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Happy Oral Cancer Awareness Month! We know oral cancer can be kind of a scary topic, but it’s worth using this opportunity to learn about the disease and spread knowledge so everyone becomes more aware. The more we know, the better we can work to prevent it!

Oral cancer is exactly what it sounds like: cancer that occurs anywhere in the mouth. It could occur on the tongue, the lips, the gums, the tongue, inside the cheek, or in the roof or floor of the mouth. Every  year, more than 8,000 people die from oral cancer. It’s a truly deadly disease.

The reason oral cancer scores a higher death rate than other common cancers such as testicular cancer, Hodgkin’s disease, thyroid cancer, cervical cancer, or even skin cancer, is because it often goes undetected until it's become too advanced and has spread to another part of the body.

So what causes this devastating disease? There is no clear answer, but some potential causes have been identified. By being aware of these, we can be alert and promote prevention of this illness:

• Age: Most patients who develop oral cancer are above the age of 40. If you’re over 40, make sure your doctor checks for signs of oral cancer and that you stay on your dental hygiene regimen.
• Tobacco: Excessive tobacco use, whether in the form of cigarette smoking or tobacco chewing, can be a substantial contributor and cause of oral cancer. So that’s another reason, among many, you should avoid tobacco.
• Alcohol: Excessive alcohol consumption can put you at risk because alcohol converts into a chemical called acetaldehyde, which damages the body’s DNA and blocks cells from repairing the damage. When paired with tobacco, the dehydrating effects of alcohol make it even easier for tobacco to infiltrate mouth tissue.
• Sun exposure: Your lips need SPF, too! Repeated sun exposure increases your risk of contracting cancer on your lips, especially the lower lip.
• Diet: Not getting all the nutrients you need, from vegetables and fruits for instance, can weaken your immune system and make you more vulnerable to the disease.

Obviously, many of these causes relate to lifestyle choices, which we have control over. It's all about balance, being aware, and making small tweaks to our habits if we need to.

If you’re concerned that you may be at risk for oral cancer, give us a call to talk about a screening. And if you’ve been putting off a visit to our Livingston office, now is an excellent time to schedule one. Regular visits to the dentist can be the first line of defense against oral cancer!

When patients of A R Periodontics hear any mention of oral or dental hygiene, they probably think of brushing and flossing their teeth. Although these are extremely important, the term dental hygiene encompasses much more than that. Your mouth’s health, including your teeth, has an important impact on your overall physical health. The National Institute of Dental and Craniofacial Research published the surgeon general's first ever report on dental health. It is called A National Call to Action to Promote Oral Health. In that report, the Surgeon General states that the 1948 World Health Organization expanded its earlier definition of health to "a complete state of physical, mental, and social well-being, and not just the absence of infirmity."

The Importance of Oral Health to Total Overall Health

One of the most important themes that the dental health report stressed is that you cannot be healthy without oral health. It went on to explain that oral health and general health are inextricably linked, and therefore can't be seen as two separate things. Because oral health is so critical to overall health, it should be included in all community health programs. For individuals, this means that it is just as important to take care of your mouth, your teeth, and your overall oral health as it is to take care of the rest of your body. The two most prevalent dental diseases are caries (cavities), also known as tooth decay, and periodontal (gum) disease.

Ways that Oral Health Impacts Overall Health

One important way in which good oral health contributes to better overall health is seen in the findings of several studies in which the blood sugar levels of diabetic patients were significantly lowered when their periodontal (or gum disease) was successfully treated. Your mouth has roughly 500 different species of bacteria. Many are harmless, and some are even good bacteria that help maintain the balance of your intestinal flora. Harmful bacteria can infect your gums, causing gingivitis. Your body's immune system may try to fight off the alien invaders, but they attack your gums, causing inflammation and bleeding when you brush.

Now that you know how important good dental hygiene is, be sure to see to get your teeth cleaned every six months, have regular dental checkups, brush and floss your teeth at least twice daily, and replace your toothbrush at least every couple of months. Call us to schedule your next appointment at our convenient Livingston location.

Many adults wonder if they should continue to receive fluoride treatments. Our team at A R Periodontics wants to set the record straight about the usefulness of fluoride treatment for adults.

There are several reasons fluoride treatments could be beneficial to you as a grownup. If you have a high risk for cavities, topical fluoride applications can cut down on that risk.

If you’re experiencing gum recession that’s softening your enamel, fluoride treatments can slow down that process. Fluoride treatments may also protect expensive restorative work on crowns or bridges that may be adversely affected by plaque.

In addition, fluoride can also protect teeth in adults who have orthodontic braces or who sometimes neglect to keep up with daily oral hygiene regimens such as flossing and using mouthwash.

Do you have sensitive teeth? Consuming foods that are highly acidic or using teeth-whitening products can lead to irritated gums. Fluoride treatments remineralize your enamel and reduce sensitivity.

If you’ve undergone radiation treatment for cancer, fluoride can help restore any dry-mouth damage that may have developed during that time. Saliva acts as a buffer against the foods we eat, and without enough of it you may be more likely to get cavities.

In general, fluoride treatments are not always necessary for adults, but they can be beneficial to your overall oral hygiene depending on your situation. If you fall into one of the general areas listed above, ask about a fluoride treatment during your next visit at our Livingston office.

We can also go over your options to treat other issues you may experience in terms of your oral health. Until then, make sure to take care of your teeth properly and use toothpaste or mouthwash that contains fluoride on a regular basis.

For most of our oral health care needs, our family dentist is the perfect person to see. Examinations, cleanings, treating cavities, restorations such as fillings and crowns, preventive care—you’ve probably seen your regular dentist for many of these procedures.

And when it comes to treating mild gum disease, known as gingivitis, your dentist is a good person to call. If you’ve noticed bleeding gums, or gum pain when brushing, or redness, or recurring bad breath, you might have gingivitis. Often, with more attention to brushing and flossing and a professional cleaning, your gums will be healthy again in no time.

Gingivitis, though, is not the only type of gum disease. Periodontitis is the medical term for advanced gum disease, and this type of gum disease is progressive, becoming more serious over time. Untreated periodontitis can lead to infection, inflammation, and loss of tooth and bone.

If you have serious gum disease, it’s time to visit Dr. Rothstein. Periodontists are specialists with years of advanced training and experience in the diagnosis and treatment of the structures supporting your teeth, including the gums, periodontal ligaments, and surrounding bone.

Here are four very good reasons to give our Livingston periodontal office a call:

• Receding gums

If you’ve noticed that you’re seeing more tooth than you’re used to, this could be a sign of receding gums. Besides affecting the appearance of your smile, gum recession can impact your dental health.

When gums pull away from the teeth, the top of the roots, which were once protected by healthy gum tissue, are now exposed to bacteria and plaque. Because our roots are covered by cementum, which is softer than enamel, they are more vulnerable to decay, and decay progresses more quickly than it does in the tooth crown.

• Infected/inflamed periodontal pockets

When the gums pull away from the teeth, a pocket forms between tooth and gum. Bacteria and plaque collect here, where your toothbrush can’t reach, leaving you at risk for abscess and infection.

A periodontal abscess is a pocket filled with pus which forms between tooth and gum. Beyond the swelling and pain caused by an abscess, infection can spread, damaging connective tissue and bone in the jaw, and potentially spreading to other parts of the body.

• Loose teeth

A loose baby tooth is a welcome surprise for a child—a loose adult tooth? Not so much! Loose permanent teeth can be caused by several conditions, including an injury, osteoporosis, and pregnancy. But the one of the most common causes of loose teeth in adults is periodontitis.

Periodontal infection and inflammation can damage the ligaments and bone that support the teeth and hold them firmly in place. This damage results in loose teeth and can lead to tooth loss if left untreated.

• Your dentist’s recommendation

If your dentist has suggested a periodontal consultation at A R Periodontics, please follow this advice!

What can a periodontist do for you?

• Receding gums can be treated with gum grafts when the recession is extensive, both to protect the roots of your teeth and to enhance the appearance of your smile.
• To prevent the formation of deep periodontal pockets, Dr. Rothstein might suggest scaling and root planing procedures, non-surgical deep cleaning treatments which encourage gum tissue to reattach to smooth, clean teeth. If necessary, pockets can be cleaned and gum tissue re-secured around the teeth with pocket reduction surgery.
• When the bone structure has been damaged, bone and tissue grafts can regenerate and restore structural integrity.

Periodontitis is progressive, and, as time goes by, infection and inflammation will continue to do damage to the gums, ligaments, and bone that support your teeth. Your Livingston periodontal team is an invaluable resource for treating periodontitis and for preventing its recurrence. So if you suffer from gum disease, let’s finish with one more reason to see Dr. Rothstein: working together proactively for a lifetime of attractive, healthy smiles.

While you don’t have to wait to start eating right, March is the month the Academy of Nutrition and Dietetics asks everyone to pay special attention to what goes into our bodies. The Academy has designated the month of March for focusing the public’s awareness on what they eat.

What Not to Eat

The academy points out that the foods you eat have a direct effect on the health of your teeth and specifically on tooth decay. Bacteria rely on carbohydrates to thrive. That is why Dr. Rothstein and our team at A R Periodontics tell our patients to cut back on both candy and sweets. They consist of simple sugars that feed the bacteria in your mouth and enhance tooth decay.

It’s the hidden sugars that will cost you, though. Get in the habit of reading labels on food and looking for products with added sugar. This includes ingredients that end with the suffix “ose.” When it comes to nutrition, these foods offer little value beyond satisfying that sweet tooth.

What You Should Eat

Turn to foods that not only taste good but are good for your teeth too. Dairy products, for example, provide the body with nutritional items that support tooth enamel. Foods high in protein feature phosphorus, a nutrient critical to oral health.

You can’t really go wrong by adding color to your diet, either. Fruits and vegetables make for a colorful plate and a healthy meal. Use some caution with acidic fruits like oranges or even tomatoes, because the acid can erode tooth enamel. It is better to include these foods in a meal instead of eating them by themselves.

Remember, good nutrition is something you should worry about all year long, not just when celebrating National Nutrition Month. March just serves as a fun reminder that eating right is a proactive step in managing your dental health.

We encourage you to give us a call at our Livingston office to learn more!

As the saying goes, you are what you eat. But did you know that what you eat also affects your smile? Chow down on these seven tasty treats, recommended by Dr. Rothstein and our staff, for a healthier mouth and a smashing smile!

Sesame Seeds

These tiny seeds that you find in some Chinese and Thai dishes (as well as on top of your hamburger bun) are packed with bone-building calcium. They help to preserve and protect the bone that supports your teeth and gums. As a bonus, they also help to build up your tooth enamel while sloughing away plaque.

Kiwi

This funny little fruit has the highest amount of Vitamin C of any fruit, including oranges! What does this mean for your chompers? Well, you need Vitamin C to keep your gum tissue healthy and strong. Without it, they are more susceptible to periodontal disease.

Sweet Potatoes

These are not just for Thanksgiving and Christmas dinner! You should add sweet potatoes to your regular diet. These tasty spuds are rich in Vitamin A, which your body uses to form tooth enamel and heal gum tissue.

Onions

You know those strong vapors from onions that make you cry? Well, they come from the sulfur compounds in the vegetable, which gives them a superpower-packed antibacterial punch. Get ready, though: Onions are most effective for your smile when you eat them raw!

Cheese

If you love cheese, you will love this news! Munching on some cheese helps prevent gum disease and cavities. The reason is that cheese is very high in calcium and phosphate, which help to balance the pH levels in your mouth. This in turn helps to preserve your tooth enamel and kill harmful bacteria.

Green Tea

Sipping on some green tea can not only help prevent cavities and gum disease, it can also kill the bacteria that cause bad breath. Score! Green tea has catechins, which actually kill the bacteria that cause plaque. So drink up! Your smile depends on it!

Celery

Have some fun with that crunchy stuff because, guess what? It is great for your smile! When you chew celery you produce saliva. Your saliva neutralizes cavity-causing bacteria. As a little added bonus, while you are chewing, it is giving your gums a little massage and cleaning between your teeth.

So grab some of these healthy snacks and give your mouth something to smile about!

You’ve planned your dream vacation. Your reservations are made. You’re packed and ready. You’ve even scheduled a dental checkup at our Livingston office to make sure you catch any potential problems, have finished any major work, and have an up-to-date chart.

But things don’t always go according to even the best of plans. So, what to do if you find you have a dental emergency while traveling? Dr. Rothstein and our team have some recommendations for problems that might arise.

• Toothache—Rinse your mouth with warm water and use dental floss to remove any food particles. Never put aspirin directly on a tooth or gum tissue. If the pain persists, call a dentist.
• Cracked or broken tooth—Immediately rinse with warm water to clean the area and apply cold compresses to the face to minimize swelling. Get in touch with a dentist.
• If you lose a tooth—Keep the tooth moist at all times. Put the tooth back in the socket without touching the root if possible. If that is not an option, place the tooth between the cheek and gums or in milk. See a dentist as soon as possible.

Know where to get help if you need it! If you are traveling in the United States, the American Dental Association offers Find-a-Dentist, a website that can locate a member dentist closest to you. If you are traveling to another country, there are steps you can take to prepare for an emergency.

• If you are out of the country and need to locate a dentist, your local embassy or consulate, your hotel concierge, or friends abroad can be a useful resource.
• Before you go, check your insurance to see if you are covered while traveling.
• If you have travel insurance, find out if it covers dental treatment and can provide information on qualified local dentists and translation help, if necessary.
• Good dental care is available in many areas internationally, but it is important to know what standards are present in the countries you plan to visit. The Organization for Safety and Asepsis Procedures offers a checklist for safe treatment in their “Traveler’s Guide to Safe Dental Care.”

If you have any questions, Dr. Rothstein and our team are happy to do all we can to answer them. While it’s unlikely that problems will arise, we are always available if you need to contact our Livingston office. Bon voyage, and we look forward to hearing about your trip!

Valentine’s Day, also known as Saint Valentine’s Day, has been said to originate with a Catholic priest named Valentine several thousand year ago. Valentine defied the emperor at the time by secretly marrying men and their brides after the emperor had made it illegal to marry. Emperor Claudius II did this because he wanted as many single young men to fight in his war as he could get.

Valentine disobeyed the emperor’s edict by continuing to marry couples until he was sentenced to death. Before his execution, he sent a letter to a secret love and signed it “From your Valentine.” Dr. Rothstein and our team have come up with some suggestions on how you can celebrate this Valentine’s Day, whether you have a valentine of your own or not.

Valentine's Day Ideas

• Enjoy a tasty treat. There are plenty of options when it comes to cooking and/or baking on Valentine’s Day. Make your significant other his or her favorite meal or sweet treat, or make your own favorite dish to enjoy on this day. Oh, and be sure to make enough for leftovers!
• Make a personalized card. Instead of buying a card from the grocery store, take the time to make your own for a loved one. People love handwritten notes, especially when it’s from someone special. If you’re single this Valentine’s Day, make a card for fellow single friend to brighten the day and remind the person that he or she is also loved.
• Watch a movie. We all know there are plenty of romance movies out there. Put on your favorite romantic comedy, or pick up your significant other’s favorite movie to watch together. Even better, if you’re single, pick up your own favorite movies to watch to pass the time this Valentine’s Day.
• Do nothing! We all know Valentine’s Day can sometimes get a lot of hype. If you’re worried about not making a reservation in time, don’t feel like planning an extravagant night out, or simply not in the holiday mood this year, spend your day sitting back and relaxing.

Valentine’s Day is a time to celebrate love and spend quality hours with the people you care about the most. Whether you’re in a relationship or single, take some time today to appreciate those you love in your life.

We wish you a happy Valentine’s Day celebration and look forward to seeing you at our Livingston office during your next appointment.

It's a moment many of our patients have experienced. One second you're chewing on a piece of gum, then suddenly you forget to keep chewing and swallow the entire rubbery gob whole! It's at this point you remember your mother warning you as a child that if you swallow gum it will stake a claim and take up residency in your belly for seven years. Dr. Rothstein and our team at A R Periodontics hate to take all the fun out of the mystery, but the truth is that chewing gum, when swallowed, will enter your stomach and move through your digestive system just like any other piece of food. So, if you ever accidentally swallow a piece of gum, there is no need to worry!

That being said, it's important to know that gum does not have any dietary benefits, so while it’s not exactly harmful to swallow, you still want to avoid swallowing it. If you are an avid gum-chewer, we encourage you to chew sugarless gum, especially if you are wearing braces, because gum with sugar can lead to cavities. Sugarless gum still has the same amount of flavor, but has fewer cavity-causing ingredients. In fact, many brands contain an additive called xylitol, a natural sweetener known to fight cavity-causing bacteria. Xylitol is also known to increase salivary flow as it rinses away plaque and acid.

The fact is, when the bacterium in your mouth breaks down sugar, what’s left behind is acid. This acid eats away at the enamel coating of your teeth, causing holes that we call cavities. Cavities can lead to other long-term mouth problems if they are not treated in time, so it is best to try and avoid overexposing your teeth to too many harmful substances!

If you have any questions about chewing gum, please contact our office. Happy (sugar-free) gum chewing!

Taking care of your gums is one of the best ways to protect your smile. But sometimes, we treat our gums like an afterthought when it comes to dental care. It might surprise you to learn just how common gum disease is—and how damaging it can be for your oral health.

Surprising Fact #1:

About half of all adults have suffered or are suffering from some form of gum disease. And about half of all children do, too. As we age, the percentages jump—in fact, some studies estimate that eventually 70% of older adults will be affected by gum disease.

Surprising Fact #2:

The major cause of tooth loss in adults isn’t tooth decay or accidents or aging—it’s gum disease.

Surprising Fact #3:

Gum disease is progressive. The gingivitis that begins with a bit of redness or some minor bleeding when you brush might seem like a temporary annoyance. But when ignored, this early form of gum disease can lead to periodontitis, a serious gum condition which causes receding gums, loose teeth, bone and tissue damage, infections, and tooth loss.

Gingivitis

Gum disease begins quietly and invisibly, and it usually starts with plaque. Plaque along the gum line irritates our gum tissue. The body’s immune system responds and triggers inflammation. Gum tissue becomes swollen and red. The gums might feel tender, or bleed easily when you brush or floss.

If you’ve experienced any of these symptoms, it’s time to call our Livingston office. Dr. Rothstein might recommend better brushing and flossing habits, a professional cleaning, and/or an anti-plaque treatment. At this stage, with proper care, gingivitis is reversible.

But left untreated, gingivitis can progress over time until it becomes periodontitis. Periodontitis affects not only gum tissue, but the bone and connective tissue which surround our teeth, supporting them and holding them firmly in place.

Mild Periodontitis

As plaque and tartar continue to irritate gum tissue above and below the gum line, inflammation increases, and the gums begin to pull away from the teeth. This is a problem, because the gums normally surround the tooth roots snugly, protecting them from plaque, bacteria, and other toxins.

When gum tissue pulls away, pockets are created between gums and teeth. These pockets become home to more bacteria, causing more irritation, inflammation, and infection. During this phase, the connective and bone tissue around the tooth’s roots might start to break down.

Moderate Periodontitis

As the disease progresses, pockets become deeper. The structures that hold the teeth in place continue to break down, and the teeth start to loosen. As the gums recede, tooth roots become more vulnerable to decay.

Advanced Periodontitis

When periodontitis has reached the advanced stage, there is significant loss of tissue and bone around the teeth. Teeth become looser and foul breath, pus, and pain when biting or chewing are common. Without prompt treatment, there’s a high risk of tooth loss.

Unlike gingivitis, periodontitis isn’t reversible, and requires professional care. Advanced treatments can do a lot to restore gum health:

• Topical, time-release, or oral medications treat infection.
• Scaling and root planing, which are non-surgical deep cleaning procedures, remove plaque and tartar above and below the gum line, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth.
• Flap surgery treats more advanced gum infection, reducing pocket depth and re-securing the gums snugly around the teeth.
• Bone grafts, gum grafts, and other regenerative procedures are available that help restore and repair tissue damaged by gum disease.

That’s good news, and there’s even better news: Because gum disease is typically triggered by plaque, it’s very preventable.

• Brush carefully at least twice each day for at least two minutes. Don’t forget to brush along the gum line!
• Use floss at least once each day or as directed by Dr. Rothstein. If you have trouble flossing, ask us for the flossing tools and techniques that will work best for you.
• See your dentist regularly to catch and treat early gum disease while it is still reversible.

While gum health is essential for dental health, healthy gums might mean more than just healthy teeth. Scientists are studying the potential links between gum disease and its effects on conditions such as heart disease, diabetes, and arthritis. Gum health should never be an afterthought. Taking care of your gums is one of the best things you can do to ensure a lifetime of healthy smiles.

It can be. There is more and more evidence to suggest people may be genetically susceptible to periodontal (gum) disease. According to a study published in the Journal of Clinical Periodontology, as much as 30 percent of the U.S. population may be genetically vulnerable to gum disease.

Research has suggested that bacteria causing periodontal disease are passed via saliva. This means that when family members come into contact with each other’s saliva by activities such as sharing drinks, they put themselves at risk for contracting periodontal disease. Based on this research, experts at the American Academy of Periodontology strongly recommend that all family members receive a periodontal disease screening if one of their family members has gum disease.

Despite persistent oral care habits such as brushing twice daily, flossing, and going to the dentist twice a year, these people may be more likely to develop periodontal disease at some point in their lifetime. Luckily, Dr. Rothstein and our team can identify these patients by having them undergo a genetic test that analyzes genes and can help us identify an person’s risk for periodontal disease, as well as getting them into early intervention treatment.

Periodontal disease prevention starts with a visit to our Livingston office. During your appointment, Dr. Rothstein and our professional team can identify whether you have gum disease or if you are at risk for developing gum disease. Together we can take the necessary steps to treat the disease or prevent it entirely.

To learn more about preventing gum disease, or to schedule your next visit at A R Periodontics, please give us a call today!

Dr. Rothstein and our team always tell our patients that if you value your overall health, not just your oral health, anytime is a good time to visit A R Periodontics for a periodontal evaluation. Sometimes the only way to identify periodontal (gum) disease is through a comprehensive periodontal evaluation. If you notice any of the following periodontal disease symptoms outlined by the American Dental Association, it may be time to give us a call to schedule an exam:

• Gums that bleed easily or are swollen, red, or tender
• Gums that bleed while brushing, flossing, or eating hard foods
• Pus between your gums and teeth
• Sores in your mouth
• Gums that are receding or pulling away from the teeth, causing teeth to look longer than before
• Frequent bad breath or a bad taste in your mouth
• A change in the way teeth align when you bite
• A change in the way partial dentures fit

It is also important to note that it’s possible to have gum disease and have no warning signs. While studies have indicated that older people have the highest rates of periodontal disease, we recommend being seen by Dr. Rothstein sooner rather than later when dealing with gum disease. An evaluation at our office can not only help catch gingivitis, the early form of gum disease in time, but can also give you peace of mind. Gingivitis, if detected early, can be treated and eventually reversed.

Not doing anything, however, can lead to periodontal disease, which can in turn lead to tooth loss. The best way to avoid gum disease is to visit our Livingston office for an evaluation. To schedule your visit, please give us a call today! We look forward to seeing you!

You might have noticed that the dental aisle of your drugstore is larger than ever, with more options than ever for getting the spaces between your teeth their cleanest. Flosses made with different shapes, materials, and coatings. Wooden dental sticks. Flexible plastic picks. Tiny interproximal brushes. Water flossers. With all these choices, what’s a conscientious person to do?

• Find What Works Best for You!

We’ve come a long way from the one-size-fits-all floss of our grandparents. Today’s plaque-removing tools are designed to make interdental cleaning easier and more efficient for users with a variety of different needs.

• Floss Choices

Flossing properly is a very effective way to get rid of the plaque that builds up between your teeth and along your gum line—not to mention the food particles which your brush may have missed. And now there are options to suit both your needs and your preferences.

Modern flosses come waxed or unwaxed, flat or rounded, made of natural or synthetic material, flavored or unflavored. There are flosses designed for specifically for braces and eco-friendly, biodegradable flosses. If you’re not happy with your regular floss, a different size, material, or texture might make all the difference.

Even with all these choices, though, flosses don’t always suit everyone. Luckily, if you’ve had trouble with floss, you have many other options available for interdental cleaning:

• Floss Picks

These tiny, handled tools hold a piece of dental floss in their curved end. You can direct the floss to the perfect spot, which is especially useful if you’re having trouble reaching your back teeth or have mobility issues.  Floss picks can be disposable or refillable, and come in different sizes to accommodate adults and children.

• Dental Picks

Back in the day, toothpicks were the go-to for dislodging food particles. But they weren’t designed for gum health and safety. Today, we have gentler, more efficient options for those of us who like the ease of using a pick and the convenience of being able to clean our teeth at work, at school, or on the go.

Triangular wooden picks are tapered to fit between the teeth and massage the gum line as they scour plaque from tooth enamel. Soft plastic picks are popular because their flexible tips fit easily in between the teeth, while their texture provides gentle scrubbing for your tooth enamel.

• Interproximal Brushes

Big name; tiny brush. These little cone-shaped brushes come in various sizes so they can fit snugly and comfortably between teeth whether widely or narrowly spaced. They’re especially handy for getting around wires if you wear braces.

• Water Flossers

These high-tech tools provide a pulsing stream of water to clean between the teeth. They’re particularly helpful for those with mobility issues and those with traditional or lingual braces. To make sure you’re getting the job done, choose a model with a dental seal of approval, which means it has been tested for safety and effectiveness.                                                                                                                                                                  

With so many options, you can sample different flossing alternatives until you find the one which works best for you.

• Technique Is Key

No matter which product you choose, the key to effective plaque removal is your technique. You need to be thorough. You need to be gentle enough to protect your delicate gums, but not so gentle that you don’t remove any plaque.

Whichever method you choose, carefully follow directions to get optimal cleaning benefits while protecting tooth enamel and gum tissue. And remember, you have an expert ally in your corner—Dr. Rothstein! If your periodontist is seeing a lot of plaque buildup at your next exam, ask for tips to improve your interdental cleaning technique and suggestions for the best products to accommodate your specific needs.

• Choose It—Then Use It!

Even after deciding on the best tool and technique, your teeth and gums won’t benefit from your research if your floss or pick or brush or water flosser is languishing in the medicine cabinet. While dentists recommend flossing at least once each day, if you have braces or a tendency toward cavities or gum disease, your periodontist might recommend flossing more often.

Why is flossing so important? Even with the best brushing technique, it can be hard to reach plaque and food particles caught between the teeth and near the gum line. Removing plaque from between teeth can help prevent cavities, and it’s especially important for gum health.

Plaque and tartar are extremely irritating to gum tissue. This irritation causes inflammation, and you’ll soon start to see the first signs of gingivitis (early gum disease)—swelling, redness, bleeding, bad breath—when flossing is hit or miss. Over time, left untreated, gingivitis can lead to periodontitis, a serious form of gum disease which can cause tooth and bone loss.

When caught early, you can often reverse the irritation, inflammation, and unpleasant symptoms of gingivitis with a week or two of careful brushing and flossing. If your gums are bothering you despite your careful cleaning, it’s time to visit our Livingston periodontal office. There are lots of options available for getting your teeth their cleanest—but you have only one smile!

It’s a new year, and a resolution found on many lists is learning to be more mindful about healthy food choices. You might have set some of these goals yourself. Gaining, losing, or maintaining your current weight. More fruits and veggies. Better proteins. Less sugar. Fewer carbs. You want to make this new year your healthiest year yet.

And while you’re making your new and improved shopping list, don’t forget your oral health! Because while brushing and flossing are extremely important, your diet can also have very real benefits for your teeth and gums.

Stronger Teeth and Jaws

We often talk about teeth and bones together, and that’s natural. Calcium and phosphorus, as well as other minerals, make them the strongest parts of our bodies. When teeth lose mineral strength, they are more vulnerable to cavities, and bone loss in the jaw can cause loose or even lost teeth.

Making sure you get the recommended daily amount of the minerals and vitamins you need will help sustain and repair both teeth and bones. A diet rich in calcium, phosphorus, and vitamin D helps build strong bones and promotes bone density. While your teeth can’t create new enamel, minerals that are eroded by acids from plaque and acidic foods can be restored, or remineralized, with the calcium and phosphates in saliva.

• Calcium

Strong teeth and bones need calcium. More than 99% of the calcium in our bodies is located in our teeth and bones. How to make sure we get enough?

Dairy products are the traditional answer. Several servings of milk, cheese, or yogurt each day supply most of our needs. If you can’t eat dairy, though, calcium is also found in other foods, such as salmon, sardines, many dark leafy vegetables, and fortified juices, tofu, and cereals.

• Phosphorus

Calcium gets most of the attention when it comes to creating strong teeth and bones, but it’s not a solo act. We need phosphorus to make full use of the calcium in our diets.

Proteins like meat, fish, and poultry are good sources of phosphorus, as are beans, nuts, whole grains and dairy.

• Vitamin D

Vitamin D is a diet essential because it enables us to absorb the calcium and phosphorus that keep teeth and bones strong.

Most dairy and many other foods are fortified with vitamin D, such as cow’s milk, soymilk, orange juice, and cereals. Egg yolks and fatty fish, such as salmon, tuna, and herring, are also a rich natural source of the vitamin.

Healthy Gums

Gum disease is more than just a nuisance. Left untreated, gingivitis (early gum disease) can become periodontitis (serious gum disease). Periodontitis can cause infection, loose teeth, and tooth and bone loss.

Brushing and flossing promote gum health and help prevent gum disease, but your diet plays an important role, too.  

• Vitamin A

Vitamin A is essential for the health and healing of mucous membranes, including gum tissue and the soft membranes in the mouth.

You can get this vitamin directly from animal products such as dairy foods and meats, or it can be formed in the body from beta-carotenes. Think orange when you hit the produce aisle, because foods such as carrots, peppers, pumpkin, squash, and sweet potatoes are a rich source of beta-carotenes.

• Vitamin C

Vitamin C is one of the so-called “essential nutrients.” These are the nutrients that are necessary for our bodies to function properly, and which can only be supplied in our diets. Vitamin C is vital for healthy gums and soft tissue—in fact, one sign that your diet is deficient in vitamin C is inflamed and bleeding gums.

Citrus fruits, those oranges, lemons, limes, grapefruit, and all their cousins, are a wonderful source of vitamin C, but you have many other flavorful options. Fruits such as kiwis, mangos, papayas, and strawberries are rich in vitamin C. Step over to the vegetable aisle to load up on red peppers, kale, cauliflower, Brussels sprouts, and broccoli—all of which contain more vitamin C per serving than a medium orange!

Fewer Cavities

Plaque thrives on a diet of sugar. Oral bacteria in plaque use the sugars in our food to produce acids. These acids erode enamel and eventually lead to cavities. Limiting your sugar consumption and choosing complex carbohydrates over simple carbs are two ways to reduce your risk of cavities.

• Sugars

The usual suspects—candies, desserts, pastries, sodas—are sugar-filled items you’re familiar with. What might surprise you is the amount of sugar in sports drinks, fruit juices, flavored yogurts, breakfast cereals, and other standard grocery purchases. Checking labels for sugar content is a great way to cut down on unexpected sweeteners.

• Carbs

The refined starches in white bread, white rice, potato chips, and other simpler carbohydrates quickly break down into sugars. This is the kind of nutrition only plaque appreciates.

Instead, fill your cart with complex carbohydrates, which contain important vitamins, minerals, and fiber. Found in foods like whole-grain breads and cereals, legumes, and many vegetables, complex carbs break down slowly for longer-lasting energy.

Of course, these suggestions don’t cover everything on your healthy dental shopping list. We could add magnesium for bone density, vitamin B to prevent oral irritation and inflammation, vitamin K for bone strength, and more. To find out the best options for your healthiest smile, talk to Dr. Rothstein or a member of our Livingston team about ideas for improving your daily diet.

Because besides leading to stronger teeth, healthier gums, and fewer cavities, a careful and conscious approach to your food choices has another wonderful benefit—a healthy dental diet is healthy for the rest of your body as well. Just something to be mindful of as we greet the new year!

Gum disease can be painful and lead to missing teeth if you don’t treat it properly. However, there are plenty of things you can do to lower your risk of getting gingivitis and periodontitis. Here are five easy ways to prevent gum disease.

1. Brush your teeth.

Basic oral hygiene is the first line of defense against gum disease. The reason is due to the way gum disease progresses. There are bacteria in your mouth that produce a sticky substance called plaque. Plaque can build up and form tartar. Together, plaque and tartar lead to the painful symptoms of gum disease. You can remove plaque from your teeth with regular careful brushing, but you can’t remove the tartar with your regular toothbrush. So, it’s best to brush at least twice a day, or after each meal, to continuously remove plaque from your teeth. Also floss your teeth and use mouthwash to prevent the bacteria in your mouth from having anything to eat.

2. Stop smoking.

Smoking is a major risk factor for gum disease. Your risk of getting gum disease if you’re not a smoker is one-seventh the risk of someone who does use tobacco. It’s also worth quitting smoking even once you do get gum disease, since treatment is less effective when you’re using tobacco.

3. Eat right.

Gingivitis is a bacterial infection, and a strong immune system helps fight it. Many nutrients are essential for a well-functioning immune system. For example, eat plenty of fruits and vegetables, such as citrus fruits, broccoli, and strawberries, for their vitamin C, which is an antioxidant. Vitamin E, which is another antioxidant, is in nuts, plant-based oils, and wheat germ.

4. Visit our Livingston office regularly.

You might not be able to detect that you have gum disease, even if you watch for symptoms. Dr. Rothstein can detect signs of gum disease before you do.

5. Catch it early.

Since only we can remove tartar once it forms, keep watching for signs of gum disease. They include sensitivity while brushing your teeth or when eating hot, cold, or sugary foods, painful or bleeding gums, and loose teeth. You might also notice that you have bad breath for no reason. Make an appointment with at our Livingston office if you think you may have gum disease.

Congratulations! You’ve made the decision to replace a missing tooth with an implant. While an implant will restore the appearance of your smile, you also know that there are many reasons that an implant will improve your health, too.

A missing tooth causes structural problems as well as cosmetic ones. Remaining teeth can shift to fill the gap, leading to wear and bite problems. Without the stimulation of biting and chewing, bone tissue under the lost tooth gradually shrinks and is resorbed. The shapes of our jaws, cheeks and lips can be affected. Replacing a lost tooth with an implant can not only restore the appearance of your smile, but maintain it.

And implant procedures have a very high rate of success. Implants are made of materials compatible with the body, and surgically placed in the jaw to act as anchors for replacement teeth. The implant will actually integrate with the bone growing around it for strong, stable, and long-lasting support. After the time it takes for the implant to integrate and the area around it to heal, a crown, designed to match your own teeth perfectly, will be securely attached to the implant post.

What can you do to help the healing process? Follow our instructions carefully. Dr. Rothstein will give you suggestions for the time immediately following the procedure as well as instructions on the importance of keeping the area clean while healing takes place. And one very important favor you can do yourself? If you smoke, this is the time to stop.

Studies have shown that smokers have a significantly increased risk of dental problems and implant failures, and there are several theories as to why.

• Smoking slows the healing process. Some studies indicate that smoking impairs blood flow in the gums, so that less oxygen and fewer nutrients are delivered to healing tissue.
• Smokers tend to be more vulnerable to gum disease.
• Smoking has been linked to a weaker immune system, so it’s harder to fight off an infection or to heal from one.
• More marginal bone loss around implants is seen in smokers than in non-smokers.
• Peri-implantitis, an inflammation of the gum tissue around the implant that can lead to bone loss and implant failure, is also more common in smokers.

Now that you have decided on a dental implant at our Livingston office, make one more decision to ensure the success of the procedure. Talk to us about ways to quit smoking before your implant, and how to reduce the chance of smoking-related complications. We know that quitting can be difficult, but your improved smile—and your improved health—are worth it!

In fancy medical terms, dry mouth is known as xerostomia. It’s really just what it sounds like: a condition in which you don’t have enough saliva to keep your mouth moist. Dry mouth can be the result of certain medications you’re taking, aging, tobacco use, nerve damage, or chemotherapy.

Depending on whether you’re aware of the cause of your dry mouth, here are some simple ways to keep it at bay:

• Avoid drinks that contain alcohol or caffeine
• Avoid tobacco use, or lower your consumption of tobacco
• Floss after every meal
• Brush your teeth after every meal using a fluoride toothpaste
• Avoid foods that have a high level of salt
• Stay hydrated and drink water frequently
• Consider using a humidifier at night

If you have any questions about dry mouth and how it is affecting you, give our Livingston office a call or make sure to ask Dr. Rothstein during your next visit!

If you have periodontal surgery scheduled at our Livingston office, you have many options for your choice of anesthesia. After all, Dr. Rothstein and our team are trained in all forms of anesthesia and sedation therapy, so you will be able to choose the anesthesia experience that best suits your needs—and your comfort!

One such option is general anesthesia. If you choose this type of anesthesia, you will be carefully monitored at all times. While you are under our care, we want to make sure your treatment is safe, painless, and free from anxiety. And to make your experience go as smoothly as possible, there are some recommendations you can follow even before you arrive at the office.

• Communication

Part of our job is to let you know all about your general anesthesia beforehand. If you have any questions or concerns, please voice them. And communication is a two-way street! If you have any medical conditions, or are taking any medications, or have a cold or the flu, please let us know in advance.

• Diet Restrictions

Talk to us before your surgery to learn about any diet restrictions you should observe before general anesthesia. You will need to abstain from food and drink for a set number of hours before the procedure, so we’ll give you directions based on whether your surgery is scheduled for morning or afternoon.

• Dress for Success

Wear loose, comfortable clothing. Make sure your sleeves are short or easily rolled up above your elbow if you’ll need an IV line or blood pressure monitoring. Leave your make-up, jewelry, and contact lenses at home.

• Go Along for the Ride

Ask a friend or a family member for a ride home after surgery. We want you to travel safely, and, even if you think you are good to go, your thinking and decision making, your reflexes, and even your memory can be impaired for up to 48 hours after general anesthesia. If you have arranged for a cab or a ride share, don’t call for your ride until our office gives you the all clear.

• Plan Ahead!

For the very same reasons you shouldn’t drive for several hours after general anesthesia, there are some normal everyday activities you should postpone as well. You shouldn’t operate machinery. Cooking can wait. Arrange for help with childcare if you have young children. The effects of general anesthesia will wear off over the course of a day or two—ask us for a timeline for returning to your normal activities.

We’re experts in providing you with a safe and comfortable anesthesia experience when you have periodontal surgery. And part of that expertise is letting you know the specifics about preparing for your general anesthesia. If you have any questions for how to get ready for the hours both before and after your surgery, give us a call!

Let’s see…

Toothbrush? Check.

Fluoride toothpaste? Check.

Floss? Check.

Two minutes of thorough brushing? Check.

Careful cleaning around your brackets and wires? Check.

Wait… there’s something else… it’s right on the tip of your…

Ah! Your tongue! Whenever you brush, morning, evening, or any time in between, if you want the freshest breath and cleanest teeth, don’t forget your tongue.

Why your tongue? Because the tongue is one of the most common sources of bad breath. Let’s examine just why this occurs.

The tongue is made up of a group of muscles that help us speak and chew and swallow. But there’s more to this remarkable organ than mere muscle. The surface of the tongue is covered with mucous membrane, like the smooth tissue which lines our mouths. But the tongue isn’t completely smooth—it’s textured with thousands of tiny bumps called papillae.

These little elevated surfaces have several shapes and functions. Some make the tongue’s surface a bit rough, which helps move food through your mouth. Some are temperature sensitive, letting you know that your slice of pizza is much too hot. And some are covered with thousands of the taste buds, which make eating that pizza so enjoyable.

All of these papillae with their various functions combine to create a textured surface, filled with miniscule nooks and crannies. And if there’s a nook or a cranny where bacteria can collect, no matter how miniscule, it’s a good bet that they will, and the surface of the tongue is no exception. But bacteria aren’t alone—the tongue’s surface can also hide food particles and dead cells.

How does this unappealing accumulation affect you? These elements work together to cause bad breath, especially the bacteria that break down food particles and cell debris to produce volatile sulfur compounds—compounds which create a particularly unpleasant odor. Including your tongue in your brushing routine helps remove one of the main causes of bad breath.

And that’s not the only benefit! Cleaning the tongue helps eliminate the white coating caused by bacterial film, and might even improve the sense of taste. Most important, studies show that regular cleaning noticeably lowers the levels of decay-causing plaque throughout the mouth.

So, how to get rid of that unwanted, unpleasant, and unhealthy debris?

• When you’re done brushing your teeth, use your toothbrush to brush your tongue.

Clean your tongue by brushing gently front to back and then side to side. Rinse your mouth when you’re through. Simple as that! And just like a soft-bristled toothbrush helps protect tooth enamel and gum tissue, we also recommend soft bristles when you brush your tongue. Firm bristles can be too hard on tongue tissue.

• Use a tongue scraper.

Some people find tongue scrapers more effective than brushing. Available in different shapes and materials, these tools are used to gently scrape the surface of the tongue clean of bacteria and debris. Always apply this tool from back to front, and rinse the scraper clean after every stroke. Wash and dry it when you’re through.

• Add a mouthwash or rinse.

As part of your oral hygiene routine, antibacterial mouthwashes and rinses can assist in preventing bad breath. Ask Dr. Rothstein for a recommendation.

• Don’t brush or scrape too vigorously.

Your tongue is a sturdy, hard-working organ, but tongue tissue is still delicate enough to be injured with over-vigorous cleaning.

Taking a few extra seconds to clean your tongue helps eliminate the bacteria and food particles which contribute to bad breath and plaque formation. Make this practice part of your daily brushing routine—it’s a healthy habit well worth remembering!

You’ve got periodontal surgery at our Livingston office coming up on your calendar and you’re prepared. The freezer is stocked with frozen yogurt, the fridge is filled with pudding and applesauce, the cupboard has boxes of gelatin dessert just waiting to be mixed and chilled.

Good for you! Eating a soft, smooth diet is the best way to treat delicate tissue after surgery. Now, let’s look at a few ways to make that diet not only soothing, but healing.

• Protein

Proteins are essential for all of our vital bodily functions. The protein in our diet is broken down into amino acids, which then combine with other amino acids to create the new protein building blocks our cells need to replace and repair damaged tissue. These proteins provide structure for cells in the skin, bone, and blood vessels as they recover. When you are healing, your body requires more protein than usual to help the process along.

Of course, right after periodontal surgery, you won’t be eating your regular protein sources of meats, seafood, beans, and nuts. But dairy foods such as yogurt and milk products are also rich in protein—and delicious in milkshakes and smoothies. You can also add a protein supplement if you will be eating soft foods for a while. Just remember, no straws!

• Vitamin A

Vitamin A helps stimulate cell reproduction and the immune system, both important factors for quicker, safer healing. It also helps our bodies form and maintain bone tissue, mucous membranes, and soft tissue, all of which are involved in bone and gum recovery after surgery.

If you are wondering where to get more vitamin A, think green and orange. Spinach, kale, leaf lettuce and other leafy greens, mild peppers, carrots, cantaloupe, mango—all these foods keep you supplied with vitamin A. How to get those solid foods into your soft diet? Think smoothies. Adding some fresh ingredients to your blender will give you this important vitamin in an easy-to-drink form.

• Vitamin C

Vitamin C is vital for wound healing because it is essential in forming the protein collagen. Collagen provides both structure and support to our tissues, especially important as tissues heal.  

We usually associate vitamin C with citrus fruits such as oranges, lemons, and limes. But if you’re avoiding acidic foods because they might irritate delicate tissue, you can also find plenty of vitamin C in green vegetables such as broccoli, cabbage, and kale, or in fruits like strawberries, mangos, and papayas. Here’s where that blender comes in handy again!

• Zinc

Zinc has been found to improve healing by promoting membrane repair, blood clotting, and skin cell recovery, and by helping to boost immunity. Too little zinc in the diet has been associated with slower wound healing, especially in the skin—and because our bodies don’t store zinc, it should be part of everyone’s regular diet.

Foods high in zinc include red meat and seafood, but since steak is off the menu for a while, where can you find another good source of zinc? Dairy products, again! Let your milkshake do double duty.

Of course, there is no one magic diet that brings instant recovery. But if you follow Dr. Rothstein and our team’s advice, eat foods designed to soothe rather than irritate your recuperating tissue, and take advantage of the nutrients that encourage healing, you will be doing all you can to make your recovery speedy and healthy. Good for you!

The electronic toothbrush has undergone several technological advances since the 1960s. Everything from design and bristle motions to rotation, oscillation, and sonic vibration has led to dramatic changes in this necessary tool over time.

Rotation oscillation happens when the head of the toothbrush rotates from one direction to the other. The benefit of powered toothbrushes is that they can produce 50,000 strokes per minute, compared to 300 strokes with a manual toothbrush.

When you’re thinking about brush head size, smaller brush heads are best for hard-to-reach areas and small mouths. Brush heads should be replaced every three to six months as needed. A good way to save money is to designate a brush head for each family member which can be taken on and off a shared base motor.

Having a base motor or rechargeable toothbrush can deliver enough power on a full charge for a week of brushing, which makes it convenient for travel or when life gets busy. Some toothbrushes include audible signals that let you know when to switch the area of your mouth you’re brushing or when a full two minutes has gone by.

Do you have sensitive teeth? Studies have indicated that people tend to apply more pressure on their teeth when they use a manual toothbrush. This makes an electric toothbrush a preferable option if you’re having issues with sensitive teeth or gums.

There are even electric models with pressure sensors that will stop the brush from spinning when you press too hard against your teeth!

Everyone can benefit from having an electric toothbrush. A large handle size can be taken into consideration if a member of the household is young, or has a physical disability or arthritis. They’re even recommended for children in order to maintain good oral hygiene from a young age.

Biofilm is a term used for plaque or debris that builds up in your mouth. If not properly addressed, this can cause serious bacterial infections to your gums and teeth. If you want to remove biofilm in the most efficient way, an automatic toothbrush is the way to go.

When you're ready to make your decision, make sure to consult with Dr. Rothstein at our Livingston office to decide which electric toothbrush is right for you!

Nobody likes a dry mouth. It is an uncomfortable and sometimes oddly unexplainable sensation that most people like to avoid. It is not a condition that automatically sends you into a panic about your health, however, a dry mouth can be a bother and something you certainly want to change if possible. So, if you find yourself in the unpleasant position of having a dry mouth, here is what you can do.

Chew Sugar-free Gum: Chewing sugar-free gum will stimulate saliva in your mouth. The chewing motion of your jaw and teeth should take care of at least some of your dry mouth problem.

Suck on Sugar-free Candy: Similarly to chewing sugar free gum, if you suck on sugar free candy it should create more saliva in your mouth and moisturize it in the process.

Cut out the Caffeine:Caffeine can contribute to a dry mouth so by limiting, or eliminating your intake all together, you may find that your dry mouth is no more.

Stop Using Tobacco Products: Tobacco is another cause of dry mouth. Whether it is smokeless tobacco products or cigarettes, if you stop using them your dry mouth will likely improve. And not to forget, these products are exceedingly bad for your oral health to begin with, so you will be doing your mouth a favor even more so.

Drink Lots of Water: It may seem obvious, but drinking lots of water will likely improve your dry mouth. This is because dry mouth is usually a sign of dehydration, so plenty of fluids will surely help.

Dry mouth can be unpleasant, but it is often easily solved by either drinking more water, or trying one of the previously mentioned techniques. If the problem still persists you can always visit our Livingston office to see Dr. Rothstein. More often than not, doing one of the above will leave your mouth more moisturized than it was previously, and hopefully it will be long-lasting as well.

Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth. Sometimes, though, due to injury or decay, an extraction is the only choice for your oral health. After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy and the extraction is a simple one, we might be able to place an implant post in the socket right away.

But often, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone that is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Dr. Rothstein will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Livingston office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible.

Bone grafting is essential for many periodontal restorations, and we are specialists in this procedure. If you have an extraction scheduled, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

Cancer has become a common word, and it seems like there is new research about it every day. We know antioxidants are important. We know some cancers are more treatable than others. We know some lifestyles and habits contribute to our cancer risk.

Smoking increases our risk of cancer, as does walking through a radioactive power plant. But there is a direct link to oral cancer that you many may not know about—the link between HPV (Human Papilloma Virus) and oral cancer.

This may come as a shock because it has been almost a taboo subject for some time. A person with HPV is at an extremely high risk of developing oral cancer. In fact, smoking is now second to HPV in causing oral cancer!

According to the Oral Cancer Foundation, “The human papilloma virus, particularly version 16, has now been shown to be sexually transmitted between partners, and is conclusively implicated in the increasing incidence of young non-smoking oral cancer patients. This is the same virus that is the causative agent, along with other versions of the virus, in more than 90% of all cervical cancers. It is the foundation's belief, based on recent revelations in peer reviewed published data in the last few years, that in people under the age of 50, HPV16 may even be replacing tobacco as the primary causative agent in the initiation of the disease process.” [http://www.oralcancerfoundation.org/facts/]

There is a test and a vaccine for HPV; please discuss it with your physician.

There are some devices that help detect oral cancer in its earliest forms. We all know that the survival rate for someone with cancer depends greatly on what stage the cancer is diagnosed. Talk to Dr. Rothstein if you have any concerns.

Please be aware and remember that when it comes to your own health, knowledge is power. When you have the knowledge to make an informed decision, you can make positive changes in your life. The mouth is an entry point for your body. Care for your mouth and it will care for you!

Halitosis is the fancy, scientific word for “bad breath.” Dr. Rothstein and our team know there are several reasons why you may have halitosis; let’s look at a few:

• Gum disease (also known as periodontal disease) – There are five main types of gum disease, and each one can range from mild to severe. For example the most common one is gingivitis; it is caused by bacteria in the plaque that has been allowed to build up, usually as a result of poor oral hygiene. A more serious and uncommon type of gum disease is called necrotizing periodontal disease. It is most common in people who have a suppressed immune system.
• Smoking
• Dry Mouth – This can be caused by something as simple as a medication you take.
• Food – Of course, if you eat something that is potent like garlic, it is going to give you bad breath.
• Diseases of the Body – Some diseases such as sinus infections and diabetes, among a few other types of infections, can also cause you to have halitosis.

How to Get Rid of Halitosis

The most obvious answer to how to get rid of halitosis is to practice good oral hygiene, although, depending on the cause of halitosis it may not be that simple. If you have an infection that is causing the halitosis then you may need an antibiotic to clear up the infection and then the bad breath will go away. Here are more tips:

• Brush your teeth after every meal and before bed.
• Floss your teeth. The more plaque you get out of your teeth, the better chance you have of not getting cavities or bad breath.
• Address any medical conditions that are not related to your teeth that can be causing the halitosis.
• Ask Dr. Rothstein for a prescription mouthwash that kills bacteria.

Halitosis (bad breath) can be an embarrassing condition to live with, but there are plenty of ways to get rid of it permanently. Start by talking to a member of our team at our Livingston office.

Here is some surprising yet worthwhile advice you might be hearing for the first time: Brushing after a meal can be incredibly bad for your teeth if you do it after eating certain foods.

Enamel is an extremely hard mineral on the exterior of each of your teeth. It’s actually the hardest substance in the human body: It’s even stronger than your bones! Its only weakness is that acids in the food we eat can easily destroy enamel.

Healthy teeth thrive in an environment that has the proper pH balance. That ensures your mouth doesn’t start the process of demineralization. That’s what happens when alkaline turns into acid, which attacks and softens the enamel on the surface of your teeth. Pores and fissures form, and that’s when the harmful bacteria go to work.

Our mouth’s pH level fluctuates depending on what we eat throughout the day. Examples of the most common highly acidic foods include citrus fruits, soda, and sugary foods. Highly acidic foods tip the balance of pH in your mouth from a healthy alkaline to a dangerous acid.

Can brushing your teeth immediately after a meal lead to even more damage? The answer is yes!

Eating highly acidic foods causes your teeth to be more susceptible. If you brush your teeth when they have been weakened by acids, even more destruction can happen to your enamel. Your toothbrush’s bristles will actually wear away some of your enamel. So it’s healthier to wait at least an hour after eating or snacking to brush.

Good preventive measures to take instead of brushing after you eat include:

• Rinsing or drinking water
• Chewing sugarless gum
• Consuming dairy or non-acidic foods to conclude your meal

These practices help produce saliva, which in turn restores a healthy pH level in your mouth and coats the teeth with minerals they need.

Once you’ve allowed time for your mouth to be restored to a healthy pH level, you may brush your teeth as you normally would. Keep in mind that acidic foods can weaken the enamel on your teeth and take the right measures to prevent spiking pH levels.

Most important, don’t forget to wait to brush at least one hour after you eat!

Still have questions? Call our Livingston office and schedule an appointment with Dr. Rothstein.

Xerostomia, otherwise known as dry mouth, can be a side effect of many common medications. Drugs used for blood pressure, birth control, antidepressants, or cancer treatments may cause the dry mouth problems you’re experiencing. When you have dry mouth, you’re more likely to experience tooth decay and an increased risk of developing periodontal disease. Medication can sometimes be the cause of dry mouth in women, and lead to an increased amount of cavities.

You may not develop a cavity for years, but suddenly find more than one when you’re on medication for several months. This is due to there being less saliva in your mouth, which normally prevents bacteria from flourishing. When there is a lack of saliva flow, your mouth will be more likely to host tooth decay and be more prone to gum disease.

You may not notice it, but birth control can lead to inflammation of the gums and bleeding because of dry mouth. The condition can also emerge if you’ve undergone cancer treatments such as radiation, because your saliva glands may be damaged in the process.

Boosting saliva production is critical for treating xerostomia. Many over-the-counter saliva products are designed to help manage dry mouth. For women with severe cases of dry mouth and decay, we may recommend in-home fluoride treatments that offer extra enamel protection. This can come in the form of fluoride trays, prescription toothpaste, or a special fluoride rinse.

Other ways to relieve dry mouth include chewing sugar-free gum, limiting caffeine intake, avoiding mouthwashes that contain alcohol, sipping water regularly, using a humidifier at night, and stopping all tobacco use.

If you believe you may be experiencing symptoms of dry mouth, contact our Livingston office to schedule an appointment with Dr. Rothstein. It’s wise to take medications that have been prescribed by your doctor, but it’s also smart to watch for any side effects. If you think a medication is causing you to have dry mouth, let’s figure out how to manage your symptoms as a team!

Unless you're aware of the signs and symptoms of gum disease and how it's caused, it's possible that you may have unknowingly developed it. Often painless, gum disease -- or periodontal disease -- becomes progressively more serious when left untreated. As you learn more about the common causes of gum disease, you'll be better-equipped to maintain the best oral health possible.

Gingivitis & Periodontitis: Common Causes of Gum Disease

• Bacteria & Plaque. Bacteria in the mouth creates a sticky film over the teeth. Good hygiene practices help remove the bacteria and the plaque they cause. When plaque is not removed, it develops into a rock-like substance called tartar. This can only be removed by a dental professional.
• Smoking & Tobacco. If you're a smoker or use tobacco, you face a higher risk of developing gum disease. Additionally, tobacco use can lead to stained teeth, bad breath, and an increased risk of oral cancers.
• Certain Medications. Some medications that are taken for other health conditions can increase a person's risk of developing gum disease. If you take steroids, anti-epilepsy drugs, certain cancer therapy medications, or oral contraceptives, speak to Dr. Rothstein about how to maintain healthy gums.
• Medical Conditions. Certain medical conditions can impact the health of your gums. For instance, diabetics face an increased risk of gum disease due to the inflammatory chemicals present in their bodies. Always talk to our team about other health conditions to ensure we take that into account when treating you.

Take a Proactive Stance

Good oral hygiene practices and regular visits to our Livingston office can help you eliminate or reduce the risks of developing gum disease. A thorough cleaning with your toothbrush and dental floss should take about three to five minutes. Brush your teeth a minimum of twice per day and floss at least once each day. Keep these tips in mind and you’ll be ready to prevent gum disease.

YES!  Studies have shown a correlation between gum disease and heart disease, underscoring the importance of good oral health care. Cardiovascular disease remains American’s leading killer, claiming more lives than the rest of major causes of death, according to our friends at the American Heart Association. In fact, an estimated 80 percent of American adults currently have some form of gum disease, also known as periodontal disease.

Studies suggest that people with gum disease are believed to have an elevated risk of heart attack and stroke. Since most patients are not regularly visiting a heart specialist, their regular visits to our Livingston office can help detect early warning signs of heart issues, prevent gum disease, or at the very least catch it at its early stage. We’d also like you to know your numbers: blood pressure (less than 120/80), cholesterol (less than 200) and BMI (less than 25).

There are many benefits to visiting A R Periodontics in addition to maintaining your dental health. If it has been a while since your last visit, please give us a call!

As we all know, or should by now, the key to maintaining great oral health is keeping up with a daily plan of flossing, brushing, and using mouthwash. These three practices in combination will help you avoid tooth decay and keep bacterial infections at bay.

At A R Periodontics, we’ve noticed that it’s usually not the toothbrush or floss that people have trouble picking, but the mouthwash.

Depending on the ingredients, different mouthwashes will have different effects on your oral health. Here are some ideas to take under consideration when you’re trying to decide which type of mouthwash will best fit your needs.

• If gum health is your concern, antiseptic mouthwashes are designed to reduce bacteria near the gum line.
• If you drink a lot of bottled water, you may want to consider a fluoride rinse to make sure your teeth develop the level of strength they need.
• Generally, any mouthwash will combat bad breath, but some are especially designed to do so.
• Opt for products that are ADA approved, to ensure you aren’t exposing your teeth to harmful chemicals.
• If you experience an uncomfortable, burning sensation when you use a wash, stop it and try another!

Still have questions about mouthwash? Feel free to ask Dr. Rothstein during your next visit to our Livingston office! We’re always happy to answer your questions. Happy rinsing!

Can you believe it's already September? At A R Periodontics, we know that gingivitis, the early stage of periodontal disease, can be difficult to recognize. Many people don’t recognize the warning signs, bleeding and swollen gums, as a precursor to gum disease. This month, a national campaign is under way to raise awareness about gum health and periodontal disease, and we wanted to help do our part to spread the word!

Dr. Rothstein will tell you early recognition and action are the most important steps to health gums, and ultimately a health body, too! Studies are published every year linking oral health, including the gums, to the health of other areas of the body, such as your heart. One of the most important steps to improving the care of your gums is recognizing the warning signs for gum disease. These can include:

• Gums that appear red or swollen
• Gums that feel tender
• Gums that bleed easily (during brushing or flossing)
• Gums that recede or pull away from the teeth
• Persistent halitosis, or bad breath
• Loose teeth
• Any change in the way teeth come together in the biting position

If you happen to notice any of these signs with you or your child, please schedule an appointment at our convenient Livingston office as soon as possible. Dr. Rothstein and our team can take proactive steps to prevent gingivitis and gum disease, while showing you how to improve gum care in your or your child’s daily oral hygiene habits.

The best way to protect yourself from gum disease is to be proactive: practice good oral hygiene at home and schedule regular checkups and cleanings in your dentist’s office.

How do you know if your dental routine is doing the job? There are specific symptoms you might notice when you brush and floss, and less obvious signs of gum disease your dentist will look for during your dental exams.

The early stage of gum disease is known as gingivitis. It’s generally caused by poor dental hygiene, although certain diseases, age, hormones, and a number of other factors can also put you at risk. It’s time to talk to your dentist about your gum health if you notice any of these symptoms:

• Bright red or purple gums
• Swollen gums
• Pain or tenderness
• Bleeding when brushing or flossing
• Persistent bad breath
• Receding gums

And sometimes, there are no obvious symptoms at all. That’s why regular checkups are so important. If you have gingivitis, careful attention to your oral hygiene, professional cleaning, prescription mouthwash, or other treatments as needed can reverse the effects of gingivitis and restore your gums to their normal, healthy state.

Why be so proactive? Because, left untreated, gingivitis leads to more serious gum disease, called periodontitis.

The bacteria in plaque and tartar cause inflammation, and inflammation leads the gum tissue to pull away from the teeth, forming pockets which become deeper over time. Here, where brushing can’t reach, bacteria continue to multiply, leading to further inflammation, infection, and the eventual breakdown of gum and bone tissues.

The results of untreated periodontitis can be very serious, including:

• Significant gum recession, leaving roots more vulnerable to decay
• Periodontal abscesses
• Loose teeth, or teeth that shift from their proper positions
• Bone loss in the area surrounding the teeth
• Tooth loss

If your dentist sees signs of advanced gum disease, you may be referred to our Livingston periodontal office.

Periodontists like Dr. Rothstein specialize in the diagnosis, prevention, and treatment of gum disease. After dental school, a periodontal degree requires three years of additional advanced education. Periodontists have the training and skill to perform surgical and non-surgical procedures to treat gum disease, as well as to perform cosmetic procedures and place dental implants.

Periodontists are trained to diagnose and treat periodontitis with a number of procedures which they will recommend based on your specific needs. Among the treatments they provide to restore your gum health:

• Topical, time-release, or oral medication
• Scaling and root planing, non-surgical deep cleaning procedures which remove plaque and tartar above and below the gum line, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth
• Flap surgery to treat persistent gum infection, reduce pocket depth, and re-secure the gums snugly around the teeth
• Bone grafts, gum grafts, and other regenerative procedures which help restore and repair tissue damaged by gum disease

If your dentist recommends a periodontal consultation, be proactive. The best way to protect yourself from the serious consequences of untreated gum disease is to see a specialist in this field. Your periodontist has the knowledge and experience to stop gum disease from progressing, treat damaged bone and gum tissue, and restore your healthy smile.

In a world where everything moves so quickly and teens and young adults find themselves pulling “all-nighters” or working long hours, energy drinks have grabbed the spotlight. You’ll have one (or three) and suddenly you have the drive you need to keep going.

The same can be said for sports drinks. It’s common for people to have one even when they’re not engaged in any strenuous physical activity, which is what they were designed for. People will drink them simply because they’ve grown to love the taste.

Although they might taste great and boost your energy, there’s a serious down side to consuming energy and sports drinks on a steady basis. Studies have shown that these drinks contain so much acid that they start to destroy your teeth after just five days of consistent use.

The acid in these drinks destroys your tooth enamel, which makes your teeth more vulnerable to bacteria. This can progress to staining, tooth decay, and hypersensitivity.

That’s why Dr. Rothstein and our team want to encourage you to try to limit the amount of sports and energy drinks you consume. If you do enjoy either or both of these drinks, you should make it a habit to rinse your mouth with water immediately after consumption, and brush your teeth about an hour later, after the period when acid has a softening effect on your enamel has passed.

If you feel like you’re already experiencing the side effects of heavy energy and sports drink consumption, visit our Livingston office, and our team can provide solutions for how to prevent further damage from occurring. It’s never too late to change a bad habit!

One of the most transformative advancements in dental restorations is the dental implant. Implants look just like natural teeth, they function just like natural teeth, and they help maintain jawbone health just like natural teeth. But the success of any implant procedure depends on the quality and quantity of the bone in which it’s placed. That’s why, before placing your implant, Dr. Rothstein might first suggest a common procedure known as ridge modification.

An implant consists of a metal post which is surgically placed in the jawbone. This post serves as the “root” of the dental implant. After several months, the post fuses with the bone surrounding it, as bone tissue grows around and attaches to the post surface. This process is called osseointegration, and it creates a strong, secure anchor for the abutment and crown which will be secured to the post when it heals.

Because of the strong pressures which biting, chewing, and clenching put on our teeth, the success of an implant depends on the strength of its integration into the jawbone. To make osseointegration possible, the bone must be healthy, with adequate size and density to hold the implant securely.

Ridge modification, also called ridge augmentation, is periodontal surgery. In this procedure, we use bone grafting to rebuild bone strength in the alveolar ridge (the part of the jawbone containing the tooth sockets) before placing a post. When is this procedure necessary?

Jawbone size and density can be compromised in several different ways, including:

• Resorption

When a tooth is missing, the bone ridge under the lost tooth gradually begins to shrink, a process called “resorption.” Over time, bone loss can lead to a noticeable indentation in the jawbone.

• Periodontitis

Serious gum disease is progressive. Without treatment, the gums begin to pull away from the teeth. This leaves bone and connective tissue exposed to destructive bacteria and infection, which can cause bone loss.

• Trauma

Bone damage caused by accident or injury might require bone replacement or recontouring.

• Bone structure and size

Sometimes the jaw ridge is too narrow or shallow to support an implant, especially in the back of the upper jaw near the sinus cavity, and will need added bone before an implant can be placed.   

Periodontists are specialists in bone grafting surgery, with years of advanced education and training in the treatment of the structures that support the teeth, including gums, connective tissues, and bone. Dr. Rothstein will recommend bone graft surgery if the success of your implant would be in jeopardy without it.

What will your surgery involve?

• Assessing bone quantity and quality

Using advanced imaging technology, we will evaluate your jaw’s condition, and map out any areas of bone loss.

• Designing your treatment plan

If a bone graft is your best option, we will recommend the best grafting materials for your needs. Bone grafting might use bone tissue taken from your own body, processed bone grafting material, or synthetic grafting material to replace and repair the damaged bone. We will also discuss your anesthesia and sedation options.

• Performing the Surgery

After anesthesia, an incision will be made in the gum tissue to reveal the damaged or missing bone. Grafting material will be shaped to restore the bone’s contours and secured to the affected area. The incision will then be closed. If you are here for an extraction, it may be possible to have augmentation done as part of the same procedure.

• Providing follow-up care

You’ll receive detailed careful instructions for after care and follow-up visits at our Livingston periodontal office. The time it takes for you to heal completely will depend on the size and type of your graft.

• Placing your implant

Once the bone has healed, we can surgically place the post for a secure, long-lasting, and healthy implant.                   

If it’s been some time since you lost a tooth, if your jaw has been damaged by injury or trauma, if you have less-than-adequate bone size and density, it’s important to restore your bone before implant surgery can be successful. See us for an evaluation, and learn how a ridge modification procedure can help you improve your dental health and transform your smile.

Dr. Rothstein and our team hear this question a lot. While many people believe periodontal disease is an adult problem, studies have indicated that periodontal disease, also known as gum disease, as well as other serious infections such as gingivitis and periodontitis, are prevalent among kids and adolescents. First, let’s identify the differences between gingivitis, periodontitis, and periodontal disease.

Gingivitis

Gingivitis is a type of periodontal disease in which only your child’s gums are affected. Characterized by swollen and red gums that bleed easily, gingivitis causes an inflammation of the gums, and is the first stage and mildest form of periodontal disease. The good news is that gingivitis is often reversible. Treatment for gingivitis includes having your child come in for a professional teeth cleaning. It also includes daily brushing, which will help eliminate plaque from the surfaces of your child’s teeth. Your child should also get in the habit of flossing daily to remove plaque and food particles wedged in the crevices between his or her teeth.

Periodontitis

If left untreated, gingivitis can progress to periodontitis, the advanced stage of gum disease that can not only damage your child’s gum tissue, but also destroy the underlying bone which supports the teeth. Eventually, teeth can become loose and may have to be removed. In some cases, the bacteria from the ensuing infection may also be distributed to other areas of the body via the bloodstream.

Periodontal Disease

Periodontal disease is a chronic bacterial infection of the gums, periodontal ligament, and bone that surround and support your child’s teeth. Periodontal disease causes gums to become red, swollen, and tender, and can even cause the gums to recede (pull away) from the teeth. If left untreated, periodontal disease can lead to tooth loss.

Having persistent at-home oral care regimen is a critical step in your child’s fight against periodontal disease. But sometimes brushing and flossing are simply not enough. Having your child’s teeth cleaned twice a year, or as recommended, is crucial.

Early diagnosis of gingivitis, periodontitis, and periodontal disease can give you and your child peace of mind. If you are concerned your child is suffering from gum disease, we recommend that you give us a call at our Livingston office. We look forward to working with you and giving your child a smile to last a lifetime!

You have probably counted a hundred reasons to stop smoking. It’s unhealthy. It’s expensive. It annoys the people around you. You have to schedule your day around the next cigarette. But here’s reason number 101: Did you know that one of the many side effects of smoking is the damage it does to your smile?

Your Appearance

One of the most obvious results of smoking is the constant yellowing and discoloration of your teeth. Tobacco stains can take longer to remove with home brushing and whitening. And, while a professional cleaning and whitening will make a world of difference, all that good work is undone once you start smoking again.

More important, no smile looks its best with periodontal disease and tooth loss. Smoking has been linked to the presence of more harmful oral bacteria and higher occurrences of cavities and gingivitis (early gum disease). Periodontitis, or severe gum disease, is much more common among smokers. Tooth loss is also much more likely.

Healing after Dental Surgery

Smoking slows the healing process. It has been linked to a weaker immune system, so it’s harder to fight off an infection or to heal from one.  And because of the harmful effect of smoking on bone tissue, there is a higher failure rate for dental implants among smokers. Bone density can be so compromised that an implant is not even an option.

Healing after Extractions

If you have a tooth extracted, the formation of a blood clot at the site of the removal is essential to avoid a condition called dry socket. Dry socket can lead to pain, serious infection, and other complications. Luckily, this clot is resilient and pretty hard to dislodge—unless you apply suction such as sipping through a straw or drawing smoke from a cigarette.

Oral Cancer

Research has shown that smoking is the single most serious risk factor for oral cancer. The good news is that this risk is cut dramatically if you quit!

Let Dr. Rothstein help you maintain your smile. We can offer many more reasons to give up the smoking habit, and we are happy to offer suggestions for quitting during your next visit to our Livingston office. We want to protect your smile and your health as well. It doesn’t really matter which number on the list finally leads you to quit—every number on that list is your lucky number!

When you have a tooth extracted, your body immediately sets to work to help protect the affected area. The blood that collects at the site of the extraction clots to cover and protect the wound. This is a normal response, and protects the nerves and bone that have been exposed with the removal of your tooth. Normally, the gum tissue will close over the area within a few weeks.

But sometimes the clot becomes dislodged or moved before you have a chance to heal. The result is that the nerves and bone in the extraction site are exposed to air and outside substances. Bacteria can contaminate the wound and lead to pain, infection, and further damage. This condition is known as dry socket.

There are certain activities that should definitely be avoided so you are not at risk for dry socket.

• Straws and suction: The action of using a straw causes suction that can dislodge the clot. You can still enjoy the soothing coolness of a milkshake, but use a spoon.
• Spitting: You might be tempted to rinse and spit immediately to clean your mouth, but spitting can also dislodge the clot. We will let you know how to clean your mouth and teeth for the next few days.
• Smoking: Not only does smoking provide a suction effect that can remove the clot, but smoking and chewing tobacco can slow healing as well.

There are also steps you can take to aid the healing process.

• Caring for your extraction site

Dr. Rothstein will give you instructions on caring for your mouth and teeth for the next few days. Gentle care for the extraction site is vital. And treat yourself gently as well. Rest if you need to, and avoid activities that might impact your wound.

• Think about your diet

Stick to soft foods for the first day or so and chew on the side opposite your extraction site. Carbonated and caffeinated beverages should be avoided, as well as food like peanuts or popcorn that lodge in the teeth.

• Watch for symptoms of dry socket

How do you know if you have a dry socket? Monitor your pain and the appearance of the site after the extraction. For the first few days, you might feel some pain in the immediate area. Pain that intensifies after three or four days is usually not a result of the extraction. An unpleasant odor or taste in your mouth could be a sign of dry socket. You might look in the mirror and notice that the clot is no longer there, or appears to have been dislodged. If any of these symptoms occur, call our Livingston office at once. If you are experiencing dry socket, the extraction site needs to be cleaned and protected from further injury, and we can prescribe antibiotics if needed.

Dry socket is a rare occurrence, but if you have any symptoms that concern you, we want to hear about them. We will work with you to make your extraction go as smoothly as possible. Talk to us about your concerns before any procedure, and we will provide detailed information for the healing process. Keep us in the loop as you recuperate, and we will work together to make your recovery a speedy one.

Why does gum disease develop? Our mouths are home to bacteria, which form a film called plaque. Plaque sticks to the surfaces of our teeth, at the gumline, and can even grow below the gumline. And this bacterial growth leads to inflammation and gum disease.

When the disease progresses, the gums gradually pull away from the teeth leaving pockets which can be home to infection. Toxins can attack the bone structures and connective tissue, which support our teeth. Left untreated, periodontal disease can lead to serious infection and even tooth loss.

Because we are dealing with bacteria, it makes sense that antibiotics are one way to combat gum disease. Depending on the condition of your gums, we might suggest one of the following treatments:

• Mouthwashes—there are mouthwashes available with a prescription that are stronger than over-the-counter antibiotic formulas, and can be used after brushing and flossing.
• Topical Ointments—These ointments or gels are applied directly to the gums, most often used for mild forms of the disease.
• Time-release Treatments—If there is severe inflammation in a pocket, we might place a biodegradable powder, chip, or gel containing antibiotics directly in the affected area. These minute methods release antibiotics over a period of time as they dissolve.
• Pills and Capsules—For more serious periodontal disease, you could be prescribed an oral antibiotic. Take in pill or capsule form as recommended, and always finish the entire prescription.

Talk to Dr. Rothstein at our Livingston office before beginning a course of antibiotics. It’s important to know if you have any allergies to medications, what to look for if you might have an allergy you didn’t know about, if you are pregnant or breast-feeding, or if you have any health concerns that would prohibit antibiotic use. Talk to us about possible side effects and how to use the medication most successfully. With proper treatment, we can treat gum disease as quickly and effectively as possible, and provide advice on maintaining a periodontal routine that will keep your gums and teeth healthy for years to come.

One of the latest foods in dietary news is also one of the oldest—ancient grains. What makes these old-timers so appealing to modern tastes? Let’s run down the menu!

Why Are Some Grains Called “Ancient”?

Unlike grains such as modern wheat, which have been crossbred for hundreds of years to bring out certain qualities, ancient grains are generally considered to be grains which have been cultivated in the same way and in the same form for centuries.

Not All Grains Are the Same

Grains are harvested from the seeds, or kernels, which grow on top of cereal grasses. But because they have many of the same uses, and many of the same nutrients, ancient grains also include pseudocereals, which are seeds and fruits from non-grasses. These seeds can be ground just like grains or used whole. This is an important distinction for many diet-mindful people because grains derived from pseudocereals are gluten-free.

The Health Benefits of Ancient Grains

Ancient grains are whole grains. This means that the seeds of ancient grains have their bran, germ, and endosperm intact—which means that all their nutrients, proteins, and fiber also remain intact. Refined grains like white flour and white rice have removed many of these good-for-your-body elements by removing the bran and germ, leaving only the endosperm behind.

The Dental Benefits of Ancient Grains

Of course, any food that offers better nutrition is better for your teeth and gums. But there’s an added bonus in the more complex structure of intact grains—they take more time to digest.

With foods made with refined grains, digestion starts taking place quickly—in fact, saliva starts the digestive process right in our mouths while we eat. And as these carbs break down into sugars, they provide a feast for the oral bacteria which convert that sugar into acids.

These acids, in turn, attack tooth enamel, leaving weaker spots which can grow into cavities, and irritate delicate gum tissue. What’s more, refined carbs tend to be extra sticky, lingering in the mouth, between the teeth, and on the enamel instead of being washed away by saliva.

So, Have Any Suggestions for My Shopping List?

We do! Because all ancient grains are loaded with protein and fiber, they are all going to be a rich source of these healthy essentials. And they can offer additional minerals, vitamins, and antioxidants to your diet. If you’re inspired to add a bit of history and geography to your plate, here are some ancient grains to consider:

• Amaranth

Cultivated by the Aztecs, this gluten-free pseudocereal seed is high in manganese, magnesium, copper, phosphorus (which helps keep your enamel strong), and also provides vitamins B1 (thiamin), B6, and B9 (folic acid).

• Barley

Grown for thousands of years in Asia and Europe, barley is one of the first cultivated grains. In its whole grain form, barley offers us selenium, manganese, copper, vitamins B1 and B3 (niacin), and antioxidants. Whole barley has a very tough outer shell and takes quite a bit of cooking, so lightly pearled barley can be substituted with only a small loss of bran.

• Buckwheat

Originating in Asia, buckwheat quickly spread to Europe and eventually made its way to early American fields. Another pseudocereal, buckwheat seed is often ground for flour, and is a good source of copper, manganese, magnesium, phosphorus, vitamins B2 (riboflavin), and B3. Not to mention, gluten-free!

• Bulgur

Often used in Middle Eastern and Mediterranean cooking, bulgur is a cracked wheat cereal grain. Bulgur adds, among other nutrients, manganese, magnesium, copper, iron, and vitamins B3 and B6 to your diet.

• Farro

“Farro” comes from an Italian word which can refer to three different varieties of wheat, with different cooking times, textures, and flavors. These grains were first cultivated in the Middle East and the Mediterranean region thousands of years ago, and are still popular today thanks to their nutty flavor and chewy texture. Try farro for a tasty serving of magnesium, zinc, vitamin B3, and antioxidants.

• Freekeh

Common in Middle Eastern, North African, and Mediterranean cuisine, freekeh is another form of cracked wheat. It’s harvested when the plants are young, so it has extra protein and fiber, as well as being a good source of iron.

• Quinoa

Another pseudocereal, quinoa originated in South America. It’s gluten-free, and filled with minerals such as manganese, magnesium, phosphorus, and vitamin B9. It’s also a complete protein, which means it contains all nine of the amino acids our bodies can’t produce on their own.

• Spelt

One of the largest wheat crops in Europe, and grown around the world, spelt’s nutty taste is an added bonus to its stores of manganese, copper, phosphorus, and vitamin B3.

• Teff

The smallest of the ancient grains, teff is an African variety of millet, a pseudocereal full of nutrients such as manganese, copper, iron, and calcium (another mineral which is vital to dental health), as well as vitamins B1 and B6. Try brown teff for its naturally sweet flavor.

This is just a taste of the ancient grains available to you, with many others from around the world waiting to be harvested for your table. But you needn’t choose ancient grains to receive all the nutritional benefits of whole grains.

Brown rice, whole wheat products, corn, oats—all these common ingredients are easily available forms of whole grains. Check the grain aisle in your local market for some new ways to brighten your recipes, to increase your dietary protein and fiber, to add minerals and vitamins, and to provide some healthy alternatives to refined grains. Your body—and your teeth—might thank you!

The Fourth of July is a great time to get together with friends and family members for BBQ, games, fireworks, and other celebrations in honor of our country’s independence. While your fellow revelers eat hot dogs and wave flags, you can impress them by sharing these fascinating facts and historical tidbits about some of our country’s traditions and symbols from the team at A R Periodontics.

The Statue of Liberty

With a torch in one hand and a tablet in the other, the Statue of Liberty is one of the most iconic and recognizable symbols of our country. However, as recognizable as certain parts of the statue are, not many people know that broken shackles, which represent oppression and tyranny, are lying at Lady Liberty’s feet. According to the Statue of Liberty-Ellis Island Foundation, the copper-plated lady weighs in at a whopping 450,000 tons and has been holding her torch up for more than 125 years, which must make for some impressive arm muscles.

Nathan’s Hot Dog Eating Contest

Since 1916, people have been flocking to Coney Island on the Fourth of July to witness what some people call the “superbowl of competitive eating.” Nathan’s Hot Dog Eating contest challenges competitors to devour as many hot dogs as they can in just ten minutes, with the current record holder swallowing a whopping 68 hot dogs! If you’d like to witness this bizarre and frenzied eating competition but you won’t be anywhere near Coney Island on the fourth, don’t worry. ESPN has been broadcasting this popular event for several years, so you can watch from the comfort of your couch while you eat a reasonably portioned meal.

The History Behind Fireworks

Viewing the nighttime fireworks display is exciting way to finish off the fourth. Many people know that these brilliant displays probably originated with the Chinese. However, many historians also believe that fireworks were stumbled upon when the Chinese roasted bamboo sticks over fires and watched them explode. After many years of roasting the sticks, a group of alchemists created an early form of gunpowder, which they stuffed into the bamboo sticks to create an even more powerful explosion, paving the way for the today’s modern fireworks.

Whether you’re planning on visiting the Statue of Liberty, watching fireworks in Livingston, or even participating in a hot dog eating contest, Dr. Rothstein and our team hope you have a safe and fun-filled holiday. Happy Fourth of July!

According to the National Institute of Dental and Craniofacial Research, more than 200 million Americans suffer from some degree of inflammation of the gums. Over the past decade, researchers have published studies that link the bacteria involved in periodontal disease to cardiovascular disease. The Centers for Disease Control and Prevention have connected oral infections to heart disease, diabetes, stroke, and low birth weights.

Studies suggest bacteria that cause periodontal disease are also responsible for causing a thickening of the carotid arteries, which increases the chance of a heart attack or stroke. Further research is being conducted to understand the link between oral health and heart disease better.

What is periodontal (gum) disease?

Dr. Rothstein and our team at A R Periodontics hear this question all the time. Periodontal disease is an infection. Our mouths are filled with bacteria, and this bacteria forms plaque. If the plaque is not removed through brushing, flossing, and regular cleanings at the dentist, it hardens into tartar. If gingivitis (gum inflammation) is not treated early, it can advance to periodontitis. Bacteria get under the gum tissue and erode it as well as the bone that supports the teeth. The gums eventually pull away from the teeth, and infected pockets form.

Proving that periodontal gum disease is connected to heart disease has been difficult for researchers. However, there are two theories about to what might connect the processes.

• Bacteria are released in the bloodstream through chewing and tooth brushing. The same species of bacteria that causes gum disease has been discovered in the plaque in arteries in the heart.
• Inflammation in the mouth is a catalyst for inflammation throughout the rest of the body.

Practice good oral health habits

While the link between periodontitis and heart disease is not yet fully understood, you can prevent the possibility of health complications by practicing good oral health. It’s recommended that you brush and floss twice a day, as well as visit your dentist twice a year for a cleaning and exam. Oral health should not be taken for granted. By preventing oral diseases, you’re also minimizing the risk of having a heart attack or stroke.

To learn more about the connection between heart disease and oral health, or to schedule an appointment with Dr. Rothstein, please give us a call at our convenient Livingston office! A clean mouth leads to a happy heart!

One of the concerns we sometimes hear at A R Periodontics is, “My gums just don’t look the same they once did. What is causing this?”

Our gums recede for a number of reasons. These include aggressive tooth brushing or the presence of periodontal disease, a bacteria-induced, inflammatory chronic condition that attacks gum tissue and the bone supporting the teeth. While you may not be able to control what is causing or has caused the recession, Dr. Rothstein and our team at A R Periodontics can help detect the factors contributing to the problem.

One of the treatments we proudly offer to fight receding gums is gum grafting, which involves removing healthy tissue from other locations in your mouth (usually the roof of your mouth) and placing it next to the affected tooth or teeth. Gum grafting helps cover the exposed roots to protect them from decay, and reduces tooth sensitivity, improving the aesthetics of your smile along the way.

How do I know if I have gum recession?

Gum recession doesn’t just appear overnight. Rather, it is a very slow, gradual process that is brought on by advanced gum disease such as periodontitis. Symptoms of gum recession include:

• Bleeding gums whenever your brush or floss
• Tender gums
• Bad breath (halitosis)
• Exposed teeth roots
• Increased space (gaps) between teeth
• Longer tooth line
• Sensitivity to hot or cold, or even to sweet, spicy, or sour foods

Gum Tissue Grafting

When you visit A R Periodontics for your procedure, Dr. Rothstein will apply a local anesthetic to numb the area involved. Depending on your specific condition, Dr. Rothstein will perform one of three different types of gum tissue grafts:

• Connective tissue graft: The most common procedure for covering exposed roots, connective tissue grafting involves cutting a flap of skin in other areas of your mouth (usually from the roof of your mouth) and stitching the tissue next to the affected tooth or teeth.
• Free gingival graft: Similar to a connective tissue graft, a free gingival graft is an excellent method of treatment in cases where the goal is to increase the amount of gum tissue. Free gingival drafting also involves the use of tissue from the roof of the mouth. But rather than making a flap and removing tissue, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated.
• Pedicle graft: In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the affected tooth. The flap is only partially cut away and the gum is then pulled over or down to cover the exposed root, then sewn into place.

The procedure you undergo will depend entirely on your condition. Dr. Rothstein will be happy to meet with you and discuss which method will work best for your unique situation. If you think you are suffering from gum recession, Dr. Rothstein will be happy to discuss and figure out which procedure can help get your smile back. To learn more about gum grafting, or to schedule your appointment at our Livingston office, please give us a call today!

Dr. Rothstein and our team at A R Periodontics know this is an exciting time as you anticipate the arrival of your new little one. We want to take this opportunity to provide you with some important information pertaining to your oral health during pregnancy. Just as the rest of your body is changing, the amount of bacteria in your mouth also changes. Scientists don’t understand all the reasons why, but during pregnancy, your mouth is more susceptible to bacterial complications that could result in increased risk for gingivitis or periodontal disease. What researchers do know is the change in hormones creates a more favorable environment for gum infections and diseases when you are pregnant.

You may experience an increase in gingivitis, even while continuing with regular daily brushing and flossing, and routine semi-annual month cleanings. You will likely complain of increased bleeding of the gums with routine daily care and more tenderness in the mouth. This is due, in part, to the increased blood flow and volume that naturally occurs with pregnancy. There is a greater amount of blood flowing through your veins, which translates into slightly engorged gum tissues. If gingivitis prevails, you may also experience pain and tenderness. We can help you navigate through your specific needs.

Brushing your teeth two times a day may not be quite enough. Similarly, if you only floss on occasion, consider making this activity a daily habit. Mouthwash is also advised, or sometimes a mild saltwater rinse may feel better than a commercial brand. Consider other products with xylitol and a WaterPik for additional cleaning.

Finally, we now know that bacteria in the mouth circulate throughout the body. These harmful bacteria compromise your immune system and may increase your risk for respiratory illness and cause other strains on your immune system. Remember that nutrients as well as pathogens are shared with your baby. If you feel tired or tempted to slack on your home-care routine, remember the importance and implications of your daily decisions on how your care for your oral health.

Contact our convenient Livingston location if you have more specific questions. We’re here to help you!

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Dr. Rothstein can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Livingston office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

For those of our patients who suffer from periodontal (gum) disease or those who have experienced moderate to severe tooth bone loss, Dr. Rothstein may suggest you undergo a procedure called a bone graft, which can help replace the bone destroyed by periodontitis, an advanced gum disease that is known to not only damage the gum tissue, but also the underlying bone which supports the teeth.

Dr. Rothstein may recommend you undergo a bone graft for reasons other than the presence of periodontal disease or tooth loss. These reasons include:

• Treating fractures
• Reconstructing chipped, broken, or shattered bones
• Placing of a dental implant
• Filling a gap in bones affected by cysts or tumors
• Shrinkage or loss of bone due to trauma
• Dentures that don’t fit properly

Bone grafting includes folding back part of the gum and cleaning out harmful bacteria that is making your gum disease worse. At that point, Dr. Rothstein will insert the bone graft, which will help spur bone growth, bridge a gap in a bone, and aid in healing. Bone grafts can repair damage from gum disease and boost the chances that you can keep your teeth for a lifetime. In addition to a bone graft, Dr. Rothstein may suggest a procedure called guided tissue regeneration, an advanced method used not only to help fight gum disease, but also to replace damaged or destroyed bone and tissue.

For more information on bone grafts, or to find out if you are a candidate for a bone graft, we invite you to give us a call at A R Periodontics or set up an appointment at our convenient Livingston office. We will be happy to answer any questions you may have!

Periodontal disease is an infection of the tissues that surround and support your teeth. Our team at A R Periodontics wants you to know that this common ailment can be fixed with little worry if treated properly.

Periodontal disease is usually identified through dental X-rays, probe depths, and visual exams. If left untreated, it can lead to tooth sensitivity, premature tooth loss, or discomfort and pain in your mouth. Some common symptoms to watch for include bleeding or swollen gums, bad breath, teeth movement, or jaw displacement.

Factors that may increase your risk of developing periodontal disease may include poor oral hygiene, smoking/chewing tobacco, genetics, stress, inadequate nutrition, pregnancy, diabetes, and some medications. Some of these causes are avoidable, but others are not.

If you have diabetes, you may be more prone to periodontal disease due to the greater difficulty in controlling blood glucose levels. Studies have shown that once periodontal disease is treated, glucose levels become more responsive to control as well. If your risk for periodontal disease is heightened by one of these factors, make sure to watch for the signs and keep up with your daily oral hygiene routine.

How can you treat this common disease that affects almost half of the population? Depending on the severity, treatment can include a medicated mouth rinse, antibiotic treatment, laser therapy, or scaling and root planing. It’s useful to recall that this condition can vary from mild to severe, which is why you should make an appointment at our Livingston office if you notice any of the above symptoms.

According to the American Academy of Periodontology, an estimated three out of four Americans suffer from gum disease. In milder cases, the disease is called gingivitis. More severe cases are called periodontitis. Despite the prevalence of periodontal disease (and it is very common), only three percent of people who suffer from periodontal disease get treatment for it. Gum disease has been linked to other serious diseases, including cancer, diabetes, and heart disease.

Periodontal Disease Is Common Among Americans

The Journal of Dental Research published the findings of a joint study from the Centers for Disease Control (CDC) and the American Academy of Periodontology (AAP). The study compared the full periodontal exam that participants received for this study against partial periodontal exams participants received for an older study.

The results show the rate of periodontal disease today could be as much as 50 percent higher than earlier estimated. Shockingly, this means that about twice as many Americans as previously believed suffer from gum disease – either moderate or severe.

The Link between Chronic Illness and Periodontal Disease

Many people who have chronic medical problems don’t have dental insurance, or the money to spend on dental care. Not surprisingly, this and a lack of understanding about proper oral hygiene leads to situations in which an initially minor problem turns into something far more severe, and probably preventable.

Gum diseases and cavities are caused by infections. When you get a cavity, the infection develops in the tooth itself. You may never feel anything, so unless you get regular, twice-a-year dental exams, you might not know there is a problem.

With gum disease, the infection occurs in the bones and tissues that form the gums and support the teeth. The tissues that surround teeth, and the bones that lie below the gums, are necessary to hold your teeth in. When those aren’t strong enough to support your teeth, you lose them.

Tooth loss has been linked to heart disease, diabetes, and an increased risk for kidney disease. Gum disease and severe infections in the mouth can spread to other parts of the body faster than people realize. A healthy mouth is alkaline. It’s vital for you to maintain an alkaline pH to keep harmful bacteria away.

When people eat, their pH changes, and the environment inside the mouth becomes more acidic. Since the typical American diet is very acidic, harmful bacteria thrive in the mouth. Typical foods include breads, grains, starches, and sweets – the foods people love the most. Since it isn’t always possible for people to brush after every meal, the mouth pH remains acidic, and the acid contributes to faster tooth erosion.

What does all this mean for you? The health of your mouth is more important than you realize. Get those regular dental exams, and make sure that you and your family keep to a regular routine of brushing and flossing. Good oral hygiene can help prevent periodontal disease, and that will lower your risk of tooth loss.

Periodontal disease is one of the most prevalent health issues in America, with the Centers for Disease Control reporting it affects approximately 65 million people, or roughly 47 percent of the population. People with periodontal disease have bacteria beneath the surface of the gums, which are responsible for tissue inflammation that can lead to pain, bleeding, gum recession, and even permanent tooth loss. Unfortunately, the chances of developing gingivitis and periodontitis only increase with age, with 70 percent of adults over age 65 having at least some degree of gum disease. However, a lot can be done to prevent periodontal disease and keep teeth and gums healthy.

Daily Hygiene

The process you take each day to clean your teeth and gums goes a long way towards preventing periodontal disease. Since gingivitis and periodontitis are caused by plaque build-up, the most important steps you can take to prevent them involve cleaning your teeth each morning, night, and after meals. Start by brushing your teeth and tongue, and follow up with mouthwash to kill any lingering bacteria. At least once per day, take time to floss thoroughly along the gum line to prevent gum infection from occurring in between teeth.

Periodontal Exams

In addition to caring for your teeth and gums at home, it is also important to see Dr. Rothstein for comprehensive exams. We can detect gingivitis in its earliest stages and treat it before it has a chance to progress. Everyone needs occasional periodontal exams, though people with certain risk factors may require them more often. Examples include individuals who smoke or have a personal or family history of gum disease.

Treating Periodontal Disease

See Dr. Rothstein right away if you suspect that you may be experiencing the warning signs of periodontal disease. Symptoms may include red, swollen, or bleeding gums, gum recession, pockets that have formed between the teeth and the gums, and even tooth loss. If you are diagnosed with periodontal disease, treatments are available to help restore your oral health depending on how advanced your gum disease has become. For example, gingivitis may require only a thorough cleaning and topical antibiotic. Periodontal disease that has been allowed to progress may require scaling and root planing, and in some cases, surgery to prevent tooth, bone, and gum loss.

Contact our Livingston office to schedule an appointment and learn about the ways we can help prevent and treat periodontal disease.

Just like that, it’s almost summertime. As the spring season ends, perhaps these lighter, brighter days are inspiring you to do a bit of last-minute spring cleaning. Or perhaps they’re not. No judgment here!

What Dr. Rothstein can recommend wholeheartedly is finishing the season with a clean, sparkling smile. And we have some bright ideas for you!

Refresh Your Cleaning Technique

Tooth brushing can become so automatic that we don’t think about the basics anymore. And suddenly, we’ve finished brushing in half the time we used to, and, hey, how long has that floss been sitting on the counter, anyway? We suggest some mindful cleaning for a healthier smile.

• Spend two minutes brushing, at least twice each day.
• Make sure you reach all the surfaces of your teeth, inside, outside, and on top of your molars.
• Use short, gentle brush strokes, covering a tooth or two at a time.
• Angle your brush to clean along the gum line. Plaque around the gums leads to irritation and inflammation, and is a common cause of gum disease.
• Use vertical strokes to clean the inside of your front teeth.
• Floss at least once each day.

Good Cleaning Requires Good Tools

Since we’re tidying up, let’s talk about some helpful cleaning tools. Is your toothbrush looking a bit—long in the tooth?  

After three to four months of brushing, your toothbrush bristles start to break down. Frayed and matted bristles can’t clean as effectively as a toothbrush in top shape. Each change of season is a good time to remind yourself to change brushes.

And, while you’re shopping, remember:

• Soft bristles are almost always all any brusher needs. Even medium bristles can be abrasive to tooth enamel and gums. And brush gently—scrubbing is also abrasive.
• If you use an electric toothbrush, those toothbrush heads need to be replaced, too! In fact, because these brushes often have shorter bristles, heads might need to be replaced every two to three months.
• Use fluoride toothpaste to clean and protect your teeth.
• Don’t forget the floss!

If you’re not a fan of your current floss, take another look at the dental aisle in your local store. There are lots of new flossing options out there just waiting to be sampled. Or consider a water flosser. Water flossers can be an effective and gentle means of cleaning bacteria from periodontal pockets for those with gum disease. Your periodontist can help you find just the right floss or water flosser for your one-of-a-kind smile.

And speaking of your dental team . . .

Some Cleaning Jobs Require Professional Help

If you suffer from gum disease, a twice-a-year cleaning with your dentist might not be enough to keep your teeth and gums their healthiest. In this case, your periodontist, a specialist in treating conditions of the gums, bones, and tissues surrounding the teeth, can perform a more thorough deep cleaning at our Livingston office. This procedure is non-surgical, and makes use of two types of cleaning:

• Scaling, to remove bacteria, plaque, and tartar above and below the gum line.
• Planing, to smooth the roots of the teeth. This process clears away bacteria and the rough spots where bacteria collect, and provides a smooth tooth surface for gum attachment.

Because periodontal cleanings are more thorough, they can take more than one appointment to complete and might require a local anesthetic. You might also be given medications to help the healing process. A follow up appointment will be scheduled to see whether further treatment is necessary.

Spring’s coming to an end, but taking care of your dental health is always in season! A clean smile isn’t just a more confident smile, it’s a healthier one. Talk to your periodontist for more tips to create your best and brightest smile at any time of year.

Injuries to our teeth and gums can have harmful effects on the bone tissue and structures that support them. In turn, this damage can impact both the appearance and the health of our smiles. One of the ways we can protect our dental health and restore our smiles is with a technique called bone grafting, available at our Livingston office.

What is Bone Grafting?

Bone grafting is a type of periodontal surgery. Bone tissue for grafting may be taken from your own body, or a graft material composed of donor tissue or synthetic substitutes can be used. This kind of graft will be absorbed gradually by the body as your own new, healthy bone tissue replaces it.

If you decide a bone graft is your best option, we will discuss the options for grafting with you beforehand, and use imaging to map out the area of bone loss and to create the best individual treatment plan for you. After anesthesia, an incision will be made in the gum tissue to reveal the damaged bone. Grafting material will be shaped and secured to the affected area, and sutures are generally used to close the incision. We will give you careful instructions for after care and follow-up visits. The time it takes for you to heal completely will depend on the type and size of the graft.

Why Consider a Bone Graft?

The bone structure that supports our teeth can be compromised in a number of ways. Dr. Rothstein might recommend a bone graft as your best option for treating many conditions which have both medical and cosmetic impacts.

• Tooth Loss Can Cause Bone Loss

The bone tissue which supports our teeth needs the stimulation of biting and chewing to stay healthy. Without that stimulation, the bone area under the missing tooth gradually shrinks. The bone tissue is resorbed into the body, which, in a relatively short amount of time, can lead to a noticeable sunken spot where the tooth used to be. A dental implant will provide the tissue stimulation that a natural tooth would, and will prevent future bone loss in the jaw. But if too much bone tissue has already been lost, you might need surgical bone grafting to achieve the right bone area and density to hold an implant.

• Gum Disease

As gum disease progresses, the gums pull away from the teeth, leaving the bone and connective tissue exposed to infection and bacteria. Infection and the body’s own response to bacteria can cause deterioration in the bone structure supporting the teeth, leading to loose teeth, a change in your normal bite, or even tooth loss. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

• Other Uses

Bone grafting can also be used to correct deformities in the jawbone, as part of nerve repositioning, to restore bone after trauma or long-term denture wear, and for other restorative and cosmetic uses.

Dr. Rothstein will recommend bone graft surgery when it will provide the best possible outcome for your individual needs. Because this is surgery, we are here to answer any questions you might have about the process and how we can provide the most skillful, gentlest, and least invasive treatment available. Above all, we want not only to protect your smile now, but to restore the strength and function of the bones which make it possible—for a lifetime of future smiles.

Have you been having trouble getting a good night’s rest?

Sometimes the reason for a poor night’s sleep is obvious. A midnight horror movie. A bedtime espresso. That anchovy and pineapple pizza you had for dinner. Not much we can do about these problems.

Sometimes, though, the cause of your sleep difficulties is dental in origin, and that is something Dr. Rothstein can help with.

Teeth grinding, or bruxism, is a very common dental problem. When people with this condition sleep, their jaws clench and their teeth grind against each other throughout the night. When to suspect you might suffer from bruxism?

• You wake with a sore jaw, or you hear pops or clicks when you move your jaw
• You suffer from frequent headaches or facial pain
• Your teeth are chipped, cracked, flattened, worn down, or sensitive
• You wake up tired, because grinding affects the quality of your sleep
• Partners, siblings, or roommates complain about nocturnal grinding noises affecting the quality of their

Pain and fatigue are unpleasant enough, but there are additional serious consequences for those who suffer from bruxism. Our jaws are extremely powerful, and clenching and grinding can put hundreds of pounds on pressure on teeth and jaws over hours of sleep. These forces can lead to:

• Damaged teeth. Cracked, chipped, and worn down teeth can mean veneers, crowns, and root canals. Seriously compromised or broken teeth might need to be extracted.
• Damaged dental work. Bruxism can lead to fractured veneers and damaged fillings and crowns. If the damage is too serious for repair, replacement might be necessary.
• Damaged jaw joints. Severe cases of bruxism can lead to injury to the temporomandibular joint, or TMJ, the complex hinge that allows our jaws to move up and down, back and forth, and side to side.

Why are periodontists concerned about bruxism? Because tooth grinding, over time, can also cause problems for your gums. Grinding your teeth doesn’t cause periodontitis, or advanced gum disease, but it can make the effects of the disease worse.

Periodontitis, left untreated, breaks down the bones and ligaments which support our teeth and hold them firmly in place. The extreme forces generated by tooth grinding put even greater pressure on these already compromised support structures, which can accelerate their breakdown.

While tooth, jaw and periodontal damage can be treated with restorations, or root canals, or implants, or surgical procedures, prevention is clearly a much better option for a healthy smile. And one of the simplest and most effective treatments for preventing the damage caused by bruxism is a night guard.

Night guards fit over the affected teeth to prevent them from touching directly, saving tooth and enamel from injury and wear. Not only do night guards prevent contact, they spread the biting forces of the jaw over the surface of the guard to greatly reduce their impact. And because they also stop the jaw muscles from clenching tightly, there’s no excess stress placed on the temporomandibular joint.

While over-the-counter products are available, a dental professional is the best person to see for the most effective night guard. A custom night guard is designed to fit your individual teeth and mouth perfectly. Impressions or 3D scans are taken in our Livingston office, and a guard is fabricated with the precise shape, strength, and thickness you need to protect your teeth. And, as a bonus, custom night guards offer the most comfortable fit for the most comfortable night’s sleep.

Scary movies, late night caffeinating, creative food combinations—not much we can do about those! But if you’re suffering lost sleep and painful mornings because of tooth grinding, give your dentist a call. In many cases, a night guard just might be the key to sweet dreams.

Sometimes people feel a tiny bit nervous when they sit in the dental chair. And sometimes it’s more than a tiny bit. If your anxiety over dental procedures is leading you to postpone scaling and root planing to treat your periodontitis, if the fear of oral surgery outweighs regenerating lost bone tissue or a gum graft, if dreading an implant procedure means you would rather live with tooth loss than give our Livingston office a call, give us a call! Sedation dentistry might be just the procedure you need to make dental anxiety a thing of the past.

Depending on your preferences, there are several levels of sedation Dr. Rothstein can provide to make your visit more comfortable.

• Minimal Sedation—this type of sedation leaves you calm and conscious, and you respond normally to verbal directions.
• Moderate Sedation—sometimes called “conscious sedation,” this option will leave you awake, relaxed and able to follow directions, but you will probably have little memory of the procedure afterward.
• Deep Sedation—a deeper level of sedation where you cannot be roused easily or respond to instructions. It is unlikely you will remember much or any of the dental treatment.

Our office is trained to administer and monitor all these forms of sedation. Because sedation in all its varieties is a regular part of our practice, we have the medical knowledge and skill to provide you with a safe and comfortable dental experience.

And we will prepare you with all the information you need to decide on any dental treatment, including sedation. We will describe the procedure in detail, and discuss any possible risks. If you have any health conditions or take any medications that might interfere with sedation, we can discuss your options with you and your doctor to make sure you are a good candidate. We will explain any preparations you should take, and let you know if there is a window of recovery time needed in our office while the sedation wears off.

Don’t let yourself suffer dental pain or discomfort because you suffer from dental anxiety! Please call us to discuss your sedation options. Whether you choose oral, inhaled, or IV sedation, we are trained to administer your treatment gently and safely. Above all, we want to help you keep your smile the heathiest it can be, and that only happens with proper dental care. Let us work with you to make that care as comfortable and stress-free as possible.

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.

“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!

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!

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.

It’s possible to develop tooth decay even when you take great care of your teeth. Brushing and flossing may not be enough to keep your teeth healthy, depending on your diet. Cavities, discoloration, and decay are still possible when certain foods feature in your daily intake. Keep an eye out for foods that will damage your enamel and cause the very issues you’ve been trying to avoid.

What causes enamel damage?

Tooth enamel is the hard outer layer of your teeth that is made of various minerals. Tooth decay results when the acids in your food react with the minerals in your enamel. Strongly pigmented foods may also cause unsightly discoloration on the surface of your teeth. Avoid wreaking havoc on your beautiful smile by identifying the foods that can harm your enamel.

Acid

Acidic food is your teeth’s worst nightmare! This is the greatest cause of enamel damage, even if you brush and floss regularly. To avoid damaging your teeth, make sure you can determine whether a food is acidic or not.

The pH levels are a way to determine acidity on a one-to-seven scale. This defines the relative acidity or alkalinity of a food or substance. Foods with high pH levels are not as likely to harm your enamel.

It’s wise to avoid or minimize foods that are high in acids. Highly acidic food can include fruits such as lemons, grapefruit, strawberries, grapes, and apples. Moderately acid foods may surprise you; they include tomatoes, maple syrup, pickles, and honey.

Not surprisingly, eggs and dairy products such as milk and cheese contain the least amount of acid. Red wine and coffee can also discolor your enamel if they’re drunk in excessive amounts.

What can I do to prevent enamel damage?

There are plenty of ways to avoid discoloration and decay of your enamel. The best thing to do is limit the amount of high-acid foods, including sugary juices and soda, in your diet.

Another way is to brush and floss regularly, an hour after each meal. If you can’t make time to brush, an easy solution is to swish your mouth with water or mouthwash to rinse away any leftover acidic particles.

Damaged tooth enamel may be common, but is avoidable when you know which foods to stay away from and the steps to take after you do eat highly acidic foods. Take our advice and you’ll be sure to slow down any future discoloration and decay that happens in your mouth.

For more advice on protecting your enamel, give our Livingston a call to learn more!

While modern dental science has made remarkable advances in treating oral diseases, prevention is always better than cure. To keep our mouth, gums, and teeth their healthiest, there are some simple practices we can follow to reduce dramatically the risk of developing some of the most common oral diseases.

Tooth Decay

We don’t usually think of tooth decay as a disease, but it is, in fact, the most common chronic disease in older children and adolescents. A great majority of adults have had at least some experience with decay. Left untreated, tooth decay can lead to pain, infection, tooth loss, and even loss of nearby bone in the jaw. Luckily, there are several time-tested ways to prevent cavities:

• Brush properly at least twice a day. Ask Dr. Rothstein for the best toothbrush for your individual needs (usually, a soft brush is best), the best technique for angling the brush to reach all of each tooth’s surfaces, and the amount of time you should spend brushing.
• Floss daily. Even with perfect brushing form, you are going to want to use floss to clean between the teeth and around the gum line.
• Use a fluoride toothpaste. Study after study has shown that the risk of cavities is reduced with regular use of a fluoride toothpaste or rinse.
• Watch your diet. Foods high in sugar and simple carbohydrates give cavity-causing bacteria the fuel they need to produce the acids which weaken enamel. On the other hand, a diet rich in protein, vitamins, and minerals is beneficial not only for your teeth, but for your whole body!
• See your dentist for regular checkups to find small problems and prevent them from becoming major ones. Your dentist can also give you tips on better oral hygiene if your brushing and flossing habits aren’t doing the job.

Gum Disease

Preventing gum disease is a lot like preventing tooth decay—your daily habits really make a difference. When plaque builds up around the teeth and gums, the bacteria in plaque cause gum tissue to become inflamed, swollen, and painful. Left untreated, the gums pull away from the teeth, leaving pockets where bacteria collect and lead to infection. Infections harm not only gum tissue, but can destroy the bone which supports the teeth. What can you do to prevent gum disease?

• Use proper brushing technique. Remember to angle the brush toward the gums to gently clean around and below the gum line.
• Floss daily—flossing removes particles and plaque between the teeth, and it also helps remove plaque from the area under the gum line.
• Smokers are at higher risk for gum disease, and smoking has been linked to slower healing. Giving up tobacco products of any kind is always a good way to protect your dental health.
• Regular dental exams will catch gingivitis (early gum disease) while it is still reversible. Periodontitis (serious gum disease) can require treatment by Dr. Rothstein. Certain diseases such as diabetes increase the risk of developing gum disease, so checkups are especially important.
• Having your teeth cleaned every six months, or as recommended, will remove plaque that brushing alone can’t handle. If there are signs of more serious gum disease, a periodontal cleaning will remove plaque and tartar from both above and below the gum line.

How Can Your Periodontist Help?

Periodontists like Dr. Rothstein have the advanced education and training not only to treat oral diseases, but to help repair the damage they can cause. A periodontist has experience in:

• Treating all forms of periodontal disease
• Periodontal cleanings such as scaling and root planning to remove plaque and tartar
• Regenerative treatment to restore bone lost to periodontal disease
• Implant surgery to provide a permanent, natural looking replacement for a lost tooth
• Regenerative procedures, if needed, to make sure the jawbone has the necessary size and density for a successful implant
• Gum surgeries to remove or reshape excess or damaged gum tissue
• Soft tissue grafts to treat exposed roots, receding gums, and gum tissue loss

An ounce of prevention is worth a pound of cure, and when it comes to your dental health, there’s a lot you can do to prevent oral diseases. But should you need treatment at our Livingston office, we have the knowledge and experience to help restore the health of your mouth, teeth, and gums. After all, you can’t weigh the worth of your oral health—that’s priceless!

Periodontal disease, also known as gum disease, is a chronic bacterial infection of the gums, periodontal ligament, and bone that surround and support the teeth. Gum disease includes gingivitis (the early stage of gum disease) and periodontitis (a more advanced stage of the disease). The condition, which studies have indicated afflicts nearly 80 percent of Americans at some point in their life, causes a chronic inflammation of the gums and surrounding tissue. You can prevent periodontal disease by brushing and flossing regularly, visiting your dentist twice a year for exams and cleaning, and sticking to a healthy, balanced diet.

Making sure that you practice good dental habits is one of the simplest things that you can do to avoid gum disease. These include:

• Brushing your teeth twice a day with toothpaste containing fluoride. Make sure to brush all sides of your teeth, including brushing your tongue as plaque can cause bad breath, also known as halitosis. We recommend chewing sugar-free gum, especially one containing xylitol, a sugar substitute.
• Using an electric toothbrush removes plaque more effectively than a regular toothbrush. Look for one that has the American Dental Association (ADA) Seal of Approval or ask Dr. Rothstein during your next visit.
• Using an antiseptic mouthwash such as Listerine. Fluoride or antiplaque mouthwash is also helpful at killing off bacteria in the mouth.
• Flossing once a day helps get rid of particles of food wedged in the crevices between your teeth. Simply curve the floss around each tooth into a U-shape, and slide it gently under the gum line. Move the floss firmly up and down several times to scrape off the plaque. If you’re not sure which floss to buy or how to floss, ask Dr. Rothstein during your next visit.

To learn more about preventing gum disease, or to schedule your next visit with Dr. Rothstein, please give us a call today!

Did you know the actions leading to the beginnings of Valentine's Day were actually centered on the avoidance of war? A Catholic priest named Valentine defied the orders of the Emperor Claudius II and secretly married young men and their brides after the emperor had declared it illegal because only single, young men could be sent to war. Rather than lose potential soldiers to fight his war, Claudius attempted to hoard them by proclaiming marriage illegal.

Valentine continued to marry young couples anyway and, eventually, was put to death for it in 270 AD. Before his death, he sent a letter to a secret love and signed it “From your Valentine”. Nearly 1,800 years later, people are still signing letters and cards in this manner. This year, carry on the tradition started long ago, while adding your own twist. Here are a few suggestions.

Simple and Creative Valentine's Day Ideas

• Memorialize it with a Photo. Couples often have photos taken around Christmas, but Valentine's Day photos allow you to capitalize on romance. Famous couple Julia Child and her husband, Paul, had their picture taken together every Valentine's Day and included their sense of humor with silly props.
• Return to Your First Date Location. Even if your first date together was at a local hotdog stand, its sentimental value can make it a fun part of your Valentine's Day agenda. Be creative and make a treasure hunt with clues that lead your partner to the original date location, where you can express your love with flowers or a gift.
• “From Your Valentine” Messages. Deliver your message in a creative way to make this Valentine's Day stand out from the others. Bake your partner's favorite treat and write a message on it with a tube of icing, or draw a note on the steamed up mirror so it shows up when your partner takes a shower.

Although Valentine's Day is a day to celebrate love, it doesn't have to be a special day only for couples. If you're single, use this special day to shower yourself with love, because you're worth it! After all, the priest Valentine believed so strongly in the sanctity of love that he was willing to risk his life for it. Whether you're in a relationship or single, young or old, romantic or not, Valentine's Day is for you. Happy Valentine’s Day from the Periodontist office of Dr. Rothstein.

Part of presenting our best faces to the world is making sure our smiles are bright and our breath is fresh. Sure, we’ve all been embarrassed by an occasional pungent reminder of that garlic bread we just couldn’t pass up, but with daily brushing and flossing, fresh breath is the norm. Until it isn’t.

If you’ve been carefully avoiding strong foods in your diet, if you’ve started brushing a lot more often, if you’re relying on mints and mouthwash to get you through the day, and you still have bad breath, it’s time to see your dentist or doctor.

Chronic bad breath can be a symptom of tooth decay, dry mouth, oral infections, diabetes, kidney disease, and many other medical or dental problems. It can also be a red flag for serious gum disease, or periodontitis.

How does gum disease cause persistent bad breath? The bacteria and plaque that we are careful to brush away from the surface of our teeth can also stick below the gum line. These bacteria irritate the tissues around them, and the area becomes inflamed. Pockets form around the teeth where bacteria collect and multiply, becoming the source of that unpleasant odor.

And, while bad breath is an embarrassing consequence of gum disease, there are other consequences that are far more serious. Infection causes inflammation, and untreated infection and inflammation lead to the breakdown of gum and bone tissue and, eventually, even tooth loss.

If your dentist discovers signs of advanced gum disease, it’s time to give a periodontist like Dr. Rothstein a call! Because this dental specialty requires three additional years of study after dental school, focusing on the treatment of periodontal disease and cosmetic restorations, periodontists have the knowledge and experience to treat the cause of your gum disease and to restore your gum and bone health.

What can your periodontist do for you? Periodontists are skilled in many procedures that can be used to save gums and teeth, including:

• Antibiotic therapy, which can be used alone or with other procedures to treat periodontitis.
• Non-surgical treatments, such as scaling and root planing, which remove plaque and tartar from areas of the teeth above and below the gum line and clean and smooth tooth surfaces.
• Flap surgery, which allows the periodontist to remove tartar, smooth any irregular tooth surfaces, and then reposition the gum tissue snugly around the teeth to eliminate pockets where bacteria can multiply.
• Bone and gum grafts, bone surgery, and surgical tissue regeneration, to replace and repair damaged bone and gum tissue.

If you are experiencing persistent bad breath, talk to your dentist or doctor about the possible causes, and whether a visit to our Livingston office is in order. Periodontal treatment can stop the progression of gum disease, and even restore damaged tissue and bone to make sure you keep your teeth for a lifetime. And one additional bonus? The return of your bright smile and fresh breath. Let your periodontist help you breathe easy once again!

According to the Centers for Disease Control and Prevention, half of adults age 30 and over suffer from some form of gum disease. Caused by plaque buildup, gum disease is an infection of the tissue that surrounds and supports the teeth. In its advanced stages, it is known as periodontal disease. If left untreated, it can result in the loss of tissue and bone that support the teeth, causing teeth loss. It’s a preventable condition seen far too often by Dr. Rothstein.

Research between periodontal disease and other diseases is ongoing. Some studies have indicated that gum disease is linked to other health conditions such as stroke or diabetes. Furthermore, while most factors that lead to periodontal disease are dependent on the individual (genetics, diet, poor oral hygiene) there is a possibility that periodontitis is capable of spreading from one person to another.

What the Research Says

Periodontitis is a gum infection, and the bacteria that cause the gums to become infected travels in saliva. Researches have used DNA coding techniques to track the path of infection from one person to another. In other words, kissing and close contact play a role in the transmission of the infection, so if you’re married to a spouse with periodontal disease, then your chances of having gum problems are slightly increased. Other studies have indicated that saliva contact is common in family settings through coughing, sneezing, and shared utensils and food. Children with parents who have periodontal disease are at a somewhat higher risk of developing it. At the same time, just because you exchange bacteria with your loved ones doesn’t mean you will get periodontal disease.

It is important to note that the scientific evidence supporting the spread of periodontal disease is limited and ongoing. The best way to prevent gum disease is through proper plaque control, which includes brushing, flossing, mouthwash, and twice a year trips for professional cleanings. Contact our Livingston office if you have any questions about periodontal disease.

Dr. Rothstein and our team recommend that you brush your teeth two to three times a day, for at least two minutes each time. But have you ever wondered what’s in toothpaste and how it actually works? The mouth is home to more than 500 types of microorganisms that feed on leftover food that gets stuck on and around your teeth. Toothpaste is the best line of defense against all those pesky microorganisms (especially when you brush two to three times a day). Here’s how it works.

Abrasives

Toothpaste contains mild abrasive additives that combat microorganisms and fight plaque. When you brush, the abrasives in toothpaste dislodge food particles and microorganisms more effectively than if you simply brush your teeth with water. The abrasives also work to remove food stains and polish the surface of the tooth. Some toothpastes include ingredients like triclosan and Xylitol. These chemicals prevent the growth of bacteria that produce plaque. Plaque not only causes cavities, but it can also lead to more dangerous issues like periodontal disease.

Fluoride

Fluoride is key ingredient in toothpaste. As the microorganisms in your mouth feed off the leftover food particles, they leave behind acid and sulfur byproducts that wear away the enamel of the teeth. This is the fancy, technical way of saying that the acid on your teeth causes cavities. As for the sulfur byproduct –well, that’s just a fancy, scientific name for bad breath. Fluoride works to fight the acid and help protect the teeth. By brushing, the fluoride is incorporated into the tooth enamel, which in turn makes the tooth more resistant to acid and plaque.

Flavoring and Sweetening Agents

Not all toothpaste tastes the same, right? The type of flavoring or sweetening agents added to the toothpaste doesn't have anything to do with fighting microorganisms and plaque, but taste is one of the most important selling points in finding a toothpaste brand you like. Flavoring agents mask the taste of some of the other ingredients in toothpaste, and without those agents chances are nobody would be brushing their teeth two to three time a day.

Today's periodontal office is a very different place than it was in the past. Yes, perhaps the same issues are still being treated, but it's the way in which they are treated which has changed drastically. Now patients with periodontal disease (gum disease) have more options.

What patients must understand is that gum disease is an infection that progresses in stages. First it affects gum tissue, and then it moves to the bones supporting the teeth, which then progresses to loss of teeth if left untreated. The main goal of treatment is to control this infection before it becomes more serious or painful.

Cutting-edge technologies used by Dr. Rothstein now allow gum disease to be treated non-surgically, which is a huge advantage for patients who don't want to get gum surgery, can't afford it, or simply aren't good candidates for it. Here are some of the ways in which our office implements the latest in periodontal technologies:

• Ultrasound gum treatments –An ultrasonic cleaning device is used to break apart stubborn plaque and tartar, as well as bacteria. The tool vibrates at a high frequency while simultaneously spraying a thin stream of water. The stream is sprayed around the teeth and at the gum line to clean and help prevent the bacterial buildup that leads to gum disease.

• Laser therapy – A tiny diode laser is aimed at the gum line to kill disease-causing bacteria. This method is able to penetrate into the pockets between the teeth and gums, all with minimal discomfort and no surgery whatsoever.

• Panoramic X-rays – These X-rays give us a much more detailed view of your mouth and the structures that support it than traditional dental X-rays. The machine spins around your head 360 degrees to produce a digital X-ray in a matter of seconds. We're then able to refer to this digital image on the computer for effective and precise treatment planning.

• Intraoral camera – The head of this device contains a small camera used to show you what we see. It produces a live feed on the monitor so you get a better understanding of the issues in your mouth. This way we can better explain how we will go about treating them and what you can do about them, too.

Patients suffering from gum disease have more options and help than ever before. If you are currently a patient or would like to know about the treatment options we offer, please speak with one of our staff members or contact our Livingston office.

Our gums cover and protect the sensitive roots of our teeth and the bone around them. While we often think of gum tissue as a rosy shade of pink, that’s not a hard and fast rule. Just as skin tones vary, gum color can vary from person to person.

Healthy gums can range from light pink to darker pink to hues of brown or black. Because your gums are a good indicator of your oral health, what’s important isn’t your normal gum color, it’s noticing any changes in your normal gum color. These changes could be symptomatic of several different dental and medical conditions.

Pale Gums

• Anemia

If the overall appearance of your gums is paler than usual, anemia is a prime suspect. Anemia is a common condition caused by a low red blood cell count. Hemoglobin in red blood cells delivers the oxygen our tissues need to function properly, and without enough, we suffer symptoms like fatigue, weakness, pallor, faintness, and rapid heartbeat.

Anemia can be caused by an underlying medical condition, or can develop because of other issues, such as iron or vitamin deficiencies, pregnancy, ulcers, certain medications, or heavy menstrual periods. If you have any of the symptoms of anemia, seeing your doctor for a blood test is a good idea.

• Teeth Whitening

Occasionally, gums can also lighten up after a tooth whitening procedure. This is due to tissue irritation caused by the bleaching chemicals. Usually this condition is very temporary.

Ask Dr. Rothstein for advice if you experience irritation after home treatments. Having your teeth whitened by a dental professional is one way to make sure your gums get the best protection possible during the process.

Red Gums

• Inflammation

Red gums are a common symptom of gingivitis (early gum disease). Plaque and tartar irritate your gums, and gum tissue reacts to this irritation by becoming inflamed. Left untreated, gingivitis becomes periodontitis (serious gum disease), which can destroy the bone around the tooth and lead to tooth loss.

If you notice signs of gingivitis—redness, swelling, bleeding, bad breath—talk to Dr. Rothstein. Often, gingivitis is easily remedied in the early stages by better attention to dental hygiene. Brushing for two minutes at least twice each day and flossing at least once a day are a good base line for keeping gum disease at bay.

• Infection

Redness can also be caused by infection. If you’re experiencing redness, pain, loose teeth, swelling, pus, or fever, it’s important to see Dr. Rothstein as soon as possible in case you have an abscess or infected dental cyst. Without treatment, infection can seriously damage gum tissue, teeth, and underlying bone.

• Over-Vigorous Brushing

Brushing too hard or using the wrong brush can cause gum irritation. Do your gums (and teeth!) a favor by using proper brushing technique—massage, don’t scrub—and always use a soft-bristled brush.

Spots of Discoloration

Sometimes you notice a patch of lighter or darker tissue that you haven’t seen before. A spot that is different from the gum tissue around it can be harmless or need further attention.

Contact our Livingston office if you have any recent discoloration, sores, pain, lumps, or any differences in appearance or sensation in your mouth. There are several types of oral cancer and prompt diagnosis and treatment is important to prevent the spread of cancerous cells.

Why a periodontist?

If you’re concerned about the health of your gums, making an appointment at our Livingston office is a great idea. The word “periodontal” comes from the Greek words for “around” and “tooth,” and a periodontist is a specialist in treating the structures surrounding the tooth, including the gums, the bone tissue holding the tooth, and the connective tissue between tooth and bone.  

Periodontists have several years of additional post-doctoral study after dental school focused on diagnosing and treating periodontal problems, including:

• Diagnosing and treating gingivitis and periodontitis
• Surgical care for periodontal disease, including gum grafting
• Scaling and root planing, procedures which remove plaque and tartar from areas of the tooth above and below the gum line
• Monitoring your gums when you have other health conditions that could affect them, such as diabetes and heart disease

You know your smile better than anyone. Any time you see a change in the usual appearance of your gums, it’s important to see Dr. Rothstein. Treating gum problems before they become serious is one of the best ways to keep yourself—and your smile—in the pink of health!

Have you ever looked in the mirror and noticed that your teeth looked longer? Does it seem like your gums are shrinking? This condition is called recession—many adults have it. Let’s look at some of the causes and what you can do about it.

During your exam at A R Periodontics, we will take measurements to check for periodontal disease. Dental professionals take recession measurements to see how much attached gingiva is present. This is the kind of tissue that is most resilient to infection.

The more recession, the less attached gingiva. The less attached gingiva, the less bone support. The less bone support, the higher your chances of tooth loss. It is quite a domino effect.

Don’t lose hope. The effect can be halted once you know the cause of your recession.

Do you ever wake up with your jaw clenched, and/or a headache that originates just above your ears? Clenching or grinding your teeth can cause recession. When there is added stress on a tooth, it flexes at the gum line.

Over time this causes microscopic breaks in the enamel and then a notch appears. The gum line is forced to move away from its original position. If this is something you see in your mouth, we can discuss the possibility of an occlusal guard at your next visit.

How do you brush your teeth? Do you brush in a straight line or circles? What kind of bristles do you use? Are the bristles on your toothbrush frayed?

When you brush in a circle, you are sweeping all along the gum line, removing the plaque from most angles. When you brush in a straight line, you may often miss the concave portion of the gums. This leaves plaque behind and leads to gingivitis. Whenever gingivitis occurs, the body attacks supporting structures like bone while trying to get rid of the infection. This is periodontal disease, which can cause recession.

Recession may also result from an irritant on the gums, such as a bar from a partial denture or orthodontic appliance (braces).

Gums do not “grow back.” The most common treatment for advanced recession is a tissue graft. There are many different kinds of tissue grafts.

Other factors can cause recession. If you think recession is happening in your mouth, schedule an appointment with Dr. Rothstein to discuss your options, so you can make the appropriate treatment choice.

People have been ushering in the New Year for centuries but it became an official holiday in 1582 when Pope George XIII declared January 1st to be the day on which everyone would celebrate the New Year. At midnight people would yell, holler, and blow horns to scare away the evil spirits of the previous year so the New Year would be joyous and filled with opportunity. Nearly 500 years later, we still greet the New Year by whooping and hollering, but in a celebratory manner instead. Whether you intend to ring in the New Year quietly at home in the Livingston area or have plans to join the countdown at a gala extravaganza, these tips can help you ring out the old and usher in the new with a smile.

Tips for a Happy New Year's Eve Celebration from A R Periodontics

• Be Safe. There's no way to predict the behavior of others on New Year's Eve, but you can be responsible for your own behavior to keep yourself safe. If adult beverages will be part of your celebration, plan on spending the night wherever you are or line up a designated driver to bring you home after the party is over.
• Enjoy Family and Friends. Spending time with the important people in your life is what makes the holidays enjoyable. Coordinate your schedules and choose New Year's Eve activities that everyone in the group will enjoy. You don't have to go to a party to ring in the New Year; some people like to go bowling, see a movie, or have a great meal at home.
• Accessorize with a Smile. Whether you dress up or have a quiet dinner with family and friends, one of the best accessories you can add to your attire is a beautiful smile.

New Year's Eve is a time to gather with friends and family, reflect on the year that's coming to an end, and look forward to the new one with anticipation. Enjoy this transitional holiday in a way that's safe, healthy, and fun. After all, counting down until the clock strikes 12 marks the beginning of a full year of opportunity ahead of you. From Dr. Rothstein, have a great new year!.

Dr. Rothstein and our team know that your smile is one of your most distinguishing features, and one of the first things people notice about your appearance. Whether you hesitate when you smile, would like to fix imperfections, or simply wouldn’t mind increasing your self-confidence, we would like to remind you that our team members at A R Periodontics are specialists when it comes to replacing teeth through dental implants, reshaping your gum line, helping you regain tissue health, or covering gum recession brought on by gingivitis.

Luckily, we provide procedures that cover unattractive, sensitive, or exposed root surfaces, as well as prevent future gum recession, ultimately giving you the smile you’ve always wanted.

Gummy Smile

For patients who feel they are showing excessive gums when they smile, we are proud to offer crown lengthening and gingival reshaping, a procedure where Dr. Rothstein and our team reshape excess gum and bone tissue in order to expose more of your natural tooth (or teeth), giving your mouth a natural-looking gum line.

Exposed Roots

When gums start receding, they begin literally pulling away from your teeth, exposing the roots and putting them at greater risk for tooth decay and bone loss, not to mention sensitivity to hot and cold foods and drinks. This condition can be alleviated through a cosmetic procedure we call a gum graft, also known as a soft tissue graft, which Dr. Rothstein can perform to reduce gum recession , cover unsightly tooth roots, and protect them from decay and subsequent loss.

Missing Teeth

Not only do missing teeth create unattractive gaps in your smile, they also take a toll on your oral health as normal activities like eating and speaking become challenging and sometimes downright painful. Dr. Rothstein and our team are proud to offer dental implants, which are the best treatment option for replacing missing teeth, and can dramatically improve the functionality and aesthetics of your smile, not to mention the impact they have on your quality of life. If properly maintained, implants can last a lifetime.

Gum Indentation

Sometimes when a tooth is extracted or falls out due to decay, the bone and gum tissue will collapse around the affected area, resulting in what Dr. Rothstein and our team call a gum indentation. If that is the case, we can replace your tooth, in addition to recommending you undergo a procedure called a ridge augmentation, where we will smooth out the indentation to recreate the natural outline of your gum line and jaw. This procedure generally includes bone grafting to regenerate the missing bone.

If you are interested in learning more about the cosmetic services we provide to give you the smile you’ve always wanted, we encourage you to give us a call at our Livingston office. During your visit, Dr. Rothstein will be happy to sit down with you and discuss your options.

Flossing is one of the most important parts of your oral care routine. Many patients know they need to do it but find it difficult to fit into their busy lives. Well, here's the good news: flossing once a day is enough if you're doing a good job!

Some patients like to brush before they floss and others like to floss before they brush. Some like to floss in the morning when they have more energy, others like to floss at night so they can go to bed with a clean mouth. Don't get hung up on any of this, the important thing is that you floss and floss effectively no matter when you do it.

Effective flossing contributes to oral health in these ways:

• It reduces the chance of cavities between teeth, since cavities can only form on teeth covered with dental plaque and you're scraping that plaque away when you floss.
• Along with brushing, it reduces the amount of time the plaque is left on your teeth, allowing them to be in a state of healing and remineralization for longer.
• It removes plaque that accumulates at or below the gum line, aiding in the prevention of gum disease.

As you can see, flossing offers many benefits for such a simple and inexpensive technique. So if you're still wondering how much to floss, don't worry about it. Don't mistake the frequency of your flossing with the effectiveness of it. Choose a dental floss that you like and one time during the day when you can floss thoroughly and just do it! If you need more tips on how to floss correctly, ask Dr. Rothstein or any member of our Livingston team—we'd be glad to help you pick up this healthy habit!

Oral-systemic health is the idea that oral health is a critical and interconnected component to a patient’s overall health and well-being. Studies show that people who have poor oral health are more likely to have other health conditions such as heart disease, diabetes, or a high likelihood of stroke.

Some of the data suggests that oral pathogens may trigger up to 50% of heart attacks, and that the oral bacteria P. gingivalis may cause a 13.6-fold increase in patients’ risk of a heart attack.

Still, the exact relationship between oral and overall health isn't fully known — whether one causes the other or how treating one might affect the other. But it should serve as a warning call to anyone suffering with poor oral health, especially periodontal disease.

More studies need to be conducted to establish the precise link between the two, but whatever it is, one thing is certain: good oral hygiene makes for good oral health. Many dentists and doctors realize the need to work together as a cohesive healthcare team to improve and maintain the health of their communities.

The American Dental Association says oral health is essential to overall health, and not just a luxury. They are setting goals to reduce the amount of tooth decay in low-income communities for both children and adults.

So what is a patient about this information regarding oral-systemic health? Here are some tips to increase and maintain your overall well-being:

• Have an effective oral hygiene routine. Brush twice a day for two minutes each time, floss daily, clean your tongue, and avoid sugary beverages.
• Visit your dentist regularly. Regular cleanings and checkups at your dentist’s office will keep your mouth clean and ensure you’re taking good care of it.
• Eat a healthful diet. A diet rich in fruits, vegetables, whole grains, and natural, unprocessed foods contributes to the overall health of your body.
• Stay hydrated. Drink plenty of pure, clean water throughout the day. A good rule of thumb is to drink eight eight-ounce glasses a day.
• Relax, destress. Stress can play a big role in all forms of disease. Take time during your day to relax, meditate, stretch, and allow your body and mind to rest.

If you have questions about your oral health and how it may be affecting your general health, feel free to ask Dr. Rothstein during your next visit to our Livingston office.

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Water picks, sometimes called “oral irrigators,” make an excellent addition to your regular home care regimen of brushing and flossing. Especially helpful to those who suffer from periodontal disease and those patients of ours undergoing orthodontic treatment with full-bracketed braces, water picks use powerful tiny bursts of water to dislodge food scraps, bacteria, and other debris nestled in the crevices of your mouth. Children undergoing orthodontic treatment may find using a water pick is beneficial if their toothbrush bristles tend to get caught on their wires or brackets.

When you use a water pick, you’re not only dislodging any particles or debris and bacteria you might have missed when brushing, you are also gently massaging the gums, which helps promote blood flow in the gums and keeps them healthy. While water picks are an excellent addition to your daily fight against gingivitis and other periodontal diseases, they are incapable of fully removing plaque, which is why Dr. Rothstein and our team at A R Periodontics want to remind you to keep brushing and flossing every day.

If you have sensitive teeth or gums and find it uncomfortable to floss daily, water picks are a good alternative to reduce discomfort while effectively cleaning between teeth. Diabetics sometimes prefer water picks to flossing because they don't cause bleeding of the gums, which can be a problem with floss. If you have a permanent bridge, crowns, or other dental restoration, you may find that a water pick helps you keep the area around the restorations clean.

So how do you choose the right water pick?

Water picks are available for home or portable use. The home versions tend to be larger and use standard electrical outlets, while portable models use batteries. Aside from the size difference, they work in the same manner, both using pulsating water streams. A more crucial difference between water picks is the ability to adjust the pressure. Most home models will let you choose from several pressure settings, depending on how sensitive your teeth and gums are. Most portable models have only one pressure setting. If you want to use mouthwash or a dental rinse in your water pick, check the label first; some models suggest using water only.

Please give us a call at our Livingston office if you have any questions about water picks, or ask Dr. Rothstein during your next visit!

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals, which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria that don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gum line, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gum line.
• Floss to remove plaque from between the teeth and near the gum line.
• See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to us about the best way to keep plaque at bay. If you have plaque and tartar that has spread below the gum line, talk to Dr. Rothstein about procedures such as scaling and planing. These non-surgical, deep cleaning treatments available at our Livingston office remove plaque and tartar around the roots and smooth away rough surfaces where bacteria can hide.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

Biofilm, the protective housing for bacteria, is a hot topic in the medical and dental fields. Routinely taking an antibiotic for a bacterial infection has become more complicated because of biofilm. Bacterial infections may become resistant to antibiotics in part because the biofilm allows for communication among the bacteria, allowing the infection to be sustained.

You’re probably wondering, Dr. Rothstein , what does this have to do with teeth? Since we’re dental professionals, we can tell you why it’s important and what you should know! There is biofilm in your mouth; healthy biofilm and diseased biofilm. Both are made of the same general compounds, but when combined with certain amino acids and cellular chemicals, the diseased biofilm conquers and destroys.

Periodontal disease, otherwise known as gum disease or pyorrhea, is a biofilm disease. If you are undergoing treatment for gum disease and you do not continue with the treatment plan the disease will progress and/or spread due to the biofilm.

There are several ways to treat diseased biofilm. But remember, antibiotics cannot touch the bacterial infection if the biofilm is established.

When your exam is complete, the Ultrasonic or Piezo Scaler should be used. This method of spraying water disturbs the biofilm and provides an opportunity to treat the infection causing bacteria.

Remember, we all need healthy biofilm. Just as your skin protects your body, biofilm housing good bacteria protects your body. The bacteria in the biofilm replicate every twenty minutes. If your body has healthy bacteria, low levels of hydrogen peroxide are produced by the biofilm, preventing harmful bacteria from residing. Harmful bacteria do not like oxygen.

At your exam, we will take measurements around your teeth checking for “pockets”. The higher the number, the deeper the pocket giving more room for harmful bacteria where there is no oxygen. Ask what your numbers are and be involved in restoring your healthy biofilm.

You brush and floss thoroughly twice a day. You have regular checkups. Everything seems fine on the periodontal radar. Sometimes, however, even healthy gums can become sensitive and irritated. Is it something you did? Maybe! Here are some common causes of gum irritation and sensitivity that you might not be aware of.

• Brushing Bravado

One of the most important tools for gum health is one we use at least twice a day—the simple toothbrush. Two minutes at night and two in the morning reduce the bacteria and plaque that lead to serious gum disease, known as periodontitis. And while preventing tooth decay and gum disease are the primary goals of brushing, let’s also protect delicate gum tissue from injuries and irritation caused by too-forceful brushing.

Try using a brush with soft bristles and brushing with short strokes and gentle pressure, especially if you know you have a tendency to be a bit heavy-handed. Massaging rather than scrubbing will clean teeth and gums just fine.

• Fierce Flossing

Just because we can use dental floss to slice cakes or cookie dough logs doesn’t mean we should apply the same pressure to our gums! While a firm sawing motion seems like the obvious way to clean between teeth and gums, you can actually cause irritation and bleeding that way.

Insert the floss between your teeth carefully, bring it to the gumline, and move the floss with gentle pressure up and down and around the tooth surface. This technique will make sure that you remove food particles and plaque from beneath the gumline without causing your gums any trauma. Ask us about the best flossing techniques—we know them all.

• Appliance Aches

You know how helpful your braces/retainers/mouth guards/dentures are. You just wish that your helpful appliance was a little less irritating to sensitive gum tissue.

This is a problem that often disappears as you get used to your new appliance. But if pain or irritation persists or gets worse, give us a call. We want to make sure your appliance fits properly, and make any necessary adjustments to ensure your comfort.

• Peroxide Problems

Most home whitening kits use peroxide-based gels or treated strips to remove surface stains from the teeth. Those same bleaching agents that make enamel whiter can also cause gum sensitivity and irritation. If you use whitening strips or gel trays, be careful to keep the peroxide solution away from gum tissue. But because these systems are one-size-fits-all, that is often easier said than done.

If you have sensitive gums, one solution is a professional office whitening. We’ll check on your gum (and tooth) health first, and monitor and protect your gums throughout the procedure. If you still want to whiten at home, we can create custom trays for you that will provide more complete exposure to the whitening solution for your teeth, and less exposure for your gums, than over-the-counter products.

• Still Smoking?

Studies have shown a strong link between gum health and smoking and other forms of tobacco use. Smokers are much more likely to suffer from gum disease than non-smokers, and those who have smoked for a long time, or who smoke heavily, have an even higher risk of developing periodontal disease. Some studies suggest that smokers don’t respond as well to treatment as non-smokers.  Unfortunately, it appears that smoking and tobacco use help mask the obvious symptoms of gum disease (redness and bleeding), which could lead smokers to delay getting treatment. If you smoke, talk to us about ways to quit.

We talk a lot about periodontal health because it is so important. Periodontitis can lead to infection, loss of bone around the tooth, and even eventual tooth loss. If you are suffering from any of the signs of gum disease—swelling, redness, bleeding, pain—give our Livingston office a call. Whether it’s as simple as making a few lifestyle changes, or a problem requiring professional dental treatment, being proactive with your dental care is more than good for your gums—it’s good for your health!

If you suffer from dental anxiety, we understand that paying a visit to our office can seem like a nearly impossible mission. Regardless of what the root of that anxiety might be, we’re here to tell you that at A R Periodontics, you have no need to be nervous. Our office is dedicated to making your dental experience as comfortable and stress-free as possible.

One of the best things to do if you experience dental anxiety is call our office in advance to let us know. By notifying us in advance, you give us the opportunity to provide you with the dental care you need in the way you need it.

We can prescribe a relaxation medication for you. During your appointment, we can provide a little bit of laughing gas to put you more at ease, teach you some behavioral techniques for relaxation, and make sure you’re never in the dark about what’s happening.

If dental anxiety makes you feel embarrassed, please be assured that you’re not alone. Studies show that as much as 75% of adults suffer some degree of dental anxiety! It might be helpful to remember that your doctor’s goal is the same as yours: We are here to keep your oral health in check so you can be your healthiest self. We certainly don’t want to make you uncomfortable in the process.

If you have any questions about other ways in which we can accommodate you during your visits, please don’t hesitate to contact our Livingston office!

By no stretch is it rare for your gums to hurt during and after flossing. Even some bleeding is to be expected. This is especially true if you have not flossed in a long time. However, if your gums do indeed hurt when you floss, and unbearably so, there are some things you can do.

Be Gentle

Perhaps the most obvious way to combat gum soreness and bleeding is to be gentle. One of the most common occurrences of these gum problems is over-aggressive flossing. In other words, if you are too rough on your gums while flossing, either because you are out of practice or because you are in a hurry, soreness and hurting is to be expected. Instead, try taking your time and be gentle. Also, if you are just starting out, be patient and consistent, your gums will become more conditioned over time.

Use an Alternative Method

If being consistent and gentle does not work, there are other alternative methods of flossing that you can try. You can also try a water floss machine, or what is sometimes called a water pick. The device essentially shoots water into the crevasses between your teeth, and in other areas of your mouth, in order to dislodge food and plaque. These oral instruments also come with different attachments that allow you to reach many of the hard to see and reach areas of your mouth. And lastly, you can always buy floss that is not as abrasive to your gums. There is floss that comes with soft and gentle coatings that will do less harm to your gums while they are adjusting to the good oral hygiene habit you are creating.

Flossing is one of the easiest parts of oral hygiene to overlook. When you first start out, it is common that you may want to stop because of the pain it can initially cause. However, if you try one, or all, of the above mentioned methods, you will give yourself the best chance of being success with your flossing, and it won't hurt as much.

For more flossing tips, schedule an appointment at our Livingston office and askDr. Rothstein or a member of our team!

No, we don’t mean the latest foamy offering from your favorite microbrewery. When you’re thirsty, one of the best options available is literally at your fingertips—tap water, straight from your faucet. It might not be the most adventurous choice, but drinking a tall glass of fresh tap water is refreshing in so many healthy ways.

Physical Health

Water conveniently available at home is much more than a convenience. We need to keep hydrated, because our bodies are made to run on water. To name just a few of its benefits, water provides nutrients to organs and cells, eliminates waste, regulates our temperature, and protects our joints and delicate tissues. Dr. Rothstein and our Livingston team will tell you all about the importance of proper hydration when it comes to your mouth, gums, and teeth, but here are a few highlights:

• We need to be hydrated to produce enough saliva. Saliva, which is more than 90% water, helps prevent cavities and protect enamel by both washing away bacteria and balancing acids in the mouth which can cause decay.
• Tooth enamel is so strong because it’s made of calcium and phosphate. These minerals are leached from our enamel by both bacteria-produced acids and dietary acids. Saliva also contains calcium and phosphate, and, with fluoride, restores these minerals in our enamel, leaving teeth stronger and less likely to develop cavities.
• As a bonus, a quick rinse with water when you can’t brush after eating is a great way to remove food particles left behand—especially healthy when you’ve had sugary or acidic foods.

Ecological Health

If you want to reduce waste, one of the easiest ways to do so is to use tap water instead of bottled water.

• Bottled water has a carbon footprint. It takes energy (and additional water) to create plastic and glass bottles, to label them, and to transport them. Water piped into your home from local sources? No bottles, labels, or long road trips necessary.
• Water bottles should be recycled. Unfortunately, many cities don’t offer, or have stopped offering, recycling. Plastic and glass empties end up in landfills, littering our neighborhoods, or in our waters.

Budget Health

Getting your daily hydration from bottles can add up quickly.

• Bottled water can cost hundreds of times as much as tap water. While local water prices vary, the average gallon of tap water costs less than a penny. No matter what kind of sale your local store is offering, bottled water will never be the bargain tap water is.
• When you buy many small bottles instead of a few larger ones, or choose more expensive “designer” water, your costs can mount up even more.
• When you need to bring water with you for work, sports, or other activities, consider filling a reusable bottle with water from home.

Dental Health

Getting the recommended amount of fluoride in your diet is one of the single best things you can do for your dental health. Fortunately, many communities make this easy for us by providing fluoridated drinking water.

• Fluoride works with the calcium and phosphate in your saliva to create stronger enamel, so cavities can’t form as easily when your teeth are exposed to plaque and food particles.
• Fluoride helps strengthen your child’s permanent teeth as they develop, and helps prevent cavities in both baby teeth and permanent teeth as children grow.
• If your community doesn’t offer fluoridated water, ask Dr. Rothstein for the best way to get the fluoride you need to protect your teeth.

For the good of your body, your planet, your wallet, and last, but most certainly not least, the health of your teeth and gums, consider a glass of water. So many benefits—and you have them all on tap!

Toothpaste ads are usually all about the teeth. Cavity-fighting benefits. Whiter smiles. Reducing tooth sensitivity. But lately, we’re also hearing a lot about toothpastes which are formulated to clean, renew, and repair our gums. Maybe it’s time to consider whether a tube of gum-healthy toothpaste should be your new main squeeze.

Gum Health Affects Our Overall Health

According to the CDC, almost half of all adults over the age of 30 suffer from gum disease—and the percentages get even higher with age. And, just like tooth decay, gum disease is most commonly caused by bacterial plaque.

Plaque is a biofilm made up of saliva and food particles and millions of bacteria. Within hours after we’ve brushed and flossed, this sticky substance starts forming again on teeth and around the gum line.

Gingivitis, or early gum disease, occurs when plaque around the gum line irritates gum tissue, causing inflammation. You’ve probably noticed some symptoms of inflammation if you’ve ever neglected your brushing and flossing routine for even a day or two. Gums become red, or swollen, or tender, or bleed easily.

Careful attention to brushing and flossing is essential to prevent gingivitis and to reverse early symptoms. That’s because, left untreated, gingivitis can lead to periodontitis, a serious gum disease.

The bacteria in plaque produce toxins, which our immune systems react to with inflammation. Over time, this inflammation response causes the breakdown of the bone and ligament tissue which hold our teeth in place. Once-snug gum tissue starts to pull away from the teeth, creating pockets around the teeth where more bacteria collect. This leads to infection and further loss of bone and tissue.

Infection, loose teeth, and lost teeth cause chronic pain, difficulty eating and speaking, and alterations in facial appearance. And it’s not just our oral health which can be affected by gum disease. Studies have found connections between gum disease and other inflammatory diseases like rheumatoid arthritis and cardiovascular disease, and between gum disease and medical conditions such as xerostomia (dry mouth) and diabetes.

How Toothpastes Can Help Prevent Gum Disease

We already know that dentists recommend fluoride toothpaste because fluoride prevents cavities. Fluoride bonds with the calcium and phosphate ions in our tooth enamel, repairing weak spots. Even better, this new bond is stronger and more cavity-resistant than enamel alone.

When it comes to preventing gum disease as well as fighting cavities, though, not all fluoride formulas are the same. The common go-to ingredient in gum-healthy toothpastes is stannous fluoride. Like the more commonly used sodium fluoride, stannous fluoride reduces the risk of cavities and strengthens tooth enamel. And more! Studies have shown that stannous fluoride:

• Has anti-microbial agents which reduce the number of gingivitis-causing bacteria
• Disrupts plaque formation
• Continues working to reduce plaque levels even after brushing.

Because inflammation caused by bacterial plaque buildup is the most common cause of gingivitis, it makes sense that toothpastes which reduce bacteria and plaque can also reduce gum inflammation and gingival bleeding when used regularly.

But Toothpaste Can’t Do It All!

No matter which paste you use, you still need to be proactive with your dental health.

• Brush at least two minutes, at least twice each day, to stop plaque buildup. And use proper technique. Angle the brush toward the gums to gently clean around and below the gum line.
• Floss at least once a day. Flossing really does remove plaque between teeth and near the gum line which your toothbrush won’t.
• Use a soft-bristled brush. It protects both delicate gum tissue and strong enamel from abrasion.
• Keep up with your regular professional cleanings.
• For specialized periodontal treatment, make an appointment at our Livingston periodontal office.

If you have sensitive, inflamed, or bleeding gums, or if you have any worries about your gum health, don’t take advice from a toothpaste carton.

Talk to Dr. Rothstein about the best toothpaste for your specific dental needs. Whether it’s a recommendation for a specific kind of toothpaste or rinse, prescription medication, or more advanced periodontal treatment such as deep cleaning procedures or gum surgery, we have the treatment options to help you keep your gums their healthiest!

Act One: Those 20 adorable baby teeth which begin arriving when you’re about six months old and are probably gone by the time you’re twelve.

Act Two: The 32 (if you have all your wisdom teeth!) adult teeth which start showing up around the age of six, and need to last the rest of your lifetime. Unless there’s an . . .

Act Three: Where science has discovered a way to repair damaged teeth or create replacements for lost teeth that would look and function just like our original teeth.

Sounds like science fiction, doesn’t it?

In biological terms, of course, we’re not there yet. But teams of scientists around the world have been working toward just this goal—the ability to repair a tooth with its own biological material or even grow a new tooth when an adult tooth is seriously damaged or lost.

Because the pulp—the living tissue inside each tooth—contains dental stem cells, some researchers are studying whether these cells can be used to regenerate the living pulp inside a damaged tooth. Even more exciting, there’s research being done into the possibility of using these stem cells to rebuild an entire tooth—pulp, dentin, and hard enamel exterior. Because the supply of usable dental stem calls is quite small, and process of guiding these cells to create all the varied parts of the tooth is quite complex, this research is in its early stages.

In other studies, scientists have focused on tooth regeneration by studying the teeth of other species. Mice, for example, have front teeth with open roots. This allows these teeth to keep growing up as they wear down, because stem cells inside mouse gums are always working to create new tissue. Even though our teeth are not exactly comparable (no open roots in human teeth!), finding out just how this tissue regeneration works in mice and other animals might help find an answer for human tooth regeneration.

Right now, these scientific goals are just that—goals for a future day. But in the meantime, your quality of life doesn’t need to suffer when you lose an adult tooth. You can enjoy a third act right now with dental implants.

Cosmetic concerns aren’t the only reasons why you want your complete smile restored in the event of a lost tooth. A missing tooth can lead to many unpleasant consequences:

• Speaking and eating can become more difficult.
• Lack of stimulation from biting and chewing can cause the bone beneath the lost tooth to shrink.
• Other teeth can shift to fill the gap left behind, which can affect tooth, bite, and jaw alignment.
• Loss of teeth can lead to loss of confidence.

Unlike dentures or bridges, dental implants are designed to function just like your natural teeth.

The post, or base, of each implant fuses with the bone in your jaw, acting as a “root” for the implant. Once the post has fused with the bone around it, a crown designed to match your other teeth in shape and color is secured to the post. You can eat, speak, brush, floss, keep your bone healthy, and smile confidently just as you did before.

Will biological replacements be ready for your third act in the near future? Probably not. But that’s not to say this will never be possible! In the meantime, take care of your teeth with daily brushing and flossing, eat a dental-healthy diet, and visiting our Livingston office as recommended.

You do your best to keep your teeth intact and in place—but if you lose one through trauma or decay, talk to Dr. Rothstein about an implant. Because in any stage of life, the most important result is the happy ending a healthy and confident smile brings you!

If Dr. Rothstein and our team have tried several different treatments without success such as antimicrobial therapy, tooth scaling, or root planing, but have been unsuccessful in curing or even stabilizing your periodontal disease, then surgery is most likely the next step.

Dr. Rothstein will recommend surgery for the following three reasons:

• Stop the gum disease from progressing
• Repair the gums and periodontal tissue
• Prevent further destruction of your periodontal issue in the future

Types of Gum Surgery

There are many types of gum surgery available at our Livingston office, including:

• Gingivectomy – This is generally the first surgical intervention for periodontal disease. The procedure aims to extract diseased or infected gum tissue. It allows new tissue to grow and reattach itself to your teeth. Gingivectomy surgery can also be used to remove unnecessary gum tissue if you have a condition called gingival hyperplasia.
• Gingivoplasty - This surgical procedure that is implemented for aesthetic reasons after a gingivectomy. It gives your gum tissue a natural look around your teeth. The procedure reshapes the areas of your gums that can look deformed after a soft tissue graft or a gingival curettage procedure.
• Osseous (bone) Surgery – This type of surgery is often used in combination with a pocket depth decreasing procedure. This type of surgery is performed to correct malformations of the bones near your teeth. These pockets can provide an area for bacteria to hide and grow. The procedure evens out the shallow holes and asymmetrical surfaces of the damaged bone caused by bone loss because of the by periodontal disease.
• Gum Graft – This type of surgery is performed to replace or reinforce the gingival tissue if you have bad gum recession. Gum grafts are used as a covering for teeth with exposed roots. The grafts also lessen the roots sensitivity and stops root cavities and gum recession.
• Periodontal Flap Surgery & Pocket Depth Reduction – This surgery is considered the most significant gum surgery to cure your moderate to severe periodontal disease. Flap surgery reduces the depth of your periodontal pockets that can trap damaging dental plaque bacteria. By reducing the size of your periodontal pockets, less plaque bacteria and tartar can get in the pockets. This surgery also allows you to remove the plaque and tartar yourself using good oral hygiene.

If you’re scheduled for periodontal surgery at our Livingston office in the near future, you probably have a lot of very important questions:

• Will it help? Your periodontist has the skill and experience to diagnose and treat problems caused by periodontal disease, perform periodontal plastic surgery, and place dental implants. Periodontists are experts in these specialties, so you are in good hands!
• Will it hurt? Your periodontist will offer you options for anesthesia, so you can choose the sedation experience which will make you most comfortable.
• What should I do after surgery? Don’t worry! Dr. Rothstein will give you clear instructions on caring for the surgical site, selecting soothing diet options, cleaning your mouth, and all of the other practices that will enable a speedy and smooth recovery.
• What should I wear? Wait—fashion questions?

Yes! Part of being prepared for your surgery is being as comfortable as you can be during and after the procedure. Happily, there is no strict dress code for periodontal surgery. It’s more a basic list of recommendations for what not to wear.

• Don’t wear something you’re not comfortable in. Generally, loose fitting clothing is best.
• Don’t wear clothing that might be difficult to clean. While you and your clothing will be well protected, blood, irrigation, and other staining hazards are all occasionally part of the surgical process.
• Don’t wear something that will be difficult to remove after surgery. No one wants to struggle out of a tight turtleneck even at the best of times!
• Don’t wear jewelry. And, by the way, this includes tongue and facial piercings.
• Don’t be afraid to layer. While the office staff will try to make sure you are as warm or as cool as you would like to be, it’s a good idea to bring a jacket or sweater for extra warmth.
• Don’t wear tight sleeves. Short sleeves or sleeves that can be rolled up easily allow access to your arm if you are having IV sedation or blood pressure monitoring.
• Don’t wear contact lenses, especially if you are planning on IV sedation or a general anesthetic, because your eyes might be closed throughout the procedure.

If you have any questions in advance of your periodontal surgery, give our Livingston office a call. Planning ahead is always in fashion!

There are many ways in which your oral health has an impact on your overall general health. There are naturally occurring bacteria in the mouth. Some of those bacteria, including strep and staph, are harmful, while other bacteria are essential for the balance of intestinal flora. The healthier your mouth is, the less likely it is the harmful bacteria will travel to other parts of your body to infect it and make you sick. There is much more to good dental hygiene than brushing and flossing.

Historical Methods of Maintaining Oral Health

Ancient civilizations relied on natural remedies for maintaining oral health. Around 250 AD, the Kemetic Egyptians used myrrh and other herbs as antiseptics for treating infected gums. Two centuries later, the Nubians, who lived in the Nile River valley, drank beer to ease the pain of infected teeth. That probably sounds crazy, but their beer was effective because they used grains that were contaminated with the same bacteria that produce the antibiotic tetracycline.

Today's Biggest Dental Hygiene Challenge

In the past, tooth decay was more of an issue because there was no routine dental care, and problems that are routinely treated today went untreated. Thanks to fluoridated water, and toothpastes containing fluoride, tooth decay is far less problematic than it was a century or more ago. Gum disease has replaced tooth decay as the most serious dental problem facing people today. According to the American Dental Association, a staggering 80 percent of Americans over age 65 suffer from some form of periodontal disease.

Ironically, if that infection attacked any other part of your body, especially in a place where it was clearly visible, you would head to your doctor for treatment immediately. People tend to ignore gum tenderness and bleeding. When the tenderness and bleeding aren't treated, the inflammation can turn into periodontitis. The longer you allow the inflammation to go untreated, the greater the likelihood that it will affect other body parts. Make sure to visit Dr. Rothstein at A R Periodontics regularly to be proactive about dental health!

Researchers are now discovering that untreated inflammation in the mouth acts as a driving force for multiple chronic illnesses, including clogged arteries, heart attacks, arthritis, and even cancer. That inflammation is one of many hypotheses that may explain how chronic infections can trigger systemic diseases, and even intensify existing ones. Bacterial overgrowth in the inflamed gum tissue can enter the bloodstream through the food you eat, and from daily brushing.

Caring for your mouth at home is just as important as visiting our office for exams!

If you are expecting, it is critical to maintain a healthy lifestyle to ensure both your health and the health of your little one. This includes maintaining your regimen of brushing twice per day and flossing. It also includes regular visits to our Livingston office, as recommended by the American Academy of Periodontology (AAP), who suggest that women who are pregnant or considering pregnancy undergo a periodontal evaluation.

Women who are pregnant are particularly susceptible to gingivitis, a mild form of periodontal disease that is characterized by reddening, swelling, and bleeding of the gums. It is a condition that is not to be overlooked and can be treated and reversed by Dr. Rothstein.

Research at the University of North Carolina has indicated a connection between periodontal disease and an increased risk of low birth weight, a serious issue that affects roughly one in ten babies born in the United States. Low birth-weight babies may be at risk to have respiratory, intestinal, and heart issues. They also face long-term health problems such as vision and hearing loss, delayed motor skills, and potential learning disabilities, according to the Center for Disease Control and Prevention.

Besides the possibility of leading to low birth weight of your baby, gingivitis, if left undetected and untreated, can also lead to periodontitis, a much more serious gum disease that attacks the gum tissue and the bone supporting the teeth. Periodontal diseases can lead to tooth loss and are associated with other serious conditions such as diabetes and cardiovascular disease.

Maintaining periodontal health is an important part of a healthy pregnancy. Seeking timely treatment for gum disease is important not just for your personal health, but also for the health of your baby. Early diagnosis of periodontal disease can give you peace of mind that both you and your baby will be healthy. To learn more about preventing gum disease, or to schedule your periodontal evaluation or cleaning at A R Periodontics, please give us a call today!

Nobody likes bad breath, and although it can sometimes be difficult to tell if you have it, it is always better to practice good oral health than risk having a smelly mouth. There are many ways to reduce or eliminate bad breath, some are definitely more effective and longer lasting than others. Check out ways to do so below.

Floss Regularly

As difficult as it can be to remember to floss regularly, when it comes to bad breath, flossing is one of the easiest and most cost effective ways to freshen your mouth. See, flossing reduces the plaque and bacteria found in areas of your mouth that a toothbrush simply can't reach, and in turn, it rids your mouth of the smell associated with that bacteria. While flossing may not eliminate bad breath on its own, if you do it along with other health oral hygiene habits like brushing, then you may just develop a fresher smelling mouth.

Use Mouthwash

Using some sort of mouthwash can really freshen up your breath, especially if you find it still smells after brushing and flossing. There is a wide variety of mouthwash products on the market, however, you can also create your own by simply using baking soda mixed with water.

Always Brush after You Sleep

Whether after taking a nap, or having a full night of sleep, you will want to brush your teeth in order to reduce bad breath. The truth is, bacteria accumulates in your mouth while you are sleeping (even during a short nap) and that is ultimately the source of bad breath. So next time you wake from a good slumber, give your mouth some brushing and you will find it makes a big difference in the freshness of your breath.

There are many ways to freshen your breath beyond just using gum or mints, the above mentioned are just a few for you to try. Test them out and you will likely find your bad breath problem is solved, or at least considerably reduced. Of course, you can always ask Dr. Rothstein at your next visit to our Livingston office.

The American Dental Association and dentists everywhere, including our own Dr. Rothstein recommend that you schedule an appointment every six months for a cleaning and checkup. Despite this universal recommendation from the experts, some people believe regular cleanings and checkups are unnecessary unless there is something wrong with your teeth—for example, a cavity or a toothache. In fact, coming in for a six-month checkup and cleaning is one of the most important things you can do for your oral health, as well as your overall health.

Why It’s Important to Visit Regularly

Numerous studies have shown that oral health is closely tied to the overall health of your whole body. In fact, having a healthy mouth can help the rest of your body stay in balance. On the other hand, an unhealthy mouth can cause all kinds of problems for you down the road.

One of the most important things we do at A R Periodontics when you come in for cleanings is remove plaque that has collected on your teeth and around your gums. If left untreated, plaque build-up can cause inflammation and irritation around your gums, and lead to gum diseases like gingivitis and periodontal disease.

According to the American Academy of Periodontology, periodontal disease has been linked to increased risk for serious health conditions such as heart disease, stroke, diabetes, inflammation, osteoporosis, and pregnancy complications.

Most oral health issues will begin with subtle changes before progressing into more serious conditions. If you visit us for regular checkups, we may be able to identify common indicators that could lead to larger issues down the road. If we only see you at our office every few years, it becomes more difficult to catch these conditions before they grow into bigger and more painful problems.

What happens at a dental checkup?

When you come in for your regular checkup, there are several things our dentists and hygienists may do, including:

• Take X-rays to determine the overall health of your teeth, jaw, bones, and the tissue surrounding your teeth, including a check for early signs of tooth decay, abnormal growths, cavities, and other damage that is not immediately visible
• Perform a thorough cleaning of your mouth and teeth to remove any excess plaque and tartar, then polish and floss your teeth
• Check for signs of gum disease or evidence of tooth decay
• Examine your bite, and look for broken or damaged teeth
• Identify any changes to your gums or teeth since your last visit
• Examine your head and neck for signs of oral health problems

Waiting to visit Dr. Rothstein until you already have a problem, like a cavity, is like waiting to put gasoline in your car until after you run out and your vehicle is stalled on the side of the road. Once you have a problem, the ripple effect can cause you a lot of pain, take considerably more time, and cost a lot more money to fix than if you had come in for preventive care and cleanings every six months.

References: American Academy of Periodontology (2012). Gum Disease Links to Heart Disease and Stroke. Retrieved from http://www.perio.org/consumer/mbc.heart.htm

Diabetes is a disease that affects the health of the entire body, including, of course, your mouth, gums, and teeth. We are trained to look for issues that might arise in our patients with diabetes, and are eager to help you maintain your dental health. What do we consider in order to give you the best treatment?

Your Teeth

Dry mouth can be a problem for diabetic patients, whether caused by blood sugar levels or medication, and this condition can lead to tooth decay. When we produce saliva, it not only helps wash away sugar in our mouths, it also helps remove the acids sugars produce which attack our enamel and lead to cavities.

Your Gums

People with diabetes are at higher risk for gum disease. With diabetes, the body is more susceptible to infection and finds it harder to fight bacteria. Early gum disease, called gingivitis, is inflammation caused by the body’s reaction to bacteria. Periodontitis, serious gum disease, leads to infections that can cause bone and tooth loss.

Other Oral Concerns

Dry mouth can lead to mouth ulcers, oral thrush, sores, and infections. And oral infections of any kind can be slower to heal when you have diabetes. We will give careful attention to any concerns you might have for your oral health, and will work with you to prevent any future problems.

Preventive dental care is important for all our patients, and we have special suggestions for you to help maintain your dental health and reduce the possibility of dental complications. Diabetes can lead to oral problems, and oral infections can in turn cause problems with controlling blood sugar, so a healthy mouth can lead to better health in general.

• Home Care

If dry mouth is a problem, talk to us about possible causes and treatments. Hydrate throughout the day, and avoid foods or beverages that lead to dehydration. Talk to us about the best products for use at home to prevent dry mouth.

Brush and floss after meals to reduce the presence of harmful bacteria and prevent the plaque buildup that leads to gum disease.

Above all, monitor your blood sugar carefully to ensure your body is at its best when combatting infection or when healing.

• Professional Dental Care

Be sure to visit our Livingston office at least twice a year for a full examination and a professional cleaning. We can reduce the plaque that leads to gingivitis and more serious periodontal infection. We can monitor your oral health and recommend solutions for problems such as dry mouth. We will make your appointments based on what is best for your schedule. If any type of oral surgery is needed, we will schedule it with an understanding of the importance of healthy blood sugar levels for healing and recovery.

It’s important to make Dr. Rothstein part of your health support system. If you have diabetes, let us know. We will work with you to monitor the well-being of your teeth and gums and to suggest ways to promote your overall oral health. Let’s work together for healthy, happy smiles!

Your trusty manual toothbrush has been with you from pre-school through high school—well, obviously not the same manual toothbrush, because that would be seriously unhygienic—but it’s the kind of toothbrush you’re used to and comfortable with.

Now, though, you’re off to college, and your lifestyle will be changing. Late night study sessions complete with study session snacks. Getting caught up in a project and making dinner from dorm vending machines. Grabbing fast food on the way to the practice field, or work-study job, or evening class. You get the point—meals can be hectic, unscheduled, and less than tooth friendly.

Maybe it’s time to consider an electric toothbrush. After all, anything that can make your life easier and more efficient during busy college days deserves a spot in your dorm room.

• Electric Brushes Are Effective

The most important reason to switch to an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Electric toothbrushes offer several design options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What these technologies all have in common is the ability to remove plaque far more efficiently than we can on our own, because electric brushes provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, compared to the hundreds we can achieve by hand.

You know by now what your brushing habits are like. If you tend to be a bit cavalier with your brushing and flossing, make sure you set yourself up for success. Because you have better things to do during semester breaks and summer vacations than visiting Dr. Rothstein!

• Electric Brushes Can Make Life Easier

Several of today’s electric brushes come with options designed to do more than simply remove plaque. They can let you know if you’ve brushed for the recommended two minutes, alert you if you’re brushing too hard, and even remind you when it’s time to replace the brush head.

Want more from your electric brush? Some models offer apps that can map out just where you’ve brushed, in case there are a few spots that often get overlooked. Or provide different brushing modes for daily cleaning, deep cleaning, whitening, and more. Or come with a travel case that can recharge while you’re busy exploring the world—or going home for a visit.

In the end, it’s up to you. Do some independent study and research the toothbrushes that will give you the best results for your individual brushing habits. You might not need or want a brush with all the technological bells and whistles.

If you’re comfortable with your manual brush and you get good grades when you visit our Livingston office, stick with it. But if you think you might benefit from the ease and efficiency of an electric toothbrush, if an electric toothbrush makes your teeth and gums healthier and your smile brighter, that’s an extra credit project worth pursuing.

Whew! It’s a hot one! And whenever the temperature soars, you need to stay hydrated, especially when you’re outside or exercising. But all cold drinks aren’t equal when it comes to healthy hydration. Which beverages shouldn’t have a prime spot in your cooler when you’re wearing braces or aligners?

• Soft Drinks

You’re probably not surprised to find soft drinks at the top of the list. After all, sugar is a) a big part of what makes soda so popular, and b) not a healthy choice for your teeth.

Sugar is a favorite food source for the oral bacteria that make up plaque. These bacteria convert sugar into acids, and these acids attack the surface of your tooth enamel. Over time, the minerals which keep enamel strong begin to erode, and weakened, eroded enamel is a lot more susceptible to cavities.

So, what about sugar-free drinks? Does this make soft drinks a better choice? Unfortunately, you can take the sugar out of many sodas, but you can’t take the acids out. Most soft drinks are very acidic, even without sugar, and will cause enamel erosion just like the acids created by bacteria will.

• Fruit Drinks

Fruit juice provides us with vitamins, which is great, but it’s also full of natural sugars and acids. And blended fruit drinks and fruit punches often contain added sugars and added citric acids. Best to choose 100% fruit content and check the labels before you buy. (And you can always get refreshing fruit flavor by adding a slice of fruit to a glass of water.)

• Sports Drinks

You might be surprised to see these on the list—after all, they promise healthy hydration while you’re working out. And hydration is healthy—but sugars and acids aren’t. Even when the label tells you there’s no added sugar, that same label will often reveal high amounts of citric acid. In fact, some sports drinks are more acidic than sodas.

We’ll make an exception, though, for thirsty people who participate in sports or activities that require a lot of physical exercise and produce a lot of sweat. When we sweat, we lose electrolytes, those ionized minerals which help regulate many vital bodily functions. Talk to Dr. Rothstein about which sports drinks are best for you if you need to replenish your electrolytes when working out.

So, what’s your best hydration choice on a hot day? Water! It not only hydrates you, it cleans your teeth, it helps you produce saliva, and it often contains tooth-strengthening fluoride. But if you only have sports drinks in the cooler, or if you just want to enjoy a soft drink or a bottle of juice from time to time, no need to go thirsty. We have some ways to make sure your teeth are safer, even with this tricky trio:

• Rinse with water after you drink a sugary or acidic drink. And remember to brush when you get home.
• Be choosy. Check labels for added sugars and acids.
• Don’t sip your drinks all day long. Saliva actually helps neutralize acids in the mouth, but sipping acidic beverages throughout the day doesn’t give saliva a chance to work.
• Use a straw to avoid washing your enamel in sugars and acids.

You need to keep hydrated when it’s hot. When you’re packing your cooler, choose drinks that are healthy for your entire body, including your teeth and gums. Ask our Livingston team for the best choices in cold drinks to make sure you’re getting the hydration you need—without the sugar and acids you don’t!

There are many reasons to choose sedation dentistry. Perhaps anxiety is an issue, or your teeth are extremely sensitive. You may have a low pain threshold, an easily triggered gag reflex, or need a lot of work done in one visit. If you think sedation dentistry might be right for you, this procedure is something we are happy to discuss before your appointment at our Livingston office.

Because your concerns and condition are unique, we will tailor your sedation to fit your specific needs. We will take a careful health history to make sure whatever medication is used is safe for you, and will not interact with your other medications or affect any medical conditions. The three most common methods of sedation include:

Our experience and training allow us to recommend a method that is specifically designed for your needs. If you would like to remain completely aware, but feel less anxious, if you would like deep sedation through the entire procedure, or if you want something in between, talk to us about your options. Whatever the reason you choose sedation dentistry, Dr. Rothstein and our team are here to provide you with a skilled and safe sedation experience.

So you might be wondering, just what are cavities? How do we get them? What do they do to our teeth? How can we prevent them? Let’s talk!

Our teeth need to be strong to bite and chew. That’s why they are protected by a coating called enamel, which is made up of very hard minerals. Enamel is the strongest part of our bodies—stronger even than our bones. But this doesn’t mean nothing can hurt it! And cavities, also called tooth decay, are one of the most common dangers facing our enamel.

So, what are cavities?

A cavity is a hole in your tooth enamel. If your tooth is not cleaned and repaired when a cavity is small, this hole can grow bigger until tooth decay reaches the inside of your tooth. Enamel doesn’t heal when it’s damaged, so you need to see a dentist to make your tooth healthy again.

How do we get cavities?

Bacteria are tiny little germs. Many kinds of bacteria live in our bodies, and some of them are quite helpful. The bacteria which cause cavities are not. These unhelpful bacteria join with our saliva and very small pieces of the food we’ve chewed to make a sticky film called plaque.

Like other living things, the bacteria in plaque need food. They get that food from the foods we eat, especially sugars and starches. As they eat, they change these sugars and starches into acids, and these acids attack the minerals which keep enamel hard and strong.

Because plaque sticks to our teeth, bacterial acids are able to make weak spots in enamel if the plaque isn’t brushed away. If you see a white spot on your tooth, that could mean that your enamel is losing minerals, and getting weaker.

What do cavities do to our teeth?

Over time, weak spots can grow bigger until there’s a hole in the enamel surface. If the cavity in your enamel is small, you might not notice it at first. But cavities can become wider and deeper, and even break through enamel to reach the inside of your tooth.

The inside of each tooth holds pulp, the part of your tooth which keeps it healthy. If tooth decay spreads to the pulp, it can cause more damage and infection, so it’s important to treat a cavity right away.

Dark spots on your enamel, a toothache, pain when you drink something hot or cold or when you bite down—these can be clues that you have a cavity, and you should visit us for an exam.

How can you prevent cavities?

Even better than treating a cavity is preventing one. Let’s make a list of some helpful do’s and don’ts for cavity prevention:

• Do: Feed yourself foods which are good for you.

Foods like milk and cheese and many dark green vegetables have lots of calcium and vitamin D to help keep your enamel strong.

• Don’t: Feed bacteria foods which are good for them.

Sugar and simple starches like potato chips are the kinds of foods bacteria like best, because they are easy to break down. This means more acids to attack your enamel.

This doesn’t mean you should never enjoy a treat! But eating lots of starchy snacks and drinking sugary sodas means more plaque, and more plaque can mean more cavities. If you’re eating something starchy or sweet, it’s a good idea to brush or rinse afterward.

• Do: Brush at least twice a day, for at least two minutes, with fluoride toothpaste.

This is the best way to get rid of plaque, which builds up every day. And fluoride toothpaste even helps make your enamel stronger.

• Don’t: Forget to floss.

Flossing takes a while to learn to do well, but it’s very important. Flossing helps prevent cavities between the teeth and near the gums.

• Do: Visit our Livingston dental office for exams and cleanings.

Not only will we look for cavities, we’ll let you know the best way to brush and floss so you can get your teeth their cleanest.

• Don’t: Feel bad if you get a cavity!

Some people are more likely to get cavities than others, even when they brush just right and eat healthy foods. If you have a cavity, we can remove decay and repair your tooth with a filling.

And one last thing to do: talk to Dr. Rothstein if you have any questions about the best ways to protect your teeth from cavities. We have lots of suggestions to help you take care of your healthy, beautiful smile!

You’ve heard people tell you to say “cheese” when you’re having your picture taken, probably more times than you can count. There is another reason you should be saying “cheese” … or “YES” to eating cheese.

Although Dr. Rothstein and our staff routinely encourage our patients to brush their teeth after eating, the one time you don’t want to do that, at least not immediately, is after eating cheese.

Study Finds Important Benefit From Eating Cheese

CBS News reported on the results of a study that was published in the May/June 2013 issue of General Dentistry, a publication of the Academy of General Dentistry. The study showed that cheese increases dental plaque pH, but in this case, the plaque increase isn’t a bad thing. When you eat cheese, you increase the pH of the plaque on your teeth, and create a protective coating that may lower your risk of getting dental caries -- more commonly known as cavities.

An analysis of the story from the General Dentistry journal, including the details of the study and its participants, was published in Science Daily. The study looked at 68 children between the ages of 12 and 15. A similar study was conducted by British researchers who reported their findings in the British Dental Journal in 1999.

How the Study Worked

For the 2013 study, researchers divided kids into three groups. Participants in group one ate cheddar cheese. Participants in group two drank milk, while participants in group three ate sugar-free yogurt. All participants were told to eat or drink their assigned foods for three minutes, after which they swished water in their mouths.

Researchers tested every participant’s mouth at ten, 20, and 30-minute intervals. They found no changes in the mouths of participants in the milk drinking and sugar-free yogurt eating groups, but every time they tested the pH levels in the mouths of the ones who had eaten cheese, researchers saw the levels quickly increased.

They concluded that cheese has anti-cavity properties. That isn’t the only benefit, however. Another study, in which related findings were reported, appeared in the Journal of Contemporary Dental Practice in the summer of 2000. In that study, researchers found that cheese may give teeth a protective coating that helps lessen enamel erosion caused by acidic foods, particularly from sugar-sweetened soft drinks.

So don’t just say cheese for pictures. If you want to have a happy, healthy and long-lasting smile, go for cheese. It’s good for your bones, too!

On a sizzling hot day, there’s not much that makes us happier than heading to the water for a quick swim, some gentle laps, or even a rousing game of water polo. And this being a sizzling hot dental blog, we are happy to offer some tips on how to make your summer swim good for your dental health as well as your mental health!

• Mouthguards

You might use your mouthguard all the time—for biking, or basketball, or skiing. But in the pool? Absolutely! Anyone who has played water polo knows what a physical workout it is. Elbows! Hard tosses! Collisions! And it’s not just pool sports. Water-skiing on the lake, surfing in the ocean—anywhere humans and solid objects are involved, tooth and jaw injuries are possible. Don’t spend valuable summer hours tending to a cracked or broken tooth as a result of sports accidents.

And, unlikely though it seems, even hanging by the pool can be hazardous to your smile. Hard concrete edges wait to greet surfacing divers. Slippery cement and tiles surrounding the pool are the downfall of many a swimmer running to jump back into the water. Be aware of possible dental dangers, and use a mouthguard as a great proactive way to avoid them.

• Swimming Pools & Chlorine

Ah, the smell of chlorine! We all want to know that swimming pools are as clean as they can be, and one method of keeping them that way is with the addition of antimicrobials to the water. But too much exposure to chemicals can cause enamel erosion, or even a condition called “swimmer’s calculus.” Swimmer’s calculus is recognized by a hard, brownish, tartar deposit that appears on the front teeth of swimmers who spent a lot of hours in the pool. It’s a cosmetic problem, but one that’s difficult to get rid of without a professional cleaning. If you’re a competitive swimmer, or simply someone who spends many hours a week in treated water, give us a call if you notice hard-to-remove discoloration or tooth sensitivity.

• Retainers

Different people have different opinions on whether or not your retainer should be exposed to the chlorine in pool water. (Or the salt in saltwater or the bacteria in lake water.) Ask us for ours! But you’re best off leaving it in your bag or locker, anyway, because retainers can be easily lost in the water. They might be able to survive a swimming pool, but a lake or ocean rescue is very unlikely. Just remember to put your retainer in a case, in a safe spot, and replace it when you’re out of the water for the day.

Enjoy your time on the water, and don’t forget to schedule an exam with Dr. Rothstein and a professional cleaning if you haven’t been in the office for a while. If you do have a dental problem or an accident, give our Livingston office a call immediately. We want to make sure you dive in to summer fun with a healthy, beautiful smile!

Happy Independence Day from Dr. Rothstein and team! The Fourth of July celebrations in America may have changed a lot over the years, but there is no doubt that we Americans love to celebrate the anniversary of our country's independence! Today we're devoting the A R Periodontics blog to some fun facts about the Fourth!

• My, how we have grown! This year the United States Census Bureau estimates that our country has 313.9 million residents celebrating the Fourth of July this year, but back in 1776 there were just 2.5 million members of the country.
• Our country loves to show how proud that we are of our independence. Did you know that there are 31 United States places with the word “Liberty” in their names? The state of Iowa actually has four towns with the word Liberty in the name: Libertyville, New Liberty, North Liberty, and West Liberty.
• The United States loves Fourth of July food! It is expected that around 150 million hot dogs are eaten on the Fourth each year. One of the Fourth's most popular sides, potato salad, goes just perfectly with the hotdogs and hamburgers that are standard Fourth of July fare. Some people choose potato chips instead, but we wouldn't have such a plethora of potatoes if not for the prodigious production of the states of Idaho and Washington -- they provide about half of all the potatoes in the United States today!
• Americans love celebrating the Fourth outdoors: About 74 million Americans fire up their BBQ grill every Fourth of July.
• The Chinese contribution: Did you know that Americans have spent more than $211 million on fireworks that were imported from China?

No matter how your family chooses to celebrate the Fourth, stay safe, take precautions, and don't forget to brush after your fabulous Fourth feast!

Dr. Rothstein and our team at A R Periodontics hear this question all the time. Millions of people have dental crowns that artificially restore the chewing surface of a tooth. Also known as caps, these restorations surround the entire portion of the tooth that is above the gum line. Crowns are custom fabricated to match the color, shape, and size of other teeth and are visually undetectable to others. Several types of materials can be used to create crowns, including stainless steel, resin, metal alloys, porcelain fused to metal, or ceramic. When properly cared for and accurately fit, crowns can stay in place for a decade or more.

There are many reasons to get a dental crown, including:

• To restore a broken or cracked tooth
• To protect a tooth after a root canal
• To restore a severely decayed tooth
• To help anchor a dental bridge
• To complete a dental implant
• To protect a tooth that is at high risk for developing decay
• For cosmetic purposes

Getting a dental crown

The process of getting a dental crown begins at our Livingston office. X-rays are used to ensure the teeth are healthy enough to receive a crown. If the roots and surrounding bone are in satisfactory condition, the tooth will be numbed, filed, and reshaped in preparation for the crown. If the tooth root is not healthy, a root canal may be necessary first.

After the tooth is prepared, a special paste is placed over the upper and lower teeth to make impressions. These impressions serve as blueprints for the dental laboratory responsible for making the crown. They also help ensure the position of the new crown will not negatively affect a patient’s bite. The prepared tooth is protected by a temporary crown while the permanent one is made. When ready, the permanent crown replaces the temporary crown and is cemented in place.

To learn more about crowns, or to schedule an appointment with Dr. Rothstein, please give us a call at our convenient Livingston office!

Father’s Day is coming up, and, just in case your dad has enough ties, we have some gifting suggestions for you. Here’s a selection of gifts large and small tailored to your dad’s interests and his dental health.

• The Outdoor Dad

If your dad is happiest out camping, or his most relaxed at the lake fishing, or gets rid of stress with a 20-mile hike, help your dad stay happy, relaxed, and stress-free with an emergency dental kit for any unexpected problems which might crop up during his adventures.

You can find these lightweight kits in sporting stores and online. Supplies like cotton rolls, dental floss, oral pain relievers, a dental mirror, and even temporary fillings are included, because, as your dad no doubt told you, it’s always best to be prepared!

• The High-Tech Dad

For the dad who’s first with the latest in smart phones and tablets, a new smart toothbrush might tick all the boxes.

Modern electric toothbrushes have plenty of options for the tech-savvy. They come with different settings for brushing and massaging. They can let your dad know if he’s brushed long enough (two minutes, please!), if he’s brushing too hard, or when the brush head needs to be retired. Smart models even link to apps, which can, among other things, map out any missed spots in his brushing coverage or suggest more effective brushing angles.

• The Dad on the Go

With his active life, any gift which makes your dad’s busy schedule run more smoothly is a good thing—such as a portable kit filled with dental necessities.

A travel toothbrush, a small tube of his favorite toothpaste, a compact mirror, dental picks, dental floss, and a mini-bottle of mouthwash are great basics for a confident smile any time of day. Put everything in a sturdy lightweight travel bag. And don’t forget to include a pack of sugarless gum! Sugarless gum helps increase saliva flow (for better hydration) and decrease oral acidity (to help prevent enamel erosion).

• The Dad with Gourmet Taste

If your dad has foodie tastes, a thoughtfully curated gift basket is a great idea for pleasing his palate and supporting his dental health.

Include items like cheeses, which are full of calcium and phosphorus for strong teeth. Fresh fruits provide vitamins for healthy teeth and gums. Nuts offer plenty of tooth-healthy minerals and vitamins, as well as packing a protein punch. For your dad’s sweet tooth, dark chocolate (at least 70% cacao) is a great source of antioxidants, iron, zinc, magnesium and other valuable minerals. It’s lower in sugar content, and some studies suggest that dark chocolate has cavity-fighting properties and supports gum health.

• The Athletic Dad

He can deke the goalie, throw a perfect spiral, and hit those threes from downtown. Or, at the very least, he gives his favorite sport his best shot! If your dad has some of his happiest moments, win or lose, on the ice, the gridiron, the court, or any other sporty venue, consider a custom mouth guard to protect his winning smile.

Custom guards are more comfortable than store-bought options because they are molded to fit the user’s teeth and mouth precisely. This is especially helpful for those with dental work like braces or bridges. And, because the fit is custom, breathing and talking are easier.

• The Picture-Perfect Dad

Your dad’s smiles light up family photos! And if he’s ever expressed an interest in lightening and brightening that beautiful smile, a professional whitening treatment might be a perfect gift.

Professional whitening at our Livingston office is the most effective way to brighten teeth, with results which are generally faster and more long lasting than over-the-counter treatments. And it’s done with your dad’s dental health in mind, with a checkup to make sure his teeth are in perfect shape before whitening, and with protective measures in place for sensitive mouth and gum tissue.

Of course your dad will appreciate another tie, or any other traditional gift, because you give it to him. But just in case you’re looking for something a little different to celebrate Father’s Day, choose a dental-healthy gift designed with your dad in mind—so you can celebrate his smile for years to come!

After your son or daughter departs for college, the last thing you want to get is a call or text to learn he or she is in pain. Dr. Rothstein and our team at A R Periodontics will tell you there aren’t many emergency situations that can be avoided when it comes to dental health, but one crisis that can easily be prevented before your teen heads hundreds of miles away for college is wisdom tooth extraction.

What are wisdom teeth?

Wisdom teeth are the third set of molars that erupt in the late teen years to early 20s. Spacing and crowding problems often cause impaction and infections, which is why many people elect to have their wisdom teeth removed. Wisdom teeth can go from barely noticeable to extremely painful in a very short period of time.

When your teen’s wisdom teeth erupt, they may cause overcrowding of his or her teeth, which can have a negative effect on their alignment. Most people’s mouths do not have enough room for wisdom teeth to erupt fully and remain perfectly aligned. Thus, pain, swelling, infection, damage to adjacent teeth, and decay are often the most common problems associated with wisdom teeth. These problems can brew beneath the surface for weeks or months, offering no warning before painful symptoms hit.

If your child does elect to go through wisdom tooth extraction, we want to inform you that the first few days of recovery consist of careful measures to control bleeding and swelling, an adherence to a special soft diet, as well as a medication routine that must be followed as recommended by Dr. Rothstein after surgery.

Dr. Rothstein and our team are dedicated to providing exceptional service before, during, and after your wisdom tooth procedure, so you can have peace of mind knowing that your child’s oral health is in good hands. We will do everything we can to minimize discomfort and help your child heal safely and quickly.

Summer break is the perfect time to remove wisdom teeth so that your child can avoid the stressful scenario of experiencing this medical emergency far away from home. If you have any questions on wisdom teeth removal or to schedule an initial consultation with Dr. Rothstein, give us a call today!

The grown-ups in your life want you to have a healthy, happy smile. That’s why they help you brush and floss, and make sure you come see Dr. Rothstein for checkups and cleanings. Did you ever wonder if there are other ways you can help build a beautiful smile? There are! And one of them is eating food that makes our teeth and gums strong and healthy.

Friendly Foods

• Enamel and Bone Builders

Calcium is a very important element that helps us grow strong bones and enamel, the hard covering on the outside of our teeth. Bacteria in our mouths can create acids that weaken enamel and lead to cavities, so we want to keep our enamel as strong as possible. Dairy products like milk, cheese, and yogurt are great sources of calcium, but you might be surprised to know dark green vegetables like kale, spinach and broccoli help build strong teeth as well, and strong teeth are less likely to get cavities!

• Good for Our Gums

Many foods have important vitamins that help keep our gums and mouths healthy. Vitamin C helps protect our gums and make them stronger. When we think of Vitamin C, we usually think of citrus fruits like oranges and lemons, but there are many other fruits and vegetables that give us this important vitamin, including mangos, potatoes, and strawberries. Vitamin A also helps keep our gums healthy. We can increase our Vitamin A by adding fish, leafy green vegetables, or orange colored foods to our diet.

• Natural Toothbrushes

Crunchy foods like apples, carrots, and celery can help keep our teeth clean. They act like gentle brushes to remove food and bacteria left on our teeth after eating. Chewing also increases saliva, which helps wash away food particles and bacteria. And, of course, drinking or rinsing with water after a snack helps clean our teeth when we can’t brush.

What Foods Aren’t Good for Our Teeth?

• Bacteria Builders

Plaque is a film of bacteria that sticks to our teeth. These bacteria make acids that soften our enamel and cause cavities. And what do these bacteria use for food? Sugar is one of their favorites! We can’t stop eating everything with sugar, of course, and we all deserve a treat every now and then. But to keep our teeth their healthiest, it really helps to cut down on sugary foods and drinks, and to brush or rinse with water when we do enjoy dessert.

• Acid Attacks

Bacteria can make acids that weaken our enamel, but we can also eat foods that damage our enamel and might lead to cavities. Drinks like sodas, citrus juices and even some sports drinks are acidic enough to make our enamel softer. Drinking with a straw or rinsing your mouth with water helps, but it’s a good idea to limit foods and drinks that make our enamel weaker over time.

• Sticky Stuff

Any food that stays on or between your teeth gives bacteria more time to grow and produce the acids that cause cavities. We can guess that hard candy and caramel would be a bad idea, but even healthy foods such as dried fruit and trail mix can be a problem when they stick to your teeth. If you eat something sticky, be sure to rinse with water or brush and floss as soon as you can.

You already know that brushing and flossing are the best way to keep your teeth clean, and that visiting us for checkups and office cleanings helps your teeth and gums stay strong and healthy. Eating well is just one more thing you can do to help. The next time you visit our Livingston office, talk to us about what you and your family can add to the menu for a lifetime of beautiful smiles!

Memorial Day didn't become an official holiday until 1971, but Americans started gathering annually in the spring to remember those who lost their lives in war during the 1860s, right after the Civil War. Celebrated on the last Monday in May, people still decorate the grave sites of war veterans and hold memorial services, but Memorial Day has also evolved into a day that signifies the beginning of summer.

During the summer months, many people take road trips to visit family members. Some head off to the airport to enjoy a long-awaited vacation far away, while others look forward to spending time with friends and family at home. However you spend Memorial Day and the subsequent summer months, there are a few things you can take care of to ensure your summertime is enjoyable.

 Checklist for an Enjoyable Summer

• Have the AC Checked. During the hottest days of summer, many families find themselves sweating it out due to a broken air conditioning system. Be proactive so you can avoid waiting for hours or days because the HVAC repair person is booked solid. Have your air conditioning system checked before or around Memorial Day each year.
• Ensure Security While You're Away. When you leave for vacation, the last thing you should have to worry about is the security of your home. Install a home security system, if possible, and put a timer on your lights so they go on and off at normal hours. You can also alert your local police department that you'll be gone, and ask them to drive by your house once in a while to make sure everything is okay.
• Visit Dr. Rothstein Before Vacation. Many people put off exams until after summer vacation. Avoid the crowds and make sure your physical and oral health are in top shape prior to vacation time so there are no unpleasant surprises.

Our team at A R Periodontics wants you to look forward to Memorial Day and the days of summer by preparing to spend the time safely and comfortably. As you plan ahead, take care of your health and secure your home, you can place your focus on creating memories with family members and friends while enjoying your favorite Memorial Day traditions.

In our continuing efforts to provide the most advanced technology and highest quality care available to our patients at A R Periodontics, we proudly screen our patients for oral cancer. The fact is, every hour of every day in North America, someone dies of oral cancer, which is the sixth most common diagnosed form of the disease. The five-year survival rate is only 50 percent, and oral cancer is one of the few cancers whose survival rate has not improved.

Oral cancer can occur on the lips, gums, tongue, inside lining of the cheeks, roof of the mouth, and the floor of the mouth. Symptoms of oral cancer may include a sore in the throat or mouth that bleeds easily and does not heal, a red or white patch that persists, a lump or thickening, ear pain, a neck mass, or coughing up blood. Difficulties in chewing, swallowing, or moving the tongue or jaws are often late symptoms. While there is no way to predict exactly which individuals will get oral cancer, there are some potential causes we want you to know about. In some cases, it is possible to minimize these risk factors.

• Age (most patients diagnosed with oral cancer are over the age of 40)
• Tobacco use, either from cigarettes or smokeless chewing tobacco
• Excessive alcohol consumption
• Persistent viral infections, such as HPV16
• A diet lacking or low in fruits and vegetables

Finding out you have oral cancer can be devastating news. If you are concerned that you might be at risk for developing oral cancer, talk to us about screenings and other things you can do to reduce your risk. Through a routine visual inspection, Dr. Rothstein and our team at A R Periodontics can often detect premalignant abnormalities and cancer at an early stage, when treatment is both less expensive and more successful, and can potentially save your life. Ask Dr. Rothstein and our team at A R Periodontics about a screening at your next appointment!

Mother’s Day is around the corner, and if you’re looking for some different gifting ideas for one of the most important people in your life, we have some suggestions for you. Here are a variety of gifts large and small tailored to your mom’s interests and chosen to support her dental health. After all, that’s what we’re here for!

• The Techie Mom

If your mother hasn’t tried the latest in brushing technology, a new electric toothbrush might be the gift to warm her techie heart.

Modern electric toothbrushes have plenty of options for the tech-savvy. They come with different settings for brushing and massaging. They can let your mom know if she’s brushing long enough, or if she’s brushing too hard, or when the brush head needs to be replaced. Some models link to apps which show a map of just where she’s brushed, in case some spots tend to get overlooked and underbrushed.

• The Adventurous Mom

A week in the woods doesn’t faze her. Backpacking? Relaxing. Day hikes? No problem. So help your mom stay unfazed, unstressed, and problem-free with an emergency dental kit for peace of mind during those adventurous outings.

Lightweight kits are available in sporting stores and online. Supplies like cotton rolls, dental floss, oral pain relievers, a dental mirror, and even temporary fillings are included, because, as your mom no doubt told you, it’s always best to be prepared!

• The Gourmet Mom

For the mom who appreciates foods which both taste good and do good, consider a gourmet gift which can satisfy her palate and contribute to her health. While normally we wouldn’t recommend sugary chocolates as having any kind of health benefit, dark chocolates are the delicious exception to the rule.

Dark chocolate (at least 70% cacao) is a great source of antioxidants, iron, zinc, magnesium and other important minerals. It’s lower in sugar content, and some studies suggest that dark chocolate has cavity-fighting properties and supports gum health. For a personal touch, deliver homemade treats like dark chocolate-covered frozen bananas (low in acidity and filled with nutrients) or dark chocolate-dipped strawberries (a good source of vitamin C, which is great for her gums).

• The Athletic Mom

She can outski you, outrun you, and hit those threes with ease. If your mom finds her bliss on the slopes, the soccer pitch, the basketball court, or any other sporty venue, consider a custom mouthguard to protect that winning smile.

Custom guards are more comfortable than store-bought options because they are molded to fit the user’s teeth and mouth precisely. This is especially helpful for those with dental work like braces or bridges. And, because the fit is custom, your mom will enjoy easier breathing and talking while exercising.

• The Mom on the Go

With her active life, any gift which makes your mom’s busy schedule run more smoothly is a good thing—such as a portable kit filled with dental necessities.

A travel toothbrush, a small tube of her favorite toothpaste, a compact mirror, dental picks, dental floss, and a mini-bottle of mouthwash are great basics for a confident smile any time of day. Put everything in a stylish lightweight travel bag. And don’t forget to include a pack of sugarless gum! Sugarless gum helps increase saliva flow (for better hydration) and decrease oral acidity (to help prevent enamel erosion).

• The Media-Ready Mom

With those perfect selfie angles, your mom’s smiles light up social media! If she’s ever expressed an interest in lightening and brightening that beautiful smile, a professional whitening treatment might be the very gift for her.

Professional whitening at our Livingston office is the most effective way to brighten teeth, with results which are generally faster and more long lasting than over-the-counter treatments. And it’s done with your mom’s dental health in mind, with a checkup to make sure her teeth are in perfect shape before whitening, and with protective measures in place for sensitive mouth and gum tissue.

We hope this list is a helpful starting point for choosing a smile-healthy gift tailored to your mom’s interests. But we can’t close without adding one last gift perfect for every mother. Including a heartfelt letter or card telling her how much she means to you will put a smile on your mom’s face long after Mother’s Day has come and gone!

Oh, wait—did you think we meant Designated Hitter? Oh, no, we’re not getting into that debate! What we want to talk about is the best Dental Habits you can practice when you’re on and off the field.

• When It Comes to Safety, Touch All the Bases

Basic baseball vocabulary lets you know it’s a tough sport. Brushback. High heat. Slide. Line drive. Hit-by-pitch. Not surprising, when it’s a game where weighty bats meet balls thrown at incredible speeds. Or where players slide into bases and stop line drives. So protect yourself. Wear a batting helmet. Use protective gear. And get yourself a mouthguard!

You can choose a one-size-fits-all stock guard, or a “boil-and-bite” model which fits a bit more closely to your teeth and mouth. But your best protection comes with a custom mouthguard. Custom guards are more comfortable, more durable, and make it easier to speak and breathe. If you or your young player wear braces, mouthguards are especially important to protect both teeth and orthodontics.

• Ball Park Snack Power Hitters

Sure, you’re not trying to match Babe Ruth’s hot dog-eating habits (a dozen dogs between two games of a doubleheader!), but we can set the bar higher than that. While it’s easy to rely on energy drinks, soft drinks, power bars, and other sugary and acidic treats to get you through nine innings, those sugars and acids put you at risk for cavities and enamel erosion.

Fresh fruits with peanut butter, vegetable sticks with hummus, cheese and whole grain crackers, yogurt, or lean meat with whole grain wraps—these and many other snacks can provide you with protein, healthy carbs, and natural sugars for an energy boost during a long game or practice. If you choose an energy bar for refueling, look for one without all the added sugars.

Hydrating is always important whenever you’re working out. And, while you can look for power drinks and energy drinks which are low in sugars and acids, a refillable water bottle is an easy, inexpensive, and effective form of hydration. Bonus: water helps wash away food particles and bacteria and helps neutralize acids in the mouth by maintaining saliva production.

• Biggest No-No?

A “no-no” is a no-hitter to baseball fans. But for your oral health, the most important no-no of all refers to tobacco.

Chewing tobacco is one of those old-time baseball cliches which we’re not nostalgic about. Chewing tobacco greatly increases the risk of neck, head, and mouth cancers, particularly oral squamous cell cancers. Don’t start the chewing tobacco habit—or any other tobacco habit, for that matter. If you do use tobacco, ask Dr. Rothstein for tips on quitting. Keep up with regular dental exams at our Livingston office for early detection of any potential warning signs of oral cancer.

When it comes to your dental safety, don’t get caught looking. For your best performance on and off field, avoid errors like playing without a mouthguard, exposing your teeth to acids and extra sugars, and using dangerous tobacco products of any kind. Play ball!

Sleep apnea is an increasingly common medical condition, and one that can have a truly devastating effect on the waking life of the sufferer. Those who suffer from the disorder may find that they suffer any or all of the following side effects:

• Saliva has several important jobs, and one of them is to protect and heal your tongue, your gums, and the inside of your mouth. Snoring and sleep apnea dry out your mouth, meaning there isn’t enough time for your saliva to do all this vital work.
• Over an extended period of sleep apnea, it’s likely that the sockets of your teeth will begin to dry out overnight as a result of your gasping for air and snoring between breaths. If this happens too frequently over a long a period of time, it can start to loosen your teeth.
• Those with sleep apnea often also practice bruxism, which is the habit of clenching and grinding your teeth together as you sleep. This can lead to all manner of problems, including TMJ disorder, damage to the enamel, headaches, and toothaches.
• For obvious reasons, sleep apnea does not lead to a particularly good night’s sleep. This means that sufferers are often tired and irritable, and suffer from the many other ill effects of sleep deprivation.
• While it is unclear whether the reasons behind this are correlative or causative, it has been suggested there are links between sleep apnea and cardiac arrests, depressive disorders, Type Two diabetes, cancerous tumors, “silent” strokes, and various complications of pregnancy.

While sleep apnea can be a troubling condition, Dr. Rothstein and our team at A R Periodontics will tell you it is eminently treatable. There are a number of ways to combat it, ranging from simple sleep hygiene to use of a CPAP machine. Of course, if it is possible for you to reduce your weight a little in a safe and healthy way, some have found that is also helpful in combating the problem. Sleep apnea is very easy to treat, once it has been correctly identified.

If you think you may be suffering from sleep apnea, or if you would like to know more about the condition, please give us a call at our convenient Livingston office to schedule an appointment with Dr. Rothstein.

Earth Day began in 1970 as an event to raise awareness of our environment. What began as a single day in April is now recognized around the world to bring attention and education to global environmental issues. Conserving our natural resources, reducing water and air pollution, and developing green technologies are all ways in which we can improve the environment around us.

Reduce, Recycle, and Reuse

One of the easiest ways to participate in Earth Day is by simply reducing the amount of refuse that ends up in landfills. Many communities have recycling programs for paper, plastic, and metal refuse. By keeping recyclable items out of landfills, we reduce the need for new disposal space and the amount of energy needed for burning refuse. Recycling products also helps conserve the resources that are used in making new products.

You can save money by reducing your consumption of many everyday products. Single disposable water bottles can be recycled but they are costly. By using filtered faucet water, you can conserve your financial resources. Disposable paper towels can also be wasteful. Consider reusable cleaning rags for the majority of your chores.

Reusing items saves both the environment and your finances. A large number of products can be re-purposed to create a new item. Old furniture can be remade into a new piece. Old clothing can be used for craft items. If you are not able to find ways to reuse your old items, donate them to a charity. Remember to continue your positive environmental steps on a daily basis.

Other things you can do to improve the environment

Everyone, young or old, can find ways to participate in improving the environment. Some ideas include:

• Planting trees
• Picking up litter
• Reducing energy consumption
• Walking, bicycling, or carpooling to work or school
• Disposing of hazardous waste properly
• Using rain barrels to conserve water for plants

Earth Day is designed to appreciate and celebrate the health of the earth. Keeping the earth healthy is important, but keeping your mouth healthy is important, too. Healthy teeth and gums contribute to your overall health and well-being, so remember to call our team at A R Periodontics to schedule an appointment. Have a happy and healthy Earth Day, from Dr. Rothstein!

It’s no secret that kids and adults have different priorities: your duty is to raise a happy, healthy child, but your little one’s only priority may be to have fun. When it comes to brushing teeth, it can be hard to combine a healthy habit with having fun. You might fear it can’t be done, but with a little creativity, brushing time can be a great experience for both of you!

Make It a Party

Brushing time doesn’t have to be a chore when you throw a little party! Get Mom and Dad together so the whole family can brush their teeth at the same time.

Let your child choose a song to dance to while you all brush for the required two minutes. Your son or daughter may grow to love this silly routine, especially when the parents are clearly dedicated to brushing their own teeth as well.

Big Kid Decisions

Kids love the responsibility of making “big kid” decisions. Keep a variety of toothbrushes, colors of floss, and toothpaste flavors on hand so they can choose something “new” each time they brush, just like when they visit our Livingston office.

Not only can this help them grow more comfortable with the idea of seeing the dentist, but they’ll love having the responsibility of picking what would be fun at brush time.

Practice Makes Perfect 

It’s true that the only way to get better at something is to practice, practice, and practice. Have your child practice brushing on his or her favorite stuffed animal, and use that opportunity to teach your youngster how to hold the brush and use circular cleaning motions. Showing how you brush your own teeth can also be worthwhile.

There’s An App For That

Did you know there are lots of fun apps that encourage good brushing habits among children? Brands like Oral-B and Aquafresh have free apps you can download on your phone.

The child gets to select a character, scenery, and a song he or she would love to accompany the task of brushing. If you have a daughter, she might like to use the Tooth Fairy Timer, which allows her to pick her very own fairy as her brushing buddy.

The important things to remember when you seek to establish good brushing habits is to keep it fun and stay consistent with your routine. It may take some getting used to, but after a while your child will become familiar with brushing and might even look forward to the new dental routine.

The Importance of Facial Protection

Americans from all walks of life should mark April as National Facial Protection Month on their calendars. The American Association of Pediatric Dentistry, Academy for Sports Dentistry, American Academy of Pediatric Dentistry, and American Association of Oral and Maxillofacial Surgeons have combined forces to sponsor this annual campaign, which aims to educate and remind us of the importance of protecting our face and teeth against impacts and injuries.

Wearing a helmet can save your life and prevent devastating physical damage in a variety of situations, from playing football to riding a bicycle. According to the American Association of Oral and Maxillofacial Surgeons, helmets reduce the risk of various head injuries by as much as 85 percent. Whether helmet laws apply in your area or not, Dr. Rothstein and our team at A R Periodontics want you to make sure you and your loved ones wear helmets with the appropriate safety ratings for specific activities. (A sticker on or inside the helmet will usually indicate this rating.) Helmets can also help save your teeth if they come with an attached faceguard, an essential addition for football players and others involved in contact sports.

Preventing Dental Injuries

A mouthguard can protect you against a variety of dental injuries, such as cracked, broken, or knocked-out teeth. The American Dental Association states that mouthguards play an essential role in preventing up to 200,000 dental injuries each year, and many states mandate their use for sports activities such as football and hockey. The Academy for Sports Dentistry warns, however, that these mouthguards must be custom-fitted as precisely as possible to prove effective. Have a professional-quality mouthguard molded and fitted by our team at A R Periodontics for better protection than a generic store-bought or “boil-and-bite” variety can offer. These cheaper versions tend to wear out quickly, interfere with proper breathing, and provide uneven degrees of cushion against impacts. Always have a fresh mouthguard fitted for each new sports season.

Choose the right combination of helmet, faceguard, and mouthguard to protect your teeth and face this April, and tell your friends to do the same! To learn more about mouthguards, or to schedule an appointment with Dr. Rothstein, please give us a call at our convenient Livingston office!

Plaque is a sticky subject! It sticks to the enamel of our teeth above and below the gum line, and it collects around fillings, braces, and other dental work. Plaque is one of the major causes of tooth decay and gum disease, and our teeth are under daily attack by this filmy menace.

What are the facts about plaque, and how can we fight back? Read on for some effective strategies!

What Is Plaque?

Plaque is a sticky film that builds up on our teeth, largely made up of millions of different types of oral bacteria. Plaque is a colorless biofilm at first, but as it collects, it takes on a white or yellow tint. If you haven’t brushed for a few days, that fuzziness you feel on your teeth is plaque build-up. Unless it’s removed, plaque hardens within a matter of days to become tartar.

• Tip: You can remove plaque with careful brushing and flossing, but it takes a dental professional to remove tartar. Be proactive!

Why Does Plaque Cause Cavities?

Bacteria in plaque use our food as their food, especially sugars and carbs. They then transform these nutrients into acids, which attack our tooth enamel, weakening it and leaving it vulnerable to further erosion and eventual decay.

• Tip: Cavities aren’t the only damage caused by accumulated plaque. Plaque also collects along and below the gum line. If tartar forms here, it irritates delicate gum tissue, leading to gingivitis and more serious gum disease. Make sure you don’t forget your gums when you brush and floss.

When Does Plaque Build Up?

The short answer? Plaque is always forming, because oral bacteria are a natural part of our biology. (In fact, there are even oral bacterial which are beneficial.) Plaque starts building up within minutes after eating, and during the night as we sleep.

That’s why we recommend brushing for two minutes at least twice a day, and flossing at least once a day. If you have braces or oral issues that make brushing more often advisable, ask us for suggestions for your best brushing schedule.

• Tip: Just because plaque is unavoidable, that doesn’t mean we need to give the bacteria in plaque any additional encouragement. Every time you have a meal or a snack that’s heavy in carbs and sugars, you are providing more fuel for acid production. Cutting down on foods like sugary desserts and sodas is not only nutrition-healthy, it’s tooth-healthy!

Where Does Plaque Collect?

Plaque builds up all over tooth surfaces, at the gum line, and even below the gum line. It’s especially easy to miss in hard-to-reach places like the irregular surfaces of molars, between the teeth, behind our front teeth, and near the gum line.

• Tip: One of the ways plaque avoids detection is its invisibility. Fortunately, if you’re having trouble brushing away all your plaque, there are plaque-disclosing toothpastes and chewable tablets available in the dental aisle which reveal the plaque hiding between, behind, or around your teeth by tinting it with a can’t-miss color. Just brush the color away, and you’ve brushed the plaque away as well.

How Do We Clean Away Plaque?

Use the Right Tools

Floss at least once a day. There are different materials, sizes, and coatings for floss, so you can find one that’s comfortable for you. Floss reaches those spots in between teeth and around the gum line that brushes miss.

Choose a soft toothbrush (soft bristles are better for your enamel) and change it every three to four months, or as soon as the bristles show wear. Make sure the head is the right size—too big, and it’s not only uncomfortable, but you won’t be able to reach all the surfaces you need to.

• Tip: If you have trouble removing plaque with a manual toothbrush, consider an electric model. Several studies have shown a reduction in plaque with the use of an electric brush.

Use the Right Toothpaste

There are many toothpastes specifically formulated to fight plaque and tartar. And fluoride toothpastes not only fight cavities, they can strengthen your enamel.

• Tip: Studies have shown that toothpastes with baking soda, in particular, are effective in reducing plaque. Ask us for a recommendation the next time you’re in for a cleaning.

Use the Right Technique

What not to do?  A forceful, horizontal sawing motion is awkward, hard on your enamel, and misses plaque and debris between the teeth. Technique is important—not for style points, but for cleaner teeth!

Hold your toothbrush at a 45-degree angle, especially at the gum line, to gently remove plaque from teeth and gums. Use short strokes or a circular motion to clean as much of the surface and between the teeth as possible. Brush the inside of your front teeth with careful vertical strokes—remember, that’s one place where plaque is easy to overlook. The same holds true for the tops of your molars, so thoroughly clean those uneven surfaces.

• Tip: Do you floss before or after you brush? While both methods have benefits, many dentists and periodontists suggest flossing first. But really, if you are flossing daily, no matter what the order, you’re doing it right!

Who Can Help You Fight Plaque?

Even when you do your best at home, plaque can still be a sticky problem. That’s why we advise regular professional cleanings. We can not only remove any plaque that’s been overlooked, we can eliminate the tartar which can cause serious gum disease.  And, of course, we can give you all the information you need to keep your teeth their cleanest.

• Final Tip: It’s important to schedule cleaning appointments at our Livingston office on a regular basis to help prevent tooth decay and gum disease. Ask us for phone, text, or email reminders when it’s time for your next cleaning.

True, you’re fighting plaque every day, but you have all the tools you need to make sure your teeth and gums stay healthy. You’re winning the battle with plaque every time you eat a nutritious meal, every time you brush and floss, every time you see Dr. Rothstein for a checkup and a cleaning. With that kind of strategy, plaque doesn’t stand a chance. And your bright smile and healthy teeth and gums? That’s a victory worth celebrating!

Remember all the things your parents would tell you when you were growing up to scare you away from doing something? Like how lying might make your nose grow, misbehaving meant you wouldn’t get money from the tooth fairy, and swallowed chewing gum would build up in your stomach and stay there for years?

Maybe that last one stayed with you well beyond your teens, and occurred to you every time you accidentally (or purposely) swallowed a piece of gum. We don’t blame you. It’s a scary thought.

But is it true?

We hate to take the fun out of parental discipline, but swallowing a piece of chewing gum is pretty much like swallowing any other piece of food. It will move right through your digestive system with no danger of getting stuck for months, let alone seven years.

This doesn’t mean you should start swallowing all your gum from now on, but if it happens accidentally now and then, there’s no need to panic.

Another common gum myth is that sugar-free gum can help you lose weight. Although it is preferable to choose sugar-free gum over the extra-sweet variety, no studies have show that sugar-free gum will help you lose weight.

If you pop a piece of gum in your mouth after dinner to avoid dessert, it could help you avoid eating a few extra calories every day. But the consumption of sugar-free gum without any other effort will not help you shed pounds.

 If you really enjoy chewing gum, we strongly encourage you to select sugarless gum, because it lowers your risk for cavities. Many brands of sugarless gum contain xylitol, a natural sweetener that can, in fact, help fight bacteria that cause cavities and rinse away plaque.

So if you can’t kick the gum habit altogether, sugar-free is definitely the way to go!

If you have any questions about chewing gum, feel free to contact Dr. Rothstein at our Livingston office.

Young adults often have the reputation of not taking good care of themselves. You may feel invincible, and not realize how much your behaviors now can affect your health later in life. Oral health is one area that is easy to neglect now, but that can lead to serious financial and quality of life consequences later.

Follow a Good Oral Care Regimen

If you don’t already do so, it’s time to brush, floss, and rinse as Dr. Rothstein taught you. Brush at least twice a day or after meals, and floss your teeth every day. If recommended, use mouthwash to kill germs in your mouth. If you are not able to brush your teeth after eating, swish water around in your mouth to remove the food from your teeth. Leaving carbohydrates in your mouth allows bacteria to ferment it and produce acid, which can destroy your tooth enamel and put you at risk for decay.

Visit Our Office Regularly

Young adulthood can be a challenging time when it comes to medical care. Your parents are no longer paying for your health insurance or taking you to your appointments. You may not worry much about getting regular cleanings and exams, especially if you’re paying for them yourself.

However, young adults have a lot to gain from visiting our Livingston office regularly. We can check for signs of problems and fix them early, which can save thousands of dollars and, ultimately, your teeth. These are some examples of what Dr. Rothstein and our hygiene team can do for you.

• Get rid of plaque so it does not develop into tartar and cause periodontitis.
• Identify and fill small areas of tooth decay to prevent it from progressing.
• Examine your gums for signs of gingivitis, or early gum disease.

Consume a Tooth-Healthy Diet

A nutritious diet is not just for preventing heart disease and diabetes later in life. It also supports your teeth. Make sure to get plenty of calcium, such as from dairy products, canned fish, and leafy green vegetables to allow for strong teeth. Also, limit sticky foods and sugary sweets.

At A R Periodontics, we know the most common oral health diseases are tooth decay and periodontal disease (or gum disease), and both are among the easiest to prevent. One of the most common ways we recommend to boost your oral health is by improving your diet, because you (and your mouth) truly are what you eat. A healthy diet can lead to a healthy mouth and body, while an unhealthy diet can lead to the exact opposite.

The Role Nutrition Plays

While diet is not the only factor that leads to periodontal disease, studies suggest the disease may be more severe among patients whose diets lack essential nutrients. Poor diets will generally lead to a weaker immune system, leaving your body susceptible to all kinds of ailments, including periodontal disease.

A Well-Balanced Approach

There is no “magic” diet that we can recommend to improve your oral health, but the most important thing is to seek a well-balanced approach in your eating. While fad diets that emphasize one food group over another may help you lose weight in the short-term, they probably will not provide all the nutrients your body needs in the long run.

Meals should include a balance of lean meats or other healthy protein sources, colorful fruits and vegetables, whole grains, low-fat dairy, and healthy fats. Foods containing substantial amounts of sugar and salt should be consumed in moderation.

Soda and Sugar: A Dangerous Duo

Millions of gallons of soda are consumed every day in America, but sipping a cold soft drink can be very harmful to your teeth. Many of these beverages wear down the enamel that protects the teeth, which weakens and even destroys them over time. The American Beverage Association estimates that soft drinks account for almost 30 percent of all drink consumption in the U.S., averaging an annual total of about 50 gallons per person (up from only 20 gallons in the 1970s). For healthy teeth and a healthy body overall, try to limit your soda intake.

Sugar is another ubiquitous treat in our daily lives. When we eat sugar, naturally occurring bacteria in our mouths convert it to acids that attack tooth enamel. Consuming too much sugar can swiftly lead to tooth decay, cavities, and gum diseases like gingivitis. Most people do not even realize how much sugar they consume each day. It’s important to limit your daily sugar intake by reading the labels of all the food you eat, and sticking with natural food sources that are low in sugar, especially ones that minimize added sugar, such as fruits and vegetables.

If you have questions about your diet and how it may be affecting your oral health, talk to Dr. Rothstein about it. See you soon!