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You’ve learned a lot from your dentist and your family about how to take care of your teeth. You brush and floss, you wear a mouthguard when you’re active, and you have regular checkups and cleanings at our New York, NY office.

And everything you’re doing is wonderful! The smile you see each day in the mirror reflects your hard work.

But what about the part of your smile you can’t see? Let’s take a look beneath the surface, and talk about your roots.

While our teeth look solid from the outside, there’s really a lot going on inside each tooth.

• The outside of every tooth is covered with a hard protective surface.

Enamel is the hardest material in our bodies, and covers the crown. This is the part of the tooth we can see above our gums.

Our roots are hidden below our gums, and are covered with cementum instead of enamel. Cementum is hard, but it’s not nearly as strong as enamel.

• Just below a tooth’s enamel and cementum layers, we have dentin.

Dentin is a hard tissue, only a little softer than enamel. Most of our tooth is made of dentin. It surrounds and helps protect the center of the tooth and supports the enamel and cementum on the outside.

• Inside the center of each tooth, there’s an area called the pulp chamber.

The pulp holds tiny blood vessels and nerves. The blood vessels give the pulp nutrients, and the nerves are the reason that our teeth can feel sensitivity or pain.

Inside the roots, we also find pulp in the root canals. These canals are very small tunnels that run from the pulp chamber down through the root, ending in a tiny hole in the tip of the root. Blood vessels and nerves running through the canals connect the pulp tissue to our bodies’ blood and nervous systems.

Around your roots, there’s a lot going on, too. Smaller teeth like the incisors, our front teeth, usually have only one root. Bigger teeth, like molars, usually have two or three roots. And while you’re busy biting and chewing, what’s holding these roots in place?

• In your jaws, you have a spot where each tooth fits called a socket. But your tooth roots don’t just sit in the socket. That wouldn’t be very secure!
• Instead, you have a periodontal ligament surrounding the roots of each tooth. Think of the ligament as groups of tissue fibers that can attach to both the cementum on your root and the bone in your jaw. This double attachment holds your teeth firmly in place. The ligament also helps cushion your teeth from the heavy pressures of chewing.
• To make things even safer for your roots, your gums help cover them and protect them from bacteria and decay.

As you can see, your body is working hard to protect your roots. What’s the best thing you can do to keep your roots healthy? Do everything you’re already doing!

• Keep up with your brushing and flossing, and your visits to our office. These good habits protect the teeth and gums you can see, and also the roots that you can’t see.
• Avoid oral habits that put lots of pressure on your teeth and roots. Biting down on pencils, or ice, or nut shells, or anything not meant for regular eating means you’re risking a cracked tooth.
• Be safe! Wear your mouthguard when you’re active.
• Don’t wait to tell your adult if your tooth hurts. Remember, those nerves inside your teeth and roots are there to warn you if your tooth is damaged. Dr. David Shipper and Dr. Howard Vogel will be able to find out what’s wrong and have you feeling better in no time.

Even though you can’t see them, your roots are one important reason you have your beautiful smile. Taking good care of your teeth now is a way to make sure you have beautiful, healthy smiles for a lifetime!

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, but sometimes, 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 that 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. Dr. David Shipper and Dr. Howard Vogel 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 New York, NY 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.

If you need oral surgery, Dr. David Shipper and Dr. Howard Vogel and our team will use our expertise and training to ensure that you have the best possible surgical outcome. And we want to make sure you have the best possible outcome for your recovery as well. Here are a few of the most common aftercare suggestions for making your healing as comfortable and rapid as possible.

• Reduce Swelling

Ice packs or cold compresses can reduce swelling. We’ll instruct you how to use them if needed, and when to call our New York, NY office if swelling persists.

• Reduce Bleeding

Some amount of bleeding is normal after many types of oral surgery. We might give you gauze pads to apply to the area, with instructions on how much pressure to apply and how long to apply it. We will also let you know what to do if the bleeding continues longer than expected.

• Reduce Pain or Discomfort

If you have some pain after surgery, over-the-counter pain relievers such as ibuprofen might be all that you need. We can recommend those which are best for you. If you need a prescription for pain medication, be sure to take it as directed and always let us know in advance if you have any allergies or other reactions to medications.

• Recovery-friendly Diet

Take it easy for the first few days after oral surgery. Liquids and soft foods are best for several days following surgery. We will let you know what type of diet is indicated and how long you should follow it depending on your particular procedure. We might, for example, recommend that you avoid alcohol and tobacco, spicy, crunchy, and chewy foods, and hot foods or beverages for several days or several weeks.

• Take Antibiotics If Needed

If you have been prescribed an antibiotic, be sure to take it as directed. If you have any allergies to antibiotics, let us know in advance.

• Protect the Wound

Do NOT use straws, smoke, or suck on foods. Avoid spitting.  Part of the healing process can involve the formation of a clot over the surgical site which protects the wound. If the clot is dislodged by suction or spitting, it can prolong your recovery time, or even lead to a potentially serious condition called “dry socket.”

• Maintain Oral Hygiene

Depending on your surgery, we might recommend that you avoid rinsing your mouth for 24 hours, use salt water rinses when appropriate, and keep away from the surgical site when brushing. It’s important to keep your mouth clean, carefully and gently.

• Take it Easy!

Rest the day of your surgery and keep your activities light in the days following.

These are general guidelines for recovery. If you have oral surgery scheduled, we will supply you with instructions for your specific procedure, and can tailor your aftercare to fit any individual needs. Our goal is to make sure that both your surgery and your recovery are as comfortable as possible.

We know how frustrating it can be to discover your child has one or more cavities when you come to visit Central Park West Dental. There are several ways to prevent baby teeth from forming cavities due to decay. Not to worry: If your child does develop a cavity on a baby tooth, Dr. David Shipper and Dr. Howard Vogel can help take care of the problem.

Let’s look at how cavities on your little one’s teeth can be prevented from developing in the first place. Most often, children suffer decay from eating sugary foods. You may think, “My child doesn’t eat lots of candy!” In truth, fruits and juices have plenty of natural sugars that can break down teeth if they aren’t brushed thoroughly.

A well-balanced diet that includes calcium and phosphorous is necessary to keep your child’s oral health in a good state. If your son or daughter drinks juice, avoid giving it before bedtime and dilute the juice with water. Good options for snacks include vegetables, low-sugar yogurt or dairy products, and plenty of milk for healthy teeth.

Another excellent preventive strategy consists of scheduling regular appointments with Dr. David Shipper and Dr. Howard Vogel for your child. Between your youngster’s annual cleanings, make sure he or she brushes and flosses every day. It’s worthwhile for your little one to brush thoroughly for at least two minutes to remove any decay or plaque that has accumulated in the mouth, especially before bedtime.

Brushing Techniques

• Move the brush both back and forth, and in circular gentle strokes.
• Brush the outer surfaces, inside surfaces, and chewing surfaces of all teeth.
• Place the toothbrush at a 45-degree angle to the gums.
• Brush the tongue to remove excess bacteria and keep breath fresh.

It’s not always possible to prevent cavities from appearing in your son or daughter’s mouth. If your child does develop a cavity, our staff will notify you during the regular scheduled cleaning.

The cavity will need to be eliminated, even when it appears on a baby tooth. Our staff will remove the decayed part of the tooth and fill in the hole so your child doesn’t have to experience any pain.

You may wonder why a baby tooth has to be fixed if it is eventually going to fall out. Baby teeth hold spaces where your child’s permanent teeth have to grow in. If the former aren’t taken care of, multiple teeth may shift and the permanent ones won’t be able to grow in properly.

If you still have questions or concerns about your child’s baby teeth, or notice signs of a cavity, please don’t hesitate to contact our New York, NY office and schedule an appointment. Remember, preventive steps can be taken to avoid bothersome cavities from forming in your child’s mouth.