Spring Lake Dental Group

Your Story

Author: Kimberly N. Powell, DDS, MS, FAGD

A recent article in AGD Impact (monthly news magazine for the Academy of General Dentistry) highlighted the importance of listening to patients’ stories. The author details his experience with a patient who was homeless. His living situation was the result of the side effects of a drug that caused him to lose his job, home, and his relationship with his daughter. His dental appointments allowed him to stretch out his 6 feet, 4 inch stature in the dental chair, a commodity not easily attained living in his Toyota sedan. We all have a story. Our patients’ appointments can last a few minutes to hours, and although we are tasked to provide a service for you in a designated time frame, we also want to provide a space for you, our patients, to share your story. At Spring Lake Dental Group, we never want to treat a stranger, and we see every patient as a family member. Family listens, family shares, family helps, family cares. Your family at SLDG is here for you, and thank you for listening to our stories.

What Is Toothpaste?

Author: Dr. Sarah Mischo, DMD

Walking down the oral hygiene aisle can be daunting, but whether it’s the flavor, texture or creative packaging that draws us to a product, we all have our preferred brand of toothpaste. There are so many different forms of toothpaste on the market these days, however, a question that you may be asking yourself is,  “what should I be looking for in a toothpaste?” Unfortunately, the answer to this question is specific to each person depending on their oral health care needs. A patient may need a sensitivity toothpaste, or a toothpaste that helps fight gum disease or tartar build-up, or a toothpaste with a higher level of fluoride to help prevent cavities.

While the ingredients may vary slightly between brands of toothpastes, they all contain a similar general base formulation that consists of:

  1. Mild Abrasives- such as modified silica particles. The abrasive component helps remove plaque and stain and may help with whitening the teeth. On every toothpaste there should be the letters ‘RDA,’ which stands for Relative Dentin Abrasivity. This is a standardized scale that ensures the tooth paste’s abrasive properties are safe to use and won’t cause damage to the tooth structure. When purchasing a toothpaste look for a toothpaste that has a RDA value of 250 or less.
  2. Humectants-ingredients that help prevent the toothpaste from drying out or getting a gummy consistency.
  3. Flavoring agents- one of the most important ingredients when choosing a toothpaste. The flavoring in toothpaste can either be natural (i.e. peppermint, spearmint etc.) or come from an artificial flavoring. All American Dental Association accepted toothpastes use flavoring that contain no sugar.
  4. Thickening agents- also known as binders. The binders help stabilize the toothpaste.
  5. Detergent- such as Sodium Layryl Sulfate. This is what causes the toothpaste to become “foamy”.

Whatever toothpaste you decide to use, one key ingredient you need to look for is fluoride! Fluoride plays a vital role in preventing tooth decay. The fluoride in toothpaste may come in the form of sodium fluoride, stannous fluoride or sodium monoflurorphosphate. The average household toothpaste contains 1000-1500 ppm (parts per million) of fluoride in it. Fluoride is safe and effective at helping prevent dental decay!

      *Children under 3 years of age- should brush 2x a day using  a smear of fluoridated toothpaste

     *Children 3-6 years of age- should brush 2x a day with a pea sized amount of fluoridated toothpaste

The last thing you should look for on your toothpaste packaging, is the American Dental Association (ADA) Seal of acceptance. For a full list of ADA accepted toothpastes, you can visit the American Dental Association website.

The next time you are in, feel free to talk to your dental provider about your toothpaste!

Thankful For

Author: Dr. Alison Vitelli, DMD

We are living in very hard and challenging times, and I know you can agree with me on this. COVID-19 has made everyday life a true mystery at times. But, with Thanksgiving and Christmas just around the corner, I wanted to take this moment for us to reflect on all the blessings we have had in spite of the obstacles we have faced.

We are blessed to see a new day, crisp fall weather and beautiful leaves changing. Just being granted one more day, is a reason to be thankful. This is another opportunity to make better decisions, hold our loved ones tight and tell them how much we love them. Maybe a chance to forgive and mend relationships, or make new memories.

Give thanks to those who are around you: family, friends, co-workers and neighbors. If we have learned anything this past year, it is that life is uncertain and we shouldn’t be wasting moments by being upset with one another, but rather enjoy the company of those around you. Show appreciation even in little things.

Here at Spring Lake Dental Group we are more than thankful to our patients and all of our staff. You all have been working along with us during this pandemic and have been more than understanding with all the new rules and safety regulations. Thank you for trusting us and support our efforts on keeping you healthy and safe. We couldn’t have done it without you!

An Update and A Lesson

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

Here we are, about to enter the holiday season already and I want to remind you that Spring Lake Dental Group remains committed to your safety in assisting in fighting this pandemic. My physician friends are starting to use the word “endemic” as they evaluate the results and recommendations from CDC but continue to use extreme vigilance when enforcing all of the protocols in preventing the spread of this deadly virus among our patient population. We are not there yet but encouraging the vaccination of our younger population is going to be key in gaining the upper hand in combating this pandemic. I hope to have a modified holiday celebration with my large family this year as we have not gathered formally for a year and a half. 

I would also like to remind you that the practice will be closed on Thursday, November 11, 2021 in honor of Veteran’s Day. As we are located in the center of the military universe here at Fort Bragg, I wanted my patients and employees/health care workers to have the ability to reflect on this occasion and to honor their service and sacrifice.  As is our custom, the reception room will have a Missing Man table erected in recognition of those veterans who are no longer among us.  From November 8-23, 2021, I invite you to bring in any pictures or mementos that honor any past service member and place them on the table to help drive home the message of their service to our great country.

Our training day this week was dedicated to learning more about vital pulp therapy. This is a term which describes treatment options on teeth that have deep carious lesions that involve or potentially involve the pulp of the tooth. Once decay decalcifies the tooth and penetrates the enamel, it is into dentin which is the protective layer over the pulp of the tooth. The pulp contains arteries, veins, lymphatics and nerve tissue that consist of the living parts of the tooth. The outer dentin is not very porous, but as you get close to the pulp, the dentin becomes microscopically much more porous. Therefore, any restorative materials that you place on deep or porous dentin are going to have a large affect on the vital pulp. Materials have been used in the past that have attempted to calm down pulpal tissue and stimulate a reparative dentin bridge over this area. But recent advancements have allowed us to achieve this result much more predictably.

When you have a carious exposure of the pulp, the traditional approaches have been to attempt a direct pulp cap with materials such as calcium hydroxide or to advance directly to a root canal. Root canals are expensive and deprive the tooth of vitality. Attempting vital pulp therapy is a conservative technique which has traditionally not resulted in a positive outcome. But newer materials that have been developed are allowing us to manage our patients with a much better chance or retaining a vital tooth that is asymptomatic. A bioactive trisilicate (Biotine by Septodent) has been shown to cover exposed pulps that are healthy and only reversibly symptomatic and keep the pulps healthy and vital. They also have been shown to stimulate the odontoblasts (dentin cells that produce new or reparative dentin) to lay down a reparative dentin bridge over this exposure. By using this technique, we can often avoid time consuming root canal therapy that usually also requires crown coverage of the tooth.

Orthodontic Treatment and Dental Hygiene

Author: Angela Weaver-Blake, RDH

This blogs topic will be aimed primarily to those patients who have completed orthodontic therapy and notice that they have some disturbing white spots on their teeth where their brackets were placed.

Orthodontic treatment is initiated for lots of different reasons. Sometimes we are treating a skeletal problem and are trying to influence growth in a developing adolescent. Other times we are addressing crowding and a developing malocclusion. Having malformed or congenitally missing teeth is also a problem that can be solved through orthodontics as well as impacted teeth that need our assistance in erupting into the mouth. Whatever your diagnostic problem is, having anchorage to address these problems through orthodontic brackets and bands may lead to these unaesthetic white spots. The white spots do not develop because of bracket placement and are not an inevitable side effect with orthodontic treatment. They develop because of hypo-mineralized enamel around the bonded surface of orthodontic brackets. These hypo-mineralized areas are usually a result of less than optimal oral hygiene while undergoing orthodontic treatment. Bands, brackets, arch wires, ligatures and elastics all work to complicate plaque removal during brushing, flossing and other oral home care efforts. Having stellar home care and routine dental hygiene visits are a large part of avoiding these hypo-mineralized areas. They are unsightly and are usually only visualized after bracket removal. But what are my options? Should I notice them after braces are taken off? The answer is now available for you and your hygienist to explore.

Your registered dental hygienist can talk with you about a specially developed infiltration product for smooth tooth surfaces, particularly well suited to remove white spots and treat incipient caries, especially those related to orthodontic treatment. It is designed for esthetic improvement of non-caries related lesions caused by demineralization and/or mild to moderate fluorosis on smooth surfaces. This product cannot be used for areas that have developed caries that are through the enamel (you need a dentist to restore these areas). But areas that are demineralized within the enamel can be treated effectively without anesthesia (numbness) with a long-lasting result. As with all dentistry, the results and their longevity are tied to individual home care and appropriate maintenance.

The procedure discussed above involves isolating the teeth with white spots and etching out with acids all of the pigmented discoloration. An ethanol drying agent is then applied to the involved teeth to allow a resin infiltration material to flow into the etched surface. This is hardened with an LED polymerization light and subsequently polished. This technique can also be applied to any tooth that is discolored or unsightly as long as the diagnosis is that the discoloration is within the enamel layer. The resin infiltration layer does not preclude the tooth from getting further dental treatment should it be necessary or absolutely protect it from potential dental disease in the future. The technique simply reinforces less than perfect enamel and fills in at a microscopic level the imperfections that may be present in the tooth’s facial enamel structure.

As an esthetic procedure, you will find that there probably is no insurance coverage for this procedure. We are currently offering this procedure at $94.00 per treated tooth. Sensitivity and an imperfect correction of the white spot are potential downsides. Most patients have reported that sensitivity is decreased with this procedure and while perfect esthetic results are not always achieved, a much better esthetic result is the normal outcome.

Address your concerns with your hygienist. They are there to answer all of your questions.

Mask Mouth

Author: Shannon Sutton, RDH

Have you noticed bad breath odor while wearing your mask? Although mask mouth is not an actual condition alone, it is a combination of side effects that dental professionals have seen with increased mask use. We have been in a pandemic for nearly two years and wearing masks are an essential and necessary part of daily life for most people across the globe.

What is mask mouth? Mask Mouth is a combination of several different conditions caused by a few different things.

1. Dry mouth- you tend to breath more through your mouth than your nose when wearing a mask. This leads to less saliva production causing dry mouth. Your are also less likely to drink adequate water causing dehydration while wearing a mask.

2. Halitosis- less saliva leads to less natural cleansing of teeth after eating. Food gets stuck on your teeth and oral surfaces such as your tongue. This leads to halitosis aka bad breath.

3. Increased risk of tooth decay and bleeding gums- lessened salivary flow can also cause an increase in tooth decay and gingivitis. Sugars that sit on your teeth after eating and drinking don’t get washed away by the normal saliva flow. This leads to increased bacterial numbers which lead to more cavities and swollen gums.

What can you do? There are some things you can do to combat that stinky side effect.

1. Have great oral hygiene- don’t skip brushing and flossing daily. Add a mouthrinse for dry mouth to help keep your tissues moisturized if you notice prolonged dryness. You can also chew gum with xylitol sugar to help stimulate saliva.

2. Get plenty of water- try to schedule water breaks into your day, especially after eating.

3. Have good mask hygiene- to lessen bacterial exposure you should be washing reusable masks after each use or once a day. Surgical masks are single use only so they should be thrown away after each use or at the end of the day. Using a dirty mask increases your risk of bacterial exposures.

4. Avoid excess sugar and eat a well balanced diet. Less sugar means less tooth decay!
Try these tips to prevent and stop those nasty side effects that can occur with frequent mask use! Hope this helps you!

To Floss Or Not to Floss: Traditional Flossing vs. Water Flossing

Bonnie Lott Author: Bonnie Lott, RDH

Over the past several years, changes in marketing by leading companies have began to mislead many to think that “water flossers” are the answer to their prayers, and traditional flossing is no longer necessary. Now let me start by saying, that as a hygienist, I’m a fan of anything that helps my patients achieve better oral health. If you like it and are willing to use it, go for it! But… please realize the differences and then determine what will work best for YOU.

The idea of cleaning between the teeth has been around for as long as teeth! History shows early use of things such as horse hair and twigs to clean between teeth. Traditional floss filament was first introduced in New Orleans by Dr. Levi Parmly in 1815 and was made from silk thread. Since then, floss has had several upgrades, evolving to nylon at the height of World War II when silk was deemed too expensive. Today we have an array of tools available to us. Just cruise down the aisle of any store and WOW products galore! It can be overwhelming to know what to use. Don’t be afraid to try different things to see what works for you and don’t forget that your dental hygienist is a great source of knowledge. 

So, now back to the question… what should I use, traditional floss or a water flosser? The answer is simply BOTH! Let’s explore the difference just a little so you’ll understand my meaning.

The main idea behind flossing is to remove food debris or plaque (biofilm) which your toothbrush cannot reach. Did you know that brushing alone only reaches approximately 70% of teeth surfaces? That’s a whopping 30% of your tooth surface that you are missing if you skip flossing! (Imagine that’s like taking a shower with your shoes on! Yuck!) Over time, the bacteria you miss builds up and can irritate gum tissues and put you at risk for not only bad breath, decay, gum issues and potentially lead to bone loss if untreated. Simply put, flossing equals better health and easier dental visits.

Most of you are probably familiar with traditional floss, so what’s up with water flossing right? Water floss, or irrigation has been around since the early 1960s. It is a wonderful method to irrigate around complex dental work, braces, or just a nice gum massage. This is also a great alternative for patients that are unable to floss by traditional methods due to dexterity issues, etc. Water flossing is simply a jet spray of water that when angled properly along the gum line clears debris and irrigates.  Now, imagine you’re washing your car… do you get that water hose out, spray it down and call it clean? Nope, not yet! Grab that sponge and put some elbow grease in to get that ride all shiny! This is the same for your teeth. Brush, floss, and water floss. Water floss will irrigate and remove what your regular brushing and flossing might miss and if you are a patient with periodontal issues the water flosser is a wonderful irrigator, reaching up to 6mm below the gumline!

So there you go, it’s not an either or, but a combo punch to bacteria!


Author: Kimberly N. Powell, DDS, MS, FAGD

This month is Breast Cancer Awareness Month. I cannot imagine the emotional and physical toll that a woman endures during diagnosis and treatment. I do know the emotions that a family member/friend feels. According to BreastCancer.org, about 1 in 8 U.S. women (about 13%) will develop invasive breast cancer over the course of her lifetime. Breast cancer became the most common cancer globally as of 2021, accounting for 12% of all new annual cancer cases worldwide, according to the World Health Organization, and about 85% of breast cancers occur in women who have no family history of breast cancer and occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations. According to the American Cancer Society, women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so, women age 45 to 54 should get mammograms every year, and women 55 and older should switch to mammograms every 2 years, or continue yearly screening. For patients being diagnosed, treated, recovering from breast cancer, family, friends, coworkers, partners are here to help, to pray, to love.

October is National Dental Hygiene & Orthodontic Month

Author: Tracey Perry Johnson, RDH

October is National Dental Hygiene & Orthodontic Month

  • Dental Hygienist: Licensed dental health care providers who use a variety of interpersonal and clinical skills to assess, treat and provide oral health therapy to patients. This includes but is not limited to dental prophylaxis (cleaning) and periodontal therapy.
  • Orthodontics: The treatment of irregularities in teeth and jaw, generally entails the straightening of crooked teeth or the correction of a poor bite, or malocclusion.

At Spring Lake Dental Group, our team of hygienist help to assess overall oral health during the hygiene appointment. We educate patients about ways to improve and maintain good oral hygiene habits to prevent disease! Our orthodontic team works to enhance function and esthetics of your teeth. We work together to help you achieve the smile you desire.

How do we work as a team? Think of hygienists as inspectors, checking for signs that Biofilm may be present. When Biofilm remains on the teeth demineralization/hypo-calcification can occur, which can result in “white spots” which can detract from your smile. It is imperative to visit your hygienist before, during and after orthodontic therapy. Think of Dr. Whitehead as a “teeth architect” aligning & strategically moving teeth in the best position to achieve a functional and esthetically pleasing smile. At Spring Lake Dental Group, we are proud to have Dr. Thorpe Whitehead as our Board Certified Orthodontist. Formerly, Colonel Whitehead, completed his military career at Ft. Bragg as Chief of Orthodontics. Dr. Whitehead and his team of assistants are available on Wednesdays and the one Saturday a month that we are performing patient care. Our wonderful team of hygienist are available daily! Give our office a call to schedule for a hygiene or an orthodontic appointment. We’d appreciate the opportunity to be an integral part of providing your dental care needs.



*Biofilm : Sticky film which can consist of  plaque, tartar and calculus that can lead to cavities, gingivitis and periodontal disease.

*Hypo-calcification/Demineralization: “White spots” which appear as defects on the teeth

Meet Dr. Sarah Mischo

Author: Dr. Sarah Mischo, DMD

For those of you that I have not had the pleasure of meeting yet, my name is Dr. Mischo and I am the newest dentist to join Spring Lake Dental Group! For me and my family, this summer was filled with plenty of miles driven and sights seen. Our 2,879-mile journey began in Seattle, Washington and covered eleven different states before finally bringing us to North Carolina, but my road to Spring Lake Dental Group began long before then.

I attended the University of Minnesota-Twin Cities (Go Gophers!) for undergraduate school and received a bachelor’s degree in nutrition. I then traveled south to Midwestern University in Glendale, AZ to receive my dental degree. After graduating from dental school, I completed an elective hospital-based residency program through the University of Washington in Seattle. The journey has not been short or easy, but I am so grateful for the people I’ve met and all of the experiences I’ve had so far. Every person has a story, and as a practitioner I love hearing my patient’s stories and getting to know them on a personal level!

A little bit about me: my husband and I both grew up in a small town in Northeastern Wisconsin known for manhole covers and cold, snowy winters. We are high school sweethearts, Packers fans through-and-through, and are excited to be welcoming our first child in February 2022. When I’m not working, I love spending time outside, hiking, skiing, and kayaking. I am an avid reader,  so if  you happen to be a lover of books I am always looking for a good recommendation.

I look forward to meeting each and every one of you as I continue my professional journey with Spring Lake Dental Group!