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President Eisenhower (Supreme Commander of the Allied Forces in Europe during World War II and President from 1953-1956) had a teeth problem! He was a bruxer – a serious grinder of his teeth. This leads to tooth breakage and loose teeth. In the President’s case, he broke his front tooth and had a crown placed. It subsequently fell out and was recemented. Here is a photo of Eisenhower with the tooth stub, missing crown. The second photo is more typical of his published photos – notice how he doesn’t show his teeth!

 

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As the population in Suffolk County ages, we are seeing more and more older people in our practice. Many are taking medications that affect their oral health. Dry mouth, or xerostomia, is a common side effect of many commonly prescribed drugs. A recent article in the New York Times asked “What is it about so many medications that causes dryness, especially in the mouth?” Drugs that can cause dry mouth include the benzodiazepines, antidepressants, especially selective serotonin reuptake inhibitors, some blood sugar reducing oral medications, respiratory agents, quinine, drugs that treat high blood pressure, especially calcium channel blockers and diuretics, drugs that treat excess urine flow, some nonsteroidal anti-inflammatory drugs, opioids, glucosamine supplements, and the magnesium hydroxide in milk of magnesia.  The effect may be amplified if a person is taking more than one of the above medications.

 

The drying mechanism of the involved drugs is not fully understood. Some drugs may suppress the action of receptors on nerve cells in various glands, including the salivary glands, that produce fluids. The drying effect can also involve other mucus membranes, like around the eyes and in the digestive system.  Dryness in the mouth can lead to decay and periodontal disease. When I observe dry mouth, I discuss the importance of hydration, meticulous home care and regular dental visits.

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To relieve your dry mouth:

Chew sugar-free gum or suck on sugar-free hard candies to stimulate the flow of saliva.
Limit your caffeine intake because caffeine can make your mouth drier.
Don’t use mouthwashes that contain alcohol because they can be drying.
Stop all tobacco use if you smoke or chew tobacco.
Sip water regularly.
Try over-the-counter saliva substitutes — look for products containing xylitol, such as Mouth Kote or Oasis Moisturizing Mouth Spray, or Biotene Oral Balance.
Try a mouthwash designed for dry mouth — especially one that contains xylitol, such as Biotene Dry Mouth Oral Rinse or ACT Total Care Dry Mouth Mouthwash, which also offer protection against tooth decay.
Avoid using over-the-counter antihistamines and decongestants because they can make your symptoms worse.
Breathe through your nose, not your mouth.
Add moisture to the air at night with a room humidifier
Avoid sugary or acidic foods and drinks because they increase your risk of tooth decay.
Brush with a fluoride toothpaste
Use a fluoride rinse or brush-on fluoride gel before bedtime. Occasionally a custom-fit fluoride applicator (which we can make for you) can make this more effective.
Visit our office at least twice yearly to detect and treat tooth decay or other dental problems.

Sharon’s dentures were old – 15 years to be exact – and were worn out.  The teeth were worn and yellow. She was having difficulty chewing and the dentures were loose. We made her a new set of dentures – this took no more than three weeks.  She was thrilled. No adhesives needed.  She was comfortable and she looked great. New teeth took several years off of her age. Note how her lip has filled out, wrinkles diminished.  She can eat again! She was so happy that she decided to add two implants to her lower arch. We attached Locator abutments, creating an overdenture. The attachments on the denture snap into the abutments and create a snug fit.  Now this lower denture was a struggle to remove.

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Old denture, teeth worn flat, stained yellow.

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New upper denture and lower overdenture – lifelike teeth, bright color

This is absolutely my favorite transformation. Rita had smoked for many years – not good for teeth and gums. What happens is that the bone resorbs, leaving long and loose teeth. Eventually these teeth fall out. The process can be delayed or halted with proper dental and periodontal treatment but, like so many people, Rita was afraid of having dental treatment. She also had a serious gag reflex. She was very happy to learn about us and about the care that we take with our patients and their dental health. She was very unhappy with her smile,  with her displaced and missing teeth. She would not smile – and Rita was a beautiful woman. Her teeth were beyond repair, and she was afraid to wear a denture because of her gag reflex.

 

Upper and lower hybrid implant bridges were the best solution to give her a beautiful smile without the embarrassment of removable dentures. The hybrid implant bridge is screwed into bone supported implants and functions like natural teeth. We call it a hybrid because the dentist can remove it, but the patient cannot. Some people call it “teeth-in-a-day” because the teeth are removed, implants are placed and the hybrid can be seated immediately. Sometimes we will seat the hybrid the following day for better cosmetics. This is a temporary hybrid – once the implants are integrated into the bone in approximately three months, we take impressions and measurements for a final hybrid. We give the temporary hybrid to the patient as a spare in case a repair is needed. All-around a wonderful service. Rita did beautifully; the result is spectacular. What you see in her photos below is the temporary hybrid. The final one will look even better! She is thrilled to have teeth again. Read what she says on our testimonials page at https://drterryshapiro.com/testimonials/.

 

Look what we can do in a day to change your smile!

 

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Thursday: Loose and displaced teeth

 

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Friday: Temporary screw retained upper and lower hybrid bridges

Ryan suffers from amelogenesis imperfecta, a hereditary disease in which there is imperfect formation of enamel, resulting in a brownish coloration and fragile teeth. These teeth are weak and tend to decay easily. Unfortunately, Ryan and other members of his family have this condition. All of his teeth were decayed; some were too decayed to be saved, others needed root canal treatment, and also periodontal treatment before we could create a fabulous smile for him with porcelain veneers.  Ryan is thrilled and is getting ready to have his lower arch restored.

 

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I’m sure you never thought there could be a connection between Welch’s Grape Juice and Dentistry but here it is! The founder of Welch’s is Thomas B. Welch who graduated from the New York Central Medical College in Syracuse in 1852.  He practiced medicine for three years before entering into a dental apprenticeship under the tutelage of Dr. Foster, a practicing dentist in upstate New York.  Dr. Welch then moved to Minnesota where he practiced dentistry for a year before settling in New Jersey.  He had a thriving career in dentistry with offices in Vineland, NJ and Philadelphia, PA.  He also founded the Welsh’s Dental Supply Co. in Philadelphia.

 

Dr. Welch had early hoped to become a minister and had joined the Wesleyan Methodist Connexion, which opposed the use of alcohol.  The alcoholic wine used in communion presented a challenge to Welch.  By 1859 he had perfected a juice pasteurization process in his kitchen, and he began selling the unfermented, alcohol-free product to churches as “Dr. Welch’s Unfermented Wine.” Dr. Welch failed to develop a following for the product until several years later when he got the idea to market the alcohol-free drink beyond the church.  He brought Welch’s Grape Juice to the 1893 Chicago World’s Fair, where he offered free samples of the drink he called  a “health tonic with medicinal uses.”   Welch’s Grape Juice was a hit and its popularity has continued to grow. So there you have it: Welch’s Grape Juice and Dentistry!

My son, an Assistant Professor of Anthropology, is an expert in Bombay’s alternative economy. He has spent much time in India studying the vast street economy.  This week he was there to deliver a paper at a conference. As is his habit, he strolled about the city investigating the vast array of vendor stalls. He emailed me that he had met a man who makes acrylic dentures in “a tiny informal workshop.”  They sell for $10 each; “basically, they are dentures for the poor.”

I was very interested in the photos that accompanied the email. I wonder what training this man has. Did he train as an apprentice? or more formal training? I carefully studied the photos. The methods are primitive compared to the sophisticated computer technology that we in the U.S. have available and the sanitation is surely lacking: rubber bands to hold the upper and lower teeth together, a stapler and lighter lying nearby, a broken air vent. But this man is supplying teeth so poor people can chew better and look better and at a price they can afford. What can be better than that?  My son asked me in his email: “Not sure if you will be impressed or horrified!!”  Impressed! for sure!

 

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Our dental office walls were painted green and gold – popular colors several years ago – but the office gets a lot of traffic and it was looking worn. Time for a change of color and a facelift!  We had the entire office painted light gray (Benjamin Moore’s Wickham Gray, HC 171, to be exact) with bright white trim (Benjamin Moore’s Ice Mist, OC 67). What a difference! The office looks so bright and cheery. It makes us happy to be at work making equally bright and cheery smiles.  We added lighter furniture, eliminated some excess (always a good thing). We still have our abundant windows that in this season frame the beautiful red and yellow fall colors of our gardens.  We also continually update our equipment – recently adding a new ProSelect scaler to help us serve you more comfortably and thoroughly.

Many people have asked us about and admired the watercolor paintings that cover our walls. The paintings were done by my husband’s aunt many years ago. Most were painted on Cape Cod and are of the sea – so appropriate to Long Island.  The larger lithographs on the mantle, in the bathroom, and in the treatment room were painted by local artists.  I actually won these paintings several years in a row in a raffle drawing benefitting the Three Village Community Trust (http://www.threevillagecommunitytrust.org/) at their yearly dinner benefit at the Neighborhood House. This organization’s mission is to “acquire and restore sites and structures that contribute to our community” and to “protect our natural resources by preserving wetlands and shorelines, green spaces and farmland.” – Goals that are dear to my heart.

Come pay us a visit – the decor will make you feel welcome even before you meet our fabulous staff – Linda and May.

 

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We welcome you to our office

 

It was late afternoon Friday – I wasn’t in the office when I received a frantic text message from my answering service: “I just moved to L.I., my son is getting married in two weeks and my dog ate my denture – help!”  I called Marie right back and she was so relieved that I offered to see her the next morning.  When she came to the office the next day, we did a complete examination, took a few xrays and began the denture process by taking careful impressions and charting a schedule so the new dentures would be ready just in time for the wedding.  We scheduled a records appointment, a try-in appointment and delivery.

So how did the dog get a hold of the denture? Marie had had a long day and was ready for a nap. She took out her denture, laid it on a nearby table and promptly fell asleep. Her dog grabbed the denture and took a few bites, chopping off several pieces of the device.  By the time Marie caught the culprit, the damage was done. She tried gluing the denture together but that at best is only a stopgap measure. The denture was old and brittle – easily broken. The teeth were worn and the denture was overdue for replacement.  Marie was missing all of her upper teeth but she was also missing her lower back teeth. I recommended that we make a lower partial denture in addition to a new upper denture. That way she would have back teeth for chewing and that support would help stabilize her remaining lower front teeth.

She is thrilled with the result and ready for wedding photos. She said she was grateful to her dog for forcing her to replace her denture which she had been putting off. Now she had a denture that looked fabulous, was secure without adhesive, and functioned well.  Just a reminder to always place your dentures in a denture box – if they fall on a hard surface, they can break. If wrapped in a napkin, they can inadvertently be thrown out. I have seen this.

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Look at what the dog did!

Several months ago I told Jay’s story on a blog post: https://drterryshapiro.com/world-trade-center-hero-teeth/. His teeth had been severely eroded by acid in the air after the World Trade Center attacks. He was a supervisor on the cleanup crew for more than four years.  We fabricated upper and lower anterior porcelain bridges for him and upper and lower precision partial dentures to replace the back teeth. He looks terrific, is comfortable and can eat anything without trouble.

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Severely eroded teeth.

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Porcelain crowns and bridges