Monday, August 27, 2012


I just recently read a cartoon that someone posted on Facebook. It had an interesting comment that stated something along the lines of "I just won't ever get why a rich person would have jacked up teeth".

This comment made me think for a bit. I've concluded that the only possible explanation would be that teeth are not a priority. For them, it may be normal to wear dentures at the age of 40. They may also have friends, relatives and acquaintances that also do not value teeth. Being rich has nothing to do with it. Having missing or rotting teeth is not a big deal to some people.

Do we really need teeth? Well, I guess many of us know someone that wears dentures. They may be perfectly happy with them. So perhaps teeth aren't really a necessity for some people. For me though, I think it would suck to wear dentures. Therefore I'm keeping my real teeth.

For some people, teeth are important. There are many reasons we could cite for their importance. Read my blog entitled The Power of a Smile, for why they are very beneficial not just from a health perspective, but socially and economically as well.

We often see people that have very limited resources place more importance on their teeth and will often find a way to finance their veneers, implants or orthodontics which can easily costs thousands of dollars. It's all a matter of priorities.

A common occurrence in dental offices is to see people with messed up teeth claim they can't afford to spend money on their teeth. However, they are often seen driving expensive vehicles, they go on nice vacations, have nice purses, smart phones and the latest and greatest televisions on the market. People have money for things they want. If they don't believe that spending a few thousand on their mouths is important, then they won't do what is necessary to keep their teeth. If they believe getting an SUV is important, they will certainly find a way to purchase it.

As I stated before, It's all a matter of priorities. I'm not going to change anyone's mind with this blog.We each have different priorities. As far as oral health goes, you must determine what is important to you. Do you  want to keep them (teeth)? Why or why not? Do you want them to look attractive? Why or why not? These are questions only you can decide on.

I'm sure most people reading this blog are the ones that do value their teeth. Ask your dental professional for options and recommendations to your concerns. There are often many potential solutions.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Monday, August 20, 2012

Bad Breath Can Kill You

Perhaps the title seems a little dramatic. Can bad breath really kill you? Yes, depending on the true source of bad breath.

There are many potential sources for bad breath. I encourage you to read my previous blog entitled Bad Breath.

On many occasions while walking through a public place, I will occasionally pick up on a distinct odor. Once you smell it, you may never forget it. Just as a decomposing animal has a distinct odor, so does periodontitis (periodontal disease). Most people have smelled the odor that is indicative of periodontitis on many occasions. They may just not be aware of what it really is.

So, how do you know if the bad breath is from periodontitis or from some other source? You don't. Only a dentist will be able to definitively diagnose it. However, there are some clues. As I mentioned before, there is a distinct odor. The odor also tends to be chronic. No amount of brushing, flossing and rinsing will seem to improve it.

So how can bad breath kill you? To put it succinctly, infection of the gums and bone travel throughout the entire cardiovascular system. Inflammatory cells and bacteria affect the entire cardiovascular system. As a result, people suffering from periodontitis are at a significantly higher risk of developing cardiovascular issues such as strokes and heart attacks. Therefore, someone may meet their demise much sooner than they otherwise would.

For a more detailed discussion on how periodontitis can kill you, refer to my previous blog entitled The Link Between Periodontal Disease and Cardiovascular Disease.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Wednesday, August 15, 2012

Botox and Juvederm

Many of us want to find the Fountain of Youth. More Americans than ever are trying to maintain their youthful appearance. California is well known for their vanity. I know, I lived in Los Angeles for the first 18 years of my life. Now, where I practice near St Louis, just as nearly anywhere else in the US, people are equally concerned about their appearance.

In Dentistry, we were mostly concerned with the youthful appearance of teeth. We've overlooked the face.

As teeth are worn, the face will appear to shorten thereby creating unwanted wrinkles. We will often see the corners of the mouth develop a downward line that gives the appearance of a frown--even when the person is smiling.  But the muscles around the face also influence the development and progression of wrinkles. We can do something about this.

Treatment with Juvederm

Treatment with Juvederm

By placing Juvederm just under the skin, we fill in unwanted lines that will not disappear when the muscles are relaxed. This is commonly done in the wrinkles around the nose and mouth. Juvederm is material that is incredibly safe and well tolerated. The effect will typically last about a year.

When we have wrinkles that will disappear by simply relaxing the muscles, we have the option of using Botox. Botox simply prevents the muscles from contracting, thereby eliminating the lines that are formed by their contraction.

Treatment with Botox
If you choose to pursue this type of treatment, ensure that it is performed by a well trained health-care provider that is well versed in the anatomy of the face. This will ensure that only the desired muscles are relaxed.

I must also mention that the worst two things someone can do to their skin is smoke and expose themselves to excessive UV radiation (sun and tanning booths). It amazes me how many people want to retain their youth, but instead accelerate the aging process with these two things.

Stay Young!

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Monday, August 6, 2012

Tooth Whitening

Most people desire a nice beautiful white attractive smile. They don't necessarily want a whiter smile. They want the benefits of a whiter smile.

A whiter smile may enhance confidence. It may improve someone's love life or enable them to keep one. It may help them improve their professional or financial worth. It may even improve overall health by improving mental health and thereby improving physical health.

Tooth whitening is a relatively safe, easy and inexpensive way to improve your smile. There are basically three ways to whiten your teeth. The first is an in-office procedure that takes roughly an hour. The second is a take-home procedure that takes roughly two weeks. The third is an over the counter product that can be purchased at many retailers. There are advantages and disadvantages with each option.

In-Office Whitening

In the In-Office option, your teeth will be whiter before you leave the dental office. The advantage here is that you get immediate results. The disadvantage is that tooth sensitivity is a common problem. I've stopped offering this option years ago for this reason.

A custom tray for Take-Home Whitening
In the take-home option, the dentist will fabricate some custom made trays to hold the whitening gel. Every practionioner has their methods and reasons for doing what they do. What I typically do is to tell my patients to place a small BB sized amount of gel into the tray on the surfaces where the teeth will be visible. I tell them to wear the trays for approximately one hour per day for two weeks. This can be modified depending on the intensity of any potential sensitivity. If sensitivity is a problem, I have them titrate it by using less gel, decreasing the amount of time to perhaps 30 minutes, or perhaps only using the trays every other day. There is no hurry. The whitening need not be completed in two weeks. If the patient does not experience any sensitivity, I advise them to not wear the trays for longer than two hours. The biggest problem with this method is that immediate results are not possible.

Over-The-Counter product
The over-the-counter method is similar to the take-home method. However, custom trays are not worn. Adhesive strips are also available. When using these kits, it's best to follow the manufacturer's instructions. Each product has a different formulation with varying concentrations of the whitening agent. The biggest disadvantage of this method is that since the trays aren't customized for your mouth, the gel will get on the gums and cause irritation. In addition, treatment isn't monitored and you are much more likely to damage the gums and the teeth.

Although teeth whitening is a relatively safe procedure, consult with your dentist immediately if any problems arise. Irreversible damage is possible. Also, I must mention that "whitening addiction" is a serious concern. Do not whiten frequently or for extensive periods.

Some stains are not amenable to whitening. There are basically two types. Those that are on the surface of the teeth (extrinsic), and those that are deep within the teeth (intrinsic). There are other options if you have stains that cannot be readily removed with whitening gels. Your dentist or hygienist can give you guidance.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit