Spring Lake Dental Group


Author: Kimberly N. Powell, DDS, MS

I am currently wearing traditional braces and have not followed my orthodontist’s recommendations. Because of my noncompliance, not wearing my elastics, my treatment is ongoing in excess of three months so far. Although I have easier access to care considering I work in the same office as my orthodontist, accelerating treatment is not possible. At this stage of care, elastics (rubber bands) are used to correct the bite, how the upper and lower teeth meet. They are to be worn 24/7 except for the TRIAD – To brush, To eat, To replace. Yes, it will be uncomfortable at first, but your body will compensate. Being compliant will prevent prolonging treatment, additional visits to the orthodontist, taking time off from work and school, and increased maintenance cost. Please be compliant, your smile will be glad you did!

Get Back To School Ready

Author: Dr. Alison Vitelli, DMD

Summer break is almost over and back to school arrangements are on the go!  Do you all think about your children’s dental check-up as part of their routine before heading back to the new school year? We understand that a lot goes on preparing for school, and unfortunately, dental appointments are not at the top of everyones list. But it should be, as it ensures that your child’s oral health is taken care of.  During the dental hygiene appointment, we provide a teeth cleaning, take radiographs as needed and check for any cavities, making sure that we decrease the chances of developing pain or infections during the school year. We also follow up with growth and development, as well as prevention of trauma. We are still on time to take care of any treatment needed to be done before heading back to school!  Have you made your re-care appointment yet? If not, call us today to schedule 910-497-3200!

Growing Up Smarter

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

I have seen enough years in this world to appreciate that trends change and being a lifelong student is important in adapting to society’s latest changes and challenges.  My parents grew up at a time when the dangers of smoking were not as well known and smoked a pack a day. I grew up at a time where my parents put a high premium on their children not being cigarette smokers. I have watched the decline in cigarette smoking among Americans and have attempted to run a progressive tobacco cessation program within our practice.  According to the US Centers for Disease Control and Prevention (CDC), the rate of smoking among Americans in 2017 is 14%, the lowest rate in many decades.  A reason to celebrate, no? Unfortunately, nicotine use has skyrocketed among our youth and has reared its ugly head in the form of electronic nicotine delivery systems (ENDS).

ENDS are tobacco products and common brand names for these products are Njoy (Njoy, LLC), Juul (Juul Labs) and Blu (Imperial Brands).  According to an article in the July/August 2019 of General Dentistry, “In 2015, 29.8% of adult ENDS users were former cigarette smokers, 58,8% were current smokers (using both) and 11.4% had never been regular cigarette smokers. Thus, there is no decrease in tobacco use; on the contrary, these numbers represent an explosion of tobacco use, especially among vulnerable ‘vaping’ teens, which currently represent 1% of the population.”

Marketing has led many to believe that vaping is a safe alternative to smoking, which is not based on fact.  The active ingredients in vaping smoke include nicotine, formaldehyde, diacetyl, acrolein, and heavy metals from the battery in the device.  Nicotine is a potent vasoconstrictor which decreases the amount of blood flow to some of the most sensitive tissues within the body, which include the gums in the mouth.  My observations in treating my smoking population during my dental career are that they are delayed healers that have many more complications to healing than do my non-smoking patients.  Nicotine use puts them at an increased risk for periodontal disease which is a loss of attachment around teeth and subsequent bone loss.  Recovery rooms stays are 20% longer for smokers than non-smokers and smoking retards wound healing.

Vaping vapor is detrimental to the health of the user and the vaping cloud is detrimental to those who are exposed to the exhaled gases. So why are our youth using this product in increasing numbers?  Remember when you were a teenager?

The novelty is appealing and the marketing of a safe alternative to smoking is getting our youth ‘hooked’ as nicotine is an adductive chemical.  Educating our youth on the dangers is essential.  Assisting them on getting them unaddicted is a challenge.  But as a parent, my hope is that education is the key.  Our practice is always available to talk openly with our patients who want to pursue a nicotine free life style.  Open that conversation with us today.

Space Maintainers for Pediatric Patients

Author: Dr. Rima Solanki, DMD

As a parent, you may have heard your dentist recommending space maintainers for your child if there is a premature loss of a baby tooth. Baby teeth are referred to a primary teeth in dentistry. The reason why your child may need a space maintainer is to make sure that the permanent tooth which will subsequently replace the primary tooth has enough space to erupt into the correct position. If the space is not maintained, permanent teeth that grow before age 6 or 7 will begin to shift and the net result will lead to the loss of space for other permanent teeth to successfully move into their proper position. At Spring Lake Dental Group, we recommend four types of fixed space maintainers. There are nance appliances for upper arch, lower lingual arch for lower arch, band and loop and distal shoe that can be used for the upper and lower arch. For more information, please consult with one of the dentists at Spring Lake Dental Group if you have any questions or concerns.

Screen Your Lips

Author: Dr. Alison Vitelli, DMD

Summer time is upon us! I’m sure you all are enjoying the wonderful outdoors. Beach, lake, sports, pool and hiking are some of my family’s favorites. With all this time outside we need to make sure we’re paying attention to taking care of our skin and lips. As we all know, sun exposure is a major source of radiation. This radiation can cause abnormalities during cell replication, which is a normal process of our bodies to keep us healthy.  Sometimes the body isn’t able to correct these mistakes because of a repeated stimulus, such as constant exposure to the UV rays from the sun, for example. When outside always stay hydrated and protect your skin and lips. Wearing hats and sunscreen, as well as sunscreen lip balm, are good ways to stay protected.  I know, we don’t always think of sunscreen for our lips, but it is so important to also take care of ours lips.  Some aggressive cancerous lesions start around the border of the lips and the tip of the nose. This is why  at Spring Lake Dental Group we dedicate ourselves to provide comprehensive care to our patients. During your dental appointments we perform an oral and extra-oral cancer screening. We check for any lesions that are not normal anatomy of the area, as well as changes in the normal appearance of anatomical structures. An example of a lesion caused by sun exposure would be blurring of the lip line or a persistent “scab” looking area mainly on nose and forehead. Always ask your dentist to check any areas you might be concerned about, that’s what we are here for. Have a happy summer!

How to Compete with Discount Dental Practices

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

This was the title of an article within my subscription magazine Academy of General Dentistry’s AGD Impact that appeared in its July 2019 issue (Vol. 47, No. 7). In the article, the author comments that, “Corporate dental clinics are backed by major health corporations with deep pockets and can saturate the market with online ads, TV commercials, billboards and radio spots. Most patients don’t know the difference between a private, quality practice and corporate dentistry.” Practices that offer specials and discounts are appealing to your sense of personal fiscal responsibility, but are you looking at the big picture when you consider your oral health.

You may ask yourself that if these large corporate dental offices are so bad, then why are they attracting so many dentists to work for them? And this may seem to be a very valid question especially if you have frequented one of their offices and found the practitioner(s) to be a very kind and skilled individual(s). The short answer is that I have a very high opinion of people who have been attracted to the health care field. The vast majority of them are motivated by a caring ethos that is served well by their clinical skills and high intelligence. They come into practices with a very high motor, pristine morality and a keen desire to heal and care for their patients.

The price of a dental education has skyrocketed during the last two decades and the average amount of student debt the last time I checked, was over a quarter of a million dollars. The price tag of the technology that we are dealing with within our dental practices has skyrocketed as well. Asking these kids that are coming out of dental school with substantial debt to go to the bank and incur even greater debt does not make sense to a lot of these young entrepreneurs. Therefore, turning to corporate dentistry where they can have immediate access to state of the art technology and a constant paycheck in order to work down their student debt is a viable alternative to them. The down side to this is losing your ability to work for yourself where you only have to answer to your own vision of what is right or wrong and not to a corporate entity that measures your worth in how much you can produce.

Do I feel that Spring Lake Dental Group only deals in high quality dentistry that stands the test of time, which uses the best techniques and technology as well as state of the art materials? You are darn right I do. Do I have procedures that turn out with a poorer outcome than I would like? Unfortunately, yes. But I have shied away from having my patients sign informed consent documents even to the chagrin of my malpractice lawyers. Why, because I feel like they create a barrier between me and my patients. Do I give all of my patients informed consent? Darn right, I do. But I do not want them thinking that they are signing a document that deprives them of any rights should a poor outcome arise. Instead, if you are a conscientious and caring health care provider, you will stand behind your work and diagnosing and make things right when a poor outcome arises. I have eaten many lab bill costs and redone many procedures when they have not lived up to my standards. It is this relationship with my patients that I value most highly. You won’t be getting any specials or discounts out of me, but you do have my word that I come to work each day loving what I do and hoping that my patients will give me the respect of having a two way conversation with me about what is important to them.

Understanding Dental Terminology

Author: Dr. Rima Solanki, DMD

During your dental appointment, you may hear your dentist, dental hygienist or assistant call out, “buccal decay, mesial decay” to name a few and as a patient, you may wonder what the true meaning of those terms are. In adult dentition, there are 32 permanent teeth. Teeth numbers 1 to 16 are top teeth (maxillary arch) starting from top right to top left and teeth numbers 17 to 32 represent the bottom teeth (mandibular arch) starting from bottom left to bottom right. Teeth numbers 1, 16, 17 and 32 are classified as wisdom teeth. Furthermore, our teeth have a total of 5 surfaces that allow dentists to classify the extent of decay (cavity) for proper note taking as well as for treatment planning using the correct American Dental Association codes. Let’s learn about the different surfaces of the teeth and what they represent when you may hear certain terminology being called out during a patient exam.

1. Distal surface is away from the midline of face.

2. Mesial surface is closest to the midline of face.

3. Occlusal surface is chewing surface of back teeth and for the front teeth, they are
referred as Incisal edge.

4. Buccal surface is facing towards the cheeks for back teeth and for the front teeth, it is
referred as facial surface and is towards the lip.

5. Lingual surface is facing towards the tongue (mandibular arch) and Palatal surface is
facing towards the roof of the mouth (maxillary arch).

Trikes, Trauma and Teeth

Author: Kimberly N. Powell, DDS, MS

Kids are pretty resilient. Bumps and bruises are normal and often in school, on vacation, or summer break. During one of their rumbles, kids can hurt their teeth or even lose them. In the event that a primary (baby) tooth falls out due to trauma, it is not recommended to replant it. The soft tissue such as the gums, tongue, cheeks, roof of the mouth should be evaluated. The hard tissue such as adjacent teeth and sockets should be assessed clinically and radiographically. A space maintainer may be needed to preserve space for eruption of the permanent tooth. It is important to be able to identify permanent teeth from baby teeth as permanent teeth can be implanted. There are 20 primary teeth which will remain in the mouth until about 33 months. Compared to permanent teeth, baby teeth are whiter and smaller. The permanent anterior (front) teeth have ridges on the chewing surface called mamelons, not present on baby teeth. Under ideal situations, if a permanent tooth is avulsed, hold the tooth by the crown, quickly rinse with cold water if soiled, correctly insert in socket and add biting pressure, and seek dental care immediately.

Sports and Your Teeth

Author: Dr. Alison Vitelli, DMD

It’s time for World Cup Soccer! My family and I are really excited for it since soccer has a very special part in my life as my boys love playing it. I know parents can relate to how much we enjoy seeing our children playing a sport they are passionate about. So, let’s review a few important points to watch for when our kids or family members are involved in sports:

 Mouthguard – Using an athletic mouthguard is extremely important and we can’t stress it enough. Sports involve speed, force and close contact with other players. Unfortunately, accidents and trauma to the teeth are very common. A simple way to prevent or to keep any trauma to the teeth to a minimum is to wear a physical protector over the teeth. At Spring Lake Dental Group, we have the ability to create custom mouthguards for the sports player in your life!

 If trauma ever happens, evaluate consciousness and contact emergency care immediately if needed. If it is only trauma to the teeth contact Spring Lake Dental Group as soon as possible, so we can guide you through the proper care and can see you right away.

 Electrolyte drinks – Hydration is essential when playing any kind of sports. Water is ideal, but we also know a lot of our players prefer drinks to replenish electrolytes. We have to be careful with these drinks as they have high sugar content, even the ones that are marketed as “low-sugar”. Bacteria in the mouth will feed on these sugars as the players are constantly sipping on them, and with high activity levels, salivation is reduced causing a drier environment in the mouth. Therefore, the acid produced by these bacteria cannot be dissolved and enamel can’t be remineralized by the saliva as effectively as when the player is relaxed. If sugary drinks are the preference, then I recommend to alternate it with water.

Enjoy and have fun this summer during all of your sport playing moments!

Buyers Beware!

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

Dear Visitors to the Spring Lake Dental Group website,

Have you seen those advertisements on television supporting your gaining orthodontic treatment through aligners from SmileDirectClub? How could you not? They’re everywhere. The positives they claim through their therapy is straight teeth through orthodontic movement with no orthodontic visits and the cost of therapy will be substantially less.

Sounds great, right? Buyer beware! By excluding an orthodontist from your treatment, many pitfalls may be experienced.

I recently received a mass making from the co-founder and CEO of SmileDirectClub, Mr. Alex Fenkell. He was writing this email to members of my profession asking for input and assistance in allowing his business model to grow. He was addressing the issues of a citizen’s petition filed with the FDA by the American Dental Association and its president., Dr. Jeffery Cole, DMD, which stated that do-it-yourself orthodontics should be regulated more rigidly.

Orthodontics is recognized as one of the ten dental specialties and requires an additional two or three years of training past the four years of dental school, after four years of undergraduate work. The problems associated with malocclusion, dental and facial orthopedics, neuromuscular function and pathology as well as temporo-mandibular joint function and pathology are numerous and complex. Just moving teeth into an uncrowded and esthetic position is not without its risks and can lead to many, massive problems. Problems such as: headache, pain on function, limited opening ability, myofascial pain and dysfunction, clicking and popping of the joint, gum recession, teeth sensitivity, malocclusion, gingivitis, periodontal bone loss and unstable retention.

As this marketing strategy has been very successful and appealing, we have already seen in our practice, many patients experiencing these issues. When this happens to you, who do you turn to? Not to SmileDirectClub. Yes, they ask you to certify that you are under the care of a general dentist and that you have had a check-up in the last six months, but there is no communication between SmileDirectClub and Spring Lake Dental Group concerning their treatment to our patients. There is a nationally certified specialty of orthodontists for a reason. This business model of Mr. Fenkell’s, who incidentally is not a dentist, carries with it a great deal of risk for patients who are looking for convenience and money saving benefits.

The profession of dentistry is not looking to restrict free trade and competition. But the profession was built on the trust and confidence if the general public and to betray that trust now would be problematic for all.