Spring Lake Dental Group


Author: Kimberly N. Powell, DDS, MS

The United States Department of Health and Human Services classified obesity as a disease in 2004. A Body Mass Index (BMI) of 30.0 or higher falls within the obese range according to the Centers for Disease Control and Prevention (CDC). Obesity is a serious health condition that can increase the risk of developing diabetes, heart disease, hypertension, sleep apnea, and certain cancers. In dentistry, an obese patient may find the simplest activity uncomfortable. The dental chair may be constricting, so armrests are adjusted to increase comfort. The clinical dental staff are aware of the demands dentistry can pose on a patient during treatment. Recognizing this for the obese patient aids in customizing their dental visit by assisting them to sit up, offering frequent breaks as breathing can be challenging in the reclined position, transferring them in and out of the dental chair, and seating them in an operatory closest to the reception area to limit the distance the patient has to walk. It can be uncomfortable for anyone when personal space is invaded, even more in a dental setting. For the obese patient, this space is likely more compromised as inadvertent body contact can occur and be a cause of embarrassment. A discussion with the patient in the presence of the assistant is necessary to avoid misinterpretation of touching that occurs during normal dental procedures such as transferring of instruments, suctioning, etc. Recognizing the different health conditions of patients and knowing how to modify treatment for their benefit helps to provide superior care for the patient physically and emotionally.

The Most Wonderful Time of the Year

Author: Dr. Alison Vitelli, DMD

We usually use our blog to share dental knowledge with our patients, but I wanted to change it up a bit this week. Believe it or not, we are just 3 weeks away from Christmas! For me and my family, this is our favorite time ever, as we enjoy the cool weather and make our home cozy and spend time together. Christmas is a beautiful season and we celebrate the birth of our Savior Jesus Christ. It’s the time we come together and share with our loved ones. Living in a military town and taking care of our military families has made me more aware of all the sacrifices they make every day, especially during this season, as not all can spend it together, as well as many other families due to different circumstances.

This season, I encourage you to slow down from the busy schedule that characterizes this time of year. It is not always about the gifts, but rather about thanking our Lord for his blessings. It is a time to make memories that will last a lifetime, to come together, listen to each other, share our love to one another and celebrate the miracle of Christmas. All our patients are family to us at Spring Lake Dental Group. And, it is because of this love we have for you all, that I did not want to let this opportunity pass without asking you to reflect on the true meaning of the most wonderful time of the year! I wish you all a blessed and Merry Christmas!

Top 3 Items We Recommend For Your Oral Health This Year!

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

Christmas is just around the corner and I have 3 recommendations for you to consider to help you and your family maintain optimum oral health.

I was always frustrated in keeping my braces clean (when I had them) by using my bathroom cassette water irrigation unit. The splashing always made a mess of my bathroom mirror and I had to use it before I got dressed because of all of the ancillary splashing. This Waterpik unit is cordless and allows me to take it into the shower with me and avoid the mess. It is rechargeable and waterproof. It has three pressure settings and a two year warranty. It is available at most stores and runs from $60-$100. It is a great investment for anyone wearing braces or treating periodontal disease. Research says that we should not treat it as a replacement for flossing, but for those patients that have little motivation for flossing or decreased dexterity, it may be a viable option.

This is a website that offers the newest technology in ultrasonic toothbrushes and offers one of the most reasonable prices that I’ve seen. I have one myself that I ordered to see if this independent company made a reliable product. I have been pleasantly surprised. They stay in touch with me through my smartphone and send replacement heads every few months for a $6 shipping fee. The motor functions well and runs quietly and gives time hacks so you know when you have reached the two minute recommended brushing time. It is well engineered and reasonably priced compared to other models on the market.

Within our office, we are an authorized distributor of OraCare by Dentist Select. It is an activated oral cleanser with Xylitol. Xylitol is the flavoring agent and it is a sugar alcohol five chain carbon molecule that stimulates salivary flow yet does not contribute to bacterial acid production. The active ingredient is chlorine dioxide which has been shown to reduce volatile sulfuric compounds (VSC’s), a major contributor to bad breath. It comes in two bottles and has to be mixed to activate. The practice offers the system (32 fluid ounces) a month’s supply for $40. For post-operative care, we also offer a $10 package that is a week’s supply.

We hope that our recommendations assist you in continuing your oral health journey with us! Spring Lake Dental Group wishes you and your family a very happy and healthy holiday season. Merry Christmas!

The Truth About Root Canals

Author: Dr. Rima Solanki, DMD

Patients always ask us, “Is a root canal procedure going to be very painful?” The answer is that if done correctly, root canal is actually gets you out of pain. What is a root canal? Who needs one and why? A root canal is the dental procedure that cleans the inside of the tooth, known as canal, when pulp (often referred as nerve) of tooth is infected. This can happen due to severe tooth decay, needing crown, dental trauma and cracked tooth or filling. Most of the time, patients will notice extreme tooth pain, lingering pain upon drinking cold beverage or eating food, swelling/soreness, tooth discoloration and not being able to sleep at night due to toothache. A radiograph is always taken to check the extent of the infection and to see the entire root and tooth area. Local anesthetic is administered to keep the patient comfortable during the entire process. A rubber dam is placed to isolate tooth so that saliva can stay from the tooth and to ensure safety. Your dentist or endodontist will open the tooth to clean the canal, subsequently removing infection. After cleaning and shaping the canal, a special kind of filling placed in the canal. Your dentist may place a post if more than 2/3 of tooth structure is missing to build the tooth back. Lastly, a crown is placed to seal root canal treated tooth and prevent it from breaking.

Remember to talk to your dentist at Spring Lake Dental group if you have concerns or questions regarding root canal treatment.

Love One Another

Author: Kimberly N. Powell, DDS, MS

A disaster is a serious disruption, occurring over a relatively short time, of the functioning of a community or a society involving widespread human, material, economic or environmental loss and impacts, which exceeds the ability of the affected community or society to cope using its own resources (Wikipedia). Disasters, natural and man-made, have occurred since the beginning of time. Each event, no matter the magnitude, no matter the location, is matched by the selfless, unwavering, compassionate, generous efforts of people serving one another for the welfare of the community. In recent months, we have been overwhelmed with news of floods, fires, and massacres. With things happening so quickly, it seems difficult to know where to direct your efforts. But, we come together, our police officers, healthcare workers, fire fighters, soldiers, neighbors, educators, friends, seeing no difference between us and pull on the rope together. We show up to do what we can, what we must to ensure that we all are taken care of, and our society is preserved. Because while we are here, our charge is to simply love one another.

Honoring Our Veterans

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

Most of my patients with Spring Lake Dental Group know that I have a military background.  Sadly, I did not retire from the Army when I separated after 14 years of service to my country, but I did develop a strong appreciation for all those who do serve.  The military gave me a great start in life as a young second lieutenant here at Fort Bragg assigned to the 82d Airborne Division. It was a chance to grow up and be mentored by outstanding leaders, both commissioned and non-commissioned. My advanced education within the dental corps after re-entering the military was three years of residency that gave me both philosophy as well as greater skills. My military life gave me the opportunity to see the fall of the Berlin Wall as well as service in Desert Shield/Desert Storm.  Since my separation from the military, I have been able to take my family to the beaches of Normandy and to appreciate the D-Day invasion from the perspective of the Airborne Museum at St. Mere Eglise. It has been an amazing adventure of a life that has always left me reflecting back on all those who have gone before.

Our practice will be closed on Monday, 12 November 2018 in observance of Veteran’s Day.  I ask my staff to use this day to tour the Airborne and Special Operations Museum or some other activity that may somehow impact their lives or the lives of our veterans and their families.  During the week of November 5th through the 9th, a ‘Missing Man’ table will be set up in our reception room.  

Spring Lake Dental Group has always been a practice who has been willing to accept military and retiree insurance.  We do this because we believe in your service and we want to honor it. Please let your military friends and neighbors know about our commitment.  We live by your referrals and consider helping to take care of your oral health to be our highest calling.

What Happens Next?

Author: Dr. Alison Vitelli, DMD

We understand, when you are in pain, you just want to get rid of that awful pain that is not letting you sleep. But what happens after you get that tooth out? Well, after losing a tooth the bone that was supporting it starts to collapse in all directions during the healing stages. It “shrinks” going down and inward creating a caved in defect. Also, adjacent teeth that were in contact with the now gone tooth will start to shift trying to get in contact again, but sadly, is just a tipping movement rather than a bodily one. I’m sure you have heard us recommending bone grafting to eventually place an implant in order to prevent all these changes from happening.

What is the purpose of grafting the extraction site? After the extraction bone particles are placed where the tooth used to be to preserve the bone dimensions. This will help have a predictable site to place a stable implant that will be surrounded by bone on every plane. There are multiple kinds of grafting materials depending on the indications and preferences of the clinician. But the main way that the bone grafting works is by providing the way and aid for the body’s bone cells to lay down bone in that empty socket. I like to describe it as an enhanced scaffolding system for the bone cells to climb while laying bone. Science keeps advancing and growing at a fast pace which allows us to provide you with safe and predictable options for great treatment.

Preventing Cavities: A Focus on Nutrition

Author: Shannon Sutton, RDH

As a Registered Dental Hygienist, my main goal in patient care is education and prevention. Nutrition plays an integral role in the prevention of dental caries aka cavities (sugar bugs for the kids). In particular, frequent exposure to carbohydrates and acidic foods and drinks are the most damaging to our healthy tooth enamel. 

To understand why this is you have to know that we all have bacteria naturally present in our mouths that we acquire sometime after birth from our parents, relatives, etc. These bacteria feed on the carbohydrates that we eat and produce acids. These acids, in turn, eat through the tooth enamel to cause a cavity. If we feed these bacteria constantly throughout our day, then we have a great chance that the excessive acidic environment will cause a cavity or two. Add acids from fruit juices, sodas, energy drinks, etc., and you up your chances of a cavity forming on your teeth. 

Some examples of cavity-causing carbohydrates include sugar, sodas, fruits and fruit juices, rice, bread, and crackers. Limiting your frequency of exposures to these foods and drinks will greatly reduce the risk of cavities. Start by swapping carbohydrate containing snacks with fresh veggies or cheese. There are many other factors that can increase risks for dental caries and of course good oral hygiene, fluoride and xylitol products can reduce the risk, but to keep it simple a few changes in your everyday nutrition can make a big impact.

Navigating New Opportunities Dental Convention

Author: Cheri Lindstrom, RDH

If you are interested in the profession of dental hygiene, I want you to know you have many options in North Carolina. As a dental hygienist, you may end up working in a traditional dental office, or you may end up working in Public Health. You may work for Crest or Colgate in the research and development industry, or as a Professional Educator teaching at one of the 13 accredited schools in North Carolina. You can attain an Associate, Bachelor, or a Master’s degree, or even a PhD in research or in Professional Practice if you wished, but with every licensure you maintain, education never stops.

As hygienists, we are required to continue our education each year with at a minimum, 6 hours of class. I am thankful to work for a provider like Dr. Dickerhoff who understands that lifelong learning is imperative in the ever-changing world of dentistry. Most often going way beyond the 6-hour minimum. Being a part of the North Carolina Dental Hygienist Association is one way we can access education. The NCDHA also works to change laws in our state to provide better access to care and programs to help the community.

Over the weekend of September 28-30, 2018, North Carolina Dental Hygienists Association held their first annual meeting “Navigating New Opportunities” conference at the Durham Convention Center in Durham, NC. I was fortunate to be able to participate as one of the delegates for the Greater Fayetteville Dental Hygienists’ component along with 13 other components from around the state. It was three days of learning more about the complex field of dental hygiene, exploring cutting edge products to enrich our patients dental care, and opportunities to network with other hygienists from all over the state.

One of the benefits of meetings like these are the opportunities to hear lectures from leaders in our community. Anne Nugent Guignon, RDH, MPH was just one of the speakers, and her lecture was “Exploring the Oral Micro-biome Disease”. Biofilm, the thin, slimy film of bacteria that adheres to surfaces found in the mouth, is a complex layer of active bacteria that is linked to cardiovascular disease, pancreatic and colorectal cancer, macular degeneration, low term birth-weight, autoimmune diseases such as rheumatoid arthritis, along with other diseases like inflammatory bowel disease and respiratory tract infections. As a hygienist, part of our job is to disrupt this biofilm to reduce oral disease. She discussed using subgingival biofilm disruption with an Air Powder Polisher (which we already use in our office), use of high fluoride toothpastes (we provide these as prescription strength fluoride toothpastes) and a natural toothpaste with arginine that can be purchased over the counter. Arginine is a natural amino acid that cause bacteria to excrete ammonia as it raises the mouth pH causing a bacterial shift that inhibits adhesion of the bacterial layers of biofilm, meaning it kills the bad bacteria! Eating a chocolate with arginine called Basic Bites after meals works the same way and it tastes good! She mentioned another product, silver diamide fluoride (SDF). It is a natural antibacterial solution used for hypersensitivity relief and is anticariogenic and we are already using it in our office!

Tom Viola, a board-certified Pharmacist, led the lecture on prescription medications, vitamins and supplements and how these can impact our patients care in our office. Patients who take supplements may not realize these can create complications in the dental office and may not disclose them, thinking its “just a supplement and doesn’t matter”, but it does! Chamomile, Dong Quai, Garlic, Black Cohosh, Horse Chesnut all influence bleeding which can cause an interaction with dental treatment, such as with a tooth extraction. One of the more common supplements, St. John’s Wart, which helps with depression, has more drug interactions that most drugs, including photosensitivity, and can affect the way the body reacts to local and general anesthesia. Disclosing your medication list to your dental professional is a necessary part for every dental visit and will help us treat you in the safest manner.

Mary Otto, a Washington, D.C. based journalist spoke about her book, “Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America”. Mary was directly impacted by the story of a child, 12-year-old Deamonte Driver, who was living in Maryland, had dental care coverage by Medicaid but lacked opportunity and access to dental care. He died from a dental infection that spread to his brain. This child’s death caused Mary to research and ask questions– how could this happen? How could this child who was able to have dental care not receive the necessary dental treatment? She found a lack of available offices, dental professionals, and transportation, led to an untreated dental infection spreading to Deamonte’s brain causing death. This was the catalyst for what was a major shift, not just in Maryland. After her story broke, there was an investigation, which created congressional hearings that changed Maryland’s Medicaid dental system and caused attention to be focused on children nationwide and the overall lack of dental care providers.

As hygienists, we don’t just “clean teeth”. We are your dental professionals and are here to help you maintain your over-all health. Your mouth is the gate-way to the rest of your body! Treat it well!


Author: Tracey Perry-Johnson, RDH

Xerostomia is the perception of dry mouth accompanied by hyposalivation. Lack of saliva & moisture in the mouth is a serious oral condition. The imbalance of oral proteins, electrolytes and salivary flow encompass what is known to dental professionals as xerostomia. Dry mouth is affecting a growing number of patients of all ages and sets the stage for caries (cavities), enamel erosion, Periodontal disease, and fungal infections. Dry mouth can cause major quality of life issues. For instance, when the mouth is dry, your sense of taste is drastically altered. Your mouth can become so dry that talking can become challenging, causing lips to stick to teeth. In severe dry mouth cases, tears to the soft tissue of the mouth can be very painful.

Since all dry mouth issues are not the same, it is important to understand the distinctions when trying to help a patient gain some relief. There are many products sold online and in retail stores which can be helpful in treating dry mouth symptoms. It is extremely important to treat dry mouth, but it is just as important to understand the underlying cause of it! Different medical conditions can cause dry mouth. Some medical conditions which can alter salivary flow are: chemo and radiation therapy, thyroid disease, diabetes, etc. Taking medications for any of these conditions can also be a culprit in causing dry mouth as well as medications being taken to help treat hypertension and psychiatric conditions.

The objective from the dental team is to educate and offer remedies to alleviate the discomforts associated with dry mouth. Visit our team at Spring Lake Dental Group to discuss any dry mouth concerns you have!