The Practice of Dr. Michael Koumas

What Happens During Scaling and Root Planing?

Gum disease can develop overtime as plaque builds up on your teeth and around your gums. The bacteria in the plaque may cause your gums to become irritated and inflamed and you may even notice your gums start to be drawn back from your teeth. When the gums pull away, pockets are created, and this is another opportunity for plaque to build up. When the plaque becomes trapped in these pockets, normal brushing and flossing cannot remove it and scaling and root planing may be necessary. Scaling and root planing is a deep cleaning procedure used to get below the gumline to treat gum disease.

Gum Disease

The good news is, when gum disease is caught and treated early on with a traditional tooth cleaning session from the dentist, you should have nothing else to worry about. Now, if you let the gum disease advance and don’t treat it, scaling and root planing may be necessary to prevent and further damage to the tooth or bone. Gingivitis is the first stage of gum disease, then comes chronic periodontitis and at this stage, it is very likely scaling and root planing is needed.

Illustration of dental tool performing scaling and root planing

Scaling and Root Planing

Scaling is the first step in the process. This is the actual plaque removal process which includes cleaning both above and below the affected gumline, and even in those hard to reach pockets. Root planing is when the dentist will attempt to reattach the gums to the teeth through smoothing out the roots of the teeth.

Arestin Option

Arestin is a bioresorbable gel which contains Minocycline Microspheres. The FDA has approved Arestin to be used for the treatment of gum disease after going through the scaling and root planing procedure. The Arestin is placed in the pocket and directly fights the gum disease infection for 30-days because of its high levels of antibiotic. Below are some Arestin Post-Op instructions to follow after receiving the Arestin therapy:

  1. Avoid contact with treated area
  2. Wait 12 hours after the treatment to brush teeth
  3. Allow 10 days to pass before flossing or other techniques to clean in between teeth, resume after 10 days
  4. Avoid crunchy, chewy and spicy foods for 1-week

To schedule your dental appointment, contact local Newburgh, NY dentist Dr. Michael Koumas.

More information can be found on Scaling and Root Planing

Are Teeth Considered Bones?

Skeleton showing teeth

Even though teeth and bones seem very similar, they are actually different. Teeth are not bones. Yes, both are white in color and they do indeed store calcium, but that’s where their similarities end.


Teeth are made out of enamel, which might be a familiar term to you. Enamel is the outer-layer of your tooth, the visible part and is responsible for protecting your teeth. The other tissues that your teeth are made up of are dentin, cementum and pulp. Teeth are the hardest parts of our bodies because of the enamel which consists of calcium phosphate. Unfortunately, enamel isn’t made of living tissue and can wear away over time.

Dentin lies beneath the enamel and is very sensitive to bacteria which can cause dental sensitivity and even cavities. Pulp is the soft, living core of a tooth that is made up of nerves and vessels running through it. Lastly, cementum is a layer of connective tissue that is responsible for keeping the teeth attached to the gum and jawbone. Teeth do not have the ability to heal themselves because no living tissue exists in the enamel. This is why when a tooth is chipped or cracked, or a cavity forms, visiting the dentist is necessary. No new enamel will form and without properly treating the tooth, the problem will only worsen over time.


On the other hand, bones are made of living tissue, so the tissue is constantly being broken down and replaced with new tissue. This repeating cycle is what keeps our bones healthy and strong. Bones, like enamel, are also made up of part calcium phosphate, but they mostly consist of a protein called collagen. As you are probably aware, the majority of broken bones are able to heal, and this process starts almost immediately. Soft callus on the injury is eventually replaced by hard callus and new bone tissue will eventually take its place, all because of the living tissue.

Protect Your Teeth

Now that you know teeth are not considered bones, and will not heal themselves, you’ll want to take extra good care of them. Remember to brush twice a day, floss, use mouthwash and most importantly, visit your dentist regularly for check-ups and cleanings.

To schedule your dental appointment, contact local Newburgh, NY dentist Dr. Michael Koumas.

More information on Are Teeth Bones

Is Coconut Oil Good for Teeth?

Coconut Oil

Recently coconut oil has been getting a lot of attention in the health world, but is it good for our teeth? And what is oil pulling?

What is Oil Pulling?

Oil Pulling has been around for hundreds of years and many cultures consider it healthy for body tissues. Around a teaspoon or so of coconut oil is swished and pulled through your mouth, this in return, is thought to remove bacteria that can cause plaque and gingivitis. With people searching for natural alternatives, oil pulling has become increasingly popular.


The touted benefits of coconut oil pulling include healthier gums, plaque removal, and whiter teeth. Other benefits such as the prevention of tooth decay and gum disease have been reported as well. However, none of these benefits have been scientifically tested and proven.


Not much research or scientific evidence has been conducted on oil pulling with coconut oil. The fact of the matter is that this method does not compare to other methods with ingredients that have been properly tested. The ADA cannot back claims that coconut oil and oil pulling is good for oral health. Overall, if you want results, whitening toothpaste infused with hydrogen peroxide or professional whitening treatments are better options to pursue.

Dr. Michael Koumas is a dentist in Newburgh, NY who has been listed as one of Hudson Valley Magazine’s Top Dentists for the past decade, as well as Hudson Valley Magazine Top Doctors. Dr. Koumas is a graduate of the University of Maryland College of Dental Surgery.

What to Do for Bad Breath

Hot lemon water

Even though no one likes bad breath, this doesn’t stop it from being a common issue among patients. There are many ways to go about preventing bad breath and identifying the causes behind why bad breath occurs is the first step to stopping it. Find out what you can do to combat that stinky breath here!

What causes bad breath?

Bad breath is a common issue that can be caused by multiple factors. Gases released by bacteria coating your teeth, gums, and tongue is essentially why your breath may smell. Also, bits of food being stuck and rotting in your mouth can cause an unpleasant smell. Eating strong smelling foods such as garlic, onions, or coffee can also make breath smell worse. Lastly, Gum Disease and Dry Mouth (xerostomia) can be a cause of bad breath, and keeping up with dental check-ups can help catch these.

How to prevent bad breath:

  • There are many ways to keep your breath smelling fresh. The most important thing is to brush both your teeth and gums at night and in the morning. Also, don’t forget to brush your tongue!
  • Cut down on sugary foods and drinks that can cause your teeth to rot. For example, replacing your morning coffee (or at least one cup of it!) with a bit of lemon juice infused into hot water can help maintain fresher breath.
  • Remember to floss your teeth once a day! Brushing does not fully clean your mouth. Flossing helps get rid of any extra food stuck between your teeth.
  • Finish with mouthwash. The majority of mouthwashes contain antibacterial agents that can kill bacteria responsible for bad breath.
  • Lastly, visit your dentist regularly! Dr. Koumas recommends you go to the dentist bi-annually, or at least yearly.

Dr. Michael Koumas is a dentist in Newburgh, NY who has been listed as one of Hudson Valley Magazine’s Top Dentists for the past decade, as well as Hudson Valley Magazine Top Doctors. Dr. Koumas is a graduate of the University of Maryland College of Dental Surgery.

Teeth Dreams & Why Teeth Can Fall Out

Have you ever had a dream where your teeth were falling out? This is a common occurrence that many people experience in their dreams. This dream could correlate to tooth irritation or other dental factors, but it more than likely has to do with stress. Here, we’ll discuss teeth dreams and what to do if your tooth nightmare comes to life.

Do teeth dreams have anything to do with actual dental problems?

Teeth dreams happen more often than you may think! The cause of them may be subconscious factors such as anxiety but can also be related to tooth irritation. Also, people going through transitional phases in their lives may experience teeth dreams because of a rise in stress levels. Overall, an increase in dental distress may be a cause of your dreams and should be checked out.

Teeth dreams

So, what causes tooth loss?

There are many reasons why teeth may fall out, but two common causes are a mix of oral hygiene and dietary habits. Dentists recommend that patients brush their teeth twice a day and floss once a day. This can help prevent against cavities and tooth decay. Both decay and gum disease can weaken surrounding tissue around the teeth. This in return can cause teeth to fall out. Also, habits such as smoking, grinding your teeth, or eating sugary snacks/drinks can lead to tooth decay. Remember to have regular dental checkups to keep up with your dental hygiene! 

What to do if a tooth falls out?

If a tooth falls out in real life, the first thing you should do is to visit your dentist and not an emergency room since this is considered a dental emergency. Locate your tooth and pick it up from the crown, not the root, and rinse it with either saliva or milk. Store the tooth back in your mouth if you can, if not, store the tooth in a cup of milk, not water. Lastly, act immediately! If the dentist is closed at the time of the incident, go right when it opens.

Dr. Michael Koumas is a dentist in Newburgh, NY who has been listed as one of Hudson Valley Magazine’s Top Dentists for the past decade, as well as Hudson Valley Magazine Top Doctors. Dr. Koumas is a graduate of the University of Maryland College of Dental Surgery.

How to Stop Teeth Grinding

How to stop teeth grinding

Bruxism, better known as teeth grinding affects about 8% of adults according to the National Sleep Foundation. Teeth grinding often occurs while we sleep and can be brought on by a number of different factors. Stress, anxiety, tobacco, alcohol, and caffeine are just a few known factors that can contribute to teeth grinding. Signs that you grind your teeth are jaw soreness, headaches and loose or fractured teeth. Though there is no pill to take that can cure teeth grinding, there are a few methods that can help you stop grinding your teeth or reduce damage from teeth grinding.

Mouth Guards

A mouth guard is one of the most common ways to combat teeth grinding. By visiting your dentist, they can fit you with a mouth guard that is comfortable for you to wear while you sleep. In some cases, a dentist may take it a step further and recommend a muscle relaxant.


Often, stress is a leading cause of teeth grinding. If this is the case, it may be helpful to try meditation, yoga or exercise and even consider therapy. Life gets stressful and it is completely normal to experiment with which activity is best to help you relieve your stress.

Bruxism in Children

Teeth grinding is very common in children and it is usually nothing to worry about. A child’s teeth and jaw are rapidly growing and changing so the occasional teeth grinding shouldn’t be causing any serious damage. As your child gets older and you notice their habit hasn’t been outgrown, talk with their dentist. Teeth grinding in children and adolescents can point to misaligned teeth, irritation in the mouth and even allergies that may be undiagnosed.

To schedule your dental appointment, contact local Newburgh, NY dentist Dr. Michael Koumas.

Tooth Extraction Aftercare

A tooth may have to be extracted for a number of different reasons and the aftercare is a crucial part of the healing process. Teeth can be severely decayed, poorly positioned or have advanced periodontal disease and extraction is necessary. Though the extraction process itself is major, the aftercare needs to be successful in order for your mouth to heal properly. After the extraction process there will be a hole in your jawbone, but after 1-2 weeks you should begin to heal. Eventually, bone will fill in the hole, but this process can take many weeks or even months.

Swelling & Pain

After the tooth extraction, swelling can occur. If it does, it is recommended that you place ice on your face for 10-minute increments and 20 minutes of rest in between. Use ice as you feel necessary for about 24-hours to help control swelling. As for pain, acetaminophen or ibuprofen can be taken to reduce pain. If bleeding occurs, place a piece of moist gauze over the area and bite down for 45-minutes to help control the bleeding. If bleeding persists, don’t hesitate to contact your dentist.

Brushing and Cleaning

For the first day following the tooth extraction, you should avoid brushing around the extraction site. After one day, gentle brushing is okay around the sensitive area. Do avoid traditional mouth rinses as they can irritate the gums, but after the first day you can begin swishing warm salt water in your mouth after eating and before bed. This can help reduce bacteria in the mouth.


For the most part, it is best to stick with softer foods for the first 24-hours, or even a liquid diet in some cases. When you have to chew, be sure to keep the food away from the extraction site. You should stay away from alcoholic beverages and hot liquids for the first 24-hours.

Dry Socket

Dry socket significantly delays the healing process and can be avoided by following the dentist’s aftercare instructions. Dry socket occurs when a blood clot fails to form in the socket where the tooth used to be or when the clot becomes dislodged. These can become very painful and may not be noticeable until three or four days after the procedure. Symptoms of dry socket are pain, a bad taste in your mouth and bad breath. Contact your dentist if this happens.

To schedule your dental appointment, contact local Newburgh, NY dentist Dr. Michael Koumas.

How often should you go to the dentist?

Yearly dentist visits are key to keeping your mouth healthy and your wallet happy. Generally, anxiety over going to the dentist can keep some patients away, but these important visits can identify early signs of dental issues that can become bigger overtime. There is no exact amount of times you should be visiting the dentist, but the American Dental Association (ADA) recommends getting checkups at least once a year, maybe even twice to be safe.

Importance of a Checkup

Regular dental checkups are meant to keep your mouth healthy. Not only will the dentist recommend a cleaning or search for cavities, but they also look for symptoms of other diseases and conditions that can develop in the mouth. It is always best to be proactive, because spotting symptoms of dental health issues in their earliest stage means it can be a whole lot easier to fix whatever the issue may be. Remember, everyone is different, and some mouths require a dental visit once a year while others may need a handful throughout the year. A best practice is to consult with your dentist and see what they recommend based on your dental history.

Don’t Wait

Putting off that dentist appointment is never a good idea for many different reasons. First, dental issues can’t and won’t fix themselves which means that over time, the issue will only become more serious. As dental issues become more serious, they can also become costlier to fix. Ongoing pain or a wiggle in your tooth should be enough encouragement to pick up the phone and schedule that dentist appointment. Dentists are there to help you and keep your smile beautiful.

Are You High Risk?

Individuals with certain medical conditions can be considered high risk for dental health issues. The following groups of people are known to be high risk and should consult with their dentist to ensure they are keeping their mouth and teeth healthy:

  • Smokers
  • Pregnant women
  • Cancer patients

To schedule your dental appointment, contact local Newburgh, NY dentist Dr. Michael Koumas.

How to Stay Cavity Free This Halloween

bowl of candy corn - how to avoid cavities this halloween

With Halloween right around the corner, all the promotion of sugar-filled candy can be scary for parents out there with children. Especially when candy from trick-or-treating can last for weeks, even months after Halloween. With that in mind, here are tips on how to celebrate Halloween the healthy way and avoid cavities.

What is a cavity?

A cavity is the result of a tooth breaking down or decaying. Literally, a cavity is a whole in a tooth that increases in size overtime, if left untreated. Cavities are caused by plaque buildup and acids that break down the protective enamel on the outer layer of your teeth.

Candy Eating Tips

Time of Day

Keeping in mind the time of day you or your child snacks on their yummy Halloween candy is a good practice. Eating candy as a dessert at meal time is a better time because of the amount of saliva present. Saliva production significantly increases during mealtime, giving you better chances of those sugary leftovers and acids being washed away with the saliva. Remember, candy should be a special treat and should not be consumed throughout the day.

Avoid Sticky Candy

Candies like tootsie rolls, taffy, starbursts and even jolly ranchers tend to stick around longer than other candy. They are more difficult to wash out of the mouth, increasing the risk of cavities developing. Either avoid these types of candy or be sure to brush your teeth soon after consuming.

Sticking to your daily mouth care routine is important to prevent cavities developing. Also, scheduling a visit with your dentist is always recommended, even if you believe your teeth are perfectly healthy.

To schedule your dental appointment, contact local Newburgh, NY dentist Dr. Michael Koumas.

When to Get a New Toothbrush

frayed toothbrush bristles - When to get a new toothbrush

Changing your tooth brush occasionally is an important step to keeping a healthy mouth. The American Dental Association recommends that you replace your toothbrush every 3 to 4 months, maybe even sooner if the bristles on the brush are frayed. As the bristles become worn out, the brush becomes less effective in cleaning in between teeth. New toothbrushes are proven to remove more plaque and build up than a used toothbrush.

On the unfortunate occasion that you get sick, dentists recommend you replace your toothbrush to prevent future illness. The toothbrush can hold onto, and even grow bacteria.

Toothbrush Maintenance

Rinsing the toothbrush under water when finished brushing is important to reduce bacteria growth. In terms of storage, the toothbrush should be left out to air dry. If a toothbrush is placed in a closed case immediately after using, bacteria can grow because of the warm, moist environment. When on vacation or traveling for business, it is recommended that a disposable toothbrush is used only for the time you are away. If you want to reduce your plastic waste, explore other biodegradable options, like bamboo toothbrushes, that can help you feel less guilty about tossing your toothbrush every 3-4 months.

Bristles Strength

When shopping for that shiny, new toothbrush, you’ll see different bristle types such as soft, medium or even extra-soft. On average, most dentists recommend a soft bristled toothbrush as it is gentle on the teeth but also gets the job done. A bristle that is medium or even hard, may wear away at the enamel that is crucial in protecting your teeth. Asking your dentist for their recommendation for you personally is always encouraged.

To schedule your dental appointment, contact local Newburgh, NY dentist Dr. Michael Koumas.