Spring Lake Dental Group

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.

Exercise and Your Gums

Author: Kimberly N. Powell, DDS, MS

Gingivitis is inflammation of the gingiva that presents with red, swollen, and/or bleeding gums. Gingivitis is caused by plaque bacteria and is the mildest form of gum disease, advanced periodontitis being the most severe. The American Dental Association (ADA) recently reported that exercise can have benefits for your gums as well as your overall health. Data collected through the Third National Health and Nutrition Examination Survey (NHANES III), a long-term national health survey, found that adults who followed government recommendations for physical activity were also less likely to have periodontal disease. Data from a select group of study participants — nonsmokers or former smokers who exercised moderately five days per week, or vigorously three times per week for at least 10 years and had a periodontal exam — showed a significantly lower risk for periodontal disease. Nonsmokers had a 55 percent lower risk for periodontal problems and former smokers a 75 percent lower risk (ADA). Although the results are interesting, dental health still depends on good oral hygiene which consists of brushing at least twice a day for two minutes, flossing, using a mouth rinse, biannual dental cleanings and exams, and a healthy diet.

Shade Selection

Author: Dr. Alison Vitelli, DMD

Esthetics are an essential part of our everyday world.  Dentistry is no exception!  We have transitioned into being able to access better and more esthetically pleasing materials that match natural tooth structure beautifully.  But it all depends on the accurate selection of the shade of the teeth, and our goal is to find the one that blends the most with the adjacent dentition.  Multiple systems are available to help get the shade that best matches your teeth. These are based on the three main properties of color: hue, value and chroma.  Hue is the actual color: red, blue, yellow, etc.  Value describes how light or dark the color is, where chroma shows the saturation or intensity of the color.  For a restoration shade to better match your teeth, good illumination and appropriate surrounding colors are required.  It is also important to mention, if you are considering whitening your teeth, it is advised to have it done before moving forward with a restoration.  Natural tooth structure has the ability to change shades whereas the filling or crown materials do not.  Lastly, we always look for your feedback while selecting the shade, so please feel free to let us know what do you think!

Compliance with Prescribed Medication

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

I have the opportunity to attend numerous continuing education classes. The mantra of being a lifelong student resonates throughout my daily activities. I attended one class recently that addressed the problem of non-compliance with taking prescribed medications. The study had been set up to analyze the chances of achieving compliance through evaluating how the medication had been prescribed. Some medications have the ability to be prescribed at differing time intervals and this study looked at achieving compliance at differing dosing regimens. As it turns out, the study found that even at dosing of just once daily (qd), the percentage of correct compliance was only 72%. This number declines precipitously as dosing went from twice daily (bid) to three times daily (tid) and finally at four times daily (qid) it bottomed out at 46%. The clinical case they were looking at was a dental abscess (a dead tooth that has an infection located outside of tooth structure) where we as clinicians were challenged to detail how we would treat the case with antibiotics. Well, of course the correct answer was to treat the infection cause first rather than rely upon antibiotics which would have the unintended result of developing a subsequent infection unresponsive to desired antibiotic therapy (a superinfection). Removing dead tissue from the tooth through pulpectomy or root canal therapy as well as incising and draining the infection from the gum-line would have made your subsequent selection of antibiotic therapy more favorable.

Regardless, when antibiotics are prescribed, having a discussion with your care provider on the indications and contraindications of this therapy is paramount to its success. Trends within medicine and dentistry are to use antibiotics for a shorter duration, shorter dosing patterns and better follow up. We in dentistry, use antibiotics from the tetracycline family often as they are especially effective on bugs that localize and mature within the gum tissue. But because the effective drug is bound up in the stomach by dairy products (products that are divalent such as calcium and sodium), they are made ineffective if taken within an hour of mealtime or two hours after. Metronidazole (Flagyl) is an antibiotic that gives a strong antibuse reaction (nausea and vomiting) if taken with alcohol.

The bottom line will always be to have a great relationship with your care provider. If he or she is intimidated by your questions or concerns, find another care provider! Finding the right medication and dosing schedule requires lots of knowledge, probing, questions and discussion. Be willing to work with your doctor to know the right decision that fits your lifestyle and diagnosis.

Aphthous Ulcers

Author: Kimberly N. Powell, DDS, MS

Aphthous mouth ulcers, known commonly as canker sores, can be very uncomfortable. Daily routines like eating, drinking, oral hygiene methods can cause pain. The cause of aphthous ulcers is unclear but can be triggered by stress, vitamin deficiency (B-12, zinc, folate, iron), food sensitivities, mouth trauma, hormonal changes, sodium lauryl sulfate found in some toothpastes and rinses (Mayo Clinic). The sores may occur because of conditions like Celiac disease, inflammatory bowel disease, weakened immune system (Mayo Clinic). Treating the ulcers include managing the symptoms. This can be done with steroid or anesthetic mouth rinses, pastes/creams/gels like Anbesol, Orabase, Lidex, Orajel, salt water or baking soda rinses, application of milk of magnesia to the site, avoiding the ulcers when eating, and applying ice (Mayo Clinic). Under ideal circumstances, the ulcers will resolve in 7-14 days. If they persists or in case of larger ulcers, consultation with your dentist is necessary.

Dental Infection

Author: Dr. Alison Vitelli, DMD

Our bodies are amazing fighting machines programmed to keep us healthy. But sometimes micro organisms may take a step ahead and this is where we see the infections happening as our bodies create an inflammatory response as they attempt to fight against these organisms. This is when pain, fever and swelling happen. Unfortunately, sometimes people see a dental cavity as something insignificant that will not affect them. But untreated cavities can progress into the nerve of the tooth where blood flow is also present, having communication with the immune system cells that fight the bacteria and forming a dental abscess. If this abscess is not treated, further swelling and complications can happen. The head and neck are extremely delicate areas in our bodies containing major blood vessels, complicated layers of muscles, and specialized tissue. Between all these structures are what is known as “potential spaces”. These are areas where the untreated infections have the “potential” to spread to, causing swelling that can be life threatening depending on how close it is to vital structures such as the airway or brain, among others. Also, the bacteria involved in that infection can be carried to other areas in the body by the systemic circulation causing sepsis, which needs immediate medical attention in a hospital environment. No infection should ever be left untreated, no matter how small it might look!

Whitening Options at Spring Lake Dental Group

Author: Shannon Sutton, RDH

Happy spring everyone! It’s the perfect time to discuss the whitening options available to our patients at Spring Lake Dental Group and get a ready to spring into a whiter brighter smile! We have a few different options to meet your specific whitening needs ranging from take home trays to in office treatments.

First, let me tell you a little about teeth whitening in general. Hydrogen peroxide and carbamide peroxide are the safest and most common active whitening ingredients. They can be used in varying concentrations to remove surface stains on the enamel and lighten the overall color of the dentin, which is the layer of tooth under the enamel. The most common side effects from whitening are tooth and gum sensitivity. These side effects can be safely managed with the help of your dental professional. Whitening is not right for everyone so an evaluation is needed to determine if it is right for you.

Because we believe in offering the best, cutting edge products for our patients, choosing Opalescence whitening products was a no-brainer. Opalescence has been delivering whitening products to dental professionals for over 20 years. They are proven effective and have years of experience perfecting their whitening products.

Opalescence Go


Our take home option for tooth whitening is Opalescence Go. These are preloaded trays with a concentration of 10% hydrogen peroxide. A box contains 10 upper trays and lower trays that are worn for 10 to 45 minutes depending on your desired results.

Custom Trays


Custom trays can also be made in our office. We will take impressions of your teeth and make custom models along with fitted trays that you can use at home to whiten or deliver fluoride. We carry Opalescence carbamide peroxide gel in a concentration of 10% that can be worn in the trays at home for up to 90 minutes per day.

Opalescence Boost


Our in office whitening system is Opalescence Boost. This is perfect for those who do not want to whiten for longer periods of time at home and want an instant result. A resin barrier is applied to your gums then a 40% hydrogen peroxide solution is applied to teeth during your scheduled appointment time. This gel is specially formulated to activate without a light and deliver long lasting results. A box of Opalescence Go is included in the fee in order to maintain your new brighter smile at home. This option is great if you have an event coming up too!


We have options available for whatever your whitening needs are here at Spring Lake Dental Group. Give us a call today to schedule an evaluation at (910) 497-3200!


The Importance of Medical History

Author: Dr. Alison Vitelli, DMD

Dentistry is a field that commonly gets disassociated with the status of our whole body health. But extensive studies have shown that dental health and systemic health go hand and hand. This is why it is so important for us to know about any medical conditions and medications you may be using. Some medical conditions are of great influence to the dental health such as diabetes, high blood pressure, heart disease, pregnancy and surgeries.

The blood circulation in our mouths, specially, our gums, communicates with the rest of our circulatory system. Whenever gum disease is present, our immune system creates an inflammatory response. This inflammation cannot be properly fought by our body cells if uncontrolled systemic conditions are present.

At Spring Lake Dental Group we strive to take care of you, our patient, in the most comprehensive and
professional way possible. In order to achieve this, we need to know you so we can take all the
measures to protect you in every way! I feel is also important for you to know, all this medical
information is used by your dentist and hygienist to take great care of your needs and it is always
confidential. We discuss your medical history together with you because we want you healthy and
showing a beautiful and healthy smile!

Colorectal Cancer Awareness Month

Author: Kimberly N. Powell, DDS, MS

March is Colorectal Cancer Awareness Month.  According to the Center for Disease Control and Prevention (CDC), colorectal cancer is the second leading cause of cancer deaths in the United States. It is a disease in which abnormal cells in the colon or rectum divide uncontrollably, ultimately forming a malignant tumor (National Cancer Institute).  The American Cancer Society reports risk factors for colorectal cancer as being overweight/obese, physical inactivity, diets high in red meat and processed meat (i.e. hot dogs and luncheon meats), smoking, heavy alcohol use (more than 2 drinks a day for men and 1 drink a day for women). These risk factors can be controlled.  The ones that can not include being older (risk increases as you age), certain ethnic or racial groups (African Americans have the highest incidence and mortality rate), type 2 diabetes, family history and/or personal history of the disease or polyps (abnormal growths), history of inflammatory bowel disease (IBD) such as ulcerative colitis or Crohn’s, inherited syndromes (Lynch syndrome and familial adenomatous polyposis).

Signs and symptoms of colon cancer may include changes in bowel habits, such as diarrhea or constipation or a change in consistency of stool that last longer than four weeks, persistent abdominal discomfort (cramps, gas, pain), rectal bleeding or blood in your stool, weakness or fatigue, unexplained weight loss (Mayo Clinic).

Screening for colorectal cancer is extremely important.  The National Cancer Institute reports the recommendation for regular screenings to begin at age 50 for individuals at average risk, and people at increased risk (family history, IBD, inherited conditions) may be advised to start screening before 50 and more frequently. Screening tests fall into two categories, stool-based tests and visual tests. Stool-based tests are noninvasive and do not require a special diet or bowel preparation (laxative).  The tests look for tiny amounts of blood in the stool and/or DNA/gene changes. Any abnormalities in the findings will need to be followed up with a colonoscopy. The visual test are invasive and include a colonoscopy or sigmoidoscopy. If a positive diagnosis results, surgery, most common treatment, chemotherapy, radiation therapy, and targeted therapies are some treatment options (MD Anderson Cancer Center). The National Colorectal Cancer Roundtable 2019 initiative is the Next 80%.  It continues the work that began in 2018 to achieve 80% colorectal cancer screening rates in every community. The rates of new colorectal cancer cases and deaths among adults aged 50 years or older are decreasing in this country due to an increase in screening and to changes in some risk factors, but incidence is increasing among younger adults for reasons that are not known (National Cancer Institute). Still, regular colorectal cancer screening is one of the most powerful weapons for preventing colorectal cancer according to the American Cancer Society.  

An ounce of prevention is worth a pound of cure.”  – Benjamin Franklin

Community Outreach

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

February is National Dental Health Month. In celebration of this national distinction proclaimed by the American Dental Association, Spring Lake Dental Group actively participated in the ADA’s sponsored program called ‘Give Kids a Smile’. We canvassed our local schools and communicated with principals, teachers and school nurses. We asked that they send children to our practice, without dental insurance who they saw as having a need for dental care. We treated these children without regard to payment and are currently still seeing them as their need was greater than what one day could provide. We do this because we have a good heart and care about children in our community and want to give back for the many blessings that we have experienced. We could not do this without your help because of your support of Spring Lake Dental Group as a patient of record. So I want to say ‘thank you’ for your support. Last year, (2018) we provided $6,110.00 in pro bono care for Give Kids a Smile. We are still treating our kids this year so I do not currently have a number for 2019, but the staff and I are happy and proud to be able to help these children.

In other matters, I hope the six people who won Spring Lake Dental Group tickets to go see Three
Dog Night at the Crown Coliseum had a great time. I would have loved to be there with you but my son was
taking me to Maryland to watch my Terrapins play basketball against Ohio State that weekend.

February Dental Health Month also gives me and my staff an opportunity to go out into the community
and give dental health educational lectures. We will be at Overhills Elementary School later this month
and want to thank them for the opportunity to educate and hopefully entertain their young scholars. If
you have a need for something along these lines, please do not hesitate to contact me or our office
manager, Angela Carr-Finch to understand our capabilities. We love to talk dentistry and where the
current state or oral health care is heading.

Again, thanks for your support of Spring Lake Dental Group.