Michael Iott Dental Blog

Periodontal Therapy

2008-04-29T16:31:00.001-04:00

Periodontal therapy is the process of treating periodontal disease, or infection of the tissues that support your teeth. Periodontal diseases attack just below the gum line between the teeth and the gums, where they cause the attachment of the tooth and its supporting tissues to break down.

Periodontal diseases are classified according to the severity of the disease. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. However, gingivitis may lead to a more serious and damaging form of periodontal disease called periodontitis.

The factors that increase the risk of developing periodontal disease are:

Cigarette smoking or tobacco chewing
Certain diseases such as diabetes
Certain types of medication such as steroids, anti-epilepsy drugs, cancer therapy drugs, calcium channel blockers and oral contraceptives
Bridges that no longer fit properly
Crooked teeth
Fillings that have become defective

Warnings signs that can indicate periodontal disease:

Gums that bleed easily
Red, swollen or tender gums
Gums that appear to have pulled away from the teeth
Persistent bad breath or bad taste in the mouth
Teeth that are loose or separating
Any change in the way your "bite"
Any change in the fit of dentures

Because it's possible to have periodontal disease with no warning signs or symptoms, I advise all my patients on the importance of regular dental checkups and periodontal examinations. Good oral hygiene at home is also essential to help keep periodontal disease from becoming more serious or from coming back after it has been treated.

If you have any questions about detecting or treating periodontal disease, please call us for more information.

Periodontal Therapy

2008-04-29T16:31:00.000-04:00

Cigarette smoking or tobacco chewing
Certain diseases such as diabetes
Certain types of medication such as steroids, anti-epilepsy drugs, cancer therapy drugs, calcium channel blockers and oral contraceptives
Bridges that no longer fit properly
Crooked teeth
Fillings that have become defective

Warnings signs that can indicate periodontal disease:

Gums that bleed easily
Red, swollen or tender gums
Gums that appear to have pulled away from the teeth
Persistent bad breath or bad taste in the mouth
Teeth that are loose or separating
Any change in the way your "bite"
Any change in the fit of dentures

Root Canals

2008-04-20T16:30:00.000-04:00

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, I will remove the nerve and pulp and clean and seal the inside of your tooth.

How do you know if you need a root canal? While sometimes no symptoms are present, signs to look for include:

Severe toothache pain upon chewing
Pain upon application of pressure
Prolonged sensitivity or pain to hot or cold temperatures (after the hot or cold has been removed)
Discoloration or darkening of the tooth
Swelling and tenderness in the nearby gum areas
A persistent or recurring pimple on the gum areas

Root canals don't have to make you nervous In fact, with today's technology and advancements in general dentistry techniques, root canals are virtually painless and simple procedures.

If you are a family member need a root canal, please don't delay and contact us today for more information.

Dental Implants

2008-04-09T16:29:00.000-04:00

Dental implants are one of the most rewarding dental procedures to perform because they make the most impact on a patient's life. Where before someone may hide their smile behind their hand, or just not smile at all, because they were embarrassed about their missing teeth, with dental implants all that can be fixed.

If you are missing any teeth due to trauma or decay, dental implants offer an aesthetically pleasing way to replace them. While high-tech in nature, dental implants are so successful at replicating your natural teeth in appearance and feel, you will hardly remember you lost a tooth.

In simplest terms, a dental implant is an artificial tooth root that I will place in the your jaw to anchor a replacement tooth. Implants provide a strong foundation for fixed (permanent) or removable replacement teeth and are designed to exactly match your natural teeth in color, shape and transluscence.

Dental implants are a safe and effective way to significantly improve your smile and boost your self-esteem. To learn more about dental implants, please call us today for more information.

Dental Veneers

2008-04-02T16:28:00.000-04:00

The application of dental veneers is one of the most popular cosmetic dentistry procedures today and it’s no wonder. With porcelain veneers, your smile can be dramatically improved in as little as two office visits, leaving with you with a healthier, more aesthetically pleasing appearance.

Porcelain veneers are thin shells of ceramic bonded to your tooth. By itself, porcelain is a naturally delicate substance, but once it’s firmly attached to your tooth it becomes amazingly strong and sturdy.

Porcelain veneers are commonly used to:

Repair minor tooth imperfections and defects
Correct crooked or overlapping teeth
Conceal stained or discolored fillings
Whiten and brighten teeth with permanent stains
Close the gaps between teeth

With porcelain veneers, your teeth imperfections can be a thing of the past and you can start enjoying your new, sparkling smile.

If you are ready to improve your smile and self-esteem, please call us today to see if porcelain veneers are right for you. With porcelain veneers, a beautiful, straight, white smile can be yours in as little as two visits.

TMD

2008-03-31T16:26:00.000-04:00

Temporomandibular jaw disorder, or TMD, is a broad term for a collection of jaw conditions caused by problems with the temporomandibular joint. This is the ball and socket joint that allows the lower jaw to open close and move sideways while chewing or speaking. When there the chewing muscles or jaw joints do not work together correctly, you may experience problems such as:

Unexplained pain in the face, jaw or teeth
Limitations in jaw movement

Identifying and treating TMD is one of the most rewarding parts of our practice. Sometimes, with just a simple adjustment to a patient's bite, relief from TMD pain and discomfort can be immediate. In my practice, treatment for TMD usually involves relaxation of the jaw muscles and restoration of the jaw joint back to its unstrained position. This can involve the utilization of plastic appliances or other adjustment of the teeth to correct any misalignments of the bite.

Many people don't even know that they have TMD, but attribute their pain to other causes such as migraine or stress. Ask yourself if you suffer from any of the following:

Dull pain in your jaw joint or surrounding areas
Problems using your jaw or inability to open the mouth comfortably
Clicking or grating sounds from your jaw joint
Locking of your jaw upon opening the mouth
A bite that feels uncomfortable or misaligned
Headache or neck, shoulder or back pain
Swelling of you jaw or on the side of your face
Dizziness
Ringing in your ears or hearing loss

If any of this sounds familiar, please contact me today to schedule a consultation.

Is Amalgam Really Dangerous?

2008-03-20T11:23:00.001-04:00

The possible heath hazards of amalgam fillings continue to be a source of controversy throughout the dental and medical fields. Because dental amalgam is a source of low-level mercury exposure, concerns have been raised about whether amalgam increases the risk of migraines, erethism, multiple sclerosis, and other chronic health problems.

Both the American Dental Association Council on Scientific Affairs and the National Institutes of Health have stated that amalgam fillings pose no personal health risk. However, other organizations and researchers have found and continue to find evidence to the contrary.

It is widely known that mercury (current amalgams contain roughly 40% mercury) is a highly toxic metal. Even low-exposure levels can pose health hazards over time. It is our opinion that no mercury exposure is good mercury exposure. There are better technologies available that produce far better results than amalgam. Therefore, no amalgam fillings are done in our office.

Amalgam and other conventional fillings have been known to reduce the strength of a natural tooth by up to 50 percent. Our CEREC 3 technology can produce a filling that can last from 15 to 30 years and actually increase the strength of a tooth by up to 75 percent.

Amalgam fillings are old-fashioned and, we believe, not worth any of the associated risks. Please contact Dr. Michael Iott & Associates today if you’re in the NYC area and need a filling, or to learn more about our CEREC 3 technology.

Diseases and Medications that Affect Your Teeth

2008-03-14T11:21:00.001-04:00

Many of our clients who don’t engage in common teeth-discoloring behaviors (tobacco use, drinking coffee, colas, red wines, and other chromogenic foods and beverages) wonder why their teeth have become discolored. For many, it is not a matter of poor dental hygiene, aging, environment, or dental trauma. Patients who find themselves in this situation are often unaware that tooth discoloration (along with other dental problems) can often result from seemingly unrelated diseases, medications, and other treatments.

Decreased salivary output can inhibit the physical removal of food debris and plaque, therefore contributing to discoloration. This may be caused by local disease (salivary obstructions and infections), systemic disease (Sjögren syndrome), head and neck radiation therapy, and chemotherapy.

Systemic postnatal infections such as measles, chicken pox, streptococcal infections, and scarlet fever can also cause discoloration. Diseases such as these can cause irregularities in the thickness of the enamel layer. In rare cases, maternal rubella, cytomegalovirus infection, and toxemia of pregnancy can lead to tooth discoloration.

Common antibiotics such as tetracycline and doxycycline are known to discolor developing teeth. Minocycline can discolor teeth during and after enamel development. Various other medications such as anticholinergics, antihypertensives, antipsychotics, and antihistamines may cause varying degrees of discoloration as well.

Sickle cell anemia, thalassemia, hemolytic disease of the newborn (HDN), biliary atresia, and other rare pediatric diseases can cause discoloration. These diseases have the potential to cause hyperbilirubinemia, which produces a jaundice-like yellow-green tint on tooth surfaces.

A number of other hereditary diseases can affect oral health. For more information about these and other medications and diseases that may be affecting your teeth, please contact Dr. Michael Iott & Associates today.

Teeth-Staining, “Chromogenic” Foods & Beverages

2008-03-01T11:18:00.000-05:00

Some foods and drinks are more likely to stain your teeth than others. The term “chromogenic” foods or beverages refer to foods or drinks that when consumed over time have the ability to stain your teeth. Though it is more typical of beverages, there are a number of foods that can contribute to teeth staining. A simple rule of thumb applies here – if it will stain your carpet, it will stain your teeth. Let’s take a quick look at some of these.

Most people are aware that coffee will stain teeth over time. Coffee drinkers typically drink coffee every day, which causes the dark compounds in the coffee to accumulate on the teeth. This leads to deeper stains and greater difficulty keeping the teeth white.
Much like coffee drinkers, daily cola drinkers will have deeper, more difficult to remove staining as the syrup used in most cola is very potent and dark. Even “lighter” drinks such as orange cola will stain teeth. Many varieties of tea can be staining, while other varieties may do the opposite. Ask your dentist about your favorite varieties.

Red wine is a common culprit. The occasional red wine drinker will not notice much staining, but if a glass of red wine is common with meals you will eventually notice some staining.

Chromogenic foods include berries, curry, mustard, tomatoes, and other dark, acidic foods.

So what can you do if these chromogenic foods and beverages are a regular part of your diet? You can have your teeth whitened, which is what many people opt to do. If you continue to use these products however, the stains will likely return within a month or so. Your second option is to cut back your consumption or quit altogether. A third option is to always be sure to brush your teeth within 15-20 minutes after drinking these beverages. Even rinsing the mouth with water will help considerably if brushing isn’t always a possibility.

Please contact Dr. Michael Iott & Associates in New York City to learn more about chromogenic foods and beverages, or to discuss how your intake of these might be causing your teeth to become stained.

Temporomandibular Joint Disorder

2008-02-26T11:16:00.000-05:00

Temporomandibular joint disorder (often shortened to TMJD, TMJ, TMD, or TMJ disorder) is a blanket term that refers to any acute or chronic inflammation of the temporomandibular joints that connect the lower jaw to the skull. These joints are complex and are composed of tendons, muscles, and bones. When the muscles are relaxed and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without pain.

Typical signs and symptoms of TMD include any combination of ear pain, bite problems, headaches, dizziness, tinnitus (ringing in the ear), fullness of the ear (muffled or clogged ears) or locked jaws. Grinding, crunching, clicking or popping sounds of the jaw are very common signs of TMD.

Many behaviors and conditions cause the disorder. Teeth grinding and teeth clenching (bruxism) increase wear on the cartilage lining of the TM joints. Habitual gum chewing, and fingernail biting are common culprits. Chewing on only one side of the jaw can either lead to, or be a result of TMJ problems.

Stress and occupational tasks such as holding the telephone between the head and shoulder can lead to TMD. Malocclusion, or the misalignment of teeth, can lead to or be a cause of TMD. In addition, a history of broken facial bones or jaw fracture can lead to the disorder.

There are a variety of different treatment approaches for TMD. They may include heat, ice, a soft diet, anti-inflammatory medications, physical therapy, stress management, occlusal therapy (“bite therapy”), correction of bite abnormalities, and, in some cases, surgery.

The appropriate treatment for TMD varies from patient to patient, as the causes and severity of the disorder vary. If you suffer from TMD, please contact Dr. Michael Iott & Associates in New York City today to arrange a consultation.

Different Causes of Tooth Discoloration

2008-02-15T11:11:00.001-05:00

There are many reasons why teeth become darkened or discolored. The vast majority of our clients are aware of some of the possible reasons why they may be experiencing discoloration. Many of the causes are “common sense” – tobacco use, for example, is a sure way to develop darkened or discolored teeth over time. Those who do not partake in commonly known stain-causing agents such as tobacco, coffee, tea, wine, or colas, are often unaware of what might be causing their teeth to become discolored. Let’s briefly discuss a few lesser-known, yet common causes of tooth discoloration.

Poor dental hygiene – No surprises here. Inadequate brushing and flossing allows the buildup of plaque and stain-producing substances (tobacco, coffee, tea, colas, wines, even certain fruits and vegetables such as berries, apples, and potatoes).

Dental materials – Some materials used in dentistry, such as amalgam restorations, especially silver sulfide-containing materials, can cast a gray-black color to teeth.

Disease – Several diseases affect enamel (the hard surface of the teeth) and dentin (the material under enamel). Systemic postnatal infections such as measles, chicken pox, streptococcal infections, and scarlet fever can lead to varying degrees of discoloration. Treatments for certain conditions can also affect tooth color including chemotherapy and head and neck radiation. In addition, certain infections in pregnant mothers can cause tooth discoloration in the infant by affecting enamel development.

Aging – As you age, the outer layer of enamel on your teeth gets worn away revealing the natural yellow color of dentin.

Medications – The antibiotics tetracycline and doxycycline are known to discolor teeth when given to children whose teeth are still developing (before the age of 8). Mouth rinses and washes containing chlorhexidine and cetylpyridinium chloride can also stain teeth. Antihistamines, antipsychotic drugs, and antihypertensive medications also cause teeth discoloration.

Genetics – The brightness and thickness of enamel varies from person to person.

Environment – Excessive fluoride either from environmental sources (high fluoride levels in water) or from excessive use (fluoride applications, rinses, toothpaste, and other supplements) can cause discoloration. A lack of vitamins C and D, calcium, and phosphate may also play a role.

Trauma – Dental injuries can disturb enamel formation in young children whose teeth are still developing. Adult teeth are also susceptible to discoloration by trauma.

There are several options in the field of cosmetic dentistry to correct tooth discoloration. Contact Dr. Michael Iott & Associates today for more information, or to set up a consultation.

A “Gummy” Smile

2008-02-11T11:09:00.000-05:00

Excess gum tissue can create the appearance of short teeth and a "gummy" smile. It can also make your oral health more difficult to manage. A periodontist, or gum specialist, can remove excess gum tissue to give your mouth a new look.

A number of factors can cause "gumminess,” including inadequate normal gum recession, irritation from braces, mouth breathing, medications, and high lip lines.

Gummy smiles are often caused by attrition, a condition where the teeth have been severely worn down. Bad habits such as nighttime teeth grinding (bruxism) can cause this wear. This problem can be corrected by tooth lengthening surgery, topped off with caps or crowns to cover the newly lengthened teeth.

There are three common procedures we use to correct a gummy smile. A gingivectomy/gingivoplasty involves removal of gum tissue. The underlying bone is not exposed. The patient may experience pain during the procedure, but usually not after. A laser may be used during this procedure

Flap Surgery is sometimes required for short or worn down teeth, or for thick or irregular bone contours. Post-operative care includes sutures, or stitches, and a periodontal dressing to cover the healing gums. This surgery tends to bring more discomfort than a gingivectomy.

During a crown lengthening, the cosmetic dentist or periodontist shifts your gums to a position that reveals more of your teeth and less of your gums. This procedure is also known as gum lift or gum re-contouring, and may involve cutting out gum and bone around the teeth.

If you live in the NYC area, and are considering surgery to correct a gummy smile, please contact Dr. Iott & Associates today to arrange a consultation.

Proper Brushing – 2 Minutes Twice a Day

2008-02-04T11:07:00.000-05:00

The most important part of dental care happens at home. The minimum amount of time you should spend brushing your teeth is 2 minutes twice a day. Proper brushing and flossing helps prevent tooth decay, gum disease, and other dental problems that may lead to extra visits to the dentist’s office. Let’s discuss some quick tips you can follow so you can be sure you are brushing properly.

Hold your brush at a 45-degree angle against your gum line and, in short strokes, brush gently from where the tooth and gum meet to the chewing surface. Brushing too aggressively can cause receding gums, tooth sensitivity, and even loose teeth. Repeat this on all inside and outside surfaces of your teeth.

Clean the chewing surfaces of your teeth using short sweeping strokes, tipping the bristles into the pits and crevices.

Clean the inside surfaces of your top and bottom front teeth and gums with back and forth motions, holding the brush almost vertical.

Gently brush your tongue and the roof of your mouth to remove the decay-causing bacteria that exist in these places.

Use a timer or play a favorite song while brushing your teeth to get accustomed to brushing for a full 2 to 3 minutes. Some electronic toothbrushes are available with built-in timers that let you know when 2 minutes are up.

Please contact Dr. Michael Iott & Associates in NYC with any further questions relating to proper brushing technique.

A Pleasant Visit to the Dentist (Formerly What Do I Need for My First Visit?)

2008-01-25T10:43:00.000-05:00

For many, a visit to the dentist is looked upon with dread. And yet, it is something you must do if you want to keep your teeth. With today's modern techniques and many advances in the art and science of dentistry, a visit to the dentist can be pain free and pleasant. It simply doesn’t make sense to avoid taking care of your teeth regularly.

Here are a few strategies to make dentists visits as stress free as possible:

Visit your dentist every six months. These regular checkups will catch any upcoming oral issues, addressing them before they become problematic.
If you have fears about dental procedures, tell your hygenist and your dentist. They will likely be very sympathetic as they want your visit to be as pleasant as possible. Sometimes you’ll find they have strategies for dealing with various fears and phobias to help you not only get through procedures you dislike, but to allay future fears if the procedure needs to be repeated. One young man could not put up with the sound of having his teeth cleaned. The hygienist suggested they polish his teeth first, then clean them. It worked! So ask for help if you need it.
Don’t be afraid to ask questions.
Don’t dwell on your appointment. Sometimes the anticipation is worse than the actual event, and worrying about what might happen will put you in a state before you’ve even arrived.
Have faith in your dentist and hygienist. If you find there is something about their demeanor that does put you totally at ease, don’t feel bad about looking for a new dentist. It’s very important that you be 100% comfortable.

Dentistry has come a long way. The needles are finer, the drills are faster, and just about every dentist does everything possible to make you comfortable and get you out of the dentist chair quickly. Dr. Michael Iott is one of those dentists who goes out his way to ensure you have such an experience. His well-appointed New York City offices also serve Manhattan and Queens, and from your first phone call to schedule your consultation, you'll be treated warmly and professionally by his trained and knowledgeable staff. Click Here to schedule your appointment to see Dr. Michael Iott right away!

3 Tips for Healthier Teeth

2008-01-17T14:08:00.000-05:00

Do you find yourself avoiding the dentist when it comes time for your regularly scheduled cleaning? Next time that happens, don’t skip the appointment. Visiting your dentist every six months for a checkup and a cleaning is one of the top tips experts say will guarantee less pain in your future. Those regular visits can catch small issues before they become the kind of big issues that nightmares are made of.

What else can you do to safeguard your smile and the health of your mouth? How about brushing and flossing daily? At the least, brush twice a day, but three times is optimal to avoid the build up of plaque, that colorless, sticky substances that causes tooth decay. And be sure to use a soft toothbrush to avoid damaging your enamel and toss it every 3 months or so for a new one to avoid bacterial buildup.

Another top tip is to eat healthy foods. Your teeth and jaw need exercise. No, not the kind that comes from gnawing on super sized jawbreakers. That’s a no-no. We’re talking about plenty of fresh water, fruits and vegetables and, most importantly, the calcium and protein found naturally in meats and dairy products.

If you do find yourself with a sweet tooth, chew sugarless gum and stay away from taffy, caramels and the like which can stick to your teeth, cause cavities and damage dental work.

You may not think much about your teeth, but you sure will if you no longer have them. Respect your teeth and take good care of your mouth and you can count on having strong beautiful teeth for years to come.

Why You Should Floss

2008-01-10T17:39:00.000-05:00

Why do we need to floss? Isn’t brushing enough? How much can get stuck in between our teeth anyway?

Dental floss can prevent tooth decay and gum disease, hold bad breath at bay, and keep our teeth and mouth generally cleaner. So it's worth paying attention to.

The biggest benefit of flossing is that it removes large particles of food from between the teeth. Tiny pieces of food can be lodged in those spaces and, in some cases, floss is the only thing that will get it out. Left there, that food particle will eventually create a fairly nasty cavity. Your gums will appreciate it too, as the flossing removes trapped food that contributes to gum disease.

And what about bad breath? Bacteria that live in between your teeth and live on the trapped food particles cause bad breath. Not a pretty picture, is it? Flossing dislodges those food bits, leaving bacteria nothing to live on. Those bacteria can lead to gingivitis and periodontal disease, causing the gums to recede and pull away from the teeth and setting you up for loose teeth that might eventually require removal.

Perhaps best of all, floss is packaged in a tiny container that fits discreetly in purse or pocket. Next time you have food stuck between your teeth, or that tenacious piece of spinach right in the front, a quick flick of your floss will solve the problem.

When you stop to consider how unpleasant any of these situations can become, doesn't it make sense to add flossing to your daily routine?

NY Times Article: Tooth Decay

2008-01-08T17:37:00.001-05:00

I found this article and thought that you might like it.

Red Laser Puts Tooth Decay in a New Light
By PETER JARET
Published: November 15, 2007

THE next time your dentist tells you to open wide, consider this: dentists fail to accurately diagnose cavities 20 to 30 percent of the time.

“Especially in the pits and fissures on the surfaces of molars, it’s easy to miss early signs of tooth decay,” said Dr. Howard Strassler, a professor and the director of restorative dentistry at the University of Maryland Dental School. “And sometimes what you think is a cavity isn’t.”

Ouch.

The widespread use of fluoride, which hardens the enamel surface of teeth, has dramatically reduced tooth decay nationwide.

But it has also made detecting cavities trickier. The harder enamel is, the more difficult it is for dentists to detect small hidden cavities by poking into suspicious-looking areas with the sharp tip of an explorer, the metal tool traditionally used for diagnosis.

Now thousands of dentists are getting help from a device called Diagnodent, which shines new light on easy-to-miss cavities. The hand-held instrument uses a red laser to penetrate the outer layer of teeth. By measuring the way light reflects back, Diagnodent detects signs of decay, but is reassuringly gentle.

Diagnodent is used by an estimated 20,000 dentists in the United States, since its approval by the Food and Drug Administration in 2000, according to the KaVo Dental Corporation, the manufacturer.

“It has become a significant piece of equipment in many areas of dentistry,” said Dr. Kenneth Malament, a clinical professor who specializes in aesthetic and reconstructive dentistry at Tufts University. “People who have it use it every day.”

Some studies have shown it significantly improves cavity detection. “The great thing is that we can pick up cavities when we visually have no evidence,” Dr. Malament explained. “By catching them early, we can treat them before there’s much damage.”

The popular device has its limitations, though. It doesn’t work on teeth that already have fillings. And it occasionally makes mistakes.

The most serious problem is a false positive reading, which indicates decay where there isn’t any.

“I tell dental students that Diagnodent shouldn’t be used as a license to drill,” said Dr. Masatoshi Ando, an assistant professor at the Indiana University School of Dentistry. “It’s useful as a second opinion.” But dentists still need to do a careful visual inspection and poke around with their explorers, he warned.

NY Times Article: Toothbrushing

2008-01-08T17:31:00.000-05:00

I came across this article and would like to share it with you.

Is This a Toothbrush or a Drill Sergeant?
By MARTHA SCHINDLER CONNORS
Published: December 20, 2007

Correction Appended

HONESTLY, how hard can it be? We’ve been doing it twice a day since kindergarten. But still we can’t get it right.

Tony Cenicola/The New York Times

“Odd as it sounds, most people are no good at brushing their teeth,” said Dr. Paul Warren, a dentist and a vice president of scientific relations for Procter & Gamble Oral Care.

All you have to do is go tooth by tooth, bristles to the gumline, for at least two minutes, according to the American Dental Association.

But most adults fail miserably. We brush haphazardly, concentrating on the front-and-center teeth and making short work of our molars. For many, the cardinal sin is scouring their gum lines as if plaque were bathtub grout.

Patience is also no virtue among toothbrushers. “They spend an average of 47 seconds doing it,” Dr. Warren said.

All of that incompetence is good news for toothbrush makers. The toothbrush is a mature product, one that designers and industry analysts say has reached far limits of amelioration. But thanks to our ineptitude, toothbrush designers have a raison d’être.

Lately, toothbrush makers have feverishly reworked one of the most worked-over devices known to man. Colgate has presented 14 manual brushes in the last five years. Oral-B typically introduces one electronic brush a year, the fruition of the work of more than 300 designers and engineers over 3 to 5 years.

Never mind that the device we know — bristles mounted on a 6-inch-long handle — has been around for more than 5,000 years. Or that its job, removing remnants of your last meal, be it a bowl of Wheaties or a slab of roasted boar, has remained unchanged. The toothbrush has had more makeovers than Michael Jackson.

Some changes are merely cosmetic, but the majority are intended to make the simple task of brushing even simpler. “Consumers aren’t good at brushing, so we’re taking them out of the equation,” said Graham Mott, a research and development executive for Philips Sonicare. “We’re making the toothbrush idiot-proof.”

How to explain our ineptness when it comes to oral hygiene? “Most people don’t really understand the process or don’t want to spend the time and effort they should,” said Dr. Howard S. Glazer, a former president of the Academy of General Dentistry, an organization devoted to advocacy and continuing education. “They think it’s O.K. to go once around the park and then home.”

People don’t follow their dentists’ instructions, either.

“Lots of patients brush way too hard, no matter what we tell them,” said Dr. Susan Karabin, a periodontist in Manhattan and the president of the American Academy of Periodontology. “They think they’re not doing a good job unless they’re spraying toothpaste all over the vanity.”

Fret not, the oral care industry is here to help. The new Ultreo brush ($169.99) adds ultrasound to sonic bristle action to make things even easier. Just gently move the handsome orange-tinged gadget until you get the signal to relocate other part of your mouth. This hint occurs every 30 seconds.

Too tough on your teeth? The Colgate 360 (about $3.99) has a NASA-worthy bristle configuration, with extra rubber bits that squeegee plaque away with almost no pressure at all.

For the truly brutish (or brainless), there’s the Oral-B Triumph ($149.99) with SmartGuide, which features a remote digital display that delivers an audible and visual warning when you’re brushing too hard. Or the Sonicare FlexCare ($179.99), with its two different routines, the speedy GoCare setting and the MaxCare mode, a 2-minute cleaning and 1-minute massage.

Gizmos like these are designed to beat heavy-handed brushers at their own game. "These brushes provide their own motion, so they do the work for you,” explained Mr. Mott of Philips Sonicare. “Even if you’re doing everything totally wrong, you get the job done —and you can’t hurt yourself."

Damage by toothbrushing is more common than you might think. After $5,000 worth of gum surgery, Stephanie Mascott, 32, a recovering aggressive brusher, bought an Ultreo and now hopes to have kissed her receding gums goodbye. “With a manual brush, it’s too easy to get carried away,” said Ms. Mascott, a brand director in San Diego.

Alli Noland, 38, a public relations executive in Jackson, Wyo., was also a bruiser of a brusher. “I always brushed really hard, so I thought I had special cavity-fighting powers when I was a kid,” she said.

After six fillings, Ms. Noland reassessed her methods and bought a Sonicare, which she says better helps her clean her nooks and crannies. “Now I’ve got no cavities, my teeth are actually cleaner and I’m not scrubbing my mouth off.”

Others see catering to the lackluster brusher as marketing plain and simple. “This rush for innovation is all madness,” said Timothy Dowd, a senior analyst with the research firm Packaged Facts and author of its Oral Care 2007 market report. “If you didn’t have product innovation, the market would rise or fall with the population because everybody brushes his or her teeth.”

Stephen Wilcox, a principal at Design Science Consulting in Philadelphia, who has designed a few in his day, is of the same mind. “The toothbrush has been around forever,” he said. “We’ve quit improving it. Now we’re just competing for the consumer’s attention, so we’re seeing a lot of mindless tweaking.”

But don’t tell that to brushing sloths. “I love my Sonicare because it does all the work,” said Barb Obergfell, 54, an outreach librarian in Indianapolis. “I can space out because I barely have to move it. It’s ironic because I advocate reading and distribute books all day, then come home and surrender to my electric toothbrush.”

Despite makers’ claims that their toothbrushes offer superior cleaning, “there are relatively few large, well-controlled studies demonstrating a clear advantage of one brush over another,” said Marjolijn Hovius, the editor of the International Journal of Dental Hygiene.

How methodically a person brushes is far more important than the brush he or she uses, most experts agree. A meticulous brusher can remove plaque with a bit of wood as well as with a state-of-the-art toothbrush, Dr. Karabin said.

But there’s one advantage to buying a $180 cutting-edge toothbrush. “If you spend a lot of money on a toothbrush, that’s a great motivational tool,” Dr. Glazer said. “You’ll probably use it more than the one I give to you for free.”

Correction: January 3, 2008

The Skin Deep column on Dec. 20, about dental care, referred incorrectly to the Ultreo, a sonic brush that signals how long to brush each tooth. It should be moved around on the tooth during these intervals; it should not be stationary.

Manual Toothbrushes v. Power Toothbrushes: Which One Works Better?

2008-01-03T11:42:00.000-05:00

If you really want to avoid frequent visits to your dentist, you must practice good oral hygiene. This includes twice daily brushing, flossing, using a fluoridated toothpaste and regular dental visits about every six months for cleaning and a checkup. But what kind of toothbrush is best—a manual toothbrush or one of those fancy electric ones? Does it matter?

Dentists surveyed on the subject discovered most patients, although they were making attempts at good oral care, were not brushing properly, either because their technique was wrong or they did not brush long enough. So the first rule in brushing well is to do it correctly. If you’re not sure how to do it, the hygienist at your dentist’s office will be happy to show you.

Most people still use a manual toothbrush, even though power toothbrushes have been available since the 1960s and have been shown to be more effective in plaque removal and reducing gingivitis. The cost of a power toothbrush and being unsure about which brand to buy are two of the reasons many people stick with a manual toothbrush. However, despite many advances in manual toothbrush design, the average manual toothbrush removes only about 50% or less of plaque. Dentists agree that, for those who cannot afford a power toothbrush, the battery-powered versions provide a significant improvement over manual toothbrushes and cost less than $6.00. Some studies show the battery-powered toothbrushes are as effective in removing plaque as the more expensive electric versions. Better yet, children who use power or battery-operated toothbrushes brushed longer and better, due in part to ease of use for their smaller fingers and hands, the smaller brush head size which helps children reach more inaccessible parts of the mouth, and the sheer fun of brushing with a toothbrush that does the work for you.

In some ways, it can be said that, since the main goal of brushing is to maintain good oral health, it is more important to be sure to brush regularly than to worry about what type of toothbrush you’re using. But why not get the very best results for your efforts? If you’re not used to using a power toothbrush, try the battery-operated version first, then take your time comparing prices, styles, designs and features before you purchase an electric toothbrush.

And be sure to schedule a checkup with Dr. Michael Iott. The hygienists are happy to talk to you about proper brushing and flossing techniques, and Dr. Iott’s entire staff is there to support you in your quest for excellent oral health. Contact the office today!

What’s Special About My Office

2007-12-26T13:39:00.000-05:00

Dr. Michael Iott’s New York City offices are abuzz with activity. Patients seek treatment for a wide variety of cosmetic and general dental needs, knowing Dr. Iott and his staff combine advanced technology, continuing education and superior patient care to provide patients with the highest quality available in today’s modern dental office.

Dr. Iott is a clinical adjunct professor at the NYU Advanced Program for International Dentists. His students (a combination of specialists and general practitioners from all over the world) have elected to spend an extra year following their graduation from dental school in advanced studies of Esthetics, Lasers and Computer Dentistry.

Your first impression of Dr. Iott’s office is warm, friendly and inviting, like being a guest in your friend’s living room. Hot coffee, newspapers, books, and your favorite magazines beckon you to sit down in the comfortable chairs and just relax. Down the hall, a 14 room complex resembles a true urban medical center, staffed by men and women dentists who, in addition to teaching responsibilities and hospital careers, provide a full range of dental services in this private and modern setting.

Dr. Iott and his team offer all dental services except orthodontics. Most of our doctors are professors at NYU Dental Center or the Columbia University School of Dentistry and are on staff at NYC hospitals. There is no other dental treatment facility or dental school in New York City that can compare with the array of modern equipment available at Dr. Iott’s offices. State-of-the-art computerization allows an array of pre-reconstruction photos, analyzed by our Director of Laboratory Services and our dental team, who create the final image of your new smile for your inspection right before your eyes.

If you notice that our office design is unlike any other you've seen, it’s of the expertise of our design consultant, who works with an international firm to create warm, inviting spaces you enjoy visiting. In fact, you may have seen an article about Dr. Iott's life and work on the front page of December 10, 2001 New York Times Home section. Our office has also been featured in Health Magazine, American Express Departures Magazine, The New York Times, The Irish Times (Dublin), and Tennis Magazine and has been chosen for a segment on Discovery Channel's Medical Breakthroughs! Dr. Iott and his practice have also been featured on NBC with Tom Brokaw and ABC with Peter Jennings.

Dr. Iott’s staff makes it easy and convenient to plan your dental visits around your busy schedule. We offer extended appointment times during the morning from 6am to 8am, and during evenings from 7pm to 9pm to accommodate those who work during the day. We also offer 24-hour emergency care to our patients, and limited care for our disabled patients who are homebound.

Why not click here to contact Dr. Iott’s office and schedule your consultation? We look forward to meeting you!

Are You a Candidate for CEREC?

2007-12-20T16:36:00.000-05:00

If your cosmetic dentist has told you your teeth are in need of restoration, you’ll be happy to know there is a revolutionary new method available that has done away with the long waits and other old-fashioned hassles of restoring your teeth. It’s called CEREC (Chairside, Economical Restorations of Esthetic Ceramic), a new technology that allows dentists like Dr. Michael Iott to create natural looking, durable restorations in as little as one visit. In fact, Dr. Iott was responsible for bringing the very first CEREC machine to the United States, as part of his continuing goal of optimum patient care. Best of all, studies show CEREC restorations are as durable as gold, a substance that has long been held as the industry’s quality standard.

How does CEREC work? Dr. Iott will examine your teeth and discuss the best course of treatment with you. If CEREC restoration is appropriate, Dr. Iott will begin to prepare your tooth or teeth for the restoration. First, he creates a high-resolution optical impression of the tooth and, from that, a ceramic restoration. The CEREC milling machine then sculpts your ceramic restoration from a porcelain block. 15 minutes later, Dr. Iott will test your CEREC restoration for fit and bond the restoration to your tooth permanently. It’s as easy as that.

If you need inlays, onlays, crowns or veneers, CEREC technology may be the fast, convenient answer you’ve been looking for. Schedule a free consultation with Dr. Iott today get started tomorrow on restoring your smile!

Teeth Whitening: Home Kits v. Professional

2007-12-19T16:40:00.000-05:00

Today, everyone can have a brighter smile, thanks to whitening systems like BriteSmile, and whitening toothpastes by Rembrandt, as well as Crest whitening strips, paint on gels, and a host of other products on the market. But should you choose professional whitening or do-it-yourself home whitening?

Many in office bleaching systems have been vastly improved, and work because light activated bleaching agents and carbamide or hydrogen peroxide act together to oxidize stains and give you the pearly whites you desire. In office whitening procedures can be inconvenient, requiring an initial trip to the dentist’s office, and touch ups every four to six months. As well, professional whitening is certainly far more expensive than over the counter systems, but because your dentist has access to stronger peroxide solutions than are available over the counter, professional tooth whitening systems tend to offer greater whitening power in about an hour for under $500.00. Your dentist is permitted to administer a whitening product that contains as much as 38% peroxide, levels not available over the counter due to safety regulations.

With home whitening systems, the level of peroxide is no higher than 12%. However, you can perform the procedure at your convenience in the privacy of your home, and repeat the procedure as you wish, a big plus for many. The lower cost for over the counter products is also appealing.

Chemically whitened teeth will always remain lighter than before whitening. However, some may experience hypersensitivity to teeth whitening procedures. Using Sensodyne when brushing can help to alleviate this problem.

Whether you choose the more expensive but longer-lasting professional whitening, or the do-it-yourself system, the number of options available today means that anyone can have a beautiful smile with very little effort.

Wow! Cosmetic Dentistry Can Make A Difference

2007-12-12T03:54:00.000-05:00

These photos were taken after we completed some recent cosmetic dentistry treatments for a patient. Not only do we specialize in this type of dentistry, we absolutely love doing it and giving our patients smiles they never thought possible.
Thanks for the opportunity to offer these types of results!
Dr. Spieler

Creating More Smiles

2007-12-12T03:21:00.000-05:00

This is an example of a maxillary porcelain veneer patient. It shows the facial change that can come from having restorative dentistry treatments at our office. Come in and see what we can do for you and see more of our before and after results.

Dr. Eric Spieler

Veneers In A Day!

2007-12-12T02:59:00.000-05:00

Porcelain veneers have become one of our most popular options to improve our clients' smile and bite. Today, many busy consumers want the results without having to go through multiple visits and long hours in the chair. With Cerec technology, we offer one-visit porcelain veneers. This is a patient that just had them done in our office. As about it when you call our office.

Dr. Eric Spieler