My Blog
By Hartman Periodontics
February 03, 2018
Category: Oral Health
Tags: canker sore  
EasingthePainandDiscomfortofCankerSores

If you occasionally experience small sores in the softer tissues of your mouth, you may have aphthous ulcers or better known as canker sores. While rarely a health concern, they can be painful and annoying particularly when you’re eating and drinking.

These breaks in the skin or mucosa (the lining membranes of the mouth) usually occur in the thinner tissues found in the cheeks, lips, under the tongue or in the back of the throat. They tend to be most painful (especially while eating acidic foods like citrus or tomato sauce) between the first few hours of appearing and for a couple of days afterward, and will often occur during periods of anxiety, stress or after a minor injury. The sores will normally heal and fade within a couple of weeks.

Although occasional outbreaks of canker sores are quite common with most people, 20-25% of people (more often women) have a recurring form of painful outbreak known as recurrent aphthous stomatitis (RAS). Another variation called herpetiform aphthae, similar in appearance to herpes simplex virus sores, is characterized by smaller clusters of ulcers. While the specific causes for canker sores are still unclear, there’s some correlation between them and abnormalities with a person’s immune system, as well as with other systemic conditions like gastrointestinal disorders or vitamin deficiencies.

The basic treatment for canker sores is to first soothe the pain and promote quicker healing. Many over-the-counter medications are available for mild cases that numb the area temporarily and provide a protective covering while the sore heals. For more severe cases, there are also prescription medications (like steroids) that can be applied topically or through injection.

While canker sores are not contagious and usually benign, there are some situations that call for a dental examination: sores that haven’t healed within 2 weeks; increasing occurrences and severity of the sores; and never being completely free of a sore in the mouth. These may indicate some other condition, or be an occurrence of cancer or a pre-cancerous condition.

If you have any concerns, be sure to schedule a visit. We’ll be glad to evaluate any occurrence of the sores and recommend the best course of treatment to ease the pain and annoyance.

If you would like more information on canker sores or other types of mouth ulcers, 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 “Mouth Sores.”

By Hartman Periodontics
January 24, 2018
Category: Dental Procedures

One of the most innovative and effective dental technologies available to help patients is called Chairside Economical Restorations of dental crownsEsthetic Ceramic or CEREC for short. It's a dental option offered by Dr. Gary Hartman, a Virginia Beach, VA periodontist. Explore the benefits of choosing CEREC crowns over the traditional way dental crowns are made.

The Convenience of CEREC for Crowns
CEREC is an alternative to having a crown created in a dental lab by a dental technician. Instead, your periodontist can create the crown while you sit in your chair. The system uses 3D imaging technology that is connected to a milling machine. After an image is taken of your tooth, it is scanned and transferred to the machine, which creates, polishes, and glazes the crown to perfection. It’s a convenient solution for patients who want to avoid multiple visits.

CEREC Benefits
There are a number of reasons why you might want to ask your Virginia Beach periodontist about CEREC. Here are a few key benefits to think about:

- You get a more accurate and precise restoration, so your periodontist doesn’t have to do much work to the crown to get it to fit properly.
- Instead of going back to the office one more time for the crown installation, you'll have everything completed at the same appointment.
- There's no need to wear an uncomfortable, unattractive temporary crown for weeks.

CEREC can also be used to immediately make temporary crowns for implant placements in the front of your smile, otherwise known as the esthetic zone because it is the part of the smile most people want to look good. Dr. Hartman uses his CEREC machine to scan the position of the implant after it is placed and mill a temporary crown that can be screwed directly to the implant the same day the tooth is removed. This helps mold the soft tissue of the gums during the implant healing phase, resulting in a natural, esthetically-pleasing result, which is critical for front teeth. It also eliminates the need for a cumbersome, uncomfortable, and unsightly removable partial denture, or “flipper,” that is traditionally worn by patients with anterior tooth implants during integration/healing phase.

Who's a Good Candidate for CEREC?
Any patient who qualifies for a crown or similar tooth restoration is a good candidate for CEREC. Your periodontist will determine if you have enough healthy bone tissue for this treatment. CEREC Same Day Crowns should be your first choice if you urgently want a tooth repaired for cosmetic reasons or you're just short on time. 

Save Time with CEREC 
If you're ready to fix up your smile fast with crowns and other dental restorations, make time to visit Dr. Hartman to ask about CEREC. Call 757-498-5480 today to schedule an appointment at his Virginia Beach, VA office.

By Hartman Periodontics
January 19, 2018
Category: Oral Health
ActressEmmaStoneRevealsHowThumbSuckingAffectedHerTeeth

It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.

“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”

While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)

When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.

Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.

But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.

Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

By Hartman Periodontics
January 04, 2018
Category: Dental Procedures
Tags: oral hygiene  
UltrasonicPlaqueRemovalanEffectiveAlternativetoManualScaling

Undergoing regular dental cleanings is an essential part of periodontal (gum) disease prevention. While a daily habit of brushing and flossing cleans bacterial plaque from most tooth surfaces, it’s difficult to remove from places your brush or floss can’t access well. That, as well as hardened plaque deposits known as calculus, must be removed by a hygienist or dentist with a technique known as scaling.

Scaling is traditionally performed manually using specialized hand instruments known as scalers. Although hand scalers are quite effective, they must be used carefully to avoid damage to gum tissue or, during deeper cleaning known as root planing, the tooth roots. A different method for plaque removal known as ultrasonic scaling has grown in popularity as an alternative to manual scaling.

Ultrasonic scaling uses equipment emitting vibrational energy that crushes and loosens plaque and calculus, and disrupts growing bacterial colonies in biofilm. Plaque particles are then washed away using water irrigation. The most recent models of ultrasonic scalers have matched the effectiveness of hand scaling in removing plaque and calculus in shallow gum pockets, and surpassed the manual technique in cleaning out pockets greater than 4 mm. In experienced hands, they’re kinder to tooth structure and other tissues. Water irrigation also improves healing by removing bacteria and scaling by-products, which also makes the area easier to view by the hygienist.

On the other hand, any type of power scaler must be used with caution with patients who have pacemakers, and are not recommended for those with hypersensitive teeth or teeth that are in the early stages of de-mineralization. The technique may also produce an aerosol of finely misted particles (with possible contamination) that requires added measures to contain them.

For most patients, though, ultrasonic scalers are an effective tool for plaque and calculus removal. As ultrasonic devices continue to evolve, patients will ultimately benefit from greater comfort and reduced treatment times.

If you would like more information on plaque removal with ultrasonic scalers, 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 “Dental Cleanings Using Ultrasonic Scalers.”

By Hartman Periodontics
December 20, 2017
Category: Oral Health
Tags: tooth wear  
KeepanEyeonTheseFourThingstoPreventAbnormalToothWear

Teeth are naturally strong and durable — if we can prevent or control dental disease like tooth decay or gum disease, they can last a lifetime. Still, teeth do wear gradually as we age, a fact we must factor into our dental care as we grow older.

Sometimes, though, the wear rate can accelerate and lead to problems much earlier — even tooth loss. There are generally four ways this abnormal wear can occur.

Tooth to tooth contact. Attrition usually results from habitual teeth grinding or clenching that are well beyond normal tooth contact. Also known as bruxism, these habits may occur unconsciously, often while you sleep. Treatments for bruxism include an occlusal guard worn to prevent tooth to tooth contact, orthodontic treatment, medication, biofeedback or psychological counseling to improve stress coping skills.

Teeth and hard material contact. Bruxism causes abrasion when our teeth regularly bite on hard materials such as pencils, nails, or bobby pins. The constant contact with these and other abrasive surfaces will cause the enamel to erode. Again, learning to cope with stress and breaking the bruxism habit will help preserve the remaining enamel.

Chronic acid. A high level of acid from foods we eat or drink can erode tooth enamel. Saliva naturally neutralizes this acid and restores the mouth to a neutral pH, usually within thirty minutes to an hour after eating. But if you’re constantly snacking on acidic foods and beverages, saliva’s buffering ability can’t keep up. To avoid this situation, refrain from constant snacking and limit acidic beverages like sodas or sports drinks to mealtimes. Extreme cases of gastric reflux disease may also disrupt your mouth’s pH — seek treatment from your medical doctor if you’re having related symptoms.

Enamel loss at the gumline. Also known as abfraction, this enamel loss is often caused by receding gums that expose more of the tooth below the enamel, which can lead to its erosion. Preventing and treating gum disease (the leading cause of receding gums) and proper oral hygiene will lower your risks of receding gums and protect tooth enamel.

If you would like more information on tooth wear, 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 “How and Why Teeth Wear.”





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