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If you were to put your toothbrush bristles under a high-powered microscope, what you would see might give you nightmares: millions of bacteria, busily crawling up and down your toothbrush bristles, consuming proteins that came from your mouth, and still clinging to the bristles even after you’ve rinsed them with water.

Rinsing your toothbrush after brushing removes some of those ferociously hungry bacteria, but not all. The American Dental Association says that bacterial infestations develop on toothbrushes within a month of daily use. The ADA also states that unless a toothbrush is sterilized before being packaged, it’s going to come with bacteria – free of charge!

Germs and Frayed Bristles: the Demise of a Toothbrush

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our staff recommend that you toss your old toothbrush in the trash and purchase a new one every three months. Children tend to bite on their toothbrushes, which makes the bristles degrade and fray faster. Chances are kids may need to have their toothbrushes changed more frequently.

Where do they hide?

Bacteria are tenacious little germs that head for those concealed areas between toothbrush bristles. They are highly adaptable and exist in every type of extreme environment. Some people actually go so far as to put their toothbrush in a microwave for a few seconds to kill germs, but this doesn't always work either. In fact, you may only end up with a toothbrush that’s as bendable as a Gumby doll – and still covered with germs.

Feed a Cold, Starve a Fever, and Get Rid of Your Toothbrush

When you have a head cold, your mouth is teeming with bacteria gleefully roaming around, and gobbling mucus and dead skin cells. If you brush your teeth while suffering a sinus condition, the brush will act like a magnet for ravenous bacteria. Use your old toothbrush while you are sick, but as soon as you feel better, throw it away and get a new one. Otherwise you could possibly re-infect yourself with the same cold germs!

Halloween is fast approaching, and Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants wanted to be sure to wish our patients a happy day, no matter how you might celebrate this holiday. The Halloween that is familiar to most people today bears little resemblance to the original Halloween; back in the "old days" it wasn't even called Halloween!

Festival of the Dead

Halloween started out as a Celtic festival of the dead that honored departed loved ones and signified a change in the cycle of the seasons. The Celtic people viewed Halloween, then called "Samhain," as a very special day – almost like our New Years day in fact, as their new calendar year began on November 1st. Samhain was the last day of autumn, so it was the time to harvest the last of the season's crops, store food away for winter, and situate livestock comfortably for the upcoming cold weather. The Celts believed that during this day, the last day of winter, the veil between this world and the spirit world is the thinnest, and that the living could communicate with departed loved ones most effectively on Samhain due to this.

Modern Halloween

Halloween as we know it today started because Christian missionaries were working to convert the Celtic people to Christianity. The Celts believed in religious concepts that were not supported by the Christian church, and these practices, which stemmed from Druidism, were perceived by the Christian church as being "devil worship" and dangerous.

When Pope Gregory the First instructed his missionaries to work at converting the Pagan people, he told them to try to incorporate some of the Pagan practices into Christian practices in a limited way. This meant that November 1st became "All Saints Day," which allowed Pagan people to still celebrate a beloved holiday without violating Christian beliefs.

Today, Halloween has evolved into a day devoted purely to fun, candy, and kids. What a change from its origins! We encourage all of our patients to have fun during the holiday, but be safe with the treats. Consider giving apples or fruit roll-ups to the kids instead of candy that is potentially damaging to the teeth and gums.

Remind kids to limit their candy and brush after eating it! Sweets can cause major tooth decay and aggrivate gum disease, so to avoid extra visits to our Worcester office, make your Halloween a safe one!

Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth, and endodontists are specialists in saving teeth if it’s at all possible to do so. Sometimes, though, due to injury or decay, an extraction is the only choice for your oral health. After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy and the extraction is a simple one, we might be able to place an implant post in the socket right away.

But often, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone which is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Worcester office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible. If you have an extraction scheduled, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

You just crunched down on a piece of hard food when you suddenly realize there is something hard still in your mouth. Your nightmare is confirmed when you retrieve a piece of your tooth from your mouth. You chipped your tooth; now what?

Obviously, the first thing you need to do is call our Worcester office. While we make every effort to see emergent cases immediately, you may have to wait a day or so before you can see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. Luckily, it’s easy to take care of your chipped tooth while you wait.

How to Take Care of a Chipped

The last thing you want is for the tooth to become infected or break even more. Let’s look at a few things you can do:

• If the chipped tooth is causing you pain take an over-the-counter pain medication, like Tylenol. Always follow the directions on the label.
• You should also rinse your mouth with lukewarm saltwater, as this will help prevent an infection from setting in.
• If your chipped tooth has a sharp edge, cover it up with a piece of wax to prevent it from cutting you cheek, tongue, or lip.
• If you have to eat, make sure you eat soft foods and don’t bite down on the chipped or broken tooth.

Treatment Options for a Chipped Tooth

• Dental Filling and Bonding – If you only have a small chip in your tooth, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will probably fix it with a filling. If it is a front tooth, we may bond the tooth using a tooth-colored compound.
• Dental Crown or Cap – If you broke a large piece of your tooth, we may grind the remaining part of your tooth and put a crown or cap on it.
• Dental Veneers – If you chipped or broke your front tooth then choosing a dental veneer may be your best choice. It will make your tooth look completely normal.
• Root Canal – If you cracked your tooth and the center (pulp) of the tooth is exposed and infected, you will need a root canal. If the center of your tooth is exposed, it becomes vulnerable to bacteria that will cause your tooth to abscess.

Chipping or breaking your tooth is never a good thing, and you should always call our Worcester office right away. The sooner you get your tooth repaired the less likely you are to have any problems with it.