Posts for: June, 2015
You may be among the one in three Americans who suffer from the pain of tooth sensitivity. Before attempting treatment, though, we must first identify the cause.
Your teeth are made of layers of different organic tissue. The pulp at the center of the tooth contains nerves that transmit pain or pressure sensation to the brain. The pulp is encased by dentin, a layer of tissue composed of tiny tubules that conduct temperature and pressure changes from outside the tooth to the pulp nerves. The hard outer enamel shell shields the dentin from over-stimulation from these sensations.
There are, however, some instances where the dentin may become exposed and cause sensitivity in the tooth. This can occur when the gum tissue recedes and the root of the tooth is exposed to the oral environment. If the root loses its surface coating (referred to as cementum, a cement-like outer layer around the root surfaces) because of over-aggressive brushing (too hard for too long) or advanced periodontal (gum) disease, sensitivity is often the result.
Another instance is enamel erosion. Although made of the hardest substance in the human body, enamel has one major enemy — acid. A high oral acid level brought on by over-consuming acidic foods and beverages or as a symptom of gastric reflux disease dissolves (de-mineralizes) the enamel’s mineral content. Brushing just after eating actually contributes to de-mineralization because the enamel is in a softer state. It requires forty-five minutes to an hour for your saliva to neutralize acid and restore minerals to the enamel — you may actually be brushing away enamel with this practice.
Once we know the underlying cause, we can use an appropriate method to reduce sensitivity. One way is to reduce nerve sensitivity in the dentin’s tubules or block them altogether. There are several chemical products for both home and dental office application that can reduce sensitivity and encourage enamel re-mineralization (as can the fluoride added to toothpaste). We can also strengthen enamel and provide a mechanical barrier to acid through concentrated fluoride in a varnish applied to tooth and root surfaces. And, life-like restorations like crowns or veneers not only improve the appearance of your teeth, they can also provide coverage for exposed dentin.
If you are experiencing painful sensitivity, make an appointment to visit us. Once we know the source, we can treat the problem and reduce your discomfort.
If you would like more information on tooth sensitivity and how to 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 article “Treatment of Tooth Sensitivity.”
Mouth injuries in children and teens are more common than you might think: about one out of three boys and one out of four girls will have experienced an injury before they graduate from high school. Besides contact sports, other types of accidents like car crashes or falls are high on the cause list.
Although most dental injuries aren’t considered true emergencies, there are a few where prompt action may mean the difference between ultimately saving or losing a tooth. One such situation is a knocked out tooth.
In the event of a knocked out (or avulsed) tooth, your primary goal is to place the tooth back into the empty socket as quickly as possible. Teeth that have been out of the mouth for less than five minutes have the best chance of reattachment and survival. The first step is to quickly locate the missing tooth.
Once you’ve found it, use only cold, clean water run or poured over the tooth to carefully clean off dirt or debris (no soaps or cleansers). You should also avoid touching the tooth root or scrubbing any part of it. After cleaning it of debris, gently place the tooth back in its socket, then immediately contact us or visit an emergency room. While you’re en route to our office the patient should carefully hold the tooth in place. If the tooth can’t be immediately placed into the socket (the patient is unconscious, for example), then you should place the tooth in a clean container and keep it moist with cold milk, a sterile saline solution or even the patient’s saliva.
Taking these steps increases the chances of a successful re-implantation, although the injury may ultimately affect the tooth’s lifespan. Replanted teeth can suffer from root resorption (where the root tissue dissolves) or a process known as ankylosis in which the tooth fuses directly to the jawbone with no healthy periodontal ligament in between. Either of these conditions can lead to tooth loss.
Still, it’s worthwhile to try to save the tooth, even if for a few more years. Those extra years can help you prepare for a future restoration.
If you would like more information on responding to dental injuries, 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 “Accidental Tooth Loss.”
There are many reasons why teeth may need a whitening treatment to achieve an appealing brightness: what we eat and drink, natural aging, genetics, and the lack of dedication to oral hygiene can all play a role in how we look.
For vital (living) teeth, there are basically three different options for teeth whitening, and we’d be happy to help you decide which is right for you:
- In-office tooth whitening: The fastest way to get your smile radiant. A high concentration of a peroxide gel solution is applied directly to the tooth surface. Gums and other soft tissues are completely protected for your safety. This technique is excellent for whitening deep surface stains as well as general tooth whitening. This professional treatment requires the least amount of time to achieve the desired whiteness.
- The professional take-home option: Custom-made bleaching trays are prepared by our office. This technique is convenient and less expensive, but the desired whiteness will take longer to achieve than the in-office option.
- Over-the-counter products: These offer the least expensive option but use weaker whitening agents. For example, whitening strips, like the ones advertised on television, are popular and easy to use but will generally take the most time to achieve the desired success. Also, even agents that are not the strongest available may cause damage to teeth if used inappropriately and without professional supervision.
While there are normally no serious side effects after professional whitening treatments, there is a potential risk of tooth sensitivity and gum irritation. If either one or both of these occur, it should disappear within a few days.
It should come as no surprise that bleaching is not permanent. The whiteness will fade eventually depending on your diet, habits, hygiene, etc., but it usually will last at least six months — more often up to two years. Obviously, if you avoid drinking coffee, tea, or red wine, don’t smoke, and have a diligent oral hygiene routine your results may last longer.
Advertisements for teeth-whitening products are everywhere. If you have any questions about what you see, or simply want to do a reality check on their claims, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine articles “Teeth Whitening: Brighter, Lighter, Whiter...,” and “Important Teeth Whitening Questions Answered.”
Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.
In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.
This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.
For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.
Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.
If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”