I forgot to pack my toothbrush! Now what?

It can happen to anyone. Even the super organized, meticulous planner, list making expert traveler. You arrive at your destination to find-NO TOOTHBRUSH! Well, now what?

Most hotels have complimentary toiletry items for just this type of  situation. If your lodging does not offer this option and you have arrived after all the shops have closed up for the day, you are not destined for  fuzzy teeth and bad breath-There are some easy short-term substitutes  you have available literally, at your fingertips.


Brush your tongue with your teeth.
Using your teeth, gently scrape along your tongue to clean off any  bacteria that could cause tooth decay and contribute to bad breath.
After scraping, rinse thoroughly with water-swishing back and forth  vigorously to make sure that any bacteria scrapped off is washed  away. Spit this water out. Don’t swallow it!   


Use your finger.
First, make sure your hands are clean and that you have fully rinsed off any soap (because, yuck!). If you have a washcloth near by you can wrap it around your finger for extra scrubbing power. If you have toothpaste use it, if you forgot that too then brushing with water will be just fine for one night.

Rub your finger across your teeth and gums along the front of your teeth. Rinse your finger, add more toothpaste if you have it, and repeat on the back and top sides.

Repeat the rinse and swish as described above. Don’t swallow this water either. You don’t want to put the bacteria you just brushed off your teeth into your gut, where it has the potential to cause stomach distress, by swallowing it. 

What about flossing?
There really isn’t a suitable substitute for floss. The best alternative we recommend in a pinch is a toothpick.If you don’t have a toothpick,not to worry, if you can get some floss the next morning or worst  case when you return home,the risks to harming your gums and teethby using a paper clip, or string outweigh the risks of not flossing for a short period of time.

Find Supplies ASAP.
These tips will certainly help you out when you are in a bind, but are not equal in effectiveness as your regular toothpaste, brush, and  floss. It is important to head to the nearest store the next morning tostock up on the necessary items you are missing.

Dr. Morris’ Secret to never forgetting his toothbrush:
“I keep an extra set of dental supplies in my travel toiletry bag. That makes it easy for me to not forget important items that I may otherwise overlook if i’m in a hurry when packing”. 


In part 1 and 2 of this series we described how a dental plan works, what type of services  are covered, key terms and how two insurances really work together, so you can start  narrowing down your plan options. In this issue we will break down what costs to consider when comparing your plan options to make the final determination of which plan  is right for you and what other options you have for keeping your smile in tip-top shape.

Deductible, Coinsurance and Copay

These are all considered out of pocket expenses in addition to the monthly or yearly premium you pay for the plan.

Deductible: The amount you need to pay before your plan will contribute towards care. Deductibles can be specified that each individual covered must meet a certain amount or as a group, make sure you are aware which it is because the difference could increase your total costs.

Coinsurance: is a fixed percentage of a treatment cost you share with your dental plan.

Copay: is the flat fee you pay for treatments and services at every visit. Typically copays are paid at the time care is received and the amount is usually printed on your card. Copays do not count towards your deductible or coinsurance.

Is there another option?

Yes! There is one more option we have for your consideration.

The Merrimack Smiles Dental Benefit Plan

We created our three prevention based plans with our patients in mind because we  understand how important your oral health is to your total body health. Our plan has:

NO Deductibles       NO Annual Maximums        NO Coinsurance                            

NO Exclusions         NO Copays                            NO Waiting Periods    

Provides a fixed percentage off all treatment- NO Limitations

A full breakdown of what the plan includes and the cost can be found on our website.

We hope you found the information presented in this series beneficial. As always if you have a question about what you are seeing when choosing the plan right for you this year, give us a call! We will happily answer any and all questions you may have.


In part 1 we described how a dental plan works, what type of services are covered and what key terms to look for so you can start narrowing down your plan options. In this issue will go into detail of how two insurances work together and discuss what usual and customary charges really mean.  Even armed with all the information we have provided, choosing the right plan can still be quite the task and what worked well for you one year may not in the next. Don’t forget that you have help and we are simply a phone call or email away! While we can’t pick the plan for you, we will gladly help guide you and answer any questions so that you can fully maximize the benefits you pay for each year.

Usual, Customary and Reasonable Charges (UCR)

UCR charges are the maximum allowable amounts that will be covered by the plan. UCR rates are not required to meet any sort of industry standard, in fact it is the opposite: each company is able to set whatever amount they want for UCR charge and they may not match the current actual fees charged by dentists in any given area. Adding to the ambiguity of this line item is that the company is not required to disclose the formula or data used to compute the number. Low UCR rates mean low employer cost, low employer cost equals more employer participation and greater revenue for the insurance company.

Primary and Secondary Plans 

If Patient A is the subscriber to a dental plan it would be their primary plan. If Patent A has a spouse who also has a dental plan, the spouses insurance would be Patient A’s secondary plan.

Birthday Rule: primary and secondary plans are determined differently for children and are usually designated using what is called the birthday rule: assigning the primary plan by which parent’s birth month comes first in the calendar year. A divorce agreement or other court ruling may supersede the birthday rule when determining which plan is primary and secondary.

Coordination of Benefits (COB)

If you have two dental benefit plans they will coordinate benefits one of two ways.
1) Standard Coordination: The secondary insurance will coincide with the primary on all claims.

Example: Mary’s Primary plays a filling at 80%, her secondary will pay the remaining 20%.

2) Non-Duplication (Non-Dup): The Secondary Insurance will not pay anything towards services the primary paid on unless the primary is completely maxed.

Example: Mary’s primary plan has $15 dollars remaining for the benefit year and pays that amount towards her filling. Her secondary insurance will not pay towards the filling, leaving the remaining as her responsibility. During the same benefit year Mary needs a second filling. Her primary plan is now maxed and will not pay towards this filling, but her secondary plan will now begin to pay and she will have her full benefit year maximum available.

Next up part three: What is the real cost for me and do I have other options?


Picking a dental benefit plan carrier for you and your family can feel overwhelming. Between the number of plan options and variations within each one individually it can be hard to feel confident even after you’ve done your due diligence and read about each plan thoroughly.

We think that understanding your dental benefit plan or choice to not be covered under a dental plan is invaluable and have compiled our most helpful tips, descriptions and definitions so you can pick (or keep) your next plan with confidence.

Understanding My Dental Plan

Using the term “insurance” for dental plans is not a truthful representation of what your plan actually is. It is not a payment to cover a loss, catastrophic event, or accident as your medical, auto or home insurance will. It is a benefit provided by employers to help employees cover the cost of dental care. Typically an employer will purchase a plan based on the amount of the benefit and cost of the premium for the company or employee.  Think of your plan as a benefit plan that your employer contributes towards which will help to offset or subsidize the cost of your dental care.

How Dental Plans Work

Dental plans are a contract between your employer and insurance company. Your employer and insurer agree on the amount your plan pays and what procedures are covered. If you are not satisfied with your plans coverage or insurer experience, talk with your employer to let them know how it could be improved or changed.

Key Terms to Compare When Looking at Plans

Plan Year: What months does you plan year start and end? Most plans follow the calendar year (Jan-Dec) or have a benefit mid-year start/end (June-July).

Benefit year Maximum: What your annual maximum benefit dollar amount is for individual and family? Preventative and diagnostic treatments will count towards your maximum benefit for the plan year. 

Waiting periods: Are there any waiting periods before you are able to use your benefits? If so, are those benefits something you had planned or needed to use right away? Do you have the ability to wait?

Age Limitations: Some plans have age limitations on service. This means that your insurance will only provide coverage up to or after a certain age. 

Frequencies: How often does your plan cover specific treatments? It is important to look at what treatments you and your family use most or know that you have coming in the next year. Even if this insurance plan is new to you, companies share history and frequency, so limitations will still apply. 

Percentage of coverage for:  
Preventative/Diagnostic-including dental examinations, x-rays, cleanings and topical application of fluoride. 

Basic Restorative– including fillings, routine extractions, root canals, periodontal treatments, & sealants. 

Major Restorative and Prosthodontics-including Surgical extractions, crowns, bridges & implants. 

Orthodontics-including braces or other appliances. Age limitations and lifetime benefit may apply. 


Read Part 2 : Important terminology to know before choosing a plan

Did you fully utilize your dental insurance benefits this year?

Maybe a better question would be- How do I know if I fully used the  value of my dental insurance plan this year?

The simplest answer is: We try to do that work for you and help to make sure that you are always getting the best value out of your individual  dental insurance plan.

Before each and every visit we send pre-determinations, research your  insurance coverage, usage and limitations, and do our very best to  communicate with you along the way regarding the information we are  receiving. Hopefully, this helps you read and understand the copy of the pre-determination and explanation of benefit (EOB) statements that  your dental insurance company sends to you.

What does this mean for me?

Since December 31st marks the end of the benefit year for most  dental plans, it means that any remaining dollars available to you  that you have already paid for, by paying your monthly premium will be lost.

What can I do to prevent losing my benefits at the end of the year?

You can log into your dental insurance companies’ user portal or callyour insurance company to ask then exactly what type of coverage  and how much you have remaining.


You can give us a call and we can help walk you though it. We can  help you determine what remains unused and how to maximize your dental insurance plan to it’s fullest.

If you have any remaining dental benefits and dental care that you  need completed, NOW is the time to schedule an appointment.

By delaying treatment, you risk more extensive and expensive  treatment down the road. Even if you’re unable to complete  treatment this year, you can at least get the ball rolling and use any  leftover benefits, then in the New Year when you dental benefit  renews, you can return to complete treatment. What may be a simplecavity now, could turn into a root canal later if left untreated.


Don’t Forget About Your Flexible Spending Account 

Your dental insurance benefits may not be the only benefit that you  could lose if you don’t use them by the end of the year. Not all  employers allow you to roll over your Flexible Spending Account  (FSA) funds at the end of each year. That means if you don’t use it, you lose it!

Electric toothbrushes, whitening strips, and our OxyFresh products  all qualify as FSA approved expenses & double as a great practical  gifts for your friends and family.

So, if you are drowning in cold medicine and have enough band aids in stock, why don’t you stop by the office and pick up a toothbrush  this year instead! Or use what you have left to pay for the dental  care that you may need!

3 Teeth friendly ways to eat sugar

October marks the start of the celebration season filled with sweet treatsand delicious hot drinks. It also means that our mouths and teeth will  have to fend off constants attacks from sugar. If we are being honest  with ourselves, there is absolutely NO WAY we won’t be consuming any of the delicious treats and drinks offered up this season. Fortunately,  there is a better way we can consume sugary treats that will keep our  mouths and teeth safe from harm. Read on for our 3 tips to help you  safely enjoy  your treats this fall and holiday season.

1. Length of time it takes you to eat or drink your treat

For your teeth it is less about the amount of cavity-causing foods and drinks you are consuming and more about how long it takes you do so. The duration our teeth are exposed to sugar the better. Bacteria in our mouth convert sugar to acid, it’s the length of time your teeth are exposed to this acid that can cause the most damage. For example, sucking on a hard candy or slowly sipping on hot chocolate can cause more damage than eating a piece of chocolate or cookie monster-ing a cookie.  

2. Wait 30 minutes before brushing your teeth

It may be tempting to brush immediately after eating but it is best to wait for at least 30 minutes after consumption. The acid created by the sugar consumed can make your tooth enamel (top layer of the teeth) weak making it easier to be scrubbed away by a toothbrush. Waiting 30 minutes will allow the enamel to re-strengthen and become safe to brush. If you can’t wait the 30 minutes then our third tip- drinking water- is your best option!

3. Rinse with or drink water

There is a good reason why water is the champion of beverages! Among its many benefits, water will also dilute the acid and help to wash it from your mouth, reducing its potential to cause harm. Eat your  treats with water instead of hot chocolate or alternate drinking water with a sugary beverage. If you can remember to swish it around yourmouth before you swallow (or spit) it that will help to remove most ofthe acid from your mouth and teeth.

Why are my teeth suddenly sensitive?

We all know the feeling. A sharp unexpected pain when you bite into  your sandwich, take a sip of water or a breath on a cool day. It does not feel good and can even make you wince. So, the question is- what  happened? Why are my teeth suddenly sensitive?

While tooth sensitivity can happen for many reasons the root cause  generally can be explained by one of a handful of common issues, which your dentist can expertly help identify by using a method called  differential diagnosis. Differential diagnosis is a process that medical  professionals use to correctly identify the cause of tooth pain in an  instance where multiple alternatives are possible.

First, your dentist will need to know if the pain is associated with  multiple teeth or one tooth. There are specific reasons for one or a few  teeth to suddenly become sensitive such as a cavity, crack, fracture,  receding gums, or an abscess. If one or more of your teeth have any of  these issues then your dentist will help you identify the next steps to  take and treatment options to help you get back on track with the goal of a pain free healthy mouth.

If none of your teeth have any of those described issues then your  dentist will know that your teeth/tooth has become sensitive as a result  of an outside factor such as:

Are you stressed? Even when we think we are dealing with our stress  levels very well on the outside our bodies can still show signs of wear  and tear as a result, and one of the first places to experience any  discomfort is our mouths. We clench and grind our teeth when stressed, most of the time without even realize that we are doing it. Which is why when your jaw is tired and your teeth hurt it can feel like it came out of  nowhere, when in reality it has slowly been building overtime. Have you ever woken up with a sore or tired feeling jaw and sensitive teeth? It’s  because often times we do the most clenching and grinding in our sleep, and if we are not aware of it during the day it is almost impossible to be aware of it while asleep.

Have you been sick? Sinus colds will make all of your teeth feel  very sensitive to any type of vibration from even the softest steps, orfrom the constant coughing and nose blowing. Also, the cough drops that we all have the best intention of only sucking on but sometimes crunch and chew after a while may have caused a crack or fracture.

Did you whiten your teeth? Using any type of teeth whitening products, whether over the counter or in your dentist’s office can result in a temporary sensitivity of your teeth.

Have you had any recent dental work? Sometimes, the slight  change in your bite from a new filling or simply holding your mouth  open for a longer period of time can cause you to begin to clench  and grind your teeth causing tooth sensitivity and pain. This is why  your dentist asks you to bite down on a colored piece of paper after a filling or crown. The colored paper leaves marks on your tooth  surfaces recording your bite so that your dentist can see if all your  teeth are hitting in the right spots. They also rely on you to tell them if it feels comfortable since sometimes our mouths can look fine but  feel slightly off. It is also normal to feel like your bite is fine in the  office but within a few days realize that it actually feels slightly off. Simply call us and we will get you right in for a bite adjustment.

Do I have to live with tooth sensitivity forever? Absolutely not!  Luckily there are many ways that we can help you defeat tooth  sensitivity! Occlusal guards can help relieve the clenching and  grinding. Fluoride toothpastes and treatments, which are available inour office, will help protect and strengthen your enamel against  sensitivity resulting from acidic foods and whitening. In office  sealants and fluoride treatments will also help to prevent the  development of cavities and reduce the likelihood of sensitivity due  to tooth decay or compromised tooth structure. Most importantly if  you are experiencing tooth sensitivity that you feel is negatively  impacting your life and has not resolved with a bit of time and  attention on your own, call us so we can help you get back to your  life tooth pain free! The more information you can give the better andwe have the years of knowledge to help you quickly get back to your life with stronger teeth and a healthier mouth!

The link between Periodontal Disease and Alzheimer’s Disease


In recent years there has been a plethora of studies revolving around the links that exist between your oral health and systemic health (total body  health).  These  studies have  consistently revealed that inflammatory diseases, such as periodontal disease, compromise the body’s ability to fight infections and can worsen systemic diseases such as diabetes and cardiovascular disease. More recently a link has been discovered that inflammation in your mouth, such as periodontal disease, can affect your brain health and function, contributing to the development of Alzheimer’s disease (AD). It is important to make note that there  have been no studies that have proven that periodontal disease causes AD, only that there is a plausible link between specific types of bacteria associated with periodontal disease  and the increased risk of developing AD.

How can there be a link between the bacteria in your mouth and the rest of your body? The most common ways bacteria can reach other areas of your body is through the bloodstream. If your gums bleed when you chew, floss, and brush, bacteria from your mouth (periodontal bacteria) will enter your bloodstream and travel throughout your body. The bacteria is usually contained by the immune cells of the body. However, in people with a reduced or weakened immune system, the bacteria is able to travel throughout the body more easily.

In two different studies with 2,415 subjects over the age of 60, it was found that those who did not have AD at the start but developed it over the course of the study had periodontal dental disease present prior to developing AD. The subjects which developed AD did have higher levels of antibodies to the periodontal bacteria suggesting that they body was already attempting to fight the bacteria, support the timing that the infectious periodontal disease was present before the AD developed.

What Does This Mean For You?

It means that taking care of your teeth and gums at any age is important. Whether you have or have not been diagnosed with periodontal disease, continue your regular visits to your dentist as prescribed, maintain a consistent and effective oral hygiene routine at home, and keep the rest of your body as healthy as possible.

Making these healthy choices is going to help reduce and/or eliminate the presence of periodontal disease. Using products that help reduce tooth decay such as fluoride and sealants,mouth rinses or gels, getting regular professional dental cleanings, and monitoring bone loss with regular exams and x-rays are also important steps in maintaining a healthy mouth. Your Dentist and Dental Hygienist are experts in the topic of oral and total body health and can help provide education and suggestions for improving home care in between visits. They are your partners in health and want you to say as healthy as possible! So the next time you see them ask as many questions as you can think of. Write them down as you think of them and bring your list to your next appointment! If you have any concerns, no matter how “small” you think it may be, please mention it. To us, it’s all important!

How Important are Sports Mouth Guards?



Recent studies have shown that most people are not aware of the frequency and severity of trauma to the mouth from both contact and non-contact sporting activities. Many sports-related traumatic dental injuries are preventable with the use of a proper fitting sports mouth guard. We know using proper fitting protective equipment works, it’s the reason we all take the time to fit ourselves and children with the right helmet or chest pads before we even consider walking onto the field. Including a properly fitted sports mouth guard in your equipment check list each season is an easy way to be sure that you protect your teeth, gums and brain from trauma associated with impact from elbows, balls, punches, head-butts and sticks to the face and head.

Typically sports mouth guards cover the upper teach (statistically these are the teeth that carry the greatest possibility of injury), however if you have braces, implants, bridges or other dental work on your lower teeth your dentist may suggest a guard to protect these areas as well.


Stock guards. These come out of the package preformed and ready to wear. These are easy, quick and are the least expensive option. Unfortunately the one-size fits all model does not work very well in your mouth and these guards are often bulky and lose, making it difficult to speak and breath easily. The rubber material that they are made of is soft and does not provide the impact resistance needed to reduce the rate and severity of concussions, and trauma to the mouth and teeth. Also, stock guards will not provide protection in areas that have missing teeth or orthodontic appliances (such as braces). I would recommend using they type of guard only if you are in a pinch and your option is a stock guard or no guard.

Boil and bite guards. These come in a preformed shape with a firm hard exterior, and moldable interior which can be altered by boiling the guard in water and then biting into the warm rubber for a more customized fit. These guards can create a better fit than stock guards, since you are fitting it to your mouth and teeth. Unfortunately you are still constrained by the general sizing (often only youth and adult) which may not fit correctly. Similar to stock guards, the materials these are made of tend to be softer and will not provide the protection needed to reduce the rate and severity of concussions, and trauma to your mouth and teeth. Cost varies depending on the brand. While a boil and bite guard may provide more protection than a stock guard will, it still lacks in the ability to provide the protection needed especially if you are missing teeth or if you have anything other than an “average size” mouth. I would recommend using a boil and bite as your “extra” guard and keep one in your sports bag at all time just in care a custom guard is not available.

Custom Made. These are made by your dental office and custom designed to precisely fit your mouth. A custom made guard will provide you with the most comfortable fit and best protection for your mouth. Most athletes prefer to use a customized mouth guard because the fit is superior to the others and therefore it interferes less with their performance (breathing, speaking, running etc.). The materials used for custom guards are designed to withstand a hard hit and provide the protection needed to reduce the rate and severity of concussions, and trauma to your mouth and teeth. Also, any missing teeth. orthodontic appliances or other specifics would be accounted for and therefore provided the best protection for your mouth. Talk with your Dentist about what would be right for you and ask them to make your guard with your name, team colors or jersey number on it! I would recommend a custom made guard for any contact or non-contact sport where you may incur trauma to your mouth and lower face i.e. mountain biking or skateboarding.

How does a sports mouth guard protect me against concussions?

There have been studies conducted that showed athletes wearing store bought mouth guards suffered more traumatic brain injuries/concussions than those wearing custom made guards. While all mouth guards will help to absorb shock, stabilize the head and neck, and limit movement caused by a direct hit to the jaw, not all guards do this equally. The main difference of protection is thickness-store bought guards are on average 1.65 millimeters (mm) thick versus a custom guard witch is on average 3.50 mm thick. The difference 2 mm makes is huge when considering the amount of shock absorbance and barrier protection provided from direct hits. Also, the type of material the mouth guard is made of can have an impact on how much protection it provides. Most store bought guards are made of a soft pliable rubber material and custom guards are made out of a stiff laminated material. If you do sustain a hit to the mouth your custom guard made from a thick stiff material will provide much more protection that a thinner pliable rubber guard.


A large portion of these injuries consist of cuts, cracked or broken teeth and broken jaws. Considering the cost of replacing or repairing a permanent tooth has been estimated between $5,000-$20,000 not including the emotional stress and time it takes to deal with an injury, investing in a well made mouth guard seems like a small price to pay for a highly reduced risk of sustaining an injury allowing you to enjoy your participation in sports and activity with reduced worry.


Eat Your Way to Your healthiest Mouth Yet!

Our teeth, small but mighty, are a lot more important to our health than we may realize. Without teeth, you would’t be able to eat popcorn at the movies, a big juicy steak off the grill or sweet strawberries right of the vine. You need healthy teeth (and gums) to eat nutritious food, and we need nutritious food to keep our teeth and bodies healthy. Tooth development and health is influenced and affected by the foods you eat as a child. As an adult, the foods you eat help to maintain the foundation you built as a child. The conditions of your teeth and gums can often be the first indication of a larger systemic issue going on in your body. The mucosal cells, which is the tissue inside your mouth that covers most of the oral cavity apart from the teeth, completely regenerate every seven days. This means that any nutrient deficiencies or excesses will show up in your mouth tissue before they have the opportunity to travel and be noticeable in other areas of your body.

Okay-so, when you are standing in the grocery store list in hand, what foods are you picking up to get your your healthiest mouth yet?

We’ve made you a chart to help sort it all out!