My Blog
Posts for: January, 2019

Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”

Every good oral hygiene regimen has two parts — the part you do (brushing and flossing) and the part we do (professional cleanings and checkups).
But what’s involved with “professional cleanings” — and why do we perform it? The “why” is pretty straightforward — we’re removing plaque and calculus. Plaque is a thin film of bacteria and food remnant that adheres to tooth surfaces and is the main culprit in dental disease. Calculus (tartar) is calcified plaque that occurs over time as the minerals in saliva are deposited in bacterial plaque. It isn’t possible for you to remove calculus regardless of your efforts or hygiene efficiency. Ample research has shown that calculus forms even in germ-free animals during research studies, so regular cleanings are a must to keep you healthy.
The “what” depends on your mouth’s state of health and your particular needs. The following are some techniques we may use to clean your teeth and help you achieve and maintain healthy teeth and gums.
Scaling. This is a general term for techniques to manually remove plaque and calculus from tooth surfaces. Scaling typically encompasses two approaches: instruments specially designed to remove plaque and calculus by hand; or ultrasonic equipment that uses vibration to loosen and remove plaque and calculus, followed by flushing with water and/or medicaments. Scaling can be used for coronal maintenance (the visible surfaces above the gum line) or periodontal (below the gum line).
Root planing. Similar to scaling, this is a more in-depth technique for patients with periodontal disease to remove plaque and calculus far below the gum line. It literally means to “plane” away built up layers of plaque and calculus from the root surfaces. This technique may employ hand instruments, or an ultrasonic application and flushing followed by hand instruments to remove any remaining plaque and calculus.
Polishing. This is an additional procedure performed on the teeth of patients who exhibit good oral health, and what you most associate with that “squeaky clean” feeling afterward. It’s often performed after scaling to help smooth the surface of the teeth, using a rubber polishing cup that holds a polishing paste and is applied with a motorized device. Polishing, though, isn’t merely a cosmetic technique, but also a preventative measure to remove plaque and staining from teeth — a part of an overall approach known as “prophylaxis,” originating from the Greek “to guard or prevent beforehand.”
If you would like more information on teeth cleaning and plaque removal, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Polishing.”

The red, scaly rash suddenly appearing on your face doesn’t cause you much physical discomfort, but it’s still embarrassing. And to make matters worse treating it as you would other skin ailments seems to make it worse.
Your ailment might be a particular skin condition known as peri-oral dermatitis. Although its overall occurrence is fairly low (1% or less of the population worldwide) it seems to be more prevalent in industrialized countries like the United States, predominantly among women ages 20-45.
Peri-oral dermatitis can appear on the skin as a rash of small red bumps, pimples or blisters. You usually don’t feel anything but some patients can have occasional stinging, itching or burning sensations. It’s often misidentified as other types of skin rashes, which can be an issue when it comes to treatment.
Steroid-based ointments that work well with other skin ailments could have the opposite effect with peri-oral dermatitis. If you’re using that kind of cream out of your medicine cabinet, your rash may look better initially because the steroid constricts the tiny blood vessels in the skin. But the reduction in redness won’t last as the steroid tends to suppress the skin’s natural healing capacity with continued use.
The best treatment for peri-oral dermatitis is to first stop using any topical steroid ointments, including other-the-counter hydrocortisone, and any other medications, lotions or creams on it. Instead, wash your skin with a mild soap. Although the rash may flare up initially, it should begin to subside after a few days.
A physician can further treat it with antibiotic lotions typically containing Clindamycin or Metronidazole, or a non-prescription, anti-itch lotion for a less severe case. For many this clears up the condition long-term, but there’s always the possibility of relapse. A repeat of this treatment is usually effective.
Tell your dentist if you have recurring bouts of a rash that match these descriptions. More than likely you’ll be referred to a dermatologist for treatment. With the right attention—and avoiding the wrong treatment ointment—you’ll be able to say goodbye to this annoying and embarrassing rash.
If you would like more information on peri-oral dermatitis, please contact us or schedule an appointment for a consultation.