Dental Blog

Zirconia Abutment

In the long term, we have learned that Zirconia Abutment are estheticly pleasing. Looking at this chart, you can imagine a white core of a tooth is more lifelike than a grey one, and gold colored titanium is more durable than silver.

Therefore the most esthetic abutment, and the most durable, is the one that has a gold/titanium implant interface bonded to a zirconia abutment above. The upper left of the photo shows an all zirconia abutment. We have found that eventually, the inner surface of the implant will scratch and wear, despite being the most important connection area. If that area becomes loose, than we will find that the implant will need to be removed. These distinctions between the core type and the durability are important distinctions however, not everyone pays attention to them. 




Laser-Lok microchannels is a dental implant surface treatment that works to create the optimal implant surface. This Laser-Lok surface has been seen to elicit a biological response of attachemnet of connective tisuse. This attachement produces a natural biological seal around the implant, protecting and maintaing crestal bone health. Because of these biological responses to the implant, Laser-Lok has been seen to be more effective than other implant designs for reducing bone loss. 

Laser-Lok technology features a unique surface: a series of cell-sized cirumferential channels that are created using laser ablation technology, producing nearly perfectly consistent microchannels that are sized to attach and organize both osteobllasts and fibroblasts. The Laser-Lok structure also features a repeating nanostructure that works to maximize surface area and enable cell pseudopodia and collagen microfibrils to bind with teh Laser-Lok surface. 

Laser-Lok is as much like a real root shape as can be. It has the rough surface at the bottom of the implant. The rings you see (laser lok) allow the gum tissue and bone to weave into the tip of the implant like none of the other implant companies can claim.

(all of the implants you see on our gallery page are Laser-Lok taper internal)

They are credited with more research than many brands.

Rubber Finger Brush for Teething Toddlers

Fortunately for me, my daughter loves to brush her teeth. At one and a half, she even uses it as an excuse to delay bedtime. As she's growing, I find that one of the easiest ways to brush her teeth is by laying her on my lap. I face her head toward my knees. At this age I do not use fluoride toothpaste as I do not want her to swallow too much. I use Oralb training toothpaste. I scrub her teeth (mind you this does not take very long because she has only a few) starting at the back right and brush to the other side gently. Then I repeat this with the lower teeth.

She tends to push a bristled brush out with her tongue so I switched to a finger brush. This rubber brush has rubber bristles and is easy to manipulate. With the rubber tip brush, I can brush her bottom teeth more than before. I think the rubber brush is more soothing to the erupting teeth and to the tender gum tissue. I mentioned in earlier blog posts that removing bacteria is the key. Time that you brush is a little less important.

Importantly though, remember that if brushing is not the last thing before bed, then your child will be falling asleep with sugars from a bottle or whatever else your child previously ate, allowing their mouth to develop early cavities. As my daughter has grown up, it has become easier to brush the last thing before bed….sometimes she even tries to brush immediately after eating. Maybe we should come up with a fork/toothbrush too. 

Omega 3 Supplements

Recently I have had 2 patients who are very healthy, and who have excellent dental hygiene, but tell me their gums bleed. Both of these patients told me that when they floss, they find a little clot of blood between their teeth.

This I would expect from the gums of a person with poor hygiene. Not a healthy person who is flossing daily.

My conclusion in questioning both of them has been that they both take double the amount of suggested Omega3 supplement. While vitamin C and Vitamin B are hard to overdose on, Omega 3 is the opposite. Omega 3, Fish oil, and Krill oil are supplements that reduce inflammation. They also act as blood thinners. While smaller, and correct, doses have beneficial effects, higher doses can cause bleeding. People who take Baby Aspirin, Warfarin/Coumadin, or Plavix should speak to their doctor about using Omega 3 instead.

People who do NOT take any medications should also pay attention to how much Omega 3 they consume so as not to overdose. Women should be especially mindful to their Omega 3 intake as another patient told me that while consuming higher doses of Omega 3, her monthly menstrual flow was much heavier.

I am a big proponent of supplements but it is important to realize that if you consume fish, olive oil, flax seed, or almonds, you are already getting the benefit of some Omega 3 (and Omega 6 and Omega 9) so adding more Omega 3 to your diet could cause a build up.

I told both patients to speak to their physicians and to return to what a recommended dose would be.

Mouth Acids

Your Dentist can help to diagnose systemic problems by looking in your mouth and should examine your mouth every six months, it is not money wasted! Usually during cleaning visits I will complete our Periodic Oral Evaluation. During this cleaning visit, I also look at the tissues of the mouth; gum tissue, teeth, and the tongue are all under great scrutiny. I look for any type of oral change. 

In this post I want to show you the changes that alerted me to my patient's case of GERD- Gastro-Intestinal-Reflux-Disease. 

He had not been in for some time but when I saw the back of his teeth I knew right away that he had some extra 
acid in his mouth. After asking the right questions, he did mention that he had excessive indigestion. 


Enamel loss, seen above, usually arises through one of two conditions: GERD or excessive vomiting. While the vomiting associated with morning sickness is not usually enough to damage teeth, excessive vomiting can cause this type of erosion. This is often associated with Bulimia and is a change that is visibly apparent to a dentist. 



When to Treat a Cavity

"My dentist told me my tooth has a dark spot. It feels fine. It doesn’t hurt when I chew and it doesn’t hurt to sweets. Why should I fix it?"

Many times I hear the same thing…"but it feels fine…can I wait".

I have here photos of someone that had a cavity. It seemed small but when we opened up the tooth it was quite large. The problem with decay is that it usually does not hurt until it touches a nerve. The problem with treating a cavity once it starts to hurt is that it treatment now requires a root canal. 

The photo on the left shows a tooth with a small dark spot. What I was most concerned with is the grayish areas around those small spots. That tells me that there is a hollow “cavity” below the surface. As you follow to the right you will see how the decay is still in the dentin of the tooth until it is quite deep. If we had been allowed to treat this tooth much sooner we would have preserved much of the patient’s tooth structure. This tooth might need a root canal in the future. Small fillings are less likely to hurt the patient and last longer.



When Should I Replace My Toothbrush

When should I replace my toothbrush head / toothbrush.

Firstly a manual toothbrush is fine HOWEVER any electric toothbrush will do a better job of brushing.

I personally prefer the Sonicar brushes in electric and Oral b Cross Action for manual brushes.

That said it does depend on you as to when you replace your brush. If you brush aggressively you will wear the bristles out faster and thus replace the brush faster. With normal use I usually suggest 3-4 months. Above is a photograph of normal brush use at 6 months. One can readily see that the bristles loose their ability to spring back and in turn wipe away plaque. The above photo also shows why I like the Sonicare brush. It has a wonderfuls shape that fits into the spaces in our teeth. The blue band in the front is supposed to show us when to change the brush head. When the blue band is down to the final 1/3 replace the brush. Many brushes have such technology and can be a good guide as well. Do pay attention to these details when selecting a brush. A brush that is more efficient in cleaning is more efficient in removing bacteria and in turn keeping your mouth healthy.



Welcome Sunlight

Recently I had my anual physical. Reading my bloodwork I realized I had less than HALF the amount of Vitamin D than I should have. We all learn in school that lack of Vitamin D during development can lead to poor bone formation, even Rickets. I personally cannot drink much milk, and even I read people I am not still growing so should I be concerned? YES.

Vitamin D is essential in proper immune system function (infact I believe I read 70% of people that develop a cancer had low Vitamin D levels). In addition to poor bone formation and osteoporosis, low Vitamin D levels can lead to depression, infections, cancer, heart disease and muscle weakness. Vitamin D is similar to a hormone and helps to regulate our absorbtion of calcium, iron, phosphate, zinc.

Interestingly I had been experiencing lower energy levels (though I did not even realize until after supplementing that I had this). My blood levels of Phosphate were off, and I had gotten a nasty cold (also odd for me).

Other than supplementation the only way we can get adequate vitamin D is though exposure to sunlight. You can see how working indoors and "wanting to avoid skin cancer" would allow our bodies (as a society not just me) to become deficient.

I have been encouraging patients of mine that have complaints of muscle cramps, fatigue, weakness / tiredness, sickness to have their blood analyzed by their physician.

After just a week of supplementation I do feel different. Just a week. I am a believer. (and I probably will try to get a bit more sun this summer :) )



Thank You Notes for CityDentist

Dr Stange,

My husband and I have elected you to the doctors hall of fame! We both feel very lucky to have found you. (Thank you ## and ## !)

You got me through a process today that I've been fearing in a deep way. I'm very grateful to you. Your commitment to your work reminds me why people who care about their profession can make an enormously meaningful difference in peoples lives.


Again I thank you so much.

Your new patient,


Thank You Note To CityDentist

Need We Say More?!!!!

This is a thank you note from one of our patient's. She lost a front tooth and we not only restored that tooth but created a new smile for her!!


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Fred Stange, DDS

Fred Stange, DDSWe deliver personalized cosmetic dental care.

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