Charcoal based toothpastes

Date posted: November 5, 2018

The new “internet sensation” known as activated charcoal warrants some discussion as whether this new whitening toothpaste is a viable alternative. We all are familiar with the charcoal from our barbeques grills but recently we have seen a surge in use of activated charcoals from everything from detox masks to ingestible pills.

Activated charcoals have been around since the birth of ancient medicine utilizing its binding qualities to cure a myriad of toxicity issues In theory, it binds to stains, tartar, bacteria and even viruses. This does seem like the ideal dentifrice but you must consider the fact the charcoal is abrasive and could potentially wear down your teeth faster and damage enamel. The absorptive capacity of charcoal may also sound beneficial but it must stay in contact with the tooth surface for a long period of time. For this benefit you would have to brush for much longer than the average brush time There also have been some concerns about ingested charcoal interfering with medication absorption in your digestive tract. Provided that you are rinsing out the charcoal rather than swallowing there is very little chance of medication absorption.

There are however antibacterial benefits and even some benefits in extrinsic stain removal. If you so choose to include charcoal based dentifrices into your daily routine, it would be best to use every other day for stain removal. There have been few studies concerning the abrasive effects of activated charcoals toothpastes. Most of the brands out today have abrasive added like baking soda. It is best to err on the cautious and alternate the use of the charcoal based tooth pastes with the more conventional formulations and to brush the paste on very gently to avoid premature wearing away of the enamel surfaces. Some of the charcoal tooth pastes also advertise that they contain fluoride. One question that must be addressed is whether or not the well known absorptive properties of charcoal are capable of inactivating the beneficial properties of fluoride and thus increasing the risk of developing caries.

Dr Thomas Silver

Intraoral Camera

Date posted: July 20, 2018

We are constantly striving to improve the quality of your dental care and experience at Shiny Happy Smiles. We offer an intra oral camera to better diagnose as well as educate both patient and parents.  This diagnostic tool allows us to show you any oral pathology and/or anomalies that we feel will allow you to better understand why a certain treatment has been recommended.

The intra-oral camera may, in certain situations, allow us to diagnose without the use of x-rays.  The camera can be used to locate tooth fractures, decay around old fillings and assist in shade matching and checking the progress of cavities. This technology also enables us to upload these images to your file for long term storage. Insurance companies may also request intra-oral images in order to approve treatments.  

Intraoral imaging is an integral part of our office and education protocol. The old saying: “A picture is worth a thousand words”, is so true for this technology. The doctors and staff use our camera frequently and will also share with you these images so that you have a better understanding of your treatment recommendations. One more way that we assure you of our ongoing commitment to update and improve technology.

Teeth Whitening

Date posted: October 5, 2017

The “Hollywood” white smile is all over the media and social media and it is sometimes confusing as to the plethora of whitening techniques that are currently being marketed to remove or reduce the effects of staining.

Tooth discoloration is usually a result of two types of tooth stains:

Extrinsic stains: These stains are usually more superficial and a result of repeated exposure to dark colored beverages, foods or poor hygiene techniques. The more plaque and associated “build up” on teeth the more readily that these teeth will attract extrinsic staining due to the surface roughness of the plaque.

Intrinsic stains: These stains are more internal in the tooth structure and most commonly associated with the development of the tooth, trauma, or exposure to certain antibiotics or childhood fevers. These stains were once thought to be impossible to reverse but some whitening techniques and in office procedures have been successful in improving dental esthetic and lightening these stains.

There are two basic methods of whitening that are recommended by your dentist:

Take home trays: We recommend Opalescence GO Whitening gel which is a disposable tray whitening system that comes in a variety of flavors. Opalescence GO contains potassium nitrate and fluoride which helps preserve tooth enamel and reduce sensitivity. It is recommended to leave the trays in for a 45 minute session once a days x 5 days. The disposable trays soften to mold around your teeth for a more custom fit and better efficacy than over the counter whiteners. You can also use the these trays to touch up any future extrinsic staining.

In office: Opalescence Boost is a chair side whitening treatment that offers excellent results in less than on hour. Boost also contains fluoride and potassium nitrate to preserve tooth enamel and tooth sensitivity. We have experienced improvements of 3-7 shades lighter during two 20 minute sessions. This treatment is chemically activated so no sitting in front of a bright light that my desiccate your teeth. Boost has also been very effective in improving the “chalky” white appearance of enamel hypoplasia or fluorosis.

To Save or Not to Save. That is a Good Question???

Date posted: May 1, 2017

Stem cells have been a buzz word for about a decade but only recently have harvesting stem cells from teeth received more attention. This method of harvesting has been looked at as less controversial than other methods. The most accessible stem cell niches are bone marrow, adipose tissue and dental pulp. Dental stem cells are a collection of cells that are able to proliferate and differentiate into many cell lines. Stem cells are defined as undifferentiated cells that posses both the capacity for self renewal and the ability to give rise to differentiated cells.

Sources of dental stem cells are from exfoliating teeth as well as extracted teeth. Research in human clinical trials has shown that these cells have shown the capability to regenerate alveolar bone and periodontal disease. Animal studies are showing that these cells may be beneficial in treating a variety of illnesses including muscular dystrophy. spinal cord injury, diabetes and liver disease.

Dental stem cells can be successfully cryopreserved while retaining their ability to differentiate. Umbilical stem cells can only be harvested once (at birth) and are mainly used for hematopoietic purposes. Dental stem cells are more accessible multiple times and can be used for other purposes thus providing a complimentary cell type for patients stem cell portfolio.

The protocol for preserving these stem cells incorporates an existing technology to a new source of cells. After the dentist collects a tooth, it is transported to the laboratory in a sterile, isotonic solution. The package is shipped chilled to reduce the growth of microorganisms and is delivered to the lab as quickly as possible. The frozen cells are then transferred to vapor phase liquid nitrogen for long term storage. The freezing slows down the biochemical process allowing the cells to remain biologically stable.

The use of cryopreserved tissues are regulated and laboratories should be registered with the FDA and licensed by the state health department where the laboratory operates. The cost of storing these cells over a long period of time usually involved a monthly fee and can be costly over time. The decision to be made is if the potential benefits of stem cell therapies in the future out weigh the cost of indefinite storage costs.


Date posted: January 17, 2017

“So doc… how long do I have to wear these retainers?” This is by
far the most common question posed after we remove a set of braces.
My answer is simple… “As long as you want to keep your teeth

Immediately after braces are removed, microscopic elastic fibers in
the gum tissue have yet to ‘reorganize’ and the supporting bone is
still soft and immature. The natural tendency is for the elastic
fibers to pull the teeth back in the direction from whence they came.
Even if you have never had orthodontic treatment, your teeth and bite,
as with every other part of your body, change as you age.

Individual teeth are in a delicate balance/equilibrium with the
muscles of the tongue, cheeks, and lips. Muscle tone and tissue
tension change as we age. Additionally, forces from chewing,
clenching, grinding, habits, as well as growth, all tend to push your
teeth in different directions.

As an analogy, nobody would think of hitting the gym for 2 years as a
teenager, and expect to stay in great physical shape for the rest of
your life without ever excercising again. Similarly, you cannot go
through two years of orthodontics as a teenager and expect to maintain
ideal alignment forever without any maintenance.

The standard retainer protocol in our office is full-time wear for 6
months, followed by night-only wear indefinitely… pajamas for your
teeth to be worn as long as you want to keep your teeth straight!
Retainers can last 2-5 years, depending on the material and design of
the retainer. If a retainer breaks, starts to appear worn or cracked,
or is lost, please call our office immediately to get replacement. If
you have moved away or gone away to college, call a local orthodontist
for a replacement. Remember, a great smile requires a lifetime

Sugar plums can lead to bad gum and teeth.

Date posted: December 9, 2016

The holidays are a time to enjoy but we also need to face the reality that not everything we put in our bodies is good for our bodies.

Here are a list of holiday food and drinks that a dentist would avoid.

  1. Candy canes – this iconic holiday treats are better left on the tree. They are loaded with sugar and can cause chipped or broken teeth.
  2. Bourbon – may be great with eggnog but this spirit can dry your mouth out and be a good environment for gum disease, tooth decay and bad breath.
  3. Dots and Jujubes – these tasty treats may be good for decorating gingerbread houses but these candies must be chewed and can cause cavities and tooth fracture.
  4. Fruitcakes – most people are looking for reasons to avoid this treat and the sticky, sugary fruits and ingredients are a good reason.
  5. Dried fruits – although dried fruits are a good source of protein and fiber, most dried fruits contain added sugars.
  6. Soda – daily intake is almost as bad for your teeth as a serious drug addiction.

The takeaway is enjoy yourself and this festive time but use common sense and moderation and meticulous oral hygiene to minimize the detrimental effects of these foods.

Breast feeding and occlusion

Date posted: November 4, 2016

The positive effects of breast feeding has been reiterated by health care professional for a long time. “Exclusive” breast feeding for 6 months and continued breast feeding for up to two years is an integral global strategy of the World Health Organization. Studies have also shown the positive effects of breast feeding as a protective effect on the development of malocclusions. A malocclusion is a deviation of the relationship between the upper and lower jaw from normal occlusion.

These studies show that the risk of overbite was one-third lower for those who exclusively breast-fed for three to six months compared to those who didn’t, the findings showed. If they breast-fed at least six months or more, the risk of overbite dropped by 44 percent.
Similarly, children who exclusively breast-fed for three months to six months were 41 percent less likely to have moderate to severe misalignment of the teeth. Breast-feeding six months or longer reduced their risk by 72 percent.

The likely mechanisms which may explain the association between exclusive breast-feeding and lower risk of having [misaligned teeth or jaws]… include the adequate development of the orofacial structures in children who are breast-fed, such as proper muscular tone and nasal breathing. In addition, children who are breast-fed are less likely to use a pacifier, which is considered a risk factor for malocclusion.”

Unlike feeding with a bottle, breast-feeding requires the baby to move her jaw and tongue in ways that help develop the oral cavity. Therefore long before a baby breaks their first tooth, they are creating the foundation for proper alignment of the teeth.
Breast-feeding requires the use of jaw muscles more so than bottle-feeding, so the mechanics of breast-feeding stimulate muscle tone in the jaw and positively influence jaw bone structure.

Open bite, overbite and moderate to severe misalignment were generally less common overall among the children who mostly or exclusively breast-fed. Children who mostly breast-fed but also used pacifiers, however, were slightly more likely to have one of these misalignment issues, the study found.

Pacifiers are used for non-nutritive sucking but when overused, they can put pressure on the developing jaw and lead to more problems in older children with malocclusion [teeth/jaw misalignment].

That does not mean parents need to toss the pacifiers, however. The American Academy of Pediatrics recommends that parents consider using a pacifier for an infant’s first six months because pacifiers are associated with a reduced risk of sudden infant death syndrome (SIDS).

Halloween Candy Buy-Back

Date posted: October 19, 2016

Halloween is quickly approaching, and our candy buy-back event at Shiny Happy Smiles is great for our patients that want to experience the fun and excitement of trick-or-treating, while protecting their braces and maintaining their dental health.

Of course, our patients may want to keep a few candies from their Halloween loot. Sticky candy, such as caramels, fruit chews, and gum should be avoided. Very hard or crunchy candies should also be avoided, due to the potential to break brackets. The following list offers some acceptable treats that children with braces can safely enjoy.

-solid chocolate, including milk, white, or dark
-soft nougat-filled candy bars, such as Three Musketeers
-powdery candy, such as Pixie Stix
-cookies or crackers

When in doubt, children should ask their parents or Dr. Ruso if a specific candy is safe. Halloween is a fun holiday for children, and having braces does not have to take away any of the excitement!

Date posted: July 12, 2016

Dental sealants and composite fillings place an important role in decay prevention and restoration and maintenance of dental health. These are the standard of care for restorative materials and have shown longevity and optimum esthetic results.

To understand PBA and oral exposure, it is important to understand some basics of dental biomaterials. Dental composites are a complex mixture of an organic matrix coupled with reinforcing inorganic filler bond together by an agent that binds these two components together. The binding agent is formulated from a mixture of monomers derived from something called Bis-GMA. Although there are several components derived from BPA used in these monomers, there is no known use of BPA itself in composite resins.

Composites without the “filler” and binding agent are called sealants. Sealants isolate pits and fissures on the biting surfaces of teeth and help prevent caries.
There have been numerous studies to investigate the release of low levels of BPA from certain sealants. It appears that only very low levels of BPA may be released from sealants immediately after application. However no detectable levels of BPA have been found in blood after application of a sealant that does release low levels of BPA in the saliva.

To minimize your exposure to any BPA when applying sealants as well as composite restorations, we routinely “scrub” the outer surface of dental restoration which is where any potential BPA may be formed. This has been shown to drastically reduce the levels of BPA that form on the surface of the sealant when it is “cured”.


Date posted: February 25, 2016


As the mosquito-borne Zika virus spreads through Latin America and the Caribbean, many Floridians are understandably concerned. Mosquitos are as much a part of Florida as orange juice and alligators. These pesky insects are present year-round, though their numbers peak in the hot summer months.

Mosquito bites are normally harmless, though irksome. And while Florida has yet to see an confirmed case of mosquito to person transmission of Zika, other diseases can be acquired. The West Nile virus disease, eastern equine encephalitis, and St. Louis encephalitis are all endemic in the state. Preventing bites is the key to avoiding these infections.

  1. Wear long-sleeved shirts and pants when outdoors.
  2. Wear insect repellent with DEET and Picaridin.
  3. Keep mosquitos outside! Use air conditioning rather than opening windows. Repair any windows or screens that could mosquitos can use to enter your home.
  4. Avoid standing water on your property. Mosquitos lay their eggs in stagnant water, and they don’t travel too far from where they breed. Turn over any containers or structures where standing water accumulates, such as tires or birdbaths.

Above all, be safe and vigilant!