Fractured Teeth: Is There More Than One Type of Fracture?

Dentist 1In a 4-Part series we are going to be discussing fractures in the teeth – what they are and how a dentist can repair them.

In order to best understand a problem with a tooth, we need to first understand what a healthy tooth looks like and how it is made up.

So, in Part 1 we will examine the simple anatomy of a tooth.

At the top of a tooth is the enamel, on the crown of the tooth, which we normally see. The second layer is called the dentin, and the third layer inside the tooth is the pulp, or the nerve tissue. Below this point are the roots in the bone.

1. Crown
Most of the tooth is under the surface, like an iceberg. The portion of the tooth that is above the gum line where we can see it is called the crown.

The purpose of the tooth determines the shape of the crown. For example, the crown of a molar is flat, for grinding, and the crown of a front tooth (incisor) is sharp, for cutting.

2. Enamel
The outer, top-most layer of the tooth is called enamel, and again, this is the layer that we see – it covers the crown. Tooth enamel is the hardest and most mineralized tissue in the entire body. At the same time, this enamel can be easily damaged.

3. Gumline
Where the crown of the tooth and the soft tissue of the gum meet is called the gumline.

4. Dentin

This is the layer in the tooth itself that is just below the enamel. Although it is the layer that protects the nerve, it is porous, with millions of microscopic tubes, called dentin tubules, leading directly to the pulp. These tubules are filled with cellular fluid.

5. Pulp
The soft tissue in the center of the tooth is called the pulp, and is where the nerve tissue and the blood vessels are. Tooth decay that reaches the pulp can cause a great deal of pain.

6. Root
The root is embedded in the bone of the jaw, and anchors the tooth to bone. The root makes up two-thirds of the tooth itself.

Take a look at this video where Dr. Mastrovich explains the tooth in detail:



 Dental fractures can occur in various places on the tooth – they can occur in the enamel or down into the dentin, or even deeper. They can occur obliquely, horizontally, or vertically, and they all have different ramifications of tooth pain and its treatment that we’ll talk about in the rest of this series as we go through the various types of fractures.


February is Heart Health Month: Can Improving Oral Health Improve Heart Health?

Good Oral Care Can Equal a Healthy Heart

When we celebrate Valentine’s Day, we naturally think of hearts, and that can’t help but bring your own heart to mind.

If you are interested in maintaining a healthy heart, you might want to add good oral care to your healthy lifestyle.

The theory that oral health can contribute to heart health has been around for the past one hundred years, but it has been in just the past couple of decades that scientific studies have started to support that suggestion. Research is now finding that oral health, and gum disease in particular, are indeed related to heart disease. Gum disease generally refers to gingivitis, inflammation of the gums, and the more severe periodontitis, a serious infection that can lead to destruction of the bone and gums that hold teeth in place.

However, the connection between periodontal disease and heart disease is not a connection that people naturally think of.

Can preventing periodontal disease with brushing and flossing  prevent heart disease? According to the American Academy of Periodontology, people with periodontal disease are almost twice as likely to have coronary artery disease (also called heart disease). And the presence of common problems in the mouth, including gum disease (gingivitis), cavities, and missing teeth, are as good at predicting heart disease as are cholesterol levels.

Scientific studies have been published in the Journal of Internal Medicine and the British Medical Journal which show that there is a connection between serious gum disease and atherosclerosis, which causes heart disease. Atherosclerosis, also known as hardening of the arteries, is the build-up of fatty deposits on the lining of artery walls that can lead to blood clots.

Bacteria, which grow between your teeth and cause dental plaque to build-up, can enter the bloodstream when your gum starts bleeding, which happens easily if you have gum disease. Once in the blood stream, these organisms attach to pre-existing fatty deposits in coronary arteries (those that supply blood to the heart). This leads to inflammation, which may cause blood clots that can decrease blood flow to the heart and cause a heart attack.

So the answer to the question “Can improving oral health help prevent cardiovascular problems?” appears to be a resounding Yes!

Brush and floss every day, and see your dentist at least twice a year for regular cleanings and oral exams. This will pay off for your dental health and for your heart health, as well.


Are there different approaches to a dental hygiene (cleaning) appointment?

RDH teamIf you are over the age of twelve, chances are you have had a prophylaxis (teeth cleaning) by more than one dental hygienist over the years. Have you ever wondered why one hygienist started by cleaning the ‘inside’ (called lingual, the side closest to your tongue) of all your lower teeth first, while another started by cleaning the inside of one quadrant of your teeth (one quarter) and then the outside (called the facial)?

Dental hygiene schools teach their students to be methodical as they clean the teeth, in order to be thorough and avoid missing any areas. We have found it helps our patients for our hygienists to share their approach at the beginning of the appointment, as there is more than one way to be consistent and thorough. A helpful perspective is “Different strokes for different folks” because each cleaning appointment is customized within the format, to meet the individual needs of the specific patient.

At the beginning of the appointment, after asking if you have any concerns, the oral cancer screening is completed by the hygienist. It is helpful to keep in mind that the hygienist is cleaning both above the gumline and below the gumline.

In one approach used, the dental hygienist then begins your cleaning by assessing the amount of mineralized deposit (tartar) on the lower anteriors (the front teeth from cuspid to cuspid). This is the most common area to have mineralized deposit because there are so many salivary glands underneath the tongue. These salivary glands are continuously releasing mineral rich saliva. If these minerals make contact with a plaque-covered tooth, the plaque acts like a web and traps the minerals. If allowed to remain on the tooth surface for hours, the minerals will crystalize on the tooth surface and the patient will not be able to brush the tartar off. That is where the benefits of dental hygienist appointments become apparent. The dental hygienist can either use hand instruments or an ultrasonic instrument (or both) to remove the tartar.

Stepping forward in this approach, after having cleaned the lower anterior teeth, the hygienist generally has you turn your head to the left. In this way, the hygienist has access to clean the upper and lower cheek (buccal) side of the teeth on your right side, and then the tongue-side (lingual) surfaces of the left side of the mouth. Then you are asked to turn your head to their right, to allow access to the cheek side of the left of your mouth, and then the lingual surfaces of the right side. A large salivary gland, the parotid, is located on the inside of the cheek opposite the first and second molars, which the hygienist checks well for tartar.

The last area to be scaled in this approach is the upper anterior teeth from cuspid to cuspid. As this area is easily accessible and easily seen by you and most patients, it is usually fairly clean. After scaling with hand instruments and, or the ultrasonic instrument, the hygienist will polish your teeth with prophy paste (you get to choose the flavor), usually polishing the lower arch, and then the upper arch. Hygienists have a tendency to be detailed and thorough, so don’t be surprised if they check and double-check for any remaining tartar, stain, or plaque.

By the time the hygienist flosses your teeth, your teeth should feel slippery and clean! Oh, what a nice feeling!


Celebrating 35 years 1978-2013 Restorative Dentistry

1978-10 CharlieWe are thrilled to share our celebration of 35 years since Dr. Mastrovich first opened the doors of his restorative dentistry practice here in the Escondido-San Marcos community! On that day thirty-five years ago, he was a baby-faced young dentist fresh from finishing his post grad general dental residency at the Sepulveda VA and had been practicing as an associate in two dental groups nearby until he discovered San Diego and made the decision to move here and start his own dental practice.

We are CELEBRATING our privilege and joy in serving YOU, our patients and community, for 35 years!! Ask us about our many Anniversary GIFTS for You!!

$5 Starbucks Gift Card

Each time you ‘check in’ on Facebook from our office and share your favorite memory of Dr. Mastrovich and the team… AND your name goes in the November 15th drawing for a Sonicare toothbrush (valued at $107!)

A $107 Value – Sonicare Toothbrush
Share your favorite memories or experiences with Dr Mastrovich and our team by writing on our Facebook ‘wall’ (different from a ‘check in’). On November 15th, Sonicare toothbrushes will be gifted for:

  1. The memory with the earliest date/year
  2. Funniest memory
  3. The memory with the most ‘likes’

Caption this Photo
Watch for pictures on Facebook and add your caption! The best captions selected can win a Sonicare Toothbrush!

We hope these fun activities will help you see how much appreciate you and spark a trip down memory lane. Our success in North County San Diego Inland has been based on our relationship and partnership with you and we just want you to know how much you mean to us.

Thank you for adding to the fun!


CPR Training: Our commitment to our dental patients health

Our team re-certified our CPR on Thursday, training that is required every two years for our license renewals. We as a team elect to train and re-certify annually so we are up to date on the latest changes, for the benefit of our patients, family and friends. CPR 2012 1

We train with the hope that we never need to use the skills we practice, and are motivated by our dedication to dental health and how that affects the health of the entire body.

CPR has changed immensely in the recent decade and several years ago we made the commitment as an office to purchase a defibrillator when we learned how the use of defibrillators by first responders dramatically increased the chances of survival for victims of cardiac arrest.

CPR 2012a


Mastrovich Dental Team pitching in for Feeding America San Diego


The Mastrovich Dental Team believes in giving back to our community and making a difference in many ways. In particular, we are thrilled to volunteer our time together in support of Feeding America San Diego and their mission to reach those in need for meals with nutrition. 1 in 4 children in San Diego County is food insecure and with our/your help, Feeding America San Diego delivers food to 73,000 people each week.   Healthy nutrition supports dental health with less tooth decay and gum disease.

Today our team worked together with other volunteers in the food reclamation area. If you would like to join us at our next volunteer session with Feeding America San Diego, drop us an email via our Escondido office website .  Vote for FeedingAmericaSanDiego Facebook every day this month for their Farm2Kids Program to help them win the $45,000 grant from Walmart.