Posts for: April, 2014
They work hard, and put in lots of time on the field and at home. They learn the rules of the game — as well as the unwritten rules of sportsmanship and teamwork. They receive the proper training, and wear appropriate protective equipment. But sometimes, in spite of everything, kids who participate in sports can be subject to injury. Fortunately, in today's dentistry there are a variety of treatments, as well as preventive measures, which can help.
When faced with serious dental injury, time is of the essence in saving teeth. So, don't delay — come in to see us immediately! If treated promptly, it's possible for teeth which have been dislodged — or even knocked out of the mouth — to be put back in position and stabilized. Afterwards, follow-up treatment will ensure that the tooth has the best chance of recovery.
The treatment of kids' dental injuries is sometimes different than that of adults. For example, in adults, a root canal would generally be necessary, followed by a tooth restoration (crown). But some kids may not need this treatment, since their teeth are still developing. Also, replacing a missing primary (baby) tooth may not be recommended, since it may hinder development of the permanent teeth. Based on his or her individual circumstances, we can develop an appropriate treatment plan for your child.
Luckily, the most common dental injuries aren't nearly as serious — they typically involve chipped or cracked teeth. Most can be repaired by reattaching the broken piece, or using a tooth-colored restoration. If a large part of the structure of a permanent tooth is missing, a crown or “cap” may be placed on the visible part, above the gum line. Smaller chips, even in primary teeth, can be successfully repaired by cosmetic bonding with composite resin materials.
Finally, if your child is involved in athletic activities — or if you are — consider obtaining a custom-made mouthguard. Numerous studies have shown that this protective gear can help prevent many dental injuries. Unlike the off-the-shelf types found in some sporting-goods stores, the ones we provide are individually fabricated from an exact model of the teeth. They're strong, fit comfortably, and offer superior protection at a reasonable cost.
If you have questions about the treatment of sports-related dental injuries, or about mouthguards, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “Mouthguards.”
When a tooth is lost, it’s important to restore your mouth to its proper function and appearance with a permanent replacement, such as a dental implant or a bridge. Recently, the implant system has received the lion’s share of attention (for some good reasons); however, in certain situations, dental bridgework offers a viable alternative. What would cause one method to be favored over the other?
In general, implants are now considered the gold standard for tooth replacement. They have the highest success rate (over 95 percent), last the longest (quite possibly the rest of your life), and don’t affect the integrity of adjacent teeth. Bridges, by contrast, require the removal of tooth structure from adjacent teeth, which can potentially compromise their health. Yet implants aren’t necessarily ideal for every situation. When might a bridge be preferred?
Some people don’t have the proper quantity or quality of bone in the jaw to support an implant; or, they may have anatomical structures (nerves or sinuses) located where they would interfere with an implant. It is possible in some cases to work around these obstacles with bone grafts, or by placing implants in alternate locations; in other cases, a bridge may be a better option.
While most tolerate the implant process quite well, a few people aren’t good candidates for the surgical procedure required to place an implant. Certain systemic diseases (uncontrolled diabetes, for example), the use of particular medications, or a compromised immune system may make even minor surgery an unacceptable risk. In these cases, a decision may be made after consulting with an individual’s other health care providers. Additionally, a few behaviors or lifestyle issues, like heavy smoking or a teeth-grinding habit, tend to make implants have a less favorable success rate.
There are also a few circumstances that could argue in favor of a bridge — for example, if you already have a need for crowns on the teeth adjacent to the gap, it can make the process of getting bridgework easier and more economical. Financial issues are often an important consideration in planning treatment — but it’s important to remember that while bridges are generally less expensive than implants in the short term, the much longer expected life of implants can make them more cost-effective in the long run.
If you have questions about dental implants or bridgework for tooth replacement, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Crowns & Bridgework.”
Periodontal gum disease is a relentless enemy to dental health that destroys gum tissue and the teeth’s attachment to the jaw. As it ravages these tissues it often creates periodontal pockets, hidden spaces between the teeth and bone that fill with infectious bacteria capable of accelerating damage to teeth and gums.
The primary treatment goal for gum disease is to create an environment that is cleansable below the gum tissues, in order to remove as much bacterial plaque from the tooth, gum and root surfaces as possible. Periodontal pockets pose a challenge to this goal as they are extremely difficult to access using standard cleaning and root planing techniques the deeper they become. Cleaning and treating these deep pockets, however, is made easier with a procedure known as periodontal flap surgery.
This procedure is not a cure, but rather a way to access the interior of a periodontal pocket to remove infection and diseased tissue. In effect, we create an opening — like the hinged flap of a letter envelope — to gain entry into the affected pocket. Not only does this opening enable us to clean out infection within the pocket, but it can also facilitate cleaning the tooth’s root surfaces.
It also provides an opening for us to insert grafting materials to regenerate lost bone and tissue. It’s nearly impossible for this tissue regeneration to occur if bacterial infection and inflammation persist in the affected area. Periodontal flap surgery provides us the critical access we need to effectively remove these contaminants that stymie healthy growth.
This procedure is normally performed with local anesthesia and usually results in little bleeding and minimal post-operative effects. Once we have finished any procedures to clean the pocket and other affected tissues, or installed grafts for future bone and tissue growth, we would then seal the flap back against the tooth using sutures and gentle pressure to promote blood clotting around the edges. We might also install a moldable dressing that re-secures the edges of the flap to their proper position and prevents food debris from interfering with healing.
Periodontal flap surgery is the result of years of research to find the best techniques for treating gum disease. It’s one of many weapons in our arsenal for winning the war against decay and gum disease, and helping you realize a healthier dental future.
If you would like more information on periodontal flap surgery, 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 “Periodontal Flap Surgery.”
If your teeth are stained and discolored, misshapen or too small, porcelain veneers may be just the opportunity to treat yourself to a beautiful smile that can last for decades. They may be used to restore a single tooth that is broken or stained, or many teeth that are worn or discolored. If you have small teeth with gaps between them, veneers can close the spaces.
Porcelain laminate veneers are thin layers of dental restorative material that are bonded onto your teeth. With porcelain laminate veneers you can change a tooth's shape, size, and color. They require a minimal amount of tooth preparation (reduction of enamel on the original tooth) and are a great way to help you have a beautiful smile now and for decades to come.
They can last from seven to twenty years or more. Part of what determines their exact longevity is the health of your mouth. Gum tissues may deteriorate and the gum line may shrink back away from the roots of your teeth. So brushing, flossing, and other good dental habits are important in maintaining your investment in your smile.
Veneers don't require special treatment, and you can eat nearly anything with them. Keep in mind one precaution, however. Porcelain, like glass, can break with too much stress. This means that biting something that applies a strong twisting movement to your teeth may cause the veneers to shatter. If you grind your teeth at night you may need to wear a night guard to protect your veneers. It doesn't happen often, but if a veneer detaches it can usually be rebonded to the tooth.
Contact us today to schedule an appointment or to discuss your questions about porcelain veneers and see if they are right for you to enhance or change your smile. You can also learn more about veneers by reading the Dear Doctor magazine article “Porcelain Veneers: How long will your porcelain veneers last?”
Don't ignore tooth pain hoping it goes away. No matter how mild or fleeting it may be, it's a sign that something's wrong. Healthy teeth shouldn't cause discomfort because the parts containing the nerves — the interior pulp and the dentin around it — are shielded by dental enamel and gums.
Here are some common reasons that teeth ache:
- Gum Recession. Over time, gums can recede. Improper or excessive brushing can affect them, especially if you are genetically predisposed by having thin gums. When gums retreat, dentin can, or eventually will, be exposed. Besides its susceptibility to sensation, dentin is also more vulnerable to erosion and decay than enamel.
- Tooth Erosion/Decay. When acid-producing oral bacteria get the upper hand, they can eat through the tooth's protective enamel to the dentin. You may start feeling sensitivity as the decay gets deeper and closer to the pulp (nerves). Only removal of the decay and filling the cavity can stop the process.
- Old/Loose/Lost Filling. Fillings seal off areas of past decay. If they don't fit right or are dislodged altogether, air or food particles can slip inside and irritate exposed nerve endings. A crevice to hide in makes it prime real estate again for bacteria, too.
- Cracked Tooth. Teeth grinding and jaw clenching can have a similar impact on teeth that a miner's pick has on rock. At first thin lines in your enamel can develop, then cracks develop that may expose the dentin, and finally the tooth might fracture, exposing the pulp. The earlier this process is caught, the better.
- Pulp Tissue Infection/Inflammation. This can be caused by deep decay or trauma and suggests your tooth may be in its death throes. Sometimes the pulp infection travels into the surrounding periodontal (peri – around; odont – tooth) tissues and causes an abscess to develop. This absolutely requires immediate attention.
- Residual Sensitivity from Dental Work. Removal of decay before placing a filling can cause tooth sensitivity. It can take 1-4 weeks or so to improve.
- Sinus Pain. Congestion can cause “referred” pain in the upper teeth. When the congestion subsides, the pain should, too.
As you can see, it's risky to discount tooth pain and “wait ‘til it goes away.” Our office can help you determine the origin of your pain and the best course of action to resolve it. When in doubt, it's always better to err on the side of caution!
If you would like more information about tooth pain and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Sensitive Teeth.”