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By Dr. Marvin Ernst General and Cosmetic Dentistry
June 09, 2021
Category: Dental Procedures
Tags: retainer  
ABondedRetainer-AnotherOptionforKeepingYourNewStraightSmile

For some, the excitement over their braces coming off gets dampened a bit with the prospect of now having to wear a retainer. But it has to be—newly realigned teeth have a tendency to revert to their previous positions out of a kind of “muscle memory.” A retainer prevents that from happening.

But as essential as it is, the standard retainer is almost as noticeable as braces, a major reason why many patients are less than enthusiastic about wearing them. And, because it's common for them to become lost when out of the mouth, replacing one becomes an added expense.

But there's another option—the bonded retainer. This retainer consists of a metal wire bonded to the back of the teeth to prevent them from moving. Because it's fixed in place, only a dentist can remove it.

The bonded retainer addresses the previous two issues associated with a removable retainer. Because it's behind the teeth rather than in front, it's out of sight to others. And, because it's fixed in place, there's no danger of losing it.

But unlike its removable cousin, which can be taken out for oral hygiene, the bonded retainer can make flossing more difficult. And, by nature, a bonded retainer must be worn all the time; a removable retainer allows for a more flexible schedule later in the treatment of a few hours a day.

So, which retainer option is best for you or another family member? A bonded retainer may be more attractive for appearance's sake, if it must be worn indefinitely, or if there's a high probability of the teeth moving out of alignment. And, it might be the right choice where there's a concern about a patient's ability to keep up with a removable retainer.

If you do decide to go with a bonded retainer, ask your dental hygienist for training on using floss with the fixed appliance—this can help improve oral hygiene. Whatever you choose, bonded or removable, your retainer will help you keep that new, beautiful, straightened smile.

If you would like more information on orthodontic retainers, 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 “Bonded Retainers.”

By Dr. Marvin Ernst General and Cosmetic Dentistry
May 30, 2021
Category: Oral Health
AsAntetokounmpoKnowsEvenanNBAStarCanBeSidelinedbyaToothache

The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”

Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.

A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.

However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:

Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.

Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.

A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.

A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.

Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.

And sometimes there is no pain, but an infection may be discovered during a dental exam.

Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.

Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”

By Dr. Marvin Ernst General and Cosmetic Dentistry
May 20, 2021
Category: Dental Procedures
Tags: oral health  
CTImagingTechnologyCanImproveOutcomesforComplexDentalProblems

The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.

Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).

Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.

A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.

CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.

But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.

And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.

If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”

By Dr. Marvin Ernst General and Cosmetic Dentistry
May 10, 2021
Category: Oral Health
Tags: oral health  
4TipsforHelpingaSeniorAdultKeepTheirOralHealth

By the time a person passes the half-century mark, they've done quite a bit of living: their share of ups and downs, successes and failures, and joys and sorrows. But while aging can take its toll on their physical and cognitive health, older adults still have much to offer from their life experience. It often falls to other family members to keep them in the best health possible—including their oral health.

Helping an older adult maintain healthy teeth and gums is crucial to their overall well-being. So in recognition of Older Americans Month in May, here are 4 tips for helping an older family member keep a healthy mouth.

Support their daily hygiene. Age-related physical and cognitive impairment can make the simple tasks of brushing and flossing much more difficult. You can help by providing an older family member with tools that make it easier for them to clean their teeth, like larger handled toothbrushes or water flossers. In some cases, you may have to perform their hygiene tasks for them, but it's worth the effort to reduce their risk of dental disease.

Watch for "dry mouth." If an older person complains of their mouth being constantly dry, take it seriously. Chronic dry mouth is a sign of not enough saliva, which could make them more prone to dental disease. The likely culprits, especially for older adults, are prescription medications, so speak with their doctor about alternatives. You can also encourage them to use saliva boosters or to drink more water.

Ask for oral cancer screens. Ninety percent of oral cancer occurs in people over the age of 40, with the risk increasing with age. Be sure, then, to ask for an oral cancer screen during their dental visits, presuming it's not already being done. Screenings usually involve visual and tactile examinations of the inside of the mouth and the sides of the neck, looking for unusual lesions, swelling or discolorations. The sooner oral cancer is found, the better the chances of a successful treatment outcome.

Have dental work checked. An older person may have acquired various forms of dental work like bridges, implants or removable dentures. Because these play an important role in their oral health, you should have their dental work checked routinely. This is particularly true for dentures, which can lose their fit and comfort over time. Dental work in need of repair makes dental function more difficult and can increase their risk of disease.

Given the depth of responsibility in caring for an older adult, it's easy to let some things slip by the wayside. Their oral health shouldn't be one of them—giving it the priority it deserves will pay dividends in their health overall.

If you would like more information about oral care for an older adult, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Dry Mouth.”

By Dr. Marvin Ernst General and Cosmetic Dentistry
April 30, 2021
Category: Dental Procedures
ThisOrthodonticDeviceCouldStopaPoorBiteFromDeveloping

“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.

A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.

The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.

Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.

For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.

As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.

These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.

If you would like more information on interceptive orthodontics, 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 “The Herbst Appliance.”





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