Riverwalk Dental

Riverwalk Dental Takes Part in the Andover/North Andover YMCA Healthy Kids Day!

Riverwalk Dental Lawrence MA at the Andover YMCA Healthy Kids DayCharge into summer!  This is the inspirational call to action by the members of the Andover/North Andover Massachusetts YMCA as they inspired children to get outdoors and enjoy the up and coming beautiful weather throughout the Merrimack Valley area.  This event took place last month on April 29th and Riverwalk Dental was there to offer giveaways and healthy smile advice to the children as they enjoyed all of the wonderful activities offered.

From storytelling to obstacle courses to advice on healthy food and snacks, it was truly a fun and educational day for everyone.  Dr. Beninato and members of the Riverwalk Dental team participated in this three-hour event.

“I very much enjoyed spending the afternoon speaking to all the children who participated.  So many healthy smiles!  The Merrimack Valley YMCA is doing a great job promoting healthy lifestyles for our children in Massachusetts” stated Dr. Beninato, “We are looking forward to participating again next year.”

Riverwalk Dental would like to thank all the volunteers and congratulate them on a wonderful day for everyone.

Better access to dental services: A new mid-level dentistry occupation?

Riverwalk Dental is a strong and unwavering advocate for extensive, affordable, and safe availability to dental care for everyone in Massachusetts.  We would like to take some time to offer our thoughts on the newest initiative in the Bay State to make this a reality.

Child tooth examin in Andover MAOver the years, on and off again the Massachusetts legislature considered a mid-level dentistry occupation that would be similar to nurse practitioners and physician assistants, opening the door to more people to practice dental procedures.  In a nutshell, the conundrum revolves around the cost and time to be educated and experienced enough to practice dentistry legally, and how that translates to the cost to administer the service.  As requirements become more stringent, the debt in time and education a dental practitioner must invest increases significantly, and therefore must charge for services once they are legally capable of doing so.

The Problem Defined by the Experts

According to MassLive.com, there are over 60 areas in Massachusetts designated as having a dentist shortage, creating a serious access problem to both adults and children.  According to the Lowell Sun, a bill proposed by Senator Harriette Chandler of Worcester, MA in 2016 would allow dental hygienists to perform tooth extractions and other procedures, but “ignores the fact that more than half a million people live in areas with a shortage of dentists and doesn’t acknowledge the national standards for these providers that ensure they will practice safely and effectively.”

Furthermore, on February 15th of this year, Dr. Raymond Martin, president of the Massachusetts Dental Society was quoted by the Boston Globe as saying “We just don’t think it’s safe enough, when you consider that they’re doing irreversible procedures,” procedures that are part and parcel of at least one of the bills being considered on Beacon Hill.

These concerns are real, but death from lack of dental care has happened.  An article written for WGBH/Frontline titled “Tragic Results When Dental Care Is Out Of Reach,” cites two cases over the last 10 years in which death has resulted from dental infections.  The article quotes Dr. Bill Calnon, the president of the American Dental Association, as saying “The vast majority of dental disease is preventable,” and “totally unnecessary.”

Could such tragedies increase if less experienced people are allowed to practice dentistry?  Or would the availability of health services due to the new mid-level occupation prevent such tragedies from happening?  It is hard to say.

Riverwalk Dental MassachusettsRiverwalk Dental’s Position

Dr. Beninato and Dr. Patsi believe strongly in safe and affordable care for everyone in the Merrimack Valley area and beyond.  With so many areas throughout Massachusetts underserved with such a critical need like oral health, improved access is an absolute necessity.  An underlying concern often expressed by caregivers of all types is the reality that when policy makers set medical standards, patients can sometimes be mislead to believe that sanction by public officials equals trust and quality service.  Although this is often the case, when it comes to one’s health, caution is strongly recommended.

No matter the results of this effort to broaden the occupational levels of the dentistry profession in order to achieve the goal of better access to oral health care, patients must always trust but verify all procedures are safe and necessary.   Once a tooth is altered or removed, it is that way forever.

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

Whether a mid-level dentistry occupation is successfully implemented in Massachusetts or not, remember to brush and floss every day while getting a checkup every six months!  Teeth can last a lifetime with only a very small amount of time dedicated every day.

Help us help: Riverwalk Dental community involvement throughout Massachusetts

Riverwalk Dental is more than just an office with people who love and care about your smile; we are active members of our community throughout the Merrimack valley area.  From Lowell to Salem and from Lawrence to Andover, we’ve worked with our patients to bring a little sunshine to those in need.  We would like to highlight these efforts, in hopes of an even better push in 2017.   We are proud of our efforts and the great people who visit our offices every week who help us do what we can to make the world a little bit better place for those in need.

Picture by Riverwalk Dental MassachusettsCandy for Our Troops Overseas

We all share in our appreciation of those who sacrifice so much to defend our country.  Last year during Halloween, we asked our coworkers, friends, and patients to donate candy so that we may ship it to our troops overseas to bring a little sweetness and joy to their time apart from their families.  Not only did our patients bring candy, but the generous and thoughtful children of North Andover Middle School and Central Catholic High School in Lawrence, MA donated their own candy to this great cause.

This year we shipped over 100 pounds of candy.  What a fantastic accomplishment by all who participated!  We are so proud of our students and clients who took part in this effort, and we hope to have an even greater impact in 2017!

Colgate Make a Wish

We are so proud of our involvement with Colgate’s professional partnerships to support the Make A Wish Foundation.  Riverwalk Dental purchases Colgate products because we know each purchase generates a donation to this very worthy cause.

Thank you to all our clients who continue each year to be a part of our practice so we can continue to do as much as we can to put a smile on the faces of the children who need it most.

Bread & Roses Food Drive

Picture by Riverwalk Dental MassachusettsBread & Roses of Lawrence, MA supports those in need throughout the Merrimack Valley community.  As one of the most compassionate and effective soup kitchens in Massachusetts, it has long been a center of hope and caring to the thousands of people who are struggling for survival.  The food donations brought to us from our clients made a real difference to those who many times do not know if or when their next meal will come.

Our commitment to those in need is only as strong as our combined efforts.  The Riverwalk Dental office wants to thank all those in the past who helped us help those in need.  We hope to continue these efforts in 2017 and want to invite our patients to continue to join and participate.

Get the most out of brushing your teeth every day: Tips from Riverwalk Dental Lawrence MA

Riverwalk dental Lawrence MassachusettsIn Massachusetts and most of the Northeast, we are known for always being in a rush.  This often means having little time to take care of ourselves.  Frequently, we economize on the necessary and routine things we do every day, such as brushing our teeth, because our schedules are packed with deadlines from morning to night.  Spending the time needed to thoroughly brush one’s teeth can and sometimes is overlooked, so using the most effective toothpaste and a process that ensures the best results will help to make the time spent brushing as productive as possible.

Twice a day we brush our teeth.  Most people do not spend as much time as they should brushing.  Dr. Beninato and Dr. Patsi have some advice for those on the run but also want the smile they worked so hard to maintain:

Here are some tips to our patients throughout Merrimack Valley:

  1. Find the right toothpaste

Besides the obvious fact that someone should always use a toothpaste that is ADA approved, knowing what challenges your particular teeth face is important to proper oral health and a fresh breath.  Some key points:

Tartar Control Toothpastes Work:  The active ingredient in tartar control toothpastes is pyrophosphate, and according to Delta Dental in Boston Massachusetts, studies have shown it will reduce tartar formation up to 36 percent.  Tartar, once it is formed, has to be removed by a professional, so the reduction of its formation is an important preventative.

Fluoride:   It almost goes without saying that fluoride is key to a healthy smile.  Demineralization, the loss of minerals that keep teeth strong is prevented with a fluoride toothpaste, and fluoride helps to actually enhance the remineralizing of your teeth.  According to the Oral Health Group of Canada, “Fluoride speeds up the growth of the new surface by bringing calcium and phosphate ions together and is also preferentially incorporated into the remineralized surface.”

We often get a surprised look from Riverwalk Dental’s patients when they realize it is actually possible to reverse the clock on your teeth!

  1. Take the time to brush your teeth

Even the best toothpaste in the world cannot replace good old hard work.  It is truly the act of brushing that does the most to preserve one’s teeth and keep them strong.  It is important to take the time necessary.  According to WedMD, rushing is one of the top mistakes to make when brushing.  They suggest a timer to ensure two minutes of brushing each time, and we agree.

  1. White_teeth_and_Oakley_sunglasses by Jenith Michael RajDon’t forget your gums

According to A.D.A.M., the Animated Dissection of Anatomy for Medicine, “More than 75% of American adults have some form of gum disease, but according to a major survey, only 60% have any significant knowledge about the problem.”

Flossing frequently and brushing your gums thoroughly while brushing your teeth will help to remove anything that can irritate your gums and cause bad breath.

Today’s busy lifestyle should not come at a cost to your health and wellbeing.  Follow these easy but important habits each day and your smile will always reward you!

The different types of mouthguards and the best one for all children in school sports

Image used with permission from pixabayRecently, a patient from North Andover Massachusetts had a child who lost a tooth during a sporting event.  Such a traumatic event is preventable, and prompted us at Riverwalk Dental to write this article informing parents and young adults about their best options to protect their teeth while playing contact sports such as football and hockey.

As we discuss in our article titled, “Sports Injury in Massachusetts: How to prevent it and what to do if a tooth is knocked out,” we cite the importance of mouthguards and the long term value of protecting a young middle school or high school student’s smile.  At Riverwalk Dental we’ve been asked by our patients, which mouthguards are best and what are the options?  In this article we’d like to offer some advice for our patients throughout Massachusetts.

First, we would like to stress the importance of custom and professionally formed mouthguards.  Although any mouthguard is better than none and if families cannot make it to the dentist to have one made for their son or daughter, buying one off the shelf is your best option.  These mouthguards will do a sufficient job in protecting teeth from injury, although it is recommended to get a few because they wear quickly.

The most basic type of guard is a stock mouthguard which can inhibit breathing, as well as be bulky and uncomfortable. They can, although, be taken out of the package and used immediately, but they offer no custom protection for a child’s unique teeth formation and mouth.

Off the shelf “boil and bite” mouthguards are sometimes better than stock mouthguards, but these too have their limitations.  According to QualityDentistry.com, these items often lack proper coverage of teeth and are thin and easily broken under stress.  They conclude, “As sports dentists and health professionals interested in injury prevention, we do not recommend store bought boil and bite mouthguards to our patients and athletic teams.”

Custom mouthguards that are formed by a dentist can insure a better fit and longer lasting durability for the sports enthusiast in the family.  There are generally two types, the older vacuum mouthguard and the modern pressure laminated mouthguard.

Vacuum mouthguards are an older technology but far superior to the store bought options described above.  In this case, a mold is made of a person’s mouth and teeth structure and that mold is used to form a mouth guard that is the proper thickness and size in accordance with a person’s unique mouth and teeth formation. Made with stronger and more durable material that does not have to be made from material soft enough to boil and bite, this product serves to better protect a person’s teeth from injury.

used with permisison from wikimediaYet there are limitations a dental patient should consider.  According to DentalEconomics.com, with vacuum mouthguards, “adaptation to the cast is only fair, and the thickness of material that can be used with them is limited.”  Nevertheless, a mouthguard that will protect all your child’s teeth and have the durability to maintain its protective properties will cost far less over the long run.

Finally, the Pressure Laminated Mouthguard is the best option to protect your son or daughter’s teeth while playing sports in school.  Formed in layers, this guard is the best and most durable option for full contact sports.  Made from EVA material, this product offers precise formation to a person’s teeth and mouth, and therefore will not wear nearly as quickly as others over time.  As stated by QualityDentistry.com, “As sports dentists and health professionals, we highly recommend the custom made mouthguard, especially those of the laboratory lamination type for the very best in oral/facial protection as well as concussion deterrence.”

Your child’s smile will be one of his or her greatest assets as they grow up.  Protecting that smile is important, especially if the child is in sports in which a tooth can be lost.  We hope this article was informative to our friends and patients throughout the Merrimack Valley area and all throughout Massachusetts and New Hampshire!

Riverwalk Dental’s 9 interesting and fun facts about teeth!

tooth-teeth brush fun

  1. Right here in Massachusetts, William Thomas Green Morton offered the first successful public demonstration of ether anesthesia. We can thank someone locally for starting to make trips to the dentist as pain free as possible!
  2. According to The Daily Caller, “A January 2010 law mandates that all children in Massachusetts daycare centers must brush their teeth after lunch . . .” Although it is very important to brush after every meal, it is somewhat of a strange consideration that lawmakers would mandate it!
  1. According to Delta Dental of Minnesota, dental floss was found in the teeth of early pre-humans but was not manufactured as we use it today until 1882 when it was produced by the Codman and Shurtleft Company in Randolph, Massachusetts.
  1. According to Medical Daily, our tongue is as unique as our fingerprints! That’s right, and over time your fingerprints can change form, but your moth protects your tongue from damage so it stays the same all your life.
  1. There is actually a market for celebrity teeth! According to com, John Lennon’s tooth sold for over $31,000!
  1. According to com, George Washington in fact did NOT have wooden teeth! George Washington’s false teeth were actually made out of a combination of rare hippopotamus ivory, human teeth, and metal fasteners.
  1. According to com, in the movie The Hangover Ed Helms, who played Stu, really is missing a tooth. When he was a teenager he had surgery to have a permanent tooth implanted, so a dentist removed it for the filming.
  1. As quoted in Woman’s Day, according E. Jane Crocker, RHD, president of the Massachusetts Dental Hygienists’ Association, you do not need as much toothpaste as you may believe to brush your teeth. She stated, “All you need is a pea-size amount of toothpaste—yes, I mean the little green vegetable!”
  1. According to com, snails’ teeth beat spider silk as nature’s strongest material!

The team at Riverwalk Dental hopes you will use these facts to win at Trivial Pursuit some day!


Sports Injury in Massachusetts: How to prevent it and what to do if a tooth is knocked out

tooth-1015425According to Oviedo Premier Dental in Florida, some interesting dental facts include the reality that sports-related injuries account for approximately 5 million missing teeth per year.  In fact, a majority of tooth loss for people under the age of 35 is caused by athletic accidents.  Here in Massachusetts, the doctors at Riverwalk Dental can confirm this is the case.  From Salem New Hampshire to Andover Massachusetts, and from Boxford to Methuen, Dr. Beninato and Dr. Patsi have seen numerous young men and women who have suffered from injuries that have long term consequences to their smile.

What to do if your child has a tooth loosened knocked out:

According to the Massachusetts Dental  Society and our experience here in Lawrence MA, a parent or coach only has about a half hour to an hour to make a difference in the future for that tooth and smile.  First, do not touch the root of the tooth.  It is extremely important that the tooth be kept free of any foreign matter.  Also, do not use any abrasive action on the tooth, including brushing; simply rinsing it with water is sufficient if this needs to be done.

If at all possible, reset the tooth by biting down gently on a soft item like a towel or handkerchief.   If this is not possible, place the tooth in water, milk, or in some way that will keep the tooth from drying.  Finally, and obviously, get the child to the hospital or dental office as soon as possible.

How to prevent a tooth from being knocked out:

Of course, the obvious answer to this is to always wear a mouthguard.  Even in sports and activities that are not full Courtesy of wikimedia.orgcontact, injuries to teeth can still happen simply by falling or tripping on a hard surface.

Mouthguards should also be replaced frequently.  As a child bites down on the guard, particularly during intense play, the mouthguard will wear quickly.  Keeping a few on hand will ensure your child’s teeth stay protected.

Finally, According to Mouth Health, an American Dental Association website, it is also important to keep mouthguards clean and dry.  This will prevent hard, foreign matter from inadvertently damaging teeth as a child plays a sport.  Also, never keep a mouthguard in the sun or in a liquid, such neglect could cause the material to change and become less effective in protecting teeth.

In Massachusetts, we want to see all our children grow up with healthy, bright smiles.  Following this advice will help parents and their children enjoy their days at sporting events while protecting their teeth from long term injury.

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Pregnancy and dental care: Advice from Riverwalk Dental

In the many years Riverwalk Dental served the people of Lawrence, Andover, Methuen, Lowell, and all throughout the Merrimack Valley Massachusetts area, Doctors Joseph Beninato and Vaso Patsi Hatzigiannis have been asked how changes in our life as we age change how we should care about our teeth.  To some patients’ surprise, the answer is certainly yes; as our bodies change during different stages of our lives, so do our needs for dental care.

The most popular of questions is during pregnancy.  Women, understandably concerned about the health of their babies, want to be sure that what they do to their bodies, and in particular their mouths, have on the health and development of their babies.  Understanding that of course smoking and drinking could have an effect, an everyday activity such as brushing and flossing also comes to mind as something that could have an effect on their bodies and therefore their developing babies.

While speaking to a patient from Lawrence Massachusetts, she asked if dental treatments and local anesthetics could Swangerschaft - Swangerschaft on Flickr.comhurt her baby.  This is a common and understandable concern, yet according to a study done by The Journal of the American Dental Association (JADA), procedures that require anesthetics are safe for pregnant women.

The study’s author Aharon Hagai, D.M.D.  stated, “We aimed to determine if there was a significant risk associated with dental treatment with anesthesia and pregnancy outcomes. We did not find any such risk.”

In fact, according to an article published by WebMD, physical and hormonal changes such as estrogen and progesterone levels will change how a pregnant woman’s gums react to the bacteria in plaque.  The adverse affects of such buildup may result in pregnancy gingivitis and research links gingivitis to increased risk of preterm birth and low birth weight.

Nothing is more precious than our children, and mothers are understandably concerned for the effects their health has on the development of their babies.  As Dr. Patsi and Dr. Beninato always tell their patients throughout Massachusetts; brush twice a day, change out your toothbrush every few months to be sure it is as effective as it can be, and visit us twice a year for a professional cleaning and to make sure if there is a problem, we address it long before they could ever cause discomfort or pain for moms to be.

Riverwalk Dental’s antibiotic prophylaxis protocol and explanations.


Since we discussed joint prophylaxis for our dental patients last week, a number of you have asked us about taking antibiotics for your heart condition. Things have changed in the last ten years or so, so we thought to get everyone up to date. The good news is that the guidelines have gotten much clearer the past several years, and many people no longer need prophylaxis.

What’s the Big Deal?

The underlying concern is that certain dental procedures can cause a small amount of bleeding, and that this could open an avenue for mouth bacteria to get into the bloodstream and potentially cause damage. The idea for the use of antibiotics is that if the antibiotics are already present in the bloodstream at a high enough concentration when bacteria enter, they will destroy the bacteria and prevent complications.

Historically, antibiotics have been given for a very wide range of conditions, even without sound scientific rationale. Over the past 10-15 years, as the problems of bacterial resistance and overuse of antibiotics have come to the surface, as well as increasing awareness of the allergic risk of some antibiotics, these recommendations have been updated to target the patients most at risk for complications.

OK, Who is At Risk?

In the patient with cardiac disease, the concern has been that bacteria floating in the bloodstream could attach themselves to the valves of the heart (almost like barnacles on ships), especially if there is already a problem with the valves that prevents normal smooth blow flow. This could build up, altering blood flow and causing an infection of the actual heart, called infective endocarditis. Complications of this infection can include heart attack, stroke, or even death.

What Signs & Symptoms are There?


In infective endocarditis of the heart caused by dental bacteria, there is often a slow subtle onset. The most common sign is a fever, often anywhere from a couple of days to a couple weeks. You may also experience a cough, joint pain, diarrhea and trouble breathing. Occasionally you may see red streaks under the fingernails or on the soles of the feet. It is not uncommon, however, to not recognize anything at all beyond a vague fever.


How Do we Diagnose This?


The most important method of diagnosing infective endocarditis is with blood cultures (finding the bacteria in your blood). Other criteria are necessary, such as an echocardiograph (ultrasound of the heart), to look for bacterial buildup, along with certain other signs and symptoms.



How Is This Treated?


When a diagnosis of infective endocarditis of the heart is made, treatment is centered largely around IV antibiotics (directly into the blood stream), often for 4 or more weeks.  This will often be done with the help of an infectious disease doctor, along with a cardiologist. Treatment can become more complex if any complications of endocarditis are evident, such as a heart attack, heart failure, or a stroke.



So, Who Needs Prophylaxis Now?

The American Dental Association, along with the American Heart Association, updated their recommendations for routine prophylaxis against infective endocarditis. Currently, patients with prosthetic valves, previous infections and certain specific congenital disorders are required to take prophylaxis. Many patients are no longer affected, such as patients with mitral valve prolapse or mitral valve prolapse with regurgitation. We have found that the risk of infection is actually lower than the risk associated with taking the antibiotics. We have also found that only a handful of cases of infective endocarditis is actually caused by oral bacteria yearly.Cardiac Prophylaxis

As far as what procedures require prophylaxis, the answer is that anything that can cause any bleeding at all. So, for instance, you’ll want to take your medicine prior to a cleaning or root canal, or a surgical procedure such as an extraction, dental implant, or gum surgery. However, for routine fillings, impressions and x-rays, prophylaxis is not needed. You’ll want to talk with us to make sure to get the correct recommendations.


What Can I Do?


The best way to minimize risk of getting endocarditis, or having your mouth be the source of infection elsewhere in your body is to maximize the health of your mouth. Make sure you are routinely brushing and flossing, at least twice daily. Make sure you see us for regular checkups twice yearly, or more frequently if you have gum disease.

If you currently take antibiotics prior to routine dental care, and have not reviewed your reasons with us and your physician for several years, you may want to bring this up with us prior to your next appointment. You may no longer need to take medication.

If there have been major changes to your health, and you are concerned that you may require medication, please feel free to contact us and also review with your physician.

Working together, we can make sure to follow the latest recommendations and keep you safe.



Drs. Beninato and Patsi