• Swollen gums that tend to bleed easily
• Gums separating from teeth
• Loose teeth
• Frequent bad breath
• A change in the way teeth fit together, or the way partials or dentures fit

• Maintain control over your blood sugar levels
• If you smoke, kick the habit
• Stick with your regular dental check-up and cleaning schedule
• Brush and floss every day
• Eat a healthy diet

It was 4pm on a beautiful Saturday afternoon. I had just got in from walking the dogs and decided to sit down in the family room and take a short cat-nap when my cell phone rang. “Hi this is Doctor Cohen”, I said. The woman on the other end of the line sounded frantic. “My son, he broke his tooth…he was skateboarding without his helmet, he never wears his helmet, and, well he fell and …”

Every year I see an increase in the number of people, young and older, coming in with one or more teeth broken or lost due to injuries from sporting activities. We all know we should put our seatbelt on before driving the car, or wear a helmet while riding a bicycle and of course if you play football you had better wear a helmet, padding and a mouthguard. But we never think to wear a mouthguard when we are doing many other lesser contact activities such as soccer, basketball, baseball, skateboarding and surfing among others.

Why Should I Wear A Mouthguard?

• Dental injuries are the most common injuries to the face that happens during sports.
• The majority of these injuries are preventable with mouth guards.
• More than 5 million teeth are knocked out each year during sports.
• The cost of a mouth guard is small compared to the cost of repairing a fractured tooth.
• A properly fitted custom mouth guard reduces the chance of sustaining a concussion from a blow to the jaw.

I always ask; “were you wearing a helmet, padding and other protective gear? How about a mouthguard?” No one seems to want to wear a mouthguard. Even professional Tony Hawk found out how valuable a mouthguard can be when he injured his tooth in a skating accident in August.

According Tony Hawk’s Twitter posts, Hawk received the injury to his upper row of teeth while at the Kona Skatepark in Jacksonville, Florida, during the execution of a doubles set with skater Tony Staab.
read the rest of the story

Think you don’t need to wear a mouthguard to protect your teeth, think again…

Daniel Jeffrey Cohen, DDS makes MOUTHGUARDS and is available 7 days a week for DENTAL EMERGENCIES

See ASE SKATESHOP for helmets, pads and other protective gear.

When we arrived to view the puppy we had seen online it turned out that she had two sisters. We were told that they were found in a trash bag along the side of the road. You guessed it; our family just rescued not one but three 6 week old puppies. I know we are in for a lot of work. Cleaning up the messes, feeding and caring for their every need and yes keeping their teeth clean. Since what I do for a living is teeth, it falls on me to make sure that the puppies get their teeth cleaned. Patients are always asking me “how do you take care of your dogs’ teeth”. The short answer is, “the same way I take care of my own teeth”; I eat the right foods, brush and floss regularly (no I don’t floss my dogs’ teeth), and see a dentist for professional teeth cleaning and examinations. For a more in depth guide to maintaining your pooches’ dental health you can check out the ASPCA’s ten steps to your dog’s dental health. There are many good tips on their website much of which applies to us two legged types. I also found this video which shows how to clean your dog’s teeth. So the next time you are brushing your teeth think about how easy it is to keep your pet healthy as well. In the mean time do enjoy the pictures of our new family members.

This past Friday I had the wonderful opportunity to speak at my youngest son’s 8^th grade “Career Day”. I came prepared with an elaborate audiovisual presentation (thank goodness for PowerPoint), visual props (text books and a skull – no not a real one, just a replica) and candy (lots of candy). The PowerPoint has done away with my useless note cards and allows me to display pictures with sound that 8^th graders find infinitely more interesting. The props, well they really just give me some credibility – after all, a professional is only as good as his props. And the candy, yes that’s right, I said candy. The candy is not just a way to drum up new business. No the candy is the smartest tool for the job of getting an 8^th grader’s attention. An 8^th grader will do just about anything (including ask intelligent questions) for a Milky Way, a Snickers or an Abazaba. More importantly, it temporarily made them act like the well-behaved young men and women they will come to be.

Pictures from Career Day at Niguel Hills Middle School:

Here are some of the highlights of “Career Day”…

Question:
How many years of school does it take to become a dentist?

Answer:
To become a general dentist one needs a Bachelor’s degree (usually 4 years in a science major) and then 4 years of dental school to earn a Doctorate of Dental Surgery (my bachelor’s degree is in Psychobiology from UCLA and my DDS degree is from UCLA School of Dentistry).

Question:
What is your favorite thing about being a dentist?

Answer:
Besides being my own boss, I love interacting with my patients on a personal level, getting to know them and helping them improve their health and appearance.

Question:
When did you decide to become a dentist?

Answer:
I decided that I wanted to become a dentist in my senior year of high school. Prior to that, I had thought of being a physicist. My love for physics was surpassed by my love for people.

Question:
What procedure in dentistry gives you the most satisfaction?

Answer:
I do enjoy every aspect of dentistry whether doing a root canal, a cleaning, an implant or a crown but, my favorite would be cosmetics. There is just something extremely rewarding when I change someone’s appearance and they tell me how they used  to be embarrassed whenever they smiled and how much more confidence they have with their new smile. Click here to see before and after photos

Click to view a before and after gallery of how Veneers can improve your smile

It’s fast, easy and painless. Do you have a crooked smile and don’t want to spend two years getting that Hollywood smile? Are your teeth worn, chipped, discolored and just not looking like they used to in your prime? You can restore your youthful appearance in one or two short appointments with long lasting cosmetic porcelain veneers.

Dental veneers are a form of cosmetic dentistry in which a wafer-thin, custom-made shell of tooth-colored material (usually porcelain laminate, lumineers or procera porcelain) is designed to cover the front surface of teeth to improve appearance.  These shells are bonded to the front of the teeth changing their color, shape, size or length.

Dental veneers also protect the surface of damaged teeth and may eliminate the need for more extensive treatments.  Other benefits of veneers include durability, an improved smile appearance, and the need for little-to-no removal of tooth structure compared to crowns.  If you have severely dull or discolored teeth, your treatment options may include porcelain dental veneers or composite veneers.  Veneers do have the added benefit of longevity and a proven ability to enhance the appearance of the mouth, smile and other facial features that are better supported by properly shaped teeth.

Veneers are routinely used to fix:

• Discolored teeth – either because of root canal treatments; stains from tetracycline or other drugs, excessive fluoride or other causes; or the presence of large resin or amalgam fillings that have discolored the tooth.
• Teeth that are worn down.
• Chipped or broken teeth.
• Teeth that are misaligned, uneven or irregularly shaped (for example, have craters or bulges in them).
• Teeth with gaps between them (to close the space between these teeth or after orthodontics).

This first step involves active participation between you and your dentist.  During this appointment your dentist will examine your teeth to make sure dental veneers are appropriate for you and discuss what the procedures will involve and some of its limitations.  We may also take x-rays and make impressions of your mouth and teeth.

To prepare a tooth for a veneer, your dentist will remove a small amount (about ½ millimeter) of excess enamel from the tooth surface, which is an amount nearly equal to the thickness of the veneer to be added to the tooth surface.  Next, your dentist will make a model or impression of your teeth.  This model is sent out to a dental laboratory, which in turn construct your veneers according to the dentist’s instruction.  In many cases temporary dental veneers won’t be necessary. It usually takes 1 to 2 weeks for your dentist to receive the veneers back from the laboratory.

Before the dental veneers are permanently cemented to your teeth, your dentist will temporarily place them on your teeth to examine their fit and color.  The veneer color is adjusted with the shade of cement to provide a perfect match.  Next, to prepare your tooth to receive the veneer, your tooth will be cleaned, polished and chemically treated – which allows for a strong bonding process.  Special cement is applied to the veneers and the veneers are then placed on your teeth.  Once properly positioned on the tooth, your dentist will apply a special light beam to the dental veneers, which activates chemicals in the cement causing it to harden or cure very quickly.  The final steps involve removing any excess cement, evaluating your bite and making any final adjustments in the veneers as necessary.

There are many advantages to dental veneers.  Dental veneers provide a natural tooth appearance.  Gum tissue tolerates porcelain well.  Porcelain veneers are stain resistant.  The color of a porcelain veneer can be selected such that it makes dark teeth appear whiter.  Veneers offer a conservative approach to changing a tooth’s color and shape.

Veneers usually last for many years and require very little special care.  Continue to follow good oral hygiene practices including brushing and flossing as you normally would.

Veneer Before and After Gallery

These are Dr Cohen’s actual patients.

Dental implants are replacement tooth roots.  Implants provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

There are many advantages to dental implants including:

• Improved appearance.  Dental implants look and feel like your own teeth.  And because they are designed to fuse with bone, they become permanent.
• Easier Eating. Sliding dentures can make chewing difficult.  Dental implants function like your own teeth, allowing you to eat your favorite foods with confidence and without pain.
• Improved Comfort. Because they become part of you, implants eliminate the discomfort of removable dentures and bridges.
• Convenience. Removable dentures are just that; removable.  Dental implants eliminate the embarrassing inconvenience of removing your dentures, as well as the need for messy adhesives to keep your dentures in place.
• Improved Self-Esteem. Dental implants can give you back your smile and help you feel better about yourself.
• Improved Speech.  With poor-fitting dentures, the teeth can slip within the mouth causing you to mumble or slur your words.  Dental implants allow you to speak without the worry that your teeth might slip.
• Improved Oral Health. Dental implants don’t require reducing other teeth, as a tooth-supported bridge does.  Because nearby teeth are not altered to support the implant, more of your own teeth are left intact, improving your long-term oral health.  Individual implants also allow easier access between teeth, improving oral hygiene.
• Durability. Implants are very durable and will last many years.  With good care, many implants last a lifetime.

Getting Started….

The first step to improving your smile with dental implants is the development of an individualized treatment plan.  The plan addresses your specific needs and is prepared by a team of professionals who are specially trained and experienced in oral surgery and restorative dentistry.  This team approach provides coordinated care based on the implant option that is best for you.

Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of the missing tooth (teeth).  As the jawbone heals, it grows around the implanted metal post, anchoring it securely in the jaw.  While some implants can have a crown placed on them the same day, generally the healing process can take from 6 to 12 weeks. Regardless of how long it takes for the implant to become secure in the bone you will always have teeth to smile and chew with when you leave the office.

Once the implant has bonded to the jawbone, a small connector post- called an abutment – is attached to the post to securely hold the new tooth.  To make your new tooth or teeth, your dentist makes impressions of your teeth, and creates a model of your bite (which captures all of your teeth, their type, and arrangement).  Your new tooth or teeth are based on this model.  A replacement tooth, called a crown, is then attached to the abutment.

Instead of one or more individual crowns, some patients may have attachments placed on the implants that retain and support a removable or permanent denture.

Your dentist also will match the color of your new teeth to your natural teeth.  Because the implant is secured within the jawbone, the replacement teeth look, feel, and function just like your own natural teeth.

Most people who have received dental implants say that there is very little discomfort involved in the procedure.  Local anesthesia can be used during the procedure, and most patients report that implants involve less pain than a tooth extraction.

Dental implants require the same care as real teeth, including brushing, flossing, and regular dental check-ups.

Basically, all the food you eat begins to be broken down in your mouth. As foods are digested and absorbed into your bloodstream, they are eventually carried to your lungs and given off in your breath. If you eat foods with strong odors (such as onions or garlic), brushing, flossing and even mouthwash merely covers up the odor temporarily. The odor will not go away completely until the foods have passed through your body.

If you don’t brush and floss your teeth daily, food particles can remain in your mouth, which promotes bacterial growth between teeth, around the gums, and on the tongue.

Smoking or chewing tobacco-based products can also cause bad breath, stain teeth, reduce your ability to taste foods, and irritate gums.

Persistent bad breath or a bad taste in your mouth may be warning signs of gum (periodontal) disease. Gum disease is caused by the buildup of plaque on teeth. The bacteria cause toxins to form in the mouth, which irritate the gums. If gum disease continues untreated, it can damage the gums and jawbone.
Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth and dental caries.
Several ways in which you can reduce and even prevent bad breath:

• Practice good oral hygiene. Brush twice a day. Don’t forget to brush your tongue, too. Replace your toothbrush every month. Use floss or an interdental cleaner to remove food particles and plaque between your teeth once a day.
• See your dentist regularly – at least twice a year(more frequently if you have gum disease).
• Stop smoking/chewing tobacco- based products. Ask for tips on kicking the habit.
• Drink lots of water. This will keep your mouth moist. Chewing gum (sugarless) also stimulates the production of saliva, which helps wash away food particles and bacteria.

In most cases, we can treat the cause of bad breath. If the odor is gum disease, for example, we can either treat the disease or refer you to a periodontist.

Read more……www.oralb.com/topics/bad-breath-causes

“How do you wear a removable partial denture, Dr. Cohen?”

Removable partial dentures are attached to your natural teeth with metal clasps or devices called precision attachments.

“How long will it take to get used to wearing a partial denture?”

Your partial denture may feel awkward or bulky for the first few weeks, but your mouth will eventually get used to it.

“Dr. Cohen, how long should you wear a partial denture?”

Initially, you may want to wear your partial denture all the time. Your dentist will give you specific instructions on how long it should be worn and when it should be removed. Generally, your mouth tissues need to rest so it is advisable that you take out your partial denture at least 15 minutes per day.

“Will the partial denture change the way you speak?”

Your partial denture may help your speech. It can be difficult to speak clearly when you are missing teeth. However, it also will take time to get used to it.

Partial dentures- Partial dentures are dentures that replace only a few missing teeth.

Complete dentures-Complete dentures are dentures that replace a complete set of missing teeth.

Conventional dentures are dentures that are made and placed after the remaining teeth are removed and the tissues have healed. Immediate dentures are dentures that are placed immediately after the removal of the remaining teeth.

An over-denture is a denture that fits over a small number of remaining natural teeth or implants.

Pregnant women and gum disease

Many mothers have experienced gum disease, dental pain and/or tooth extraction during or shortly after their pregnancy. This is often seen as being a “normal” side effect of being pregnant. However Dr. Cohen feels that dental disease, which is an infection of the teeth and/or gums, is not “normal” for any patient.

There are three basic events that happen during pregnancy which make the patient more susceptible to dental disease. First, hormonal changes may make the gums more susceptible to gum disease.

Second, pregnant women tend to eat smaller, more frequent meals, exposing their teeth and gums to sugars and acids more often. Third, cravings for “junk foods” and inadequate oral hygiene pose an increased threat to the teeth and gums.

Pregnant women in the Mission Viejo area are advised to schedule a dental evaluation and receivepreventive dental care at Daniel Jeffrey Cohen DDS. Personalized oral hygiene instruction by Dr. Cohen will be given to fight disease and promote overall good health for the mother and her baby.

Stages of gum disease

The American Dental Association says that over 75-80% of all adults, even in the Mission Viejo, Laguna Niguel and Ladera Ranch area, have or will have some form of gum disease.

Gum disease, or more correctly called “periodontal disease”, is a bacterial infection in the gums and supporting structures of the teeth. It can be divided into several categories.

The first stage is called “gingivitis” and is characterized by gum tissue that is red, puffy, and bleeds easily when touched with a toothbrush, floss or dental instrument.

The second, third, and fourth stages are initial, moderate, and advanced “periodontal disease”, respectively. These stages are different from gingivitis because the infection has destroyed the bone supporting the teeth, causing eventual tooth loss. At Daniel Jeffrey Cohen DDS the treatment is more involved at these stages, usually consisting of a special cleaning with anesthesia and sometimes gum surgery.

Severe gum disease can instigate joint replacement infections

Periodontal disease is a commonly occurring oral infection of the adult population (80% of adults are affected) destroying the bony support of the teeth. This infection slowly progresses over the lifetime of the patient and is often manifested in the advanced stage in the senior population.

Because of the lack of any discomfort to the patient until total loss of bony support to the teeth, many adults are unaware that they have this infection until they visit Daniel Jeffrey Cohen DDS. However, the bacteria from this bone destroying disease, especially in the more advanced cases, has been attributed to possible infection of joint replacements.

Candidates for joint replacements who have not been seen by Dr. Cohen in over a year should consider a thorough dental evaluation of their teeth and gums before surgery.

Depending on the severity of the infection, treatment of gum infections and tooth abscesses may take from two weeks to two months before the patient reaches adequate health before surgery.

Undetected gum and bone disease

Dr. Cohen feels that prevention is an overused word in our vocabulary but we all know it works. You see it in what you do every day. Who wouldn’t rather prevent a crisis than manage one?

In the Mission Viejo area awareness of gum and underlying bone disease is very low. Only 50% of the population visits a dentist on a regular basis. Of that 50%, 80% have some degree of gum and bone disease. It is an epidemic. Were this any other disease, we would be calling on the CDC for immediate action!

Gingivitis – Oral gum disease

Gingivitis is the most common periodontal disease, affecting 90% of the population, including our local Mission Viejo area community. It is an infection of the gums caused by bacteria that form plaque.

In small amounts (when it is newly formed), plaque is invisible and relatively harmless. But when left to accumulate, it increases in volume and the proportion of harmful bacteria grows.

These bacteria release toxins that result in inflammation of the gum tissue. Eventually, the plaque hardens and forms hard deposits called calculus or tartar.