Dr. Rosamina De La Rosa
21 Summit Street
Parsippany, NJ 07054
973-257-0707

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Posts for category: Oral Health

By Rosamina De La Rosa DDS, FAGD, PA
January 06, 2019
Category: Oral Health
Tags: tmj disorders  
WhytheTreatmentModelforYourJawJointDisorderMatters

Your temporomandibular joints (TMJ), located where your lower jaw meets the skull, play an essential role in nearly every mouth function. It’s nearly impossible to eat or speak without them.

Likewise, jaw joint disorders (temporomandibular joint disorders or TMD) can make your life miserable. Not only can you experience extreme discomfort or pain, your ability to eat certain foods or speak clearly could be impaired.

But don’t assume you have TMD if you have these and other symptoms — there are other conditions with similar symptoms. You’ll need a definitive diagnosis of TMD from a qualified physician or dentist, particularly one who’s completed post-graduate programs in Oral Medicine or Orofacial Pain, before considering treatment.

If you are diagnosed with TMD, you may then face treatment choices that emanate from one of two models: one is an older dental model based on theories that the joint and muscle dysfunction is mainly caused by poor bites or other dental problems. This model encourages treatments like orthodontically moving teeth, crowning problem teeth or adjusting bites by grinding down tooth surfaces.

A newer treatment model, though, has supplanted this older one and is now practiced by the majority of dentists. This is a medical model that views TMJs like any other joint in the body, and thus subject to the same sort of orthopedic problems found elsewhere: sore muscles, inflamed joints, strained tendons and ligaments, and disk problems. Treatments tend to be less invasive or irreversible than those from the dental model.

The newer model encourages treatments like physical therapy, medication, occlusive guards or stress management. The American Association of Dental Research (AADR) in fact recommends that TMD patients begin their treatment from the medical model rather than the dental one, unless there are indications to the contrary. Many studies have concluded that a majority of patients gain significant relief with these types of therapies.

If a physician or dentist recommends more invasive treatment, particularly surgery, consider seeking a second opinion. Unlike the therapies mentioned above, surgical treatments have a spotty record when it comes to effectiveness — some patients even report their conditions worsening afterward. Try the less-invasive approach first — you may find improvement in your symptoms and quality of life.

If you would like more information on treating TMD, 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 “Seeking Relief from TMD.”

By Rosamina De La Rosa DDS, FAGD, PA
December 07, 2018
Category: Oral Health
Tags: local anesthesia  
LocalAnesthesiaisaKeyPartofPain-FreeDentalWork

We can easily take for granted the comfort we now experience when we undergo dental work. For much of human history that hasn't been the case.

Local anesthesia has been a major factor in the evolution of pain-free dentistry. The term refers to the numbing of nerve sensation in the tissues involved in a procedure. This type of anesthesia is usually applied in two ways: topical and injectable.

We apply topical anesthetic agents to the top layers of tissue using a cotton swab, adhesive patch or a spray. Topical agents are useful for increasing comfort during cleanings for patients with sensitive teeth or similar superficial procedures. Topical anesthesia is also used in conjunction with injections as a way to prevent feeling the minor prick of the needle. In essence, you shouldn't feel any pain or discomfort from beginning to end of your procedure.

Injectable anesthesia deadens pain at deeper levels of tissue. This makes it possible for us to perform more invasive procedures like tooth extraction or gum surgery without using general anesthesia. The latter form is a more intense undertaking: it renders you unconscious and may require assistance for lung and heart function.

Most important of all, subtracting pain sensation from the procedure helps relieve stress: first for you and ultimately for us. If we know you're comfortable, we can relax and concentrate on the work at hand. The procedure goes much more smoothly and efficiently.

Many people, though, have concerns about how long the numbness will linger after the procedure. This has been viewed in the past as an annoying inconvenience. But in recent years, dentists have become more adept at fine-tuning the agents they use as a way to reduce post-procedure numbness. There's also promising research on chemical agents that can quickly reverse the numbing effect after a procedure.

All in all, though, using local anesthesia broadens the range of dental work we can perform without putting you to sleep. More importantly, you'll be able to relax as we perform procedures that could improve your dental health for years to come.

If you would like more information on pain-free dentistry, please contact us or schedule an appointment for a consultation.

By Rosamina De La Rosa DDS, FAGD, PA
November 17, 2018
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Rosamina De La Rosa DDS, FAGD, PA
November 07, 2018
Category: Oral Health
Tags: aspirin  
MakeSureYourDentistKnowsYoureTakingDailyAspirin

Aspirin has been a popular pain reliever and fever reducer for over a century. Its effect on the clotting mechanism of blood, however, has led to its widespread and often daily use in low dose form (81 mg) to help reduce the chances of heart attack or stroke in cardiovascular patients. While this has proven effective for many at risk for these conditions, it can complicate dental work.

Aspirin relieves pain by blocking the formation of prostaglandins; these chemicals stimulate inflammation, the body’s protective response to trauma or disease. Aspirin reduces this inflammatory response, which in turn eases the pain and reduces fever. It also causes blood platelets to stop them from clumping together. This inhibits clotting, which for healthy individuals could result in abnormal bleeding but is beneficial to those at risk for heart attack or stroke by keeping blood moving freely through narrowed or damaged blood vessels.

Even for individuals who benefit from regular aspirin therapy there are still risks for unwanted bleeding. Besides the danger it may pose during serious trauma or bleeding in the brain that could lead to a stroke, it can also complicate invasive medical procedures, including many in dentistry. For example, aspirin therapy could increase the rate and degree of bleeding during tooth extraction, root canal or other procedures that break the surface of soft tissue.

Bleeding gums after brushing is most often a sign of periodontal (gum) disease. But if you’re on an aspirin regimen, gum bleeding could be a side effect. A thorough dental examination will be necessary to determine whether your medication or gum disease is the root cause.

It’s important, then, to let us know if you’re regularly taking aspirin, including how often and at what dosage. This will help us make more accurate diagnoses of conditions in your mouth, and will enable us to take extra precautions for bleeding during any dental procedures you may undergo.

If you would like more information on the effects of aspirin and similar medications on dental treatment, 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 “Aspirin: Friend or Foe?

By Rosamina De La Rosa DDS, FAGD, PA
October 28, 2018
Category: Oral Health
Tags: toothache  
WhatsCausingYourThrobbingToothache

There are few more painful experiences than a toothache. You can't ignore it: it's as if your mouth is screaming for relief.

But while the throbbing pain can tell you something's wrong, it may not be clear exactly what's wrong. There's more than one possibility — it could be with the tooth itself, the gums around the tooth or a combination of both.

In the first case, a toothache could be a sign of severe tooth decay within the tooth's innermost layer, the pulp. The pain you feel comes from the nerves within the pulp under attack from the infection.

For this level of decay there's one primary way to save the tooth and stop the pain: a root canal treatment. In this procedure we remove all the infected and dead tissue from the pulp and fill the empty chamber and root canals with a special filling. We then seal and crown the tooth to prevent further infection.

Another source of toothache happens when your gums have become painfully inflamed due to infection. This is usually caused by periodontal (gum) disease, triggered by a thin film of bacteria and food particles on tooth surfaces known as plaque. In this case, we must remove all plaque and calculus (hardened plaque deposits) from tooth and gum surfaces, including on the roots. Your gums can then heal and return to health.

But your situation could be more complex. Untreated tooth decay can advance to the roots and subsequently infect the gums. Likewise advanced gum disease can pass the infection from the gums to the root and into the pulp.  For such cases you may need a specialist, either an endodontist specializing in root canal issues or a periodontist specializing in the gums.  They can better diagnose the origin and extent of the problem and offer advanced techniques and treatments to deal with it.

It's possible in these more complex situations your tooth has become diseased beyond repair and must be replaced. It's important, then, that you see us if you experience any significant tooth pain, even if it seems to go away. The sooner we diagnose and begin treating the cause of your pain, the better your chances of regaining your dental health.

If you would like more information on treating dental disease, 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 “Confusing Tooth Pain.”