John F. Carpenter DMD, MAGD Family, Cosmetic & Imp

All-on-Four Implants

Terminal failing dentition

Pre-op condition

zirconium porcelain implant bridge

Post-op zirconium implant bridge

For patients who have lost all their teeth or their remaining teeth are hopeless, several options are available.  One of the most advanced and beautiful option is a fixed implant solution.

This solution is known by several names:   All-On-4, Fixed Hybrid, Teeth in a Day, Teeth Tomorrow, Malo Bridge, Prettau Bridge and Hybridge, to name a few.

Usually 4 to 6 implants are placed, which replace the root part of missing teeth.  Then, zirconium porcelain teeth are screwed in to the titanium implant roots.   This has become widely popular worldwide.  If the idea of having to wear a denture for the rest of your life makes you uncomfortable, call us.  Your 1st visit will include an exam, consultation and a 3D CAT scan so we can properly review your options.

Don’t hesitate to contact us.  Remember – – creative financial options are available.

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Can Gum Disease Spread to Other Parts of the Body?

80% of Americans have some form of gum disease.

Bacteria forms on the teeth and grows down into the space between the teeth and gums (a periodontal pocket).  These pockets become breeding grounds for bacteria and cause inflammation, tenderness, bleeding and infection.

If not addressed properly, this bacteria will spread to other parts of the body through the bloodstream. (Think of “Toe bone is connected to the foot bone.  Foot bone connected to the ankle bone . . . “)

Scientific studies have substantiated links to heart disease, diabetes, colorectal cancer and even Alzheimer’s disease.

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Change your Smile

Like it or not, we live in beauty-conscious society.  This is particularly true in the entertainment industry.  Not all “beautiful people” were born that way.

Many have taken advantage of Cosmetic Dentistry.  Remember Cher’s early smile?  Fortunately, self-improvement is not exclusive to the Rich and Famous.

Visit Before and After photos.


What’s New in Dental Implantology?

dental implants“Immediate implants” and “teeth” are the latest buzz words in dentistry.  Do they work?  Yes, but it depends on the unique situation a patient presents with.  It’s great to be able to remove bad teeth and place implants the same day when it is indicated.  After the implants (the foundation)  are placed, a second decision must be made regarding which type of temporary will be placed on top of the implant.

In the anterior esthetic zone, ideally I like to place  a fixed, immediate replacement.  However, if the implant isn’t stable enough at placement and requires time to heal, removable teeth can be placed.  Utilizing either a fixed or removable temporary, patients leave with teeth and a great smile.

New Windsor Dentist Sedates Anxious Patients

Many patients tell me they had a traumatic dental experience as a child, the dentist had trouble getting them numb or they easily gag.

You are not alone.  Dr. Carpenter’s office has been offering conscious sedation for the past 15 years to help you.

Conscious sedation utilizes oral medications and nitrous oxide.  It is completely safe because you are conscious and always breathing on your own with all your protective reflexes intact.  Afterwards, most patients tell us they remember nothing or very little of the appointment.

What to Expect:

You will need a responsible adult to drive you to and from the office.  The appointment is usually 2-3 hours long and allows for the correction of years of neglect.  When the appointment is finished, you will go straight home and usually sleep the remainder of the day.

Dental anxiety

Dental anxiety

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Sedation Dentistry, a Bad Case of Gum Disease and a Happy Family

bad breath, halitosisA 42 year old male patient, let’s call him “Bob”, presented to the office last month.  Bob’s main complaint was he was afraid to kiss his wife because of his bad breath.  “Our sex life is suffering because of it and my kids have been avoiding me.”

After spending time getting to know Bob, he disclosed that he hadn’t been to a dentist since he was a teenager.  “I had gone for bleeding gums, was traumatized and hadn’t been back since”.  Bob allowed us to examine him and take basic X-rays.  Heavy calculus (tartar) and bleeding gums were visible.  All the signs and symptoms of gum disease were present.

We let Bob know that he was a perfect candidate for dental sedation.  All his gum treatments, the extraction of 2 hopeless teeth and a few fillings could all be done in one visit with sedation.  He was scheduled for his sedation visit the next week and in over 3 hours, all his treatment was completed.

But the best part was when Bob returned for a 2 week follow-up.  Happy and smiling in the welcome area, he called out to me “My mouth hasn’t felt this good in years and my family loves what you did for me.”

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Difference Between Cold Sores and Canker Sores, Part III

Cold sore vs Canker soreCold sores need to be treated at the prodromal stage.  This stage is just before blisters are noted and when tingling, itching, and burning around the lips is felt.

OTC Treatment

Cold compress and lubrication are older remedies and can be effective.  Abreva is the only FDA-approved over the counter remedy.

In Office Treatment

Low-level laser treatment


Denavir (penciclovir) is an anti-viral prescription medicine.  This is my favorite treatment for patients who have recurrent episodes of cold sores.  It is best to keep this prescription handy and apply when symptoms are first noted and before the outbreak is more severe.


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The Difference Between Cold Sores and Canker Sores, Part II


Laser Treatment of Canker Sore

How do we treat canker sores (Apthous Ulcer)?

Treatment is pallative,  for comfort only.  These lesions will disappear completely in 7 – 10 days with or without treatment.  The problem is these ulcerated lesions can be quite painful!

For a Small Lesion

  • OTC topical anesthetic,  (contains benzocaine, e.g. Orabase with benzocaine)
  • A prescribed topical corticosteroid ointment

For a Larger and More Painful Lesion

  • In office treatment
  • Debacterol – applied by your dentist and it basically cauterizes the lesion
  • Low-level laser treatment.  This is my preferred method and usually provides immediate pain relief

Cold Sore Treatment, Part III


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The Difference Between Cold Sores and Canker Sores

Cold Sore (fever blister)

Cold Sore (fever blister)

Canker Sore (apthous ulcer)

Canker Sore (aphthous ulcer)

I find patients are frequently confused by these lesions and often use these terms interchangeably.  Canker Sores (recurrent aphthous ulcers) and Cold Sores (recurrent herpes labialis) are two different ailments and require different treatments.  While these conditions are usually not serious, they are very common and painful.

A Canker Sore is an intraoral sore usually located on the cheeks, tongue or floor of the mouth.  Typically it is a small, round ulcerated lesion surrounded by a red halo.  It is not contagious and its cause is usually multifactorial.  Stress, trauma such as cheek biting, some food allergies, smoking and sodium lauryl sulfate (a foaming agent in many toothpastes) all have been implicated as causative factors.

Cold Sores are extraoral lesions usually located under the nose and around the lips.  They start as tiny fluid-filled blisters which break open, coalesce and then crust over.  These lesions are contagious, especially when the blisters break open.  The cause is the herpes virus (HPV) that was contracted in early childhood.  This virus lies dormant until triggered by stress, fatigue, hormonal changes or exposure to sun or wind.  90% of the population tests positive for HPV but only approximately 20% of the population will experience a cold sore outbreak.  Cold sores have a tendency to recur in more or less the same place each time.  Such recurrences may happen often (once a month) or occasionally, (once or twice a year).

Treatment and Prevention to follow.

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Dry Mouth (Xerostomia)

imagesRQLW7GB7 imagesWMQF7T8Z imagesZQC1707SWhat is Xerostomia?  Xerostomia is a condition related to the salivary glands which keep the mouth moist.  When the glands do not work properly, the amount of saliva in the mouth decreases, causing dry mouth.  Saliva prevents tooth decay, helps us taste and swallow our food and aids in digestion.  Xerostomia affects approximately 25% of the population, although most patients do not realize they have a problem until they lose up to 50% of their saliva.  Over the past 10 years, I have seen a significant increase in the number of patients with xerostomia.  The rapid progression of dental decay caused by dry mouth is devastating and can create a “dental cripple”.

What is the cause of dry mouth?  There are several causes of dry mouth, such as radiation therapy, chemotherapy, diabetes and dehydration.  However, medicines are the most common culprit.  There are more than 400 medications that can contribute to dry mouth.  While medications are necessary to treat medical problems, it is their side effect of dry mouth that is harmful to the teeth.

How important is saliva?  Saliva is the “bloodstream of the mouth” which nourishes and protects our teeth and gums.  It’s composed mostly of water, but contains electrolytes, mucus, antibacterial compounds and various enzymes.  Without adequate saliva, patients are more vulnerable to tooth decay, periodontal disease and fungal infections.  Saliva helps food naturally be moved away from teeth.  Saliva has an important role in buffering the pH of the mouth.  After the intake of sugars, carbohydrates, soda, fruit juice and sport drinks, the mouth becomes acidic (pH 2-4) and leads to tooth decay.  The oral pH of a patient with a healthy flow of saliva returns to neutral (pH 7) in approximately 20 minutes after food and drink consumption.  The oral pH of a patient with a poor flow of saliva may take up to 2 hours to return to neutral pH.

What can I do to prevent dry mouth?  Treatment involves identifying correctable causes and removing them if possible.  Hydration is important, drink plenty of water.  Eliminate drying alcoholic mouth washes, and avoid a diet high in sugars and sticky carbohydrate-rich foods.  Many over-the-counter dry mouth products exist to help lubricate and neutralize the mouth.  Vigilant home oral hygiene, a careful evaluation by your dentist and a customized dry mouth plan will also help.


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