Primary (baby) teeth might not last long, but their impact can last a lifetime. Their first set of teeth not only allows young children to eat solid foods, but also guide permanent teeth to form and erupt in the proper position.
Unfortunately, primary teeth aren't immune to tooth decay. If the decay is extensive, the tooth may not last as long as it should. Its absence will increase the chances the permanent teeth won't come in correctly, which could create a poor bite (malocclusion) that's costly to correct.
If a primary tooth is already missing, we can try to prevent a malocclusion by installing a “space appliance.” This keeps nearby teeth from drifting into the empty space intended for the permanent tooth. The best approach, though, is to try to save a primary tooth from premature loss.
We can often do this in much the same way as we would with a permanent tooth — by removing decayed material and filling the prepared space. We can also perform preventive applications like topical fluoride or sealants that strengthen or protect the tooth.
It becomes more complicated, though, if the pulp, the interior of the tooth, becomes decayed. The preferred treatment for this in a permanent adult tooth is a root canal treatment. But with a primary tooth we must also consider the permanent tooth forming below it in the jaw and its proximity to the primary tooth. We need to adapt our treatment for the least likely damage to the permanent tooth.
For example, it may be best to remove as much decayed structure as possible without entering the pulp and then apply an antibacterial agent to the area, a procedure known as an indirect pulp treatment. We might also remove only parts of the pulp, if we determine the rest of the pulp tissue appears healthy. We would then dress the wound and seal the tooth from further infection.
Whatever procedure we use will depend on the extent of decay. As we said before, our number one concern is the permanent tooth beneath the primary. By focusing on the health of both we can help make sure the permanent one comes in the right way.
If you would like more information on caring for children's primary teeth, 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 “Root Canal Treatment for Children's Teeth.”
Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.
“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.
Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.
Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.
Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.
If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.
When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.
Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.
The term “root canal” is a part of our social lexicon, and not always with a positive meaning. But contrary to its negative reputation, a root canal treatment can make all the difference in your dental health.
Here are 3 things you may not know about this important procedure.
A root canal treatment is a “tooth” saver. Decay deep inside the tooth pulp puts the entire tooth at risk. The infection not only destroys nerves and tissue in the pulp, it has a direct path to the root through tiny passageways known as root canals. By cleaning out this infected tissue, then filling the empty pulp chamber and the root canals with a special filling, the procedure stops the disease from further harm and seals the tooth from future infection. Without it, it’s highly likely the tooth will be lost and other teeth threatened by the infection.
A root canal doesn’t cause pain — it relieves it. The biggest misconception about root canal treatments is their supposed painfulness. That’s just not true, thanks to anesthetic techniques that numb the teeth and gums — and any discomfort afterward is quite manageable with mild anti-inflammatory drugs like ibuprofen. The procedure actually stops the real pain, caused by the infection damaging and finally killing the tooth’s nerves, when it stops the infection.
Root canal treatments are even more effective thanks to recent advancements. Not all infected tooth situations are the same: some teeth have smaller offset passageways called accessory canals that grow off a larger root canal that can be quite difficult to detect and access. Missing them can leave the door open for re-infection. In recent years, though, endodontists, specialists in root canal disorders, have improved the way we address these complications using advanced technologies like specialized microscopic equipment and new filling techniques. The result: a lower risk of re-infection and a higher chance of long-term success.
Hopefully, you’ll continue to enjoy good dental health and won’t need a root canal treatment. But if you do, rest assured it won’t be the unpleasant experience you might have thought — and will be a welcomed solution to pain and threatening tooth loss.
If you would like more information on root canal treatments, 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 “A Step-By-Step Guide to Root Canal Treatment.”
When the multi-platinum recording artist, songwriter and TV personality Jason Derulo was recently asked about his ideal woman, his answer covered a remarkably broad spectrum. "There’s no specific thing," he said, "so I think it’s unfair to say what my ‘type’ is." But it turns out that there is one thing the So You Think You Can Dance judge considers essential: A beautiful smile.
"I’m not into messy teeth," Derulo said. "If the grill has spaces and different colors, it’s not my vibe."
As it turns out, he may be on to something: A number of surveys have indicated that a bright, healthy smile is often the first thing people notice when meeting someone new. Yet many are reluctant to open up that big grin because they aren’t satisfied with the way their teeth look. If you’re one of them, consider this: Modern cosmetic dentistry offers a variety of ways to improve your smile — and it may be easier and more affordable than you think.
For example, if your smile isn’t as bright as you would like it to be, teeth whitening is an effective and economical way to lighten it up. If you opt for in-office treatments, you can expect a lightening effect of up to 10 shades in a single one-hour treatment! Or, you can achieve the same effect in a week or two with a take-home kit we can custom-make for you. Either way, you’ll be safe and comfortable being treated under the supervision of a dental professional — and the results can be expected to last for up to two years, or perhaps more.
If your teeth have minor spacing irregularities, small chips or cracks, it may be possible to repair them in a single office visit via cosmetic bonding. In this process, a liquid composite resin is applied to the teeth and cured (hardened) with a special light. This high-tech material, which comes in colors to match your teeth, can be built up in layers and shaped with dental instruments to create a pleasing, natural effect.
If your smile needs more than just a touch-up, dental veneers may be the answer. These wafer-thin coverings, placed right on top of your natural teeth, can be made in a variety of shapes and colors — from a natural pearly luster to a brilliant "Hollywood white." Custom-made veneers typically involve the removal of a few millimeters of tooth enamel, making them a permanent — and irreversible — treatment. However, by making teeth look more even, closing up spaces and providing dazzling whiteness, veneers just might give you the smile you’ve always wanted.
If you would like more information about cosmetic dental treatments, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Cosmetic Dentistry — A Time for Change.”
Baby (primary) teeth look and function much like their permanent counterparts. Besides having a visible crown, they also have roots that maintain contact with the jawbone.
But there are some differences, the biggest one being the normal process whereby primary tooth roots dissolve or, in dental terms, resorb. Root resorption eventually leads to the tooth coming loose to make way for the permanent tooth.
Adult tooth roots can also resorb — but it's decidedly not normal. If adult root resorption isn't promptly treated, it could also lead to tooth loss — but there won't be an incoming tooth to take its place.
Although it can begin inside a tooth, adult root resorption usually begins on the outside. One type, external cervical resorption (ECR), begins around the neck-like area of the tooth not far below the gum line. Its initial signs are small pink spots where the tooth enamel has eroded; those pink cells within the space are doing the damage.
We don't fully understand the mechanism behind ECR, but there are some factors that often contribute. People with periodontal ligament damage or trauma, sometimes due to too much force applied during orthodontic treatment, have a high risk of ECR. Some bleaching techniques for staining inside a tooth may also be a factor.
The key to treating ECR is to detect it as early as possible before it does too much root damage. Regular checkups with x-rays play a pivotal role in early detection. Advanced stages of ECR might require more advanced diagnostics like a cone beam computed tomography (CBCT) scan to fully assess the damage.
If the lesion is small, we can surgically remove the cells causing the damage and fill the site with a tooth-colored filling. If ECR has spread toward the pulp, the tooth's inner nerve center, we may also need to perform a root canal treatment.
Either of these methods intends to save the tooth, but there is a point where the damage is too great and it's best to remove the tooth and replace it with a life-like dental implant or other restoration. That's why it requires vigilance through regular, semi-annual dental visits to detect the early signs of root resorption before it's too late.
If you would like more information on adult tooth root resorption, 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 “Root Resorption.”
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