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Dr. Gentry’s article in The Elm, The University of Maryland

October 19, 2015articles/publications, cavities-before/after, halloween candy tipsarlington, caries, cavities, cavity, decay, dentist, Dr Gentry, northern virginia, Philip Gentry, smile, virginiaDoctorGentry

The University of Maryland

Tips for Your Teeth: Halloween Edition

Tips for Healthy Teeth

Eat Halloween candy right after meals. The saliva produced during meals will help dilute the acids produced by the mouth bacteria in response to the sugar and the saliva will help rinse away food particles.
Avoid candy that lasts a long time. It’s the length of time the sugar is in your mouth that is the critical factor. The longer the candy is in the mouth the more damage to the teeth.
Stay away from sticky candy. The longer the sugary candy is stuck to the teeth the more decay will occur. Stay away from gummy bears, sticky fudge and taffy. Stay away from sour candy. Sour candy is highly acidic leading to erosion of enamel.
Drink more water. Tap water with fluoride is best. This will help wash away the candy.
Eat good healthy foods and don’t fill up on sugary candy. You need good nutrition for healthy teeth and gums.
Stay away from sodas and sports drinks. The frequent contact with the sugary liquid will increase damage to teeth.
Chewing sugarless gum after eating candy will cause increased saliva production, which will neutralize the acid in the mouth and wash away food.
Brush as soon as possible after eating. If you ate sour or acidic foods rinse with water a few times first to neutralize the acid so not to push the acid into the enamel. Brush for two minutes.
Floss! Flossing removes plaque and food stuck between the teeth where the toothbrush can’t reach.
Visit your dentist regularly to catch dental problems early, and “treat” them before they get really scary. … Remember good oral health is a major contributor to good overall health.

by Philip A. Gentry, DDS, FAGD
Fellow, Academy of General Dentistry
Dean’s Faculty, Clinical Asst. Professor, Department of General Dentistry, Advanced Education in General Dentistry,
University of Maryland School of Dentistry

unnamed-5 — Halloween treats that Dr. Gentry hands out to trick or treaters

From The Horse’s Mouth

October 17, 2015equine dentistryarlington, dentist, Dr Gentry, equine dentistry, northern virginia, Philip Gentry, smile, virginiaDoctorGentry

Horses have 2 sets of teeth, 24 baby teeth, which are replaced by 5 years of age by between 36-40 permanent teeth. These consist of 6 upper and 6 lower incisors, 12 upper and 12 lower back premolar and molar teeth. Most male horses also have canine teeth, called fighting teeth, while females do not. There is an interdental space with no teeth, just gums, between the incisors and premolars. This is where the bit part of the bridle is placed.

Horses eat pretty much constantly for 10-12 hours a day and their teeth continuously erupt to offset the wear from the repeated chewing. Young adult horse teeth can be 5 inches long. Most of the tooth is under the gums and it slowly erupts about 1/8 of an inch each year until the horse gets old and eventually the teeth become very short and eventually fall out.

It is possible to tell the approximate age of a horse by its teeth. The expression “Don’t look a gift horse in the mouth” means that it is rude and ungrateful to check the teeth of a horse given to you as a present, as you would one you were considering purchasing. So don’t be ungrateful when you receive a gift.

Horses teeth wear unevenly and develop sharp edges, which irritate and lacerate the tongue and cheeks and make it difficult and painful to eat and have the bit in their mouth. A procedure called floating the horse’s teeth, where an equine dentist smoothes the sharp edges is done 1-2 times a year.

Friday afternoon chipped and broken teeth.

October 17, 2015chipped teeth-before/after, cracked teeth, dental bonding-before/afterarlington, caries, cavities, cavity, composite restorations, cracked tooth, crown, decay, dental, dentist, Dr Gentry, northern virginia, Philip Gentry, smile, tooth bonding, virginiaDoctorGentry

The next patient broke her upper first molar biting on a hard piece of food.

Thursday morning chipped tooth.

October 8, 2015chipped teeth-before/after, cracked teeth, dental bonding-before/afterarlington, cavities, cavity, composite restorations, cracked tooth, crown, dental, dentist, Dr Gentry, northern virginia, Philip Gentry, smile, tooth bonding, virginiaDoctorGentry

My first patient of the day today chipped his front tooth biting his finger nail.

Fractured teeth of the day. Every day I see broken teeth. Here are 2 examples from today.

October 6, 2015cracked teeth, crownsarlington, caries, cavities, cracked tooth, crown, decay, dental implant, dental implants, dentist, Dr Gentry, northern virginia, Philip Gentry, smile, tooth bonding, virginiaDoctorGentry

This patient cracked his molar biting a chicken bone. I was able to save the tooth, and without a root canal, but it did require a crown lengthening periodontal surgery and a crown.

unnamed-22 — Fractured distal lingual cusp.

unnamed-23 — Porcelain crown cemented over tooth.

This next patient bit down on a mint candy and fractured her molar down the root. The tooth could not be restored and was extracted and we will place a dental implant.

unnamed-2 — Fractured mesial lingual cusp.

unnamed-24 — Piece removed, fracture extends down root.

Implant case of the week.

October 4, 2015dental implantsarlington, bridge, crown, dental implant, dental implants, dentist, Dr Gentry, implant supported overdenture, northern virginia, Philip Gentry, virginiaDoctorGentry

This was a challenging implant restoration case due to the alignment of implants. In order for the implant to osseointegrate firmly into the jaw bone we like to place the implants where the jaw bone is the thickest and strongest. In this case the best bone was not lined up nicely so we had to stagger the implants. I was still able to make the final implant crowns line up perfectly in the mouth.

Before and After

Retention Grooves to help crowns last longer.

October 4, 2015crownsarlington, bridge, cracked tooth, crown, dentist, Dr Gentry, gold crown, northern virginia, Philip Gentry, virginiaDoctorGentry

On these 2 crowns, the first porcelain and second gold, that I did last week in my office I show how I place retention grooves in my crown preparations to help lock my crowns in. These grooves prevent rotation and help secure the crowns in place. These slots allows for more surface area for the cement and results in a longer lasting restoration that holds firmly in place. This is especially important in short weak teeth. With this technique I am able to save teeth that otherwise would need to be extracted or require periodontal crown lengthening surgery.

reatin1 — Cleaned out and composite buildup and retention grooves/slots placed.

unnamed-15 — Porcelain crown cemented in place.

Two patient’s smiles I made happy today.

October 1, 2015crownsarlington, cavities, cavity, composite restorations, crown, dentist, digital dentistry, Dr Gentry, Dr. Philip Gentry, northern virginia, Philip Gentry, porcelain crowns, porcelain veneers, smile, teeth whitening, tooth bonding, virginiaDoctorGentry

The first patient was concerned about his broken down front upper teeth and the gap between the teeth.

The next patient broke her lateral incisor tooth. It is very dark since it was traumatized and had a root canal many years ago.

Cone Beam Computerized Tomography Dental Imaging

September 19, 2015Cone Beam CT x-ray machine, digital dentistryarlington, CBCT, Cone Beam CT, dental, dental implant, dental implants, dentist, digital dentistry, Dr Gentry, implant supported overdenture, northern virginia, Philip Gentry, virginiaDoctorGentry

CBCT systems used by dental professionals rotate around the patient, capturing data using a cone-shaped X-ray beam. This data is used to reconstruct a three-dimensional (3D) image of the of the patient’s head and neck. CBCT uses more radiation than regular dental teeth x-rays, but still less than 10% of the radiation used in conventional medical CT scan of the same area.

This is the Carestream 9300 Imaging machine we have at the University of Maryland Dental School. I mostly use this to plan dental implant placement.

Dentists use Cone Beam CT imaging for the following:• 3-D observation of overall oral/facial bony characteristics, allowing easier diagnosis and placement of dental implants • Surgical guide fabrication for implant placement • 3-D observation of teeth for endodontic diagnosis and treatment • Diagnosis and treatment of tooth impactions • Identification of inferior alveolar nerve and mental foramen location • Identification of the location of the maxillary sinus • Identification of the presence of odontogenic lesions • Trauma evaluation and treatment • Analysis of temporomandibular joint characteristics leading to diagnosis and treatment • Integration with CAD/CAM devices for fabrication of prosthodontics or orthodontic appliances • Identification for referral of numerous conditions or diseases not normally within the realm of dentistry, but that can be shown on typical cone beam images.

These last 2 pictures show how we use information obtained from the Cone Beam CT to plan placement of dental implants.

Dr Gentry explains how sugar causes cavities and that it’s okay to enjoy a few scrumptious desserts over the holidays.

September 14, 2015articles/publications, cavities-before/afterarlington, caries, cavities, cavity, decay, dental, dentist, Dr Gentry, Philip Gentry, toothbrush, virginiaDoctorGentry

It is true that sugar does cause cavities, but it’s not the sugar directly. The naturally occurring streptococcus bacteria that live in our mouths consume the sugar, ferment it, and produce acid such as lactic acid. It is these acids that cause teeth demineralization and the formation of cavities. So it is actually the acid from the bacteria in plaque in our mouth that eats the holes in our teeth causing cavities.

Here’s the interesting part, it’s not the total amount of sugar we eat, but the total amount of time the sugar is in contact with our teeth. It is preferable to have a piece of pumpkin pie with a scoop of ice cream for Thanksgiving dessert, than sip on a soda all afternoon. It is better to have a few sugar cookies, or slice of Christmas apple pie, than to repeatedly sip coffee with sugar all morning long. One Altoids mint or cough drop per hour throughout the day is ten times more cavity producing than 1 big piece of cake for dessert, even though the cake has much more sugar and calories.

The repeated cycles of eating sugar and acid formation is what is the key. It is the frequency, or the amount of time the sugar is in the mouth, not the total amount of sugar. So do enjoy a few scrumptious (and quick) holiday desserts, just please make sure to brush and floss after every meal and visit your dentist regularly. Happy Holidays!!!

Philip A. Gentry, DDS, FAGD

imgres-1 — Article published in The Elm, The University of Maryland