaces the visible part of your tooth.

Dental implants help keep your teeth straight

Have you ever taken a crayon out of the package and noticed that the other crayons don't remain completely upright any longer? It's the same principle when you lose a tooth. Your teeth work together as a unit and help support each other. When one tooth is lost, the other teeth begin to drift toward the opening.

Eventually, your teeth begin to overlap after you lose a tooth. Overlapping can affect your appearance and cause bite issues if your upper and lower teeth no longer meet perfectly. It's also difficult to clean cavity-causing plaque from your teeth when they overlap. Unfortunately, if you can't remove plaque efficiently, you'll increase your risk of tooth decay.

When you choose a dental implant, surrounding teeth will remain straight and healthy. Flossing and brushing will be much easier, and you won't experience any of the painful or uncomfortable symptoms of bite issues.

Dental implants offer the perfect solution no matter how many teeth you've lost. Call Dr. Epstein, your Burlington, MA, dentist at Paul David Epstein, D.M.D., & Associates, P.C., at (781) 273-1152 to find out if you're a good candidate for dental implants. Keep your smile healthy with implants!


By Paul David Epstein, D.M.D. & Associates, P.C.
July 02, 2016
Category: Oral Health
Tags: dentures  
SleepinginDenturesDontDoIt

Maybe you don’t like to be without teeth — ever. Or maybe you get a little forgetful sometimes. Whatever the reason, if you’re wearing your dentures to bed at night, we have one message for you: Please stop!

Sleeping in dentures can have serious health consequences. A recent study published in the Journal of Dental Research found that nursing home residents who wore their dentures to sleep were 2.3 times more likely to be hospitalized or even die of pneumonia as those who did not sleep in dentures. But how can wearing dentures at night more than double your chances of getting a lung infection?

As the study noted, pneumonia-causing bacteria can readily be moved from the mouth to the lungs simply by breathing. And dentures that are not removed at night can become breeding grounds for all kind of bacteria and fungi (such as yeast). That’s what makes them potentially dangerous.

Another condition often seen in people who wear upper dentures continually is called denture stomatitis, which is characterized by a red, inflamed palate (roof of the mouth) that has been infected with yeast. The yeast microorganisms can also infect cracked corners of the mouth, a condition known as angular cheilitis. Moreover, it has also been shown that people who sleep in dentures have higher blood levels of a protein called interleukin 6, which indicates that the body is fighting an infection. Need we go on?

Wearing dentures is supposed to improve your quality of life, not reduce it. So promote good health by taking your dentures out at night, and sticking to a good daily oral hygiene routine:

  • Remove and rinse your dentures after every meal.
  • Brush your dentures at least once a day with a soft toothbrush or denture brush and dish soap, liquid antibacterial soap, or denture cleanser (but don’t use toothpaste — it is too abrasive).
  • Store your dentures in water or a solution made for this purpose.
  • Brush your gums and tongue every day with a soft toothbrush (not the same one you clean your dentures with).
  • Rinse your dentures in clean water before you put them back in your mouth.

If you would like any more information on dentures and oral hygiene, please contact us or schedule an appointment for a consultation.