From January 2023
Oral Health and Your Overall Wellness—The Connection
If it has been a while since you have been to the dentist, you may be surprised by all the latest technology, expanded offerings, and modern treatment options available at your next visit. Even if you have never heard of some of these newer services, there is a good chance you will need—or want—a few of them, particularly those that can shave a few years from your appearance.
Sure, you can get your teeth cleaned and a cavity filled while you are in the dentist chair, but there is more about your dental health to consider. The connection between healthy teeth and gums and one’s systemic health is strong, and dentists are making it a priority to educate their patients about its importance. From noninvasive treatments that reduce snoring to gentle lasers to treat gum disease (a potential indicator of heart disease) today’s modern dental office is geared toward comprehensive patient health. And with spa-like amenities designed to make you feel more comfortable and relaxed during your treatment, you will wonder why you have been putting off making an appointment.
The COVID-19 pandemic taught us many things. Among those lessons is the importance of having a strong immune system. Maintaining a nutrient-rich diet, taking vitamins, and engaging in an active lifestyle all play a role in strengthening the immune system. Add to this list taking care of your periodontal health. Gum health is often overlooked, but shouldn’t be, as medical researchers have found a direct link between oral health and overall systemic health.
Gum disease, or periodontal disease, has been linked to diabetes, respiratory disease, and certain cancers. Poor oral health has also been connected to pre-term birth, and researchers have discovered a link between gum disease and Alzheimer’s disease as well. “Periodontal disease is quite prevalent,” says Dr. Mark Sowell, M.A.G.D., A.A.C.D., with Sensational Smiles in Plano. “When you have periodontal disease, the biofilm and plaque around your teeth destroys bone support, which leads to bacteria getting into your blood stream. This causes an inflammatory response that weakens your immune system, making it harder on your body to fight illnesses.”
Gum disease can be an indicator of heart disease, too. The plaque in your mouth is the same plaque that clogs arteries. “I have had patients come to our practice for treatment of gum disease because they were referred by a cardiologist or other specialist,” Dr. Sowell says. “The doctors have asked them to treat their gum disease before taking the next medical steps.” Anaerobic bacteria from the mouth associated with gum disease have been found to migrate to the circulatory system and increase the risk of sudden heart attack and stroke, says Dr. Mary Swift with Dallas Laser Dentistry. “Studies continue to be published that show more and more places gum disease bacteria go in the body, leading to generalized inflammation,” she says. “This is a likely cause of chronic disease.”
When harmful bacteria grow in the mouth and gum disease remains untreated, the body stays in an inflammatory state, making it more difficult to fight disease and illness. “When we treat the oral cavity, it’s like a window into the rest of your health,” Dr. Sowell says. “The link between systemic health and oral health was discovered about 15 years ago, and we are learning more all the time. There is no magic pill to treat gum disease, which is why it is important to identify and treat it early so it doesn’t continue to cause issues.”
Dr. Salvatore La Mastra, D.M.D., with Hamlett & La Mastra, D.D.S., takes ample time with his patients to discuss the link between oral health and their general health. Most patients, he says, aren’t aware of the connection. “If you have healthy gums, you may have a reduced risk of disease because there is a reduced chance of infection in the body, as many systemic diseases start with the oral cavity,” he says. “Beyond that, aligning teeth if they are crooked makes it easier to floss and clean. Therefore, correcting your bite could potentially keep the entire body healthier.”
Dr. Ashly Cothern, a general and cosmetic dentist, says that because the health of the mouth and the body’s health are so intimately connected, it is imperative to maintain good oral hygiene. “If you have inflammatory properties in your mouth, those same inflammatory properties can get into the bloodstream,” she says. “Much of what ails us begins with inflammation in our bodies. There is a lot about health we can’t control, but there is also a lot we can control—like daily brushing and flossing. See your dental professional regularly to keep your mouth healthy, which can lead to overall wellness.”
Sleep and Look Better with the Help of Dental Lasers
From treating periodontal disease to gum shaping to eliminating snoring, lasers have taken center stage in many of today’s dental offices. Some traditional procedures, particularly those involving the gums and soft tissues in the mouth, once required cutting with a scalpel. With the use of lasers, these same procedures are less painful and yield better results.
Dr. Melisa Christian frequently uses lasers in her state-of-the-art dental practice, Dallas Dental Concierge, for general dental procedures and aesthetic procedures. She spends much of her time outside of her busy practice completing continuing education courses and learning about the latest dental technologies that can benefit her patients.
Dr. Christian provides most every general and cosmetic dental service at her practice. Recently, patients have requested aesthetic laser procedures in addition to routine dental care. She uses the Fontana LightWalker for LipLase, SmoothLase, and NightLase treatments. While there are several specialized lasers that can be used in the mouth, the Fontana LightWalker is the only laser with patented quantum square pulse (QSP) technology, affording it much greater results when interacting with both hard and soft tissues. Dr. Christian uses this laser in the mouth to improve lip volume, eliminate wrinkles around the mouth, and treat symptoms of sleep apnea.
LipLase. This procedure is designed to enhance the body’s natural production of collagen in the lips. In turn, the lips fill out more due to increased volume. To achieve the best results, Dr. Christian recommends two or three treatments scheduled 21 days apart that take around 30 minutes each to perform. Many patients find LipLase to be a desirable alternative to injectable lip fillers due to its noninvasive nature. “There is a huge subset of patients who want an enhanced look for the lips—similar to the way their lips looked 10 to 15 years ago,” Dr. Christian says. “However, many of these same patients don’t want to inject fillers into their lips. The great thing about LipLase is that you can get fuller-looking lips immediately, and the laser adds some color due to enhanced blood flow to the lips. Loss of color and volume in the lips are natural results of aging. With a yearly touch-up, patients are happy with these laser results because they still look like themselves. A naturally appearing fuller lip isn’t always achieved with injectables.”
NightLase. Patients with sleep apnea have several treatment options, and at their dental office, NightLase is one of them. NightLase is a simple and fast procedure that can tighten the tissues within the throat, reducing snoring and keeping the airways open throughout the sleep cycle. Patients usually need anywhere from three to four sessions before they will notice peak results. After this, Dr. Christian recommends scheduling maintenance sessions about once every eight to 12 months. “Patients love NightLase because it addresses snoring by enhancing their airway and treating the soft palate and tongue with near-infrared light therapy—all without cutting or pain,” Dr. Christian says. “Activating the mitochondria helps stimulate collagen production. As we get older, the cells that make collagen aren’t as active—but they’re still there, only dormant. When I do a NightLase treatment, I am going in at the cellular level noninvasively and reactivating those cells to boost collagen production.” Changes continue for up to six months as the soft tissue tightens. Patients not only report breathing better in general, but their snoring is substantially improved. “We usually can’t eliminate snoring with laser treatment, but there is a significant reduction,” Dr. Christian says. “Some of my married patients say they were almost at the point of moving to separate bedrooms because the quality of their sleep was affected by snoring. Sleep is critical for you and your loved ones, and NightLase is a simple, quick, and effective way to get more of it!”
SmoothLase. A common sign of aging is the formation of wrinkles around the mouth. SmoothLase is a noninvasive procedure that tightens skin around the mouth by treating the tissue from the inside, thus alleviating wrinkles and restoring a youthful appearance to the face. “I have had patients complete this treatment and look 10 years younger,” Dr. Christian says. “The laser treatment rejuvenates skin from the inside. It’s a great alternative for those who don’t want fillers and Botox, but still want to look refreshed.” No numbing and no downtime are involved with SmoothLase, and each treatment takes about 45 minutes with a recommended annual maintenance treatment.
Dr. Maheeb Jaouni, a board-certified endodontist with The Dental Specialists, uses the GentleWave System in his practice to disinfect teeth during a root canal. GentleWave uses sound waves to clean the teeth, meaning there isn’t a need to cut the tissues, and more of the tooth’s structure is maintained. “It cleans better in the side channels and is more efficient,” Dr. Jaouni says. “Because of its efficiency, patients don’t have to be in the chair as long and report less postoperative discomfort.” When patients need a root canal, they, of course, want the least painful treatment option. “With traditional root canals, there is a greater chance of missing areas inside of the tooth, meaning the likelihood of losing the tooth is higher,” Dr. Jaouni says. “With GentleWave and with laser technology, we have a greater chance of saving the tooth.”
Laser dentistry is noninvasive, which means patients can usually receive multiple treatments in one visit. Dental lasers also mean there will be no sutures or surgery, little or no downtime after treatment, faster healing, reduced risk of infection, and a reduction in swelling and bleeding. “I like to call it the latest in the ‘non-cutting edge’ dental technology,” Dr. Sowell says. “In many cases, lasers completely replace the older cutting methods of oral surgery. We can also treat a lot of early gum disease more effectively than we can with typical modalities, like scaling or root planing. Often with those modalities, the biofilm on the gums is never completely removed. The bacteria population is reduced, but remnants remain. A laser will remove all the biofilm that accumulates—the cause of gum disease.”
Dr. Sowell also uses lasers for bone and gum grafts, drill-free dental fillings, gum lifts and reshaping, TMJ therapy, and teeth whitening. “We also use lasers to decrease pain post-surgery, such as after having wisdom teeth removed or after periodontal surgery, implant placement, or a bone graft,” Dr. Sowell says. “Lasers speed healing. Patients come in once a week after their surgery for low-energy laser therapy. It’s a wonderful tool because it reduces pain for patients during and after the procedures that typically cause the most discomfort. The healing is accelerated so patients experience better results.”
Dr. Sowell says patients have told him they have avoided going to the dentist because they feared the sound and feeling of dental drills. “With laser dentistry, the sound, vibrations, and pressure of a drill is eliminated,” he says. “Removing the drill from your treatment also removes the emotional stress it causes. I use dental lasers in almost every phase of patient treatment to ensure conservative, comfortable, rapid healing This minimizes the need for anesthesia, allowing busy people to get dental treatments in fewer visits, as well as causing less interruption of their ability to speak and chew during the business day. Patients who receive laser dental treatments tell me they can feel the procedure somewhat, but it’s not painful, especially after we put on a topical numbing gel. Most patients, and dentists, prefer laser dental treatments because they are more comfortable and promote faster healing.”
Whether you have had crooked teeth since childhood or because you didn’t wear your retainer as your orthodontist recommended, there is now a quick, discreet, and aesthetically pleasing way to get the straight teeth you have always wanted. Many adults don’t have the time to dedicate to a lengthy orthodontic treatment plan and are concerned about what a mouth full of metal will look like in their professional career. For more than two decades, Invisalign has been an option for patients who want a less noticeable way to straighten their teeth. Dr. Nadia Lyotard with Highland Park Orthodontics specializes in Invisalign. She has considered offering her patients other clear aligner systems as they enter the market, but says she has always found their 3-D design tools to seem like a step backward compared to the intricate manual controls offered by Invisalign, which she relies on to deliver beautiful, custom results for her patients.
Dr. Lyotard has become an Elite Platinum Invisalign provider and has combined her adult Invisalign expertise with her extensive experience in providing children’s orthodontics to offer Invisalign for Kids and Invisalign for Teens. “I typically recommend using Invisalign for adult patients, simply because it is much more aesthetic,” Dr. Lyotard says. “And, it is a gentler way of moving the teeth. Most adults no longer have virgin teeth, so to straighten their teeth, we may need to work around implants, bridges, crowns, and worn or missing teeth. We get the best results when we work with a patient’s general dentist and other specialists as a team to coordinate care.” Invisalign is often the first part of a smile restoration, followed by gum contouring, implants, and other cosmetic dentistry procedures as needed. Invisalign is now also becoming increasingly popular with Dr. Lyotard’s kid and teen patients who love Invisalign’s more grown-up look as well as the flexibility they have to remove them for school photos and social events. Although Dr. Lyotard prefers Invisalign because the software allows very precise and detailed results, she is also sought after for her results with traditional braces, which can be a more effective option for some patients. And for some cases, she combines Invisalign with traditional braces for an optimal result.
For patient comfort, Dr. Lyotard is currently one of a select number of doctors in Dallas offering the FDA-approved OrthoPulse light therapy device, capable of significantly reducing orthodontic treatment time with increased comfort. “This at-home treatment increases the body’s ability to adapt to the teeth moving as a result of orthodontic treatment,” she says. “I often recommend this for adult patients because it causes the teeth to move faster, which means their treatment time is reduced.”
Dr. Lyotard stresses to her patients that the order in which they undergo corrective or restorative work is just as critical as having quality work done, particularly with treatments such as implants that cannot be moved later or crowns that are specifically shaped to fit their surroundings. “If you are planning on either, consult with an experienced orthodontist for a plan to align the foundation of your smile before moving forward on finishing details that are either difficult change or cannot be changed later,” she says.
Dr. Patty Fleming, an orthodontist with Fleming Orthodontics, frequently treats her patients with Invisalign as well as numerous other straightening options, from traditional braces to braces hidden behind the teeth. Whatever reason her adult patients have had for avoiding braces, she can offer an aesthetically pleasing solution. In addition to discussing orthodontic options with her patients, Dr. Fleming spends time assessing the function of their mouth and bite, especially as it relates to proper breathing and, ultimately, sleep quality.
“How we breathe and how we sleep are so important,” she says. “Of course, everyone wants straight, perfect teeth, but when you zoom out to look at the larger picture, this is only part of the equation because the bones that hold the teeth in the top and lower jaw—and how they relate to each other—are just as important. This positioning affects how air comes in through the nose and throat. I look for the root cause of the problem. In children, we can use orthodontics to modify the size and position of their jaw bones and make sure the air is going in properly through the nose into the lungs. Expanders aren’t only used to make more room for the teeth but can be used for greater airflow through the nose. It is critical to address airflow first because of how it impacts one’s sleep. This affects how well we concentrate in the day and our quality of sleep at night.”
Dr. Fleming focuses on this aspect of dentistry at every orthodontic consultation, evaluating airway flow and making sure the top and bottom teeth align properly—all before discussing which type of braces to choose. If she pinpoints a concern, she often refers her patients to an ENT or sleep specialist to address airway function before starting orthodontic treatment for teeth straightening.
When it is time to select which type of teeth straightening system works best, Dr. Fleming offers clear aligners, such as Invisalign, lingual (behind-the-teeth) braces, traditional braces, and gold braces. “Gold braces have become quite popular with my adult patients,” she says. “Silver braces tend to look stark against the teeth—almost like black and white—but the yellowish undertones in teeth work well with gold braces. It’s almost like a neutral shade and provides a nice alternative.” Whatever type of braces adult patients choose, they usually tell Dr. Fleming they wish they didn’t wait so long to seek orthodontic treatment to straighten their teeth. “They are happy with the results and can’t believe what a difference it makes in their smile and self-confidence,” she says.
The Latest in Cosmetic Dentistry
Plastic surgery isn’t the only option to achieve a more youthful appearance. Cosmetic dentistry can turn back the clock, too, and is a less invasive way to look years—or even decades—younger. “In addition to whitening, porcelain veneers and crowns really enhance the shape, uniformity, and color of the teeth,” Dr. La Mastra says. “Even by changing the length, shape, and color of the teeth just somewhat, the results can be better than a facelift. Most studies show that the first feature someone notices about you is your teeth and smile. Cosmetic dentistry can be life-changing.”
When it comes to smile restoration, some patients are interested in minor adjustments and others may have concerns that require more intricate procedures. “Some smiles can be enhanced with simple whitening or dental bonding treatments, and others will require porcelain veneers, crowns, bridges, implants, gum contouring, periodontal therapy, or a combination of all these treatment options,” Dr. La Mastra says.
Dr. Cothern says new patients seeking a smile makeover often walk into her office hiding their teeth and even have a difficult time making eye contact with her, but once the treatment is complete, they are beaming. “Whether we treat just four teeth in the front of the mouth, whiten the teeth, or adjust alignment with Invisalign, even the most minor treatments make such a difference, and patients leave the office with a little pep in their step from their new-found confidence,” she says.
Dr. Christian says that while making a good first impression with a healthy, beautiful smile has always been important to her patients, in recent years, there has been even more focus on the achieving the perfect smile. She says video conferencing platforms, such as Zoom, can magnify a first impression. Smile makeovers, which can include everything from teeth whitening and clear braces to veneers and implants, help her patients feel more confident. “Their reaction is almost instantaneous,” Dr. Christian says. “Their entire face lights up. A lot of people think they will have to make several changes to improve their smile; they don’t. Even if it’s just one discolored tooth that has always bothered you—we can fix that. And sometimes, that one minor thing can make a huge, positive impact.”
The following treatments are among the most popular in Dallas area dental offices.
Whitening. Whitening treatments are the most requested cosmetic dental procedure in Dallas dental offices. Most patients choose either laser teeth whitening, power bleaching, or at-home supervised bleaching trays for convenience and affordability. Laser treatments, such as Zoom!, typically last one to three hours in a dentist’s office and can whiten teeth an average of eight shades or more. During the procedure, a special whitening gel and blue light laser treatment work together to when teeth to their optimal shade. Make sure to check if the in-office bleaching agents used have the American Dental Association Seal of Acceptance, an assurance that the product has met the ADA standards of safety and effectiveness. “Whitening is the least expensive cosmetic procedure and can make a big difference,” says Dr. Swift. “Whitening can make you look younger, since our brains equate yellower, darker, teeth with age. This is what will happen naturally when you age without cosmetic intervention.”
Veneers. Crafted from tooth-colored porcelain materials, veneers are thin, custom-made cosmetic enhancements designed to cover the front of the teeth. The size, shape, color, and length of the teeth can be enhanced with a thin layer of porcelain applied to your natural tooth. Porcelain veneers offer an aesthetic alternative to orthodontic care and are so durable they last up to 20 years. Porcelain veneers result in a natural-looking appearance because they are so thin. Veneers are a great option for people with gaps between their teeth, broken or chipped teeth, and unsightly stains and fillings. “The newest porcelains are more aesthetic looking and stronger, meaning not only do they look good, but they last longer,” Dr. La Mastra says.
Porcelain Crowns. A dental crown is a tooth-shaped cap that is placed over the tooth, covering it to restore the shape, size, and strength and to improve its appearance. Once cemented into place, crowns fully encase the visible portion of a tooth that lies at and above the gum line. Today’s porcelain crowns are now metal-free, which means you can avoid the dark lines and poor matching you see with old-style crowns. Porcelain crowns have a more natural look and are virtually imperceptible. The crowns blend with your other teeth as if they grew there.
Bonding. From lightening to restoration, bonding is a common solution for anyone seeking a healthier looking smile. Bonding is a composite resin filling placed in the teeth. Composites are the solution for restoring decayed teeth, making cosmetic improvements and even changing the color of teeth or reshaping them. Bonding will lighten stains, close minor gaps, and can sometimes correct crooked teeth. Bonding covers natural flaws by applying a thin coating of a plastic material on the front surface of the teeth followed by bonding material that can be sculpted, colored, and shaped to the patient’s liking. A high-intensity light then hardens the plastic, and the surface is finely polished.
Dental Implants. A dental implant is a small, yet sturdy titanium post that acts as the root structure would for a natural tooth. Dental implants are often necessary due to loss of a tooth or several teeth due to injury or disease. Dental implants are placed into the upper or lower jawbone. Once the bone has grown around the implants, they can hold a crown, bridge, or denture just like roots hold natural teeth in place. Permanently anchored to the jawbone, dental implants restore chewing ability, provide support for the facial muscles, and prevent jawbone atrophy. Most of today’s implants are designed to last a lifetime.
Dr. Swift says most of her patients who come to her for a smile makeover also want to straighten their teeth or replace missing teeth. She says patients are often relieved to learn that some cosmetic procedures, such as replacing a missing tooth, can also have health benefits by maintaining bone structure in the skull/jaw, which could eventually disappear if there is no tooth to stimulate the bone. This can lead to a “collapse” of the facial/skin structure, even when the teeth aren’t showing. She says most patients believe a smile restoration is worth the time and financial investment. “When you are proud of your smile, you smile more often and bigger,” Dr. Swift says. “Smiling triggers endorphins, which makes you feel happier. Knowing you have a great smile generates tremendous self-confidence.”
Ashly Cothern, D.D.S.
Dallas Dental Concierge
Dallas Laser Dentistry
The Endodontic Specialists
Hamlett & La Mastra, D.D.S.
Highland Park Orthodontics
Mark Sowell, D.D.S., M.A.G.D.