Uncategorized

We’ve been celebrating the new year for a really, really long time. It goes way back, but it started formally in 1582, when Pope George XIII made January 1^st the official holiday for ushering in the new year. The idea was to yell, cheer, and blow horns to scare away all the evil spirits of the previous year with the hope that the new one would be filled with happiness and opportunity.

While scaring away evil spirits isn’t what’s on our mind these days, we still ring in the New Year by cheering and hollering with friends and family. It’s a time to set new goals, refocus on old ones, and look forward to all the surprises the coming year will bring.

Whether you’re saying hello to the New Year snuggled up at home on your couch in the Worcester area or by gathering your friends for a social celebration, here are some tips to help ensure you welcome this new chapter with a smile.

Tips for a great New Year’s Eve celebration from Central New England Endodontics and Implantology

• Stay safe. This one’s vital, because nothing puts a damper on your party like an emergency trip to the hospital. Stay responsible and try to plan ahead, whether that means taking a taxi, staying with a friend, or recruiting a designated driver. Do what you have to do to keep yourself and everyone around you safe.
• Spend time with the people you love most. The way we see it, the whole point of the holiday season is to cherish your family and friends. Regardless of what you’re doing, make sure there’s something for everyone. It’s essential to do something the whole group will enjoy!
• Smile! Whether you get all dressed to go out or have a quiet gathering with family and friends, make sure you accessorize with a smile. There’s always something to smile about!

We can all agree that change can be scary sometimes, but ringing in the New Year is an observance we all welcome with open arms. We hope you’ll enjoy this transitional holiday in a fun, healthy, and safe way. You have endless possibilities ahead of you!

From Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, have a fantastic New Year!

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.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, as well as our team at Central New England Endodontics and Implantology, would like to give those patients with flex spend, health savings, or insurance benefits a friendly end of the year reminder that it’s high time to schedule your dental visits so you optimize your benefit.

Now is the time to reserve your appointment with us. Space is limited and we tend to get busy around the holidays, so don’t wait to give us a call at our convenient Worcester office!

Have you ever thought about how you're cleaning and storing your toothbrush when you're not using it? Did you know that the way you store your toothbrush could have an affect on your oral health? In this post, we'll look at some steps you can take to maximize toothbrush cleanliness and minimize bacteria.

Below are some tips from Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for toothbrush use and storage:

• Don't share your toothbrush – This may seem obvious, but sharing a toothbrush exposes both users to bacteria and microorganisms from the other user, which can increase chances of infection. You should also avoid storing your toothbrush in the same container as other people’s toothbrushes.
• Thoroughly rinse your toothbrush after each use – Rinsing your toothbrush well under running water will help remove food particles, toothpaste, and other debris from the bristles of your brush.
• Store your toothbrush in an open-air container not a sealed one – Putting a wet toothbrush in a sealed container creates a favorable environment for microorganisms and bacteria.
• Soak your toothbrush in an antibacterial mouthwash after use – There is some evidence to suggest that soaking your toothbrush in an antibacterial solution may reduce the amount of bacteria present on the toothbrush.
• Change your toothbrush every three months – The bristles of your toothbrush become less effective and frayed after repeated use so it's a good idea to replace it on a regular basis. It's also wise to replace it after you've been sick.

There are many simple things you can do to make your oral-care regimen as clean as possible. Use common sense when storing your toothbrush—don't put it in a dirty place like the edge of your sink or in the shower (please, not by the toilet!), and keep it upright in a cool dry place—and you're usually good to go. If your toothbrush is looking a little worse for wear, drop by our Worcester office and we'll be glad to provide you with a new one!

One of the latest foods in dietary news is also one of the oldest—ancient grains. What makes these old-timers so appealing to modern tastes? Let’s run down the menu!

Why Are Some Grains Called “Ancient”?

Unlike grains such as modern wheat, which have been crossbred for hundreds of years to bring out certain qualities, ancient grains are generally considered to be grains which have been cultivated in the same way and in the same form for centuries.

Not All Grains Are the Same

Grains are harvested from the seeds, or kernels, which grow on top of cereal grasses. But because they have many of the same uses, and many of the same nutrients, ancient grains also include pseudocereals, which are seeds and fruits from non-grasses. These seeds can be ground just like grains or used whole. This is an important distinction for many diet-mindful people because grains derived from pseudocereals are gluten-free.

The Health Benefits of Ancient Grains

Ancient grains are whole grains. This means that the seeds of ancient grains have their bran, germ, and endosperm intact—which means that all their nutrients, proteins, and fiber also remain intact. Refined grains like white flour and white rice have removed many of these good-for-your-body elements by removing the bran and germ, leaving only the endosperm behind.

The Dental Benefits of Ancient Grains

Of course, any food that offers better nutrition is better for your teeth and gums. But there’s an added bonus in the more complex structure of intact grains—they take more time to digest.

With foods made with refined grains, digestion starts taking place quickly—in fact, saliva starts the digestive process right in our mouths while we eat. And as these carbs break down into sugars, they provide a feast for the oral bacteria which convert that sugar into acids.

These acids, in turn, attack tooth enamel, leaving weaker spots which can grow into cavities, and irritate delicate gum tissue. What’s more, refined carbs tend to be extra sticky, lingering in the mouth, between the teeth, and on the enamel instead of being washed away by saliva.

So, Have Any Suggestions for My Shopping List?

We do! Because all ancient grains are loaded with protein and fiber, they are all going to be a rich source of these healthy essentials. And they can offer additional minerals, vitamins, and antioxidants to your diet. If you’re inspired to add a bit of history and geography to your plate, here are some ancient grains to consider:

• Amaranth

Cultivated by the Aztecs, this gluten-free pseudocereal seed is high in manganese, magnesium, copper, phosphorus (which helps keep your enamel strong), and also provides vitamins B1 (thiamin), B6, and B9 (folic acid).

• Barley

Grown for thousands of years in Asia and Europe, barley is one of the first cultivated grains. In its whole grain form, barley offers us selenium, manganese, copper, vitamins B1 and B3 (niacin), and antioxidants. Whole barley has a very tough outer shell and takes quite a bit of cooking, so lightly pearled barley can be substituted with only a small loss of bran.

• Buckwheat

Originating in Asia, buckwheat quickly spread to Europe and eventually made its way to early American fields. Another pseudocereal, buckwheat seed is often ground for flour, and is a good source of copper, manganese, magnesium, phosphorus, vitamins B2 (riboflavin), and B3. Not to mention, gluten-free!

• Bulgur

Often used in Middle Eastern and Mediterranean cooking, bulgur is a cracked wheat cereal grain. Bulgur adds, among other nutrients, manganese, magnesium, copper, iron, and vitamins B3 and B6 to your diet.

• Farro

“Farro” comes from an Italian word which can refer to three different varieties of wheat, with different cooking times, textures, and flavors. These grains were first cultivated in the Middle East and the Mediterranean region thousands of years ago, and are still popular today thanks to their nutty flavor and chewy texture. Try farro for a tasty serving of magnesium, zinc, vitamin B3, and antioxidants.

• Freekeh

Common in Middle Eastern, North African, and Mediterranean cuisine, freekeh is another form of cracked wheat. It’s harvested when the plants are young, so it has extra protein and fiber, as well as being a good source of iron.

• Quinoa

Another pseudocereal, quinoa originated in South America. It’s gluten-free, and filled with minerals such as manganese, magnesium, phosphorus, and vitamin B9. It’s also a complete protein, which means it contains all nine of the amino acids our bodies can’t produce on their own.

• Spelt

One of the largest wheat crops in Europe, and grown around the world, spelt’s nutty taste is an added bonus to its stores of manganese, copper, phosphorus, and vitamin B3.

• Teff

The smallest of the ancient grains, teff is an African variety of millet, a pseudocereal full of nutrients such as manganese, copper, iron, and calcium (another mineral which is vital to dental health), as well as vitamins B1 and B6. Try brown teff for its naturally sweet flavor.

This is just a taste of the ancient grains available to you, with many others from around the world waiting to be harvested for your table. But you needn’t choose ancient grains to receive all the nutritional benefits of whole grains.

Brown rice, whole wheat products, corn, oats—all these common ingredients are easily available forms of whole grains. Check the grain aisle in your local market for some new ways to brighten your recipes, to increase your dietary protein and fiber, to add minerals and vitamins, and to provide some healthy alternatives to refined grains. Your body—and your teeth—might thank you!

A strong, healthy smile is built on a strong, healthy foundation. Let’s take a moment to explore just what creates that foundation—your roots.

The Root of the Matter

The visible part of your tooth is called the crown. And while we spent the great majority of our time thinking about what goes on above the gum line—brushing, flossing, whitening, sealing, preventing cavities—the roots, the parts of the teeth below the surface, are also essential to our dental health.

• What’s inside the root?

The inside of each tooth holds pulp, which is living tissue made of nerves, blood vessels, and connective tissue. The nerves in the pulp allow us to feel pain when a tooth is damaged, decayed, or infected. Tiny blood vessels provide oxygen and nutrients to the cells.

The inside of each root also contains pulp, located in one or more root canals. These canals are small tunnels that travel from the pulp chamber to the tip of each root. Nerves and blood vessels connect pulp tissue to the nervous and circulatory systems in the body, entering and exiting the tooth from very small openings in the root tip.

• What’s outside the root?

On the outside, while roots look like crowns, they’re covered with a different protective surface. Roots are covered by cementum rather than enamel. This is a hard tissue, but not as hard as enamel. But cementum has another advantage—it not only helps protect our teeth, it helps them stay anchored in our jaws. (More on this below.)

• How many roots are we talking about?

The number varies, not just depending on the tooth, but depending on the individual. Most adults have 32 adult teeth: eight incisors, four canines, eight premolars, eight molars, and four wisdom teeth, or third molars. Because the number of wisdom teeth can range from four to zero, though, that total can be smaller.

Rooted to the Spot

The reason that you can rely on your teeth for a lifetime of chewing, biting, and grinding food is the fact that they’re so securely anchored in the jaw.

• Alveolar bone in the jaw contains a socket for each tooth.

• A thin layer of connective tissue called the periodontal ligament lines the socket and surrounds each root. It’s filled with fibers that attach to the root’s cementum covering and to the alveolar bone, holding the tooth securely in place.
• The periodontal ligament not only anchors the tooth, it cushions it from the daily pressure of biting and chewing.
• Finally, the gums surround the teeth and bone, protecting them from bacteria and plaque.

Even though this design is very secure, there are situations where the root becomes vulnerable. In that case, you should see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office right away. Our goal is for you to keep your teeth healthy and strong, and for a lifetime!

It's the end of summer, and fall is just around the corner. Soon the temperatures will cool down, the leaves will start to change, and Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology are sure that you’ll soon be thinking about Halloween costumes and Thanksgiving plans in no time. But wait! First, we want to know about your favorite parts of the summer! Did you go on a wonderful family trip? Did you pick up a new hobby? Did you try to spend as much time outside and in the sun as possible?

Share your favorite memories, stories, or photos with us by leaving a comment below or on our Facebook page.

Labor Day honors the contributions that workers have made to this country, and for many Americans, the holiday is a great time to relax at home with family and friends. But there are quite a few people who celebrate the holiday by getting out of town, with an estimated 33 million people traveling more than 50 miles over Labor Day weekend each year. If you’re dreaming of a great Labor Day escape but you’re not quite sure where to go, here are a few ideas from our team at Central New England Endodontics and Implantology to give you some travel inspiration.

Explore a National Park

On a national holiday like Labor Day, it’s only fitting to experience the beauty of America’s landscapes by heading to the nearest national park. If you’re confined to an office most days of the year, national parks can provide a relaxing and scenic escape, whether you’re by yourself, traveling with a group of friends, or bringing the whole family along. Depending on how close you live to the nearest park, you can stay for an afternoon or for longer than a week. With 58 parks located in 27 states, there are plenty of beautiful areas to choose from.

Chow Down in a BBQ Haven

Barbecuing is a popular Labor Day activity, but instead of sweating over your own grill or oven, try visiting one of the country’s BBQ capitals. U.S. News and World Report names Memphis as the top BBQ destination, with more than 80 BBQ restaurants in the city, most notably Corky’s BBQ and Central BBQ. Kansas City is also known for the sweet taste of its sauces, while central Texas is said to have perfected the technique of smoking tender and flavorful brisket.

Relax on the Beach

Many people think of Labor Day as the unofficial start of fall, which brings cooler temperatures, more rain, and for many people, an end to lazy days at the beach. End your beach days with a bang by taking a trip to one of the coasts or to a lakeside beach. For an added dose of festivity, find a city or town that celebrates the occasion with a fireworks display over the water.

Whether you’re looking to turn your getaway into a full week affair or you simply want to experience a quick escape, make the most of your holiday by changing your surrounding scenery. Happy Labor Day from the dental practice of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants!

At our office, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team do all that we can to make sure that your experience with us is the best it can possibly be. However, there’s an important role you play in this as well: leaving us reviews and feedback.

Whether there is something you’d like us to improve upon, or you’d just like to express your thanks for a job well done, your feedback is essential to our practice’s success.

We look forward to hearing from you, and are excited to hear what you thought of your most recent visit at our Worcester office.

By now, everyone knows that smoking is bad for you. But the truth is its broad-reaching health effects are not all known by everyone. This is especially true of oral health. Smoking can have serious repercussions in this regard. To give you a better idea of how smoking can affect your oral health, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have listed some issues that can arise.

Oral Cancer

Oral cancer can have steep ramifications for anyone that gets it. Surgery can be required to eliminate the cancer before it spreads to more vital parts of your body. Any type of cancer is about the worst health effect you can get, and this especially holds true to the affects that smoking has on your mouth. The type of mouth surgery required with oral cancer can leave your face deconstructed in certain areas, and it is all due to smoking or use of other tobacco products.

Tooth Discoloration and Bad Breath

At the very least, it is fair to say that as a smoker you will often have bad breath, and while you may try to cover it up with gum or mints, tooth discoloration is a whole other story. The chemicals and substances in cigarettes stick to your teeth staining them brown and yellow colors that are increasingly difficult to disguise.

Gum Disease and Loss of Bone

Another effect of smoking is the increased risk of gum disease. Your gums may start to recede, which can eventually lead to the loss of teeth. Smoking can also increase bone loss and density in your jaw which is vital to the health of your mouth. Gum disease and bone loss are two signs that smoking is definitely bad for your mouth.

When it comes to the health of your mouth, the question is not whether smoking affects your health, it's how does it affect your health and to what degree. If for no other reason than because smoking involves your mouth as its entry point, it is safe to say that it can have long-lasting and detrimental consequences on your oral health.

To learn more about smoking and your oral health, contact our Worcester office to schedule an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

Nobody likes a dry mouth. It is an uncomfortable and sometimes oddly unexplainable sensation that most people like to avoid. It is not a condition that automatically sends you into a panic about your health, however, a dry mouth can be a bother and something you certainly want to change if possible. So, if you find yourself in the unpleasant position of having a dry mouth, here is what you can do.

Chew Sugar-free Gum: Chewing sugar-free gum will stimulate saliva in your mouth. The chewing motion of your jaw and teeth should take care of at least some of your dry mouth problem.

Suck on Sugar-free Candy: Similarly to chewing sugar free gum, if you suck on sugar free candy it should create more saliva in your mouth and moisturize it in the process.

Cut out the Caffeine:Caffeine can contribute to a dry mouth so by limiting, or eliminating your intake all together, you may find that your dry mouth is no more.

Stop Using Tobacco Products: Tobacco is another cause of dry mouth. Whether it is smokeless tobacco products or cigarettes, if you stop using them your dry mouth will likely improve. And not to forget, these products are exceedingly bad for your oral health to begin with, so you will be doing your mouth a favor even more so.

Drink Lots of Water: It may seem obvious, but drinking lots of water will likely improve your dry mouth. This is because dry mouth is usually a sign of dehydration, so plenty of fluids will surely help.

Dry mouth can be unpleasant, but it is often easily solved by either drinking more water, or trying one of the previously mentioned techniques. If the problem still persists you can always visit our Worcester office to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. More often than not, doing one of the above will leave your mouth more moisturized than it was previously, and hopefully it will be long-lasting as well.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology understand that many of our patients have a fear of dentistry. You may be concerned about experiencing pain from sensitive teeth or routine procedures. General anxiety is also common. Do not put off visiting our Worcester office; we offer various types of sedation to take the pain and fear out of your dental procedure.

Nitrous Oxide Sedation

For many patients, nitrous oxide, combined with local anesthetics, will both provide pain relief and reduce anxiety. Nitrous oxide is beneficial because the dosage can be regulated during treatment and patients are normally capable of driving shortly after the procedure is completed.

Oral or Injected Sedation

With oral sedation, you may be given a pill or liquid to consume several hours before your procedure. You will not be able to drive yourself to the appointment. An oral liquid is often given to children before any shots or intravenous anesthesia. An intramuscular injection may be given at the office that provides relaxation benefits for 20 to 30 minutes.

Nitrous Oxide with an Oral Sedative

If you experience higher levels of anxiety, an oral or injected sedative can be offered before nitrous oxide is started. This is also effective for reducing anxiety regarding the injection of local anesthetics. A liquid medication followed by nitrous oxide is beneficial for children. This combination can produce a deep sedation level.

General Anesthesia

This type of anesthesia can be offered as an inhaled gas or intravenous liquid. If no oral sedative is given before the general anesthesia is administered, you should wake up quickly after your procedure is complete. An injection, pill, or liquid medication can be offered to reduce anxiety before intravenous sedation begins. Intravenous sedation can also be used at moderate-to-deep sedation levels without complete loss of consciousness.

Do not hesitate to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about receiving sedation or pain prevention when you visit. We will be glad to explain the options we have available and answer all your questions to ensure that your exam is pleasant for you.

An endodontist like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is a specialist in the diagnosis and treatment of conditions affecting the inner tooth. Most of us are familiar with root canals, where infected or damaged pulp is removed, the inside of the tooth is cleaned and shaped, and a filling is placed inside before the tooth is sealed. In fact, root canals are one of the most common ways to save a tooth that would otherwise be a candidate for extraction.

But what if your tooth needs further attention? Fortunately, we also have training in surgical techniques that can save teeth with more serious or complex problems. These endodontic surgeries can take a number of forms:

• Apicoectomy

Inflamed or infected tissue can sometimes persist near the apex, or tip, of a root even after a root canal procedure. An apicoectomy allows Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to make an incision in the gum tissue, remove the affected root tip, clean the infected tissue from the root canal and the bone surrounding it, and seal the tip.

• Root Resection

Sometimes a tooth with two or more roots suffers decay or damage in only one root, or in the bony area surrounding it. If the root is unrestorable, an endodontist can perform a root resection, removing only the damaged or infected root and tissue. Care is taken to preserve the healthy roots and crown.

• Tooth Resection

In this procedure, a molar tooth with multiple roots is treated surgically to preserve as much of the tooth and crown as possible. The tooth is separated into two sections, and both sides are reconstructed (bicuspidization), or the part of the root and crown that can be saved is treated while the other section is extracted (hemisection). While extraction followed by an implant has become a common method of treating a seriously decayed or damaged tooth, these procedures can often save as much of the natural molar as is possible.

• Root Canals

Most root canals are performed without surgery, but sometimes calcium deposits build up in the roots making the canals too narrow for regular root canal files. In this case, a surgical procedure will enable Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to remove infected tissue, clean, and seal these narrow spaces.

• Diagnostic Surgery

Sometimes, the reason you are suffering tooth pain is clear as soon as you open your mouth. Sometimes, an X-ray will show the cause of unexplained discomfort. And sometimes, a tooth fracture or the branch of a root canal might be so small that it is not apparent even with the help of X-rays. In this case, endodontic surgery will allow us to locate, diagnose, and treat hidden root problems.

These procedures are just some of the methods we have for preserving teeth that would once have been considered impossible to save. And saving your natural teeth? That’s simply the best.

Sometimes food that’s good for your body isn’t necessarily the best for your teeth. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team want you to know which healthy foods can harm your teeth and gums, and what steps you can take to continue enjoying these foods, even when you’re dieting.

When you begin to substitute empty calories with whole foods, make sure you also remember to focus on your dental health. The majority of people tend to switch out sugary foods in favor of fruits and vegetables when they diet.

It’s worth knowing that most fruits are highly acidic and composed of natural sugars. Some of the highly acidic fruits to watch out for include apples, grapes, strawberries, pineapples, blueberries, oranges, and grapefruit. Moderation is key here, as with all other things. Fruits can be a great source of energy to help you through your day, but try not to overdo them.

Often, people also incorporate more leafy greens into their diets, which mean plenty of salads. Salad dressing is another item you’ll want to watch out for. Many dressings are filled with vinegars and sweeteners that include harmful acids, which change the pH of your mouth. When your mouth shifts from alkaline to acidic, your smile also turns to a higher risk for erosion and decay.

Rather than get rid of these foods altogether, simply change what you do after you eat them. Rinse your mouth out with water, brush your teeth, or eat alkalizing foods after consuming these acidic foods. Healthy alkalizing foods include dairy products such as eggs and yogurt, or any type of vegetable.

If you have questions regarding your current diet and its effect on your oral health, please contact our Worcester office and speak with a member of our staff. If you’ve begun to make changes in your diet toward a healthier lifestyle, we hope these tips can help your make positive changes to your oral health. Our team at Central New England Endodontics and Implantology wants a healthy lifestyle to be a top priority in your life.

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

We’re all friends here, so if you feel a bit nervous before your endodontic appointment, no judging! Ask us about any worries you might have. We are happy to explain procedures, equipment, and sedation options so you know just how safe and comfortable your experience can be. And if X-rays are a concern, we can put your mind at ease here as well.

What Exactly Are X-rays?

Sometimes patients feel reluctant about the process of imaging because X-rays are a kind of radiation. But the fact is, radiation is all around us. We are exposed to radiation naturally from our soil and water, sun and air, as well as from modern inventions such as cell phones, WiFi, and air travel.

Why is radiation so common? Because matter throughout the universe constantly gives off energy, and the energy that is emitted is called radiation. This radiation takes two forms—as particles (which we don’t need to consider!) and as traveling rays. This second type is known as electromagnetic radiation, created by photons traveling in regular waves at the speed of light.

We are exposed to electromagnetic radiation every day, because, whether we can see them or not, these different wavelengths and frequencies create various forms of light. Radio waves, microwaves, infrared, visible, and ultraviolet light, X-rays, and gamma rays are all part of the electromagnetic light spectrum.

Different types of radiation on this spectrum have different wavelengths and different frequencies, and produce different amounts of energy. Longer wavelengths mean lower frequencies and less energy. Because X-rays have shorter wavelengths and higher frequencies than, for example, radio waves and visible light, they have more energy.

How Do Dental X-rays Work?

An X-ray machine produces a very narrow beam of X-ray photons. This beam passes through the body and captures images of our teeth and jaws on special film or digital sensors inside the mouth (intraoral X-rays), or on film or sensors located outside the mouth (extraoral X-rays). These X-ray images are also known as radiographs.

Why are X-rays able to take pictures inside our bodies? Remember that higher energy we talked about earlier? This energy enables X-rays to pass through the softer, less dense parts of our bodies, which are seen as gray background in a radiograph. But some substances in our bodies absorb X-rays, such as the calcium found in our bones and teeth. This is why they show up as sharp white images in radiographs. 

There are several different types of dental X-rays used in endodontics, including:

• Bitewing X-rays, which are used to examine the roots and surrounding bone in the back teeth.
• Periapical X-rays, which allow us to look at one or two specific teeth from crown to root.
• Panoramic X-rays, which use a special machine to rotate around the head to create a complete two-dimensional picture of teeth and jaws.
• Cone Beam Computed Tomography, an external device which uses digital images to create a three-dimensional picture of the teeth and jaws.

Why Do We Need X-rays?

If all of our dental conditions were visible on the surface, there would be no need for X-rays. But there are many conditions that can only be discovered with the use of imaging—infection, decay, a decrease in bone density, or injuries, for example, can show up as darker areas in the teeth or jaws.

Endodontists specialize in treating the pulp chamber and root canals within each tooth that hold tissue, nerves, and blood vessels and the supporting tissues around them. “Endodontic” literally means “inside the tooth,” so it’s clear why X-rays can be essential for both diagnosis and treatment!

Some of the procedures which might require X-rays include:

• Root canal treatment or retreatment
• Apicoectomies (removing the tip of a root to treat recurring infection)
• Treating abscesses and infections in the tooth and surrounding bone
• Repairing fractures or other injuries to a tooth
• Treating an avulsed, or knocked out, tooth

How Do Endodontists Make Sure Your X-rays Are As Safe As They Can Be?

First of all, the amount of radiation you are exposed to with a dental X-ray is very small. In fact, a set of bitewing X-rays exposes us to slightly less than the amount of radiation we are exposed to through our natural surroundings in just one day. Even so, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team are committed to making sure patients are exposed to as little radiation as possible.

Radiologists, the physicians who specialize in imaging procedures and diagnoses, recommend that all dentists and doctors follow the safety principal known as ALARA: “As Low As Reasonably Achievable.” This means using the lowest X-ray exposure necessary to achieve precise diagnostic results for all dental and medical patients.

The guidelines recommended for X-rays and other imaging have been designed to make sure all patients have the safest experience possible whenever they visit the dentist or the doctor. We ensure that imaging is safe and effective in a number of ways:

• We take X-rays only when they are necessary.
• We provide protective gear, such as apron shields and thyroid collars, whenever needed.
• We make use of modern X-ray equipment, for both traditional X-rays and digital X-rays, which exposes patients to a lower amount of radiation than ever before.
• When treating children, we set exposure times based on each child’s size and age.

And now that we’ve talked about some things you might like to know,

Please Let Us Know If . . .

• You are being treated after previous endodontic work. We’ll let you know if your earlier X-rays might be useful, and how to transfer them. (With digital X-ray technology, this transfer can be accomplished electronically!)
• You’re pregnant, or think you might be pregnant. Even though radiation exposure is very low with dental radiographs, unless there is a dental emergency, dentists and doctors recommend against X-rays for pregnant patients.

X-rays play a vital part in helping us diagnose and treat endodontic issues. If you have any concerns, contact our Worcester office. When it comes to making sure you’re comfortable with all of our procedures, including any X-rays that might be necessary, we’re happy to give you all the inside information!

It’s not that we’re superficial. It’s just that most of our daily dental activities deal with surface issues. Are we brushing too hard? Flossing enough? Is there visible plaque? Or invisible plaque? Are our teeth gleaming white?

And these are all good questions—for another day. Today, we’re going to go below the surface, under the enamel, beneath the dentin, and talk about the substance that fills the inside of each tooth—our pulp.

The outer surface of the tooth crown is covered with enamel. This protective, mineralized coating is the hardest substance in the body. Cementum, a hard connective tissue, covers the roots of the tooth. Underneath the enamel and cementum surfaces, we find dentin, a layer slightly softer than enamel, which makes up most of the tooth. And inside the dentin lies the pulp chamber.

This chamber holds the tooth’s pulp, which is living tissue made of nerves, blood vessels, and connective tissue. Nerves and blood vessels travel from the chamber through our root canals, where they enter and exit through a small opening in the root tip, connecting to our nervous and circulatory systems. Healthy pulp performs several important functions, which help protect healthy smiles:

• Sensation

The nerves in the pulp allow us to feel temperature and pressure. They also alert us when a tooth is decayed, damaged, or infected. Sensitivity and pain are warnings that a visit to your dentist is in order.

• Nourishment

Tiny blood vessels provide oxygen and nutrients to the pulp cells. The pulp, in turn, nourishes the dentin and keeps the tooth from becoming brittle.

• Creating new dentin

Unlike enamel, which can’t be replaced or regenerated, dentin production is ongoing, and it begins with cells called odontoblasts, which are found in the pulp.

Even though this tiny organic system is well protected by the tooth’s outer layers, tooth pulp is still vulnerable to damage:

• Decay

When a cavity isn’t treated quickly, decay can progress from the enamel through the dentin layer and reach the tooth’s pulp.

• Trauma

Accidents happen. And sometimes, an accident will expose the pulp of the tooth. Or the pulp can be affected by repeated dental treatments or tooth grinding. Or a fracture can extend into the pulp chamber.

• Inflammation

Inflammation of the pulp is known as pulpitis. Sometimes pulpitis is mild and reversible, when the source of pulp irritation (a small cavity, for example) is treated. But sometimes it is not.

Irreversible pulpitis occurs when bacterial infection or pulp trauma is severe, and prompt treatment is necessary. When inflammation and swelling lead to the death of pulp tissue, acute pain, spreading infection, and tooth loss can result. Whenever the health of your tooth pulp is in question, it’s always a good idea to see an endodontist.

The word endodontic means “inside the tooth,” and endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, are the expert in pulp-related issues, saving teeth, which could otherwise be lost. While all dentists receive some endodontic training in dental school, endodontists receive two or three years of additional advanced training, concentrating on the diagnosis and treatment of diseases and injuries that affect the inner tooth and its supporting tissue.

One of the most common treatments for irreversible pulpitis is a root canal. In this procedure, done at our Worcester office, the infected or dead pulp tissue is removed (a procedure called a pulpectomy), and the pulp chamber is cleaned, filled, and sealed. After treatment, a crown is usually placed to protect and restore the appearance of the tooth. Your tooth can still function without its pulp, and, even when the pulp can’t be saved, a timely root canal or endodontic surgical procedure can often save your tooth from extraction.

In perfect conditions, the strong mineralized layers of our teeth would be enough to protect our pulp. But since conditions aren’t always perfect, there are some simple steps you can take to reinforce the protection your enamel, cementum, and dentin provide:

• Keep up with regular dental hygiene and checkups

Decay won’t reach your pulp if you prevent it from ever developing in the first place. And if, despite your careful brushing and flossing, a cavity does form, regular checkups make sure your dentist catches decay early before it can affect your pulp.

• Protect your teeth

Avoid incidents which can expose pulp to trauma by wearing a mouthguard when you’re active, a night guard if you’re a tooth grinder, and a seat belt whenever you’re in the car. And don’t forget a helmet if your sport offers one!

• Be proactive

Never ignore severe or continuing tooth pain. Whatever the cause of injury or inflammation, once the pulp has been compromised, treatment needs to take place to prevent further infection, pain, and even tooth loss. Call Central New England Endodontics and Implantology, especially if extraction is recommended. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team work to save injured teeth with a variety of procedures, including root canals, treatment of injuries caused by trauma, and endodontic surgeries.

This is just a bit of the inside story on pulp. If you have questions or concerns about your pulp, your teeth, or any facets of your dental health, talk to our Worcester team. We are experts in treating your teeth—inside and out!

Health gurus rave about replacing unhealthy food choices with healthy ones in your diet. If you want to maintain your beautiful smile as well as your waistline, choose foods that are good for your teeth and good for losing weight. This article will discuss some of the worst healthy foods for your teeth and gums, and what you can do to continue to enjoy them.

When watching your weight, snacks heavy in sugar and starch are the first target for elimination. You want to trade those empty calories for something with more nutritional value. A healthier snack is fruit and vegetables. When you are substituting empty calories with whole foods such as fruits and vegetables, consider a few implications for your dental health.

The most acidic fruits are grapes, grapefruit, and strawberries. Want to know the number-one worst healthy food for your tooth enamel? Apples! An apple a day may keep the doctor away but you may soon be calling your dentist.

Another healthy food often incorporated into dieting is salads. But consider what you put in those salads. Salad dressings are filled with vinegar and sweeteners. These make a salad very acidic and can change the pH of your mouth from alkaline, which is good for your teeth and gums, to acidic, which puts your smile at risk for erosion and decay.

Last but not least is diet soda. You might be cutting down on the calories but you are still putting your teeth at risk for decay. Though calories are reduced, the acid is not.

You do not need to eliminate any of these foods from your diet. Simply alter what you do after eating these foods to decrease the amount of acid your teeth are exposed to.

During your next visit to Central New England Endodontics and Implantology in our Worcester office, we can discuss your diet. We may recommend using certain products to fortify your teeth or change the way you routinely care for your teeth.

Please enjoy the wonderful whole foods that are great for a healthy waistline. A healthy waistline and a healthy smile have a positive influence on your general health. A healthier you is a happier you. The happier you are, the more you smile. Keep your smile brilliant and beautiful with the care your teeth deserve at the practice of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

When you leave on a trip, you probably double-check that evrything’s ready: your clothes are packed, your ticket is handy, and your passport waits patiently on top of your bag or in a special pocket.

The same level of preparedness should apply with regard to caring for your oral health when you’re about to leave home for a while. Whether you’re jumping in the car for a weekend camping trip or flying halfway across the globe for a longer stint, the tips below will help you keep your teeth healthy whil you’re away.

Prepare Ahead of Time

The key to maintaining good oral hygiene during travel is preparation. Schedule a regular dental appointment so your teeth are freshly cleaned and ready before you leave. This can identify potential issues that might cause problems while you’re away.

If you have any items on a dental “to-do” list, such as wisdom tooth removal, replacement of a filling, or orthodontic adjustment, it’s a good idea to get those procedures completed before your trip.

En Route

If you’re stuck on a long flight or trekking far into the woods, you might find yourself where there’s no sink or even a toothbrush at hand. We speak for everyone when we say that nothing is worse than a mouth that feels, shall we say, less than fresh.

A lemon wedge or Granny Smith apple slice can help freshen up your breath when you’re in need of a quick fix. Rinsing your mouth thoroughly with water can help to wash away bacteria that causes cavities and reduce that gritty sensation. If you’ve got toothpaste, put a dot on your finger or a damp washcloth to serve as a makeshift toothbrush.

Nowadays, travel-sized dental products are available at most grocery stores and pharmacies. You can find travel toothbrushes, mini mouthwashes, and pocket-sized floss to slip into your travel bag.

Colgate makes disposable mini-toothbrushes called Wisps that can help you freshen up when you may not have access to a regular toothbrush. Packing a few extra dental supplies may also be a good idea in case one gets damaged or lost.

At Your Destination

Traveling abroad can expose you to unfamiliar conditions. Some countries have compromised water sources that will make you extremely ill if ingested, even from the tiny amount of water with which you wet your toothbrush.

Minimize that risk and keep bottles of water on hand instead for rinsing your mouth and toothbrush. If your toothbrush comes in contact with contaminated water, swapping it out for a new one is the safest option.

Storing your toothbrush properly is necessary to prevent bacteria from growing on it. Place your brush in a Ziploc bag when you’re on the go and allow it to breathe once you get to a temporary destination.

Traveling near or far should be an enjoyable experience. Dental issues shouldn’t be a source of worry on your vacation. As long as you’re prepared and take precautions, your teeth can stay healthy even when they’re out of the country!

Of course, if you have any questions, don’t hesitate to contact our Worcester office.

Flossing is one of the most important parts of your oral care routine. Many patients know they need to do it but find it difficult to fit into their busy lives. Well, here's the good news: flossing once a day is enough if you're doing a good job!

Some patients like to brush before they floss and others like to floss before they brush. Some like to floss in the morning when they have more energy, others like to floss at night so they can go to bed with a clean mouth. Don't get hung up on any of this, the important thing is that you floss and floss effectively no matter when you do it.

Effective flossing contributes to oral health in these ways:

• It reduces the chance of cavities between teeth, since cavities can only form on teeth covered with dental plaque and you're scraping that plaque away when you floss.
• Along with brushing, it reduces the amount of time the plaque is left on your teeth, allowing them to be in a state of healing and remineralization for longer.
• It removes plaque that accumulates at or below the gum line, aiding in the prevention of gum disease.

As you can see, flossing offers many benefits for such a simple and inexpensive technique. So if you're still wondering how much to floss, don't worry about it. Don't mistake the frequency of your flossing with the effectiveness of it. Choose a dental floss that you like and one time during the day when you can floss thoroughly and just do it! If you need more tips on how to floss correctly, ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or any member of our Worcester team—we'd be glad to help you pick up this healthy habit!

X-rays have been a function of dental healthcare for a long time. That in and of itself should be good news, because it means we've had plenty of time to improve them. While there is always some risk in exposure to radiation, dental X-ray exposure has decreased significantly due to all the advances in technology. So there’s risk, but X-rays are quite safe.

Think of X-rays as you would about a car. Automobiles these days have all kinds of technology to make them as safe as possible. There's still a chance that you’ll suffer an accident. Would you stop using a car because of that risk? When it comes to dental X-rays, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team believe the positives clearly outweigh the negatives.

X-rays can be done digitally or with film. For film, X-rays require different exposures at different speeds to produce the image. Digital X-rays have software that automatically adjusts the exposure and produces the X-ray in a digital file. Since they substantially reduce your exposure to radiation, digital X-rays are the current standard in dental offices.

In addition to digital X-rays, lead aprons are an essential piece of X-ray safety. They help protect internal organs from X-rays by acting as a shield. They usually come with a thyroid collar as well, since that is one of the most vulnerable areas to X-rays in the body. Lead aprons can absorb up to 95% of any scatter rays that result from an X-ray. Not bad, right?

Although dental X-rays involve some radiation exposure (not all of it can be eliminated), so does everyday life. Getting too much sun, for example, can be dangerous. The truth is, we accumulate radiation in our bodies over a lifetime, so it’s worthwhile to be aware and avoid as much unnecessary exposure as possible. When it comes to your dental health, though, getting an X-ray — especially when your doctor says you need it — offers more benefits than risks.

Ask us about the type of dental X-rays we use during your next visit to our Worcester office!

Did you know that there are certain foods you can eat which help to clean your teeth? We call them "detergent foods." In dentistry we look at the impact of food in three ways: the kind of food, how often it is eaten, and when it is eaten. Detergent foods should be the last piece of food you consume during a meal for best results. Think of them as the closest you can get to brushing your teeth.

A healthy diet is important for oral health as well as overall health, but here are some particular foods that can help clean your teeth and mouth:

• Carrots
• Apples
• Celery sticks
• Popcorn
• Cucumbers
• Pears
• Lettuce
• Cheese

As you can see, detergent foods are usually foods that are firm and crisp. They act like scrubbers on and around your teeth and gums and bring your mouth's pH back to 7.0, which is optimal.

Which foods are the worst for your teeth?

Cookies, cakes, breads, chips, crackers, soft drinks, dried fruit, and candies (what many people’s diets are full of) provide carbohydrates (sugar) to the bacteria in your mouth causing an acidic environment and increasing the chance of cavities and decay. These foods are sticky and don't rinse easily from your mouth. Avoid letting these foods sit on your teeth after eating them.

It also depends on how often you consume these foods throughout the day. For example, if you drink soft drinks, it's best to have it all in one sitting instead of sipping it all throughout the day. Doing so causes the perfect environment in your mouth for bacteria to flourish and your saliva never gets the chance to neutralize its pH.

This is where detergent foods can come into play. When you're about to finish your meal, have an apple, celery stick, or carrot. It will act like a "natural toothbrush." Also, try to make these detergent foods the basis for snacks you have throughout the day.

Always remember, these foods are not a replacement for brushing and flossing. You still need good dental hygiene regardless of what you're eating! For more tips and tricks for ideal oral health, ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants the next time you visit our Worcester office!

Oral-systemic health is the idea that oral health is a critical and interconnected component to a patient’s overall health and well-being. Studies show that people who have poor oral health are more likely to have other health conditions such as heart disease, diabetes, or a high likelihood of stroke.

Some of the data suggests that oral pathogens may trigger up to 50% of heart attacks, and that the oral bacteria P. gingivalis may cause a 13.6-fold increase in patients’ risk of a heart attack.

Still, the exact relationship between oral and overall health isn't fully known — whether one causes the other or how treating one might affect the other. But it should serve as a warning call to anyone suffering with poor oral health, especially periodontal disease.

More studies need to be conducted to establish the precise link between the two, but whatever it is, one thing is certain: good oral hygiene makes for good oral health. Many dentists and doctors realize the need to work together as a cohesive healthcare team to improve and maintain the health of their communities.

The American Dental Association says oral health is essential to overall health, and not just a luxury. They are setting goals to reduce the amount of tooth decay in low-income communities for both children and adults.

So what is a patient about this information regarding oral-systemic health? Here are some tips to increase and maintain your overall well-being:

• Have an effective oral hygiene routine. Brush twice a day for two minutes each time, floss daily, clean your tongue, and avoid sugary beverages.
• Visit your dentist regularly. Regular cleanings and checkups at your dentist’s office will keep your mouth clean and ensure you’re taking good care of it.
• Eat a healthful diet. A diet rich in fruits, vegetables, whole grains, and natural, unprocessed foods contributes to the overall health of your body.
• Stay hydrated. Drink plenty of pure, clean water throughout the day. A good rule of thumb is to drink eight eight-ounce glasses a day.
• Relax, destress. Stress can play a big role in all forms of disease. Take time during your day to relax, meditate, stretch, and allow your body and mind to rest.

If you have questions about your oral health and how it may be affecting your general health, feel free to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office.

15.00

Happy Independence Day from Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and team! The Fourth of July celebrations in America may have changed a lot over the years, but there is no doubt that we Americans love to celebrate the anniversary of our country's independence! Today we're devoting the Central New England Endodontics and Implantology blog to some fun facts about the Fourth!

• My, how we have grown! This year the United States Census Bureau estimates that our country has 313.9 million residents celebrating the Fourth of July this year, but back in 1776 there were just 2.5 million members of the country.
• Our country loves to show how proud that we are of our independence. Did you know that there are 31 United States places with the word “Liberty” in their names? The state of Iowa actually has four towns with the word Liberty in the name: Libertyville, New Liberty, North Liberty, and West Liberty.
• The United States loves Fourth of July food! It is expected that around 150 million hot dogs are eaten on the Fourth each year. One of the Fourth's most popular sides, potato salad, goes just perfectly with the hotdogs and hamburgers that are standard Fourth of July fare. Some people choose potato chips instead, but we wouldn't have such a plethora of potatoes if not for the prodigious production of the states of Idaho and Washington -- they provide about half of all the potatoes in the United States today!
• Americans love celebrating the Fourth outdoors: About 74 million Americans fire up their BBQ grill every Fourth of July.
• The Chinese contribution: Did you know that Americans have spent more than $211 million on fireworks that were imported from China?

No matter how your family chooses to celebrate the Fourth, stay safe, take precautions, and don't forget to brush after your fabulous Fourth feast!

One good question; two good answers!

Why see an endodontist?

Many of us have experienced occasional minor tooth or gum pain and sensitivity. A new filling can lead to a brief period of sensitivity to pressure or heat and cold. Braces can be uncomfortable when they are new or recently adjusted. You might simply be brushing too hard! But sometimes, pain and sensitivity are caused by a more serious dental problem which should be treated as soon as possible.

When exposure to hot and cold foods causes continuous discomfort, or your gums are red or swollen or tender around a tooth, or when you can’t bite down without pain, it could mean that the pulp or roots of your tooth have suffered infection or damage. Damage to the tooth’s pulp can also be the result of an injury, such as a blow to the mouth. A chip, a crack, or a deep cavity can leave an opening for infection.

Whatever the cause of injury or inflammation, once the pulp and roots have been compromised, treatment needs to take place promptly to prevent further infection, pain, and even tooth and bone loss.

Why see an endodontist?

While all dentists receive some endodontic training in dental school, fewer than three percent go on to become endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. “Endodontic” means “inside the tooth,” and refers to the pulp chamber and root canals within each tooth that hold tissue, nerves, and blood vessels. Two to three years of additional education are required to become a specialist in this complex field, with advanced training in the diagnosis and treatment of injuries and diseases that affect the inner tooth and its supporting tissue.

When a tooth’s pulp is damaged, prompt treatment is necessary, and an endodontist has the ability, the experience, and the tools to provide you with the care you need. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team work to save injured teeth with a variety of procedures available at our Worcester office, including root canals, endodontic surgeries on tooth and root structures, and placement of posts and cores to strengthen and stabilize compromised teeth. With today’s advances in the field, endodontists have more sophisticated tools and treatments than ever before to save your injured tooth.

No matter how you ask the question, the answer is clear. If you have tooth, gum, or unexplained facial pain, talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about endodontic treatment.

For most of our dental concerns, seeing the family dentist is the first and only appointment we need. But when you need specialized treatment for an injured tooth, an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can not only save you pain and discomfort—it can even save your tooth.

Every tooth is protected by its hard enamel covering—in fact, tooth enamel is the hardest substance in the body—but it’s not perfect protection. Beneath that enamel lies less dense tissue called dentin, filled with tubules leading to the inner chamber of the tooth. This small inner chamber and the even more delicate canals inside each root of the tooth contain the sensitive dental pulp, which holds nerves, blood vessels, and connective tissue.

If the pulp has been compromised through decay, injury, or infection, treatment needs to take place to prevent pain, further infection, and even bone and tooth loss. The diagnosis and treatment of the inner tooth are the special focus of endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

Which symptoms could be a clue that your inner tooth needs treatment?

1. Sharp, severe pain when you bite down or put pressure on a tooth: This could be a sign that the pulp tissue inside is irritated, damaged, or infected.
2. Continuous facial pain, toothache, redness or swelling around the tooth: These symptoms could be signs of pulp inflammation, infection, or abscess.
3. Persistent sensitivity to heat and cold: Any sensitivity to temperature is a good reason to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. Cavities and even heavy-handed brushing can cause sensitivity for a few seconds after exposure to heat or cold. Any pain or sensitivity that lasts longer, though, could indicate pulp damage.
4. Unexplained soreness or pressure in the jaws and teeth: Grinding your teeth and certain sinus conditions can cause these symptoms, but if you have ruled out obvious causes, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants should be consulted.
5. A cracked or injured tooth: A crack or other injury can leave the pulp vulnerable to irritation, bacteria, and infection. Endodontists are trained to diagnose and treat the different varieties of tooth fractures, including crown, cusp, and root fractures.

If you are experiencing one or more of these symptoms, don’t put off endodontic treatment at our Worcester office. Once the inner tooth has suffered injury or infection, treatment should take place as soon as possible to prevent further damage to tooth, tissue, and bone. Endodontists work to save injured teeth with a variety of procedures, including root canals, endodontic surgeries on tooth and root structures, and placement of posts and cores to strengthen and stabilize teeth.

If you suspect that you have a tooth that needs endodontic treatment, call your endodontist, or, if you haven’t worked with an endodontist before, ask your regular dentist for a recommendation. Seeing a specialist trained in the latest and most effective endodontic techniques is the best option to save an injured tooth.

A lot of patients go at their teeth like they were sanding an old floor—that is to say, way too hard! Brushing too hard is probably the most common mistake patients make in their oral care routine, and it can be detrimental to the gums and teeth.

What can brushing too hard cause?

• Receding gums
• Bone loss around teeth
• Loss of teeth
• Tooth sensitivity, especially to hot and cold
• Worn down enamel

Brushing too hard wears away at your gums, which can lead to the neck of the teeth being exposed. This part of the tooth isn't covered by hard enamel like the rest of the tooth and hence the soft inner layer, or dentin, is exposed. Dentin is very sensitive to hot and cold and much more susceptible to bacterial decay. Once the gums recede due to improper brushing, it’s usually irreversible.

How to brush your teeth properly

You know you're supposed to brush your teeth twice a day, so why not do it right? First and foremost, you should only ever brush with a soft bristled brush—not medium or hard—unless directed otherwise by Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. Unless you have braces or specific oral health issues, brushing twice a day for two minutes is usually plenty.

The main purpose of brushing is to remove plaque from your teeth and gums. Plaque is actually soft and is a buildup of bacteria, saliva, and food debris. You really don't need to brush hard to remove it, just make sure you aim your toothbrush at the gum line (where plaque grows) and brush in small circular motions, never a back-and-forth motion.

It's also wise to hold your toothbrush gently. People tend to brush harder the tighter they hold their toothbrush.

Still have questions about proper tooth brushing technique or gum health? Ask any staff member or Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office; we'd be happy to help!

While modern dental science has made remarkable advances in treating oral diseases, prevention is always better than cure. To keep our mouth, gums, and teeth their healthiest, there are some simple practices we can follow to dramatically reduce dram the risk of developing some of the most common oral diseases.

Tooth Decay

We don’t usually think of tooth decay as a disease, but it is, in fact, the most common chronic disease in older children and adolescents. A great majority of adults have had at least some experience with decay. Left untreated, tooth decay can lead to pain, infection, tooth loss, and even loss of nearby bone in the jaw. Luckily, there are several time-tested ways to prevent cavities:

• Brush properly at least twice a day. Ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for the best toothbrush for your individual needs (usually, a soft brush is best), the best technique for angling the brush to reach all of each tooth’s surfaces, and the amount of time you should spend brushing.
• Floss daily. Even with perfect brushing form, you are going to want to use floss to clean between the teeth and around the gum line.
• Use a fluoride toothpaste. Study after study has shown that the risk of cavities is reduced with regular use of a fluoride toothpaste or rinse.
• Watch your diet. Foods high in sugar and simple carbohydrates give cavity-causing bacteria the fuel they need to produce the acids which weaken enamel. On the other hand, a diet rich in protein, vitamins, and minerals is beneficial not only for your teeth, but for your whole body!
• See your dentist for regular checkups to find small problems and prevent them from becoming major ones. Your dentist can also give you tips on better oral hygiene if your brushing and flossing habits aren’t doing the job.

Gum Disease

Preventing gum disease is a lot like preventing tooth decay—your daily habits really make a difference. When plaque builds up around the teeth and gums, the bacteria in plaque cause gum tissue to become inflamed, swollen, and painful. Left untreated, the gums pull away from the teeth, leaving pockets where bacteria collect and lead to infection. Infections harm not only gum tissue, but can destroy the bone which supports the teeth. What can you do to prevent gum disease?

• Use proper brushing technique. Remember to angle the brush toward the gums to gently clean around and below the gum line.
• Floss daily—flossing removes particles and plaque between the teeth, and it also helps remove plaque from the area under the gum line.
• Smokers are at higher risk for gum disease, and smoking has been linked to slower healing. Giving up tobacco products of any kind is always a good way to protect your dental health.
• Regular dental exams will catch gingivitis (early gum disease) while it is still reversible. Periodontitis (serious gum disease) can require treatment by a specialist. Certain diseases such as diabetes increase the risk of developing gum disease, so checkups are especially important.
• Having your teeth cleaned every six months, or as recommended, will remove plaque that brushing alone can’t handle. If there are signs of more serious gum disease, a periodontal cleaning will remove plaque and tartar from both above and below the gum line.

How Can Your Endodontist Help?

Endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants have the advanced education and training not only to treat several oral diseases, but to help repair the damage they can cause. Endodontists are experts in such procedures as:

• Root canals—your first option for preserving your tooth when the inner pulp has been damaged or infected
• Surgeries which allow access to tiny root fractures and canals, calcium deposits, or damaged roots and bone which can’t be reached non-surgically
• Apicoectomies, which treats recurring pain and infection by removing the tip of the root and any inflamed or infected tissue, then cleaning and resealing the root
• Endodontic surgeries such as root resections, which retain as much of the natural tooth as possible when a tooth is too damaged for normal restorations
• Implant surgery to provide a permanent, natural looking replacement for a lost tooth

An ounce of prevention is worth a pound of cure, and when it comes to your dental health, there’s a lot you can do to prevent oral diseases. But should you need endodontic treatment at our Worcester office, we have the knowledge and experience you need. After all, you can’t weigh the worth of your oral health—that’s priceless!

In a perfect world, we would all jump out of bed ready to greet the day with a big smile and a toothbrush close at hand to clean our teeth immediately. But if you can’t even find your toothbrush before you’ve had your first cup of coffee, does it really make a difference if you brush and floss after breakfast? Perhaps! Let’s talk biology.

Normal saliva production during the day benefits our teeth and mouths in surprising ways. Saliva washes away food particles to keep our teeth cleaner. It contains cells which combat bacteria and infection. It even provides proteins and minerals to help protect our teeth from decay. But saliva production slows dramatically as we sleep, and the amount of bacteria in our mouths increases. While one of the nasty—and obvious—side effects of bacterial growth is morning breath, there is an invisible effect, which is more harmful. Bacteria in plaque convert sugar and carbohydrates into acids which attack our gums and enamel and can lead to both gingivitis and cavities.

• If You Brush Before Breakfast

Brushing and flossing first thing in the morning removes the plaque that has built up during the night and takes care of many of the bacteria who are ready to enjoy the sugar and carbs in that breakfast with you. If you brush before eating breakfast, rinse your mouth with water after your meal, floss if needed, and you are good to go.

• If You Choose to Brush After Breakfast

But if you decide that doughnut simply can’t wait, you should ideally postpone brushing for 20-30 minutes after your meal. Of course, these are minutes in which bacteria can make use of those new sugars and carbohydrates. So why shouldn’t you brush immediately after eating? Many foods and beverages, especially acidic ones such as grapefruit and orange juice, can weaken the surface of your teeth. If you rinse with water after eating and wait at least 20-30 minutes before brushing, your enamel will be “remineralized” (another benefit of saliva) and ready for cleaning.

No matter if you take a “seize the day” approach and brush first thing in the morning, or a “seize the doughnut” approach and brush soon after eating, the important word here is “brushing.” Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our Worcester team are happy to make suggestions as to the best morning routine for you. One thing is certain: if you give your teeth and gums two minutes of careful brushing and flossing in the morning, you can’t help but start your day off right!

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Worcester office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

You may have bitten down on a hard food or object, or perhaps you had a cavity that weakened your tooth. Either way, your tooth is now broken, and the steps you take to care for it will determine whether you get to keep your natural tooth or not. Millions of people suffer from broken teeth every year, so you are not alone. However, that does not mean your newly cracked tooth does not need immediate attention.

What is a broken tooth?

A broken tooth is one that has been fractured, chipped, cracked, broken apart, or completely knocked out of the mouth. You may or may not feel your tooth break, depending on the extent of the break and whether your tooth was decaying prior to the break. It is usually very easy to diagnose a broken tooth, because the evidence will be visible. In the case of hairline cracks in the teeth, you may start to note a sensitivity to hot or cold in the neighborhood of the fracture.

The Right Way to Handle a Broken Tooth

As soon as you know your tooth is broken, chipped, or fractured, make an appointment to visit our emergency dental office. Even the tiniest fractures require attention: bacteria can infect the fractured area, which could cause you to lose the tooth altogether.

Until you are in our office, you can manage your pain using over-the-counter pain medication, such as Tylenol, or you can apply a cold compress to prevent swelling and inflammation. Be sure to rinse your mouth with warm salt water after every meal until you are able to visit us.

Keep in mind that while pain medication is an effective way to manage a broken tooth at home, it is only a temporary fix. Broken teeth should not be treated solely at home, and over-the-counter solutions are not substitutions for professional dental care. Failing to make an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants after breaking or chipping a tooth can place your health at risk.

Treatment

Treating your broken tooth will depend on the type of break you have and how much of the tooth is affected. A minor chip or tiny fracture line may easily be repaired with bonding. On the other hand, a more serious break that exposes the tooth's pulp may require a root canal or extraction to prevent infection. Ultimately, our team here at Central New England Endodontics and Implantology will explain to you the best treatment plan based upon our evaluation of the condition and extent of your break.

If you have broken, cracked, chipped, or fractured one or more of your teeth, don’t hesitate to contact our office immediately. We specialize in emergency dental care and are available to serve you 24 hours a day, seven days a week.

Do you ever find yourself gnawing at your nails? Nail-biting is a very common and difficult to break habit which usually has its beginnings in childhood. It can leave your fingers and nail beds red and swollen. But if you think that your nails are the only ones getting roughed up by nail-biting you'd be mistaken—so are your teeth!

According to a study by the Academy of General Dentistry, those who bite their nails, clench their teeth, or chew on pencils are at much higher risk to develop bruxism (unintentional grinding of the teeth). Bruxism can lead to tooth sensitivity, tooth loss, receding gums, headaches, and general facial pain.

Those are some nasty sounding side effects from chewing on your nails. Most nail-biting is a sign of stress or anxiety and its something you should deal with. So what steps can you take if you have a nail-biting habit?

There are several things you can do to ease up on nail-biting:

• Trim your nails shorter and/or get regular manicures – Trimming your nails shorter is an effective remedy. In so doing, they'll be less tempting and more difficult to bite on. If you also get regular manicures, you’ll be less likely to ruin the investment you’ve made in your hands and fingernails!
• Find a different kind of stress reduction – Try meditation, deep breathing, practicing qigong or yoga, or doing something that will keep your hands occupied like squeezing a stress ball or playing with a yo-yo.
• Wear a bitter-tasting nail polish – When your nails taste awful, you won't bite them! Clear or colored, it doesn't matter. This is also a helpful technique for helping children get over the habit.
• Figure out what triggers your nail-biting – Sometimes it's triggered by stress or anxiety and other times it can be a physical stressor, like having hang nails. Knowing what situations cause you to bite your nails will help you to avoid them and break the habit.
• Wear gloves or bandages on your fingers – If you've tried the steps above and they aren't working, this technique can prove effective since your fingernails won't be accessible to bite.

If you're still having trouble with nail-biting after trying these self-help steps, it's best to consult your doctor, dermatologist, or Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. For some, it may also be the sign of a deeper psychological or emotional problem.

Whatever the cause, nail-biting is a habit you need to break for your physical and emotional well-being. If you have any questions about the effects it can have on your oral health, please don't hesitate to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office.

A root canal entails the removal of the nerve supply from a tooth. If you know the purpose of a root canal, the process may seem a little less intimidating.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will explain the steps in person before your scheduled root canal. Here are some reasons why you may need one and how it will be done when you visit our Worcester office for your appointment.

Let’s look at the parts of a tooth. Teeth are made up of layers. The outside is the enamel you see, which is composed of minerals. The middle layer is called dentin. It is less dense and made of calcified tissues.

The center of the tooth, also known as the pulp, holds the nerves and blood vessels. When a tooth has decayed or been infected all the way down to the pulp, a root canal is used to remove and replace the root with a filling.

A cavity, sudden trauma, severe cracks, or other events that may cause nerve damage can start an infection of the root of your tooth. You may notice an infection if you experience abnormal pain, swelling, sensitivity, or change in tooth appearance.

Don’t hesitate to contact our Worcester office to schedule an examination if you notice these symptoms. We may need to take X-rays of the problem tooth to find out if a root canal is necessary.

Once an appointment is scheduled for a root canal and we’re ready to begin the procedure, you’ll be given anesthesia to keep you comfortable. The problem tooth will be isolated and sterilized. We work to remove all the infected area after that.

The treatment will include getting rid of nerve tissue and blood vessels, then filling in the spot where the nerve used to be. A crown is placed over the area to secure enamel from breaking down in the future and prevent the potential loss of the tooth. The root canal can block the possibility of having your tooth extracted due to decay or infection.

If you have further questions about root canals or notice any new issues in your mouth, please don’t hesitate to call our office and speak with a member of our staff. We’d be happy to answer your questions and schedule an appointment for you to come and get your problem tooth checked out.

Don’t forget: You can avoid having to undergo a root canal if we catch the problem early on!

When patients of Central New England Endodontics and Implantology hear any mention of oral or dental hygiene, they probably think of brushing and flossing their teeth. Although these are extremely important, the term dental hygiene encompasses much more than that. Your mouth’s health, including your teeth, has an important impact on your overall physical health. The National Institute of Dental and Craniofacial Research published the surgeon general's first ever report on dental health. It is called A National Call to Action to Promote Oral Health. In that report, the Surgeon General states that the 1948 World Health Organization expanded its earlier definition of health to "a complete state of physical, mental, and social well-being, and not just the absence of infirmity."

The Importance of Oral Health to Total Overall Health

One of the most important themes that the dental health report stressed is that you cannot be healthy without oral health. It went on to explain that oral health and general health are inextricably linked, and therefore can't be seen as two separate things. Because oral health is so critical to overall health, it should be included in all community health programs. For individuals, this means that it is just as important to take care of your mouth, your teeth, and your overall oral health as it is to take care of the rest of your body. The two most prevalent dental diseases are caries (cavities), also known as tooth decay, and periodontal (gum) disease.

Ways that Oral Health Impacts Overall Health

One important way in which good oral health contributes to better overall health is seen in the findings of several studies in which the blood sugar levels of diabetic patients were significantly lowered when their periodontal (or gum disease) was successfully treated. Your mouth has roughly 500 different species of bacteria. Many are harmless, and some are even good bacteria that help maintain the balance of your intestinal flora. Harmful bacteria can infect your gums, causing gingivitis. Your body's immune system may try to fight off the alien invaders, but they attack your gums, causing inflammation and bleeding when you brush.

Now that you know how important good dental hygiene is, be sure to see to get your teeth cleaned every six months, have regular dental checkups, brush and floss your teeth at least twice daily, and replace your toothbrush at least every couple of months. Call us to schedule your next appointment at our convenient Worcester location.

Nobody likes bad breath, and although it can sometimes be difficult to tell if you have it, it is always better to practice good oral health than risk having a smelly mouth. There are many ways to reduce or eliminate bad breath, some are definitely more effective and longer lasting than others. Check out ways to do so below.

Floss Regularly

As difficult as it can be to remember to floss regularly, when it comes to bad breath, flossing is one of the easiest and most cost effective ways to freshen your mouth. See, flossing reduces the plaque and bacteria found in areas of your mouth that a toothbrush simply can't reach, and in turn, it rids your mouth of the smell associated with that bacteria. While flossing may not eliminate bad breath on its own, if you do it along with other health oral hygiene habits like brushing, then you may just develop a fresher smelling mouth.

Use Mouthwash

Using some sort of mouthwash can really freshen up your breath, especially if you find it still smells after brushing and flossing. There is a wide variety of mouthwash products on the market, however, you can also create your own by simply using baking soda mixed with water.

Always Brush after You Sleep

Whether after taking a nap, or having a full night of sleep, you will want to brush your teeth in order to reduce bad breath. The truth is, bacteria accumulates in your mouth while you are sleeping (even during a short nap) and that is ultimately the source of bad breath. So next time you wake from a good slumber, give your mouth some brushing and you will find it makes a big difference in the freshness of your breath.

There are many ways to freshen your breath beyond just using gum or mints, the above mentioned are just a few for you to try. Test them out and you will likely find your bad breath problem is solved, or at least considerably reduced. Of course, you can always ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at your next visit to our Worcester office.

Getting to the Root of the Problem

While our roots are well-protected, they’re not indestructible! Several conditions can damage them. But we’re not just about problems—we also have some suggestions to keep your roots solid and intact for a lifetime.

• Traumatic Injury

A blow, a fall from a bike, a sports injury—any trauma which can hurt your visible tooth can hurt your roots as well. And it’s not just accidents that cause harm. Cracks in the tooth caused by oral habits like chewing on ice, pencils, or other hard objects can lead to root fractures.

You can help prevent root injuries by wearing a mouth guard whenever you are engaged in contact sports or any physical activity that might cause damage to your face or mouth. If you have harmful oral habits, talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about how to break them. And if you do suffer a dental injury, see us as soon as possible to avoid more serious complications.

• Bruxism

Bruxism, or tooth grinding, is most often an unconscious habit that takes place while you sleep. Grinding puts enormous pressure on teeth and their roots. The damage can be obvious, with cracked and worn crowns, but your roots can be affected, too. The strain of this constant pressure can stretch the periodontal ligament, causing loose teeth.

Night guards are one of the easiest ways to relieve pressure on individual teeth and roots. Your dentist can fabricate a night guard which will provide comfortable, effective protection for your teeth and jaw.

• Gum Recession

Taking care of your gums is one of the best ways to protect your roots.

Gums often recede as we age, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can also lead to gum recession. The newly revealed cementum is now exposed to the plaque and acids which cause cavities in our enamel, and, since it’s not as strong as enamel, cementum is more vulnerable to erosion and cavities progress more quickly.

When more severe recession takes place, the gums pull away from the teeth, creating pockets which become home to plaque and bacteria. Left untreated, infection and inflammation can develop, attacking teeth, connective tissue, and bone. Talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about scaling and planing procedures for a deep cleaning of the root surface, or grafting procedures to replace the gum tissue which protects your roots.

• Infected or Injured Roots

An endodontist is a specialist in diagnosing and treating conditions affecting the inner tooth and its surrounding tissues. To specialize in this field, endodontists have two or more years of additional advanced training in procedures designed to save your natural teeth.

Any infection or trauma which injures the pulp of the tooth will affect the roots as well. Most of us are familiar with root canal treatment, where infected or damaged pulp is removed, and the insides of the pulp chamber and canals are cleaned, shaped, and filled. A crown is usually placed afterward to cap and protect the tooth.  Endodontists are specialists in root canal treatment, saving teeth which would otherwise be lost.

Endodontists are also trained in surgical procedures which treat persistent root pain and infection:

• When infections recur near the tip of a root after a root canal, an apicoectomy is the most common surgical treatment. In this procedure, your endodontist will carefully remove a few millimeters from the tip of the tooth, then clean the infected parts of the tooth and the tissues around it before sealing the root tip.
• If a single root in a molar with multiple roots is seriously damaged, decayed, or infected, your endodontist might recommend a root amputation. Here the damaged root is surgically removed, preserving the remaining roots and crown. If the crown is damaged as well, your endodontist can perform a hemisection, removing the root and part of the crown to save as much as possible of the molar.
• When the reason for your discomfort is unclear, diagnostic surgery can find the cause of persistent pain when a tooth fracture or root canal branch is so small that even an X-ray doesn’t reveal it.

Healthy roots help you keep your teeth for a lifetime, so it’s important to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants as soon as possible if you have any symptoms of potential problems:

• Constant pain in tooth, gums, or jaw
• Pain when biting down
• Loose teeth
• Tooth discoloration
• Sensitivity to hot and cold
• Swelling or pain in the gums around a tooth

Do your part by keeping up with daily brushing and flossing, seeing your dentist for exams as recommended, and making an appointment at our Worcester office if you are feeling any pain or discomfort. Strong roots are essential to our oral health, and a lifetime of healthy smiles is something we’re all rooting for!

What exactly does an endodontist do?

If you are in need of a root canal, your regular dentist may refer you to an endodontist—a dental specialist who concentrates on performing root canals. After completing dental school, endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, attend an additional two or more years of specialty training in their field. They learn all about root canal therapy and other procedures that involve care of the roots of the teeth. Because they specialize in root treatments, endodontists develop considerable experience with these procedures. If you have been directed to an endodontist to address a root canal problem, you may rest assured that your teeth are in expert hands.

How will an endodontist save my teeth?

One of the many benefits of seeing an endodontist is the fact that endodontic procedures can help you avoid the extraction of your tooth. When your tooth is removed, obtaining a replacement can be costly and painful. It is also a time-consuming process that may still lead to a fairly unattractive end result. To avoid losing your natural teeth, treatment by Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can be highly preferable. When you require a root canal, it is most often because the root, or interior, of your tooth has become infected with bacteria or other diseases. During an endodontic procedure, the doctor removes the inflamed and infected pulp of the tooth, cleans and shapes the interior, fills the tooth with protective material, and seals it so no more bacteria can get inside. After that, you will receive a crown or other restoration device to protect the tooth from further damage and return it to full function. After the endodontic procedure, you essentially have a brand-new natural tooth!

Will I need additional treatment?

In some cases, patients need additional treatment following a root canal. One of the most common post-root-canal procedures is a root-end resection. If a patient continues to experience pain or inflammation in a tooth after endodontic treatment, it usually means the infection has spread to the bony area around the tooth. This is especially common when the tooth has experienced new trauma or decay since the root canal, or the crown has become cracked or broken. During a root-end resection, the doctor will open the gum tissue, remove the infected areas, and fill in the treated space to seal the root canal. After this procedure, it is rare that a patient will need further treatment. The careful and precise work of an endodontist can save you from future pain and additional dental work. If you need one or more root canals, treatment by a qualified endodontist can save your teeth.

If you have further questions about how how Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can help you save your natural teeth, please don't hesitate to contact Central New England Endodontics and Implantology at our Worcester office for more information!

Many smokers believe that chewing tobacco is a safer alternative to smoking cigarettes. This simply isn't the case! In fact, smokeless tobacco can cause serious health concerns.

Smokeless tobacco comes in many forms and goes by many names: dip, snuff, snus, or simply chewing tobacco. Use of these products usually involves sucking or chewing on shredded or loose tobacco leaves, sometimes flavored, for a prolonged period. There are even products that emulate a dissolvable candy-like consistency which are made of compressed tobacco powder.

What are risks and smokeless tobacco?

Whichever form a tobacco product takes, the dangers of using or consuming them is very real. According to a 2007 study by the World Health Organization's International Agency for Research on Cancer, there are upwards of 28 cancer-causing chemicals in smokeless tobacco that are known to cause cancer. And these products are habit-forming just like any other tobacco product that contains nicotine. Using them will increase your risk for many serious diseases including but not limited to: cancer (especially oral and esophageal), gum and heart disease, cavities, and pre-cancerous mouth lesions.

At the end of the day, long-term use of smokeless tobacco can cause serious health issues. These products really take a toll on both your oral and overall health. They put a strain on your immune system and make it less capable of warding off infection and disease.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team strongly advise you to stop using smokeless tobacco—or any kind of tobacco product—and not to pick up the habit if you aren't. There is no safe level of tobacco use, smokeless or otherwise.

Need to quit smoking or using smokeless tobacco products?

You can and should always talk to your doctor, healthcare practitioner, or Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for help quitting. But there are many other resources available today for those who'd like to quit. The National Cancer Institute offers information, support (local and online), and tools to help smokers and smokeless tobacco users quit. They offer live online chat with cessation counselors Monday through Friday and even have a smartphone application available to help people who are serious about quitting.

You can take a look at their website at smokefree.gov or call them toll-free at 1–877–44U–QUIT (1-877-448-7848). There is also help available from your state's quit line at 1-800-QUIT-NOW (1-800-784-8669).

Make the best choice for your health and well-being; avoid the bad habit of tobacco products. If you have any questions about how tobacco related products affect your oral health and hygiene, please don't hesitate to ask one of our Worcester staff members.

You and your endodontist are partners in making sure you have the best dental care. You do your part by eating a tooth-healthy diet, brushing and flossing as recommended, seeing your dentist regularly, and making an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants whenever endodontic treatment is needed.

And one more essential step you can take for your dental health? Let Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants know which prescriptions and over the counter medications you’re taking.

Medications Have Oral/Dental Side Effects

We’ve all grown used to hearing “Possible side effects include . . .” at the end of every pharmaceutical commercial. That’s because those unintended side effects can affect our health in any number of unexpected ways—and this includes oral health.

For example, a common side effect of many medications is xerostomia, or “dry mouth.” Because saliva helps keep our teeth and gums healthy by washing away food particles and oral bacteria and by reducing acidity in the mouth, a reduction in saliva production means a greater risk of cavities, gum disease, oral infections, denture discomfort, and bad breath.

Knowing a patient is taking one of the hundreds of medications that cause xerostomia allows Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to both monitor the condition and suggest the most effective treatment options to counteract these unpleasant symptoms.

Medications can cause not only dry mouth, but excessive gum tissue growth, oral sores, tooth discoloration, and changes in taste, among other side effects, so knowing which medications you are taking can provide essential information for Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to diagnose and treat these conditions.

Medications Interact

Medication might be needed for your endodontic treatment. Because certain drugs and supplements can affect the way our bodies metabolize, absorb, and respond to other medications, we need to know which medicines you are taking to arrive at your best treatment options.

• There are different classes of antibiotics used to treat oral infections. Knowing your medical history enables us to choose an antibiotic option that won’t interact with your other medications.
• Local anesthetics such as lidocaine, which numb the area to be treated, can also interact with certain medications. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can prescribe an alternative local anesthetic or adjust the dosage as needed.
• If you will be using sedation during your procedure, you have several options, including nitrous oxide gas, oral sedation, or IV sedation. Be sure we know about all of your medications beforehand because of possible interactions. Changes can be made to the type of sedation and/or the dosage as needed.

Medications Impact Treatment

It’s important for Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to know if any of your medications will affect your treatment.

Anticoagulants, for example, are medications which prevent blood clots from forming, and are often prescribed for certain heart conditions, after joint replacement surgery, or for anyone at risk for developing clots. Because these medications prevent the blood from clotting, we need to know if you are taking such drugs before oral surgery.

If needed, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can work with you and your doctor to create a treatment plan which will be safe, effective, and designed to work with any of your medications. You should never discontinue taking your prescribed medications before dental work without medical approval, as this can be dangerous.

Your endodontist needs the most up to date information about your health to provide you with the best care possible. Knowing which medications you take and why you take them can help Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants:

• Diagnose and treat any side effects from non-dental medications which have affected your oral health,
• Prevent drug interactions from occurring, and
• Tailor your treatment to your specific medical needs.

Your prescriptions, over the counter medications, and even herbal supplements and vitamins are essential information. It’s a good idea to make a list before your next appointment at our Worcester office so you have specific medications and their dosages at hand. It’s one small—but vital—step you can take to partner with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for your best dental health!

In fancy medical terms, dry mouth is known as xerostomia. It’s really just what it sounds like: a condition in which you don’t have enough saliva to keep your mouth moist. Dry mouth can be the result of certain medications you’re taking, aging, tobacco use, nerve damage, or chemotherapy.

Depending on whether you’re aware of the cause of your dry mouth, here are some simple ways to keep it at bay:

• Avoid drinks that contain alcohol or caffeine
• Avoid tobacco use, or lower your consumption of tobacco
• Floss after every meal
• Brush your teeth after every meal using a fluoride toothpaste
• Avoid foods that have a high level of salt
• Stay hydrated and drink water frequently
• Consider using a humidifier at night

If you have any questions about dry mouth and how it is affecting you, give our Worcester office a call or make sure to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit!

If you suffer from sensitive teeth, you already know the frustration of having a type of pain that is hard to deal with. Because tooth sensitivity is sometimes unpredictable, you can't necessarily take medication to ward off the pain like you could if you just felt a headache coming on.

However, there is still something you can do about sensitive teeth. Use the following tips to help put your sensitivity and pain problems with your teeth behind you!

Use the Right Toothbrush: Select a toothbrush made just for sensitive teeth, or the softest bristles possible. This helps you avoid putting any extra pressure on your teeth or gums.

Choose a Special Toothpaste: There are several good options for toothpastes made just for sensitive teeth today. Usually, toothpaste formulated for sensitive teeth will be fluoridated and use a non-abrasive formula. The toothpaste will help with the pain usually associated with brushing and flossing if you use it regularly.

Avoid Trigger Foods: You may have noticed certain trigger foods that cause tooth sensitivity and pain for you. Avoid these foods whenever possible, and if you absolutely must eat them, try to consume them in very small quantities. Trigger foods may include:

• Foods with high acid content for example citrus fruits
• Very hot or very cold foods
• Hard or crunchy foods

Visit Our Office

If your sensitive teeth problem is too serious to manage on your own, a visit to our Worcester office may be in order. There are a couple of ways Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can help:

• Fluoride Treatments: We can put a special fluoride formula on the most sensitive areas to help make your enamel stronger and to help lower pain levels.
• Sealing Exposed Roots:In some cases, your roots become exposed due to a receding gumline, which in turn causes teeth sensitivity and pain. We can apply a dental sealant that protects the exposed roots and reduces your pain dramatically.

Dental floss is similar to a lot of products that depend mainly on the consumer’s preference. Fact is, floss comes in a wide variety of flavors, coatings, and other variations, but all types of floss essentially do the same thing. After all, that is what is most important: that the dental floss you buy is functional—cleaning the areas in between your teeth. If you want to know what the best dental floss is, the answer is the kind that enables you to successfully and regularly clean those areas. So to help you find the right type of floss for you, here are some options.

Flavored Dental Floss

Many people that floss prefer a flavored dental floss because it freshens their breath even more than unscented floss. The latter can also take on the smells associated with bacteria in your mouth. And we all know how bad that can be. So, if flavored dental floss is what you prefer, and it allows you to floss your teeth regularly, then it is automatically best for your mouth.

Flossers

There are also products on the market called flossers, which usually consist of a plastic instrument with strung floss and a pick on the opposite end. This option can be both effective at cleaning the areas in between your teeth and scraping off plaque. These flossers also come flavored in mint and various other varieties.

Gentle Dental Floss

Some people find that typical dental floss is too harsh on their gums. For that reason some companies make floss with soft coatings that are less abrasive on the gums. For the most part these types of floss are just as effective as regular floss, and for those people that require a more sensitive approach to flossing, especially when just starting out, this is the best option.

Of the aforementioned options, it is difficult to name an absolute best type of floss. However, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team say that the type of floss that works best for you, giving you the greatest chance of succeeding at regular flossing, is the best. For more information on floss, contact our Worcester office.

The effects of bad oral habits are something our team sees all too often. You might have bad oral habits that stem from childhood, possibly because your parents did not know about proper oral care or force you to follow it. Or, your bad habits could develop gradually, like slacking on your frequency of brushing.

Bad oral habits can lead to tooth decay, gum disease, and consequences such as losing teeth and experiencing bad pain. They may be deeply ingrained and easy to continue, but you can break them with a little effort. Focus on developing good habits to replace your current ones, and eating a diet that is healthy for your teeth.

Replace Bad Habits with Good

Breaking your bad oral habits may not be as difficult as you expect when you focus instead on developing good habits. These new good habits can naturally replace your bad habits.

• Brush your teeth after each meal or at least twice a day.
• Visit a dentist every six months for an exam and a professional cleaning.
• Floss your teeth every day.

These good habits may not seem natural, so you can take steps to make sure you follow these behaviors. For example, make a daily checklist with your scheduled sessions of brushing and flossing your teeth and using mouthwash. You can also set a timer to be sure you brush your teeth for the full recommended two minutes.

Eat Properly

Poor eating habits can be detrimental to your teeth. A common mistake is to let food, especially carbohydrates such as starch and sugar, stay on your teeth for a long time. You can stop doing this by rinsing your mouth with water after each meal or snack. Also, avoid candy and soft drinks between meals, since the sugar sits on your teeth.

A healthy diet provides the nutrients you need to maintain strong teeth. The mineral calcium is key for healthy teeth, so try to get your three daily servings of high-calcium foods, such as low-fat milk or yogurt, canned fish, or fortified soy or almond milk. Also include vegetables and fruits, which have a high water content.

If you need more tips about breaking your bad oral health habits, contact our Worcester office and speak with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or a member of our team.

You might remember that famous grade school dental poster teaching you all about teeth. A large white tooth with a crown, two roots with a bit of a curve, and two perfectly matched root canals inside each root. And, often, a big smiling face on the happy enamel surface—and why not? That tooth is a simple, symmetrical marvel!

But, unfortunately, those grade school posters aren’t exactly the last word in dental anatomy. Real molars might have multiple root canals in each root. The root canals might be curved in odd ways. They might have tiny branches that lead out from the main canal. They might have tiny branches that lead out from the main canal that are curved in odd ways. It can get very complicated.

This complexity is why an endodontist, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, has spent two or more additional years of advanced training after dental school studying the diagnosis and treatment of the inner tooth. And when a root problem puts your tooth in danger of extraction, an endodontist is a specialist in saving at-risk teeth. What can Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants do for a troublesome root?

• Root Canal

Endodontists are specialists in root canal treatments. We have the education, experience, and tools to find, clean, shape, and fill complex root canal formations and tiny root canal branches.

• Surgical Root Canal Treatment

When a regular root canal isn’t possible, we can still reach the root canals by approaching them surgically through the root rather than the crown.

• Apicoectomy

For a tooth that has recurring problems even after a root canal, an apicoectomy (the removal of the root tip) and the cleaning and sealing of the affected root might be recommended.

• Root Resection, Hemisection, and Bicuspidization (Bisection)

For molars with serious decay, fractures, infection, or surrounding bone loss, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants might suggest a surgical procedure which removes a single root (root resection), part of the tooth and root (hemisection) or divides the tooth and roots into two pieces (bicuspidization). These surgeries allow you to preserve as much of your natural molar as possible.

If a root problem is causing you pain, give our Worcester office a call. Because an endodontist is a specialist in saving teeth—and you deserve a poster-perfect smile!

Sports and energy drinks cause irreversible damage to the teeth of teens and young adults. A recent study published in General Dentistry states that energy and sports drinks contain so much acid that they begin destroying teeth after only five days of consistent use. According to the Academy of General Dentistry, an estimated 30 percent to 50 percent of U.S. teenagers consume energy drinks and as many as 62 percent consume at least one sports drink per day. The high acidity levels in the drinks erode tooth enamel and the result is irreversible damage.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology encourage our patients to limit their intake of sports drinks. The enamel erosion ultimately makes teeth more susceptible to bacteria and that can lead to hypersensitivity, staining, and tooth decay. If you do consume an energy or sports drink, make sure to wait at least 45 minutes until you brush, as consumption of acidic drinks causes tooth enamel to soften, making teeth more vulnerable to wear from the abrasives found in toothpaste.

Tooth decay is the most common chronic childhood disease, five times more common than asthma. It’s also preventable with proper care. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team can help identify early signs of erosion and offer solutions on how to prevent further damage and more serious problems from occurring.

Endodontists are specialists in treating the inner tooth, and perform root canal procedures every day. They have completed years of additional advanced studies after dental school to diagnose and treat both common root canal issues and more complicated endodontic problems. Calcified root canals are one such complication that make a visit to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants the right choice for your professional care.

What’s involved in a typical root canal procedure?

After the area around the tooth is numbed, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will make an opening in the crown to allow access to the pulp inside. Very small instruments will be used to clean the inner tooth and remove dead or dying pulp tissue. The area inside of the tooth will be shaped, filled, and sealed, a process which can take one or more appointments. A temporary filling might be placed in the tooth to prevent bacteria and food from entering the site before a permanent seal is created. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can consult with you as to whether a crown or other restoration is best to protect your tooth after root canal treatment.

How do calcified roots develop?

Calcium is an essential mineral because it keeps our enamel strong, protecting the delicate pulp tissue inside the tooth. Sometimes, though, calcium deposits will partially or completely block a root canal. This build-up might occur in a canal as a response to injury or infection. It’s also a process that occurs naturally over time, and because of today’s advances in dental care, people are keeping their natural teeth much longer. This calcification can become a problem when you need a root canal procedure.

Why are calcified roots a problem?

It’s very important that we have access to every root, and to the entire length of every root, for the root canal procedure to succeed. If calcium deposits block all or part of a canal, even delicate instruments will have difficulty reaching all of the pulp tissue inside the canal. To make matters even more complicated, calcified roots can be hard to locate. Dealing with calcified canals requires experience and skill.

How can an endodontist help?

• Endodontists have sophisticated imaging technology and microscopes, which, together with their experience in the anatomy of the inner tooth, help them locate even difficult-to-detect roots and their branches.
• Endodontists have the skill and training to precisely and patiently clear the blocked roots.
• Specifically engineered endodontic instruments have been designed to clean and shape narrow, calcified canals.
• Finally, if the root canals are not treatable through the crown of the tooth, endodontic surgery can allow access to the canals that regular non-surgical methods cannot.

If you have calcified roots, making a root canal more difficult, schedule an appointment at our Worcester office. We are experts in root canal procedures, whether common or complex, and experts in saving teeth.

Taking care of your oral health involves a daily regimen of brushing, flossing, and rinsing to prevent tooth decay and bacterial infections. Though you may have asked us which toothbrush to use, few patients at Central New England Endodontics and Implantology ask about mouthwash.

However, different mouthwashes you might choose will have varying effects on your oral health. So which type is best for you?

Gum Health

Antiseptic mouthwashes are designed to reduce the majority of bacteria on and near the gum line. Using an antiseptic mouthwash can help decrease your chances of developing gingivitis. If possible, look for a mouthwash with antibacterial or antimicrobial ingredients.

Fluoride

Fluoride is beneficial for oral health and can help prevent tooth decay. If you drink a lot of bottled water without fluoride, we may recommend that you purchase a rinse with fluoride in it.

Bad Breath

Although mouthwash is designed to prevent bacterial build-up within the mouth, many people use it to combat bad breath. Most mouthwashes will help eliminate the bacteria that cause bad breath, and some are specifically designed to do so.

However, if bad breath is a chronic problem that requires daily treatment with a mouth rinse, contact Central New England Endodontics and Implantology to discuss your symptoms.

American Dental Association Approval

The ADA reviews mouth rinses for safety and effectiveness. A mouthwash with the ADA Seal of Approval will meet strict criteria, and will have scientific evidence or clinical studies that support the claims of the manufacturer. If possible, select a mouthwash that bears the ADA Seal of Approval to ensure you are using a quality rinse.

Considerations

If you are unsure as to which mouthwash is right for you, contact our Worcester office or ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit. Also, be sure to keep mouthwash out of the reach of children, as it contains alcohol and other substances that could be harmful to them. Avoid letting children under age six use a mouth rinse, and discontinue use if you experience a burning sensation in the soft tissues of your mouth.

At Central New England Endodontics and Implantology, we prefer our patients to practice good oral hygiene between office visits. Part of that process includes flossing, which Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will tell you, is the process of cleaning between the teeth to remove food and debris from the areas that are hard to reach with a toothbrush. When food is allowed to remain between the teeth, it provides a breeding ground for bacteria, which can cause periodontal disease.

Should you floss before or after brushing?

You can floss either before or after brushing, according to your own preference. By flossing first, you can brush away dislodged food debris afterward. On the other hand, brushing first allows you to loosen plaque between the teeth, making it easier to floss more effectively.

Whichever you choose, the most important goal is to floss thoroughly. That means using a fresh strand of dental floss each day, and carefully pulling it back and forth between all of the teeth. Do not skip flossing because your teeth look or feel clean.

When to Floss

Unlike brushing, you need only floss between your teeth once per day. Although you may choose to do it in the morning or afternoon, many prefer to floss at night to prevent food and debris from remaining in the crevices of the teeth overnight. This could prevent the build-up of plaque too, which is a cause of tooth decay.

Help with Flossing

If you have questions about your flossing technique or what type of floss is best for your teeth, contact our office. Our staff will be more than happy to assist you in perfecting your home hygiene regimen. In most cases, you can choose between interdental cleaning picks or flexible floss strands to perform your daily flossing routine. If you have permanent oral appliances or restorations, be sure to follow the flossing instructions provided to you, and contact our Worcester office with any questions.

Eating, talking, smiling—consciously or unconsciously, so much of daily life is influenced by our oral health. And here’s one more thought to chew on: oral health affects digestive health as well.

After all, digestion doesn’t begin the moment food reaches the stomach—it begins before we swallow that very first bite. The digestive process gets its start in two ways:

• Mastication

“Chew your food properly.” Probably every child has heard this piece of helpful advice, because it’s hazardous to swallow large pieces of food. But there’s more to it! There’s a positive benefit for your digestive system when you keep chewing until that mouthful has been pulverized into a uniform, almost paste-like consistency.

But even though chewing food properly leads to easier digestion, dental problems can make the simple act of eating difficult and uncomfortable. Missing teeth or tooth pain can lead to swallowing food before it’s been properly broken down and softened, making it harder for your meal to make its way down the esophagus and more work to digest.

• Saliva Production

As it happens, there’s science behind the expression “mouth watering.” Saliva contains digestive enzymes. These enzymes help break carbohydrate molecules into smaller sugar molecules, which are easier for our bodies to digest and use for energy. Saliva also contains enzymes that begin the digestion of fat and helps neutralize acids as we eat.

When your oral health is compromised, the normally smooth operation of your digestive system can suffer as well. Fortunately, you have options.

• Relief for Tooth Pain

When eating is painful, or when you avoid putting pressure on a loose or sensitive tooth, you’re probably chewing more cautiously and less thoroughly. You might be dining on soft foods or liquids, avoiding chewier proteins, vitamins, and fibers on the menu.

Recurring tooth pain means it’s time to give Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants a call. Whether you have a cavity that needs treatment, an infection or inflammation, pain from grinding your teeth, or any problem which makes eating uncomfortable, we can provide the answers you need to make eating enjoyable once again.

If the source of your pain, swelling, or sensitivity could be a problem inside the tooth or its surrounding tissue, it could be time to see your endodontist, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. Endodontists have years of additional advanced training after dental school, specializing in diagnosing and treating tooth pain and injuries to the tooth pulp and roots.

Endodontists are experienced in root canal procedures, treating traumatic tooth injuries, and performing endodontic surgeries, saving teeth that might otherwise be extracted. If you are experiencing symptoms of pulp or root damage, it’s best to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants as soon as possible.

If you haven’t visited our Worcester office for a while, there’s no time like the present. Restoring your oral health will lead to easier digestion, more enjoyable dining—and a very good reason to smile. Food for thought!

We’re not talking post-holiday “I can’t eat another bite” discomfort. No, we’re here to talk about the discomfort caused by bite pain.

Usually, our teeth and jaws work so harmoniously that we don’t even think about biting and chewing. But when a sharp jolt or a dull ache accompanies any sort of pressure on your tooth, it’s time to call your dentist, who may then refer you to Central New England Endodontics and Implantology. Let’s look at a few of the possible causes.

• Tooth Decay

When a cavity reaches below the enamel and into the dentin, the middle part of the tooth, you might feel discomfort and sensitivity. If a cavity reaches the inner pulp, which contains the tooth’s blood supply and nerves, it’s not only very painful, it can lead to a serious infection called an abscess.

Root canal treatment can help save a tooth when decay has reached the pulp, but prevention is always the best option! Good dental hygiene, regular checkups, and prompt treatment of small cavities will help prevent deep cavities from forming.

• Damaged Dental Filling

A loose or damaged filling can be uncomfortable. Even worse, bacteria can get under a damaged filling where your toothbrush and floss can’t reach, causing decay which can eventually reach the pulp if undetected.

During your regular checkups, your dentist will look for any signs of decay around and under your fillings, and will find any fillings that need replacing. If you notice a loose filling, or suffer discomfort when you bite down on a filling, don’t wait until your next checkup to see your dentist.

• Bruxism (Tooth Grinding)

Your jaws can provide more than 20 pounds of pressure to your teeth when you need to chew food. When you grind your teeth, your jaws can produce hundreds of pounds of pressure on your teeth all night long. It’s no wonder you wake up with tooth or jaw pain. Over time, constant grinding will damage enamel and can chip and even crack teeth.

Your dentist can create a custom-made night guard which will protect your teeth from grinding pressure—relieving tooth and jaw pain, preventing more serious damage, and giving you a better night’s sleep!

• Cracked Tooth

A painful cracked tooth can be obvious after a trauma, or it might not be obvious at all. So whenever you suffer dental trauma, call your dentist immediately for instructions and any necessary referrals.

Cracks can spread over time, and speedy medical attention from an endodontist like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants might be the difference between a tooth which can be repaired and a tooth which must be extracted. An endodontist is a specialist in diagnosing and treating cracked teeth, and in saving injured teeth if possible with root canal treatment or endodontic surgery.

• Infection/Abscess

When the pulp inside a tooth is infected or inflamed, the result can be a painful abscess. Abscesses are pockets of pus caused by bacterial infection. Continuous severe pain, a swelling near your tooth, redness, fever, chills, a bad taste in your mouth, or bad breath can all be signs of a tooth abscess.

An abscess isn’t just painful, it’s dangerous, because it can cause bone loss around the tooth and further infection if not treated promptly. Root canal treatment is usually necessary to remove damaged pulp from the pulp chamber and from every tiny canal in each root of the tooth, and then to clean, shape, and fill the tooth’s interior. Your endodontist is a specialist in this procedure, as well as an expert in dealing with recurring infections and performing any necessary endodontic surgery to treat such infections.

Pain is an important signal that something is wrong, and you need to get to the root of the problem. Conditions that cause you pain often become more serious over time. For your comfort and your health, make an appointment at our Worcester endodontic office right away whenever you hesitate to take another bite.

“St. Patrick's Day is an enchanted time -- a day to begin transforming winter's dreams into summer's magic.” Adrienne Cook

Lucky green shamrocks, leprechauns, and pots of gold – it must be St. Patrick’s Day! If you’re not Irish, how do you go about celebrating St. Patrick’s Day? It’s easy: You just put on one of those tall leprechauns hats, dress in green from head to toe, and wear one of those carefree pins that say “Kiss Me, I’m Irish”. On St. Patrick’s Day, everyone is Irish, and that is the universal beauty of the holiday. Celtic pride does not discriminate.

Wondering what our team at Central New England Endodontics and Implantology is doing to celebrate March 17th? Well, we’ve thought about doing everything from handing out lucky gold coins (you know, the fake ones that are made of chocolate) to shamrock stickers. Maybe we’ll even give away green toothbrushes and floss! You’ll never know unless you come in to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants !

All kidding aside, St. Patrick’s Day is an important cultural and religious holiday. There are lavish parades and church services across Ireland on March 17th. Over time, however, the holiday has developed into a day to observe Irish culture in general. In places like England and the United States, where there is a large Irish Diaspora, the holiday has greater significance than other countries. From the streets of Boston to St. Patrick’s Cathedral in New York, it is a day of celebration, and many Americans of Irish descent will cook up a traditional meal of corned beef and cabbage.

So, to all of you with Irish ancestry, and to all of you who have decided to be Irish for the day, our office wishes you a Happy St. Patrick’s Day. Good luck looking for a pot of leprechaun gold, which is said to exist at the end of the rainbow. However, keep away from those sugary Lucky Charms; sweet cereals might taste good, but your kids’ teeth might not be feeling too lucky if they eat it for breakfast every day. Have a great St. Paddy’s Day!

Many smokers believe that chewing tobacco is a safer alternative to smoking cigarettes. This simply isn't the case! In fact, smokeless tobacco can cause serious health concerns.

Smokeless tobacco comes in many forms and goes by many names: dip, snuff, snus, or simply chewing tobacco. Use of these products usually involves sucking or chewing on shredded or loose tobacco leaves, sometimes flavored, for a prolonged period. There are even products that emulate a dissolvable candy-like consistency which are made of compressed tobacco powder.

What are risks and smokeless tobacco?

Whichever form a tobacco product takes, the dangers of using or consuming them is very real. According to a 2007 study by the World Health Organization's International Agency for Research on Cancer, there are upwards of 28 cancer-causing chemicals in smokeless tobacco that are known to cause cancer. And these products are habit-forming just like any other tobacco product that contains nicotine. Using them will increase your risk for many serious diseases including but not limited to: cancer (especially oral and esophageal), gum and heart disease, cavities, and pre-cancerous mouth lesions.

At the end of the day, long-term use of smokeless tobacco can cause serious health issues. These products really take a toll on both your oral and overall health. They put a strain on your immune system and make it less capable of warding off infection and disease.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team strongly advise you to stop using smokeless tobacco—or any kind of tobacco product—and not to pick up the habit if you aren't. There is no safe level of tobacco use, smokeless or otherwise.

Need to quit smoking or using smokeless tobacco products?

You can and should always talk to your doctor, healthcare practitioner, or Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for help quitting. But there are many other resources available today for those who'd like to quit. The National Cancer Institute offers information, support (local and online), and tools to help smokers and smokeless tobacco users quit. They offer live online chat with cessation counselors Monday through Friday and even have a smartphone application available to help people who are serious about quitting.

You can take a look at their website at smokefree.gov or call them toll-free at 1–877–44U–QUIT (1-877-448-7848). There is also help available from your state's quit line at 1-800-QUIT-NOW (1-800-784-8669).

Make the best choice for your health and well-being; avoid the bad habit of tobacco products. If you have any questions about how tobacco related products affect your oral health and hygiene, please don't hesitate to ask one of our Worcester staff members.

Did you know your toothbrush could be covered with almost ten million germs? We know … it’s gross! That’s why you should know how to store your toothbrush properly, and when it’s time to replace it.

If you need to brush up on your toothbrush care knowledge, we’ve got you covered so brushing will always leave you feeling squeaky clean.

Keeping a Clean Toothbrush

Your mouth is home to hundreds of types of microorganisms, so it’s normal for some of them to hang onto your toothbrush after you’ve used it. Rinsing your brush thoroughly with water after each use can get rid of leftover toothpaste and food particles that cling to the bristles. Some dentists suggest soaking your toothbrush in mouthwash every now and then can help reduce the amount of bacteria further.

Store your toothbrush in a cool, open environment away from the toilet or trash bin to avoid airborne germs. Closed containers should be avoided because they provide a warm, wet habitat that bacteria love to grow in.

If you have multiple people sharing one sink, an upright holder with different sections will keep everyone’s brushes separated and avoid cross contamination. In addition, we would hope this is a no-brainer, but please don’t share toothbrushes!

Microwaves and dishwashers are not suitable tools for cleaning a toothbrush, because brushes aren’t built to last through this kind of treatment. If you want a really clean toothbrush, your best option is simply to buy a new one.

Replacing Your Toothbrush

The American Dental Association recommends you replace your toothbrush every three to four months, or sooner depending on individual circumstances. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team agree. If you have braces, tend to brush too strongly, or the bristles become frayed, it’s time for a new brush.

Children will also need replacement brushes more frequently than adults. If you or your child has been sick, you should replace the toothbrush immediately to avoid re-exposing yourself to illness.

Worn-out brushes are not only unsanitary, they don’t do a good job cleaning teeth. Bristles that are worn out and dull won’t scrape away plaque and bacteria as well as a fresh toothbrush can.

Though the idea of ten million germs can be worrisome, if you take a few small precautions, you may ensure your toothbrush stays in good shape. And the cleaner the toothbrush, the cleaner the smile!

At Central New England Endodontics and Implantology, we prefer our patients to practice good oral hygiene between office visits. Part of that process includes flossing, which Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will tell you, is the process of cleaning between the teeth to remove food and debris from the areas that are hard to reach with a toothbrush. When food is allowed to remain between the teeth, it provides a breeding ground for bacteria, which can cause periodontal disease.

Should you floss before or after brushing?

You can floss either before or after brushing, according to your own preference. By flossing first, you can brush away dislodged food debris afterward. On the other hand, brushing first allows you to loosen plaque between the teeth, making it easier to floss more effectively.

Whichever you choose, the most important goal is to floss thoroughly. That means using a fresh strand of dental floss each day, and carefully pulling it back and forth between all of the teeth. Do not skip flossing because your teeth look or feel clean.

When to Floss

Unlike brushing, you need only floss between your teeth once per day. Although you may choose to do it in the morning or afternoon, many prefer to floss at night to prevent food and debris from remaining in the crevices of the teeth overnight. This could prevent the build-up of plaque too, which is a cause of tooth decay.

Help with Flossing

If you have questions about your flossing technique or what type of floss is best for your teeth, contact our office. Our staff will be more than happy to assist you in perfecting your home hygiene regimen. In most cases, you can choose between interdental cleaning picks or flexible floss strands to perform your daily flossing routine. If you have permanent oral appliances or restorations, be sure to follow the flossing instructions provided to you, and contact our Worcester office with any questions.

It may come as a surprise to learn that dogs, like humans, have both baby and adult teeth. Most dogs, unlike humans, have all of their adult teeth by the time they are seven months old, so it’s time to start looking after their dental health when they are still puppies.

While dogs generally don’t develop cavities, periodontal disease is the one of the most common diseases affecting dogs. Periodontal disease starts when the bacteria in your pet’s mouth form plaque. The plaque can harden into tartar, and, if plaque and tartar spread under the gum line, can be responsible for a number of serious problems. Veterinarians warn that tooth loss, tissue damage, bone loss and infection can be the result of periodontal disease. Professional dental treatment is important if your dog is suffering from periodontal disease, and your vet can describe the options available to you. But the time to act is before disease develops. Let’s bone up on some preventative care!

Brushing

There are brushes and toothpastes designed especially for your dog. Train your puppy from an early age to open his mouth to allow you to examine his teeth and gums. (This will also come in handy if you ever need to give him medicine.) Most dogs will accept brushing, and toothpastes come in dog-friendly flavors. Human toothpaste should never be used because it contains cleaners and abrasives that should not be swallowed by your pet. There are also dental wipes available that can be used once and thrown away. Your vet can advise you how to ease your pet into a brushing routine.

Gels and Rinses

Whether you rub an antiseptic gel on your dog’s teeth or squirt an antiseptic rinse into his mouth, these formulas can reduce the build-up of plaque. Not all dogs take to the taste of these solutions, but in general they are safe and effective. Ask your vet for recommendations if you would like to try this method.

Diet

Several dietary products offer anti-plaque ingredients or a kibble shape designed to reduce the formation of plaque. Talk to your vet for the best possible diet and nutrition suggestions for your unique pet.

Chew Toys

Chewing can help reduce plaque build-up if done consistently, and chew toys should be chosen for tooth and digestive safety. Some animal-based products and hard plastic toys are so rigid that they can cause damage to teeth or gums, so be sure to look for safe toys.  Dogs shouldn’t be left alone with toys due to choking or swallowing hazards—if the chew toy becomes small enough to cause choking, or your dog is swallowing large chunks that might not be digestible, time to replace it.

Your veterinarian is the best resource for maintaining your dog’s health and developing a dental routine both you and your pet can live with. When your four-legged friend goes for his next check-up, ask your vet what you can do to keep him and his smile fetching for a long, long time.

Oral-systemic health is the idea that oral health is a critical and interconnected component to a patient’s overall health and well-being. Studies show that people who have poor oral health are more likely to have other health conditions such as heart disease, diabetes, or a high likelihood of stroke.

Some of the data suggests that oral pathogens may trigger up to 50% of heart attacks, and that the oral bacteria P. gingivalis may cause a 13.6-fold increase in patients’ risk of a heart attack.

Still, the exact relationship between oral and overall health isn't fully known — whether one causes the other or how treating one might affect the other. But it should serve as a warning call to anyone suffering with poor oral health, especially periodontal disease.

More studies need to be conducted to establish the precise link between the two, but whatever it is, one thing is certain: good oral hygiene makes for good oral health. Many dentists and doctors realize the need to work together as a cohesive healthcare team to improve and maintain the health of their communities.

The American Dental Association says oral health is essential to overall health, and not just a luxury. They are setting goals to reduce the amount of tooth decay in low-income communities for both children and adults.

So what is a patient about this information regarding oral-systemic health? Here are some tips to increase and maintain your overall well-being:

• Have an effective oral hygiene routine. Brush twice a day for two minutes each time, floss daily, clean your tongue, and avoid sugary beverages.
• Visit your dentist regularly. Regular cleanings and checkups at your dentist’s office will keep your mouth clean and ensure you’re taking good care of it.
• Eat a healthful diet. A diet rich in fruits, vegetables, whole grains, and natural, unprocessed foods contributes to the overall health of your body.
• Stay hydrated. Drink plenty of pure, clean water throughout the day. A good rule of thumb is to drink eight eight-ounce glasses a day.
• Relax, destress. Stress can play a big role in all forms of disease. Take time during your day to relax, meditate, stretch, and allow your body and mind to rest.

If you have questions about your oral health and how it may be affecting your general health, feel free to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office.

15.00

While they may sound refreshing, especially after participating in sports activities or after a jog, recent studies suggest that energy and sports drinks can damage tooth enamel, thus elevating your cavity risk. These drinks are especially popular among our younger patients.

In the study, researchers analyzed the fluoride content and pH levels of 13 sports and nine energy drinks by soaking tooth enamel samples in the aforementioned drinks. The samples were soaked for 15 minutes in each drink, and then were soaked for two hours in artificial saliva four times a day for five days.

As much as sports drinks are harmful to your teeth, researchers found that exposure to energy drinks such as Rockstar, Monster®, and Red Bull® resulted in twice as much enamel loss as exposure to sports drinks such as Powerade®, Gatorade®, and Propel® (3.1 percent to 1.5 percent).

Yes, there are health benefits to consuming orange juice, fruit juices, sports drinks, and flavored waters, which can contain valuable ingredients such as vitamin C and other antioxidants; these drinks can also replenish nutrients lost during a sporting event and lower the chance of heart disease and cancer. But, if not consumed carefully, these beverages can harm your teeth. They are full of sugar, which converts to acid and wears away at your teeth, causing cavities, sensitivity, and eventually tooth loss.

Even one drink a day is potentially harmful, but if you are absolutely unable to give up that sports or energy drink habit, we encourage you to minimize their use and rinse with water afterward or chew a sugar-free piece of gum. Do not brush immediately after drinking them; softened enamel due to acid is easier to damage, even when brushing. Remember, it takes your mouth approximately 30 minutes to bring its pH level back to normal. The best thing to do is to wait an hour, then brush to remove sugar that lingers on your teeth and gums.

There are many sports drinks, energy drinks, and flavored waters out there today. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team recommend you take the time to read the labels. Check for sugar content and citric acid in the ingredients. If you have any questions, or would like suggestions on the best sports drink options, please give us a call at our Worcester office or ask us during your next visit!

At our office, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team do all that we can to make sure that your experience with us is the best it can possibly be. However, there’s an important role you play in this as well: leaving us reviews and feedback.

Whether there is something you’d like us to improve upon, or you’d just like to express your thanks for a job well done, your feedback is essential to our practice’s success.

We look forward to hearing from you, and are excited to hear what you thought of your most recent visit at our Worcester office.

Not many people look forward to going to the dentist, especially if you already know that you need dental work done. A small amount of anxiety is one thing, but dental phobia, or odontophobia, is something else entirely. It is an irrational fear of going to the dentist. If you have it, you might be unable to force yourself to go to the dentist, even if you are suffering from bad tooth pain. The effects of dental phobia can be serious, but there are ways to overcome your fear of the dentist to help you achieve and maintain good oral health.

Causes of Dental Phobia

You can develop dental phobia for a variety of reasons, including the following.

• Fear of pain, which you might acquire based on others’ horror stories of their trips to the dentist.
• Fear of needles, such as those used to provide anesthesia.
• A previous bad experience, when something went wrong and pain was intolerable.
• Lack of control from not knowing what is happening or how uncomfortable a procedure might be.

Consequences of Dental Phobia

Avoiding the dentist can have long-term consequences. When caught early, tooth decay is easily stopped with a minor filling. If you let the decay go, you can end up losing your tooth and have chronic pain. A dentist can also check for early signs of gum disease, which, if left untreated, could lead to losing one or more teeth.

Even if you do not have a particular problem, going to a dentist for regular cleanings is a good idea because the hygienist can point out where you need to brush better and remove the plaque from your teeth.

Getting Over Fear of the Dentist

Most patients with dental phobia can get over their condition. These are some approaches that Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team recommend:

• Explain each step of the process
• Let you know that you can stop the procedure at any time
• Encourage you to come with a family member or friend
• Help you with deep breathing techniques

Valentine’s Day, also known as Saint Valentine’s Day, has been said to originate with a Catholic priest named Valentine several thousand year ago. Valentine defied the emperor at the time by secretly marrying men and their brides after the emperor had made it illegal to marry. Emperor Claudius II did this because he wanted as many single young men to fight in his war as he could get.

Valentine disobeyed the emperor’s edict by continuing to marry couples until he was sentenced to death. Before his execution, he sent a letter to a secret love and signed it “From your Valentine.” Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have come up with some suggestions on how you can celebrate this Valentine’s Day, whether you have a valentine of your own or not.

Valentine's Day Ideas

• Enjoy a tasty treat. There are plenty of options when it comes to cooking and/or baking on Valentine’s Day. Make your significant other his or her favorite meal or sweet treat, or make your own favorite dish to enjoy on this day. Oh, and be sure to make enough for leftovers!
• Make a personalized card. Instead of buying a card from the grocery store, take the time to make your own for a loved one. People love handwritten notes, especially when it’s from someone special. If you’re single this Valentine’s Day, make a card for fellow single friend to brighten the day and remind the person that he or she is also loved.
• Watch a movie. We all know there are plenty of romance movies out there. Put on your favorite romantic comedy, or pick up your significant other’s favorite movie to watch together. Even better, if you’re single, pick up your own favorite movies to watch to pass the time this Valentine’s Day.
• Do nothing! We all know Valentine’s Day can sometimes get a lot of hype. If you’re worried about not making a reservation in time, don’t feel like planning an extravagant night out, or simply not in the holiday mood this year, spend your day sitting back and relaxing.

Valentine’s Day is a time to celebrate love and spend quality hours with the people you care about the most. Whether you’re in a relationship or single, take some time today to appreciate those you love in your life.

We wish you a happy Valentine’s Day celebration and look forward to seeing you at our Worcester office during your next appointment.

When we think of Valentine’s Day, we think of cards, flowers, and chocolates. We think of girlfriends celebrating being single together and couples celebrating their relationship. We think of all things pink and red taking over every pharmacy and grocery store imaginable. But what Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team would like to think of is when and how this joyous, love-filled day began.

Several martyrs’ stories are associated with the origins of Valentine’s Day. One of the most widely known suggests that Valentine was a Roman priest who went against the law at a time when marriage had been banned for young men. He continued to perform marriage ceremonies for young lovers in secret and when he was discovered, he was sentenced to death.

Another tale claims that Valentine was killed for helping Christians escape from Roman prisons. Yet another says that Valentine himself sent the first valentine when he fell in love with a girl and sent her a letter and signed it, “From your Valentine.”

Other claims suggest that it all began when Geoffrey Chaucer, an Englishman often referred to as the father of English literature, wrote a poem that was the first to connect St. Valentine to romance. From there, it evolved into a day when lovers would express their feelings for each other. Cue the flowers, sweets, and cards!

Regardless of where the holiday came from, these stories all have one thing in common: They celebrate the love we are capable of as human beings. And though that’s largely in a romantic spirit these days, it doesn’t have to be. You could celebrate love for a sister, a friend, a parent, even a pet.

We hope all our patients know how much we love them! Wishing you all a very happy Valentine’s Day from the team at Central New England Endodontics and Implantology!

Nobody likes a dry mouth. It is an uncomfortable and sometimes oddly unexplainable sensation that most people like to avoid. It is not a condition that automatically sends you into a panic about your health, however, a dry mouth can be a bother and something you certainly want to change if possible. So, if you find yourself in the unpleasant position of having a dry mouth, here is what you can do.

Chew Sugar-free Gum: Chewing sugar-free gum will stimulate saliva in your mouth. The chewing motion of your jaw and teeth should take care of at least some of your dry mouth problem.

Suck on Sugar-free Candy: Similarly to chewing sugar free gum, if you suck on sugar free candy it should create more saliva in your mouth and moisturize it in the process.

Cut out the Caffeine:Caffeine can contribute to a dry mouth so by limiting, or eliminating your intake all together, you may find that your dry mouth is no more.

Stop Using Tobacco Products: Tobacco is another cause of dry mouth. Whether it is smokeless tobacco products or cigarettes, if you stop using them your dry mouth will likely improve. And not to forget, these products are exceedingly bad for your oral health to begin with, so you will be doing your mouth a favor even more so.

Drink Lots of Water: It may seem obvious, but drinking lots of water will likely improve your dry mouth. This is because dry mouth is usually a sign of dehydration, so plenty of fluids will surely help.

Dry mouth can be unpleasant, but it is often easily solved by either drinking more water, or trying one of the previously mentioned techniques. If the problem still persists you can always visit our Worcester office to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. More often than not, doing one of the above will leave your mouth more moisturized than it was previously, and hopefully it will be long-lasting as well.

As you probably know, you can always connect with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team by calling our Worcester office, or going to our Facebook page. However, if you’ve recently moved or gotten a new phone number, we’ll need to update our records so we can easily connect with you!

If any of your contact information has changed, please let our team at Central New England Endodontics and Implantology know, just in case we need to reach you. While you’re at it, you can also schedule your next appointment! We look forward to hearing from you!

Do you ever find yourself gnawing at your nails? Nail-biting is a very common and difficult to break habit which usually has its beginnings in childhood. It can leave your fingers and nail beds red and swollen. But if you think that your nails are the only ones getting roughed up by nail-biting you'd be mistaken—so are your teeth!

According to a study by the Academy of General Dentistry, those who bite their nails, clench their teeth, or chew on pencils are at much higher risk to develop bruxism (unintentional grinding of the teeth). Bruxism can lead to tooth sensitivity, tooth loss, receding gums, headaches, and general facial pain.

Those are some nasty sounding side effects from chewing on your nails. Most nail-biting is a sign of stress or anxiety and its something you should deal with. So what steps can you take if you have a nail-biting habit?

There are several things you can do to ease up on nail-biting:

• Trim your nails shorter and/or get regular manicures – Trimming your nails shorter is an effective remedy. In so doing, they'll be less tempting and more difficult to bite on. If you also get regular manicures, you’ll be less likely to ruin the investment you’ve made in your hands and fingernails!
• Find a different kind of stress reduction – Try meditation, deep breathing, practicing qigong or yoga, or doing something that will keep your hands occupied like squeezing a stress ball or playing with a yo-yo.
• Wear a bitter-tasting nail polish – When your nails taste awful, you won't bite them! Clear or colored, it doesn't matter. This is also a helpful technique for helping children get over the habit.
• Figure out what triggers your nail-biting – Sometimes it's triggered by stress or anxiety and other times it can be a physical stressor, like having hang nails. Knowing what situations cause you to bite your nails will help you to avoid them and break the habit.
• Wear gloves or bandages on your fingers – If you've tried the steps above and they aren't working, this technique can prove effective since your fingernails won't be accessible to bite.

If you're still having trouble with nail-biting after trying these self-help steps, it's best to consult your doctor, dermatologist, or Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. For some, it may also be the sign of a deeper psychological or emotional problem.

Whatever the cause, nail-biting is a habit you need to break for your physical and emotional well-being. If you have any questions about the effects it can have on your oral health, please don't hesitate to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office.

It's almost game day and you're wondering what to put on the menu for your guests. Most snacks are typically highly processed and unhealthy. Why not mix it up this year and opt for some snacks that promote good oral health? Here are some of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants favorites!

• Apples, carrots, celery, and cucumbers: These foods and other crispy, fibrous, fruits and vegetables are an excellent choice for the big game. Not only are they rich in vitamins and minerals which your body and mouth need, they are also known as detergent foods because of the cleaning effect they have on the teeth and gums. Try apples wedges spread with peanut butter and sprinkled with cinnamon.
• Beans: Beans are filling because they are packed with fiber and that keeps you from opting for sugary or fatty snacks. Along with fruits and vegetables, beans should be one of the stars of your game-day snack lineup. How about some hearty chickpea hummus with cucumber chips?
• Nuts like almonds, walnuts, pistachios, and cashews: Nuts abound in the minerals that help keep your teeth and gums strong like calcium, magnesium, and potassium. Put out a bowl of raw or roasted nuts for your guests as a crunchy, satisfying alternative to chips or crackers. Recent research even shows that the polyunsaturated fatty acids in nuts may help prevent gum disease. But remember not to eat the whole bowl! Nuts are very high in calories and a little goes a long way. Enjoy and handful or two along with your other healthy snacks.
• Dark chocolate: This one may be hard to believe at first, but research shows chocolate can be great for your teeth and help prevent decay! Now don't run off and start stocking your pantry with a bunch of that super sweet stuff, because these benefits come mainly from the tannins, polyphenols, and flavonoids present in the cacao bean. Dark chocolate is the least processed variety of chocolate and the closest to the cacao bean, so make sure you purchase a variety that is listed as 70% cocoa or more for these benefits. Like with nuts, chocolate is easy to overdo — aim to eat two or three squares.

Endodontists are specialists in treating the inner tooth, and perform root canal procedures every day. They have completed years of additional advanced studies after dental school to diagnose and treat both common root canal issues and more complicated endodontic problems. Calcified root canals are one such complication that make a visit to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants the right choice for your professional care.

What’s involved in a typical root canal procedure?

After the area around the tooth is numbed, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will make an opening in the crown to allow access to the pulp inside. Very small instruments will be used to clean the inner tooth and remove dead or dying pulp tissue. The area inside of the tooth will be shaped, filled, and sealed, a process which can take one or more appointments. A temporary filling might be placed in the tooth to prevent bacteria and food from entering the site before a permanent seal is created. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can consult with you as to whether a crown or other restoration is best to protect your tooth after root canal treatment.

How do calcified roots develop?

Calcium is an essential mineral because it keeps our enamel strong, protecting the delicate pulp tissue inside the tooth. Sometimes, though, calcium deposits will partially or completely block a root canal. This build-up might occur in a canal as a response to injury or infection. It’s also a process that occurs naturally over time, and because of today’s advances in dental care, people are keeping their natural teeth much longer. This calcification can become a problem when you need a root canal procedure.

Why are calcified roots a problem?

It’s very important that we have access to every root, and to the entire length of every root, for the root canal procedure to succeed. If calcium deposits block all or part of a canal, even delicate instruments will have difficulty reaching all of the pulp tissue inside the canal. To make matters even more complicated, calcified roots can be hard to locate. Dealing with calcified canals requires experience and skill.

How can an endodontist help?

• Endodontists have sophisticated imaging technology and microscopes, which, together with their experience in the anatomy of the inner tooth, help them locate even difficult-to-detect roots and their branches.
• Endodontists have the skill and training to precisely and patiently clear the blocked roots.
• Specifically engineered endodontic instruments have been designed to clean and shape narrow, calcified canals.
• Finally, if the root canals are not treatable through the crown of the tooth, endodontic surgery can allow access to the canals that regular non-surgical methods cannot.

If you have calcified roots, making a root canal more difficult, schedule an appointment at our Worcester office. We are experts in root canal procedures, whether common or complex, and experts in saving teeth.

If you have been thinking about getting a piercing, or if you already have one or more, there are some health risks our team at Central New England Endodontics and Implantology wants you to know about. It's important to know the risks involved with oral piercing, including infection, chipped teeth, gum damage, nerve damage, loss of taste, or tooth loss that could occur as a result.

Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Many people who have piercings tend to regularly touch them, paving the way for bacteria to enter piercing sites. Also, food particles that collect around piercing sites can lead to infection.

Besides hindering your ability to talk and eat, oral piercing also leads people to develop a habit of biting or playing with their piercings, which can lead to cracked or fractured teeth. While the fracture can be confined to the enamel of the tooth and require a simple filling, you also run the risk of the fracture going deep into the tooth, which may require a root canal, tooth extraction, and additional dental treatment.

If you still decide to get an oral piercing, you should realize that it will take some time to heal (anywhere between four to six weeks) and it may be very uncomfortable. Also please keep in mind that it will be an added responsibility to your life, as it will require regular upkeep. We want you to make sure that you’re committed to the task of taking care of it for the full healing period and beyond.

We encourage you to clean the piercing with antiseptic mouthwash after eating, and brush the jewelry each time you brush your teeth. If you have any questions, please don't hesitate to give us a call!

One good question; two good answers!

Why see an endodontist?

Many of us have experienced occasional minor tooth or gum pain and sensitivity. A new filling can lead to a brief period of sensitivity to pressure or heat and cold. Braces can be uncomfortable when they are new or recently adjusted. You might simply be brushing too hard! But sometimes, pain and sensitivity are caused by a more serious dental problem which should be treated as soon as possible.

When exposure to hot and cold foods causes continuous discomfort, or your gums are red or swollen or tender around a tooth, or when you can’t bite down without pain, it could mean that the pulp or roots of your tooth have suffered infection or damage. Damage to the tooth’s pulp can also be the result of an injury, such as a blow to the mouth. A chip, a crack, or a deep cavity can leave an opening for infection.

Whatever the cause of injury or inflammation, once the pulp and roots have been compromised, treatment needs to take place promptly to prevent further infection, pain, and even tooth and bone loss.

Why see an endodontist?

While all dentists receive some endodontic training in dental school, fewer than three percent go on to become endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. “Endodontic” means “inside the tooth,” and refers to the pulp chamber and root canals within each tooth that hold tissue, nerves, and blood vessels. Two to three years of additional education are required to become a specialist in this complex field, with advanced training in the diagnosis and treatment of injuries and diseases that affect the inner tooth and its supporting tissue.

When a tooth’s pulp is damaged, prompt treatment is necessary, and an endodontist has the ability, the experience, and the tools to provide you with the care you need. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team work to save injured teeth with a variety of procedures available at our Worcester office, including root canals, endodontic surgeries on tooth and root structures, and placement of posts and cores to strengthen and stabilize compromised teeth. With today’s advances in the field, endodontists have more sophisticated tools and treatments than ever before to save your injured tooth.

No matter how you ask the question, the answer is clear. If you have tooth, gum, or unexplained facial pain, talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about endodontic treatment.

As a patient at Central New England Endodontics and Implantology, your opinion matters! Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team love hearing what our patients think about our practice and the services we provide, and now we want to know, what do you think we should blog about?

Perhaps there’s a treatment you’ve always wanted to know about, or you’d like to learn about a specific way to improve your health and smile. Whatever your idea, we’d love to hear about it! You can let us know by posting here or on our Facebook page!

A strong, healthy smile is built on a strong, healthy foundation. Let’s take a moment to explore just what creates that foundation—your roots.

The Root of the Matter

The visible part of your tooth is called the crown. And while we spent the great majority of our time thinking about what goes on above the gum line—brushing, flossing, whitening, sealing, preventing cavities—the roots, the parts of the teeth below the surface, are also essential to our dental health.

• What’s inside the root?

The inside of each tooth holds pulp, which is living tissue made of nerves, blood vessels, and connective tissue. The nerves in the pulp allow us to feel pain when a tooth is damaged, decayed, or infected. Tiny blood vessels provide oxygen and nutrients to the cells.

The inside of each root also contains pulp, located in one or more root canals. These canals are small tunnels that travel from the pulp chamber to the tip of each root. Nerves and blood vessels connect pulp tissue to the nervous and circulatory systems in the body, entering and exiting the tooth from very small openings in the root tip.

• What’s outside the root?

On the outside, while roots look like crowns, they’re covered with a different protective surface. Roots are covered by cementum rather than enamel. This is a hard tissue, but not as hard as enamel. But cementum has another advantage—it not only helps protect our teeth, it helps them stay anchored in our jaws. (More on this below.)

• How many roots are we talking about?

The number varies, not just depending on the tooth, but depending on the individual. Most adults have 32 adult teeth: eight incisors, four canines, eight premolars, eight molars, and four wisdom teeth, or third molars. Because the number of wisdom teeth can range from four to zero, though, that total can be smaller.

Rooted to the Spot

The reason that you can rely on your teeth for a lifetime of chewing, biting, and grinding food is the fact that they’re so securely anchored in the jaw.

• Alveolar bone in the jaw contains a socket for each tooth.

• A thin layer of connective tissue called the periodontal ligament lines the socket and surrounds each root. It’s filled with fibers that attach to the root’s cementum covering and to the alveolar bone, holding the tooth securely in place.
• The periodontal ligament not only anchors the tooth, it cushions it from the daily pressure of biting and chewing.
• Finally, the gums surround the teeth and bone, protecting them from bacteria and plaque.

Even though this design is very secure, there are situations where the root becomes vulnerable. In that case, you should see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office right away. Our goal is for you to keep your teeth healthy and strong, and for a lifetime!

A famous mouthwash company chose the marketing slogan, “Better than flossing.” As a consumer, would you believe a high-end commercial that essentially tells you to stop flossing? Just use this brand of mouthwash and the risk of gingivitis, cavities, etc., is gone. What a wonderful idea! Now for the reality: This is simply not true.

The company that made these claims received some negative feedback for making this false claim. Does this mean that all mouthwashes are ineffective? Absolutely not. It takes a little bit of research to know which mouthwashes are most effective and best suited for you. Here are some key points to remember when choosing a mouthwash.

First, think about why you want to use a mouthwash. If you are at high risk for cavities, you would benefit from a fluoride mouthwash. Check the labels to see which ones contain fluoride.

If you have active gingivitis, a mouthwash with some antibacterial properties would be preferable. Read the labels carefully. You do not want a mouthwash containing alcohol. If you have active periodontal disease, an antibacterial mouthwash is appropriate, though you may want to discuss which kind would be best for your individual needs.

Prescription mouthwashes are also an option. You should pay close attention to the directions, such as how much and how long to use them. There is one brand in particular whose effectiveness can steadily diminish if you use it continually. There can also be side effects you should discuss with our office and/or your pharmacist.

Some great mouthwashes for kids change the color of plaque on their teeth to help them see how they are doing with their brushing. This is a great learning tool for the child and the parent! Why not pick up a bottle for yourself next time you’re at the store and evaluate your own performance?

Beware of claims that a mouthwash can loosen plaque. This is not accurate. Beware of any mouthwash that has alcohol. This is worth mentioning twice. Take care of your taste buds. If you are using a strong mouthwash, it can reduce your sense of taste.

These tips should help you choose the right mouthwash for your needs. Please contact Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office with any specific questions!

People have been ushering in the New Year for centuries but it became an official holiday in 1582 when Pope George XIII declared January 1st to be the day on which everyone would celebrate the New Year. At midnight people would yell, holler, and blow horns to scare away the evil spirits of the previous year so the New Year would be joyous and filled with opportunity. Nearly 500 years later, we still greet the New Year by whooping and hollering, but in a celebratory manner instead. Whether you intend to ring in the New Year quietly at home in the Worcester area or have plans to join the countdown at a gala extravaganza, these tips can help you ring out the old and usher in the new with a smile.

Tips for a Happy New Year's Eve Celebration from Central New England Endodontics and Implantology

• Be Safe. There's no way to predict the behavior of others on New Year's Eve, but you can be responsible for your own behavior to keep yourself safe. If adult beverages will be part of your celebration, plan on spending the night wherever you are or line up a designated driver to bring you home after the party is over.
• Enjoy Family and Friends. Spending time with the important people in your life is what makes the holidays enjoyable. Coordinate your schedules and choose New Year's Eve activities that everyone in the group will enjoy. You don't have to go to a party to ring in the New Year; some people like to go bowling, see a movie, or have a great meal at home.
• Accessorize with a Smile. Whether you dress up or have a quiet dinner with family and friends, one of the best accessories you can add to your attire is a beautiful smile.

New Year's Eve is a time to gather with friends and family, reflect on the year that's coming to an end, and look forward to the new one with anticipation. Enjoy this transitional holiday in a way that's safe, healthy, and fun. After all, counting down until the clock strikes 12 marks the beginning of a full year of opportunity ahead of you. From Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, have a great new year!.

New Year’s Day marks the beginning of the calendar year in most parts of the world. The holiday is celebrated on January 1st of each year. Customs and celebrations vary by country, religion, and even individual desires. Whether celebrated quietly or with gusto, the day brings the start of new opportunities for those that observe it.

United States and Canada

In both the US and Canada, celebrations begin on New Year’s Eve. At midnight on January 1st the New Year is welcomed with bells, horns, whistles, and other noisemakers. Fireworks are often part of the celebrations. In New York City, Times Square comes alive with revelers. In Toronto, there are large celebrations which may feature concerts, late-night partying, sporting events, and fireworks, with free public transit service during peak party times. Many individuals in North America greet the year by making resolutions for improvements in their lives.

China

In China, many people celebrate two forms of a new year. They may observe January 1st, but the traditional Chinese New Year is based on a lunar calendar. Parades with paper lanterns and dragons made from silk are a significant part of the festivities. Legends say that the dragon spends most of its time in hibernation so fireworks are used to keep the dragon awake.

Jewish Celebration

Jewish New Year’s observances begin with Rosh Hashanah, the first day of the New Year, and end with Yom Kippur, the Day of Atonement. This ten-day celebration is held in September or October, based on the Hebrew calendar. The New Year is not marked as much with loud celebrations as with personal insight to mend wrongs and resolve to better oneself.

Other countries and cultures also have different dates for New Year’s Day observances:

• Vietnam observes the New Year in February
• In Iran, the day is celebrated on March 21st
• Islamic cultures often observe the tenth day of the month of Muharram
• Russian Orthodox observers use the Julian calendar and celebrate on January 14th
• Buddhist celebrations are held from April 13th through 15th

If you observe New Year’s Day by making healthy resolutions, include dental care in your plans with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. The health of your teeth and gums contributes to your overall health. Caring for your mouth now can prevent many dental problems later in life. Central New England Endodontics and Implantology wishes you a healthy, prosperous, and happy New Year!

One of the latest foods in dietary news is also one of the oldest—ancient grains. What makes these old-timers so appealing to modern tastes? Let’s run down the menu!

Why Are Some Grains Called “Ancient”?

Unlike grains such as modern wheat, which have been crossbred for hundreds of years to bring out certain qualities, ancient grains are generally considered to be grains which have been cultivated in the same way and in the same form for centuries.

Not All Grains Are the Same

Grains are harvested from the seeds, or kernels, which grow on top of cereal grasses. But because they have many of the same uses, and many of the same nutrients, ancient grains also include pseudocereals, which are seeds and fruits from non-grasses. These seeds can be ground just like grains or used whole. This is an important distinction for many diet-mindful people because grains derived from pseudocereals are gluten-free.

The Health Benefits of Ancient Grains

Ancient grains are whole grains. This means that the seeds of ancient grains have their bran, germ, and endosperm intact—which means that all their nutrients, proteins, and fiber also remain intact. Refined grains like white flour and white rice have removed many of these good-for-your-body elements by removing the bran and germ, leaving only the endosperm behind.

The Dental Benefits of Ancient Grains

Of course, any food that offers better nutrition is better for your teeth and gums. But there’s an added bonus in the more complex structure of intact grains—they take more time to digest.

With foods made with refined grains, digestion starts taking place quickly—in fact, saliva starts the digestive process right in our mouths while we eat. And as these carbs break down into sugars, they provide a feast for the oral bacteria which convert that sugar into acids.

These acids, in turn, attack tooth enamel, leaving weaker spots which can grow into cavities, and irritate delicate gum tissue. What’s more, refined carbs tend to be extra sticky, lingering in the mouth, between the teeth, and on the enamel instead of being washed away by saliva.

So, Have Any Suggestions for My Shopping List?

We do! Because all ancient grains are loaded with protein and fiber, they are all going to be a rich source of these healthy essentials. And they can offer additional minerals, vitamins, and antioxidants to your diet. If you’re inspired to add a bit of history and geography to your plate, here are some ancient grains to consider:

• Amaranth

Cultivated by the Aztecs, this gluten-free pseudocereal seed is high in manganese, magnesium, copper, phosphorus (which helps keep your enamel strong), and also provides vitamins B1 (thiamin), B6, and B9 (folic acid).

• Barley

Grown for thousands of years in Asia and Europe, barley is one of the first cultivated grains. In its whole grain form, barley offers us selenium, manganese, copper, vitamins B1 and B3 (niacin), and antioxidants. Whole barley has a very tough outer shell and takes quite a bit of cooking, so lightly pearled barley can be substituted with only a small loss of bran.

• Buckwheat

Originating in Asia, buckwheat quickly spread to Europe and eventually made its way to early American fields. Another pseudocereal, buckwheat seed is often ground for flour, and is a good source of copper, manganese, magnesium, phosphorus, vitamins B2 (riboflavin), and B3. Not to mention, gluten-free!

• Bulgur

Often used in Middle Eastern and Mediterranean cooking, bulgur is a cracked wheat cereal grain. Bulgur adds, among other nutrients, manganese, magnesium, copper, iron, and vitamins B3 and B6 to your diet.

• Farro

“Farro” comes from an Italian word which can refer to three different varieties of wheat, with different cooking times, textures, and flavors. These grains were first cultivated in the Middle East and the Mediterranean region thousands of years ago, and are still popular today thanks to their nutty flavor and chewy texture. Try farro for a tasty serving of magnesium, zinc, vitamin B3, and antioxidants.

• Freekeh

Common in Middle Eastern, North African, and Mediterranean cuisine, freekeh is another form of cracked wheat. It’s harvested when the plants are young, so it has extra protein and fiber, as well as being a good source of iron.

• Quinoa

Another pseudocereal, quinoa originated in South America. It’s gluten-free, and filled with minerals such as manganese, magnesium, phosphorus, and vitamin B9. It’s also a complete protein, which means it contains all nine of the amino acids our bodies can’t produce on their own.

• Spelt

One of the largest wheat crops in Europe, and grown around the world, spelt’s nutty taste is an added bonus to its stores of manganese, copper, phosphorus, and vitamin B3.

• Teff

The smallest of the ancient grains, teff is an African variety of millet, a pseudocereal full of nutrients such as manganese, copper, iron, and calcium (another mineral which is vital to dental health), as well as vitamins B1 and B6. Try brown teff for its naturally sweet flavor.

This is just a taste of the ancient grains available to you, with many others from around the world waiting to be harvested for your table. But you needn’t choose ancient grains to receive all the nutritional benefits of whole grains.

Brown rice, whole wheat products, corn, oats—all these common ingredients are easily available forms of whole grains. Check the grain aisle in your local market for some new ways to brighten your recipes, to increase your dietary protein and fiber, to add minerals and vitamins, and to provide some healthy alternatives to refined grains. Your body—and your teeth—might thank you!

Many people who are careful about brushing and flossing their teeth wonder how they still end up with cavities or tooth decay. Several factors affect wear and tear on tooth enamel. Diet is a major factor, with certain foods increasing the likelihood that your enamel will become discolored or decayed. Pay close attention to the foods you eat to keep your pearly whites looking healthy and clean.

What causes enamel damage?

Tooth enamel refers to the hard, semi-translucent, whitish part of the tooth that shows above your gums. The enamel is primarily composed of minerals that are strong but susceptible to highly acidic foods. When acid reacts with the minerals in enamel, it results in tooth decay. Strongly pigmented foods can also damage enamel by discoloring the surface of the tooth.

Foods that harm enamel

Acidic foods are the greatest source of enamel damage. To determine whether a food is acidic, look up its pH. Scientists use pH, on a one-to-seven scale, to define the relative acidity or alkalinity of a substance. Foods with low pH levels, between a one and three, are high in acidity and may damage your enamel. Foods with high pH levels, such as a six or seven, are far less likely to cause enamel harm.

So which foods should you avoid? Many fruits are high in acidity, including lemons, grapefruit, strawberries, grapes, and apples. The high sugar and acid content in soda makes it another huge contributor to enamel decay. Moderately acidic foods include pineapple, oranges, tomatoes, cottage cheese, maple syrup, yogurt, raisins, pickles, and honey. The foods that are least likely to cause enamel damage include milk, most cheeses, eggs, and water.

Beverages such as red wine and coffee also damage the enamel by discoloring it. Although stains do not necessarily undermine the integrity of your teeth, they can be unsightly.

What can I do to prevent enamel damage?

Fortunately, there are several measures you can take to prevent your enamel from discoloring or decaying. The easiest way to avoid decay is to steer clear of high-acidity foods. This may not always be possible, but eliminating sugary fruit juices and soda from your diet is a good start. Brushing your teeth after each meal and flossing frequently also preserves your enamel. Another good idea is to rinse your mouth with water or mouthwash after eating to wash away high-acidity particles.

Although enamel damage is common, it does not have to be an inevitable occurrence. Knowing the foods that harm your teeth gives you the tools to prevent discoloration and decay. With some easy preventive measures, your teeth will stay strong and white for years to come! Give us a call at Central New England Endodontics and Implantology to learn more!

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.

Our pets are a valued part of the family, but dogs and cats are not regularly known for their minty-fresh breath. Did you know that bad breath can be a sign of a more serious dental problem for your furry companion?

If you live with a pet or two, you’ll want to brush up on your animal dental knowledge and make sure everyone’s teeth stay healthy.

Proper dental care is essential to a pet’s overall well-being. About 80 percent of dogs and 70 percent of cats suffer from periodontal disease after the age of three.

Not only is this unhealthy for their mouth, it can lead to more serious health problems, including organ damage and heart failure. Toxins from periodontal disease seep into your pet’s bloodstream and have the potential to cause fatal organ damage.

Your veterinarian will check your pet’s teeth at an annual or six-month examination, but here are a few signs of periodontal disease you should watch for at home:

• Yellow/brown tartar
• Foul breath
• Red, inflamed, or bleeding gums
• Excessive drooling
• Pawing at the mouth or rubbing one’s jaw against objects
• Difficulty chewing

Aside from regular checkups at the vet, the best thing you can do for your pet is brush its teeth daily. Bacteria can recolonize onto the surface of teeth within 24 to 36 hours, so it’s essential to remove plaque before it turns into tartar. Ask your vet for a recommended toothbrush and pet toothpaste.

Dental hygiene chews can also help to reduce the effects of gingivitis, but some chews can actually make your pet’s oral health worse. Treats such as cow hooves, pig’s ears, and animal bones can damage teeth and cause other problems if ingested. Your vet can help you choose items that are healthiest for your pet.

Your dog’s favorite toys may also pose a threat to their oral health. Abrasive toys such as the popular green tennis balls can create wear and tear on the surface of pets’ teeth.

As with your own teeth, your dog or cat’s oral health plays a large role in its overall health. Remember to schedule regular checkups and ask your veterinarian for more tips on how to care for your pet’s teeth most effectively.

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Worcester office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

Between the huge number of toothpaste brands on the market today, the different flavors, and claims from most to do different things, it isn’t surprising that people feel so confused when it comes to something that should be as simple as buying a tube of toothpaste. This guide will help you identify the common ingredients in toothpaste, and help you understand the important factors to consider before buying toothpaste again.

Toothpaste comes in gel, paste, and powdered forms. When it comes to the type of toothpaste, the choice is more a matter of preference.

Basic Ingredients

• Abrasive Agents – Abrasive agents are the scratchy substances added to toothpastes to help in the removal of food particles, bacteria, and minor stains. Calcium carbonate is one of many abrasive materials, and arguably the most common.
• Flavor – When toothpastes are flavored, they almost always have artificial sweeteners to enhance the flavor of the toothpaste and increase the likelihood that you’ll use it. Flavors run the gamut from traditional mint to cinnamon that may appeal to adults, and bubble gum or lemon lime – flavors to target children.
• Humectants – Humectants are moisturizing agents that keep paste and gel toothpastes from drying out. Glycerol is commonly used as a humectant.
• Thickeners – Thickeners are used to give toothpaste its distinctive consistency, and to make it maintain a uniform consistency and come out of the tube easily.
• Detergents – Sodium lauryl sulfate is the most common detergent used in products that foam up, like toothpaste does in your mouth.

What to Look For in Toothpaste

Fluoride is naturally occurring mineral. It is the most important ingredient to look for in a toothpaste. Although there are people who argue against using fluoride toothpaste, dental professionals like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants emphasize that the fact that the incidence of tooth decay has decreased so significantly in the past 50 years is because of fluoridated toothpaste.

The suggestion that fluoridated water gives you enough fluoride to protect your teeth is wrong. Fluoride toothpaste is the best cavity protection there is. In addition to strengthening tooth enamel and protecting teeth from acid erosion (from acidic foods and drinks,) it remineralizes the surfaces of teeth that are suffering from early acid damage and may prevent developing tooth decay from worsening.

Tartar Control

Tartar is the result of hardened plaque buildup on the teeth. Good oral hygiene and in between twice yearly cleanings from a dental hygienist are the best defense against plaque buildup. Plaque turns to tartar when people neglect their oral hygiene. Over time, tartar can build up on teeth and under the gums, increasing the risk of gum disease.

Your best bet is to use a toothpaste that has a combination of anti-plaque agents. Products containing more than one plaque reducer may be more effective than products that only one. Common ingredients to look for are zinc citrate or pyrophosphates. Triclosan is an antibiotic that is believed to kill bacteria in the mouth, and it can be found in some anti-plaque toothpaste.

Look for toothpaste that bears the seal of the American Dental Association. That seal is an endorsement of the ADA – and it means that many dentists agree that that particular toothpaste does what toothpaste is designed to do. We can also recommend toothpaste to meet your specific oral health concerns at your next visit to our Worcester office.

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.

Your opinions matter to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team! Our blog is meant to be an educational channel, but we always want to know what things you’re interested in learning more about. After all, our blog is here for you to enjoy!

We’d like to encourage you to send us any ideas about what you want to see more of. No idea is too small! Whether it involves a specific treatment or advice on what kind of toothpaste you should use, we’d love to hear from you about it.

To share your thoughts with us, simply leave your comments below or on our Facebook page! You can also fill out a comment card the next time you visit our Worcester office!

When patients of Central New England Endodontics and Implantology hear any mention of oral or dental hygiene, they probably think of brushing and flossing their teeth. Although these are extremely important, the term dental hygiene encompasses much more than that. Your mouth’s health, including your teeth, has an important impact on your overall physical health. The National Institute of Dental and Craniofacial Research published the surgeon general's first ever report on dental health. It is called A National Call to Action to Promote Oral Health. In that report, the Surgeon General states that the 1948 World Health Organization expanded its earlier definition of health to "a complete state of physical, mental, and social well-being, and not just the absence of infirmity."

The Importance of Oral Health to Total Overall Health

One of the most important themes that the dental health report stressed is that you cannot be healthy without oral health. It went on to explain that oral health and general health are inextricably linked, and therefore can't be seen as two separate things. Because oral health is so critical to overall health, it should be included in all community health programs. For individuals, this means that it is just as important to take care of your mouth, your teeth, and your overall oral health as it is to take care of the rest of your body. The two most prevalent dental diseases are caries (cavities), also known as tooth decay, and periodontal (gum) disease.

Ways that Oral Health Impacts Overall Health

One important way in which good oral health contributes to better overall health is seen in the findings of several studies in which the blood sugar levels of diabetic patients were significantly lowered when their periodontal (or gum disease) was successfully treated. Your mouth has roughly 500 different species of bacteria. Many are harmless, and some are even good bacteria that help maintain the balance of your intestinal flora. Harmful bacteria can infect your gums, causing gingivitis. Your body's immune system may try to fight off the alien invaders, but they attack your gums, causing inflammation and bleeding when you brush.

Now that you know how important good dental hygiene is, be sure to see to get your teeth cleaned every six months, have regular dental checkups, brush and floss your teeth at least twice daily, and replace your toothbrush at least every couple of months. Call us to schedule your next appointment at our convenient Worcester location.

Sometimes food that’s good for your body isn’t necessarily the best for your teeth. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team want you to know which healthy foods can harm your teeth and gums, and what steps you can take to continue enjoying these foods, even when you’re dieting.

When you begin to substitute empty calories with whole foods, make sure you also remember to focus on your dental health. The majority of people tend to switch out sugary foods in favor of fruits and vegetables when they diet.

It’s worth knowing that most fruits are highly acidic and composed of natural sugars. Some of the highly acidic fruits to watch out for include apples, grapes, strawberries, pineapples, blueberries, oranges, and grapefruit. Moderation is key here, as with all other things. Fruits can be a great source of energy to help you through your day, but try not to overdo them.

Often, people also incorporate more leafy greens into their diets, which mean plenty of salads. Salad dressing is another item you’ll want to watch out for. Many dressings are filled with vinegars and sweeteners that include harmful acids, which change the pH of your mouth. When your mouth shifts from alkaline to acidic, your smile also turns to a higher risk for erosion and decay.

Rather than get rid of these foods altogether, simply change what you do after you eat them. Rinse your mouth out with water, brush your teeth, or eat alkalizing foods after consuming these acidic foods. Healthy alkalizing foods include dairy products such as eggs and yogurt, or any type of vegetable.

If you have questions regarding your current diet and its effect on your oral health, please contact our Worcester office and speak with a member of our staff. If you’ve begun to make changes in your diet toward a healthier lifestyle, we hope these tips can help your make positive changes to your oral health. Our team at Central New England Endodontics and Implantology wants a healthy lifestyle to be a top priority in your life.

At Central New England Endodontics and Implantology, we have been creating beautiful smiles for years. Whether you or your family have visited Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team for a single visit or have been loyal patients throughout the years, we would love to hear your thoughts about your experience! In fact, we encourage you to leave a few words for us below or on our Facebook page!

We look forward to reading your feedback!

While modern dental science has made remarkable advances in treating oral diseases, prevention is always better than cure. To keep our mouth, gums, and teeth their healthiest, there are some simple practices we can follow to dramatically reduce dram the risk of developing some of the most common oral diseases.

Tooth Decay

We don’t usually think of tooth decay as a disease, but it is, in fact, the most common chronic disease in older children and adolescents. A great majority of adults have had at least some experience with decay. Left untreated, tooth decay can lead to pain, infection, tooth loss, and even loss of nearby bone in the jaw. Luckily, there are several time-tested ways to prevent cavities:

• Brush properly at least twice a day. Ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for the best toothbrush for your individual needs (usually, a soft brush is best), the best technique for angling the brush to reach all of each tooth’s surfaces, and the amount of time you should spend brushing.
• Floss daily. Even with perfect brushing form, you are going to want to use floss to clean between the teeth and around the gum line.
• Use a fluoride toothpaste. Study after study has shown that the risk of cavities is reduced with regular use of a fluoride toothpaste or rinse.
• Watch your diet. Foods high in sugar and simple carbohydrates give cavity-causing bacteria the fuel they need to produce the acids which weaken enamel. On the other hand, a diet rich in protein, vitamins, and minerals is beneficial not only for your teeth, but for your whole body!
• See your dentist for regular checkups to find small problems and prevent them from becoming major ones. Your dentist can also give you tips on better oral hygiene if your brushing and flossing habits aren’t doing the job.

Gum Disease

Preventing gum disease is a lot like preventing tooth decay—your daily habits really make a difference. When plaque builds up around the teeth and gums, the bacteria in plaque cause gum tissue to become inflamed, swollen, and painful. Left untreated, the gums pull away from the teeth, leaving pockets where bacteria collect and lead to infection. Infections harm not only gum tissue, but can destroy the bone which supports the teeth. What can you do to prevent gum disease?

• Use proper brushing technique. Remember to angle the brush toward the gums to gently clean around and below the gum line.
• Floss daily—flossing removes particles and plaque between the teeth, and it also helps remove plaque from the area under the gum line.
• Smokers are at higher risk for gum disease, and smoking has been linked to slower healing. Giving up tobacco products of any kind is always a good way to protect your dental health.
• Regular dental exams will catch gingivitis (early gum disease) while it is still reversible. Periodontitis (serious gum disease) can require treatment by a specialist. Certain diseases such as diabetes increase the risk of developing gum disease, so checkups are especially important.
• Having your teeth cleaned every six months, or as recommended, will remove plaque that brushing alone can’t handle. If there are signs of more serious gum disease, a periodontal cleaning will remove plaque and tartar from both above and below the gum line.

How Can Your Endodontist Help?

Endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants have the advanced education and training not only to treat several oral diseases, but to help repair the damage they can cause. Endodontists are experts in such procedures as:

• Root canals—your first option for preserving your tooth when the inner pulp has been damaged or infected
• Surgeries which allow access to tiny root fractures and canals, calcium deposits, or damaged roots and bone which can’t be reached non-surgically
• Apicoectomies, which treats recurring pain and infection by removing the tip of the root and any inflamed or infected tissue, then cleaning and resealing the root
• Endodontic surgeries such as root resections, which retain as much of the natural tooth as possible when a tooth is too damaged for normal restorations
• Implant surgery to provide a permanent, natural looking replacement for a lost tooth

An ounce of prevention is worth a pound of cure, and when it comes to your dental health, there’s a lot you can do to prevent oral diseases. But should you need endodontic treatment at our Worcester office, we have the knowledge and experience you need. After all, you can’t weigh the worth of your oral health—that’s priceless!

This may come as a surprise, but brushing your teeth right after a meal can be one of the worst things you can do for your healthy teeth. A toothbrush can be considered an assault weapon against your smile if used immediately after eating certain foods.

Enamel is like the tooth’s shield. It is a hard mineral exterior on each of your teeth. In reality, enamel is the hardest part of the human body—even stronger than bone! I like to regard it as a “super-structure.” But every superhero has a weakness, and enamel’s kryptonite is acid.

A healthy tooth lives in a mouth that has a proper pH balance. When that balance tips from alkaline to acidic, a harmful process called demineralization begins. Demineralization occurs when acids attack and soften the tooth surface. Pores and fissures form and harmful bacteria move in.

With each bite of food or drink, our mouth pH fluctuates. Highly acidic foods tip the balance of your mouth from a healthy alkaline to a dangerous acid. Here are some examples of those sources of acid: citrus fruits, soda, and sugary foods. There are certainly many others, but these are the most common.

So how does brushing your teeth immediately after a meal make this process even worse?

After eating highly acidic foods, your teeth are susceptible to damage. When you brush your teeth in this weakened state you are actually damaging your enamel. The abrasive bristles of the brush wear away the protective surface of the teeth. You should avoid brushing for at least an hour, or take other, simple preventive measures immediately following a meal.

First, rinse with or drink clear water. Then chew some sugarless gum. Both of these practices will produce saliva, restore a healthy pH level in your mouth, and coat your teeth with nourishing minerals. Out of all the sugarless gums available, the best of the best are those that list xylitol as the first ingredient. Another option is to consume cheese, milk, or another non-acidic food or drink to conclude your meal.

After you have given your mouth time to return to a healthy pH, feel free to brush your teeth. Just keep in mind that any time you eat acidic foods, you weaken your teeth. Make sure not to worsen the problem by brushing immediately after dining and damaging your teeth even more. Questions? Call us at Central New England Endodontics and Implantology.

Getting to the Root of the Problem

While our roots are well-protected, they’re not indestructible! Several conditions can damage them. But we’re not just about problems—we also have some suggestions to keep your roots solid and intact for a lifetime.

• Traumatic Injury

A blow, a fall from a bike, a sports injury—any trauma which can hurt your visible tooth can hurt your roots as well. And it’s not just accidents that cause harm. Cracks in the tooth caused by oral habits like chewing on ice, pencils, or other hard objects can lead to root fractures.

You can help prevent root injuries by wearing a mouth guard whenever you are engaged in contact sports or any physical activity that might cause damage to your face or mouth. If you have harmful oral habits, talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about how to break them. And if you do suffer a dental injury, see us as soon as possible to avoid more serious complications.

• Bruxism

Bruxism, or tooth grinding, is most often an unconscious habit that takes place while you sleep. Grinding puts enormous pressure on teeth and their roots. The damage can be obvious, with cracked and worn crowns, but your roots can be affected, too. The strain of this constant pressure can stretch the periodontal ligament, causing loose teeth.

Night guards are one of the easiest ways to relieve pressure on individual teeth and roots. Your dentist can fabricate a night guard which will provide comfortable, effective protection for your teeth and jaw.

• Gum Recession

Taking care of your gums is one of the best ways to protect your roots.

Gums often recede as we age, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can also lead to gum recession. The newly revealed cementum is now exposed to the plaque and acids which cause cavities in our enamel, and, since it’s not as strong as enamel, cementum is more vulnerable to erosion and cavities progress more quickly.

When more severe recession takes place, the gums pull away from the teeth, creating pockets which become home to plaque and bacteria. Left untreated, infection and inflammation can develop, attacking teeth, connective tissue, and bone. Talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about scaling and planing procedures for a deep cleaning of the root surface, or grafting procedures to replace the gum tissue which protects your roots.

• Infected or Injured Roots

An endodontist is a specialist in diagnosing and treating conditions affecting the inner tooth and its surrounding tissues. To specialize in this field, endodontists have two or more years of additional advanced training in procedures designed to save your natural teeth.

Any infection or trauma which injures the pulp of the tooth will affect the roots as well. Most of us are familiar with root canal treatment, where infected or damaged pulp is removed, and the insides of the pulp chamber and canals are cleaned, shaped, and filled. A crown is usually placed afterward to cap and protect the tooth.  Endodontists are specialists in root canal treatment, saving teeth which would otherwise be lost.

Endodontists are also trained in surgical procedures which treat persistent root pain and infection:

• When infections recur near the tip of a root after a root canal, an apicoectomy is the most common surgical treatment. In this procedure, your endodontist will carefully remove a few millimeters from the tip of the tooth, then clean the infected parts of the tooth and the tissues around it before sealing the root tip.
• If a single root in a molar with multiple roots is seriously damaged, decayed, or infected, your endodontist might recommend a root amputation. Here the damaged root is surgically removed, preserving the remaining roots and crown. If the crown is damaged as well, your endodontist can perform a hemisection, removing the root and part of the crown to save as much as possible of the molar.
• When the reason for your discomfort is unclear, diagnostic surgery can find the cause of persistent pain when a tooth fracture or root canal branch is so small that even an X-ray doesn’t reveal it.

Healthy roots help you keep your teeth for a lifetime, so it’s important to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants as soon as possible if you have any symptoms of potential problems:

• Constant pain in tooth, gums, or jaw
• Pain when biting down
• Loose teeth
• Tooth discoloration
• Sensitivity to hot and cold
• Swelling or pain in the gums around a tooth

Do your part by keeping up with daily brushing and flossing, seeing your dentist for exams as recommended, and making an appointment at our Worcester office if you are feeling any pain or discomfort. Strong roots are essential to our oral health, and a lifetime of healthy smiles is something we’re all rooting for!

As more people turn to bottled water and away from the tap, they may be missing out on one important ingredient that most brands of bottled water fail to include: fluoride! Because fluoride helps strengthen teeth, it is an important component of maintaining good oral health. Our friends at the American Dental Association have endorsed both community water fluoridation and the use of fluoride-containing products as a safe means of preventing tooth decay.

In fact, the Centers for Disease Control and Prevention has also warned that “bottled water may not have a sufficient amount of fluoride, which is important for preventing tooth decay and promoting oral health.” If you are avoiding fluoridated tap water in favor of ever-more-popular bottled water, you could be missing out on the levels of fluoride necessary to make a difference in your oral health. One 2012 study in the Journal of Pediatric Dentistry found that more than 65 percent of parents using bottled water did not know what levels of fluoride it contained.

If bottled water happens to be your or your children’s beverage of choice, check the label to make sure your brand contains fluoride. Of course, simply drinking fluoridated water is not a magic ticket to perfect teeth. To keep your pearly whites in tip-top shape, it’s important to brush and floss daily and avoid sugary sweets, in addition to maintaining your fluoride intake.

Questions about fluoride? Give us a call at our convenient Worcester office! We look forward to hearing from you!

X-rays have been a function of dental healthcare for a long time. That in and of itself should be good news, because it means we've had plenty of time to improve them. While there is always some risk in exposure to radiation, dental X-ray exposure has decreased significantly due to all the advances in technology. So there’s risk, but X-rays are quite safe.

Think of X-rays as you would about a car. Automobiles these days have all kinds of technology to make them as safe as possible. There's still a chance that you’ll suffer an accident. Would you stop using a car because of that risk? When it comes to dental X-rays, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team believe the positives clearly outweigh the negatives.

X-rays can be done digitally or with film. For film, X-rays require different exposures at different speeds to produce the image. Digital X-rays have software that automatically adjusts the exposure and produces the X-ray in a digital file. Since they substantially reduce your exposure to radiation, digital X-rays are the current standard in dental offices.

In addition to digital X-rays, lead aprons are an essential piece of X-ray safety. They help protect internal organs from X-rays by acting as a shield. They usually come with a thyroid collar as well, since that is one of the most vulnerable areas to X-rays in the body. Lead aprons can absorb up to 95% of any scatter rays that result from an X-ray. Not bad, right?

Although dental X-rays involve some radiation exposure (not all of it can be eliminated), so does everyday life. Getting too much sun, for example, can be dangerous. The truth is, we accumulate radiation in our bodies over a lifetime, so it’s worthwhile to be aware and avoid as much unnecessary exposure as possible. When it comes to your dental health, though, getting an X-ray — especially when your doctor says you need it — offers more benefits than risks.

Ask us about the type of dental X-rays we use during your next visit to our Worcester office!

Since the introduction of the power toothbrush in the 1960s, this tool has undergone many technological advances, from design and bristle motions to rotation oscillation and sonic vibration.

What is rotation oscillation? That’s when the head of the toothbrush alternately rotates in one direction and then the other. Power toothbrushes can deliver up to 50,000 strokes per minute, which is much more effective than the average 300 strokes per minute with a manual toothbrush.

A smaller brush head is available for hard-to-reach areas, which is a good alternative for small mouths. The brush heads are replaceable and should be changed every three to six months. Each family member should have his or her own brush head while sharing the base motor. What a great deal! Check the handle size. A large handle is better for members of the household with arthritis, children, or family with other physical disabilities.

A rechargeable toothbrush is ideal. It should deliver enough power on a full charge for one week of brushing.

We recommend you brush for a minimum of two minutes. Some electric toothbrushes include a signal you can hear, such as a beep every 30 seconds, to indicate it's time to switch to a different area of the mouth. Others sound an alert after the full two minutes has elapsed.

Will an electric toothbrush harm the teeth or gums? Studies indicate that people tend to apply more damaging pressure to their teeth and gums during manual brushing than when they use an electric toothbrush. If you experience tooth sensitivity, choose a model with pressure sensors that stop the toothbrush any time you press too hard.

Who would benefit from an electric toothbrush? Everyone! Consumers with a physical disability may have specific needs that power toothbrushes can address. Children also tend to maintain better oral health hygiene when they use an automatic toothbrush. Plus, many of them find it fun to brush!

Automatic toothbrushes really do remove debris better than the old-fashioned way. You may have heard the term “biofilm.” Better known as plaque when it occurs in the mouth, biofilm is the debris and bacteria that cause infections to your teeth. It regenerates quickly, so healthy habits are the best defense for a healthier you! With a healthier mouth, you face a lower risk of gum disease and other conditions like heart disease: mouth health has been linked to heart health.

When you're ready to make your decisions, be a wise comparison shopper. Consult with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at Central New England Endodontics and Implantology to decide what is best for you!

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!

Some people choose bottled water over tap because they think it’s cleaner. Some do it out of convenience: It’s easy to grab a bottle of water to take with you for the day as you run out the door or hop in your car.

Whatever the reason, bottled water has been coming in ahead of tap water for the last couple of years. What many people may not know is that choosing bottled water over tap can actually be detrimental to your dental health.

Most brands of bottled water fail to include a vital ingredient: fluoride. Fluoride plays an important role in helping maintain good oral health because it helps strengthen our teeth. Stronger teeth mean a lower chance of tooth decay, and who doesn’t want that?

When we choose bottled water over tap water, we deprive our pearly whites of something they might very well need.

The good news is that the American Dental Association has endorsed both community water fluoridation and products that contain fluoride as a safe way to prevent tooth decay. If bottled water happens to be the preference for you or your family, you don’t necessarily have to force everyone to start drinking tap water.

Just check the label and make sure the brand you purchase contains fluoride.

It’s essential to remember that switching up the water you drink isn’t going to put you on the fast track to perfect teeth, though. Flossing and brushing three times a day is vital!

If you have any questions about fluoride or your dental health, don’t hesitate to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office!

In fancy medical terms, dry mouth is known as xerostomia. It’s really just what it sounds like: a condition in which you don’t have enough saliva to keep your mouth moist. Dry mouth can be the result of certain medications you’re taking, aging, tobacco use, nerve damage, or chemotherapy.

Depending on whether you’re aware of the cause of your dry mouth, here are some simple ways to keep it at bay:

• Avoid drinks that contain alcohol or caffeine
• Avoid tobacco use, or lower your consumption of tobacco
• Floss after every meal
• Brush your teeth after every meal using a fluoride toothpaste
• Avoid foods that have a high level of salt
• Stay hydrated and drink water frequently
• Consider using a humidifier at night

If you have any questions about dry mouth and how it is affecting you, give our Worcester office a call or make sure to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit!

We probably all remember sitting through history lessons during our schooling years. Revolutionary war heroes, English royals, and pop-culture icons filled the pages of our textbooks. Although you may recall a detail or two about their historical significance, how much do you know about their teeth?

Picture England in the mid 1500s. People wore frilly clothes as they hustled along the street, and talked about the latest import from the Indies: sugar. Wealthy Brits did not hesitate to indulge their sweet tooth, and it was no different for the monarch, Queen Elizabeth I.

The queen was especially fond of sweets, but not so fond of the dentist. Her teeth rotted; they turned black and gave off a foul odor. Eventually, Elizabeth lost so many teeth that people found it difficult to understand her when she spoke.

Flash forward to the Revolutionary-era colonies in the 1770s and we encounter the famous dentures of George Washington. They were not made of wood, but rather a combination of ivory and human teeth, some of which were his own pulled teeth and some he purchased from slaves.

Washington did not practice proper dental hygiene throughout his life. He began to suffer dental problems as early as age 24, when he had his first tooth pulled. By the time he was inaugurated in as the first president in 1789, he had only one tooth remaining in his mouth, which was pulled in 1796.

Washington’s dentures were made too wide and never quite fit his mouth properly. He complained that they were painful to wear and caused his jaw to protrude visibly outward.

If you’ve heard of Doc Holliday, you know him as the gun-toting, mustached criminal that ran the Wild West in the late 1800s. You might be surprised to learn that John Henry “Doc” Holliday actually had a career as a dentist.

He graduated from dental school in 1872 and began to practice in Griffin, Georgia. Holliday was later diagnosed with tuberculosis and his violent coughing fits during exams drove patients away. Jobless, he packed his bags for Texas and spent the rest of his days running from town to town as a criminal.

The Beatles brought pop music and British culture to their fans, as well as … teeth? In the mid-1960s, John Lennon had a molar removed that he presented as a gift to his housekeeper, Dorothy. Dorothy’s daughter was a huge fan of the Beatles and he thought she might like to a keepsake. Her family held onto the tooth until 2011, when they auctioned it off to a Canadian dentist for $31,000.

These historical figures had very different experiences with their teeth, but it’s safe to say a bit of extra brushing and flossing could’ve saved them a lot of trouble. Whether you’re queen, president, or an average citizen, it’s up to you to practice good dental hygiene!

Ask a member of our team at our Worcester office if you have any questions about how to keep your teeth in top shape!

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, as well as our team at Central New England Endodontics and Implantology, would like to give those patients with flex spend, health savings, or insurance benefits a friendly end of the year reminder that it’s high time to schedule your dental visits so you optimize your benefit.

Now is the time to reserve your appointment with us. Space is limited and we tend to get busy around the holidays, so don’t wait to give us a call at our convenient Worcester office!

Did you know that the most common oral health diseases are tooth decay and gum disease? Not so coincidentally, they are also the easiest to prevent. As much as we would like for the brushing and flossing to do all the work for us, in reality, we really are what we eat — and a healthy diet is just as important for dental health as it is for the rest of the body.

Eating well boosts your immune system, and makes you less susceptible to gum disease and tooth decay. When you maintain a balanced diet, you provide your body with all the nutrients it needs to succeed. So what does a healthy, balanced diet entail? It’s really quite simple. Here are some tips:

1. Focus on lean meats, veggies, whole grains, and healthy fats.
2. Limit your intake of sugary drinks like energy drinks and soda.
3. Keep your sweet tooth in check.
4. Beware of acidic meals and snacks that are high in salt and sodium.
5. Drink lots of water.

Unfortunately, there’s no “one size fits all,” magic diet that will automatically improve your oral health, but following the five guidelines above as best you can is a great way to start. Food and drinks that are high in sugar or acidity weaken your enamel, stain your teeth, and make you more likely to develop a cavity or gum disease.

At Central New England Endodontics and Implantology, we like to encourage our patients to drink a lot of water during the day. Doing so not only keeps you hydrated, but also helps rinse out the sugar and acid from various things you’ve consumed during the day.

If you think your diet might be affecting your smile, come pay Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants a visit or give our Worcester office a call! We’re always happy to answer your questions.

Health gurus rave about replacing unhealthy food choices with healthy ones in your diet. If you want to maintain your beautiful smile as well as your waistline, choose foods that are good for your teeth and good for losing weight. This article will discuss some of the worst healthy foods for your teeth and gums, and what you can do to continue to enjoy them.

When watching your weight, snacks heavy in sugar and starch are the first target for elimination. You want to trade those empty calories for something with more nutritional value. A healthier snack is fruit and vegetables. When you are substituting empty calories with whole foods such as fruits and vegetables, consider a few implications for your dental health.

The most acidic fruits are grapes, grapefruit, and strawberries. Want to know the number-one worst healthy food for your tooth enamel? Apples! An apple a day may keep the doctor away but you may soon be calling your dentist.

Another healthy food often incorporated into dieting is salads. But consider what you put in those salads. Salad dressings are filled with vinegar and sweeteners. These make a salad very acidic and can change the pH of your mouth from alkaline, which is good for your teeth and gums, to acidic, which puts your smile at risk for erosion and decay.

Last but not least is diet soda. You might be cutting down on the calories but you are still putting your teeth at risk for decay. Though calories are reduced, the acid is not.

You do not need to eliminate any of these foods from your diet. Simply alter what you do after eating these foods to decrease the amount of acid your teeth are exposed to.

During your next visit to Central New England Endodontics and Implantology in our Worcester office, we can discuss your diet. We may recommend using certain products to fortify your teeth or change the way you routinely care for your teeth.

Please enjoy the wonderful whole foods that are great for a healthy waistline. A healthy waistline and a healthy smile have a positive influence on your general health. A healthier you is a happier you. The happier you are, the more you smile. Keep your smile brilliant and beautiful with the care your teeth deserve at the practice of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

When you replace your old toothbrush every three or four months with a new model, you accomplish three things:

• You keep your teeth cleaner (frayed brushes don’t clean as well)
• You protect your gums (you won’t be scrubbing harder to get your teeth clean)
• You add another toothbrush to your growing collection of used brushes

If creative recycling is one of your talents, you might have already discovered how handy repurposed brushes are for cleaning delicate or hard-to-reach spaces around the house. But those old brushes don’t have to spend their entire existence cleaning! Here are some ideas from Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to give a new, artistic life to your old, uninspired toothbrush.

• Splatter Painting

As your bathroom mirror can confirm, toothbrushes are great for splattering. Why not put those bristles to creative use by adding color bursts to canvas, wooden picture frames or boxes, fabric, cards, gift wrap and more? Just dip the tips of the bristles into the paint, point them toward your surface, and brush your finger over the head. For more formal effects, splatter paint over your favorite stencils on paper or fabric. Or work your magic by splattering around a stencil for a dramatic silhouette.

• Children’s Painting

Your child might find it great fun to use an old toothbrush to create new works of art. The easy-to-grip handle and wide bristles are perfect for painting those first masterpieces. Splatter painting is also a wonderful art activity for children—but be prepared for some clean-up!

Texturizing Clay Pieces

Whether you work in potter’s clay, polymer clay, or Play-Doh, an old toothbrush can provide any number of interesting textures to your piece. Press the bristles into the clay for a sophisticated stippled background, or brush long gentle strokes for a striated effect.

• Carpentry

Wood glue creates strong bonds when you are joining edges, mitering corners, or fitting mortise and tenon joints. It also creates a sticky mess when you use your fingers, a wood or plastic spreader, or one of your good paint brushes. For any gluing jobs or joinery, try a toothbrush for greater control and easy application.

• Jewelry Making

If you work with jewelry pieces, you know that sometimes there are nooks and crannies that are almost impossible to clean or polish. Try a gentle brush with an old toothbrush and the recommended polish for your piece—but do keep brushes away from the delicate surface of pearls. And for the boldly creative, why not use your toothbrush itself as jewelry? There are online instructions out there for transforming that old brush into a colorful bangle bracelet.

In turns out that there’s a second career waiting for your toothbrush after all! Make sure to clean your toothbrushes thoroughly before using them in another role. After that, let your creativity run wild—including your creative recycling! It’s just another way you are crafting a more beautiful environment for all of us.

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

Although using mouthwash is certainly not the equal of brushing and flossing, it does have benefits for your dental hygiene. If you use mouthwash regularly, you should find out which type is best suited for your needs. Here are some things to think about the next time you’re at the store.

The first item to weigh is why you want to use mouthwash. If the reason involves a high risk for cavities, you should focus on a mouthwash that contains fluoride. Make sure to double-check the label, because some mouthwashes do not necessarily include fluoride.

If you’re looking for a mouthwash to fight gingivitis, select an oral rinse with antibacterial properties. Make sure to read labels and avoid picking one that contains alcohol. Antibacterial mouthwash would also be best for a patient who has periodontal disease.

Another option is prescription mouthwash. These should be discussed with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and/or your pharmacist in order to avoid negative side effects. Pay close attention to the directions regarding how much to use and for how long. Keep in mind that some brands may lose their effectiveness if you use them on an ongoing basis.

For children, you can find a mouthwash that changes the color of plaque on their teeth. This is a fun way to help them understand how well they are brushing, and what areas they need to focus on. It can even be a tool for adults who have trouble reaching certain areas of their mouth.

While mouthwash is generally considered as a safe means to improve your oral health, you need to keep certain things in mind. Avoid using any mouthwash that has alcohol in it. If you are using a strong one, it can reduce your sense of taste over time. Be wary of a mouthwash that claims it can loosen plaque; this is not accurate and can mislead consumers.

We hope these simple suggestions will help you the next time you’re at the store. Make sure you pick the right mouthwash to keep that healthy smile! Feel free to contact Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester with any questions you may have.

Dental floss is similar to a lot of products that depend mainly on the consumer’s preference. Fact is, floss comes in a wide variety of flavors, coatings, and other variations, but all types of floss essentially do the same thing. After all, that is what is most important: that the dental floss you buy is functional—cleaning the areas in between your teeth. If you want to know what the best dental floss is, the answer is the kind that enables you to successfully and regularly clean those areas. So to help you find the right type of floss for you, here are some options.

Flavored Dental Floss

Many people that floss prefer a flavored dental floss because it freshens their breath even more than unscented floss. The latter can also take on the smells associated with bacteria in your mouth. And we all know how bad that can be. So, if flavored dental floss is what you prefer, and it allows you to floss your teeth regularly, then it is automatically best for your mouth.

Flossers

There are also products on the market called flossers, which usually consist of a plastic instrument with strung floss and a pick on the opposite end. This option can be both effective at cleaning the areas in between your teeth and scraping off plaque. These flossers also come flavored in mint and various other varieties.

Gentle Dental Floss

Some people find that typical dental floss is too harsh on their gums. For that reason some companies make floss with soft coatings that are less abrasive on the gums. For the most part these types of floss are just as effective as regular floss, and for those people that require a more sensitive approach to flossing, especially when just starting out, this is the best option.

Of the aforementioned options, it is difficult to name an absolute best type of floss. However, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team say that the type of floss that works best for you, giving you the greatest chance of succeeding at regular flossing, is the best. For more information on floss, contact our Worcester office.

You found the perfect toothbrush! The bristles are soft, to avoid irritating your delicate gum tissue. The angle of the bristles is perfect for removing plaque. The handle is durable and comfortable when you spend at least two minutes brushing in the morning and two at night. Why, you love this toothbrush and you’ll never let it go… for the next three or four months.

The life of a toothbrush is naturally a short one. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team recommend replacement every three to four months because the bristles become frayed and worn with daily use. They cannot clean as effectively when the bristles begin to break down, and, depending on your brushing style, may wear out even more rapidly. (Children will probably need to replace toothbrushes at least every three months.) But even in the short time you have your toothbrush, there are ways to keep it ready for healthy brushing.

• Don’t share. While sharing is normally a virtue, sharing toothbrushes can lead to an increased risk of infections, especially for those with compromised immune systems or existing infectious diseases. Similarly, keep different brushes separate when drying to avoid cross-contamination.
• Rinse thoroughly after brushing. Make sure to remove any toothpaste or debris left after you brush.
• Store the brush upright. Air-drying is the preferred way to dry your brush, as covering the brush or keeping it in a closed container can promote the growth of bacteria more easily.

There are several products on the market that promise to sanitize your brush. The verdict is still out on its success, but if you or someone in your home has a compromised immune system, call our Worcester office to see if it might be worth your while to check them out.

Even though your toothbrush won’t be with you long, make its stay as effective and hygienic as possible. And if you find a brush you love—stock up!

It's the end of summer, and fall is just around the corner. Soon the temperatures will cool down, the leaves will start to change, and Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology are sure that you’ll soon be thinking about Halloween costumes and Thanksgiving plans in no time. But wait! First, we want to know about your favorite parts of the summer! Did you go on a wonderful family trip? Did you pick up a new hobby? Did you try to spend as much time outside and in the sun as possible?

Share your favorite memories, stories, or photos with us by leaving a comment below or on our Facebook page.

Dry mouth, also medically known as xerostomia, is the condition of not having enough saliva, or spit, to keep your mouth wet. There are many ways to keep dry mouth at bay, including:

• Brushing your teeth after every meal with a fluoride toothpaste
• Flossing every day after a meal
• Avoiding tobacco, as well as drinks containing alcohol or caffeine
• Avoiding dry foods, as well as foods containing high salt, acid, spice, or sugar levels
• Drinking water frequently or sucking on ice chips
• Using a humidifier at night

Please call our convenient Worcester dental office to learn more about dry mouth, or ask us during your next visit!

You might remember that famous grade school dental poster teaching you all about teeth. A large white tooth with a crown, two roots with a bit of a curve, and two perfectly matched root canals inside each root. And, often, a big smiling face on the happy enamel surface—and why not? That tooth is a simple, symmetrical marvel!

But, unfortunately, those grade school posters aren’t exactly the last word in dental anatomy. Real molars might have multiple root canals in each root. The root canals might be curved in odd ways. They might have tiny branches that lead out from the main canal. They might have tiny branches that lead out from the main canal that are curved in odd ways. It can get very complicated.

This complexity is why an endodontist, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, has spent two or more additional years of advanced training after dental school studying the diagnosis and treatment of the inner tooth. And when a root problem puts your tooth in danger of extraction, an endodontist is a specialist in saving at-risk teeth. What can Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants do for a troublesome root?

• Root Canal

Endodontists are specialists in root canal treatments. We have the education, experience, and tools to find, clean, shape, and fill complex root canal formations and tiny root canal branches.

• Surgical Root Canal Treatment

When a regular root canal isn’t possible, we can still reach the root canals by approaching them surgically through the root rather than the crown.

• Apicoectomy

For a tooth that has recurring problems even after a root canal, an apicoectomy (the removal of the root tip) and the cleaning and sealing of the affected root might be recommended.

• Root Resection, Hemisection, and Bicuspidization (Bisection)

For molars with serious decay, fractures, infection, or surrounding bone loss, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants might suggest a surgical procedure which removes a single root (root resection), part of the tooth and root (hemisection) or divides the tooth and roots into two pieces (bicuspidization). These surgeries allow you to preserve as much of your natural molar as possible.

If a root problem is causing you pain, give our Worcester office a call. Because an endodontist is a specialist in saving teeth—and you deserve a poster-perfect smile!

Your feedback is very important to us at Central New England Endodontics and Implantology. We always want to make sure that our practice is meeting its full potential, so whether you’ve visited Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants once or been a loyal patient throughout the years, we encourage you to share your thoughts about your experience with us!

You can do this easily by giving us a review on our Facebook page or writing down your comments below. If you feel more comfortable, you’re always welcome to give our Worcester office a call, too! We feel fortunate to have you all as patients and look forward to reading all your feedback!

Flossing is one of the most important parts of your oral care routine. Many patients know they need to do it but find it difficult to fit into their busy lives. Well, here's the good news: flossing once a day is enough if you're doing a good job!

Some patients like to brush before they floss and others like to floss before they brush. Some like to floss in the morning when they have more energy, others like to floss at night so they can go to bed with a clean mouth. Don't get hung up on any of this, the important thing is that you floss and floss effectively no matter when you do it.

Effective flossing contributes to oral health in these ways:

• It reduces the chance of cavities between teeth, since cavities can only form on teeth covered with dental plaque and you're scraping that plaque away when you floss.
• Along with brushing, it reduces the amount of time the plaque is left on your teeth, allowing them to be in a state of healing and remineralization for longer.
• It removes plaque that accumulates at or below the gum line, aiding in the prevention of gum disease.

As you can see, flossing offers many benefits for such a simple and inexpensive technique. So if you're still wondering how much to floss, don't worry about it. Don't mistake the frequency of your flossing with the effectiveness of it. Choose a dental floss that you like and one time during the day when you can floss thoroughly and just do it! If you need more tips on how to floss correctly, ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or any member of our Worcester team—we'd be glad to help you pick up this healthy habit!

Brushing your teeth regularly is one of the most crucial parts of maintaining good oral health, and perhaps the most fundamental, however, there are also other elements involved. Flossing, for instance, is also vital; some experts would say, and Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team would agree, that it holds just as much importance as brushing your teeth. To give you a better idea of why, here are some reasons that flossing is so vital to your oral health.

Getting in-between the Teeth

While brushing your teeth effectively cleans all of the areas of your teeth that are visible, or otherwise not touching, flossing is vital because it reaches all of the areas between your teeth that you cannot see, and subsequently cannot clean using a toothbrush. These areas are among the most sensitive and vulnerable parts of your mouth because they are most susceptible to plaque and tartar buildup.

Reducing Bad Breath

It is not uncommon for someone who brushes their teeth once or twice a day to still have bad breath. The reason being is that bad breath is often created by smelly bacteria that lives in between your teeth, as well as other areas of your mouth that are not accessible using a toothbrush. And that is why flossing is one of the best ways to reduce or eliminate bad breath. Still skeptical? Try flossing your teeth with unscented floss, then smell it after, that awful scent is the source of your bad breath. Coupled with frequent brushing of your teeth, you will find that flossing can really help that stinky breath.

Brushing your teeth twice a day is hard enough, add flossing on top and it can be difficult to establish a regular habit. However, doing so is totally worth it; just look at the aforementioned reasons why. Use these for motivation the next time you don’t feel like flossing, and let us know if it worked at your next visit to our Worcester office.

By now, everyone knows that smoking is bad for you. But the truth is its broad-reaching health effects are not all known by everyone. This is especially true of oral health. Smoking can have serious repercussions in this regard. To give you a better idea of how smoking can affect your oral health, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have listed some issues that can arise.

Oral Cancer

Oral cancer can have steep ramifications for anyone that gets it. Surgery can be required to eliminate the cancer before it spreads to more vital parts of your body. Any type of cancer is about the worst health effect you can get, and this especially holds true to the affects that smoking has on your mouth. The type of mouth surgery required with oral cancer can leave your face deconstructed in certain areas, and it is all due to smoking or use of other tobacco products.

Tooth Discoloration and Bad Breath

At the very least, it is fair to say that as a smoker you will often have bad breath, and while you may try to cover it up with gum or mints, tooth discoloration is a whole other story. The chemicals and substances in cigarettes stick to your teeth staining them brown and yellow colors that are increasingly difficult to disguise.

Gum Disease and Loss of Bone

Another effect of smoking is the increased risk of gum disease. Your gums may start to recede, which can eventually lead to the loss of teeth. Smoking can also increase bone loss and density in your jaw which is vital to the health of your mouth. Gum disease and bone loss are two signs that smoking is definitely bad for your mouth.

When it comes to the health of your mouth, the question is not whether smoking affects your health, it's how does it affect your health and to what degree. If for no other reason than because smoking involves your mouth as its entry point, it is safe to say that it can have long-lasting and detrimental consequences on your oral health.

To learn more about smoking and your oral health, contact our Worcester office to schedule an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

Our grandmothers and grandfathers, our moms and dads—we’ve known them our whole lives. So, why are they so hard to shop for?

If your older family members have all the sweaters, socks, and scents they need, consider a gift that can make life a bit easier and perhaps a lot healthier—an electric toothbrush!

• Easy Efficiency

The most important reason to choose an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Using a manual brush is not just a matter of applying toothpaste and scrubbing. Proper technique means short brush strokes at a 45-degree angle for the outer and inner surfaces of the tooth, thoroughly cleaning the uneven chewing surfaces of the molars, and brushing the inside of the front teeth with gentle vertical strokes. Meticulous cleaning of all these surfaces can be difficult, especially for people with dexterity issues.

Electric toothbrushes offer several options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What they all have in common is the ability to remove plaque far more effectively than we can on our own, because they provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, as opposed to the hundreds we can achieve by hand.

• Comfortable Control

An electric toothbrush can be not only more efficient, but also more comfortable for older brushers. For those with arthritis, limited mobility, injuries, or other health conditions, the larger handles can be easier to control and much more grip-friendly. And, with the work being done by the brush head, users avoid repetitive hand and wrist motion.

Also, the pressure applied to teeth and gums with an electric brush is designed to clean thoroughly while protecting the mouth. Heavy-handed manual brushing can irritate delicate gum tissue and even damage enamel over time. With an electric brush, users only need to guide it along teeth and gums as it supplies all the power needed. There are even pressure sensors available to warn users that their brushing is too vigorous.

• Apps, Anyone?

If your grandfather likes to keep things old school, a basic model with a convenient two-minute timer and several cleaning modes will offer all the bells and whistles he needs. But if your nana has more Instagram followers than you do, consider a more tech-savvy option.

Several of today’s electric brushes come with features designed to make brushing even more effective. They can let her know if she’s brushing long enough, alert her if she’s brushing too hard, and remind her that it’s time to replace the brush head. Some models link to handy apps that will map out just where she’s brushed, in case there are a few spots that get overlooked. Or choose a model which comes with a travel case that can recharge while she’s busy seeing the world.

Okay, all that being said, we’ll admit it—a toothbrush might not be the most glamorous gift your grandparent unwraps on that special day. But helping a favorite family member brush more effectively and comfortably while improving dental health? That’s a gift that keeps on giving!

Have you ever thought about how you're cleaning and storing your toothbrush when you're not using it? Did you know that the way you store your toothbrush could have an affect on your oral health? In this post, we'll look at some steps you can take to maximize toothbrush cleanliness and minimize bacteria.

Below are some tips from Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for toothbrush use and storage:

• Don't share your toothbrush – This may seem obvious, but sharing a toothbrush exposes both users to bacteria and microorganisms from the other user, which can increase chances of infection. You should also avoid storing your toothbrush in the same container as other people’s toothbrushes.
• Thoroughly rinse your toothbrush after each use – Rinsing your toothbrush well under running water will help remove food particles, toothpaste, and other debris from the bristles of your brush.
• Store your toothbrush in an open-air container not a sealed one – Putting a wet toothbrush in a sealed container creates a favorable environment for microorganisms and bacteria.
• Soak your toothbrush in an antibacterial mouthwash after use – There is some evidence to suggest that soaking your toothbrush in an antibacterial solution may reduce the amount of bacteria present on the toothbrush.
• Change your toothbrush every three months – The bristles of your toothbrush become less effective and frayed after repeated use so it's a good idea to replace it on a regular basis. It's also wise to replace it after you've been sick.

There are many simple things you can do to make your oral-care regimen as clean as possible. Use common sense when storing your toothbrush—don't put it in a dirty place like the edge of your sink or in the shower (please, not by the toilet!), and keep it upright in a cool dry place—and you're usually good to go. If your toothbrush is looking a little worse for wear, drop by our Worcester office and we'll be glad to provide you with a new one!

Modern dentistry has made the most of today’s technological innovations. And we’ve come a long way from the fraying sticks our ancestors used as toothbrushes.

On the other hand, while it’s a lot better than a fraying stick, the manual toothbrush model you’ve used for years might be ready for an upgrade. Should you take this opportunity to try out some new technology offering all the bells and whistles? Let’s answer that question by asking a few more questions.

Happy with your manual brush?

If you like your manual toothbrush and it’s doing the job, by all means, stick with it. But even your old familiar brush can evolve:

• There are lots of bristle options, but soft bristles are almost always the way to go. Medium and hard bristles can be too abrasive for your enamel.
• Heads come in a variety of sizes, so make sure the head size is comfortable. You want to be able to maneuver to reach every tooth surface, which a too-large brush head just can’t do.
• Try a different handle shape if you’re having trouble maneuvering and keeping a firm grip.
• Change your brush regularly. Brushes are effective for about three months before the bristles start to fray and breakdown. This is a good opportunity to experiment with different brands and styles.

Does your old brush suit your current needs?

Different types of manual toothbrushes are available for effective and comfortable brushing when you need options that a typical brush doesn’t provide:

• Special orthodontic toothbrushes are designed with bristles trimmed to fit around brackets and wires and smaller heads to reach into tight places.
• For those with mobility issues, brushes with larger or easy-grip handles make cleaning more comfortable.
• Brushes with extra-soft bristles are available if you have enamel erosion or sensitive gums.
• Because many women find their gums become especially sensitive during pregnancy, there are brushes designed especially for moms-to-be.

Is it time to go electric?

If you haven’t tried an electric toothbrush before, you might find that getting braces is a great reason to give one a spin.

• Electric toothbrushes can outperform manual models. A dedicated brusher might manage hundreds of brushstrokes for each minute of brushing, while an electric brush can provide thousands. If, despite your regular brushing, you have plaque build-up, an electric brush might be a good alternative to your manual brush.
• Models are available which can alert you when you’re brushing too hard—which is important for your enamel if you’re a heavy-handed brusher.
• If you tend to *think* you’ve brushed for the recommended two minutes, but have *actually* brushed 32 seconds, some electric brushes come with timers!
• There are tapered electric orthodontic brush heads designed just for people with braces.
• Electric brushes have bigger handles and can be easier to grip.

Is your current brush doing the job?

So, should you stick with the familiar toothbrush that’s worked for you all these years, or take this opportunity to try out some new technology that offers all the bells and whistles? The answer is clear: the right brush for you is the one that works!

If your regular checkups show that plaque is under control, you’re doing just fine with the brush in hand. If you or Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants notice plaque buildup, it’s time to consider making some changes. Whether it’s a question of tools, techniques, or time spent brushing, your Worcester dental team has the answers you need for state-of-the-art dental hygiene.

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Central New England Endodontics and Implantology. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

• If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

• This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

• Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Worcester office.

Endodontics is a specialty branch of dentistry dedicated to the treatment of conditions affecting the soft inner tissues of the teeth. Endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, routinely perform root canals, root canal retreatment, and endodontic surgeries to treat infected pulp and damaged root surfaces. Unlike a general dentist, who may only perform a few root canals each month, endodontists are specialists in these procedures, making them the go-to authority on endodontic treatment.

Education

Endodontists have the same education that general dentists do. However, endodontists also pursue additional specialized training in endodontics after graduating dental school. The average endodontist will have at least two years of dedicated training in root canals, retreatment, and other types of endodontic surgery. This specialty training is in addition to a traditional dental education – something a general dentist does not have.

Technology and Efficiency

Because an endodontic practice is finely honed for specific types of dental treatment, the technology to perform such treatments is typically of high caliber and often far more advanced than that which is found in a general dentist’s office. State-of-the-art technology, such as operating microscopes and ultrasonic instrumentation, make it possible for endodontists to carry out complex procedures with simplicity and accuracy. This translates into highly effective treatment rapid pain relief, and a speedy recovery for many patients.

Who should visit an endodontist?

A general dentist is a wonderful resource for maintaining a lifetime of dental health. However, anyone in need of root canal treatment or treatment for a previous failed root canal may benefit from visiting an endodontist. An endodontist is the most qualified person to perform a root canal and preserve a damaged or decayed tooth. Furthermore, treatment from a specialist is typically no less comfortable than getting a filling. A patient may request root canal treatment from an endodontist, or a general dentist may make the decision to refer a patient to a specialist – especially patients who are elderly, have complex treatment needs, or have significant anxiety about endodontic treatment.

To learn more about endodontic treatment at our Worcester office, give us a call!

As you age, it becomes even more important to take good care of your teeth and dental health. According to the Centers for Disease Control and Prevention, approximately one-fourth of adults age 65 and older have no remaining teeth. What's more, nearly one-third of older adults have untreated tooth decay.

Oral health, regardless of age, is crucial to overall good health. Ideally, we all want to keep your natural teeth, but whether you're caring for natural teeth or dentures, advancing age may put older adults at risk for a number of oral health problems, including:

• Dry mouth
• Diminished sense of taste
• Root decay
• Gum disease
• Uneven jawbone caused by tooth loss
• Denture-induced tissue inflammation
• Overgrowth of fungus in the mouth
• Attrition (loss of teeth structure by mechanical forces)
• Oral cancer

These conditions may not be diagnosed until it is too late. If you want to feel good, stay healthy, and look great throughout life, you might be surprised what a difference a healthy mouth makes.

Here are some tips for maintaining and improving your oral health as you become older:

• Brush twice a day with a toothbrush with soft bristles. You may also benefit from using an electric toothbrush.
• Clean between your teeth once a day with floss or another interdental cleaner.
• If you wear full or partial dentures, remember to clean them on a daily basis. Take your dentures out of your mouth for at least four hours every day. It’s best to remove them at night.
• Drink tap water. Since most contains fluoride, it helps prevent tooth decay no matter how old you are.
• Quit smoking. Besides putting you at greater risk for lung and other cancers, smoking increases problems with gum disease, tooth decay, and tooth loss.
• Visit Central New England Endodontics and Implantology regularly for a complete dental checkup.

If you have any questions about keeping up with your oral hygiene at home, please give us a call!

When most patients ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants this question, they're thinking strictly about sugar content — cut out the bacteria-feeding sugar that's present in regular soda by opting for a diet soda and it will be better for your teeth. That seems logical, right? Well, there's a bit more to it than that. Let's take a closer look at how any kind of soda can affect your dental health.

Diet Soda – Why it can also lead to tooth decay

The main culprit in these drinks that leads to decay is the acid content. Diet sodas and other sugar-free drinks are usually highly acidic, which weakens the enamel on your teeth and makes them more susceptible to cavities and dental erosion. The level of phosphoric acid, citric acid, and/or tartaric acid is usually high in sugar-free drinks so it's best to avoid them.

Some patients also enjoy drinking orange juice or other citrus juices. These drinks are high in citric acid and have the same effect on the enamel of your teeth.

So what about regular soda?

We know the acidity of diet sodas and sugar-free drinks contributes to tooth decay, so what about regular soda? Like we alluded to earlier, regular soda is high in sugar — a 12 ounce can contains roughly ten teaspoons of sugar — and sugar feeds the decay-causing bacteria in the mouth. This also includes sports drinks and energy drinks, which are highly acidic and loaded with sugar too. So these drinks are a double-whammy of sugar and acidity your teeth and body simply don't need.

The problems caused by both diet and regular soda is exacerbated when you sip on them throughout the day. If you drink it all in one sitting, you won't be washing sugar and/or acids over your teeth all day long and your saliva will have a chance to neutralize the pH in your mouth.

The best beverages to drink and how to drink them

Drinking beverages that are lower in acid is a good step to take to keep your enamel strong. According to a study conducted by Matthew M. Rodgers and J. Anthony von Fraunhofer at the University of Michigan, your best bets are plain water, black tea or coffee, and if you opt for a soda, root beer. These drinks dissolved the least amount of enamel when measured 14 days after consumption of the beverage.

If you still choose to drink soda, diet soda, sugar-free drinks, or juices here are some other tips to lessen tooth decay:

• Drink your soda or acidic beverages through a straw to minimize contact with teeth
• Rinse with water immediately after consumption of the beverage
• Avoid brushing your teeth between 30 minutes to an hour after drinking the beverage as this has been shown to spread the acids before your saliva can bring your mouth back to a neutral pH
• Avoid drinks that have acids listed on the ingredients label

Still have questions about soda, sugar, and acid? Give our Worcester office a call and we’d be happy to help!

You’ve got endodontic surgery at our Worcester office coming up on your calendar and you’re prepared. The freezer is stocked with frozen yogurt, the fridge is filled with pudding and applesauce, the cupboard has boxes of gelatin dessert just waiting to be mixed and chilled.

Good for you! Eating a soft, smooth diet is the best way to treat delicate tissue after surgery. Now, let’s look at a few ways to make that diet not only soothing, but healing.

• Protein

Proteins are essential for all of our vital bodily functions. The protein in our diet is broken down into amino acids, which then combine with other amino acids to create the new protein building blocks our cells need to replace and repair damaged tissue. These proteins provide structure for cells in the skin, bone, and blood vessels as they recover. When you are healing, your body requires more protein than usual to help the process along.

Of course, right after endodontic surgery, you won’t be eating your regular protein sources of meats, seafood, beans, and nuts. But dairy foods such as yogurt and milk products are also rich in protein—and delicious in milkshakes and smoothies. You can also add a protein supplement if you will be eating soft foods for a while. Just remember, no straws!

• Vitamin A

Vitamin A helps stimulate cell reproduction and the immune system, both important factors for quicker, safer healing. It also helps our bodies form and maintain bone tissue, mucous membranes, and soft tissue, all of which are involved in bone and gum recovery after surgery.

If you are wondering where to get more vitamin A, think green and orange. Spinach, kale, leaf lettuce and other leafy greens, mild peppers, carrots, cantaloupe, mango—all these foods keep you supplied with vitamin A. How to get those solid foods into your soft diet? Think smoothies. Adding some fresh ingredients to your blender will give you this important vitamin in an easy-to-drink form.

• Vitamin C

Vitamin C is vital for wound healing because it is essential in forming the protein collagen. Collagen provides both structure and support to our tissues, especially important as tissues heal.  

We usually associate vitamin C with citrus fruits such as oranges, lemons, and limes. But if you’re avoiding acidic foods because they might irritate delicate tissue, you can also find plenty of vitamin C in green vegetables such as broccoli, cabbage, and kale, or in fruits like strawberries, mangos, and papayas. Here’s where that blender comes in handy again!

• Zinc

Zinc has been found to improve healing by promoting membrane repair, blood clotting, and skin cell recovery, and by helping to boost immunity. Too little zinc in the diet has been associated with slower wound healing, especially in the skin—and because our bodies don’t store zinc, it should be part of everyone’s regular diet.

Foods high in zinc include red meat and seafood, but since steak is off the menu for a while, where can you find another good source of zinc? Dairy products, again! Let your milkshake do double duty.

Of course, there is no one magic diet that brings instant recovery. But if you follow Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team’s advice, eat foods designed to soothe rather than irritate your recuperating tissue, and take advantage of the nutrients that encourage healing, you will be doing all you can to make your recovery speedy and healthy. Good for you!

Every year, Americans all over the world celebrate the birth of the country and its independence on the Fourth of July. There are countless ways that people celebrate and they range from community parades and large scale gatherings to concerts, fireworks displays, and smaller scale celebrations among family and friends. For some people, July 4th is synonymous with baseball, while for others it is all about the beach of barbecues. However you celebrate, you can be sure that red, white, and blue is visible everywhere throughout the area.

The Beginnings of Fourth of July Celebrations

Although it wasn't officially designated as a federal holiday until 1941, the actual tradition of celebrating Independence Day goes back to the time of the American Revolution (1775 – 1783). At the time of the American Revolution, representatives from the 13 colonies penned the resolution that ultimately declared their independence from Great Britain. The continental congress voted to adopt the Declaration of Independence on July 2nd of 1776. Two days later, Thomas Jefferson's famous document that is now known as the Declaration of Independence, was adopted by delegates representing the 13 colonies.

First States to Recognize the Fourth of July

In 1781, Massachusetts became the first state (or commonwealth) whose legislature resolved to designate July 4th as the date on which to celebrate the country's independence. Two years later, Boston became the first city to make an official designation to honor the country's birth with a holiday on July 4th. In that same year, North Carolina's governor, Alexander Martin, became the first governor to issue an official state order stipulating that July 4th was the day on which North Carolinians would celebrate the country's independence.

Fun Facts About the Fourth of July

• The reason the stars on the original flag were arranged in a circle is because it was believed that would indicate that all of the colonies were equal.
• Americans eat over 150 million hot dogs on July 4th.
• Imports of fireworks each year totals over $211 million.
• The first “official” Fourth of July party took place at the White House in 1801.
• Benjamin Franklin didn't want the national bird to be the bald eagle. He believed that the turkey was better suited to the coveted distinction. John Adams and Thomas Jefferson disagreed with him, and he was outvoted, so the bald eagle became the official bird of the United States.

For many, the tradition is something entirely different. Along the coastal areas of the United States, people may haul out huge pots to have lobster or other types of seafood boils. Others may spend the day in the bleachers at a baseball game, or at a park, cooking a great traditional meal over an open fire. No matter how or where you celebrate, one thing is certain: all Americans celebrate July 4th as the birth and independence of our country.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology wish you a safe and happy Fourth of July!

According to the American Association of Endodontists, root canals have a success rate of over 95% and in most cases they last a lifetime.

There are a few factors that ensure the root canal will last and should be followed.

• You want to make sure you allow Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to perform a permanent restoration of the tooth. That means getting the filling and the crown immediately after the canals have been cleaned of all bacteria and debris.

• Practice good oral hygiene; that means brushing and flossing at least three times a day especially after meals and before bed.
• Just because a tooth has had a root canal that does not mean the tooth is safe for as long as it remains in your mouth. That tooth can still get a cavity. Since the nerves are no longer present in that tooth you will not feel any pain or experience any other signs of a cavity. That’s why it is important to get regular cleanings and checkups.
• If the tooth becomes fractured or you develop an abscess, you will feel pain and know there is a problem with the tooth.

Why do root canals fail?

As mentioned above, only about five percent of root canals fail, and sometimes it is not actually a “failure.” In cases, of teeth that have more than one root, it is possible that only one root was infected and filled. If the remaining root(s) become infected in the future, they will also need a root canal performed on them.

There are a few other reasons why your root canal may fail:

• The first reason is you may not have taken good care of your tooth (teeth). This is commonly seen in children and teens who often have inconsistent oral hygiene habits.
• If the tooth has more than one root, and one of the roots has a minute infection that is undetectable and goes unnoticed it can cause the root canal to fail. While this scenario is very unlikely, it does occasionally happen.
• Over time, the seal can become weak and bacteria can enter the tooth. This is also very uncommon but it does happen.

No procedure dental or medical comes with a 100% guarantee to last a lifetime, but if you take care of your treated tooth, the chances of success are great.

If you have any additional questions about root canals and your oral health, be sure to ask a member of our team at our Worcester office.

Bad breath, or halitosis, is probably not a matter of life or death. But it can make you feel self-conscious and have a negative impact on your life. The majority of people suffering from bad breath are dealing with oral bacterial. However, there are other causes of this embarrassing problem. Learning more can help you fight this solvable problem.

Five Causes of Embarrassingly Bad Breath

1. Dry Mouth. A decrease in saliva flow can be caused by several things. Most often, medication or mouth breathing are the culprits. As saliva helps wash away food particles from your mouth, it prevents bad breath. Dry mouth can be dealt with by stimulating salivation.
2. Gum Disease and Poor Oral Hygiene. Not brushing and flossing well enough or with enough frequency can lead to gum disease, which leads to bad breath. Halitosis can be a sign that plaque is present on your teeth.
3. Food-Related Bad Breath. Food particles that aren't brushed or flossed away attract bacteria that leads to bad breath. It's especially important to brush after eating strong-smelling foods, such as garlic or onions.
4. Smoking and Tobacco. Tobacco is bad for your health, and that includes your oral health. Smoking or chewing tobacco can contribute toward the development of gum disease, as well as oral cancer.
5. Mouth Infections and Other Medical Problems. A mouth infection, sinus infection or even the common cold can cause you to temporarily have bad breath. Even conditions such as diabetes and reflux can cause halitosis. It's always wise to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to help determine the cause.

We are Your Ally

Even if you maintain good oral hygiene, it's important to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office to deal with or avoid problems with bad breath. We can help you uncover the cause of halitosis, while also providing solutions that allow you to enjoy fresh breath without relying on mints and breath fresheners. As is the case with all things related to oral health, we are your number-one ally when it comes to eliminating the problem of bad breath.

Across the continent, the May calendar is filled with meaningful days. Cinco de Mayo. Memorial Day. Victoria Day. National Patriots’ Day. And, of course, Mother’s Day. One occasion that’s probably not on your calendar? This May marks the return of the American Association of Endodontists’ “Root Canal Awareness Week”! Let’s take this opportunity to talk about the many amazing ways a root canal can improve your dental health.

• Root Canals Save Teeth

Left untreated, a seriously damaged or infected tooth will almost inevitably be lost. And even one lost tooth can affect your eating, your speech, your bite, and your confidence. A root canal procedure at our Worcester office can prevent tooth loss, and is safe and straightforward. After infected and damaged tissue is removed from the pulp chamber in the crown of the tooth and from the root canals within the root, the interior of the tooth is carefully cleaned, disinfected, shaped and filled. A crown will help protect the tooth after treatment. A tooth that has undergone a root canal procedure can go on to last a lifetime.

• Root Canals Relieve Pain

If you have suffered a tooth injury or pulp infection, you know how painful that trauma can be. With a root canal, the source of your pain and discomfort is removed. Many patients experience immediate relief from severe pain after the procedure, and any post-treatment sensitivity or discomfort usually only lasts a few days.

• Root Canals Protect Your Health

You are saving more than a tooth when you are proactive about root canal treatment. If infection persists, it can spread to other parts of the body, resulting in tooth loss, bone loss, and even more serious consequences. A root canal can not only save your smile, it can actually save your health.

If you’ve been postponing a trip to the dentist because you’re worried about a root canal—don’t! Here’s another great fact about root canals:

• Root Canals Are Nothing to Fear

Endodontists have two or more years of additional training after dental school to become specialists in the treatment of the inner tooth. They keep up with the latest in endodontic technology, tools, and treatments, and the root canal is a procedure that they perform on a daily basis. With today’s advances in the field, many patients find a root canal appointment with an endodontist no more uncomfortable than getting a normal filling!

Root Canal Awareness Week is meant to remind us that we can have a lifetime of healthy, natural smiles with proper dental care and treatment. But, really, any week is a great time to acquaint yourself with what endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can do for you and for your smile. It will be time well spent!

No, we don’t mean the latest foamy offering from your favorite microbrewery. When you’re thirsty, one of the best options available is literally at your fingertips—tap water, straight from your faucet. It might not be the most adventurous choice, but drinking a tall glass of fresh tap water is refreshing in so many healthy ways.

Physical Health

Water conveniently available at home is much more than a convenience. We need to keep hydrated, because our bodies are made to run on water. To name just a few of its benefits, water provides nutrients to organs and cells, eliminates waste, regulates our temperature, and protects our joints and delicate tissues. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our Worcester team will tell you all about the importance of proper hydration when it comes to your mouth, gums, and teeth, but here are a few highlights:

• We need to be hydrated to produce enough saliva. Saliva, which is more than 90% water, helps prevent cavities and protect enamel by both washing away bacteria and balancing acids in the mouth which can cause decay.
• Tooth enamel is so strong because it’s made of calcium and phosphate. These minerals are leached from our enamel by both bacteria-produced acids and dietary acids. Saliva also contains calcium and phosphate, and, with fluoride, restores these minerals in our enamel, leaving teeth stronger and less likely to develop cavities.
• As a bonus, a quick rinse with water when you can’t brush after eating is a great way to remove food particles left behand—especially healthy when you’ve had sugary or acidic foods.

Ecological Health

If you want to reduce waste, one of the easiest ways to do so is to use tap water instead of bottled water.

• Bottled water has a carbon footprint. It takes energy (and additional water) to create plastic and glass bottles, to label them, and to transport them. Water piped into your home from local sources? No bottles, labels, or long road trips necessary.
• Water bottles should be recycled. Unfortunately, many cities don’t offer, or have stopped offering, recycling. Plastic and glass empties end up in landfills, littering our neighborhoods, or in our waters.

Budget Health

Getting your daily hydration from bottles can add up quickly.

• Bottled water can cost hundreds of times as much as tap water. While local water prices vary, the average gallon of tap water costs less than a penny. No matter what kind of sale your local store is offering, bottled water will never be the bargain tap water is.
• When you buy many small bottles instead of a few larger ones, or choose more expensive “designer” water, your costs can mount up even more.
• When you need to bring water with you for work, sports, or other activities, consider filling a reusable bottle with water from home.

Dental Health

Getting the recommended amount of fluoride in your diet is one of the single best things you can do for your dental health. Fortunately, many communities make this easy for us by providing fluoridated drinking water.

• Fluoride works with the calcium and phosphate in your saliva to create stronger enamel, so cavities can’t form as easily when your teeth are exposed to plaque and food particles.
• Fluoride helps strengthen your child’s permanent teeth as they develop, and helps prevent cavities in both baby teeth and permanent teeth as children grow.
• If your community doesn’t offer fluoridated water, ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for the best way to get the fluoride you need to protect your teeth.

For the good of your body, your planet, your wallet, and last, but most certainly not least, the health of your teeth and gums, consider a glass of water. So many benefits—and you have them all on tap!

During the early days of the environmental awareness movement, those who demonstrated against pollution, toxic chemicals, and the general public health were known as hippies. The early 1970s were a time of change, and assertions that we needed to pay more attention to the Earth's atmosphere were generally dismissed. But within a couple decades, it had become clear that the previous generation was right; the citizens of the world needed to become more environmentally conscious.

Many people feel that they can't make a difference if they don't do something big. But caring for the environment doesn't have to be an all-or-nothing concept. In fact, the little things you do can add up to make a great impact, especially in our community. Here are a few ways you can help the environment on Earth Day, April 22nd and all year around.

Four Small Ways to be Environmentally Friendly

• Recycle Your Textiles. Nearly 21 million tons of textiles are added to American landfills each year, according to the Environmental Protection Agency. Donating your unwanted clothing to a secondhand store or an organization that repurposes fabric helps cut down on solid waste and conserves natural resources.
• Reduce Usage of Disposables. Plastic bottles and bags, disposable diapers and other things we can use and toss out are convenient, but they're not necessary. Simply choosing to replace one of type of disposable with a reusable product can help you cut down on waste that has a large negative impact on our environment.
• Conserve Water. If everyone in the United States turned off the water while brushing their teeth, more than 1.5 million gallons of water could be conserved. Turn the water on long enough to wet your toothbrush for brushing and rinsing, and then immediately turn the water off again.
• Turn Off the Lights. Flip the light switch to "Off" if you're going to leave a particular room for 15 minutes or more. This will conserve energy on incandescent light bulbs and cut down on cooling costs.

It's not necessary to be an activist or install solar panels all over your home to help the environment. Although you can do these things, the little everyday measures make a big difference in helping to conserve energy and the environment, while reducing your carbon footprint. Our team at Central New England Endodontics and Implantology wants to remind you to celebrate Earth Day and help the environment, knowing that it will benefit your and your children's generation.

Fear of going to the dentist is more common than you may think. That’s why Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team want to make your visit as relaxing as possible.

Your anxiety about pain or routine procedures doesn’t have to stop you from visiting our Worcester office; we offer various types of sedation to remove the pain and stress from your dental procedure.

Nitrous Oxide Sedation

Nitrous oxide combined with local anesthetics ensures both pain relief and reduced anxiety for many patients. It’s useful because the dosage can be regulated during treatment, and patients are usually able to drive shortly after the procedure is completed.

Oral or Injected Sedation

With oral sedation, you may be given a pill or liquid to consume several hours before your treatment. Make sure someone will be available to drive you to your appointment, because you will not be able to drive yourself.

An oral liquid is often given to children before any shots or intravenous anesthesia. An intramuscular injection may be given at the office to provide relaxation benefits for 20 to 30 minutes.

Nitrous Oxide with an Oral Sedative

For patients with higher levels of anxiety, an oral or injected sedative can be offered before nitrous oxide begins. This can also be effective for reducing anxiety about the injection of local anesthetics itself. A liquid medication followed by nitrous oxide is beneficial for children to produce a deep sedation level.

General Anesthesia

This type of anesthesia can be offered as an inhaled gas or intravenous liquid. If no oral sedative is given before the general anesthesia is administered, you should wake up quickly after your procedure.

To reduce your anxiety, we can offer a pill or liquid medication before intravenous sedation starts. Intravenous sedation can also be used at moderate-to-deep sedation levels without complete loss of consciousness.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team are happy to go over your sedation or pain prevention options when you visit. We’re here to ensure all your questions are answered and your procedure is a relaxing one.

Happy Oral Cancer Awareness Month! We know oral cancer can be kind of a scary topic, but it’s worth using this opportunity to learn about the disease and spread knowledge so everyone becomes more aware. The more we know, the better we can work to prevent it!

Oral cancer is exactly what it sounds like: cancer that occurs anywhere in the mouth. It could occur on the tongue, the lips, the gums, the tongue, inside the cheek, or in the roof or floor of the mouth. Every  year, more than 8,000 people die from oral cancer. It’s a truly deadly disease.

The reason oral cancer scores a higher death rate than other common cancers such as testicular cancer, Hodgkin’s disease, thyroid cancer, cervical cancer, or even skin cancer, is because it often goes undetected until it's become too advanced and has spread to another part of the body.

So what causes this devastating disease? There is no clear answer, but some potential causes have been identified. By being aware of these, we can be alert and promote prevention of this illness:

• Age: Most patients who develop oral cancer are above the age of 40. If you’re over 40, make sure your doctor checks for signs of oral cancer and that you stay on your dental hygiene regimen.
• Tobacco: Excessive tobacco use, whether in the form of cigarette smoking or tobacco chewing, can be a substantial contributor and cause of oral cancer. So that’s another reason, among many, you should avoid tobacco.
• Alcohol: Excessive alcohol consumption can put you at risk because alcohol converts into a chemical called acetaldehyde, which damages the body’s DNA and blocks cells from repairing the damage. When paired with tobacco, the dehydrating effects of alcohol make it even easier for tobacco to infiltrate mouth tissue.
• Sun exposure: Your lips need SPF, too! Repeated sun exposure increases your risk of contracting cancer on your lips, especially the lower lip.
• Diet: Not getting all the nutrients you need, from vegetables and fruits for instance, can weaken your immune system and make you more vulnerable to the disease.

Obviously, many of these causes relate to lifestyle choices, which we have control over. It's all about balance, being aware, and making small tweaks to our habits if we need to.

If you’re concerned that you may be at risk for oral cancer, give us a call to talk about a screening. And if you’ve been putting off a visit to our Worcester office, now is an excellent time to schedule one. Regular visits to the dentist can be the first line of defense against oral cancer!

We all want to live our healthiest lives. We know that part of keeping ourselves healthy is regular visits to our Worcester office for checkups and necessary dental work. And that dental work might require an X-ray. Should the amount of radiation in an X-ray concern us?

First, it is helpful to know that the radiation you are exposed to from a dental X-ray is very small. A set of most bitewing X-rays, for example, produces an amount of exposure about equal to the amount of background radiation we get from our normal surroundings in a typical day. We also take care to minimize your exposure even further by using specially designed equipment and protective shielding, and taking only necessary X-rays. If your child is very young, if you are pregnant, or if you have other health concerns, talk to us about the advisability of X-rays and whether they are essential to treatment.

Second, much of our careful general examination will be done visually. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can check for cavities and other problems and assess tooth and gum health. But sometimes, there are conditions which can’t be detected without an X-ray.

• Decay that isn’t visible in an oral exam—if a small cavity develops between teeth, or is hidden underneath a filling, an X-ray will catch it before more damage can take place.
• Infection—An X-ray will reveal infections such as abscesses that can damage both bone and tooth, and gum disease that has harmed bone and connective tissue.
• Orthodontic and periodontal issues—We might need an X-ray to determine the spacing and development of your child’s incoming teeth and maturing jaw structure, to properly create braces for adults or children, or to place an implant within the jawbone.
• If you are a new patient, it is helpful to have complete X-rays taken as a baseline of your current dental health and previous dental work. This baseline allows us to track tooth and jaw development, if necessary, and to evaluate any future changes that might be a concern. (If you have had X-rays taken in another office, we can help you have them transferred so we have a background of your dental history.)

Even though the radiation from a dental X-ray is minimal, be assured that we will never request any unnecessary procedure. When we recommend an X-ray, we do so to make sure there is no decay or infection threatening the health of your gums and teeth, and that we have the essential knowledge we need to treat any dental, periodontal, or orthodontic condition. Because we all want to live our healthiest lives—and part of that healthy life is both active and proactive dental care.

A solid oral health routine begins with daily brushing, flossing, and rinsing. Without a consistent oral health regimen, you may begin to experience tooth decay and bacterial infections. Few patients ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about different mouthwash options, so we’ve put together a list of the conditions that mouthwashes can treat. This should help you decide which oral rinse would be best for you.

Gum Health

Antiseptic mouthwashes reduce large amounts of bacteria on and near the gum line and generally help to decrease your chances of developing gingivitis. The key ingredients of antiseptic mouthwashes are antibacterial and antimicrobial items. Antiseptic mouthwash is a preferable option if you are concerned about the general gum health of your mouth.

Fluoride

Fluoride is a great tool for preventive tooth decay treatment. It prevents tooth decay and is great for oral health in general because it kills germs that can live in your mouth. Fluoride also builds stronger teeth. If you’re a bottled water drinker, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may recommend that you purchase a simple fluoride rinse to use after brushing.

Bad Breath

Fluoride mouthwash can be used to fight any bad breath issues you may be facing. It’s designed to combat any bacteria that might be building up in your mouth. Most mouthwashes will help eliminate bad breath, but some are specifically designed to address this difficult problem. If you feel as though this might be turning into a chronic problem, please contact Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to discuss other options that would be effective for treating your symptoms.

American Dental Association (ADA Approval)

The ADA reviews all mouth rinses for safety measures and to prove effectiveness. Any mouthwash approved by the ADA has met strict guidelines according to whether the manufacturer’s claims are supported with scientific evidence. If you’re looking for a quality mouthwash, look for one that has the ADA seal of approval to ensure you have a great rinse for your mouth.

Considerations

When you’re trying to decide which mouthwash to pick, contact our Worcester or ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next appointment. If you experience a burning sensation in the soft tissues of your mouth, be sure to discontinue use immediately. Avoid letting children under age six use a mouth rinse, and be sure to keep all mouthwashes out of the reach of children, because they contain alcohol and other substances that could be harmful.

Millions of people, around Worcester and beyond, wear green on St. Patrick’s Day so they can show their spirit for the holiday and avoid getting pinched. While it may be easy for you to throw on a green shirt, sport a St. Patrick’s Day button, or wear a pair of emerald-hued shoes, if you’re an avid St. Patty’s Day enthusiast you may want to try something different this year. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants thought of a few ideas that will help you take your holiday spirit to the next level:

Visit Chicago’s Green River

If you happen to be near the Windy City during St. Patrick’s Day or you’re thinking of planning a trip, don’t miss out on going downtown to watch the large-scale celebration that kicks off when the city dyes the river bright green. According to the Chicago Sun-Times, Chicago has been celebrating the holiday with this tradition for more than 50 years, with tens of thousands of people gathering annually to witness the mysterious dying process and the stunning result.

Don Green Face Paint

Just like an avid sports fan on game day, you can use green face paints to showcase your enthusiasm for this holiday. Avoid breakouts or allergic reactions by only using paints that are specifically meant to be applied to the skin. A little bit of face paint can cover a large area, so feel free to get creative and decorate the whole family on St. Patrick’s Day.

Eat Green All Day

Not a fan of green eggs and ham? With the increasing popularity of green smoothies, there’s no better time to get in on this health craze. To create a green smoothie without the aid of food coloring, you can simply blend a generous amount of a leafy green vegetable, such as spinach or kale, with the ingredients that you would typically use to make a smoothie, like fruit, ice, milk, or juice. Keep the trend going throughout the day by using those same vegetables to create a green soup, egg salad, or a batch of bright green pastries. As an added bonus, you’ll get a healthy dose of vitamins without changing the taste of most of these foods.

If your old holiday routine has gotten stale, leave your green T-shirt in the drawer and try one or all of these tips. Don’t be surprised if you have so much fun that you decide to start a new, annual St. Patrick’s Day tradition! Have a happy St. Paddy’s day from Central New England Endodontics and Implantology!

Part of presenting our best faces to the world is making sure our smiles are bright and our breath is fresh. Sure, we’ve all been embarrassed by an occasional pungent reminder of that garlic bread we just couldn’t pass up, but with daily brushing and flossing, fresh breath is the norm. Until it isn’t.

If you’ve been carefully avoiding strong foods in your diet, if you’ve started brushing a lot more often, if you’re relying on mints and mouthwash to get you through the day, and you still have bad breath, it’s time to see your dentist or doctor.

Chronic bad breath can be a symptom of tooth decay, dry mouth, oral infections, diabetes, kidney disease, and many other medical or dental problems. It can also be a red flag for infections within or around your tooth.

How does an infected or injured tooth cause persistent bad breath? Bacteria produce compounds that have distinct and unpleasant odors. A damaged or seriously decayed tooth provides an opening for these bacteria to reach the pulp of the inner tooth and its canals, causing persistent bad breath.

And, while bad breath is an embarrassing consequence of an injured or decayed tooth, there are other consequences that are far more serious. Without prompt treatment, bacteria and infection can spread from the inner tooth and root to the bone and tissue surrounding the tooth. Infection causes inflammation, and untreated infection and inflammation lead to the breakdown of surrounding gum and bone tissue and, eventually, tooth loss.

If your dentist recommends a root canal or other root treatment, it’s time to give an endodontist like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants a call! Because this dental specialty requires years of additional study after dental school focused on the diagnosis of tooth pain and the treatment of the interior of the tooth, endodontists have the knowledge and experience to treat your inner tooth, its roots, and the surrounding bone and tissue.

What can your endodontist do to help save your tooth?

• Root canal procedures remove damaged or infected pulp tissue and clean, fill, and seal the inside of the tooth.
• An apicoectomy can treat recurring infections at the root tip and any infection or inflammation in the bone tissue surrounding it.
• Endodontic surgeries can be used to locate and treat hard-to-find canals and repair damaged roots.
• Surgical procedures can remove sections of severely damaged or decayed teeth in order to save as much of the natural tooth as possible.

If you are experiencing persistent bad breath, talk to your dentist or doctor about the possible causes, and whether a visit to our Worcester office is in order. Endodontic treatment can stop the progression of tooth and bone damage, and save your tooth for a lifetime of natural smiles.

And one additional bonus? The return of your fresh breath and social confidence. If you need root canal or any other endodontic treatment, your endodontist can help you breathe easy once again!

Cancer has become a common word, and it seems like there is new research about it every day. We know antioxidants are important. We know some cancers are more treatable than others. We know some lifestyles and habits contribute to our cancer risk.

Smoking increases our risk of cancer, as does walking through a radioactive power plant. But there is a direct link to oral cancer that you many may not know about—the link between HPV (Human Papilloma Virus) and oral cancer.

This may come as a shock because it has been almost a taboo subject for some time. A person with HPV is at an extremely high risk of developing oral cancer. In fact, smoking is now second to HPV in causing oral cancer!

According to the Oral Cancer Foundation, “The human papilloma virus, particularly version 16, has now been shown to be sexually transmitted between partners, and is conclusively implicated in the increasing incidence of young non-smoking oral cancer patients. This is the same virus that is the causative agent, along with other versions of the virus, in more than 90% of all cervical cancers. It is the foundation's belief, based on recent revelations in peer reviewed published data in the last few years, that in people under the age of 50, HPV16 may even be replacing tobacco as the primary causative agent in the initiation of the disease process.” [http://www.oralcancerfoundation.org/facts/]

There is a test and a vaccine for HPV; please discuss it with your physician.

There are some devices that help detect oral cancer in its earliest forms. We all know that the survival rate for someone with cancer depends greatly on what stage the cancer is diagnosed. Talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants if you have any concerns.

Please be aware and remember that when it comes to your own health, knowledge is power. When you have the knowledge to make an informed decision, you can make positive changes in your life. The mouth is an entry point for your body. Care for your mouth and it will care for you!

An article was released to the public stating that dental X-rays contribute to a type of brain cancer. After reading an article like this, your first thought may be to avoid dental X-rays, but you may want to hold off on that quick judgment. As with any treatment we offer at Central New England Endodontics and Implantology, education is your most valuable tool in deciding what is best for you.

How often dental X-rays are taken is based on risk for infection, physical symptoms, and clinical findings. The American Dental Association (ADA) is a governing body over the dental profession. The ADA states, “ . . . healthy adults receive routine mouth X-rays every two to three years. Dental X-rays are recommended every one to two years for children and every 1.5 to three years for teens. Children often require more X-rays than adults because of their developing teeth and jaws and increased likelihood for cavities.”

A "caries risk category" often determines how often dental X-rays are taken. The most recent documented resource to determine a caries risk is Caries Management by Risk Assessment (CAMBRA). This was adopted by the ADA and is used by dental professionals giving interval recommendations for X-rays.

With knowledge of your risk for dental infection, you will be informed by Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants of the interval at which dental X-rays should be taken. You can rest assured that the standards published by the ADA have been researched extensively and are there to protect your personal health and safety.

Dental X-rays are most commonly digital, which significantly reduces exposure. There is more radiation exposure from the sun or in an airplane than in a dental X-ray. It is common practice to use a lead apron with a thyroid collar for protection during X-ray exposure.

Having a cavity means having an active, potentially harmful infection. Diagnosing such infection with minimal exposure through digital dental X-rays at our Worcester office does more good than harm.

Valentine’s Day is the holiday to celebrate all the treasured relationships in your life. It’s a time to honor love in all shapes and forms with cards, social gatherings, and sometimes even binge eating of sweets.

It's hard to look the other way when grocery stores and pharmacies are invaded with goodies connected to the Valentine’s Day theme, and especially if you’re on the receiving end of some of these sweets. We get it. In fact, we’re all for it!

However, we also support a cavity-free smile. So in the interest of your dental and general health, and because we think it’s genuinely tasty, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants recommends an alternative to the Valentine treats you may be accustomed to: dark chocolate. 

Yes, Healthy Chocolate Exists

Studies have shown that dark chocolate is high in flavonoids, an ingredient found in the cocoa beans used to make chocolate. Flavonoids can help protect the body against toxins, reduce blood pressure, and improve blood flow to the heart and brain.

By opting for dark chocolate rather than milk chocolate, you get to reap these benefits! Pretty sweet, right? Just make sure to stick to high-quality dark chocolates that have undergone minimal processing.

Dark Chocolate, AKA Protector of Teeth

Not only does dark chocolate provide some nice benefits for your overall health, it also helps protect your teeth against cavities! According to the Texas A&M Health Science Center, dark chocolate contains high amounts of tannins, another ingredient present in cocoa beans.

Tannins can actually help prevent cavities by interfering with the bacteria that causes them. Think of them as scarecrows for bacteria. They don’t always prevail, but isn’t it nice to have them there?

Smooth Never Sticky

Unlike many popular candies, dark chocolate is less likely to stick in the crevices of your teeth. Chewy, gooey sweets are more likely to hang around in your mouth for longer periods of time, which means they raise the odds of your harboring cavity-creating bacteria.

While some dark chocolates have additives like caramel or marshmallow, it’s best to opt for the plain varieties, which are just as delicious. If you’re feeling festive, though, a dark chocolate with caramel is still better than a milk chocolate with caramel, so that’s the way to go!

While dark chocolate has some pretty sweet benefits, the most important thing to remember (whether you go the dark chocolate route or not), is that moderation is key. That being said, we hope you have fun satisfying your sweet tooth and shopping for treats for your friends and loved ones. Happy Valentine’s Day from all of us at Central New England Endodontics and Implantology!

There are many understandable reasons why you might be feeling less than enthusiastic about your upcoming endodontic treatment.  Perhaps anxiety is an issue, or your teeth are extremely sensitive. You may have a low pain threshold, an easily triggered gag reflex, or require longer or more complex work during your visit. These are also excellent reasons to consider sedation dentistry.

Of course, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will always try our best to make sure that every procedure is pain free. A local anesthetic will be provided to numb the treatment area completely. You might decide that this all that you need, especially for relatively simple procedures. But if you would prefer to remain completely aware, but feel less anxious, if you would like deep sedation throughout the entire procedure, or if you want something in between, talk to us about making sedation part of your treatment.

The most common methods of sedation include:

• Oral Sedation

Usually, oral medications that reduce anxiety are given in pill form. The level of sedation and how much you will be aware during your procedure will depend on the dosage, and you will need time to recover from the drug’s effects after we are done.

• Nitrous Oxide

Commonly referred to as “laughing gas,” this has been used since the 1800’s to relieve dental anxiety and reduce pain.  Today’s equipment is designed to provide a precise mixture of nitrous oxide and oxygen inhaled through a mask that you will wear throughout the procedure. Once the mask is removed, you will recover quickly.

• IV Sedation

Medication will be delivered through an intravenous line placed in a vein. This delivery system allows the sedative to take effect very quickly, unlike oral sedation, and adjustments to the sedation level can be made throughout the procedure. This method will also require recovery time when your work is complete.

Because your concerns and condition are unique, we will tailor your sedation to fit your specific needs, and our experience and training enable us to recommend the sedation that is best for you. We will take a careful health history to make sure that whichever medication is used won’t interact with your other medications or affect any pre-existing medical conditions.

Our Worcester office is trained to administer and monitor all these forms of sedation. Because sedation is a regular part of our practice, we have the medical knowledge and skill to provide you with a safe and comfortable endodontic experience. If you think sedation dentistry might be right for you, this procedure is something we are happy to discuss before your appointment.

Anyone who has had a compromised tooth knows that the amount of discomfort it causes can be extremely unpleasant. Although no one looks forward to a root canal, this procedure is actually the best way to both eliminate pain and save your tooth. If the pulp inside your tooth is infected or damaged, a root canal is probably necessary.  

The process is relatively straightforward and can take place over one or two visits to our Worcester office. The area around the tooth is numbed, the pulp is removed from the inside of the tooth, the area is thoroughly cleaned, and a temporary filling or crown is placed on the tooth to prevent bacteria and food from entering the site. A permanent crown will be fabricated and affixed to the tooth at a later visit.

Once your root canal is finished, recovery is usually only a matter of days. What can you to keep yourself as comfortable as possible during that time?

• The area around the affected tooth might be somewhat sore or sensitive for a few days. Let us know, and we can talk about medication to reduce pain and inflammation. If you are prescribed antibiotics, be sure to take the entire course of medication as directed.
• Taking an ibuprofen (if this is a pain reliever that is safe for you) before the anesthetic wears off will reduce the soreness in the hours immediately after the procedure.
• Wait until the numbness is gone before eating to avoid biting down on a temporary filling (or your tongue). Hot drinks are also best avoided.
• Avoid chewing on the side of the affected tooth until the restoration is complete. A soft diet is recommended for the first several days—chewy, sticky, and crunchy foods should wait.
• Continue with regular brushing and flossing.
• Call Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants immediately if you experience severe pain or visible swelling, if you have an allergic response to medication, if your bite feels uneven, or if you lose the temporary filling.

Follow the instructions we’ll give you carefully, and feel free to call us with any concerns. We want to ensure that your root canal is as pain-free and worry-free as possible.

An endodontist is a dentist who specializes in the pulp, or inside of the tooth. Endodontic treatment, also known as root canals, addresses any inflammation or infection that occurs in the root of your tooth. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can perform a root canal in order to remove any of the deep tissue that may be causing you pain. Endodontists also perform procedures such as an apicoectomy, and treatment of abscessed teeth.

Root Canals

You may require a root canal if you have been experiencing swelling of the gums, general tenderness, discomfort when chewing, tooth discoloration, or sensitivity to hot and cold foods. Other side effects of an infected root may include pain and swelling around the gums, jawbone, and lymph nodes, or other parts of the face.

There are different reasons why the root of a tooth can become infected. If it is cracked or chipped, has developed excessive decay, or has experienced trauma, you may notice these symptoms.

A root canal may be intimidating, but it’s a fairly straightforward procedure that can relieve you of the pain you’ve been suffering. When the treatment begins, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will numb the area and drill a small hole in the tooth to get access to the infected pulp. The dead pulp tissue is removed and treated with antibacterial solution. Then the open canal is filled with dental cement and closed off with a permanent crown to finish.

Apicoectomy

Although root canals are the most common treatment endodontists perform, apicoectomy procedures are also common. If this form of treatment is recommended by Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, it usually means a conventional root canal did not solve the issue.

During this procedure, the gums are cut away from the tooth and the infected tissue removed along the root. The very end of the root is removed as well. Then the tooth root is cleaned and sealed.

Abscessed Teeth

Endodontists also commonly treat abscessed teeth. An abscessed tooth contains pus that needs to be drained. Pus can form when the inflamed pulp isn’t fixed properly or quickly enough. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may need to drain the pus with a small incision in the gum tissue, or perform a process similar to a root canal to remove the diseased tissue from the area.

We hope this information answers some of the questions you may have had about endodontic procedures. If you’ve noticed any symptoms that may involve inflammation or infection of a tooth, please give our Worcester office a call and schedule an appointment. Treating the problem early is essential if you wish to avoid more extensive endodontic procedures.

It's a moment many of our patients have experienced. One second you're chewing on a piece of gum, then suddenly you forget to keep chewing and swallow the entire rubbery gob whole! It's at this point you remember your mother warning you as a child that if you swallow gum it will stake a claim and take up residency in your belly for seven years. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology hate to take all the fun out of the mystery, but the truth is that chewing gum, when swallowed, will enter your stomach and move through your digestive system just like any other piece of food. So, if you ever accidentally swallow a piece of gum, there is no need to worry!

That being said, it's important to know that gum does not have any dietary benefits, so while it’s not exactly harmful to swallow, you still want to avoid swallowing it. If you are an avid gum-chewer, we encourage you to chew sugarless gum, especially if you are wearing braces, because gum with sugar can lead to cavities. Sugarless gum still has the same amount of flavor, but has fewer cavity-causing ingredients. In fact, many brands contain an additive called xylitol, a natural sweetener known to fight cavity-causing bacteria. Xylitol is also known to increase salivary flow as it rinses away plaque and acid.

The fact is, when the bacterium in your mouth breaks down sugar, what’s left behind is acid. This acid eats away at the enamel coating of your teeth, causing holes that we call cavities. Cavities can lead to other long-term mouth problems if they are not treated in time, so it is best to try and avoid overexposing your teeth to too many harmful substances!

If you have any questions about chewing gum, please contact our office. Happy (sugar-free) gum chewing!

Watching the clock tick down the final seconds until midnight, many of us- Central New England Endodontics and Implantology included- feel nostalgic about the passing year and hopeful about the new one to come. New Year’s Eve is one of the most widely celebrated holidays in the world, with over-the-top celebrations taking place in dozens of countries. The Gregorian calendar, which is widely used in Western nations and around the world, was implemented in 1582. Since that time, December 31st has marked the final day of the year, with midnight heralding the beginning of a brand new year. In the United States, New Year’s Day is a public holiday; government offices, schools, public organizations, and many businesses are closed for the day. Ponder the following fun facts as you think about your plans for the holiday:

• Approximately one billion people watch the New Year’s Eve ball drop in Times Square, New York City. This televised event is one of the most iconic New Year’s celebrations in the world. For many years, watching the ball drop meant tuning in to Dick Clark’s Rockin’ New Year’s Eve, an iconic television special dear to the hearts of many viewers.
• The idea for the New Year’s Eve ball came about because of a citywide ban on fireworks. Before 1907, when fireworks became illegal in New York City, celebrations included an elaborate fireworks show. The large, glittering, illuminated ball was developed as an alternative. Although the first ball was heavy at 700 pounds, the modern New Year’s Eve ball is made of Waterford crystal and tips the scale at six tons!
• The top five New Year’s resolutions are: to lose weight, quit smoking, get a new job, return to school, or increase personal savings. However, approximately 88% of New Year’s resolutions fail. But don’t let that discourage you! Resolutions are most likely to succeed when they are clear, achievable goals. Setting out a concrete plan to achieve your resolution also boosts your chances of success.
• Eating black-eyed peas on New Year’s Day is said to bring good fortune in the new year. Collard greens, cabbage, and ham hocks are also considered lucky foods to enjoy. Just steer clear of the chicken or turkey dinners; eating poultry is a bad omen for the year to come.

Whether you plan to stay in Worcester, or head out into the crowds to watch the ball drop in Times Square, New Year’s Eve is a time to enjoy friends and family. Send your loved ones well wishes for the New Year, and look for that special someone to share a midnight kiss with for good luck!

X-rays are a vital diagnostic tool for any dental professional. X-rays help your dentist locate cavities that aren’t easily visible, your orthodontist check the position of a tooth’s root, your oral surgeon discover a fracture. X-rays reveal what we can’t see with the naked eye—and that’s why they are an especially important tool for Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

“Endodontic,” after all, means “inside the tooth,” and refers to the pulp and roots within each tooth that hold tissue, nerves, and blood vessels. Endodontists specialize in the diagnosis and treatment of diseases and injuries that affect the inner tooth and its supporting tissue.

Why Are X-rays Necessary?

There’s a lot going on below the surface. An X-ray can reveal conditions such as infections and abscesses, major fractures and tiny cracks, and the health and density of the supporting structures and bone surrounding a tooth. All of this information helps your endodontist arrive at the best treatment plan for these and other endodontic procedures:

• Root Canals
• Apicoectomies (removing the tip of a root to treat recurring infection)
• Fractures or other injuries to a tooth
• Restoring an avulsed, or knocked out, tooth
• Implant placement

How Do X-rays Work?

Traditional X-rays, or radiographs, make use of film just like traditional cameras. When you have an intraoral X-ray, for example, the film is sealed in a moisture- and light-proof packet, and placed inside the mouth to capture images of specific teeth and the bone around them.

The X-ray machine is aligned precisely with the film and an exposure is taken. The image at this point is latent, and won’t show on the film, because, just like photo film, traditional radiographs need to be chemically processed before they produce a visible image.

Digital technology, on the other hand, uses an electronic sensor instead of film. For an intraoral digital X-ray, a small sensor is positioned in the mouth just like a film. When the X-ray is taken, a digital image capture device produces an image which is formed by a matrix of pixels instead of a photo-like film exposure. This format allows the image to be sent directly to a computer for immediate display without requiring processing.

Even though these methods seem very similar, digital X-rays offer some significant advantages over traditional films. Let’s look at how they compare, more or less.

• More Diagnostic Advantages

A traditional X-ray is a fixed image. It cannot be modified or enhanced. Here the digital X-ray offers a clear advantage in diagnosis.

Just as you can enlarge certain types of images on your computer without blurring or losing detail, a digital X-ray uses computer software to magnify images while keeping their details sharp. They can also be enhanced through brightness and contrast applications to make details stand out even more. Both of these benefits are extremely helpful for diagnosis, especially when looking for small injuries, subtle irregularities, or early signs of infection.

There is even digital subtraction radiography software available that can be used to compare recent images to older ones, removing (“subtracting”) all the similarities in the two images to display only the changes in the two—even small changes—that have taken place over time.

• Less Exposure to Radiation

Modern technology means traditional X-rays expose patients to less radiation than ever before, but digital X-rays have significant advantages here as well. Radiation exposure can be reduced by an additional 10%, 20%, or more with a digital radiograph.

Endodontic procedures often require several images of the tooth during each phase of treatment, and, while all types of dental X-rays expose you to very little radiation, it’s always best to reduce exposure whenever possible.

• More Convenient for Sharing and Transmitting

If you need to share your X-rays with another dentist or physician, digital technology allows you to simply have them e-mailed to another office or multiple offices. You no longer need to worry about preserving physical copies, either.

• Less Waste

Unlike traditional X-rays, digital X-rays don’t need to be processed, so you save time in the office. And while the processing time is not significant (usually several minutes), if you need to repeat some X-rays for a clearer picture, or require different images for several teeth, this time can add up.

Digital X-rays are also more eco-friendly.  The fact that they don’t need to be developed means that the chemicals used to process traditional films are no longer necessary—which also means that there is no need to dispose of chemical waste products afterward.

Our goal is to provide you with the safest, most efficient, and most effective treatment possible. Digital X-rays are an important tool for endodontists, helping us to diagnose endodontic conditions in the tooth and surrounding bone and to plan your treatment. If you have any questions about digital X-ray technology, contact our Worcester office. We’re happy to explain the science—and the benefits—of high-tech radiography.

While there is no definite evidence that if your prevent gum diseases, like periodontitis, that you may be able to prevent a heart condition or heart disease. The only thing experts, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, know for sure is that if you take care of your gums it can lessen atherosclerosis, (build-up of artery clogging plaque) that may result in a heart attack or stroke.

Could periodontal disease cause heart attacks?

Regardless of your oral health, if you're at a high risk for heart disease, you need to take action.

• Maintain a healthy weight or lose weight.
• Consume healthy foods and beverages.
• Exercise several days the week. Walking is a powerful and lightweight exercise and will clear your head while helping your body get or stay healthy.
• Control any medical conditions you may have such as high cholesterol, diabetes, or high blood pressure.
• Reduce your stress. Have lunch with a friend, go for a walk in the park, take a bubble bath, mediate, or do whatever you find relaxing.
• Get a social life. Laughing reduces stress and “feel good” hormones. Everyone needs to feel like they are a part of something: join a book club or any activity where you can interact with other people at least once or twice a week
• Be sure to get enough sleep. The recommended amount is eight to nine hours a night. It has been proven that a lack of sleep increases your risk for angina, strokes, and heart attacks.
• Practice good oral hygiene to keep bacteria in check and your mouth healthy.

Contact our Worcester office if you have questions about your heart and oral health. If you take practice good oral hygiene, both your mouth and your heart will thank you.

What will my endodontic treatment include?

If you are in need of a root canal or any other type of root procedure, you have probably been referred to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. An endodontist is a dental professional who specializes in root canals. Because of the additional training they receive after completing dental school, endodontists are able to perform many different root therapy procedures. They are also prepared to do more precise work than your regular dentist. If you have been referred to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for endodontic treatment, you may likely expect the following:

• Anesthesia: Your endodontist will ensure your comfort during the procedure by providing either local or general anesthesia.
• Removal of the infected area: After your tooth is numbed, the endodontist will drill into it and remove the infected pulp.
• Cleaning the tooth: Once the inflamed area has been removed, your endodontist will carefully clean the inside of the tooth and shape it for the next step.
• Filling the tooth: After the tooth has been cleaned and prepped, the endodontist will fill it with a protective material and seal it to prevent further infection.

After a period of recovery time, you will return to your dentist to receive a crown or other protective element to restore your tooth to its original function.

What can I expect after the treatment?

While most patients come to endodontic treatment in considerable pain, many of them experience very little of that pain during or after a root canal. After the anesthesia wears off, your tooth may be a little bit sensitive for a few days, but the discomfort should be minimal compared to the pain you experienced when your tooth was infected. To relieve this pain, you may use over-the-counter pain relievers, or request a prescription in more severe cases.

Does my treated tooth need any special care?

After your endodontic treatment here at Central New England Endodontics and Implantology, your tooth will be somewhat vulnerable until you receive a crown or other restoration treatment from your dentist. To avoid any cracks or fractures in your treated tooth, try not to chew or bite on it until it has been restored to full capacity. If it hurts while you are eating, that is a strong indication that you should be more careful about where you chew your food. In addition, you should avoid chewing gum until your tooth is back to normal. Staying away from any unnecessary chewing can help prevent further damage to your treated tooth. Other than that, just remember to practice good oral hygiene and your tooth should be just fine! Recovering from your endodontic treatment can be easy and relatively painless if you follow these simple guidelines. Of course, if you have any further questions about your endodontic treatment you can always contact us at our Worcester office!

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology know this is an exciting time as you anticipate the arrival of your new little one. We want to take this opportunity to provide you with some important information pertaining to your oral health during pregnancy. Just as the rest of your body is changing, the amount of bacteria in your mouth also changes. Scientists don’t understand all the reasons why, but during pregnancy, your mouth is more susceptible to bacterial complications that could result in increased risk for gingivitis or periodontal disease. What researchers do know is the change in hormones creates a more favorable environment for gum infections and diseases when you are pregnant.

You may experience an increase in gingivitis, even while continuing with regular daily brushing and flossing, and routine semi-annual month cleanings. You will likely complain of increased bleeding of the gums with routine daily care and more tenderness in the mouth. This is due, in part, to the increased blood flow and volume that naturally occurs with pregnancy. There is a greater amount of blood flowing through your veins, which translates into slightly engorged gum tissues. If gingivitis prevails, you may also experience pain and tenderness. We can help you navigate through your specific needs.

Brushing your teeth two times a day may not be quite enough. Similarly, if you only floss on occasion, consider making this activity a daily habit. Mouthwash is also advised, or sometimes a mild saltwater rinse may feel better than a commercial brand. Consider other products with xylitol and a WaterPik for additional cleaning.

Finally, we now know that bacteria in the mouth circulate throughout the body. These harmful bacteria compromise your immune system and may increase your risk for respiratory illness and cause other strains on your immune system. Remember that nutrients as well as pathogens are shared with your baby. If you feel tired or tempted to slack on your home-care routine, remember the importance and implications of your daily decisions on how your care for your oral health.

Contact our convenient Worcester location if you have more specific questions. We’re here to help you!

At Central New England Endodontics and Implantology, we love to celebrate the holidays with vigor! Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants would love to share some unique ways of celebrating Thanksgiving from beyond the Worcester area to the national level!

When Americans sit down to dinner on the last Thursday of November, the day that Abraham Lincoln designated as the day on which Thanksgiving would be celebrated, they do so thinking that the first Thanksgiving feast was held at Plymouth in 1621. According to National Geographic, the Spanish explorer Francisco Vásquez Coronado and his men celebrated a feast of Thanksgiving in Texas in 1541, giving Texas the distinction of being the first place where Thanksgiving was celebrated.

Different Types of Celebrations

Native Americans had rituals around which they celebrated in hopes of ensuring a bountiful harvest. The Cherokees had a Green Corn Dance that they did for this very purpose. The Pilgrims (not to be confused with the Puritans,) rejected any type of public religious display. They held a three-day long non-religious Thanksgiving feast. Although they said grace, the focus of their celebration was on feasting, drinking alcohol (they did have beer,) and playing games.

The Pilgrims at the Plymouth Plantation celebrated a different day of Thanksgiving in 1623. Plagued by a crop-destroying drought, the settlers prayed for relief. They even fasted. A few days later, they got the rain they so desperately needed. Soon thereafter, they received another blessing when Captain Miles Standish came with staples they couldn't otherwise get. He also told them that a Dutch supply ship was en route. In gratitude for the abundance of good fortune, the Plymouth settlers celebrated a day of prayer and Thanksgiving on June 30, 1623.

The Story of Squanto

No discussion of Thanksgiving is complete without a discussion of Squanto, or Tisquantum, as he was known among his people, the Patuxet Indians. It is believed that he was born sometime around 1580. As he returned to his village after a long journey, he and several other Native Americans were kidnapped by Jamestown colonist, Thomas Hunt. Hunt put them on a ship heading to Spain where they were to be sold into slavery.

As fate would have it, some local friars rescued him and many of the other kidnapped natives. Squanto was educated by the friars. Eventually, after asking for freedom so he could return to North America, he ended up in London where he spent time working as a ship builder. By 1619, he was finally able to get passage on a ship headed to New England with other Pilgrims.

Upon arriving at Plymouth Rock, he learned that his entire tribe was wiped out by diseases that accompanied earlier settlers from Europe. In gratitude for passage on their ship, he helped them set up a settlement on the very land where his people once lived. They called the settlement Plymouth. Since they knew nothing about how to survive, let alone how to find food, Squanto taught them everything, from how to plant corn and other crops, how to fertilize them, how and where to get fish and eels and much more.

After a devastating winter during which many settlers died, thanks to Squanto's teaching, they had an abundant harvest. After that harvest, they honored him with a feast. It is this feast of 1621 which was celebrated between the Pilgrims and Wampanoag Indians that is widely considered the first Thanksgiving celebration.

About the Meal of the Plymouth Settlers

Surviving journals of Edward Winslow that are housed at Plymouth Plantation indicate that the first Thanksgiving feast was nothing like what Americans eat today. The meal consisted of venison, various types of wild fowl (including wild turkey,) and Indian corn. There were no cranberries, stuffing, pumpkin pie, potatoes, or any of the other “traditional” foods that appear on modern menus.

Today, Thanksgiving is celebrated on the fourth Thursday of November, the day that Abraham Lincoln designated as the holiday. It is still a day of feasting, and for some, a day of prayer and thanksgiving. For others, it is a celebration of gathering, especially for families. Still others may celebrate in entirely different ways, including watching college football bowl games, or by playing family games.

If you ever wonder why you're so tired after the Thanksgiving meal, it's because turkey contains an amino acid, tryptophan, and it sets off chemicals whose chain reaction combine to make people sleepy.

Our molars work hard to crush, grind, and chew our food. They withstand over 100 pounds of pressure per square inch when chewing—and let’s not even discuss stress clenching and grinding! Not surprising, then, that they are our largest and strongest teeth, anchored by multiple roots.

How does this biology work in our favor? Sometimes a tooth suffers decay or damage in the root, or in the bony area surrounding it. When a tooth has only one root, options can be fairly limited. But when a tooth has multiple roots, an endodontist might be able to save your molar with a surgical procedure called a “root resection.”

If the root is too damaged to be repaired by procedures such as a filling, a root canal, or an apicoectomy (removal of the root tip), Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can remove the damaged or infected root entirely. This resection procedure can save a tooth that might otherwise need to be extracted.

What conditions lead your endodontist to recommend a root resection?

• Decay: If serious decay is confined to a single root, a resection might be a good option.
• Damage to the root: A broken root, or one that has suffered a serious fracture or other injury that doesn’t extend too far into the tooth, can be removed to save the healthy part of the tooth.
• Recurring infection: If you have already undergone a root canal for a pulp infection, but the infection keeps reappearing in one root, root removal might be indicated.
• Bone loss caused by gum disease: When periodontitis isn’t promptly treated, the result can be a serious loss of bone around one root. A root resection can facilitate healing in the bone around the tooth, and save the tooth from extraction or loss.

Can all teeth benefit from a root resection?

The maxillary molars, located in the upper jaw, are often the best candidates for a root resection because they generally have three roots, but other multi-rooted teeth might also be considered for root resection treatment. Your endodontist will be able to tell you if the root structure and the overall condition of your molar make root resection an option for saving your tooth.

What’s involved in a root resection?

Because this surgery will necessarily involve the dental pulp, a root canal will be performed before the procedure to remove the nerves, blood vessels, and connective tissue inside the tooth. During the root resection, a small incision is made in the gum tissue to expose the roots. The affected root is then sectioned off and removed. The area is carefully cleaned, and the incision closed with a few stiches. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will give you instructions for post-surgery care, and most likely a permanent crown will be needed to protect the remaining tooth structure.

Roots serve to anchor our teeth, but they aren’t indestructible. On the other hand, an injured or diseased root doesn’t necessarily mean an extraction is necessary or inevitable. If you have a problem in or near a molar root, an endodontic consultation at our Worcester office just might leave you smiling.

Dentine hypersensitivity can be described as a sharp and sudden pain caused by cold food and beverages. It’s present in more than half the population and result from receding gums that expose the root surfaces of your teeth.

That being said, hypersensitivity can be triggered by forceful tooth brushing, teeth whitening products, gum disease, and erosion from acid reflux, bulimia, or highly acidic foods. Symptoms can range from moderate to severe, depending on the cause and how quickly it’s treated.

Tooth sensitivity begins when the dentin develops some exposure. This layer that surrounds the nerve of the tooth is usually covered by gum tissue, but when recession takes place, the dentin can get exposed and the pain begins. The dentin contains numerous pores that run from the surface of the tooth inward. This direct connection to the nerve and blood supply of the tooth can be affected by external stimuli, such as the triggers cited above.

The good news is there are several different ways to treat dentinal hypersensitivity at Central New England Endodontics and Implantology.

Treatment of dentin tooth sensitivity begins by making an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. We encourage you to begin treatment sooner rather than later in order to figure out the cause and to reduce the pain you’re experiencing. In most cases, quick treatment options will solve the problem, including the use of desensitizing toothpaste, switching to a soft-bristled toothbrush, starting a daily fluoride rinse treatment, or minimizing teeth grinding with the help of a custom mouthguard.

For more serious cases, we may recommend you get crowns put on problematic teeth, start a gel or varnish fluoride treatment, or even schedule a surgical gum graft or root canal, depending on the cause and severity of your pain.

If you’re concerned about any tooth sensitivity you’re experiencing, please give our Worcester office a call and schedule an appointment. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team want to help you identify the cause of your pain, and give you the best possible treatment plan. We look forward to seeing you to help alleviate discomfort and solve your tooth sensitivity.

Did you know that Human Papilloma Virus (HPV) and oral cancer are linked? This information may prevent you or a loved one from suffering from oral cancer if a diagnosis is made early. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team want you to understand how you can prevent the spread of oral cancer and protect yourself if you have HPV.

People don’t often speak up about this common virus, but we believe it’s important to educate yourself to prevent the potential spread of oral cancer. According to the Centers for Disease Control and Prevention, up to 80% of Americans will have HPV infections in their lifetime without even knowing it. Symptoms usually go unnoticed, though it’s one of the most common viruses in the U.S. The body’s immune system is generally able to kill the HPV infection without causing any noticeable issues. If you think you might have HPV, talk with primary care physician about getting the preventive vaccine or taking an HPV test.

According to the Oral Cancer Foundation, “HPV is the leading cause of oropharyngeal cancers (the very back of the mouth and throat), and a very small number of front of the mouth, oral cavity cancers. HPV16 is the version most responsible, and affects both males and females.”

Common signs of oral cancer may include:

• Ulcers or sores that don’t heal within a couple of weeks
• Swelling, lumps, and discoloration on the soft tissues in the mouth
• Difficult or painful swallowing
• Pain with chewing
• Persistent sore throat
• Numbness of the mouth or lips
• Lumps felt on the outside of the neck
• Constant coughing
• Earaches on one side of your head

If you experience any of these side effects, please contact Central New England Endodontics and Implantology as soon as possible.

We hope this information will help you understand the interactions between HPV and oral cancer. Please remember to take precautionary steps if you notice anything out of the ordinary with regard to your oral health. If you have any questions or concerns, contact our Worcester office.

All Hallows' Eve, more commonly known as Halloween, is a yearly event celebrated on October 31, and one that is anticipated by the young and young at heart all over the world. Some scholars claim that Halloween originated from Celtic festivals that honored the dead or that celebrated the harvest, while others doubt that there's any connection at all to Samhain (a Gaelic harvest festival.) Regardless of its origin, our team at the dental office of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants hopes that Halloween is fun and enjoyed by all of our awesome patients!

Trick or treat?

In North America, Halloween is predominantly celebrated by children who dress up in costumes, which range from scary to cute, who then go around the neighborhood knocking on doors asking "trick or treat", and they are given candy in return. Trick-or-treating is a time honored tradition, and though many parents groan at the pounds and pounds of candy collected by youngsters and fear for the health of their teeth, there are a few things you can do to help their teeth stay in great shape until the candy is gone:

• Limit the amount of candy they can consume each day
• Have them brush their teeth after eating candy
• Avoid hard, chewy candies as they can stick in hard to brush places
• Keep candy out of sight to reduce temptation
• Don't buy candy too far in advance to limit pre-Halloween consumption
• Help or encourage your children to floss

Halloween Fun

Halloween isn't just about gorging on candy; there are other events associated with this festive day including carving jack-o'-lanterns, painting pumpkins, decorating sugar cookies, bobbing for apples, going to haunted houses, or just curling up on the couch with a bowl full of popcorn and watching some classic, scary movies.

Halloween Around the World

Some countries, like Australia, frown upon Halloween, claiming it is an American event and not based in Australian culture, while others like Italy have embraced the fun and celebrate much as Canadians and Americans do. Mexicans have been celebrating this fun day since around 1960, and it marks the beginning of the Day of the Dead festival. Some countries in Europe have come late to the party, but since the 1990s, countries like Sweden, Norway, and Germany have started celebrating Halloween as well, and finding children in costumes or having ghosts hanging in windows has become commonplace.

Halloween is about fun; stepping outside our normal lives and donning a costume or gathering with friends to knock on doors and ask for candy is as much a part of our culture as hot dogs and barbecue on Labor Day. Have a safe and happy Halloween from the team at Central New England Endodontics and Implantology!

If you suffer from dental anxiety, we understand that paying a visit to our office can seem like a nearly impossible mission. Regardless of what the root of that anxiety might be, we’re here to tell you that at Central New England Endodontics and Implantology, you have no need to be nervous. Our office is dedicated to making your dental experience as comfortable and stress-free as possible.

One of the best things to do if you experience dental anxiety is call our office in advance to let us know. By notifying us in advance, you give us the opportunity to provide you with the dental care you need in the way you need it.

We can prescribe a relaxation medication for you. During your appointment, we can provide a little bit of laughing gas to put you more at ease, teach you some behavioral techniques for relaxation, and make sure you’re never in the dark about what’s happening.

If dental anxiety makes you feel embarrassed, please be assured that you’re not alone. Studies show that as much as 75% of adults suffer some degree of dental anxiety! It might be helpful to remember that your doctor’s goal is the same as yours: We are here to keep your oral health in check so you can be your healthiest self. We certainly don’t want to make you uncomfortable in the process.

If you have any questions about other ways in which we can accommodate you during your visits, please don’t hesitate to contact our Worcester office!

Adults are no strangers to feeling like there is never enough time in the day to get everything done. Your alarm clock rings and within minutes you ping pong around trying to spread peanut butter on sandwiches, answer your cell phone, remove the dog hair from your clothes, and make sure your child has completed his or her science fair project. Brushing your teeth can easily fall to the wayside. That is why our office promotes a simple, daily oral health regimen that you can easily incorporate into your busy lifestyle.

The American Dental Hygienists' Association (ADHA), in partnership with the Wrigley Jr. Company, is celebrating National Dental Hygiene Month (NDHM) during October. The ADHA encourages people to "Brush. Floss. Rinse. Chew...Keep it Clean, Keep it Healthy!" and offers some great tips for a quick and effective home oral health routine, below:

Oral Health Routine at Home

• Brushing your teeth twice daily is the most important thing you can do to diminish the accumulation of plaque and the potential for other oral problems such as cavities and gingivitis.
• Flossing once daily removes plaque and food from beneath the gums and between teeth that brushing alone cannot remove. Tooth decay and gum disease often begin in these areas.
• Rinsing your mouth with an antibacterial, non-alcohol based mouthwash kills plaque and gingivitis germs that brushing and flossing do not catch. We recommend using a mouthwash with the ADA Seal of Acceptance.
• Chewing sugar-free gum helps produce saliva, which battles cavities. The gum also neutralizes plaque, strengthens enamel, and removes remaining food. It is especially important to chew gum after eating or drinking.

It's easy to put the toothbrush down in order to take care of matters you feel are more urgent, but remember, a good oral health routine at home is the best way to prevent periodontal disease. "Periodontal disease is the most common cause of tooth loss in adults. An estimated 75 percent of Americans reportedly have some form of periodontal disease," said the ADHA. Periodontal disease also is linked to more serious illnesses such as diabetes and stroke.

Also, remember to keep regular visits with our office. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can help you learn more about proper care for your teeth and gums.

You’ve planned your dream vacation. Your reservations are made. You’re packed and ready. You’ve even scheduled a dental checkup at our Worcester office to make sure you catch any potential problems, have finished any major work, and have an up-to-date chart.

But things don’t always go according to even the best of plans. So, what to do if you find you have a dental emergency while traveling? Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have some recommendations for problems that might arise.

• Toothache—Rinse your mouth with warm water and use dental floss to remove any food particles. Never put aspirin directly on a tooth or gum tissue. If the pain persists, call a dentist.
• Cracked or broken tooth—Immediately rinse with warm water to clean the area and apply cold compresses to the face to minimize swelling. Get in touch with a dentist.
• If you lose a tooth—Keep the tooth moist at all times. Put the tooth back in the socket without touching the root if possible. If that is not an option, place the tooth between the cheek and gums or in milk. See a dentist as soon as possible.

Know where to get help if you need it! If you are traveling in the United States, the American Dental Association offers Find-a-Dentist, a website that can locate a member dentist closest to you. If you are traveling to another country, there are steps you can take to prepare for an emergency.

• If you are out of the country and need to locate a dentist, your local embassy or consulate, your hotel concierge, or friends abroad can be a useful resource.
• Before you go, check your insurance to see if you are covered while traveling.
• If you have travel insurance, find out if it covers dental treatment and can provide information on qualified local dentists and translation help, if necessary.
• Good dental care is available in many areas internationally, but it is important to know what standards are present in the countries you plan to visit. The Organization for Safety and Asepsis Procedures offers a checklist for safe treatment in their “Traveler’s Guide to Safe Dental Care.”

If you have any questions, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team are happy to do all we can to answer them. While it’s unlikely that problems will arise, we are always available if you need to contact our Worcester office. Bon voyage, and we look forward to hearing about your trip!

With so many toothpastes available in so many price ranges, it can be difficult to be sure you are selecting the right one for your needs. You need a product that not only protects against tooth decay, but also addresses any special concerns that Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have raised. Look for the American Dental Association seal and do some research to find the toothpaste that best meets your needs.

Choose a Product Approved by the American Dental Association

The American Dental Association approves dental products such as toothbrushes, dentures, mouthwashes, dental floss, and toothpastes when they meet certain quality standards. Before products can display the seal, the American Dental Association must verify that the product does what it claims to do. Look for the American Dental Association seal on the toothpaste package before you buy it. Also, check to make sure that the toothpaste contains fluoride, which helps protect against decay.

Consider Special Needs

You may be depending on your toothpaste to perform extra tasks beyond cleaning your teeth. These are some common concerns that the right toothpaste can address.

• Bad breath (halitosis)
• Sensitive teeth
• Plaque or gingivitis
• Tartar
• Yellowing teeth

The American Dental Association’s website has a tool that lets users input their requirements and view a list of the toothpastes that carry the American Dental Association’s seal and address those particular oral health needs.

Make Your Children’s Tooth-Brushing Experience Fun

If you select toothpaste that contains fluoride and has the American Dental Association seal, most types of toothpaste will be fine for your children as long as they have no special needs. Allowing your kids to select fun toothpaste can encourage them to enjoy the brushing experience more, so that they brush more frequently and do a better job.

The following toothpaste characteristics can make brushing more fun for children.

• Fun flavors, such as bubble gum, berry, and watermelon
• Sparkles and swirls that make the toothpaste appear more attractive
• Toothpaste that comes in a pump
• Toothpaste with a container decorated with superheroes

We often have patients who ask, “Can drinking alcohol affect my oral health?” There are, in fact, a few reasons why that martini may not be good for your pearly whites.

In addition to creating an overly acidic environment in your mouth, alcohol severely dehydrates oral tissues because of its desiccant and diuretic properties. Because alcohol saps oral tissues of their moisture so readily, saliva glands can't keep enough saliva in the mouth to prevent dry mouth. In addition, saliva contains antibacterial properties that inhibits growth of anaerobic bacteria, a destructive type of oral bacterial responsible for tooth decay, gingivitis, chronic bad breath, and periodontitis.

What are anaerobic bacteria?

When there is a lack of saliva flow in the mouth and the mouth cannot naturally cleanse itself of oral debris (food particles, dead skin cell, mucous), conditions develop that promote activity of anaerobic bacteria, or bacteria that thrive in dry, airless places. These anaerobes also flourish when an unending supply of proteins (food debris) are available to consume, creating rapidly multiplying layers of plaque that stick to teeth and demineralizes tooth enamel unless removed by brushing and professional dental cleanings.

Oral Cancer and Alcohol

Acetaldehyde is a chemical compound leftover after the liver has metabolized alcohol. Capable of causing genetic mutations, acetaldehyde is also a known carcinogen that contributes to the ill feelings of hangovers. Although most metabolism of alcohol is done in the liver, evidence shows that metabolism also occurs outside the liver and that enzymes in the mouth could encourage accumulation of acetaldehyde in oral tissues.

When combined with poor oral health, smoking, and other detrimental lifestyle factors, alcohol may be considered a primary contributory factor in the development of oral cancer.

Even if you don't drink or drink only occasionally, remaining aware of symptoms that may indicate oral cancer will improve your chances of recovering successfully when you start treatment in the early stages of oral cancer. Signs include red or while speckled patches in the mouth, unexplained bleeding, lumps/swellings, chronic ear or throat pain, and areas of numbness in the mouth or on the face.

If you have any questions about alcohol and its connection to oral health, don’t hesitate to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at your next visit to our Worcester office.

The most common procedure for an endodontist is a root canal, which involves treating infected roots in order to save the tooth. To become a specialist, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants had to complete at least two additional years of schooling. Your general dentist may refer you to Central New England Endodontics and Implantology if you experience chronic tooth pain and your X-rays show signs of infection.

Just like a cardiologist only deals with disorders of the heart, an endodontist only works with the pulp, or inside tissues, of your teeth. This specialization allows for more accurate diagnostics and better results with treatment. Your regular dentist is qualified to perform simple root canals, but an endodontist can provide you with more treatment options that can restore your teeth for life. Procedures that endodontists can perform but general dentists cannot include:

• Cracked teeth treatment
• Diagnosis and treatment of complex root problems
• Tooth replacements
• Consultations for facial trauma patients
• Surgical removal of roots

Why visit an endodontist?

While no type of replacement is as good as your natural teeth, root canals and other endodontic procedures effectively save teeth, and specialists prefer these methods over extractions, bridges, and implants. If your dentist ever suggests tooth removal as treatment, you should request an endodontic consultation for other options. Endodontists have access to more advanced diagnostic technology, such as ultrasonic imaging and operating microscopes, and can offer you a larger selection of treatment options to prevent the loss of adult teeth.

Endodontic treatment reduces the time it takes for treatment and recovery. While you do not need to see a specialist for every dental issue, there are some symptoms that indicate problems with your teeth’s blood vessels, roots, nerves, and soft tissues. Seek an endodontist’s specialized care when you experience the following symptoms.

• Sharp pain when biting
• Sensitivity to hot or cold foods followed by lingering pain
• Persistent and severe pain with swollen gums
• Uncomfortable aches in the upper teeth and jaws

You value your natural teeth, and at our Worcester office, we can help ensure the longevity and function of your pearly whites for the years to come!

Labor Day, celebrated on the first Monday each September here in the United States, is a holiday devoted to the American working community. The purpose of the holiday is honoring the country's workers and their contributions to the strength of our country as a whole.

How Labor Day Started

There is actually some debate as to the origins of Labor Day. It is uncertain whether Peter McGuire, a cofounder for the American Federation of Labor, or Matthew Maguire, who was the secretary of Central Labor Union of New York, had the great idea. However, the Central Labor Union's plans were what launched the first Labor Day in America.

The First Labor Day

The very first Labor Day was celebrated on September 5th, 1882. The Central Labor Union then held annual celebrations on September 5th for what they called a working man's holiday. By the year 1885, the Labor Day celebration had spread to many different industrial areas, and after that it began spreading to all industries in the United States.

Labor Day Today

Labor Day today is a huge United States holiday during which we honor the country's workers with a day of rest and relaxation or a day of picnics and parades. This holiday is truly one to honor the many people who work hard to contribute to the economic well-being of our great country!

Our team at Central New England Endodontics and Implantology hopes all of our patients celebrate Labor Day, and every holiday, safely and happily. Whether you stay in the Worcester area, or travel out of town, have fun, and don't forget to brush!

Xylitol tastes sweet, but unlike sugar, it is not converted to acid that can cause your teeth to decay. It’s a naturally occurring sweetener found in plants, fruits, and vegetables; even the human body produces it in small amounts. Xylitol is widely used in sugar-free chewing gum, mints, candies, and even certain forms of medicine.

The World Health Organization has approved xylitol because only a small amount is needed for its health benefits. It’s even safe for diabetics, with a glycemic index of only seven. Xylitol has 40% fewer calories than other types of carbs: less than three calories per gram.

So how can this natural sweetener benefit your oral health? Take a look at the facts. Tooth decay starts when bacteria consumes the sugars left in your mouth. When you eat sugary foods, the bacteria on your teeth will multiply and make acid that can destroy your enamel.

Xylitol is derived from fibrous parts of plants, so it does not break down like a regular sugar. It actually helps maintain a neutral pH level in the mouth, which in turn prevents bacteria from sticking to the teeth. The bacteria are then unable to digest xylitol, which means your teeth won’t develop enamel damage and cavities.

Studies have shown the consumption of xylitol as a sugar substitute or a dietary addition had a dramatic reduction in new cavities and even reversed existing cavities. These effects are long lasting: low cavity rates remained years after the trials were done.

When there’s less bacteria and acid in your mouth due to xylitol, your teeth stay healthier. The more frequently it’s ingested, the more you will prevent enamel damage.

Aim to consume around five grams a day, or one gram every three hours if possible. You can do this by consuming gum, tablets, candy, or mints that have xylitol as one of the first ingredients after your meals. You can find these products in health food stores and specialty grocery stores.

Since xylitol replaces sugar on a one-to-one ratio, it’s used in several common items:

• Toothpaste
• Mouth rinse
• Baby oral wipes, gel, and pacifiers
• Nasal wash
• Dry mouth spray
• Granulated forms for cooking
• Granulated packets to add to drinks
• Commercially prepared foods

Make sure to pick up items that contain xylitol the next time you’re at the store! This is an easy way to maintain great oral health. If you have specific questions about xylitol, ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next appointment at our Worcester office.

When you chip a tooth badly, it can be a very nerve-wracking situation. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team want to provide you with some information that can help if you ever suffer a chipped or broken tooth. The most common ways people break their teeth are by biting down on something hard, getting hit in the mouth, falling down, or developing cavities that weaken the tooth and allow it to be broken easily. There are a few things you can do if you find yourself in this situation, however.

First, we recommend that you investigate whether the tooth is partially chipped or completely broken. Unless you are experiencing a lot of pain or bleeding, this should not be treated as an emergency. You may call our office and we will try to schedule an appointment with you as soon as possible. Once we have evaluated the tooth during your appointment, we can start to treat it. For minor chips or cracks, we may simply smooth out the area or fill in the space so the crack doesn’t spread.

If your teeth show severe damage such as a serious break, split tooth, split root, or a decay-induced break, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may need to take more time to fix the problem. If you need emergency dental care because a tooth has fallen out, call our practice immediately to schedule an appointment for that day. If you’re waiting for an emergency appointment, you can rinse your mouth with warm salt water and apply slight pressure to the area to stop the bleeding. We recommend using an ice pack to reduce swelling, but do not take any aspirin because that may increase the bleeding.

If your tooth has completely fallen out of the socket, hold it by the crown and rinse it under running water. Do not let the tooth become dry; instead, place it in salt water or milk until you get to our office. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will determine whether the broken tooth can be salvaged or will need to be completely replaced.

We know how upsetting it can be to chip or break a tooth, which is why we want to guide you through this process. Most chipped teeth are usually just cosmetic problems, fortunately, but we know that dental emergencies can come up rather suddenly. Be sure to schedule an appointment at our Worcester office as soon as an emergency situation occurs.

While mouthwash goes a long way in improving your oral care, it is not a substitute for flossing. Mouthwashes and flossing provide different benefits that you should understand.

Mouthwash Benefits

Mouthwash comes in two categories. Some are considered cosmetic. This type of rinse provides temporary relief from bad breath and has a pleasant taste. These do not actually kill any bacteria.

Therapeutic mouthwashes provide the healthier benefits. These may contain different ingredients including fluoride or antimicrobial agents. This type is used to remove plaque buildup and reduce the potential for calculus formation. Therapeutic rinses can also help prevent cavities, bad breath, and gingivitis. In addition, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can prescribe special rinses to assist patients after periodontal surgery or other procedures.

Flossing Benefits

Flossing is what removes the plaque formation before it can harden and become calculus. While a rinse reduces buildup, only flossing will fully remove plaque, especially between teeth. The bristles on a toothbrush do not get between teeth completely. If plaque is not removed, it hardens into tartar or calculus. When this builds below the gum line, gum disease can start.

Types of Floss

Floss is available in a thin string form or a tape. It can be waxed or unwaxed. If you find flossing difficult, you might want to try a different type of floss. You can buy bulk floss in containers or purchase the disposable type with a plastic handle attached. This style can be easier for many individuals to use. Interdental picks are available for bridgework or other situations where regular floss cannot be used.

If you have questions regarding the best mouthwash or floss, or need tips for easier flossing, please ask our Worcester team for advice. We will be glad to give you solutions to help keep your mouth clean and healthy.

The dog days of summer are upon us, and what better time for Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team to ask our patients about their summer!

Whether you visited our nation’s capital, went on a camping trip, or just stayed in Worcester and relaxed, we want to know how you’re all spending your summer! Please feel free to share your summer plans and experiences with us below or on our Facebook page as summer rolls on!

The Fourth of July is a great time to get together with friends and family members for BBQ, games, fireworks, and other celebrations in honor of our country’s independence. While your fellow revelers eat hot dogs and wave flags, you can impress them by sharing these fascinating facts and historical tidbits about some of our country’s traditions and symbols from the team at Central New England Endodontics and Implantology.

The Statue of Liberty

With a torch in one hand and a tablet in the other, the Statue of Liberty is one of the most iconic and recognizable symbols of our country. However, as recognizable as certain parts of the statue are, not many people know that broken shackles, which represent oppression and tyranny, are lying at Lady Liberty’s feet. According to the Statue of Liberty-Ellis Island Foundation, the copper-plated lady weighs in at a whopping 450,000 tons and has been holding her torch up for more than 125 years, which must make for some impressive arm muscles.

Nathan’s Hot Dog Eating Contest

Since 1916, people have been flocking to Coney Island on the Fourth of July to witness what some people call the “superbowl of competitive eating.” Nathan’s Hot Dog Eating contest challenges competitors to devour as many hot dogs as they can in just ten minutes, with the current record holder swallowing a whopping 68 hot dogs! If you’d like to witness this bizarre and frenzied eating competition but you won’t be anywhere near Coney Island on the fourth, don’t worry. ESPN has been broadcasting this popular event for several years, so you can watch from the comfort of your couch while you eat a reasonably portioned meal.

The History Behind Fireworks

Viewing the nighttime fireworks display is exciting way to finish off the fourth. Many people know that these brilliant displays probably originated with the Chinese. However, many historians also believe that fireworks were stumbled upon when the Chinese roasted bamboo sticks over fires and watched them explode. After many years of roasting the sticks, a group of alchemists created an early form of gunpowder, which they stuffed into the bamboo sticks to create an even more powerful explosion, paving the way for the today’s modern fireworks.

Whether you’re planning on visiting the Statue of Liberty, watching fireworks in Worcester, or even participating in a hot dog eating contest, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team hope you have a safe and fun-filled holiday. Happy Fourth of July!

If you have endodontic surgery scheduled at our Worcester office, you have many options for your choice of anesthesia. After all, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team are trained in all forms of anesthesia and sedation therapy, so you will be able to choose the anesthesia experience that best suits your needs—and your comfort!

One such option is general anesthesia. If you choose this type of anesthesia, you will be carefully monitored at all times. While you are under our care, we want to make sure your treatment is safe, painless, and free from anxiety. And to make your experience go as smoothly as possible, there are some recommendations you can follow even before you arrive at the office.

• Communication

Part of our job is to let you know all about your general anesthesia beforehand. If you have any questions or concerns, please voice them. And communication is a two-way street! If you have any medical conditions, or are taking any medications, or have a cold or the flu, please let us know in advance.

• Diet Restrictions

Talk to us before your surgery to learn about any diet restrictions you should observe before general anesthesia. You will need to abstain from food and drink for a set number of hours before the procedure, so we’ll give you directions based on whether your surgery is scheduled for morning or afternoon.

• Dress for Success

Wear loose, comfortable clothing. Make sure your sleeves are short or easily rolled up above your elbow if you’ll need an IV line or blood pressure monitoring. Leave your make-up, jewelry, and contact lenses at home.

• Go Along for the Ride

Ask a friend or a family member for a ride home after surgery. We want you to travel safely, and, even if you think you are good to go, your thinking and decision making, your reflexes, and even your memory can be impaired for up to 48 hours after general anesthesia. If you have arranged for a cab or a ride share, don’t call for your ride until our office gives you the all clear.

• Plan Ahead!

For the very same reasons you shouldn’t drive for several hours after general anesthesia, there are some normal everyday activities you should postpone as well. You shouldn’t operate machinery. Cooking can wait. Arrange for help with childcare if you have young children. The effects of general anesthesia will wear off over the course of a day or two—ask us for a timeline for returning to your normal activities.

We’re experts in providing you with a safe and comfortable anesthesia experience when you have endodontic surgery. And part of that expertise is letting you know the specifics about preparing for your general anesthesia. If you have any questions for how to get ready for the hours both before and after your surgery, give us a call!

Water picks, sometimes called “oral irrigators,” make an excellent addition to your regular home care regimen of brushing and flossing. Especially helpful to those who suffer from periodontal disease and those patients of ours undergoing orthodontic treatment with full-bracketed braces, water picks use powerful tiny bursts of water to dislodge food scraps, bacteria, and other debris nestled in the crevices of your mouth. Children undergoing orthodontic treatment may find using a water pick is beneficial if their toothbrush bristles tend to get caught on their wires or brackets.

When you use a water pick, you’re not only dislodging any particles or debris and bacteria you might have missed when brushing, you are also gently massaging the gums, which helps promote blood flow in the gums and keeps them healthy. While water picks are an excellent addition to your daily fight against gingivitis and other periodontal diseases, they are incapable of fully removing plaque, which is why Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology want to remind you to keep brushing and flossing every day.

If you have sensitive teeth or gums and find it uncomfortable to floss daily, water picks are a good alternative to reduce discomfort while effectively cleaning between teeth. Diabetics sometimes prefer water picks to flossing because they don't cause bleeding of the gums, which can be a problem with floss. If you have a permanent bridge, crowns, or other dental restoration, you may find that a water pick helps you keep the area around the restorations clean.

So how do you choose the right water pick?

Water picks are available for home or portable use. The home versions tend to be larger and use standard electrical outlets, while portable models use batteries. Aside from the size difference, they work in the same manner, both using pulsating water streams. A more crucial difference between water picks is the ability to adjust the pressure. Most home models will let you choose from several pressure settings, depending on how sensitive your teeth and gums are. Most portable models have only one pressure setting. If you want to use mouthwash or a dental rinse in your water pick, check the label first; some models suggest using water only.

Please give us a call at our Worcester office if you have any questions about water picks, or ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit!

The electronic toothbrush has undergone several technological advances since the 1960s. Everything from design and bristle motions to rotation, oscillation, and sonic vibration has led to dramatic changes in this necessary tool over time.

Rotation oscillation happens when the head of the toothbrush rotates from one direction to the other. The benefit of powered toothbrushes is that they can produce 50,000 strokes per minute, compared to 300 strokes with a manual toothbrush.

When you’re thinking about brush head size, smaller brush heads are best for hard-to-reach areas and small mouths. Brush heads should be replaced every three to six months as needed. A good way to save money is to designate a brush head for each family member which can be taken on and off a shared base motor.

Having a base motor or rechargeable toothbrush can deliver enough power on a full charge for a week of brushing, which makes it convenient for travel or when life gets busy. Some toothbrushes include audible signals that let you know when to switch the area of your mouth you’re brushing or when a full two minutes has gone by.

Do you have sensitive teeth? Studies have indicated that people tend to apply more pressure on their teeth when they use a manual toothbrush. This makes an electric toothbrush a preferable option if you’re having issues with sensitive teeth or gums.

There are even electric models with pressure sensors that will stop the brush from spinning when you press too hard against your teeth!

Everyone can benefit from having an electric toothbrush. A large handle size can be taken into consideration if a member of the household is young, or has a physical disability or arthritis. They’re even recommended for children in order to maintain good oral hygiene from a young age.

Biofilm is a term used for plaque or debris that builds up in your mouth. If not properly addressed, this can cause serious bacterial infections to your gums and teeth. If you want to remove biofilm in the most efficient way, an automatic toothbrush is the way to go.

When you're ready to make your decision, make sure to consult with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office to decide which electric toothbrush is right for you!

The community health awareness group Oral Health America has reported that 82 percent of adults are unaware of the role that infectious bacteria can play in tooth decay or cavities, and almost three out of five children aged 12 to 19 have tooth decay. Since June is National Smile Month, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology thought we’d remind our patients about the importance of good oral hygiene visits between office visits.

To keep your family’s smiles healthy and beautiful for years to come, be sure to:

• Brush at least twice a day with fluoride toothpaste
• Floss every day to clean between your teeth
• Eat a healthy, well-balanced diet
• Reduce your intake of sugary foods and drinks
• Visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for scheduled appointments

If you want to know more about healthy home care habits, feel free to ask our team at your next appointment, or ask us on Facebook!

Memorial Day didn't become an official holiday until 1971, but Americans started gathering annually in the spring to remember those who lost their lives in war during the 1860s, right after the Civil War. Celebrated on the last Monday in May, people still decorate the grave sites of war veterans and hold memorial services, but Memorial Day has also evolved into a day that signifies the beginning of summer.

During the summer months, many people take road trips to visit family members. Some head off to the airport to enjoy a long-awaited vacation far away, while others look forward to spending time with friends and family at home. However you spend Memorial Day and the subsequent summer months, there are a few things you can take care of to ensure your summertime is enjoyable.

Checklist for an Enjoyable Summer

• Have the AC Checked. During the hottest days of summer, many families find themselves sweating it out due to a broken air conditioning system. Be proactive so you can avoid waiting for hours or days because the HVAC repair person is booked solid. Have your air conditioning system checked before or around Memorial Day each year.
• Ensure Security While You're Away. When you leave for vacation, the last thing you should have to worry about is the security of your home. Install a home security system, if possible, and put a timer on your lights so they go on and off at normal hours. You can also alert your local police department that you'll be gone, and ask them to drive by your house once in a while to make sure everything is okay.
• Visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants Before Vacation. Many people put off exams until after summer vacation. Avoid the crowds and make sure your physical and oral health are in top shape prior to vacation time so there are no unpleasant surprises.

Our team at Central New England Endodontics and Implantology wants you to look forward to Memorial Day and the days of summer by preparing to spend the time safely and comfortably. As you plan ahead, take care of your health and secure your home, you can place your focus on creating memories with family members and friends while enjoying your favorite Memorial Day traditions.

No one looks forward to dealing with a cracked or fractured tooth, but, fortunately, there are treatments available. Fractures take a variety of forms, from cosmetic annoyance to tooth-threatening, so if you suspect your tooth is injured, it’s important to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants right away.

If you have suffered any kind of serious fracture, we are uniquely equipped to help save your tooth. Endodontists have two or more years of advanced training after dental school, and we specialize in treating the inner tooth, which contains the blood vessels, nerves, and connective tissue found in the pulp chamber and root canals. Endodontists save teeth that would otherwise be automatic candidates for extraction.

When should you call Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants? We identify five types of cracks and fractures, and your options will be different depending on which type of injury your tooth has suffered.

• Crazing fractures

These are the small, shallow cracks that appear over time in the exterior enamel. They are often a cosmetic concern more than a medical one, and usually require no treatment. If the cracks are very bothersome, whitening treatments or even veneers can take care of the problem. If there is any pain in the tooth, it is caused by something other than a surface crack in the outer enamel.

• Cusp fractures

When the cusp of a tooth has broken off, treatment will depend on the degree of damage. The chewing surface of the tooth can be treated by your dentist with a crown or even a filling, depending on the extent of the cusp loss. Cusp fractures rarely extend to the tooth’s pulp, but, if they do, a root canal will probably be necessary. This is a good time for an endodontic evaluation, because endodontists specialize in root canal procedures.

• Cracked Tooth

A crack which begins in the tooth crown and travels toward the root should be treated as soon as possible. If the damage has extended to the pulp, a root canal will be necessary, and a crown will protect the tooth from further damage and help prevent the crack from growing. If the crack is not caught in time and extends below the gumline and into the root, the prognosis for the tooth is much less favorable.

• Vertical Root Fracture

In this type of fracture, a crack begins in the root of the tooth and can gradually spread toward the crown. This is one of the more serious types of tooth fractures, because it can be difficult to detect and often has no immediate symptoms. By the time you feel pain, it might be because the bone and gum tissue surrounding the root have become infected. If the fracture is limited, endodontic surgery can sometimes save the tooth by removing the damaged root, but extraction is often necessary with more serious fractures.

• Split Tooth

This type of fracture goes all the way through the tooth, splitting it into two distinct segments. These sections cannot be put back together, but, depending on the type and location of the break, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may be able to save a portion of the tooth with endodontic surgery.

When you are treated for a broken bone, over time the bone will knit together. A crack in a tooth, however, does not heal. If you have suffered any kind of traumatic dental injury, it’s important to visit our Worcester office as soon as possible. With proper treatment and restoration, even a tooth that has suffered a serious fracture might be saved.

Some foods are just terrible for your teeth — think cookies and candy bars — but there are certain foods that are beneficial to your oral health. Below, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have covered five of the top foods to keep your teeth and gums healthy!

1. Crispy, low-acid fruits and vegetables: Fruits like apples and vegetables such as carrots and celery act like “natural toothbrushes,” helping to clear plaque from your teeth and freshen your breath.

2. Kiwis: These little green superstars are packed with vitamin C which is essential for gum health. The collagen in your gums is strengthened when you consume foods that are high in vitamin C, like kiwis, thus helping to prevent periodontal problems.

3. Raw onions: Onions have long been studied for their antimicrobial, antibacterial, and antioxidant properties. Proliferation of bacteria is what leads to tooth decay and cavities. By including raw onions in your diet, you'll be doing your part to wipe out those little microbes before they can multiply!

4. Shiitake Mushrooms: A specific compound in shiitake mushrooms, lentinan, has been shown to have antibacterial properties that target the microbes that cause cavities while leaving other beneficial bacteria alone. It may also help prevent gingivitis, or inflammation of the gums.

5. Green Tea: Often lauded for its high antioxidant content and many health benefits, it turns out green tea also benefits your oral health! A Japanese study found men who drank green tea on a regular basis had a lower occurrence of periodontal disease compared to men who drank green tea infrequently. It's believed this is due to the catechins in green tea, a type of flavonoid that may help protect you from free radical damage, but more research needs to be done. Either way, drink up for your overall health, as well as your teeth!

If you have any questions about your oral health, or are looking for even more oral health tips, contact our Worcester office!

Summer is almost here, which means a season full of vacations, adventures and great memories is just around the corner for our patients at Central New England Endodontics and Implantology.

Everyone wants a glowing and radiant white smile when the sun comes around and we have a few reminders to keep your pearly whites healthy and beautiful over the summer! Try to stay away from drinks that will stain your teeth like coffee, soft drinks, or dark colored juices. Not only will drinks like this weaken your enamel but they will also darken that fabulous smile you're working on! Another tip is to try and focus on brushing your teeth; everyone knows that when busy schedules start picking up, getting a good brushing session in tends to take the backseat! A good tip for keeping your mouth safe from staining and other possible pitfalls is to rinse your mouth with water after any meal you can’t fully brush your teeth after. Your teeth, inside and out, will benefit!

And remember, whether you are headed to a barbecue, a camping trip, or just having fun in the backyard this summer, we want to hear all about it! Make sure to let us know what you’re up to below or on our Facebook page! We also encourage you to post any photos from your adventures!

When you have a dental health concern about one or more of your teeth, the best option is always to keep your natural teeth! Often, the only alternative to endodontic treatment (also known as root canal treatment) is extraction of the tooth.

That’s followed by implant surgery or the placement of a bridge, and although these are common treatments nowadays, endodontic treatment should be your first consideration.

If you’re told by Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants that you need a root canal or endodontic treatment, you will probably have some questions. We'll try to answer some of them here.

What is endodontic treatment?

The most common type of endodontic treatment performed at our Worcester office is called an apicoectomy. In this procedure, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will surgically open the gum tissue, remove infected or inflamed material from the underlying bone, and remove the tip of the root.

Who needs endodontic treatment?

Usually, endodontic treatment is recommended for patients who have persistent pain or symptoms that can’t be detected by other, non-surgical means such as X-rays or a visual examination. This means typically the tooth has a hairline fracture or a small canal that’s causing discomfort. There are also cases where a patient may have a canal that has become calcified.

Why do I need surgery?

By performing a root canal, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can examine the entire root of the tooth to learn what is causing the discomfort and address it. So it’s not just a treatment but a means of diagnosis too. After the problem has been addressed, you will be able to keep your natural tooth and use it as you always have.

What’s the benefit of root canal treatment as opposed to getting an implant or a bridge?

A root canal allows patients to keep their natural tooth. Nothing comes close to how a natural tooth looks and functions, no matter how advanced implant technology or bridges may become. Often, a tooth that’s undergone a root canal can last patients their entire lifetime without any need for further treatment.

What if I’ve had a root canal but still have pain?

In rare cases, it’s possible that a tooth that has undergone a root canal could become inflamed or infected again. If this is the case, other surgical options may be able to save your tooth.

It's a habit many people have and not only can it be annoying to the people around you, it can be detrimental to your dental health. Chewing ice is so common that it even has its own name, pagophagia. We're not talking about a slushy or shaved ice (although those artificially sugary treats should be avoided too!) but more like the hunks of ice rattling around in the bottom of your glass.

Ice chewing can be a sign of emotional problems like stress or obsessive-compulsive disorder, but it can also be a marker for iron deficiency anemia and other physical problems. Then again, some people just like to have something to chew on. For whatever reason you find yourself chewing on it, it's a habit you need to break.

Chewing on ice can cause:

• Chipped and cracked teeth
• Damaged enamel
• Sore jaw muscles
• Damage to dental work such as crowns, fillings, or other appliances

If chewing on ice is becoming a problem in your life, don’t hesitate to speak with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about it. But if you find yourself still wanting to chew on something, here are a few alternatives to ice:

• Baby carrots
• Celery sticks
• Sugar-free (xylitol) gum

We know you need to chill sometimes, but chomping down your entire glass of ice is not the way to do it. If you have any other questions on the topic, feel free to talk with a member of our Worcester team. It may be beneficial in solving the issue and helping to remediate any damage to your teeth.

What is oral cancer?

April is Oral Cancer Awareness Month. If you have been putting off a visit to our Worcester office, now is an excellent time to schedule one. Regular visits to Central New England Endodontics and Implantology can be the first line of defense against oral cancer, by identifying early warning signs of the disease, or helping you with preventive care tips to lower your chances of developing it.

Oral Cancer Rates in America

Nearly 40,000 people in the U.S. will be diagnosed with oral cancer this year, and more than 8,000 die every year from this disease. It is a devastating illness: most people who are diagnosed with it do not live more than five years beyond their diagnosis. Oral cancer has a higher death rate than many other common cancers, including cervical cancer, testicular cancer, Hodgkin’s lymphoma, and thyroid or skin cancers. The high death rate results from the fact that most oral cancers go undiagnosed until the disease is well advanced and has spread to another part of the body—most often, the lymph nodes in the neck.

What causes oral cancer?

While there is no way to predict exactly which individuals will get oral cancer, there are some potential causes you should know about—because in some cases, you can minimize these risk factors.

• Age (most patients diagnosed with oral cancer are over the age of 40)
• Tobacco use, either from cigarettes or smokeless chewing tobacco
• Excessive alcohol consumption (especially in combination with tobacco use)
• Persistent viral infections, such as HPV16
• A diet low in fruits and vegetables

In addition, oral cancer tends to occur at a rate six times greater in men than in women, and more often for African Americans than other ethnic groups. No genetic links have been identified to explain the higher incidence in these populations, so lifestyle choices remain the likeliest cause.

Oral Cancer Treatments

Once a diagnosis has been made, treatment of oral cancer usually involves a multi-disciplinary team that includes surgeons, oncologists, dentists, nutritionists, and rehabilitation and restorative specialists. Our team will decide on the best approach for each patient, depending on the risk factors and how far the cancer has progressed. The strategy will be different in every case. Some of the most common methods include chemotherapy, radiation, and potential surgery.

Finding out you have cancer can be devastating news. If you are concerned that you might be at risk for developing oral cancer, talk to us about screenings and other things you can do to reduce your risk.

By no stretch is it rare for your gums to hurt during and after flossing. Even some bleeding is to be expected. This is especially true if you have not flossed in a long time. However, if your gums do indeed hurt when you floss, and unbearably so, there are some things you can do.

Be Gentle

Perhaps the most obvious way to combat gum soreness and bleeding is to be gentle. One of the most common occurrences of these gum problems is over-aggressive flossing. In other words, if you are too rough on your gums while flossing, either because you are out of practice or because you are in a hurry, soreness and hurting is to be expected. Instead, try taking your time and be gentle. Also, if you are just starting out, be patient and consistent, your gums will become more conditioned over time.

Use an Alternative Method

If being consistent and gentle does not work, there are other alternative methods of flossing that you can try. You can also try a water floss machine, or what is sometimes called a water pick. The device essentially shoots water into the crevasses between your teeth, and in other areas of your mouth, in order to dislodge food and plaque. These oral instruments also come with different attachments that allow you to reach many of the hard to see and reach areas of your mouth. And lastly, you can always buy floss that is not as abrasive to your gums. There is floss that comes with soft and gentle coatings that will do less harm to your gums while they are adjusting to the good oral hygiene habit you are creating.

Flossing is one of the easiest parts of oral hygiene to overlook. When you first start out, it is common that you may want to stop because of the pain it can initially cause. However, if you try one, or all, of the above mentioned methods, you will give yourself the best chance of being success with your flossing, and it won't hurt as much.

For more flossing tips, schedule an appointment at our Worcester office and askDrs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or a member of our team!

Although teeth are strong enough to tear through food, they are also fragile. An accident such as a fall may loosen teeth or knock a tooth out entirely. When a child loses a baby tooth in this manner, no permanent damage is usually done. However, adults who loosen permanent teeth may need to visit our Worcester office.

The Anatomy of a Loose Tooth

The hard external layer of teeth covers a more vulnerable interior. The center of a tooth consists of the pulp, which contains blood vessels and nerves. The entire tooth extends below the surface of the gums into the jaw. Special tissue called cementum and the periodontal ligament hold teeth in place, preventing them from moving.

When a fall or blow to the face loosens a tooth, the tissues anchoring a tooth to the jaw may be damaged. This results in a loosened tooth that wiggles in place. There may be inflammation or bleeding of the gums, which signals dental damage.

Dental Treatments for a Loose Tooth

The range of dental treatments for loose teeth varies by the severity of the problem. If your teeth are just slightly loose following a fall, it may be fine to wait a few days. Teeth often retighten on their own. Simply avoid chewing with that tooth and enjoy softer foods for a few days.

If a tooth is very loose or nearly falling out, call Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants immediately. Immediate placement of the tooth back into the socket is needed to ensure its survival. In general, a tooth must return to its socket within two hours or it may be lost.

In some cases, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may recommend splinting, in which teeth are joined together to strengthen them and reduce strain on an individual tooth. Tightening or straightening the tooth can restore your ability to chew regularly without stressing the loosened tooth.

Regardless of the extent of the problem, it is essential to keep the tooth clean to prevent decay. Brush carefully with a soft-bristled brush, and use mouthwash regularly to kill bacteria.

On March 17, everyone has a little Irish in them. St. Patrick’s Day is a joyous celebration of Irish heritage. The holiday originated as a commemoration of Saint Patrick, who brought Christianity to Ireland. The saint arrived in Ireland in 432 and earned the reputation of a champion of Irish Christianity. March 17th, the day of St. Patrick’s death, has been commemorated by the Irish for over 1,000 years. St. Patrick’s Day is still observed as a religious feast day by several Christian denominations, but it is better known in the public imagination as a rich celebration of Irish culture.

St. Patrick’s Day has been an official public holiday in Ireland since 1903. Each year, the Irish celebrate with a several-day festival that includes theater performances, music, fireworks, and festive parades. The celebration is also a public holiday in Northern Ireland, Montserrat, and Newfoundland and Labrador. In other parts of the world with heavy Irish populations, it is an unofficial celebration of Irish heritage. Parts of Great Britain, Canada, Argentina, South Korea, Switzerland, New Zealand, the United States, and Australia commemorate the holiday each year. Typical celebrations in these countries include drinking green beer, wearing green, eating traditional Irish foods, parades, and shamrock decorations.

Many people, Irish and non-Irish alike, take part in the “wearing of the green” on St. Patrick’s Day. In fact, the color originally associated with Saint Patrick was blue. His use of shamrocks to explain the Holy Trinity to the Irish made the green clover emblematic of the holiday, leading to the traditional green attire worn by thousands on St. Patrick’s Day. Other little-known facts about St. Patrick’s Day include the following:

• Each year, the United States and Ireland face off in a rugby competition called the “St. Patrick’s Day Test.”
• Montreal celebrates the holiday with an annual parade, which has been held each year since 1824. The Montreal city flag even features a shamrock in its corner, as a nod to its Irish heritage.
• The Guinness World Records named St. Patrick’s Day the “Friendliest Day of the Year.”
• Along with Valentine’s Day, St. Patrick’s Day is one of the most widely celebrated saint’s day in the world.

No matter your cultural heritage, St. Patrick’s Day is a great time to let loose and celebrate your inner Irish-ness! Don your greenest attire and exclaim “Erin go Bragh!” (Ireland forever!) to everyone you meet. From Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants - have a great St. Paddy’s day!

Every tooth packs a lot of layers in a very small area. The outer, visible part of our tooth, the crown, is covered in protective enamel, and the lower root area is protected by a similar substance called cementum. Inside these very hard layers is dentin, a hard but more porous tissue which surrounds the pulp. In this central pulp chamber, we have the blood vessels which nourish the tooth and the nerves which send our bodies signals from the tooth. And if one of those signals is persistent tooth pain, you may need a procedure called a root canal.

There are a number of reasons that a tooth may cause you pain, including:

• Fracture—a cracked or broken tooth can allow bacteria to enter the pulp chamber and cause inflammation and infection
• Cavity—an untreated cavity can leave an opening where bacteria can reach the pulp of the tooth, and again lead to infection
• Gum Disease—bacteria can attack from the root area of the tooth if gum disease has become serious
• Injury—an accident or injury to a tooth can damage the nerve or the blood supply which nourishes the pulp
• Abscess—if infection is left untreated, an abscess may form under the root

While a damaged tooth may sometimes be symptom-free, usually there are signs that the pulp has been injured or infected. What symptoms should lead you to give Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants a call?

• Persistent pain in the tooth
• Long-lasting sensitivity to heat or cold
• Gum tissue adjacent to the tooth that is sore, red or swollen
• A cracked, broke, darkened or discolored tooth
• A bump on your gums that persists or keeps recurring—this might indicate an abscess

A root canal is performed by a trained dentist or endodontist. After an anesthetic is used to numb the area, the damaged tissue, including pulp, blood vessels and nerves, is removed from the pulp chamber and each root. The inside of the tooth is then cleaned and shaped, and filled and sealed with a temporary filling. The tooth is filled again permanently, usually on a second visit, and might require a crown in order to protect it from further damage.

The most painful part of a root canal is far more often the time spent suffering before the procedure than the procedure itself. Delaying action when a root canal is necessary can lead to infection, abscess, and even tooth loss. If you experience any of the symptoms mentioned above, please give our Worcester office a call!

Endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, are dentists who specialize in the treatment of the inside of the tooth. The type of treatment an endodontist performs is designed to go deep into the tooth where the infection or inflammation resides, and to remove that tissue to alleviate pain. Obvious signs that you need to seek endodontic treatment include pain, swelling, and tenderness in the area around the gum, bone, lymph nodes, or elsewhere on the face. Tenderness to the tooth area, discomfort and sensitivity to hot and cold, chewing, and tooth discoloration are also indications that you should seek endodontic treatment.

Reasons to Seek Endodontic Treatment

Endodontic treatment (a root canal) is necessary when the pulp within the tooth becomes inflamed or infected. Many factors can contribute to the infection or inflammation, including cracked or chipped teeth, deep decay, and even repeated treatment (such as the replacement of fillings). Teeth can also incur pulp damage from injuries that don't cause visible damage to the tooth. Without treatment, an inflammation or infection can turn into an abscess.

What is a root canal?

A root canal allows Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to literally get to the "root" of the problem and treat it. A hole is drilled to allow access to the pulp within the tooth. The pulp and any infected and/or inflamed tissue are removed. The exposed area is then thoroughly cleaned. At this point, the open canal is filled with gutta-percha, which is cemented to the canal with adhesive. The hole is then covered with a temporary crown that is removed once the permanent crown, which is typically made of porcelain and metal, is installed. The tooth then functions normally.

Other Types of Endodontic Treatment

Other types of treatment that endodontists perform to save teeth include an apicoectomy. In this procedure, the gum is opened near the tooth to allow the endodontist to explore the area near the bone. Any impacted tissue, either inflamed or infected, is then removed. The end of the root is also removed. The rest of the procedure involves cleaning the area, packing it with protective material, and then covering the tooth with a permanent crown.

Endodontists also perform procedures on abscessed teeth. An abscess contains pus and/or other infected material. It usually occurs when an infected or inflamed tooth pulp isn't treated. Sometimes, the absence of pain or other symptoms prevents a patient from knowing they have an infection or inflammation. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will remove the infected area and perform a procedure much like the root canal, and patients recover quickly.

At Central New England Endodontics and Implantology, it's our goal to help you sustain excellent oral health so that you can keep all of your natural teeth! Our Worcester office staff is always here to answer all of your questions and help you feel comfortable about your endodontic treatment.

Tooth decay affects everyone, with studies reporting that 92% of adults have had a cavity at one point in their lifetime. In more serious instances of tooth decay, however, the nerve of the tooth may become infected. This type of infection requires a root canal, in which the affected nerve is removed, and the interior of the tooth is cleaned and filled.

Tooth Anatomy

Although each tooth is covered by a hard outer shell, the interior of a tooth consists of dental pulp. This pulp is soft, containing blood vessels that bring nutrients to the tooth. Each tooth also has an associated nerve, which resides within a root canal passing from the tooth’s root into the dental pulp. This nerve provides information about temperature, allowing teeth to sense heat or cold.

Symptoms of Nerve Infection

Damage to the dental pulp or nerve tissue leads to a rapid multiplication of bacteria within the interior of the tooth. The result may be an abscess, a small pocket near the root of the tooth that becomes full of pus. This infected area commonly causes the following symptoms:

• Intense pain or sensitivity when pressure is applied to the tooth
• Sensitivity to hot or cold temperatures, even after the heat or cold has been removed
• Darkening or discoloration of the affected tooth
• A small, persistent pimple that forms on the gums
• Swollen or tender gums
• Swelling in other areas of the face, neck, or head

Nerve infection may occur due to deep decay, although repeated dental procedures, facial trauma, chipping or cracking of a tooth, or large fillings may also contribute to an abscessed tooth.

What to Do if You Think You Need a Root Canal

Only a visit to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can confirm whether a tooth’s nerve has become infected. We will perform an oral examination and X-rays to confirm whether the tooth is abscessed. If a root canal procedure is needed, a small hole will be placed in the tooth. The pulp and nerve tissue are removed from the tooth, which is thoroughly cleaned and filled. Then, the hole is sealed with a special compound to prevent bacteria from entering the tooth’s interior. The entire procedure is performed under local anesthesia to numb pain.

If you think you may have tooth or nerve decay, call our Worcester office today to schedule a diagnostic appointment.

Did you know the actions leading to the beginnings of Valentine's Day were actually centered on the avoidance of war? A Catholic priest named Valentine defied the orders of the Emperor Claudius II and secretly married young men and their brides after the emperor had declared it illegal because only single, young men could be sent to war. Rather than lose potential soldiers to fight his war, Claudius attempted to hoard them by proclaiming marriage illegal.

Valentine continued to marry young couples anyway and, eventually, was put to death for it in 270 AD. Before his death, he sent a letter to a secret love and signed it “From your Valentine”. Nearly 1,800 years later, people are still signing letters and cards in this manner. This year, carry on the tradition started long ago, while adding your own twist. Here are a few suggestions.

Simple and Creative Valentine's Day Ideas

• Memorialize it with a Photo. Couples often have photos taken around Christmas, but Valentine's Day photos allow you to capitalize on romance. Famous couple Julia Child and her husband, Paul, had their picture taken together every Valentine's Day and included their sense of humor with silly props.
• Return to Your First Date Location. Even if your first date together was at a local hotdog stand, its sentimental value can make it a fun part of your Valentine's Day agenda. Be creative and make a treasure hunt with clues that lead your partner to the original date location, where you can express your love with flowers or a gift.
• “From Your Valentine” Messages. Deliver your message in a creative way to make this Valentine's Day stand out from the others. Bake your partner's favorite treat and write a message on it with a tube of icing, or draw a note on the steamed up mirror so it shows up when your partner takes a shower.

Although Valentine's Day is a day to celebrate love, it doesn't have to be a special day only for couples. If you're single, use this special day to shower yourself with love, because you're worth it! After all, the priest Valentine believed so strongly in the sanctity of love that he was willing to risk his life for it. Whether you're in a relationship or single, young or old, romantic or not, Valentine's Day is for you. Happy Valentine’s Day from the dental office of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

The American Academy of Periodontology stresses the importance of good oral health since gum disease may be linked to heart disease and stroke. Thus far, no cause-and-effect relationship has been established, but there are multiple theories to explain the link between heart disease and periodontal disease. One theory suggests that oral bacteria may affect heart health when it enters the blood and attaches to the fatty plaque in the heart's blood vessels. This can cause the formation of blood clots. Another theory suggests the possibility that inflammation could be a contributing link between periodontal disease and heart disease. Gum disease increases plaque buildup, and inflamed gums may also contribute to the development of swollen or inflamed coronary arteries.

What is coronary artery disease?

Coronary artery disease is caused in part by the buildup of fatty proteins on the walls of the coronary arteries. Blood clots cut off blood flow, preventing oxygen and nutrients from getting to the heart. Both blood clots and the buildup of fatty proteins (also called plaque) on the walls of the coronary arteries may lead to a heart attack. Moreover, periodontal disease nearly doubles the likelihood that someone will suffer from coronary artery disease. Periodontal disease can also worsen existing heart conditions, so many patients who suffer from heart disease need to take antibiotics before any dental procedures. This is especially true of patients who are at greatest risk for contracting infective endocarditis (inflammation of the inner layer of the heart). The fact that more than 2,400 people die from heart disease each day makes it a major public health issue. It is also the leading killer of both men and women in the United States today.

What is periodontal disease?

Periodontal disease is a chronic inflammatory disease that destroys the bone and gum tissues around the teeth, reducing or potentially eradicating the system that supports your teeth. It affects roughly 75 percent of Americans, and is the leading cause of adult tooth loss. People who suffer from periodontal disease may notice that their gums swell and/or bleed when they brush their teeth.

Although there is no definitive proof to support the theory that oral bacteria affects the heart, it is widely acknowledged better oral health contributes to overall better health. When people take good care of their teeth, get thorough exams, and a professional cleaning twice a year, the buildup of plaque on the teeth is lessened. A healthy, well-balanced diet will also contribute to better oral and heart health. There is a lot of truth to the saying "you are what you eat." If you have any questions about you periodontal disease and your overall health, give our Worcester office a call!

Here is some surprising yet worthwhile advice you might be hearing for the first time: Brushing after a meal can be incredibly bad for your teeth if you do it after eating certain foods.

Enamel is an extremely hard mineral on the exterior of each of your teeth. It’s actually the hardest substance in the human body: It’s even stronger than your bones! Its only weakness is that acids in the food we eat can easily destroy enamel.

Healthy teeth thrive in an environment that has the proper pH balance. That ensures your mouth doesn’t start the process of demineralization. That’s what happens when alkaline turns into acid, which attacks and softens the enamel on the surface of your teeth. Pores and fissures form, and that’s when the harmful bacteria go to work.

Our mouth’s pH level fluctuates depending on what we eat throughout the day. Examples of the most common highly acidic foods include citrus fruits, soda, and sugary foods. Highly acidic foods tip the balance of pH in your mouth from a healthy alkaline to a dangerous acid.

Can brushing your teeth immediately after a meal lead to even more damage? The answer is yes!

Eating highly acidic foods causes your teeth to be more susceptible. If you brush your teeth when they have been weakened by acids, even more destruction can happen to your enamel. Your toothbrush’s bristles will actually wear away some of your enamel. So it’s healthier to wait at least an hour after eating or snacking to brush.

Good preventive measures to take instead of brushing after you eat include:

• Rinsing or drinking water
• Chewing sugarless gum
• Consuming dairy or non-acidic foods to conclude your meal

These practices help produce saliva, which in turn restores a healthy pH level in your mouth and coats the teeth with minerals they need.

Once you’ve allowed time for your mouth to be restored to a healthy pH level, you may brush your teeth as you normally would. Keep in mind that acidic foods can weaken the enamel on your teeth and take the right measures to prevent spiking pH levels.

Most important, don’t forget to wait to brush at least one hour after you eat!

Still have questions? Call our Worcester office and schedule an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

Your first endodontic appointment at our Worcester office establishes an essential foundation between you, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, and our endodontic staff. It involves completing paperwork, discussing your condition, and may include treatment.

Paperwork

The first visit begins with obtaining important contact, insurance, and medical history information. There is paperwork to complete in the form of a medical history, and various consent forms. In addition, we ask that you bring a list of all the medications you take on a regular basis, whether prescriptions or over-the-counter, you are taking with you. Further, if you have a referral document or X-rays that your primary dentist gave to you, please bring them with you as well.

Meet with Assistant

Once all the required paperwork is completed, you’ll meet with an assistant who will ask you about your pain and dental issue that prompted a visit to us. The assistant will take a set of X-rays for the endodontist to review.

Meet with the Endodontist

After the x-rays are complete, your endodontist will review them with you, in addition to talking to you about your symptoms. The endodontist will test the affected tooth or teeth, along with adjacent teeth. This will often include mild tapping which patients tolerate well.

Once all of the testing is done, your endodontist will make a diagnosis, and discuss the treatment options with you. These may include a root canal and a crown to protect the treated tooth. As with any treatment, your endodontist will discuss the benefits and risks along with each option.

The goal of endodontics treatment is to:

• Relieve your pain
• Save your tooth
• Protect surrounding teeth and gums from further damage

Endodontic Treatment

If you decide to receive the endodontic treatments, in many cases, the treatment is started that same day. However, prior to beginning the treatment, a local anesthesia is applied to numb your tooth, gums, and nerves to any painful sensations you might otherwise feel without local anesthesia.

While a root canal, which is a common endodontic procedure, has received a bad rap for being extremely painful, the reality is that with modern dental technology and medications, most patients report no significant discomfort during a root canal.

In order to determine the results of the treatment, further X-rays will be taken once the treatment is complete. You will receive post-endodontics treatment instructions and you learn what you might feel or see in your treated area over the next several days to a week. This may include tooth sensitivity and mild swelling in the gums and jaw.

Patients are typically able to drive after their procedure, and go back to work, or resume regular activities immediately following their endodontic treatment.

Most people hear the word root canal and panic. With today’s state of the art equipment and improved local anesthetic devices, and some knowledge, a root canal does not have to cause panic. Root canals are a common dental procedure, done quite often at our Worcester office.

Why do I need a root canal?

There are several reasons why Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may suggest a root canal including:

• An infection in your tooth that has reached the nerves
• A deep cavity that cannot be filled because the pulp and nerves are also effected
• Injury to the tooth
• A deep cracked tooth
• Broken tooth
• Repeated fillings of the effective tooth

What is a root canal?

A root canal is a dental procedure that is used to prevent the loss of a tooth and relieve pain. Inside your teeth is pulp which consists of soft tissue blood, connective tissue, blood vessels, and nerves. When the pulp becomes infected, swollen or diseased a root canal is necessary to save your tooth. During a root canal, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will remove the infected pulp. The tooth’s root canals and pulp chamber of your tooth will be cleaned, so all the diseased pulp is removed and then your tooth will be sealed.

What to Expect During a Root Canal

Your root canal will start out just like any other dental procedure. We will go over any questions you may have, and then numb the area surrounding the tooth. After the area is numb the root canal will begin.

The amount of time it takes to do your root canal varies depending on number of roots that need to be cleaned. Most teeth have one root canal, while others have between two and four. For a single canal, the procedure usually lasts less than an hour. The more canals your tooth has the longer amount of time it will take and in some cases, you will require more than one visit.

How much pain will I have after a root canal?

Once the local anesthesia wears off, your pain can be controlled by over the counter pain medications such as Ibuprofen, Naproxen, or Acetaminophen. In some cases, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may prescribe a prescription dose of pain medication. Within two days you should be feeling much better and able to return to your regular lifestyle.

Five words no one welcomes: “You need a root canal.” But if you are delaying treatment because you are worried about pain and an uncomfortable day in the dentist’s chair, please think again! Modern root canal procedures are designed to repair your damaged tooth gently and efficiently, and leave you with a restored natural tooth that can last a lifetime.

• Why might you need a root canal?

First, a little tooth biology. Each tooth has a crown (the part we see above the gums) and one or more roots (the part of our tooth below the gum line that is attached to bone in our jaw). The tooth has three basic layers: the hard enamel and cementum that cover the outer crown and root, the softer dentin beneath that layer, and, on the inside, the pulp. Pulp is made of living tissue, and contains the blood vessels and nerves that nourish the tooth and keep it vital.

Even with the protection the enamel and dentin provide, sometimes the pulp can be infected or damaged. If you have suffered an injury to your mouth or jaw, or an infection has developed from an opening in the tooth caused by a deep cavity or crack, you may need a root canal to prevent further infection, pain, and even tooth loss. Call our Worcester office immediately if you feel pain with chewing or pressure, prolonged sensitivity to heat or cold, swollen, and tender gums around a tooth, or tooth discoloration.

• The Root Canal Procedure

If a root canal is necessary, the procedure is very straightforward. After the area around the tooth is numbed, we will make an opening in the crown to allow access to the pulp inside. Very small instruments will be used to clean the inner tooth and removed bacteria and dead or dying tissue. The area will be thoroughly disinfected, and the inside of the tooth shaped and then filled and sealed. A temporary filling or crown might be placed on the tooth to prevent bacteria and food from entering the site if a permanent crown needs to be created. The entire process usually takes from one to three visits.

If we suggest a root canal, it is because this is the best way to save your tooth. Please feel free to talk to us about your particular needs and concerns. Which tooth is affected, how many roots are involved, what type of filling or crown might be best—we will work with you to provide all the information you need and all the options you have available.

Common Concerns

• Are you concerned about pain?

The most painful part of a root canal is often the severe discomfort your tooth causes before treatment. And infections and damaged nerves can affect not only the injured tooth, but the gums, tissue and even bone surrounding it. With our modern dental techniques, a root canal procedure is often no more uncomfortable than a regular filling. The local anesthetic we use will prevent you from feeling any pain during the procedure, and, while the area around your tooth might be a bit sensitive following treatment, the pain caused by the infection or injury should be gone.

• Are you anxious about the procedure?

If dental treatment causes you anxiety, please let us know. There are several sedation options we can pursue to make this procedure less worrisome. Our goal is to make your treatment as gentle and comfortable as possible.

No one welcomes the news that a root canal is necessary, but with today’s procedures, this treatment can be just what you need to relieve your pain and keep your natural tooth where it belongs for many years to come. And that is welcome news, indeed!

If you have a hard time understanding your dental insurance plan, particularly the treatments and services it covers, you’re not alone. That’s why Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have put together a cheat sheet to help you through them.

It’s common for patients to get lost in the morass of the terms and phrases that surface when you’re dealing with a dental insurance plan. Knowing the commonly used terms can help speed up the process and enable you to get the most out of your coverage.

Common Terms

Annual Maximum: The most your policy will pay per year for care at Central New England Endodontics and Implantology. It is often divided into cost per individual or per family.

Co-payment: Typically, a small amount the patient has to pay at the time of service before receiving care, and before the insurance pays for any portion of it.

Covered Services: A list of all the treatments, services, and procedures the insurance policy will cover fully under your contract.

Deductible: An amount you must pay out of pocket each year before the insurance company will contribute for any treatments or procedures. The amount can vary according to your plan.

Diagnostic Services: A category of treatments or procedures that most insurance plans will cover before the deductible, which may mean services that occur during preventive appointments with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, including X-rays or general screenings.

Exclusions: Dental services not covered under a dental benefit program.

In-Network: An insurance company will usually cover a larger portion of the cost of the care if you see an in-network provider for treatment.

Out-of-Network: If you visit someone who is not a part of your provider’s network, the insurance company may pay for a portion of the care, but you will be responsible for a significantly larger share out of your pocket.

Lifetime Maximum: The most that an insurance plan will pay toward care for an individual or family over the entire life of the patient(s).

Limitations: A list of all the procedures the insurance policy does not cover. Coverage may limit the timing or frequency of a specific treatment or procedure, or exclude some treatments altogether.

Member/Insured/Covered Person/Beneficiary/Enrollee:  A person who is eligible to receive benefits under an insurance plan.

Premium: The regular fee charged by third-party insurers and used to fund the dental plan.

Provider: Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or other oral-health specialist who provides treatment.

Waiting Period: A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments.

It’s essential to understand the various insurance options available to you. Knowing what your insurance covers can save you major costs in the future.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our dental staff hope this list of terms will help you understand your dental insurance plan better. Be sure to review your plan and ask any questions you may have about your policy the next time you visit our Worcester office.

Fortunately, most of our dental work is fairly straightforward. You have an exam and a cleaning, or a cavity gets filled, or a crown might be used to protect a fragile tooth. But sometimes, a more complex dental problem affects one of your molars. In this case, it could be the right time to call in an endodontist like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants—a dental professional skilled in saving at-risk teeth.

Endodontists have two or more years of specialized training in the diagnosis and treatment of the inner tooth and the tissue surrounding it. An endodontist has the knowledge and experience to treat complex molar issues, and modern endodontics provides a number of options to protect the health and appearance of your natural teeth even when they have suffered an injury.

The inside of each tooth contains the vital (living) pulp, which includes blood vessels, nerves, and connective tissue. Once the pulp has suffered injury or infection, a root canal is almost always necessary to save the tooth. The bone and connective tissue surrounding the tooth can also suffer trauma or infection.

In the case of serious molar trauma or infection that goes beyond root canal treatment, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants might be able to save part or even most of your tooth with endodontic surgery. Two of the surgical procedures which can save such a molar are hemisection and bicuspidization.

When might an endodontist consider hemisection or bicuspidization?

• A root canal is a common endodontic procedure in which the damaged pulp is removed, and the tooth is cleaned, shaped, and sealed. Sometimes, though, an infection persists. In this case, part of the tooth might be removed to save the remaining natural tooth.
• When a traumatic vertical fracture occurs, a tooth is split from top to bottom. Depending on the location of the fracture, part of the tooth may be saved with surgical intervention.
• Serious decay or injury can damage a limited area of the tooth, while leaving another part of the tooth intact. Surgery can save the healthy part of the tooth.
• When periodontitis (serious gum disease) attacks the bone around the roots, severe bone loss can take place between the roots or around a single root. Surgery might be necessary to repair the damage.

In each of these procedures, the goal of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is to preserve as much of your molar as possible. How is this done?

• Hemisection

In a hemisection, the injured tooth is split into two parts, and the part of the crown and the root that cannot be restored are removed. The remaining healthy crown area and root will be cleaned and treated, and a temporary crown will be put in place to protect the tooth. A permanent crown will then be designed to custom-fit the tooth.

• Bicuspidization

In this procedure, the damaged tooth is separated into two parts, each with a crown section and a root. The divided portions are cleaned and shaped, and temporary crowns will protect each section. A custom crown or crowns will be needed to cover and protect each segment of the tooth.

Why should you consider a hemisection or a bicuspidization? These procedures are alternatives to tooth extraction, and allow Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to preserve as much of your natural tooth as possible. While an implant or a bridge is certainly an option, we always prefer saving your natural teeth. If your dental problem involves the inner tooth or the tissue around it, ask us about your treatment options when you visit our Worcester office. It’s not only worth your while—it’s worth your smile!

What Is an endodontist?

If you have been to the dentist lately, you may have been directed to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for additional care. You may be asking, “What exactly is an endodontist?” The answer is pretty simple: An endodontist is a dental specialist who has completed two or more extra years of specialty training in endodontics (which is the field of dentistry that focuses on root canals), as well as the four basic years of dental school. Put simply, an endodontist is a root canal specialist. If you have been referred to an endodontist, you are probably in need of special root canal treatment.

What exactly does an endodontist do?

An endodontist is able to perform all kinds of root canal therapy. Because of their extensive training, endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, can do routine root canals, complex root canals, retreatments, endodontic surgery, and more. Endodontists concentrate on these types of treatments, and therefore possess extensive experience performing root canals and other root procedures.

What are the benefits of seeing an endodontist?

While many regular dentists are capable of performing root canals, there are added benefits to seeing an endodontist when you have root problems with your teeth. The endodontist can give you more precise, specialized care, which typically means less pain and stronger teeth in the future. Some of the many benefits of seeing an endodontist include:

• Advanced anesthesia: If you are nervous about experiencing pain during your root canal, most endodontists offer more advanced forms of anesthesia than regular dentists. Whether it is general or local anesthesia, an endodontist can ensure your comfort during the procedure.
• Cosmetics: Endodontists can generally help you avoid an extraction and save your natural tooth. Fake teeth can be painful and costly, and sometimes less attractive. If you are interested in saving your natural teeth, an endodontist can help.
• Comfort after the procedure: Because of the advanced methods used by endodontists, the recovery time for your root canal will most likely be shorter and less painful than if you had received the same treatment from a general dentistry practice.
• Better long-term results: Seeing an endodontist can help you prevent future problems. Because of the precise care that an endodontist puts into root canal treatment, you are less likely to experience the same problems with that tooth in the future.

In terms of time, money, and comfort, there are many benefits to seeing an endodontist. If you are in need of a root canal, consider calling our Worcester office to schedule an appointment. We're looking forward to answering all of your questions and helping you achieve your optimal oral health here at Central New England Endodontics and Implantology!

Convertible or sedan? Downtown or suburbs? Electric or manual toothbrush? As life decisions go, it’s certainly not choosing your next car, or deciding where you want to live. But, even when you are selecting a toothbrush, it helps to make a list of the pros and cons of the contenders before you make that final selection.

• Efficiency

The most important factor in choosing a toothbrush is finding out which model works best to eliminate bacteria and plaque. And studies have shown that, used properly, both electric and manual toothbrushes do a great job of removing plaque. Some electric models can reach the backs of teeth and the gumline more easily, some manual head designs work better for your individual mouth and teeth, so your particular needs should dictate which style of toothbrush you use. Talk to us about the best methods to brush with your preferred toothbrush, and we’ll let you know if one type of toothbrush or the other might work better for you.

• Health Considerations

Brushing too energetically can actually harm teeth and gums, causing sensitivity and damage to the enamel and gum tissue. An electric toothbrush should provide a continuous brushing motion without needing any pressure from the brusher. This might be the model for you if you have a too-vigorous approach to brushing, or sensitive teeth and gums.

An electric toothbrush can also be more efficient for older and younger brushers, those with limited mobility, and those with health conditions or injuries that make brushing with a regular toothbrush more difficult.

• Cost

An electric toothbrush is not a one-time investment. You should change the removable head as often as you change your manual toothbrush (every three to four months, please). But this cost is offset if an electric toothbrush is more efficient in removing your plaque, easier to use, or even if you just prefer it to manual brushing. If you find that you brush better and more often with an electric toothbrush, the added expense is well worth it.

Whichever brush you decide on, the most important part of the brush is the person holding it! A regular appointment with your toothbrush for two minutes of thorough brushing in the morning and two in the evening, daily flossing, and regular visits to our office for checkups and cleanings will keep your teeth healthy and strong no matter which toothbrush you choose.

Questions about your toothbrush choices? Don’t hesitate to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office.

At Central New England Endodontics and Implantology we love learning trivia and interesting facts about Thanksgiving! This year, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants wanted to share some trivia that might help you feel a bit smarter at the holiday dinner table and help create some great conversation with friends and family.

The Turkey

There is no historical evidence that turkey was eaten at the first Thanksgiving dinner. It was a three-day party shared by the Wamponoag Indians and the pilgrims in 1621. Historians say they likely ate venison and seafood.

According to National Geographic, the dinner at the Plymouth colony was in October and included about 50 English colonists and 90 American Indian men. The first Thanksgiving dinner could have included corn, geese, and pumpkin.

Today, turkey is the meat of choice. According to the National Turkey Association, about 690 million pounds of turkey are consumed during Thanksgiving, or about 46 million turkeys.

The Side Dishes

The green bean casserole became popular about 50 years ago. Created by the Campbell Soup Company, it remains a popular side dish. According to Campbell’s, it was developed when the company was creating an annual holiday cookbook. The company now sells about $20 million worth of cream of mushroom soup each year, which is a major part of the recipe.

While there were likely plenty of cranberries for the pilgrims and Indians to enjoy, sugar was a luxury. What we know today as cranberry sauce was not around in those early Thanksgiving days. About 750 million pounds of cranberries are produced each year in the US, with about 30 percent consumed on Thanksgiving.

The Parade

Since Thanksgiving did not become a national holiday until Lincoln declared it in 1863, the annual parades were not yearly events until much later. The biggest parade that continues to draw crowds is the Macy's Thanksgiving Day Parade. Beginning in 1924 with about 400 employees, they marched from Convent Avenue to 145th Street in New York City. Famous for the huge hot-air balloons today, it was actually live animals borrowed from the Central Park Zoo that were the stars of the show then.

However you choose to spend your Thanksgiving holiday, we wish you a safe, happy and healthy holiday with those you love.

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria that don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gum line, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gum line.
• Floss to remove plaque from between the teeth and near the gum line.
• See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to your dentist about the best way to keep plaque at bay. And if deep cavities or damage to the roots or the bone surrounding them have put you at risk for tooth loss, call Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office. Endodontists are specialists in saving teeth when the health of a tooth’s pulp or roots is compromised.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

Whether it’s a constant ache when you chew food or a sharp, jolting pain every time you bite down, if bite pain has you considering a permanent liquid diet, a trip to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is definitely in order!

What causes bite pain? You might feel an ache because of a cavity, a loose filling, bruxism (grinding the teeth) or a malocclusion (bad bite). Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will be able to help you get to the root of this type of tooth pain and provide treatment that will leave you smiling again.

But sometimes, pain is caused by damage or infection located in the inner chamber of the tooth. In this case, pain caused by biting or pressure on the tooth might indicate:

• Pulp Infection

The pulp of a tooth contains blood vessels, nerves, and connective tissue. Because it is composed of living tissue, pulp can be subject to injury, inflammation, and infection. If bacterial infection sets in, the pulp will need to be removed and the site cleaned, shaped, and filled. This is something that should not be postponed, because without treatment infection can spread to the surrounding bone and tissue.

• An Abscess

An abscess forms when pus collects into a pocket at the site of an infection. When tooth pulp suffers bacterial infection, the infection spreads through the interior of the tooth. An abscess can form at the tip of the root, or appear in the surrounding tissue. If the abscess finds a path to drain, you might feel some temporary relief, but treatment is essential. Unless the infected pulp is removed and the inner tooth cleaned, shaped, and filled, pain can not only recur, but the infection can spread to other parts of the body—sometimes with serious results. Endodontists are trained to treat infection in the tissues surrounding a compromised tooth.

• A Cracked or Injured Tooth

When a tooth suffers a significant crack or fracture, the pulp can become infected or damaged. An endodontist is trained to discover and diagnose cracks and fractures that might not appear on an X-ray. If the crack is treatable, there are a variety of procedures, including oral surgery, which can preserve a tooth even if some of the root area needs to be removed.

Of course, bite pain is not the only symptom of a damaged or infected inner tooth. Any redness, swelling, fever, or prolonged sensitivity to heat and cold are signs that your tooth should be examined as soon as possible.  If you are suffering from discomfort because the pulp of the tooth has been injured, endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants are experts in treating your pain.

Whether the answer is a root canal or more complex oral surgery, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have the training and experience to relieve pain, protect you from further infection, and save injured teeth.

If you are avoiding biting or chewing because of tooth pain, call our Worcester endodontic office. We can let you know how we can help give you back your happy—and healthy—smile.

If Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team recommend an “apicoectomy” to save your tooth, you probably have a few questions about the procedure. Here are some of the basics you might discuss when you visit our Worcester office:

• What is an apicoectomy?

The tip of a root is also called its “apex.” An apicoectomy means the removal (“ectomy”) of the apex (“apico”) of the tooth. This is a surgical procedure performed by a specialist in the treatment of the inner tooth.

• Who performs apicoectomies?

Your endodontist is a specialist in tooth-saving surgical procedures. Endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants diagnose and treat problems of the inner tooth and its surrounding tissue. They have two or more additional years of study in the field of endodontics, and have the experience, knowledge, skill, and specialized equipment needed to perform delicate endodontic surgeries.

• Why choose this procedure?

Usually, a root canal is all that you need to treat any damage or infection in your inner tooth. But when inflammation or infection returns at the tip of the root, or in the bone surrounding the tip, or a tooth can’t be treated with a conventional root canal, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may recommend an apicoectomy both to save your natural tooth and to prevent further infection or damage to the surrounding bone and teeth.

• How does the procedure work?

Often local anesthesia is all that is needed. (But if you have concerns, talk to us about your anesthesia and sedation options. We will have suggestions for you.) After the area is numb, an incision is made in the gum tissue to allow access to the root and any affected bone tissue.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will carefully remove a few millimeters from the tip of the tooth as well as any infected tissue from the area. Because the tip of the tooth is small, and cracks or extra canals in a root are often difficult to discover even with an X-ray, we might make use of microscopic technology to be sure there are no additional canals or large cracks or breaks in the root. Using specialized instruments, the end of the tooth will be cleaned and sealed.

Stitches or sutures will be used to close the incision, and will either dissolve on their own or might need to be removed on a follow-up visit. We will let you know just how to take care of the site after surgery.

In general, any pain or sensitivity after the procedure can be treated with over-the-counter anti-inflammatory pain relief such as ibuprofen. Follow post-op instructions carefully to reduce any swelling, and be sure to follow any dietary suggestions and restrictions. If pain or swelling are a problem, or if you have any other concerns, call our Worcester office.

Apicoectomies are a common procedure used by endodontists to save a compromised tooth.  If you have recurring or new pain or infection after a root canal, if you have an undetected extra canal, if there is a crown and post in place that would make it impractical to reach the root or pulp chamber area with conventional treatment, and if you want to preserve your natural tooth, an apicoectomy is an option well worth discussing.

A dental emergency can strike anywhere, anytime, and without warning. Perhaps you’re playing a game of touch football on Thanksgiving and your brother-in-law decides to up the ante and tackles you, accidentally knocking out your two front teeth. Or maybe you’re on vacation somewhere in the tropics and decide to go deep-sea fishing, but when you’re climbing onto the boat you slip on the dock, fall, and chip three of your teeth. From misplaced fly balls to bagel seeds causing a painful bout of inflammation, there are all kinds of dental emergencies.

Here are the five most common reasons for emergency care visits.

1. Somehow you've managed to knock out a tooth. Whether it's the result of a sports injury or because of decay, when you lose a tooth, you need emergency dental care. If the tooth is salvageable, then it can be reattached to the socket, but this needs to be done within a one- or two-hour window.
2. A chipped tooth is the most common dental emergency. Small chips can be caused by food (chicken bones and nuts have sent many people to the dentist); however, it's usually some sort of accident or injury that more often causes a chip. While you might be embarrassed to walk around with a gaping chip in your front tooth, it is easily fixed with a bond, crown, or veneer.
3. A broken tooth is more severe than a chipped tooth. When a tooth breaks, it might be due to a small or hidden chip. However, chances are the pain and discomfort will be more severe.
4. It might seem comical, but getting a piece of food lodged in the wrong place can result in a dental emergency. If something gets stuck deep in a crevice, it can cause pain and inflammation.
5. The loss of a filling happens more often than you think. When you lose a filling, you need to receive emergency care immediately. If you don’t, you risk further damage to your tooth.

When you injure your teeth or mouth, you need to seek emergency care as soon as possible. In the event of a suspected emergency, don't wait. Contact Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants immediately.

There are many ways in which your oral health has an impact on your overall general health. There are naturally occurring bacteria in the mouth. Some of those bacteria, including strep and staph, are harmful, while other bacteria are essential for the balance of intestinal flora. The healthier your mouth is, the less likely it is the harmful bacteria will travel to other parts of your body to infect it and make you sick. There is much more to good dental hygiene than brushing and flossing.

Historical Methods of Maintaining Oral Health

Ancient civilizations relied on natural remedies for maintaining oral health. Around 250 AD, the Kemetic Egyptians used myrrh and other herbs as antiseptics for treating infected gums. Two centuries later, the Nubians, who lived in the Nile River valley, drank beer to ease the pain of infected teeth. That probably sounds crazy, but their beer was effective because they used grains that were contaminated with the same bacteria that produce the antibiotic tetracycline.

Today's Biggest Dental Hygiene Challenge

In the past, tooth decay was more of an issue because there was no routine dental care, and problems that are routinely treated today went untreated. Thanks to fluoridated water, and toothpastes containing fluoride, tooth decay is far less problematic than it was a century or more ago. Gum disease has replaced tooth decay as the most serious dental problem facing people today. According to the American Dental Association, a staggering 80 percent of Americans over age 65 suffer from some form of periodontal disease.

Ironically, if that infection attacked any other part of your body, especially in a place where it was clearly visible, you would head to your doctor for treatment immediately. People tend to ignore gum tenderness and bleeding. When the tenderness and bleeding aren't treated, the inflammation can turn into periodontitis. The longer you allow the inflammation to go untreated, the greater the likelihood that it will affect other body parts. Make sure to visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at Central New England Endodontics and Implantology regularly to be proactive about dental health!

Researchers are now discovering that untreated inflammation in the mouth acts as a driving force for multiple chronic illnesses, including clogged arteries, heart attacks, arthritis, and even cancer. That inflammation is one of many hypotheses that may explain how chronic infections can trigger systemic diseases, and even intensify existing ones. Bacterial overgrowth in the inflamed gum tissue can enter the bloodstream through the food you eat, and from daily brushing.

Caring for your mouth at home is just as important as visiting our office for exams!

Pregnancy can be one of the most exciting times in a woman’s life, as you eagerly wait for the birth of the new addition. Needless to say, pregnancy comes with a lot of responsibilities. Everything you do to your own body can affect your baby’s health, so you eat right and try to avoid anything that could harm your baby.

You may not realize it, but even your oral health affects your baby. You have a lot to worry about during this time in your life, but it’s important not to let your oral health slide. Maintaining good routines before and during pregnancy can improve the health of your baby.

Gum Disease and Pregnancy

Gum disease includes gingivitis and the more severe condition called periodontitis. Pregnancy gingivitis is a condition that results from bacteria in your teeth. Symptoms include gum inflammation and bad breath. If it progresses to periodontitis, your baby is at higher risk for preterm delivery and low-birth weight. You can also develop pregnancy tumors, or pyogenic granulomas, which can interfere with speaking and eating. Throughout pregnancy, continue to visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at your regularly scheduled appointments to look for signs of gum disease.

Pregnancy and the Role of Our Office

Make an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office when you first learn that you’re pregnant, especially if you have unresolved oral health issues. If possible, try not to schedule necessary treatment during the first trimester or second half of the third trimester.

Oral Health Care Habits to Follow

Maintain a normal good oral health care regimen, which includes brushing your teeth at least twice daily with a fluoride toothpaste and soft toothbrush, and flossing daily. If your regular regimen is not up to par, now is a good time to develop good habits. You can use an unflavored toothpaste if you have morning sickness and regular toothpaste makes you feel nauseous. Also, rinse your mouth with water or mouthwash if you experience morning sickness to prevent acid damage to your teeth.

Many adults wonder if they should continue to receive fluoride treatments. Our team at Central New England Endodontics and Implantology wants to set the record straight about the usefulness of fluoride treatment for adults.

There are several reasons fluoride treatments could be beneficial to you as a grownup. If you have a high risk for cavities, topical fluoride applications can cut down on that risk.

If you’re experiencing gum recession that’s softening your enamel, fluoride treatments can slow down that process. Fluoride treatments may also protect expensive restorative work on crowns or bridges that may be adversely affected by plaque.

In addition, fluoride can also protect teeth in adults who have orthodontic braces or who sometimes neglect to keep up with daily oral hygiene regimens such as flossing and using mouthwash.

Do you have sensitive teeth? Consuming foods that are highly acidic or using teeth-whitening products can lead to irritated gums. Fluoride treatments remineralize your enamel and reduce sensitivity.

If you’ve undergone radiation treatment for cancer, fluoride can help restore any dry-mouth damage that may have developed during that time. Saliva acts as a buffer against the foods we eat, and without enough of it you may be more likely to get cavities.

In general, fluoride treatments are not always necessary for adults, but they can be beneficial to your overall oral hygiene depending on your situation. If you fall into one of the general areas listed above, ask about a fluoride treatment during your next visit at our Worcester office.

We can also go over your options to treat other issues you may experience in terms of your oral health. Until then, make sure to take care of your teeth properly and use toothpaste or mouthwash that contains fluoride on a regular basis.

As we all know, or should by now, the key to maintaining great oral health is keeping up with a daily plan of flossing, brushing, and using mouthwash. These three practices in combination will help you avoid tooth decay and keep bacterial infections at bay.

At Central New England Endodontics and Implantology, we’ve noticed that it’s usually not the toothbrush or floss that people have trouble picking, but the mouthwash.

Depending on the ingredients, different mouthwashes will have different effects on your oral health. Here are some ideas to take under consideration when you’re trying to decide which type of mouthwash will best fit your needs.

• If gum health is your concern, antiseptic mouthwashes are designed to reduce bacteria near the gum line.
• If you drink a lot of bottled water, you may want to consider a fluoride rinse to make sure your teeth develop the level of strength they need.
• Generally, any mouthwash will combat bad breath, but some are especially designed to do so.
• Opt for products that are ADA approved, to ensure you aren’t exposing your teeth to harmful chemicals.
• If you experience an uncomfortable, burning sensation when you use a wash, stop it and try another!

Still have questions about mouthwash? Feel free to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office! We’re always happy to answer your questions. Happy rinsing!

Sometimes people feel a tiny bit nervous when they sit in the dental chair. And sometimes it’s more than a tiny bit. If your anxiety over dental procedures is leading you to postpone the root canal that can save your tooth, if worrying about an apicoectomy outweighs treating a recurring infection, if dreading endodontic surgery means you would rather live with tooth loss than give us a call—give our Worcester office a call! Sedation dentistry might be just the procedure you need to make dental anxiety a thing of the past.

Depending on your preferences, there are several levels of sedation Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can provide to make your visit more comfortable.

• Minimal Sedation—this type of sedation leaves you calm and conscious, and you respond normally to verbal directions.
• Moderate Sedation—sometimes called “conscious sedation,” this option will leave you awake, relaxed and able to follow directions, but you will probably have little memory of the procedure afterward.
• Deep Sedation—a deeper level of sedation where you cannot be roused easily or respond to instructions. It is unlikely you will remember much or any of the dental treatment.

Our office is trained to administer and monitor all these forms of sedation. Because sedation in all its varieties is a regular part of our practice, we have the medical knowledge and skill to provide you with a safe and comfortable endodontic experience.

And we will prepare you with all the information you need to decide on any endodontic treatment, including sedation. We will describe the procedure in detail, and discuss any possible risks. If you have any health conditions or take any medications that might interfere with sedation, we can discuss your options with you and your doctor to make sure you are a good candidate. We will explain any preparations you should take, and let you know if there is a window of recovery time needed in our office while the sedation wears off.

Don’t let yourself suffer dental pain or discomfort because you suffer from dental anxiety! Please call us to discuss your sedation options. Whether you choose oral, inhaled, or IV sedation, we are trained to administer your treatment gently and safely. Above all, we want to help you keep your smile the heathiest it can be, and that only happens with proper dental care. Let us work with you to make that care as comfortable and stress-free as possible.

Baby teeth come with a built-in expiration date. That charming first smile is meant to make way for a healthy, beautiful adult smile. Unfortunately, before they are ready to make way for permanent teeth, primary teeth can be affected by decay, trauma, or infection—problems which can lead to damage to the pulp within the tooth. If your dentist tells you that your child’s tooth needs specialized endodontic treatment, is treatment really that much better for your child than losing a baby tooth prematurely?

Quite often, the answer is yes!

Baby teeth do much more than serve as temporary stand-ins for adult teeth. They are essential for:

• Biting and chewing—a full set of baby teeth helps your child develop proper chewing, which leads to healthy digestion. And chewing also helps build face and jaw muscles.
• Speech development—primary teeth help guide speech production and pronunciation.
• Spacing—a baby tooth serves as a place holder for the adult tooth waiting to arrive. If a primary tooth is lost too early, the remaining baby teeth may drift from their proper location. This, in turn, can cause overcrowding or misalignment of the permanent teeth when they do erupt.

Baby teeth, like adult teeth, contain living pulp tissue. The pulp chamber inside the crown (the visible part of the tooth) and the root canals (inside each root) hold nerves, blood vessels, and connective tissue. When the pulp is damaged by trauma or infected, a baby tooth can still be saved with endodontic treatment. Endodontic treatment in baby teeth can take two forms.

• “Vital” pulp is pulp that can be saved. Vital pulp therapy uses procedures to deal with damaged pulp inside the crown, or visible part, of the tooth. Pulp therapy can be used on teeth when only the top of the pulp has been affected by decay, limited exposure, infection, or trauma, but the root pulp remains healthy. Specific treatment will depend on the nature of the pulp injury, and a crown will usually be placed over the tooth after treatment to protect it.
• With non-vital pulp, your dentist will probably recommend a traditional root canal procedure. All of the pulp tissue will be removed from inside the crown and the roots, and the pulp chamber and root canals will then be cleaned, disinfected, shaped, and filled. Finally, because the treated tooth will be more fragile, a crown will be used to protect the tooth from further damage.

There can be good reasons for extracting a seriously damaged baby tooth, and there are situations where preserving the tooth is the best and healthiest option for your child. Discuss your options with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants when you visit our Worcester office for the safest, most effective way to treat your child’s compromised tooth.

Your teeth generally give you no reason to complain. In fact, brushing and flossing regularly for tooth and gum health, getting good check-ups, and appreciating your beautiful smile in your latest selfie are all very positive experiences. But sometimes, a tooth demands attention in a less than positive way.

When exposure to hot and cold foods causes discomfort, or your gums are swollen and tender around a tooth, or when you can’t bite down without pain, it might mean that the pulp or roots of your tooth have been injured or infected. If your regular dentist suspects there is a problem inside your tooth, he or she might recommend that you see an endodontist, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

“Endodontic” means “inside the tooth,” and refers to the pulp and roots within each tooth that hold tissue, nerves, and blood vessels. While all dentists receive some endodontic training in dental school, to specialize in this field, endodontists receive two or three years of additional advanced training. Here they concentrate on the diagnosis and treatment of diseases and injuries that affect the inner tooth and its supporting tissue.

Damage to the tooth’s pulp can be the result of an injury, such as a blow to the mouth. A chip, a crack, or a deep cavity can leave an opening for infection. Whatever the cause of injury or inflammation, once the pulp and roots have been compromised, treatment needs to take place to prevent further infection, pain, and even tooth loss. Endodontists work to save injured teeth with a variety of procedures, including root canals, treatment of injuries caused by trauma, and endodontic surgeries.

If you have a compromised tooth, or if you have oral or facial pain that is difficult to find an explanation for, talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about specialized endodontic treatment at our Worcester office. Saving a tooth is, after all, one of the most important ways to preserve our smiles. And that’s nothing but positive!

It is common to experience dentine hypersensitivity, with symptoms ranging from moderate to severe. Why does it happen and how do you know if this sensitivity is something to be concerned about? The first step is to determine the cause.

The most common cause of the sensitivity is exposure of the dentin. Dentin is the layer immediately surrounding the nerve of the tooth. It is alive and usually covered by the gum tissue. When gum recession is present hypersensitivity is common. Other contributors to temporary tooth hypersensitivity include teeth whitening and dental procedures such as fillings, periodontal treatment, and braces placement or adjustment. These are temporary and should be of no concern.

Permanent hypersensitivity, however, may require treatment. To understand the cause of sustained hypersensitivity, let us explain the structure of dentin and why it serves as a ‘hot spot’.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When dentin tubes are exposed, there is a direct connection between the mouth and dental pulp, which houses the nerve and blood supply of the tooth. External stimuli, such as mechanical pressure (tooth grinding or clenching - bruising the ligaments holding the teeth in place), temperature changes, as well as chemical stimuli (sweet–sour) are transmitted to the pain-sensitive dental pulp and activate nerve endings. A short and sharp pain is the result. These external stimuli cause fluid movement in the open tube that is transmitted as pain sensations. Something needs to be placed into the dentin tube to plug it and stop this fluid movement.

The first step in doing something about dental hypersensitivity is to determine the cause; our professional team at Central New England Endodontics and Implantology can help you with this. Whether the sensitivity is due to exposed dentin or an underlying cause such as abscess or decay, corrective measures are needed. Contact us sooner rather than later so Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can reduce the sensitivity, and provide you with some relief!

Advancements in dental treatment, and in dental training, have made it possible for specialized dentists, called endodontists, to treat inflammation and infection deep within the core of a tooth. Endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, receive two additional years of specialized training beyond dental school, where they learn the sophisticated techniques needed to treat problems related to the inside of the tooth. Historically, the only solution for problems within the tooth was to extract the tooth. Today, people who eat a healthier diet have better oral health. They also take better care of their teeth and have regular dental checkups and twice yearly cleanings, all of which contribute to better oral health. Sometimes, however, unforeseen problems arise, and a tooth gets injured, or somehow becomes infected or inflamed. This leads to the need for endodontic treatment.

Understanding Tooth Anatomy

Understanding basic tooth anatomy will put things in proper perspective. The tooth is composed of several parts. The outer layer consists of the enamel and the hard layer called dentin. These layers protect the inside of the tooth, which has a canal that extends from the very top (crown) of the tooth all the way down to the roots. Surrounding that canal is soft tissue known as the pulp. The pulp contains the "guts" of the tooth — or the living parts. Those living parts include blood vessels, connective tissues, and nerves.

Importance of Tooth Pulp

The pulp is most important when your teeth are developing. It connects the area from the top of the tooth to the roots, and then to the supporting tissues around the roots (or gums). Once teeth are fully mature, they can still survive without the pulp because as long as the surrounding tissue is healthy, it continues to nourish the tooth.

Can all teeth be treated endodontically?

Most infections benefit from endodontic treatment. The only reason that a tooth can't be treated endodontically is when the tooth itself isn't salvageable. That might include the inability to access the root canal, a severe fracture of the tooth root, inadequate bone support, or a damaged tooth that can't be restored. Endodontic surgery might be a viable alternative treatment.

Although endodontic treatment is sometimes inevitable and unavoidable, good oral hygiene keeps the teeth, mouth and entire oral cavity in good health. If you experience pain, prolonged sensitivity, swelling, gum sensitivity, swollen lymph nodes, or fever, give our Worcester office a call or consult your general dentist. You may then be referred to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for specialized treatment at Central New England Endodontics and Implantology.

You have been recommended to Central New England Endodontics and Implantology for an endodontic treatment — commonly known as a root canal — and now you may be wondering if there are any alternatives to this procedure? Before discussing other options, it’s important to understand exactly what this common procedure accomplishes.

What is the purpose of an endodontic treatment?

Endodontic treatment is done when a tooth’s pulp — the inside of the tooth that houses the nerves and blood vessels — becomes infected or inflamed. In order to eliminate any pain and save the tooth, the damaged pulp is removed, the area is cleaned, and the tooth is sealed.

What are my other options?

According the American Association of Endodontics (AAE), the alternative to endodontic treatment is usually the complete removal the damaged tooth. If you have a tooth extracted, the AAE recommends replacing it with a dental implant, a bridge, or a removable partial denture. Failure to replace the extracted tooth could result in problems with chewing and biting, shifts in your remaining teeth, and self-consciousness.

Here are more details on the most common types of tooth replacements:

• Dental implants – According to the American Dental Association, dental implants are effective and common options for replacing teeth. The implant is made from materials that are compatible with the human mouth and the device includes an artificial tooth. The placement of the implant and artificial tooth can be completed in one day, although some patients may need to wait up to several months before an artificial tooth can be added to the implant.
• Bridges – Bridges do exactly what their name suggests: they bridge the space left by one or two missing teeth. Your dentist will bond the bridge to your remaining, natural teeth in order to keep it in place. Bridges can only be removed or put in place by a dentist.
• Removable partial denture – Much like bridges, removable partial dentures are made up of replacement teeth that attach to your natural teeth. These, however, may be removed and replaced by the patient on a daily basis.

The AAE notes that dental implants have the same success rates as endodontic treatments. Even so, nothing can fully replace the look, capabilities, or the feel of your own teeth, which is why endodontic treatment (preserving the natural tooth) with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is an important decision!

Don't hesitate to contact our Worcester office if you have further questions!

Regardless of the type of dental emergency you experience, it is important that you visit Central New England Endodontics and Implantology for emergency dental care as soon as possible. A chipped or cracked tooth requires professional attention, as bacteria may gather in these areas, potentially causing infection that could require a root canal. Remember, you may be capable of managing pain, bleeding, and swelling at home, but by visiting our office for immediate treatment, you can fight infections and minimize lasting damage to your mouth, teeth, and gums under the expert care of our emergency dentist.

24/7 Emergency Dental Care

Central New England Endodontics and Implantology is proud to offer emergency dental care around the clock, seven days a week. Dental emergencies do not wait for regular business hours, and if you experience a serious dental emergency, you need immediate treatment. Whether you have a broken tooth or if you have bitten through your tongue, do not hesitate to visit us day or night. Until you arrive at our office, however, there are some helpful steps you can take if you encounter a serious dental dilemma.

Managing Your Dental Emergency

If a toothache is causing problems, you can probably keep the discomfort under control until our emergency doctor can treat you. Start by checking the gums that surround the affected tooth for inflammation, bleeding, or foreign objects. There may be food lodged in the gum that could be removed by flossing. You can control pain by placing a cold compress against your mouth, or by using an over-the-counter oral numbing agent.

More serious situations may be extremely time sensitive, and require immediate emergency attention. For example, if a tooth is completely knocked out, carefully clean it with water. Try to place the tooth back into its socket or briefly store it in a cup of milk if it will not fit back into the gum. Never pick up a tooth by the root or force it into the socket. Come straight to our office, as your tooth will need to be replaced within a short amount of time. Similarly, if you have bitten through your lip or tongue, the American Dental Association recommends carefully cleaning the area before coming as quickly as you can to our emergency dental office for treatment.

Remember, there is no reason you should live with discomfort. By visiting our Worcester office immediately in an emergency, you can take control of your oral health comfortably and safely.

An endodontist is a dental specialist who concentrates on root canals, or procedures involving the soft inner tissues of the teeth, otherwise known as the pulp. This type of doctor has gone through extensive training and extra years of schooling to be able to complete these procedures effectively.

You will be referred to an endodontist such as Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants if you’re in need of a root canal, or other specific procedures necessitated by a problem tooth. Nowadays, endodontists have the ability to avoid extraction altogether and save your natural tooth by restoring it to a healthy state.

Getting a root canal may not be on the top of your list of fun things to do, but it can make it possible for your endodontist to save a problem tooth if the pulp has become infected with bacteria. During this surgery, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will remove the infection from the root of the tooth, clean and fill the area, then seal it so bacteria can no longer get inside. Finally, a crown is placed on top of the tooth to prevent damage from occurring down the road.

Sometimes, additional treatment is necessary after a root canal, if you continue to experience pain in the area where the root canal took place. Inflammation and pain that persists after an initial root canal may mean the infection has spread to the bony area that surrounds the tooth.

This can occur if the tooth has experienced trauma, decay, or the crown has been cracked since the surgery. A root-end resection will fix these issues by opening the irritated gum tissues, then removing the infection and filling in the space. It’s unlikely that you will experience more problems following a root-end resection.

Endodontists such as Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants have the ability to save and restore problem teeth. When it comes to your oral health, being able to avoid a tooth extraction can be extremely relieving. If you think you may need a root canal, or notice recurring pain in your mouth, don’t hesitate to schedule an appointment at our Worcester office.

If you’re scheduled for endodontic surgery at our Worcester office in the near future, you probably have a lot of very important questions:

• Will it help? An endodontist has the skill and experience to diagnose and treat conditions affecting your inner tooth, the pulp of the tooth, and the tissues surrounding the root. Endodontists are the experts in this specialty, so you are in good hands!
• Will it hurt? Your endodontist will offer you options for anesthesia, so you can choose the sedation experience which will make you most comfortable.
• What should I do after surgery? Don’t worry! Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will give you clear instructions on caring for the surgical site, selecting soothing diet options, cleaning your mouth, and all of the other practices that will enable a speedy and smooth recovery.
• What should I wear? Wait—fashion questions?

Yes! Part of being prepared for your surgery is being as comfortable as you can be during and after the procedure. Happily, there is no strict dress code for endodontic surgery. It’s more a basic list of recommendations for what not to wear.

• Don’t wear something you’re not comfortable in. Generally, loose fitting clothing is best.
• Don’t wear clothing that might be difficult to clean. While you and your clothing will be well protected, blood, irrigation, and other staining hazards are all occasionally part of the surgical process.
• Don’t wear something that will be difficult to remove after surgery. No one wants to struggle out of a tight turtleneck even at the best of times!
• Don’t wear jewelry. And, by the way, this includes tongue and facial piercings.
• Don’t be afraid to layer. While the office staff will try to make sure you are as warm or as cool as you would like to be, it’s a good idea to bring a jacket or sweater for extra warmth.
• Don’t wear tight sleeves. Short sleeves or sleeves that can be rolled up easily allow access to your arm if you are having IV sedation or blood pressure monitoring.
• Don’t wear contact lenses, especially if you are planning on IV sedation or a general anesthetic, because your eyes might be closed throughout the procedure.

If you have any questions in advance of your endodontic surgery, give our Worcester office a call. Planning ahead is always in fashion!

Central New England Endodontics and Implantology is excited to announce that we have a new doctor joining our team! Let us introduce you to Dr. Kaplan, specializing in Root Canal Therapy.

Dr. Kaplan has been practicing in Rhode Island and Massachusetts for over 22 years. He has had the honor of being selected as America’s top dentist in the field of endodontics for the past 16 years in a row. Dr. Kaplan also served as a clinical instructor and professor at Tufts University and Boston University School of Dental Medicine where he taught post-graduate residents. Currently, he runs the endodontics department and teaches the AEDG residents at U. Mass Memorial Hospital.

We can’t wait for you to meet Dr. Kaplan!

Happy July from Central New England Endodontics and Implantology. We hope everyone is having a safe and wonderful start to the summer. If you weren’t already aware our office reopened on May 18, 2020, so we are ready to see you.

Before you arrive at your appointment there are a few new health implementations to be aware of. If you are a new patient, you can access the new patient forms on our website and fill them out prior to coming in. We ask all patients to bring and wear a face covering. Additionally, standard COVID questions will be asked when scheduling an appointment and again upon checking in. Your temperature will be taken upon arrival.

We ask that patients come alone and if that is not possible, we kindly ask that any accompanying people present wait in their car or come back to pick up the patient after the appointment. This helps us limit the number of people in the office and stick to social distancing measures. We thank each and every one of you for your cooperation during this time!

So far, with the new health implementations, we have received positive feedback from patients regarding visits and our new procedures to keep everyone safe and healthy. We do everything in our power to make sure your time with us is safe and comfortable so that you leave our office feeling satisfied.

If you are experiencing tooth discomfort or have questions about our procedures please give us a call to learn how we can help you. We hope to see you soon!

Brushing your teeth properly removes the food particles and bacteria that can lead to tooth decay and gum disease. However, you do not want to scrub your teeth or gums heavily. A heavy hand can lead to tooth and gum erosion, as Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our staff see all too often.

You should also use a soft bristle toothbrush to avoid damaging the surface of your teeth. Make sure the head of the brush fits in your mouth, because if it is too large you will not be able to reach all tooth surfaces. Follow these steps to ensure you are brushing properly.

1. Use a small amount of toothpaste on your brush. The recommendation is a pea-sized amount or thin strip on the bristles.
2. Hold your toothbrush at a 45-degree angle to the surface of your teeth, angling towards your gums. Use a circular motion on all exterior tooth surfaces, and avoid back-and-forth “scrub” brushing.
3. Once you have cleaned the outer surfaces, hold the brush vertically and clean the inner teeth surfaces — the side of your teeth that face your tongue. Do not forget the inner surfaces of your front teeth.
4. Finally, finish by cleaning all the chewing surfaces of your teeth. You need to maintain a gentle touch, but make sure you get into the full depth of your molars. The entire process should take about two minutes.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our staff recommend changing your toothbrush every three to four months for best results. Do not forget to clean your tongue, which helps remove excess bacteria from your mouth. Special brushes are available just for cleaning your tongue, and they are easy to use.

Proper care of your teeth also requires flossing on a regular basis. Flossing can be performed before or after you brush. Following up with a quality mouthwash will provide you with even more protection. Do not be afraid to ask the Central New England Endodontics and Implantology team for tips on proper brushing and flossing.

Thank you for taking the time to visit our blog. Please check back often for weekly updates on fun and exciting events happening at our office, important and interesting information about orthodontics and the dental industry, and the latest news about our practice.

Feel free to leave a comment or question for our doctors and staff - we hope this will be a valuable resource for our patients, their families, and friends!