Good Teeth Gone Bad

So how does it happen? You start with good teeth. Your teeth come in pearly white, your gums are healthy, all is great. Then one day you wake up and look in the mirror, OMG, What happened to me? Those teeth are no longer so pearly or so white. How did I ignore this for so long? Where did I go wrong? I don’t like to smile. I am embarrassed by my smile. I have difficulty eating, I actually avoid eating foods I like because I can’t chew. Food doesn’t even taste the same. How did I get here? I’d like to say that this is a bad dream but for many people unfortunately this is real life.

Good Teeth-Unfortunate Decisions

I have heard it all. It actually makes me sad to see these patients sitting in my chair. Good teeth gone bad.Woman with toothache wanting good teeth I see these patients as victims, as nobody ends up here by choice. They are victims of a lack of dental education, their parents often had lousy teeth and didn’t know better for their children. They are victims of poor dentists, who treated them poorly with painful dentistry that didn’t last very long. Dentists who never took the time to care,  or teach their patients how to care for their teeth. They may have felt tortured in the dental chair, and then for years after,  found the pain of a toothache  more preferable then a trip to the dentist to alleviate the pain.

A periodontist who came out to Smithtown in the early sixties (1960s) actually told me that the dentists in Smithtown, and probably elsewhere at that time, believed that patients had three sets of teeth; baby teeth , adult teeth and dentures. What are the odds of you keeping your teeth in your mouth if you were a patient of one of these dentists? Not a bet I would take. The majority of these teeth which were lost were due to gum disease. Dentists were not as aware about the ravages of gum disease as we are today. Unfortunately the effects of gum disease took its toll not only on the teeth but I would be willing to bet there was an unfortunate systemic effect as well.

Keeping Your Teeth for a Lifetime

Now for the good news. We can learn from the past. Today we know that your teeth can and should last a lifetime. I have compiled a list of stratigies to use if you want to keep your teeth

  • Brush at least twice a day, more is better, especially before bedtime so you don’t go to bed with a mouthful of food and bacteria
  • Floss or use a Water Pik to remove hidden food debris.
  • See a dentist at least twice a year for professional cleanings and exams. Visit a dental practice which pays attention to the health of your gums, discusses your periodontal health and gives you tips to improve your gum health.
  • Your dentist should be proactive in dealing with small problems. Small problems mean easier and less costly fixes. The continual need for root canals, crowns or extractions should be a red flag. There are times where these procedures are absolutely necessary but prevention of disease needs to be a focus as well.
  • The goal of dental health is to get to a point where your teeth are well restored and are able to be maintained in that condition with routine care. Dental restorations do fail, but I have crowns and other restorations routinely last 15 years or more. If you always need dentistry find out why. Maybe fluoride would help make your teeth stronger.
  • Seek out high quality dental care. It will pay off in the long run. Looking for deals on body parts may not ultimately be in your best interest.
  • If you want to see where you are heading with your teeth look at where you have been, look at where you are now and draw a line into the future. If you have been plagued by dental problems and you continue to do the same thing you are doing now your problems will only continue to get worse. Loosing teeth makes the remaining teeth have to work harder. they then break down faster. Dental disease is like a snowball rolling down a hill. You need to get your situation under control if you want to keep your teeth for a lifetime.

Your Teeth-Your Choice

It is a wonderful time in dentistry. The techniques and materials we have available today are truly amazing. There is hope for worn teeth, decaying teeth and infected gums. Having good teeth should not be a dream. The problems of tomorrow are avoided by making good decisions today. I always advise my patients to listen to that little voice in their heads. Now you really know what to do. If you would like my help please give me a call.  It would be my pleasure to help you get the smile you deserve…

Keep Smiling LI…

Could Fall Allergies Harm Your Teeth?

Allergies are not much fun; between the sniffles, congestion, sneezes, and headaches, they can make your life downright miserable. Now, on top of everything else, it appears that some allergies may be able to cause pain in your teeth, too.

Issues In The Sinus Cavity Can Often Lead To Issues With The Teeth

Remember that your sinus cavity is right above the roof of your mouth. This means that if you have an infection in the sinus cavity, the change in pressure and other complications can lead to aches in your top teeth.

The good news is that, while the allergies may be causing you additional pain in your teeth, the pain in your teeth does not necessarily mean that something is wrong with the tooth itself. So if you treat the allergy and clear up the issue in the sinus cavity, it should take care of the tooth pain, too.

How to Tell if You Have a Sinus or Dental Problem

Patients often come into the office with pain in their upper molars. A simple test I perform is to have my patient stand and bounce on their heels. If their teeth hurt when bouncing then the pain is really coming from their sinuses. Fluid along with inflammation of the walls of the sinus combine to create the pain which is referred to their back teeth.

When An Allergy Causes More Than Just Pain

The bad news is that your body is an intricate system with many interconnected areas. If an infection in your sinus cavity gets bad enough, there is always the chance that the infection could spread, especially to nearby areas such as the roots of your upper teeth.

If you are suffering from allergies and notice pain developing in your teeth—especially the top ones—it may be nothing more than a change in the pressure of the sinus cavity causing some discomfort for your teeth. However, you surely have heard the saying that it is better to be safe than to be sorry, and you should not try to ride out the pain.

Please contact us, and let us take a look. We can help determine whether your teeth are developing any sort of infection, and we can help with the pain.


Dangers of Sharing a Toothbrush

The toothbrush A toothbrush is a crucial tool in your fight against tooth decay, gum disease, and other issues. It is used to scrub away bacteria, food sediment, and other particles that may be hanging around in your mouth.

Because of the nature of the tasks it is used to perform, the brush should never be shared between people, even between spouses or long-term partners.

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Dr. Shapiro offers a free, no-pressure consultation for any service at any time. All you have to do is give us a call, ask for your FREE consultation, and tell us what you’d like to learn more about. Dr. Shapiro can’t wait to meet you and find out how he can make you happy. He takes the time to figure out exactly what you want, and he does it with precision and care. Find out what Dr. Shapiro can do for you! Click to learn more or schedule your FREE consultation.

Sharing A Toothbrush Is Not The Same Thing As Kissing

Some people reason that if they kiss another person, there is no reason why they cannot or should not share a toothbrush with them as well. This reasoning is incorrect due to the nature of brushing your teeth.

Remember that a toothbrush has tiny bristled all over it; at some point, even if you have perfectly healthy gums and teeth—to say nothing of the situation if you have some form of gum disease—the toothbrush will probably draw a little bit of blood.

Do You Have Insurance? We can Find out What is Covered.

We take all kinds of insurance, and we will work with you to determine what your insurance will cover. Our front office staff is always helpful, and they happy to answer any of your questions. At no point will we rush you through the process or push you into something you don’t want, don’t need, or can’t afford. During your FREE consultation, everything will be explained clearly at every step of the process. Click to learn more or schedule your FREE consultation.

This means that sharing a toothbrush goes beyond sharing saliva, and can lead to the spread of blood borne diseases such as hepatitis. Kissing someone will expose you to some germs, yes, but sharing a toothbrush will expose you to many more.

Contact Us If You Have Any Questions

We know that maintaining proper oral hygiene habits can sometimes be a bit confusing. We are here to help you and we want you to know that if you have any questions about your oral hygiene regimen you should feel free to ask.

Just pick up the phone and give us a call, or bring it up during your next regularly scheduled cleaning appointment. We are here to help you keep a healthy smile, and we want to make sure we do our part in keeping you educated. We look forward to talking with you!

We Will Never Pressure You Into Anything!

Dr. Shapiro will never push a service or procedure on you that you don’t want. When deciding whether or not to proceed with a service, Dr. Shapiro will walk you through the pro’s and con’s of the procedure, provide you with alternative options, and even create a mock-up for you so that you can see exactly what you’ll be getting–at no cost to you! Do you have some part of your smile or mouth that you’d like to improve? Find out what Dr. Shapiro can do for you! Click to learn more or schedule your FREE consultation.

Dry Mouth Relief

dry mouthDry mouth is known in the medical industry as xerostomia. It can be caused by a wide array of factors. Treatment for dry mouth depends on what the cause of the condition is.

There are ways that you can temporarily ward off the negative effects of your mouth being dry, but this is only like putting a Band Aid on it. In order to really treat and prevent the detrimental effects of dry mouth you need to figure out what is causing it.

Saliva plays a very important role in the mouth. It serves to aid in digestion, maintain a balance between healthy bacteria and unhealthy bacteria, and it wards off infection. It neutralizes acids and can even help repair early tooth damage caused by bacteria. When there is not enough saliva in the mouth problems like decay can run wild. Therefore, it is important to control your dry mouth to the best of your ability by finding out what is causing it.

How to Relieve Dry Mouth

There are steps that you can take to manage your symptoms. Try these tips to offer you relief if your mouth is dry.

  • Limit the amount of caffeine you consume
  • Medications are often the cause-discuss this with your physician
  • Chew sugar-free gum
  • Do not rinse your mouth with mouthwashes that contain alcohol
  • Do not smoke
  • Drink more than the recommended daily allowance of water
  • Talk to your pharmacists about over-the-counter saliva substitutes like Biotene
  • Avoid over-the-counter acetaminophen
  • Choose mouthwashes specifically designed for dry mouth
  • Avoid acidic and sugary foods
  • Brush with fluoride toothpaste

These tips will help you to temporarily manage your condition. To resolve your issues with dry mouth you should talk to your doctor or dentist to figure out what it causing it. It could be medications or even a chronic illness such as rheumatoid arthritis.

Please call us today if you have any questions about persistent dry mouth!

Invisalign Can Bring a Smile To Your Face

Hand holding an invisalign clear aligner.Invisalign, also known as clear aligner therapy, is a popular procedure right now. Orthodontics using thin plastic removable trays molded to your teeth can give you that great smile you always wanted. The process seems quite simple, but you will be amazed at the amount of technology that is packed into those clear plastic aligner trays.

Invisalign is all about the trays

It is in the clear Invisalign trays are where all the magic happens. The trays are designed by Invisalign which is basically a high tech dental laboratory. The plastic of which the trays are made out of is no ordinary plastic. It has been designed to deform and apply a continuous amount of uniform pressure to the teeth throughout their useful life. Powerful software provided by the company allow the dentist to choreograph the movement of teeth from their starting position to their end point.

Tooth movement

The movement of the teeth is not the responsibility of Align Technology who make Invisalign but the responsibility of the dentist who designs the treatment plan. A skilled dentist can move teeth faster and more predictably then one not thoroughly trained in the procedure. To aid in the movement, the dentist bonds tooth colored attachments to the teeth. These attachments apply the correct forces in just the right way to move teeth. The trays sequentially guide teeth to their final position. Each tray moves teeth about a quarter of a millimeter till they are in their  ideal position. Trays are changed every two weeks, though it is possible to accelerate the process by using vibration creating devices or by increasing the amount of inflammation in the bone. More about that in a future post.

Invisalign vs Traditional Orthodontics

So what’s the difference between Invisalign and traditional wires and brackets which Orthodontists have used for years? Anytime you have different choices things are always benefits and drawbacks. The biggest differences are esthetics and the ability to clean your teeth without having anything on them. Invisalign trays are almost invisible and are easily removed while eating and brushing your teeth. These are two major factors for adults wearing braces. There are times where difficult tooth movement is more easily accomplished using traditional braces but this is not often the case. In teens who probably not wear their trays or lose them traditional orthodontics is preferable. The orthodontist has more control over the outcome. Invisalign trays apply just the right amount of force to move teeth. One unfortunate common outcome of adult tooth movement using traditional braces can be resorption of the tip of the root. This occurs because the tightening of orthodontic wires is so uncontrolled as to the forces which are applied to teeth. The forces of Invisalign trays are so carefully controlled that this is never seen using trays.

Invisalign patient

The Finishing Touches

Moving teeth into their ideal position often the first step in getting a great smile. Whiter teeth is the next step. Our office provides tooth whitening free of charge to all of our Invisalign patients. Teeth which are badly positioned often have worn edges as a result of accelerated wear. At The Center for Cosmetic Dentistry we have found restorative cosmetic bonding can be the difference between a good smile and a great one. Bonding can restore an worn smile to a youthful smile. You don’t have to be older to have an worn smile, as even teenagers with badly positioned teeth can have an amazing amount of wear. The best part about bonding is that it is an additive procedure that conserves tooth structure and it is less costly then other options.

Straighter Teeth Can Lead To a Better Life

Is your smile holding you back? Your smile affects how you relate to the world around you. Your beautiful new smile will keep you healthier. Straighter teeth makes cleaning easier. A better balanced bite will result in less wear and healthier gums. You might even get fewer cavities, and need fewer fillings along the way.

At the Center For Cosmetic Dentistry we can provide you with a complimentary smile analysis to see if Invisalign is right for you. Getting that great healthy smile is just a phone call away. Call today!





Tongue Cleaning

A woman engaged in tongue cleaning.Brushing your teeth and flossing regularly is a great start, but it could leave you facing other issues if you are neglecting other parts of your mouth. Your tongue is known for harboring bacteria that can leave you with halitosis, also known as bad breath. Time to cover the finer arts of tongue cleaning.

Tongue Cleaning

If you are not brushing your tongue each time you are brushing your teeth, you may be leaving your mouth open to bacterial growth despite your conscious efforts to keep your mouth clean. Here is a breakdown of what you want to do each time you clean your tongue.

Brushing Your Tongue Leaves You with Fresher Breath

The first thing you need to do is just put a tiny dab of your favorite toothpaste on your toothbrush and wet it slightly. From there, you should begin by brushing the back portion of your tongue. You should use sweeping motions towards your front teeth, and not go so far back on your tongue that you make yourself gag.

Keep moving forwards in small increments, making sure to get all of the film off your tongue as you go. Once you get to the tip of your tongue, make sure you sweep up the sides of your tongue, towards your front teeth. Rinse your brush frequently. After all of your brushing is complete thoroughly rinse your mouth out to get anything that may be left behind.

Taking the few minutes a day that brushing your tongue would take leaves you with nice, fresh breath, and it helps you to keep your mouth healthier than if you were to forget brushing your tongue. Your dentist will appreciate the extra effort, as this simple procedure also helps to keep your teeth in better shape, as it gets more of the damage-causing bacteria out of your mouth and away from your teeth.

Tongue Cleaning Using a Tongue Scraper

A tongue scraper is a curved plastic or metal device used to do just as its name implies. It removes a buildup of food debris, dead cells and bacteria. using the edge of the device. People who have a coated tongue caused by dry mouth, poor oral hygiene or medications will benefit from scraping.

One additional benefit from cleaning your tongue is that food tastes better as taste buds are exposed. We provide tongue scrapers to our patients who are interested in adding this ritual to their daily dental hygiene program.

Contact our office if you have any questions about cleaning your tongue.

How to Tell If You Have an Untreated Cavity

Woman with a dental cavity and painNobody likes getting a cavity.  Going to the dentist, getting numb, and sitting in the chair while he or she repairs it is probably not anyone’s idea of a fun time.  However, if left untreated, a cavity (also known as dental decay) can result in serious tooth damage or loss, damage to your facial bones, and even an infection that can spread to other areas. Some people have actually died as a result of dental infections that progressed to the brain!

Thus, getting cavities treated as soon as possible is an important part of maintaining your health.  But how can you tell when you are getting a cavity?  Here are some things to look for; note that not all of them will be present when you have a cavity, and it is important that you see your dental health professional for regular cleaning and inspection of your teeth.

Cavity symptoms:

Toothaches.  If your teeth are hurting, it may indicate presence of cavities.  Although other things can cause a toothache—and, not all cavities will result in tooth pain—if your tooth hurts, see your dentist as soon as you can.

Pain when eating foods that are sweet, A break in the enamel caused by a cavity will allow the nerve in the tooth to react painfully. This is a very common sign that you have a tooth that needs repair.

Pain when eating or drinking hot or cold foods and beverages.  Normally, the covering over your teeth keeps them from being overly sensitive to temperature; however, as a cavity progresses, you may begin to experience mild to severe discomfort from temperatures at either extreme.

Pain when biting.  Your teeth are supposed to hold up to the strain that comes from biting and chewing.  If one of them begins to hurt during normal everyday activities such as eating, it may be a sign of a cracked tooth or a cavity.

Irregularities or discoloration in the tooth surface.  A cavity is by definition a hole in your tooth.  If you notice that the surface of a tooth is beginning to develop a hole or a pit, or is changing color, that may be the beginning of a cavity.  You should get it checked out as quickly as you can.

Esthetic treatment choices

While having cavities treated is not fun, it’s even worse to have a cavity that does not get treated.  By watching for these and other symptoms, you can help ensure your smile remains healthy and functional. With today’s esthetic materials you wont even know you your tooth has been repaired. If you ever do need to get that cavity repaired Dr. Shapiro can make the whole process as easy as it can possible be, probably a lot easier then you think.

Please contact us if you have any questions about your oral health.

Keep Smiling LI…



Is Arthritis Impacting Your Oral Health?

Arthritis is a condition that affects the joints, and inflammation can affect manual dexterity to the point that it causes complications in managing your oral hygiene.

Anything from handling dental floss properly to holding your toothbrush could be compromised. Fortunately, there are ways that you can continue to care for your teeth even if you are living with arthritis.

Oral Health and Arthritis

If the joints in your hands are affected by arthritis, it is important to find ways to brush and floss your teeth that you can use despite your physical limitations. Here are a few tips that might be able to help:

• Use an electric toothbrush, as these brushes are typically easier to grip and will require less movement of your hand and wrist in order to thoroughly clean your teeth.

• Consider modifying your manual toothbrush, such as cutting a hole inside of a tennis ball and then putting the end of the brush in the ball. This can make it easier to hold onto and control the brush, as you will have more surface area to grip.

• Invest in a floss holder in order to make it easier to hold on the edges of your floss so that you can clean between your teeth.

Arthritis can affect your oral health but it is interesting to note that your oral health can affect your arthritis. Gum disease leads to an increased level of inflammatory proteins in the body.

Is your Oral Health Impacting Your Arthritis?

The mouth is the number one source of inflammation in the body. If you have periodontal disease it is possible that the inflamed gum tissue is creating higher levels of inflammation in your body. Increases in  inflammation have been linked to arthritis. I have had patients who have seen an improvement in their arthritis after getting their mouth healthier. It should be a no brainer for you to get your gums healthy as this can only help improve your overall health. You might even be able to keep your teeth for a lifetime.  A healthier mouth leads to a healthier body.

Dealing with Arthritis Pain

If your pain is becoming a problem, it is important to see your doctor. Over the counter and prescription medications may be able to ease pain and swelling, which could make it easier to care for your teeth. Hot and cold compresses can also be beneficial.

There are a variety of assistive devices out there that can help to make your life easier if you are living with arthritis. Contact our office about options that can help you to live a pain-free life in which you can better care for your teeth despite your arthritis diagnosis.

Patient Centered Health Care

A family happy with Dr. Shapiro's patient centered health care.You may be aware of the news about a dentist in Florida who was accused of abusing his pediatric patients by doing much more dentistry then necessary, including extractions, and billing Medicaid for it. If true, this act goes way beyond Medicaid fraud.  This dentist assaulted his young patients. This is not patient centered health care.

It is unfortunate but I personally believe that this type of treatment occurs more commonly than we could ever think. I have seen patients passing through my office who were recommended treatment which was aggressive and at times unnecessary. There have been patients who were recommended  crowns on teeth that could easily be filled. In my photo gallery there are pictures of a 24-year-old patient who had worn front teeth.

Another bad example:

Another dental office recommended that he have 12 veneers placed while offering no other treatment options. His top front teeth were severely worn and could have benefited from porcelain veneers but his lower teeth did not require veneers at all. I used composite restorations to replace the portion of the tooth which was worn away them while preserving remaining tooth structure.

Patient Centered Health Care

This is all my humble opinion but it is based on over 30 years of experience. It is also based on the concept that it’s the obligation of the provider to inform patients of all of their treatment options and explain the pros and cons of each option. This allows patients to participate in their care. This may seem like a time-consuming practice but in the end it saves time and money and results in happier patients. Most medical malpractice lawsuits occur not from poor outcomes, but from a lack of communication. Patients become upset after getting disappointing results often feel they never were presented with other options which now seem like the better choice.

Too many medical providers are driven by a profit centered approach to care, while many patients are often looking to spend the least.  There is a happy medium where better educated patients are informed of the value of treatment options. The best approach to medical care is a patient centered educational approach where informed consent is the backbone of treatment.This is patient centered health care.

How we serve you.

So what does this mean to you? It means you need to ask questions and participate in your care. Providers who have their patients best interest at heart encourage questions and are willing to listen to their patients. And if by chance you feel like your doctor isn’t listening to you, find a new doctor. In the end, the reality is that we teach people how we want to be treated, accept poor care and you will continue to receive it.

Till next time…

Keep Smiling Long Island

Toothpaste, Microbeads & Your Health

microbeadsDo you know about microbeads? These are tiny little beads of polyethylene or other plastics that are in many of our personal care products. From toothpastes to facial cleansers, they make the products more effective at removing debris.


These ingredients may not be as beneficial as they may sound.  In our office we have often seen these little blue beads embedded between the teeth. They act as an abrasive agent but in the end they wind up becoming debris themselves.  The debris is also harmful to the environment.  These particles are small enough to pass through water treatment plants and enter our waterways where they ultimately end up in the bellies of fish. The Great Lakes are polluted with these particles. These particles take forever to degrade.

Science has shown that some plastics attract toxins and some may even be hormone disrupters mimicking estrogen. We are hurting ourselves and our environment by using these products.

I am personally bewildered by what is going on. Four years ago I read articles on microbeads, pollution and the personal and environmental risk these pose. At that time I chose to find products that did not use them. I can’t understand if there was research condemning  their use,  why are new products manufactured with them? In terms of environmental and health preservation, I was way ahead. Large bodies of research are proving how detrimental these ingredients are to us. My advice is to stay educated and don’t expect products manufacturers to have your best interest at heart.

What can you do to avoid microbeads?

Many companies have pledged to remove these beads from their products. For instance Crest plans to remove microbeads from their toothpaste products next year. My recommendation is to avoid using all products containing microbeads  as soon as possible.

Till next time…

Keep Smiling LI