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By Jean Lafayette, D.D.S.
July 04, 2016
Category: Oral Health
Tags: sleep apnea   snoring  
ConsultYourDentistforHelpwithDiagnosingandTreatingSleepApnea

Sleep — you'll spend a third of your life in its blissful embrace. But it isn't a luxury: you need it as much as nutrition and exercise. An occasional bad night's sleep leaves you irritable and drowsy; a bad night's sleep every night could endanger your health.

One of the most common causes for chronic poor sleep is obstructive sleep apnea. This occurs when the airway becomes blocked and you stop breathing temporarily. The blockage may be due to an oversized tongue, tonsils or uvula, an abnormal jaw or chin structure, or nasal polyps and congestion. When your brain notices you're not breathing, it rouses you just enough to relieve the blockage. These incidents can occur and end in seconds several times a night without you being aware of it.

This interrupts your normal sleep patterns, including the critical rapid eye movement (REM) of deep sleep that occurs at different times during the night. The results of not getting enough REM sleep are quite unhealthy: besides irritability and reduced concentration, poor REM sleep is linked to depression, headaches, decreased sex drive, acid reflux, high blood pressure or the onset of diabetes. Your night time experience — as well as your sleep partner's — won't be pleasant either as you may experience night time sweating and snoring.

Fortunately, sleep apnea can be treated. Our first considered treatment is a custom-fitted night guard you wear while you sleep that holds the tongue back from the airway. If your apnea is more severe, you may need to consider continuous positive airway pressure (CPAP) therapy, which uses a machine to pump pressurized air through a mask you wear while sleeping to force the airway open. You might also benefit from surgery to remove excess soft tissue obstructing the airway.

If you or your family has noticed any of these symptoms mentioned, make an appointment to see us — we're trained to look for oral signs in the mouth that may indicate sleep apnea. The sooner we can implement a treatment strategy, the sooner you'll begin experiencing a good night's sleep and better health.

If you would like more information on sleep apnea and what to do about it, 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 “Sleep Disorders & Dentistry.”

By Jean Lafayette, D.D.S.
June 26, 2016
Category: Dental Procedures
Tags: tooth decay   crowns  
ACrownCouldbetheAnswertoPreservingYourDamagedTooth

We’ve been treating one of your decay-prone teeth for some time with one filling after another. Each incident required a little more removal of decayed tooth material until now there isn’t enough structure to support another filling.

We could remove the tooth and replace it with a bridge or a dental implant, both viable restoration options. But keeping the tooth if possible would be more beneficial in the long-run for your gums, bone and remaining teeth. If it still has a healthy and stable root, it’s possible to permanently cover or “cap” the tooth with a life-like crown.

Crowns have been used for decades: the first were mainly composed of metal like gold or silver and later dental porcelain, a ceramic material that could be molded, shaped and oven-fired to resemble a real tooth. The earliest porcelains, though, were brittle, so a hybrid with a metal interior for strength and a fused exterior porcelain layer for appearance came into prominence.

Today, advances in materials have led to all-porcelain crowns strong enough to withstand biting forces. While the metal-porcelain hybrid still account for about 40% of crowns installed annually, the all-porcelain types are steadily growing in popularity.

Regardless of the type, though, the process for fitting any crown is relatively the same. The first step is to reshape the affected tooth so that the future crown will fit over it, followed by an impression mold of the tooth a dental technician will use to form a custom crown. Once the new crown has been prepared, we then permanently bond it to the tooth.

With a crown, you’ll be able to enjoy normal function and have a tooth that looks as healthy and normal as its neighbors. Be aware, though, that your underlying tooth is still subject to decay — so diligent, daily hygiene and regular dental visits are a must. With proper care your newly crowned tooth can continue to serve you and your smile for many years to come.

If you would like more information on dental restoration options, 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 “Crowns & Bridgework.”

4ReasonsSavingYourChildsDecayedBabyToothisaGoodIdea

Despite everyone’s best efforts, one of your child’s primary (“baby”) teeth has become decayed to the point it might be lost prematurely. Saving it would require extensive treatment like capping it with a crown or performing a pulpotomy, similar to a root canal treatment.

You may be thinking: since it’s going to come out eventually, why go to the expense of trying to preserve it longer? Actually, there are good reasons to save a baby tooth depending on your child’s age — for now and for the future. Here are 4 of them.

They’re important for nutrition. Baby teeth are quite similar to permanent teeth — not only do they look like them, they perform like them too, enabling a growing child to chew and digest food needed to boost their development. Even the loss of one tooth for an extended period makes effective chewing harder.

They’re important for speech development. With their first words, children develop speech patterns rather quickly. Their baby teeth play an important role in this: just like permanent teeth, they provide the tongue with points of contact for making a variety of sounds. A missing tooth for a prolonged period could interfere with making certain sounds and could have a stunting effect on their speech development.

They’re important for permanent teeth eruption. Baby teeth also serve as placeholders for their successors, the permanent teeth that are in development just under the gums. A baby tooth normally remains until the permanent tooth is ready to erupt within the path set by the primary. If they’re lost prematurely, the permanent tooth may not erupt as it should; and adjacent permanent teeth can drift toward the empty space and out of alignment.

They’re part of their smile. Baby teeth help children fit in socially with adults and other children — they help them look normal. A missing tooth stands out when they smile — and not in a good way. This could impact the way they interact socially with others, extending even into adulthood.

If you would like more information on dental care for your child, 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 “Importance of Baby Teeth.”

By Jean Lafayette, D.D.S.
May 27, 2016
Category: Dental Procedures
Tags: gummy smiles  
TreatingaGummySmileStartswithFindingouttheCause

You’re a bit self-conscious about your smile. But not because of your teeth — it’s your upper gums, which seem too prominent when you smile. While “too much” is a matter of perception varying from individual to individual, it’s generally accepted that a smile is “gummy” if four or more millimeters (a bit more than an eighth of an inch) of the gums are visible.

The good news is there are ways to improve the appearance of your gums. Which method we use, though, will depend on the underlying reason why the gums are prominent. The amount of gum tissue, in fact, may not be the problem at all, but could be the size of the crowns (the visible parts of teeth), the upper lip’s range of motion, the upper jaw’s position in relation to the face, or a combination of any of these.

For example, if your teeth didn’t erupt and develop properly, the gums might not have moved back to their proper position and stabilized as they should in your late teens or early twenties. A normal crown (the visible part of a tooth) is about 10 millimeters long, with a ratio of width to length of about 75-85%. Below those measurements the teeth can appear smaller, making even normal gum tissue appear larger. In another scenario, the upper lip may rise too high when you smile (hypermobility), which reveals too much of the gums.

If tooth size is the problem, we may recommend a periodontal surgical procedure called crown lengthening that reveals more of the tooth. A hypermobile lip can be treated with Botox shots to temporarily restrict the movement (it must be repeated every six months) or by surgically repositioning the lip muscles that control movement. Similarly, surgically repositioning an overlong upper jaw to make it appear shorter may be the right course.

That’s why our first step is to determine why your gums are too prominent with a complete dental examination. Knowing exactly why they stand out will help us devise a treatment plan that will greatly enhance your smile.

If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”

PrudentUseofX-RaysinChildrenProvidesthemostBenefitattheLowestRisk

It’s important for your child’s current and future health that we watch out for tooth decay. Taking x-rays is a critical part of staying one step ahead of this common disease.

But while x-ray imaging is commonplace, we can’t forget it’s still a form of radiation that could be potentially harmful, especially for a child whose tissues are rapidly developing. We must, therefore, carefully weigh the potential benefits against risk.

This concern has given birth to an important principle in the use of x-rays known as ALARA, an acronym for “As Low As Reasonably Achievable.” In basic terms, we want to use the lowest amount of x-ray energy for the shortest period of time to gain the most effectiveness in diagnosing tooth decay and other conditions.

A good example of this principle is a common type of radiograph known as a bitewing. The exposable x-ray film is attached to a plastic devise that looks like a wing; the patient bites down on it to hold it in place while the x-ray exposure takes place. Depending on the number of teeth in a child’s mouth, an appointment usually involves 2 to 4 films, and children are typically spaced at six months apart. Frequency of x-rays depends on your child’s tooth decay risk: lower risk, less need for frequent intervals.

Each bitewing exposes the child to 2 microsieverts, the standard unit for radiation measurement. This amount of radiation is relatively low: by contrast, we’re all exposed to 10 microsieverts of background radiation (natural radiation occurring in the environment) every day or 3,600 microsieverts annually. Even two appointments of four bitewings each year is a fraction of a percent of the background radiation we’re exposed to in the same year.

This conservative use of x-rays is well within safe parameters for children. As x-ray technology continues to advance (as with the development of digital imaging) we anticipate the exposure rate to diminish even more. Prudently used, x-rays remain one of our best tools for ensuring your child’s teeth are healthy and developing normally.

If you would like more information on the use of x-rays with children, 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 “X-Ray Safety for Children.”





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