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Thanksgiving marks the start to the holidays; a season filled with feasting, indulging, and spending time with family and friends are always special. Thanksgiving is a holiday meant for giving thanks, and while this may seem like such a natural celebration, the United States is only one of a handful of countries to officially celebrate with a holiday.

Unlike many holidays, Thanksgiving is a secular holiday, and it is celebrated on the fourth Thursday in November in the United States. In Canada, it is celebrated on the second Monday of October, which is, oddly enough, much closer to a time when harvests were likely gathered. In addition to the different dates, the origins of the celebration also share different roots.

Thanksgiving in the United States

Giving thanks for a bountiful harvest are not new, but the modern day holiday in the US can be traced to a celebration at Plymouth in Massachusetts in 1621. This feast of thanksgiving was inspired by a good harvest, and the tradition was simply continued on. At first, the colony at Plymouth didn't have enough food to feed everyone present, but the Native Americans helped by providing seeds and teaching them how to fish, and they soon began to be able to hold a feast worthy of the name. The tradition spread, and by the 1660s, most of New England was hosting a Thanksgiving feast in honor of the harvest.

Canadian Thanksgiving

An explorer of early Canada named Martin Frobisher is accredited for the first Canadian Thanksgiving. He survived the arduous journey from England through harsh weather conditions and rough terrain, and after his last voyage from Europe to present-day Nunavut, he held a formal ceremony to give thanks for his survival and good fortune. As time passed and more settlers arrived, a feast was added to what quickly became a yearly tradition. Another explorer, Samuel de Champlain, is linked to the first actual Thanksgiving celebration in honor of a successful harvest; settlers who arrived with him in New France celebrated the harvest with a bountiful feast.

A Modern Thanksgiving

Today, Thanksgiving is traditionally celebrated with the best of Americana. From feasts and football games to getting ready for the start of the Christmas shopping season, Thanksgiving means roasted turkey, pumpkin pie, and green bean casserole. No matter how you celebrate this momentous day, pause for a moment to give thanks for your friends, family, and all the bounties you’ve received. Happy Thanksgiving from Montchanin Implant Center!

Diabetes is a disease that affects the health of the entire body, including, of course, your mouth, gums, and teeth. We are trained to look for issues that might arise in our patients with diabetes, and are eager to help you maintain your dental health. What do we consider in order to give you the best treatment?

Your Teeth

Dry mouth can be a problem for diabetic patients, whether caused by blood sugar levels or medication, and this condition can lead to tooth decay. When we produce saliva, it not only helps wash away sugar in our mouths, it also helps remove the acids sugars produce which attack our enamel and lead to cavities.

Your Gums

People with diabetes are at higher risk for gum disease. With diabetes, the body is more susceptible to infection and finds it harder to fight bacteria. Early gum disease, called gingivitis, is inflammation caused by the body’s reaction to bacteria. Periodontitis, serious gum disease, leads to infections that can cause bone and tooth loss.

Other Oral Concerns

Dry mouth can lead to mouth ulcers, oral thrush, sores, and infections. And oral infections of any kind can be slower to heal when you have diabetes. We will give careful attention to any concerns you might have for your oral health, and will work with you to prevent any future problems.

Preventive dental care is important for all our patients, and we have special suggestions for you to help maintain your dental health and reduce the possibility of dental complications. Diabetes can lead to oral problems, and oral infections can in turn cause problems with controlling blood sugar, so a healthy mouth can lead to better health in general.

• Home Care

If dry mouth is a problem, talk to us about possible causes and treatments. Hydrate throughout the day, and avoid foods or beverages that lead to dehydration. Talk to us about the best products for use at home to prevent dry mouth.

Brush and floss after meals to reduce the presence of harmful bacteria and prevent the plaque buildup that leads to gum disease.

Above all, monitor your blood sugar carefully to ensure your body is at its best when combatting infection or when healing.

• Professional Dental Care

Be sure to visit our Wilmington office at least twice a year for a full examination and a professional cleaning. We can reduce the plaque that leads to gingivitis and more serious periodontal infection. We can monitor your oral health and recommend solutions for problems such as dry mouth. We will make your appointments based on what is best for your schedule. If any type of oral surgery is needed, we will schedule it with an understanding of the importance of healthy blood sugar levels for healing and recovery.

It’s important to make Dr. Keller and Dr. Tibbs part of your health support system. If you have diabetes, let us know. We will work with you to monitor the well-being of your teeth and gums and to suggest ways to promote your overall oral health. Let’s work together for healthy, happy smiles!

Diabetes is a chronic disease that increases the risk for many serious health problems, including severe gum disease. November is Diabetes Awareness Month, and it’s a great time for us at Montchanin Implant Center to remind our patients that the way you care for your teeth at home doesn’t just affect your oral health; keeping your mouth healthy is vital to your overall health, too.

Diabetes is the result of a deficiency, or lack of the hormone insulin to properly transport glucose (blood sugar) to the cells throughout the body. According to the American Diabetes Association, the most common types of diabetes are Type One (90-95 percent of cases), Type Two (five percent), and gestational or pregnancy diabetes. Women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes, mostly Type Two, in the ten to 20 years following their pregnancy.

In the past decade, researchers have found links between periodontal (gum) disease and diabetes. Not only are people with diabetes more vulnerable to gum disease, but diabetes may also have the potential to affect blood glucose control, as well as contribute to the advancement of diabetes.

Nearly 26 million Americans currently live with the disease, with an additional 79 million in the pre-diabetes stage. There is some good news we want you to know, however; you can protect your gums and teeth from the effects of diabetes by visiting our Wilmington office for an exam. Patients who are living with diabetes may require more often visits to ensure their dental health remains in tip-top shape. Many insurance plans provide expanded benefits for diabetic patients, and Dr. Keller and Dr. Tibbs can tell you how often you need to come in for an appointment.

For more information on how we can help, please do not hesitate to give us a call at our Wilmington office.

Halloween is fast approaching, and Dr. Keller and Dr. Tibbs 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 Wilmington office, make your Halloween a safe one!

Women using medication to treat a variety of medical conditions are often unaware of the potential side effects. One common side effect of medications such as blood pressure medication, birth control pills, antidepressants, and cancer treatments is dry mouth. The technical term for dry mouth is xerostomia.

Xerostomia can lead to undesirable effects in the oral cavity including periodontal disease and a high rate of decay. Many women who have not had a cavity in years will return for their routine exam and suddenly be plagued with a multitude of cavities around crowns and at the gum line, or have active periodontal disease. The only thing that the patient may have changed in the past six months is starting a new medication.

Saliva washes away bacteria and cleans the oral cavity, and when saliva flow is diminished harmful bacteria can flourish in the mouth leading to decay and gum disease. Many medications can reduce the flow of saliva without the patient realizing the side effect. Birth control pills can also lead to a higher risk of inflammation and bleeding gums. Patients undergoing cancer treatments, especially radiation to the head and neck region, are at a greatly heightened risk of oral complications due to the possibility of damage to the saliva glands.

There are many over the counter saliva substitutes and products to temporarily increase saliva production and help manage xerostomia. One great option for a woman with severe dry mouth or high decay rate is home fluoride treatments. These work in a number of ways, including custom fluoride trays that are worn for a short period of time daily at home, a prescription strength fluoride toothpaste, or an over the counter fluoride rinse. If you have more questions on fluoride treatments, make sure to ask Dr. Keller and Dr. Tibbs at your next visit to our office.

The benefits of many of the medications on the market outweigh the risks associated with xerostomia, however, with regular exams you can manage the risk and prevent many oral consequences of medications.

Gum disease is a common problem among adults, and one Dr. Keller and Dr. Tibbs and our periodontal team see all too often. Early stages of gum disease are known as gingivitis, or inflammation of the gums. This can progress to more serious gum disease known as periodontitis.

If you notice signs and symptoms of gum disease, take early action to prevent progression of gingivitis to more serious periodontitis and the risk of losing your teeth due to gum loss.

Watch for These Signs and Symptoms

It’s important to watch for signs and symptoms of gum disease, especially if you have risk factors. Early detection at home can help you get treatment sooner so that you don’t risk losing your teeth. These are the classic signs and symptoms of gum disease:

• Inflamed gums, or gums that are red or swollen
• Pain when you chew
• Teeth that are sensitive to heat, cold, sweets, or brushing
• Loose teeth
• Bad breath that you can’t get rid of by brushing or using mouthwash, even when you don’t eat particularly smelly food
• Gums that are sore to the touch or bleed easily, including when you brush your teeth
• Teeth that seem to be taller or longer due to receding gums
• A change in the way your teeth fit together when you bite
• A change in the way your dentures fit in your mouth

Signs We Look For

When you visit our Wilmington office, we will examine you to see how far your gum disease has progressed. We do this by:

• Discussing your medical history with you to see which risk factors you have
• Checking your gums to see if they are swollen or red, and how far the inflammation has progressed
• Measuring the depth of any pockets around your teeth using a type of ruler called a probe.

Treatment for Gum Disease

Brushing and flossing go a long way toward preventing bacteria from forming acid on your teeth and allowing tartar to build up. However, once you have the beginnings of gum disease, your regular brushing and flossing routine aren’t enough. Dr. Keller and Dr. Tibbs can provide more extensive treatment, such as:

• Deep cleaning through scaling and root planing
• Medications to fight the infection
• Surgical treatments, like bone or tissue grafting to replace lost tissue

If you think you may have gum disease, or are concerned about the state of your gum health, be sure to contact our Wilmington office to schedule an appointment. Together, we can help you achieve a lifetime of good oral health.

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. Dr. Keller and Dr. Tibbs can help you learn more about proper care for your teeth and gums.

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 Wilmington office may be in order. There are a couple of ways Dr. Keller and Dr. Tibbs 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.

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 Dr. Keller and Dr. Tibbs 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.

Dr. Keller and Dr. Tibbs 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 Montchanin Implant Center team for tips on proper brushing and flossing.

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, Dr. Keller and Dr. Tibbs can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Wilmington 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.

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 Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center 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, 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 Montchanin Implant Center hopes all of our patients celebrate Labor Day, and every holiday, safely and happily. Whether you stay in the Wilmington area, or travel out of town, have fun, and don't forget to brush!

Gingivitis is an early stage of gum disease that results when bacteria in your mouth cause inflammation in your gums. This is a common condition, and you can treat it effectively if you are aggressive. Otherwise, it could develop into more advanced gum disease, or periodontitis, and you could lose one or more teeth.

Watch for symptoms of gingivitis so you can ask Dr. Keller and Dr. Tibbs for help as soon as you need it. Strategies for treating gingivitis include thoroughly cleaning your teeth and assessing the scope of your gingivitis and how serious the problem is.

Gingivitis: Early Gum Disease

Your mouth contains many bacteria that form plaque, which is a sticky substance. You can get rid of plaque by brushing well, but if you don’t, it can build up on your teeth and form tartar. Bacteria can make your gums inflamed and cause pain and bleeding, or gingivitis. Other symptoms include loose teeth, bad breath, receding gums, and sensitive teeth. You’re at higher risk for gingivitis if you’re a smoker, if you have a weakened immune system, or if you have diabetes.

Assessment and Diagnosis

If you think you recognize the symptoms of gingivitis, contact our Wilmington office to make an appointment. We will ask you about your risk factors for gingivitis and examine your teeth and mouth for signs of red and swollen gums. We may also measure the pockets around your teeth. If they are larger than usual, your gingivitis may be more advanced. Finally, will take some X-rays to get a picture of the bone structure of your jaw.

Deep Cleaning

You can’t get rid of the tartar on your teeth just by brushing at home. Instead, you need a deep cleaning consisting of scaling and root planing. Scaling involves scraping the plaque off of your teeth, both below and above the line of your gum. In root planing, the rough surfaces of your teeth where tartar is more likely to build up are smoothed. A laser may be used to make the procedure more effective, more accurate, and more comfortable.

One of the most transformative advancements in dental restorations is the dental implant. Implants look just like natural teeth, they function just like natural teeth, and they help maintain jawbone health just like natural teeth. But the success of any implant procedure depends on the quality and quantity of the bone in which it’s placed. That’s why, before placing your implant, Dr. Keller and Dr. Tibbs might first suggest a common procedure known as ridge modification.

An implant consists of a metal post which is surgically placed in the jawbone. This post serves as the “root” of the dental implant. After several months, the post fuses with the bone surrounding it, as bone tissue grows around and attaches to the post surface. This process is called osseointegration, and it creates a strong, secure anchor for the abutment and crown which will be secured to the post when it heals.

Because of the strong pressures which biting, chewing, and clenching put on our teeth, the success of an implant depends on the strength of its integration into the jawbone. To make osseointegration possible, the bone must be healthy, with adequate size and density to hold the implant securely.

Ridge modification, also called ridge augmentation, is periodontal surgery. In this procedure, we use bone grafting to rebuild bone strength in the alveolar ridge (the part of the jawbone containing the tooth sockets) before placing a post. When is this procedure necessary?

Jawbone size and density can be compromised in several different ways, including:

• Resorption

When a tooth is missing, the bone ridge under the lost tooth gradually begins to shrink, a process called “resorption.” Over time, bone loss can lead to a noticeable indentation in the jawbone.

• Periodontitis

Serious gum disease is progressive. Without treatment, the gums begin to pull away from the teeth. This leaves bone and connective tissue exposed to destructive bacteria and infection, which can cause bone loss.

• Trauma

Bone damage caused by accident or injury might require bone replacement or recontouring.

• Bone structure and size

Sometimes the jaw ridge is too narrow or shallow to support an implant, especially in the back of the upper jaw near the sinus cavity, and will need added bone before an implant can be placed.   

Periodontists are specialists in bone grafting surgery, with years of advanced education and training in the treatment of the structures that support the teeth, including gums, connective tissues, and bone. Dr. Keller and Dr. Tibbs will recommend bone graft surgery if the success of your implant would be in jeopardy without it.

What will your surgery involve?

• Assessing bone quantity and quality

Using advanced imaging technology, we will evaluate your jaw’s condition, and map out any areas of bone loss.

• Designing your treatment plan

If a bone graft is your best option, we will recommend the best grafting materials for your needs. Bone grafting might use bone tissue taken from your own body, processed bone grafting material, or synthetic grafting material to replace and repair the damaged bone. We will also discuss your anesthesia and sedation options.

• Performing the Surgery

After anesthesia, an incision will be made in the gum tissue to reveal the damaged or missing bone. Grafting material will be shaped to restore the bone’s contours and secured to the affected area. The incision will then be closed. If you are here for an extraction, it may be possible to have augmentation done as part of the same procedure.

• Providing follow-up care

You’ll receive detailed careful instructions for after care and follow-up visits at our Wilmington periodontal office. The time it takes for you to heal completely will depend on the size and type of your graft.

• Placing your implant

Once the bone has healed, we can surgically place the post for a secure, long-lasting, and healthy implant.                   

If it’s been some time since you lost a tooth, if your jaw has been damaged by injury or trauma, if you have less-than-adequate bone size and density, it’s important to restore your bone before implant surgery can be successful. See us for an evaluation, and learn how a ridge modification procedure can help you improve your dental health and transform your smile.

Does your mouth always feel like it’s dry? If it does you may be suffering from xerostomia. Xerostomia is defined as dry mouth resulting from reduced or absent saliva flow. There are various medical conditions that can cause this type of dry mouth, which you can ask more questions next time you visit us at Montchanin Implant Center.

Xerostomia can factor into both minor and more serious health problems. It can affect the ability to eat and enjoy food and it can jeopardize one’s dental health. Some of the more common symptoms can include sore throat, burning sensation in the oral cavity or tongue, and difficulty swallowing.

One of the more serious problems associated with dry mouth is an increased risk of tooth decay. Decrease in saliva causes more plaque to form and there is less saliva to act as a buffer to the things we eat and drink. Less saliva also means more food debris is retained in the mouth. These things can lead to an increase in tooth decay.

So, what causes xerostomia?

There are several things that may cause xerostomia. Among the biggest culprits are prescription medications. Some examples are antihistamines, antidepressants, anti-hypertensives, anti-anxiety agents, anti-diarrheals, bronchodilators, and muscle relaxers.

Certain diseases can also cause dry mouth. The more common ones include rheumatoid arthritis, lupus, diabetes, hypertension, and thyroid disease. Xerostomia is also common in patients being treated for cancer. Head and neck radiation as well as certain chemotherapy drugs can cause severe dry mouth.

What should you do if you are experiencing dry mouth symptoms? First make sure to hydrate with plenty of water. If you are taking medications that cause xerostomia, make sure to drink water before taking the medication as well as a full glass of water with the medication. Be diligent with brushing and flossing and discuss your condition at your next appointment with Dr. Keller and Dr. Tibbs. We can recommend specific products to help moisten the oral cavity and reduce your symptoms such as saliva substitutes, xylitol products, and certain toothpastes. Another option may be a prescription home fluoride treatment to help prevent new cavities. You may want to try gum or candies to stimulate saliva flow but make sure they are sugar free! Avoid food and beverages that dehydrate such as caffeine and alcohol.

Xerostomia is a common problem that is currently on the rise. Our team can help you to reduce any symptoms and improve your comfort while living with a dry mouth. Contact our Wilmington office today!

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, Dr. Keller and Dr. Tibbs 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 Wilmington office.

Dr. Keller and Dr. Tibbs and our team always tell our patients that if you value your overall health, not just your oral health, anytime is a good time to visit Montchanin Implant Center for a periodontal evaluation. Sometimes the only way to identify periodontal (gum) disease is through a comprehensive periodontal evaluation. If you notice any of the following periodontal disease symptoms outlined by the American Dental Association, it may be time to give us a call to schedule an exam:

• Gums that bleed easily or are swollen, red, or tender
• Gums that bleed while brushing, flossing, or eating hard foods
• Pus between your gums and teeth
• Sores in your mouth
• Gums that are receding or pulling away from the teeth, causing teeth to look longer than before
• Frequent bad breath or a bad taste in your mouth
• A change in the way teeth align when you bite
• A change in the way partial dentures fit

It is also important to note that it’s possible to have gum disease and have no warning signs. While studies have indicated that older people have the highest rates of periodontal disease, we recommend being seen by Dr. Keller and Dr. Tibbs sooner rather than later when dealing with gum disease. An evaluation at our office can not only help catch gingivitis, the early form of gum disease in time, but can also give you peace of mind. Gingivitis, if detected early, can be treated and eventually reversed.

Not doing anything, however, can lead to periodontal disease, which can in turn lead to tooth loss. The best way to avoid gum disease is to visit our Wilmington office for an evaluation. To schedule your visit, please give us a call today! We look forward to seeing you!

A vital step in your oral health routine is flossing. We hope our patients at Montchanin Implant Center maintain good oral hygiene, including daily flossing between each visit to our Wilmington office. A toothbrush is not always enough to get to the hard-to-reach areas of your mouth. When food remains between your teeth, bacteria starts to grow and will break down your enamel. This is where flossing comes in!

Should you floss before or after brushing?

Whatever your personal preference, you may floss before or after you brush your teeth. When you floss first, you can brush away any leftover dislodged food debris from your teeth. On the other hand, when you brush first, you will loosen the plaque between your teeth, which makes flossing more effective.

The essential aspect is that you floss thoroughly by using a fresh strand of floss and make sure to get between every tooth. Even if your teeth look and feel clean, don’t skip flossing or plaque will begin to build up on your teeth.

When is the best time to floss?

Although you should brush your teeth at least twice a day, Dr. Keller and Dr. Tibbs and our team recommend flossing your teeth thoroughly once a day. Many people prefer to floss before bed, so that plaque doesn’t sit between their teeth all night.

What kind of floss should I use?

You may 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.

Do you need help flossing?

If you’re having trouble flossing or have questions about which floss is best for your teeth, contact our Wilmington office and we can provide you with support. Be sure to keep up with your daily flossing routine, and we will see you at your next appointment!

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 Dr. Keller and Dr. Tibbs or any member of our Wilmington team—we'd be glad to help you pick up this healthy habit!

The dog days of summer are upon us, and what better time for Dr. Keller and Dr. Tibbs 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 Wilmington 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!

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.

Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center wish you a safe and happy Fourth of July!

Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center 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 Wilmington location if you have more specific questions. We’re here to help you!

Getting to the Root of the Problem(s)

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 Dr. Keller and Dr. Tibbs 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.

• Root Infections

Any infection in the pulp of the tooth will affect the roots as well. Your dentist will examine you carefully to see if a root canal is advisable. In this procedure, injured or infected pulp is removed from the pulp chambers and the root canals, the tooth is cleaned and filled, and, usually, a crown caps the tooth afterwards.

• Gum Recession

Finally, one of the best ways to protect your roots is to take care of the tissues surrounding them. A periodontist is a specialist in the diagnosis and treatment of the gums, bones, and other tissues supporting the teeth.

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 your periodontist 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 and bones.

Healthy roots help you keep your teeth for a lifetime, so it’s important to see your dentist as soon as possible if you have any symptoms of potential root or gum 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
• Receding gums

Do your part by keeping up with daily brushing and flossing, seeing Dr. Keller and Dr. Tibbs for exams as recommended, and making an appointment at our Wilmington 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!