Welcome to Dr. Gottlieb's blog

This is the place to talk about what’s new in dentistry and answer any of your questions or concerns. And whether you are looking for a dentist in Levittown or Commack, or you are just interested in learning about dentistry, I hope this page will be a valuable resource

For immediate answers or for questions of a personal nature please feel free to email me at marc@anxietyfreedental.


  • Post Featured Image

    What's that large bump or lump on my lower jaw?

    What's that large bump or lump on my lower jaw? 

    Many patients are often unaware of this benign process. Slowly over time a benign growth of bone, bump or lump, forms on the inside of the jaw. You first realize you have this common condition when you eat a hard bagel or object and you scratch or bruise the skin over the bone. Most are small but some can be very large.

    Small benign growth of bone

                        Large Lingual Tori                                         Single Small Lingual Tori.

    The following information was taken from Wikipedia:

    Torus mandibularis (pl. tori mandibulares) (or mandibular torus (pl. mandibular tori) in English) is a bony growth in the mandiblealong the surface nearest to the tongue. Mandibular tori are usually present near the premolars and above the location of the mylohyoid muscle's attachment to the mandible.[1] In 90% of cases, there is a torus on both the left and right sides, making this finding an overwhelmingly bilateral condition.

    The prevalence of mandibular tori ranges from 5% - 40%. It is less common than bony growths occurring on the palate, known as torus palatinus. Mandibular tori are more common in Asian and Inuit populations, and slightly more common in males.[2][3] In the United States, the prevalence is 7% - 10% of the population.

    It is believed that mandibular tori are caused by several factors.[1] They are more common in early adult life and are associated withbruxism. The size of the tori may fluctuate throughout life, and in some cases the tori can be large enough to touch each other in the midline of mouth. Consequently, it is believed that mandibular tori are the result of local stresses and not solely on genetic influences.

    Mandibular tori are usually a clinical finding with no treatment necessary. It is possible for ulcers to form on the area of the tori due to trauma. The tori may also complicate the fabrication of dentures. If removal of the tori is needed, surgery can be done to reduce the amount of bone, but the tori may reform in cases where nearby teeth still receive local stresses.

  • I'm even afraid to have my teeth cleaned.

    A recent study in Europe found many dental patients experience pretreatment anxiety before having their teeth cleaned.

    In the report about a third of patients waiting for regularly scheduled dental hygiene appointments experience “high levels of pretreatment anxiety.” The European study published in BMC Oral Health found that even with advances in technology and treatment delivery, dental phobia and anxiety appear to have stayed at the same level during the past 50 years.

    This study involved 46 adult patients at the University of Zurich’s dental clinic. Many of the younger adult patients with gingivitis  had the highest anxiety levels. Patients understand that red bleeding gums is not a good thing and worry that the dentist will yell at them for not taking care of their teeth.

    In our office we never judge and are here to help. If you experience anxiety or fear of any dental procedure Dr. Gottlieb can offer various medications to relax or sedate you so you can keep yourdent teeth and smile.

    If you have any question or concerns don't hesitate to call.


  • What can I eat following and extraction?

    Immediately following an extraction don't eat anything. If you are still numb you will only hurt yourself. If you insist on consuming some calories then stick with a liquid diet until the feeling returns. Once the feeling returns then you may cautiously eat a soft diet.

    A soft diet consists of any food you can mush or separate with your fingers. It also means nothing with seeds, nuts or any particle that will not easily dissolve or can be rinsed away. If you need to hold it with you hands to bite off a piece of food that's probably not a good idea. 

    You just had a tooth extracted and now you have a hole in your jaw. That hole needs to fill up with a blood clot and form a plug to allow healing. If the extraction involved an upper tooth it's unlikely to be a problem. Most humans eat sitting up or standing. Any food that enters the hole with likely fall out of the hole the same way due to simple gravity. Lower extractions are another story. The further back in your mouth the more likely pieces of food will collect and be deposited into the hole. Food in an extraction site is equivalent to having a splinter in your finger. If not removed it will likely get infected.

    So avoid popcorn, peanuts and seeds. Stick with high protein shakes, scrambled eggs, yogurt and similar soft foods.  If in doubt you can always call Dr. Gottlieb for some healthy suggestions.

     

     


  • Lingering Toothache

    Many of my patients will tell me that the worse pain they have ever felt is the pain of a dental toothache. For most patients a visit to the dentist usually leads to a clear-cut direction of care and a predictable resolution of pain. The solution may require a root canal or extraction. Depending on the location of the toothache, root canal therapy is 95% successful. The remaining 5% that remain symptomatic is the result of the irritated ligaments and bone that supports the tooth. Normal chewing will produce pain. The tooth may throb and wake you out of a sound sleep.  A number of conditions may still persist and the tooth pain now becomes chronic. If you experience tooth pain after a root canal, that lasts for more than two weeks, then the dentist needs to examine the tooth for an untreated canal, a tooth fracture, or possible neurological condition. 

    When a tooth fracture and untreated canal have both been ruled out medications are the first and most likely therapy to help restore the health of the ligaments and bone.  A dose of antibiotics may be administered to rule out an active dental infection. If the pain persists after dental treatment and antibiotics then the cause of the pain may be neurologic in origin and require a dentist that specializes in this type of pain management or a neurologist. The oral medications of choice are often not easily tolerated by patients and require some creativity in terms of dosage, time of administration, and the need for polypharmacy. Common choices include low-dose tricyclic antidepressants inclusive of amitriptyline, nortriptyline and sinequan. Additional medications such as benzodiazepines, lyrica, gabapentin, baclofen and trileptal are frequently used as well. The amount of medications will vary from case-to-case and may at times require the use of liquid suspensions instead of pills to achieve a balance between effectiveness and side effects. Topical medications used intra or extra orally may be beneficial as well. In situations where an autoimmune influence may be suspected medications called biologics (Enbrel, Humira) may be required. These medications should be prescribed by a rheumatologist whose skills are often essential as part of the pain care team. There are times, however, that response to these therapies is poor and pain continues. At some point in time if the pain just doesn't get any better you must consider extracting the tooth and hope this solves your problem.  

    For additional information or a second opinion call Dr. Gottlieb for a consolation without an obligation.

  • Dental Cleaning with sedation.

    Yes, you can have your teeth cleaned with sedation. You can have every dental procedure done with sedation. Sedation dentistry is not limited to oral surgery. When you need to have a tooth removed many patients request sedation to help them overcome their anxiety or fear of the dentist and the dental procedure. A significant number of men and woman would like to have sedation just to have their teeth cleaned or to fill a few cavities. 

     At Anxiety Free Dental we understand that you mouth is a very sensitive part of your body.  Dr. Gottlieb offers Oral or IV sedation to every patient for all dental procedures. Below is an example of a very apprehensive young man who put off cleaning his teeth for years. He was afraid of the pain and anxious about hearing the sound a dental instrument makes while scraping the tartar off the teeth. With oral sedation and good local anesthesia he was able to have a couple of fillings done and his teeth professionally cleaned. For a no obligation consultation call Dr. Gottlieb at the Levittown  dental office.

    Before cleaning with sedationafter cleaning with sedation dentistry

     

  • Halitosis - Your Bad Breath

    Your Bad Breath - Halitosis

    If someone’s breath smelled bad once, you’d probably forgive them for it. Right? What if their breath smelled bad regularly? Would you have the guts to bring this potentially embarrassing personal issue up to them? You’re more likely to keep silent about it so you don’t offend. After all, there are so many remedies to this common problem you would think there should be no reason for anyone to have chronic bad breath.

    Bad breath, or halitosis, is produced as a result of excessive build up of volatile sulfur compounds (VSCs) from the breakdown of proteins by bacteria in the mouth. The more food particles in your mouth, and around your teeth, the higher the levels of bacteria further contributing to bad odor. To get rid of bad breath, start regularly brushing your teeth and tongue after every meal. Heavy plaque and tartar that accumulates around your teeth may also contribute to bad breath and periodontal disease. A professional cleaning will help and you will smell the difference immediately.

    You should already know to avoid tobacco products, as well as consuming onion, garlic, spicy or sugary food. Mouthwashes, breath fresheners, mints, and flavored gum can only mask the odor for so long.

    Dry mouth could be another blame for bad breath. Think about the smell of your breath in the morning. Awful, isn’t it? During sleep, saliva production decreases, leaving your mouth dryer than normal. Since saliva helps to cleanse the mouth, having chronic dry mouth can result in harboring more bacteria to produce bad smell.

    If you are part of the unfortunate population that suffers from chronic bad breath, know that it can be subsided, if not eliminated completely. For more tips, remedies or just for laughs, you’ll want to watch this video: https://www.youtube.com/watch?v=A0FAVR6_ZEQ  

    You are always welcome to come into the Levittown Dental Office for a free consultation without an obligation. So call today to meet Dr. Marc Gottlieb and his amazing compassionate  staff.


  • Post Featured Image

    Fear of Needles and the dental injection.

    One of the biggest fears many patients have in the dental chair is the fear of the needle or dental injection. Many patients worry about the pain of the injection or the shock type feeling when trying to numb a lower tooth. Even the thought of the dentist using dental instruments for cleaning, examining, and/or drilling teeth causes them to break into a cold sweat. Of the many sharp and pointy objects a patient may first encounter is the needle. Today most dentists will typically apply a topical anesthetic  (cherry flavored) to help eliminate any sensations of the injection. Today's modern local anesthetics have a neutral Ph so you hardly feel any discomfort. The type of local anesthesia can be tailored to the procedure so your entire face doesn't have to be numb for hours after you leave the dental office.  

    Fortunately, we do understand needle phobia, also known as trypanophobia. It is completely natural and common among patients of all ages. If you are terrified of needles, we understand that you can’t “just get over it” and mentioning this phrase to you would probably not help you to either.  After all, the slight pinches you feel are very minor compared to pain you would feel without the anesthesia and you sure won’t want to undergo dental work without it.
    Here are two tips to help your fear of needles:
    1. Focus on how much better you will feel after your dental work. Understand that Sedation Dentistry helps alleviate your fear of the dental injection and once numb you can receive pan less dental care.  
    2. If sedation dentistry is not you you then perhaps listening to music, through your head phones or trying your best to close your eyes and relax. The point is not to build up anxiety about the perception of pain you will feel by being stuck with a needle. Modern dentistry has come a long way to eliminate your fear of the needle.
    Hopefully, you find these tips helpful when visiting us in the Levittown office. Ask Dr. Gottlieb as many questions as you like and he will explain the many options you have to overcome your fear of the dentist and the fear of the dental injection.

    If your terrible fear of the dental injections is preventing you from even staying in the dental chair comfortably, sedation dentistry is an option that can be taken which would help you overcome your fear of needles. Sedation dentistry is a very safe option for many patients. You are given pills or a liquid to take about 30 minutes before treatment. The medication will make you drowsy and relaxed. You will not be unconscious however, many patients do not remember the appointment. For those very nervous patients I.V. Sedation may be another option as well.  Sedation dentistry helps many patients get over their initial fears of needles. 

    Katherine Ynsinare
    & Marc Gottlieb DDS


  • Why Patients Fear the Dentist

    Fear of the dentistFears not only paralyze, they also lead to avoidance. A fear of heights, for example, would make one stay far from anything that isn’t grounded. Similarly, a fear of the dentist can make someone avoid the dentist. In efforts to avoid the dentist individuals may brush their teeth three times a day. They floss daily and rinse with a Fluoride mouthwash. Unfortunately, most apprehensive dental patients neglect proper oral care and wait until they are in pain to start dental treatment.

    If you are someone who will go to the dentist only when it is absolutely necessary, not only are you more likely to delay treatment, the treatment may be more costly and complicated. This procrastination may in turn make your fear of the dentist worse and turn into a vicious cycle of dental fear.” Frankly, the longer you wait for your next dental visit, the more fearful you’re likely to be.

    For many patients, this stems from previous experiences with a dentist, especially during childhood. If this is the case for you, you should be very glad to know that the field of dentistry is continually advancing and there are many options for you to be treated so you feel no pain. The newer generations of local anesthetics are virtually painless. Sedation dentistry is also a very safe option for most apprehensive dental patients.

    We are here to make you feel more comfortable. Before any procedure, the dentist will clearly explain what you will be feeling and for what duration. Don’t let your fear of the dentist keep you from receiving the preventative oral care you need or suffer with a toothache that can be painlessly treated in our Levittown office.

    Written by
    Katherine Y. and Dr. Marc Gottlieb

    Sources:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945617/

    http://www.biomedcentral.com/1472-6831/7/1


  • Pacemaker / Defibrillators and the dental appointment

    Dentistry and Cardiac Devices: Is there an interference?

    Individuals with abnormal sequences in their electrical impulses, also known as arrhythmia, could have medical devices, such as Cardiac Pacemakers and Implantable Cardioverter Defribillators (ICDs), which can help prevent future complications and or treat their heart conditions. If you currently have one of these devices or will soon be receiving one, your physician will remind you to be aware of surrounding items in your environment that might cause interference with it.

    According to the American Heart Association, an item as simple as a pair of headphones can cause interference with defibrillators and pacemakers due to a magnetic substance they contain. The interference is dependent on their distance to the medical device. Being conscious of your surroundings, you might have wondered whether electrical dental devices could cause any interference.


    Several studies have suggested select dental devices may cause interference with pacemakers and ICDs. Thus, dentists have been cautioned to avoid these dental devices. However, many of these studies were conducted in vitro, in laboratory settings, which are not necessarily the same conditions as in the clinic or operatory. The authors of a recently published study aimed to demonstrate that dental devices do not interfere with pacemakers’ and defribillators’ pacing and sensing function.

    Perhaps, you may be wondering what these electrical dental devices include? Some of the more commonly used electrical dental equipment in our office include the battery operated curing light (used in many restorative procedures), ultrasonic bath (for sterilization of our instruments), cavitron (used during dental cleanings), amalgamator, and hand pieces. Investigators in the study operated these devices at various distances of the cardiac devices on 32 patients, making this one of the largest in vivo study to investigate these effects. These participants ranged in ages from 18 to 90 years of age. It is significant that there was not a single major interaction among them. After testing pacemakers and ICD units, it was concluded that “…dental devices presented minor electromagnetic interference with programmers that interrogate cardiac devices implanted in patients. Those interactions are not typically observed in a dental setting because cardiac devices wouldneverbe interrogated there, and the observed interactions were not associated with significant clinical implications.”

    Although the study noted interference with the telemetry from the cardiac programming unit, there is “no clinical impact on patient safety.” If you’ve ever been concerned about how items in our office may affect devices used for your heart conditions, we hope this information reassures you that dental devices have posed and continue to pose very little threat to you. We hope future studies are conducted to provide even greater validity, not only for dental professionals but for our patients. Continue visiting your dentist without worries! If you have any questions or have a dental emergency don't hesitate to call Dr. Gottlieb at the Levittown office.

    AHA:
    https://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Devices-that-may-Interfere-with-Implantable-Cardioverter-Defibrillators-ICDs_UCM_448464_Article.jsp

    Interference between dental electrical devices and pacemakers or defibrillators
    http://jada.ada.org/article/S0002-8177(14)00026-9/fulltext

    Electromagnetic interference of electrical dental equipment with Cardiac pacemakers (2007):
    http://www.ncbi.nlm.nih.gov/pubmed/17937372brillator

     
    Written by: Katherine Ynsinare
     Dr. Marc Gottlieb's Levittown Dental Assistant


  • Flossing: There is an app for that.

    You know that favorite question your dental hygienist asks when you get your cleaning in twice a year. It goes something like, “Are you flossing regularly?”

    After poking around your teeth and gums, your dentist and dental hygienist probably already know the answer. No matter what your response, the hygienist will tell you to floss daily. She will even demonstrate, yet again, how to do so properly. Still, such a simple technique is so hard for some people to keep up with.
    I recently came across an article written by an individual who proposed to make daily flossing a New Year’s resolution. In fact, it’s admirable that he went as far as to even hire a flossing coach. I never knew they existed! But, you could hire a coach for yourself as well, through an app called Coach.me. This app allows you to choose your own goals and then provides you with different types of coaching material, free or paid, in order to help you achieve them.

    You might believe brushing is enough. But, flossing will reach those spaces which brushing will not. And being aware that you must floss is also not enough. You have to actually do it, and this app is a great way to help you make flossing a daily habit. Maybe you’d want to track other goals. Use the app to help you become fit, stop smoking, brush before going to bed, learn a new skill, or journal more often. I guarantee you will find other users with similar goals. About 70,000 users alone have made flossing their goal. A community will cheer you on and hold you accountable. If that encouragement isn’t enough, the app is able to give you motivation and “props” as well.

    If there’s any habit worth starting and keeping, flossing should be among them. You might not need to hire a flossing coach. Maybe you might need to start off with flossing just one tooth. No shame. Remember, you don’t have to floss all your teeth, just the ones you want to keep! FYI Bleeding gums is a warning sign. Gingivitis over time will advance to periodontal disease and tooth loss. For a free consultation without obligation feel free to call our Levittown Office.

    Dental Assistant Levittown office
    Written by Katherine Ynsinare 
    Dental Assistant Levittown, NY 11756

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Levittown dental office.

Serving Long Island

Since 1985

Convenient Central Levittown location on Hempstead turnpike.

3601 Hempstead Tpke, Suite 420
Levittown, NY 11756
Call (516) 796-6600

Levittown Office Hours by appointment:
Monday 8:30-5:00
Tuesday 10:00-8:00
Wednesday Closed
Thursday 8:30-5:00
Friday 8:30-5:00

Marc@AnxietyFreeDental.com

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