Dr. Giscombe and Associates, P.A.

2801 Blue Ridge Rd. Suite G10
Raleigh, NC 27607

(919) 781-3862

My Blog

By Blue Ridge Dental Care
November 10, 2017
Category: Dental Procedures
Tags: orthodontics   adult braces  

It’s something you think about often—especially when you look in a mirror or at a photo of yourself. You wish something could have been done about it a long time ago. But now you think you’re too old to correct your misaligned teeth—your “crooked” smile.

Actually, you can transform your smile through orthodontics, whatever your age. Millions of your peers have done just that—currently, an estimated one in five orthodontic patients is an adult.

If orthodontics isn’t right for you it won’t be because of age, but most likely the condition of your gums and underlying bone or your overall health. That first factor is extremely important: if you’ve lost a significant amount of bone due to periodontal (gum) disease, there may not be enough to support the force of moving the teeth during orthodontics.

Health conditions like severe heart-valve disease, uncontrolled diabetes or drugs to treat arthritis or osteoporosis can also make tooth movement difficult. And, if you have restricted saliva flow (dry mouth), wearing orthodontic devices could be uncomfortable and increase your risk of tooth decay.

If, however, your mouth and body are reasonably healthy (and you don’t have a difficult bite problem to correct), there’s no reason why you can’t undergo orthodontic treatment. The only other thing that might hold you back is concern over your appearance during treatment. Many adults balk at the possible embarrassment of wearing metal braces “at their age.”

If this is a concern, you may have an alternative: clear aligners. These are a series of computer-generated clear plastic trays that conform to the individual contours of your teeth. Each tray is slightly different—you wear one for a short period of time (usually two weeks) before moving on to the next tray to successively and gradually move your teeth. They’re nearly invisible to others and, unlike fixed metal braces, you can take them out for a rare special occasion.

The only way you’ll know whether correcting your misaligned teeth is a viable option is to undergo a full orthodontic evaluation. From there we can help you decide if and how you want to gain a straighter, more attractive smile.

If you would like more information on adult orthodontics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontics for the Older Adult.”

By Blue Ridge Dental Care
November 09, 2017
Category: Dental Procedures
Tags: cosmetic dentistry   veneers  

Your dentist at Raleigh, NC, knows his patients want to have better-looking smiles. For that reason, Dr. Ajamu Giscombe suggests dental veneersveneers. Veneers are used to resurface an individual's teeth, especially if they're damaged.

Here are some things veneers can help with:

  • Stained teeth or discolored, due to poor hygiene, drinking coffee and tea, smoking, chewing tobacco or using antibiotics containing tetracycline.
  • Mishappened teeth, such as:
    • Crooked teeth
    • Worn or chipped teeth
    • Irregularly shaped teeth
    • Uneven surfaces and spacing between teeth, like overcrowdedness.

When you come into the Raleigh office, your doctor will examine your teeth and assess whether veneers are right for you. If he decides it is, then any underlying issues, like cavities, will need to be resolved first. Your dentist will prepare the teeth by removing some enamel from the surface of your teeth. Then a model of your teeth will be sent to a lab where a custom set of veneers matching the color of your teeth will be made for you. When your veneers finally arrive, your dentist will then cement the veneers. Because your dentist removes some enamel, which is an irreversible process, and because veneers are made out of thin porcelain, you won't feel like your teeth are protruding. On the contrary, they will feel smooth, even and properly aligned with the rest of your teeth. 

Other advantages to veneers, besides them concealing the faults mentioned above, is that veneers last longer than dental bondings and have an impressive color stability which makes them highly resistant to staining. So you'll be able to sip your tea or coffee without any worries.

In order to take proper care of your veneers, you need to brush twice a day and floss at least once before bed. It's important to prevent the buildup of plaque which may result in cavities and other serious issues.

For more information on veneers, contact your dentists at Blue Ridge Dental Care in Raleigh, NC, by calling today!

By Blue Ridge Dental Care
October 26, 2017
Category: Oral Health

Proactive dental care is an essential part of childhood growth. But that care can be much harder for children with chronic health issues than for healthier children.

“Chronic condition” is an umbrella term for any permanent and ongoing health issue. Asthma, Down’s syndrome, cystic fibrosis, congenital heart defects and many others fall under this umbrella, with varying symptoms and degrees of intensity. But they all have one common characteristic — a long-term effect on all aspects of a child’s health.

That includes the health of a child’s teeth and gums. Here, then, are a few areas where a chronic health condition could impact dental care and treatment.

Ineffective oral hygiene. Some chronic conditions like autism or hyperactivity disorder (ADHD) that affect behavior or cognitive skills can decrease a child’s ability or willingness to brush or floss; some conditions may also limit their physical ability to perform these tasks. Parents and caregivers may need to seek out tailored training for their child’s needs, or assist them on a regular basis.

Developmental defects. Children with chronic conditions are also more likely to have other developmental problems. For example, a child with Down, Treacher-Collins or Turner syndromes may be more likely to develop a birth defect called enamel hypoplasia in which not enough tooth enamel develops. Children with this defect must be monitored more closely and frequently for tooth decay.

Special diets and medications. A child with a chronic condition may need to eat different foods at different times as part of their treatment. But different dietary patterns like nutritional shakes or more frequent feedings to boost caloric intake can increase risk for tooth decay. Likewise, children on certain medications may develop lower saliva flow, leading to higher chance of disease. You’ll need to be more alert to the signs of tooth decay if your child is on such a diet or on certain medications, and they may need to see the dentist more often.

While many chronic conditions raise the risk of dental disease, that outcome isn’t inevitable. Working with your dentist and remaining vigilant with good hygiene practices, your special needs child can develop and maintain healthy teeth and gums.

If you would like more information on dental care for children with chronic health conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Managing Tooth Decay in Children with Chronic Diseases.”


When you think orthodontics, you may instantly picture braces or clear aligners worn by teenagers or adults. But there’s more to orthodontics than correcting fully developed malocclusions (poor bites). It’s also possible to intervene and potentially reduce a malocclusion’s future severity and cost well beforehand.

Known as interceptive orthodontics, these treatments help guide jaw growth in children while mouth structures are still developing and more pliable. But timing is critical: waiting until late childhood or puberty could be too late.

For example, we can influence an upper jaw developing too narrowly (which can cause erupting teeth to crowd each other) with an expander appliance placed in the roof of the mouth. The expander exerts slight, outward pressure on the upper jaw bones. Because the bones haven’t yet fused as they will later, the pressure maintains a gap between them that fills with additional bone that eventually widens the jaw.

Functional appliances like the Herbst appliance influence muscle and bone development in the jaws to eventually reshape and reposition them. The Herbst appliance utilizes a set of metal hinges connected to the top and bottom jaws; when the patient opens and closes their jaws the hinges encourage the lower jaw to move (and eventually grow) forward. If successful, it could help a patient avoid more invasive treatments like tooth extraction or jaw surgery.

Some interceptive objectives are quite simple in comparison like preserving the space created by a prematurely lost primary tooth. If a child loses a primary tooth before the incoming permanent tooth is ready to erupt, the nearby teeth can drift into the empty space. Without enough room, the permanent tooth could erupt out of position. We can hold the space with a simple loop device known as a space maintainer: usually made of acrylic or metal, the device fits between adjacent teeth and prevents them from drifting into the space until the permanent tooth is ready to come in.

Interceptive orthodontics can have a positive impact on your child’s jaw development, now and in the future. For these techniques to be effective, though, they must begin early, so be sure your child has a complete orthodontic evaluation beginning around age 7. You may be able to head off future bite problems before they happen.

If you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation.

By Blue Ridge Dental Care
September 29, 2017
Category: Cosmetic Dentistry

Working together--it's a great philosophy for interpersonal relationships, professional pursuits and even your dental care. Yes, your dentistdental crowns in Raleigh, NC, Dr. Ajamu Giscombe, joins with you in pursuing a laudable goal--your best oral health. If you have a failing tooth or are missing one or more adjoining teeth, Dr. Giscombe offers beautiful crown restorations and bridgework tooth replacements which work together to save your smile. At Blue Ridge Dental Care, you get the best that modern dentistry has to offer.

What is a dental crown?

It's a customized, tooth-shaped cap crafted from porcelain, gold or porcelain-fused-to-metal. If you have a severely decayed and/or abscessed tooth, a dental crown could restore the tooth's appearance and strength.

Through digital X-rays and visual inspection, Dr. Giacombe can tell you if a crown could spare your tooth from needless extraction and the subsequent bone loss and gum recession. Also, he can tell you what material would work best for your restoration.

To place a crown, your Raleigh dentist injects the area around the tooth with a local anesthetic. Then, he removes the decayed and cracked portions, along with any old fillings. He shapes the tooth to receive a crown and takes an oral impression which will give the dental lab a three-dimensional image of the tooth. Dr. Giscombe finishes this portion of the restorative process with a temporary crown.

At the next appointment, the dentist removes the crown and permanently bonds the new one in place. The crown covers the shaped tooth completely--right to the gum line. The result is a strong, functional and good-looking tooth.

What is fixed bridgework?

Fixed bridgework spans smile gaps with artificial, or pontic teeth, that are strong and lifelike. To anchor the replacement teeth, Dr. Giscombe designs dental crowns which cover the natural teeth on either side of the gap. The bridge actually is one unit composed of the pontics and the crowns.

Fixed bridgework looks natural and optimizes biting, chewing and speech. To place this prosthetic, Dr. Giscombe makes sure the support teeth and underlying gums and bone are viable. He also shapes the teeth appropriately to receive their crowns.

Bonding is permanent, and just as with single dental crowns, fixed bridgework requires regular brushing and flossing at home and six-month maintenance cleanings at Blue Ridge Dental Care.

Modern variations

Your dentist in Raleigh may use crowns and bridges to restore, or cover, dental implants--titanium cylinders which screw right into the jawbone for superior anchorage and longevity. These prosthetics boast an almost 95 percent success and retention rate, says the Institute for Dental Implant Awareness, and they improve jaw bone integrity through a process called osseointegration.

Do you need restorative treatments?

Ask your dentist at Blue Ridge Dental Care in Raleigh, NC if a crown or bridge would help your smile. Call today for a consultation--(919) 781-3862.

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