Family & Cosmetic Dentistry 716.754.4810 Jason C. Marshall, Lewiston Family Dental



“An ounce of prevention is worth a pound of cure.”

The Bad Guys
  • Plaque: A nice way to say oral bacteria. This term refers to a collection of multiple organisms that cause various oral disease.
  • Tartar: Well organized, calcified plaque.
Either of the above metabolize simple sugars into lactic acid, protease and various other destructive compounds.

How often should we brush?
  • We should brush a minimum of three times per day.

What are the best times to brush?
  • After breakfast in the morning
  • After you get home from school/work in the afternoon
  • Most importantly - just before you go to bed

What other ways do we keep our teeth and gums clean?
  • Flossing - this removes the germs from between our teeth
  • Using a good mouthwash - this kills any other germs that are just hanging out
  • Brushing our tongue - this gets rid of the germs that are hiding in the furry areas of our tongue


Gingivitis is the swelling of the “gum” tissue induced by a number of mechanisms but most commonly by plaque and tartar. Symptoms include erythema (redness), discomfort and bleeding with minimal irritation.

Periodontal Disease

Periodontal disease is the loss of the supporting structure of the tooth. The Alveolar bone and periodontal ligament can “dissolve” over time in the presence of bacterially produced fluids.

Recommended dental care for the healthy patient
  • Brushing with a soft or extra soft bristle brush 3 to 4 times daily with an ADA approved toothpaste.
  • Follow up brushing with an antiseptic mouth rinse like Listerine (ideal contact time 2 minutes).
  • Flossing once daily-preferably before bedtime.
  • Professional cleaning every ~ 6 months
  • Bitewing films every year to diagnose decay between teeth and under existing dental restorations.
  • Panoramic films every ~ 3 years



Decay is the degradation of tooth structure caused by the acidic chemicals produced by oral bacteria. (Streptococcus mutans and viridans, Lactobacillus etc.)

Risk factors: plaque, decreased salivary flow, radiation therapy, diet high in simple carbohydrates, lack of fluoridation, and immune compromise.

“Drill and Fill” - Still the standard of care?

The “meat and potatoes” of dentistry is still used to treat the majority of conservative lesions. Air abrasion and hard tissue laser techniques are currently being developed and used by some, but I believe, lack the precision of the traditional drill.

  • Dental Amalgam: silver, mercury, copper, tin and zinc. Studied to exhaustion over the years with no credible evidence of detrimental side effects. Inexpensive and very durable over time.
  • Composite Resin: (a.k.a Bonding) Essentially plastic “glued” into the void. Cosmetic, more expensive and less durable. Composites have improved greatly even in the past 5 years.


What is a Root Canal?

Each tooth has a hollow chamber in its center which houses the neurovascular bundle. The neurovascular bundle of any tooth is no longer necessary after the tooth is fully formed and may be removed if it becomes problematic (i.e. necrosis or hypersensitivity). When a dentist removes this tissue and puts a filling in its place, the procedure is referred to as a root canal.


When may a crown be recommended?
  • When there is excess filling:tooth ratio
  • After a root canal
  • When bulimia or other enamel disorders such as amelogenesis imperfecta have caused significant damage to the structure of the tooth
  • When genetic abnormalities are present and cosmetic benefits will be gained


Full Removeable Denture

Partial Removeable Denture

Fixed Partial Denture (Bridge)




Teeth Whitening has become very popular. Patients are offered many options for methods to whiten, all of which will yield positive results. From over the counter whitening strips to custom bleaching trays or our BRITESMILE procedure, each choice will appeal differently and provide different results to each patient.

Any of the over the counter white strips may do a fine job for you, provided you follow the manufacturers directions and maintain treatment often. However, if you are looking for more long term effects with professional results, we offer two types of whitening. Before considering either of these options, it would be best to set up a brief consult with the doctor to be sure you are a good candidate for professional whitening, as crowns, bridges and resin fillings may affect your desired results.

Custom Trays

Patients are required to come into the office for an impression appointment so that molds of the teeth may be taken and trays can be custom made. Once the patient has the custom made trays ready, a bleaching gel is used to fill the trays and the patient can bleach at home as needed. Dr. Marshall will advise each patient as to the duration of time that the trays should be worn to achieve desired results. Additional tubes of bleaching gel can be purchased right here at the office. Results vary by patient and depend on personal habits like frequency of bleaching, eating foods that stain teeth, and regular home maintenance. The price for custom trays averages about $500, and treatment must be maintained by the patient.

BRITESMILE (In Office Procedure)

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