Fisher & Orfaly Blog


Oral Anti-Snoring Guard

There are over 90 million American adults that snore.  Snoring does not only affect the snorer but often times their loved ones as well.  It is estimated that over 185 million Americans are negatively affected by snoring.  I often hear from patients that snoring has caused them and their spouse to sleep in separate rooms.

Snoring occurs when there is an obstructed airway.  Often times, when we sleep, our tongue slides to the back of our mouth and our jaw relaxes both of which contribute to the airway becoming obstructed. The noise of snoring is caused by the air we breath in trying to pass through this obstructed airway; the air vibrates off if the tongue, soft palate, and tissue of the throat.

At Fisher and Orfaly Dental, we fabricate an anti-snore guard called a mandibular advancement device.  This custom designed appliance moves the jaw in a forward position bringing the tongue forward as well.  This increases the size of the airway which in turn reduces air velocity, vibration, and snoring.

The anti-snore guard is fabricated from impressions of your mouth and requires only two appointments.

The device consists of two soft plastic forms which seat over your upper and lower teeth.  These are attached by short connectors that bring the lower jaw in a forward position during sleep preventing snoring.  To demonstrate this, I ask you now to try and make the snoring noise.  Once you do that, move your jaw forward and try making the snoring sound.  I imagine that you had great difficulty making the noise with your jaw forward.

If the airway is blocked completely for longer than 10 seconds, you may have sleep apnea and we suggest you see a medical doctor.


February is National Children’s Dental Health Month

The team at Fisher & Orfaly Dental want to help make taking care of your children’s teeth fun.  Here are some tips.

1.  Make brushing your teeth twice a day for two minutes each time an event.  Play your child’s favorite music for two minutes (you can even make up a fun dance to go with the music).  Or, read from your child’s favorite book for the two minutes.

2. Reward good brushing.  Maybe you let them pick the book you read at bedtime or make a sticker chart.  Or, simply ask to see their pearly whites and give them a high five.

3.  Go shopping together and let them pick out their toothbrush and toothpaste.  We at Fisher & Orfaly Dental recommend buying products that have the American Dental Association Seal of Acceptance.

4.  All of the products have popular children characters on them.  This makes it fun and exciting for kids.

5.  If they cannot find a character they like, make up a story in which they are the superhero fighting the “bad guys” that want to start cavities.

6.  Make brushing a family affair.  Remember, your children learn from you so set a good example.

7.  Start a routine and stick to it.  You may be tempted to let them skip brushing their teeth after a long day but do not.  The more brushing becomes second nature the easier it will be for them to maintain good oral hygiene habits for a lifetime.



Why Would You Need a Dental Crown

A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size.  A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.

Although there are several types of crowns, porcelain (tooth colored crown) are the most popular.  They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced.  Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

Reasons for Dental Crowns:

  • Broken or fractured teeth.
  • Cosmetic enhancement.
  • Decayed teeth.
  • Fractured fillings.
  • Large fillings.
  • Tooth has a root canal.

What Does Getting a Dental Crown Involve?

A crown procedure usually requires two appointments.  Your first appointment will include taking highly accurate molds (or impressions) that will be used to create your custom crown.  A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown.  Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.  At Fisher & Orfaly Dental, you will be given care instructions and encouraged to have regular dental visits to check your crown.


Mouthwash for Better Oral Health

Mouthwash should not be viewed as a replacement for daily brushing and flossing, but as a helpful addition to your daily oral hygiene routine.

Some benefits of mouthwash are: reducing bad breath, help to prevent cavities, fight against gum disease, and relief of dry mouth.

Mouthwashes are divided into two categories:  cosmetic and therapeutic.  Cosmetic mouthwash may combat bad breath temporarily and leave a pleasant taste.  Therapeutic mouthwash has active ingredients that help fight against gingivitis, plaque, dental decay and bad breath.

A mouthwash that is formulated to fight against gingivitis and plaque will likely have antimicrobial ingredients such as chlorhexidine, cetylpyridinium, and essential oils.

Mouthwashes that are designed to be anti-cavity will have fluoride ions which help remineralize broken-down enamel.

There are also whitening mouthwashes. These mouth washes will usually contain carbamide peroxide or hydrogen peroxide as an active ingredient.

A few important thought to end this blog.

  1. Using mouthwash does not mean you do not need to brush and floss. It is used in conjunction with a proper oral hygiene regimen.
  2. Always use mouthwash that has the ADA Seal of Acceptance.
  3. Use prescription mouthwash as directed.



Dental Cavities and the Role Sugar Plays

With Halloween around the corner, and our dental office being in Salem, MA, the Halloween capital of the world, we wanted to talk about dental cavities and the role sugar plays.

A cavity by definition is an empty space within a solid object.  So, a dental cavity is an empty space within a tooth.  The empty space is first created by destruction of a tooth’s enamel.  The enamel is the hard, outer layer of a tooth.

How does the enamel breakdown?  Plaque, a sticky film of bacteria, constantly forms on teeth. When we eat and drink foods containing sugars, the bacteria in the plaque produce acids that attack enamel.  Because plaque is sticky, it keeps the acid in contact with the teeth and over time, if not removed, the enamel will erode.  This erosion of enamel is when a cavity is formed.

With Halloween, comes eating of candy which has a high sugar content.  It is important that we do not allow the sugar and the plaque to stay on our teeth for long periods of time. What we recommend is:

  1. Brushing twice a day and even throw in an extra time on days such as Halloween, when you consume a lot of sugar.
  2. Floss daily.
  3. Eat nutritious and balanced meals.
  4. Visit your dentist regularly for professional cleanings and exams.


Proper Toothbrushing Technique

The American Dental Association recommends that you brush your teeth twice a day for two minutes each time with a soft-bristled toothbrush.

To review the proper brushing technique, here are the essentials.

  1.  Place your toothbrush at a 45-degree angle to the gums.
  2. Move the brush back and forth in gentle, short strokes.
  3. Tilt the brush vertically and make several up-and-down strokes to clean the inside surface of the front teeth.
  4. Brush your tongue to help fight against bad breath by removing bacteria that hide in the bumps and grooves of your tongue.
  5. Replace your toothbrush every 3 months or sooner if the bristles become frayed.


Breast Cancer and Oral Health

October is Breast Cancer Awareness month.  With that being said, we want to help spread the word and also discuss the connection between breast cancer and oral health.

The World Health Organization conducted a 16 year study that linked gum disease with an increase in risk of breast cancer.  Common signs of gum disease are red, puffy gums and bleeding when brushing and flossing.

In the United States alone, there are over 200,000 new cases of breast cancer diagnosed each year.  These patients have to deal with multiple health issues including challenges with their dental health.  Women with breast cancer often develop xerostomia, commonly known as dry mouth. Dry mouth can lead to dental cavities due to the lack of saliva which helps remove plaque and food debris.  To combat dry mouth, breast cancer patients often will place a hard candy or mint in their mouth.  These candies/mints often have sugar which leads to tooth decay.  We recommend having sugar-free candies or mints.

Ask your dentist about the best way for you to maintain dental health during treatment.


How to Prevent Bad Breath

Bad, breath, also called halitosis, is a common problem that causes many to be self conscious and embarrassed.  I am often asked how to eliminate bad breath so I want to share some helpful tips.

Brush Your Teeth Twice a Day

Brushing your teeth for two minutes twice a day will help prevent the bacteria that cause bad breath to grow.  Brushing more than twice a day would not hurt either.

Floss at Least Once a Day

You will remove food debris and bacteria in between your teeth that can cause bad breath by flossing.

Brush Your Tongue

Often bacteria that cause bad breath hide between your taste buds and grooves on the back of your tongue so brushing there will help remove that bacteria.

Rinse with a Mouthwash

Dental mouthwashes help climate the bacteria that cause bad odors and are often flavored with mint which will freshen your breath.

Drink Water

By drinking 50 to 70 ounces of water daily you will help to prevent bad breath by washing away food pieces and bacteria and keeping your mouth moist.  Dry mouth can contribute to bad breath.

Chew Sugarless Gum or Eat Sugarless Mints

Having a piece of sugarless candy or gum helps increase your saliva flow which in turn will wash away food particles and bacteria.

Avoid Smoking and Tobacco Products

Smoking drys out your mouth which will lead to bad breath.  Also, tobacco leaves an unpleasant odor.

See Your Dentist Regularly

Having your teeth professionally cleaned will help remove bacteria, plague and tartar which cause bad breath.  If you have chronic bad breath it is important to see your dentist to ensure there is not an underlying dental condition which is causing the odor.




Is Vaping Safe and What is it Exactly?

Vaping has become increasingly popular today. I am sure you have seen someone walking down the street or driving in their car blowing out a thick cloud of smoke while holding some foreign looking device. Well, they are vaping.

Vaping involves inhaling vapor from a cylindrical device (the vape) that is filled with liquid chemicals. There is a heating element in the vape that changes the liquid into steam.

So, should you assume this is a safer alternative to cigarettes? No! There are the same carcinogenic chemicals in vapes as there are in cigarettes. The vapor from this has been identified to worsen the air quality by releasing nicotine, formaldehyde, lead and other chemicals. Exposure to these chemicals are dangerous — especially for younger children.

An unfortunate trend is that vaping has become popular with pre-teens and teenagers. These children are made to believe that vaping is not harmful because they can buy flavored liquids to put in the vape. They think, “how could something that smells and tastes like cotton candy, apples, or bananas be bad for me?” Unfortunately, this is how these vaping companies are attracting young smokers and has turned this into a billion dollar industry.

If you do vape, here are some signs and symptoms to look for in terms of oral cancer:

Red and/or white patches in the oral cavity
Sores in the mouth and on the lips that do not heal
A sore throat that persists

Please contact your doctor immediately if you notice any of these signs or symptoms.

Remember, the best precaution is not to vape, but if you do continue, it is important to see a dentist regularly so they can do an oral cancer screening.


Teeth Whitening

Patients often ask about teeth whitening and we wanted to provide you with accurate information.

Over time, teeth become stained for many reasons.  Coffee, tea, red wine, and tobacco are the usual culprits causing teeth to become darker.  They release molecules that attach to the outer surface of teeth (enamel) and create extrinsic stains.

Some extrinsic stains can be removed by using a whitening toothpaste.  Whitening toothpastes contain silicates that gently remove surface stains.

Underneath the enamel layer of teeth is a softer, more porous inner layer called dentin.  Due to the porosity of dentin, it can absorb darker stains.  These stains are called intrinsic stains.  Also, adding to discoloration of teeth is that as we get older, the dentinal layer gets darker naturally.

These intrinsic, dentinal stains require peroxide bleaching agents to be removed.  There are two safe peroxides:  (1) hydrogen peroxide and (2) carbamide peroxide.  When applied to the teeth, carbamide peroxide becomes hydrogen peroxide.  Hydrogen peroxide is a strong bleaching agent that oxidizes and breaks up the molecules that are creating the stain into smaller and less-colored molecules.  You should only use a product containing hydrogen peroxide for teeth whitening that is approved by a dental professional.  

At our office, we consider custom bleaching trays as the gold standard method of whitening.  We take accurate impressions of your teeth from which we make stone models.  We place the stone models on a vacuum-forming machine to produce the whitening trays.  We will then deliver the trays and peroxide gel and go over the instructions.

If you have any questions regarding teeth whitening, please contact us.