Posts for category: Dental Procedures
Most dental problems are caused by tooth decay or periodontal (gum) disease, easily preventable with dedicated daily hygiene and regular dental care. But there are a few other rare conditions to be on alert for that could pose just as serious a threat to your dental health.
One of these is a phenomenon called root resorption. Put simply, certain cells arise within a tooth root that eat away and dissolve (resorb) tooth structure. Left unchecked, it could eventually lead to the tooth's demise.
Although its exact cause remains elusive, we suspect root resorption is associated with trauma to the gum ligaments earlier in life, perhaps from an injury or too much force applied during orthodontics. Other possible contributing factors include teeth-grinding habits or internal tooth bleaching procedures.
Root resorption in adults isn't that common, so your chances of experiencing it are low. But it is still possible, so you should be on the lookout for potential signs: Early on, it may appear as faint pink spots on teeth where the enamel has filled with the destructive cells eating away at the tooth. In time, these spots can increase to form cavities.
More than likely, though, your dentist may detect the problem during a dental exam. That's why regular dental cleanings and checkups are essential—a routine exam is a prime opportunity to uncover conditions like root resorption that silently undermine your teeth.
If found early, we can often treat root resorption effectively. We can often expose a small affected area with minor gum surgery, remove the harmful cells and fill any cavities with a tooth-colored filling. In some cases, we may recommend orthodontics beforehand to encourage a buildup of bone around the root by moving the affected tooth outward from the jawbone. If the resorption has affected the tooth pulp, you may also need a root canal treatment.
There is also the possibility with advanced resorption that the best course of action is to remove the tooth and replace it with a dental implant. So, keep up your regular dental visits—early detection and intervention can stop this destructive dental condition from destroying your tooth.
If you would like more information on 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: An Unusual Phenomenon.”
In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.
But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.
The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.
A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.
Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.
Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.
Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.
If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”
What a difference forty years can make: Dental bridges once occupied the top spot for choices to replace missing teeth until the arrival of dental implants in the 1980s. Today, dental implants are the gold standard for dental restoration.
But although bridgework may have lost “first chair” in the orchestra of restorations, it's still a viable option. In fact, it can be the best option in certain situations.
Bridges consist of a series of porcelain crowns fused together like fence pickets. The center crowns, known as the pontics, “bridge” the gap left by a missing tooth or teeth. The crowns on each end, the abutment teeth, crown the natural teeth on either side of the gap to support the bridge.
Bridges are effective and durable, but with a major downside: To accommodate the abutment crowns, we must reduce the size of the natural teeth to which they'll be attached. This alteration can weaken those teeth's structure and require them from then on to have some form of restoration. They're also at higher risk for tooth decay.
Implants, on the other hand, don't require this alteration, and may also be more durable than bridges. Why then consider a bridge?
Price can be a factor: Implants may be more expensive, especially involving multiple teeth. Keep in mind, though, that this only compares the initial cost: Because implants have a 95% or more ten-year success rate, with further evidence they could potentially last for decades, they may actually cost less in the long-run than bridge restorations that have a higher chance of being replaced sooner.
But the prime reason is that some dental situations aren't suitable for dental implants. For instance, implants require a certain amount of bone for proper placement, so people with extensive bone loss may not be able to acquire them. Health conditions like uncontrolled diabetes or a compromised immune system can also complicate implant installation. A bridge in these cases may represent a better alternative.
With the help of your dentist, you'll need to consider your individual situation, dental and financial, in deciding between an implant or a bridge. And, if a dental bridge is your best option, it will be a solid choice for restoring your missing teeth and your smile.
If you would like more information on various dental restoration methods, 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 “Crowns & Bridgework.”
Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they're still giving us something to watch via virtual interviews. In the process, we're given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon's daughter Winnie interrupted with breaking news: She had just lost a tooth.
It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it's not an uncommon experience. Nevertheless, it's still good to be prepared if your six-year-old is on the verge of losing that first tooth.
Primary teeth may be smaller than their successors, but they're not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That's why it's optimal for baby teeth to remain intact until they're ready to come out.
When that time comes, the tooth's roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness, though, doesn't automatically signal a baby tooth's imminent end. But come out it will, so be patient.
Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.
Here's some advice from your dentist: Don't. Trying to pull a tooth whose root hasn't sufficiently dissolved could damage your child's gum tissues and increase the risk of infection. It could also cause needless pain.
Left alone, the tooth will normally fall out on its own. If you think, though, that it's truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it's ready, it should pop out. If it doesn't, leave it be for another day or two before trying again.
Your child losing a tooth is an exciting moment, even if it isn't being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.
If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”
While anyone can lose a permanent tooth, the cause often varies by age group. Adults usually lose their teeth to disease, while those under twenty lose a tooth to accidents.
For adults, a dental implant is usually the best way to replace a missing tooth. Teenagers and younger, on the other hand, must wait to get implants until their jaws fully develop. An implant placed on an immature jaw will eventually look and feel out of place.
For most, their jaws won't reach full maturity until their early twenties. Even so, they still have a couple of good options for restoring their smiles in the meantime, albeit temporarily.
One is a removable partial denture or RPD, a device with the replacement prosthetic (false) tooth or teeth set in a gum-colored acrylic base. Of the various types of RPDs, most teenagers do well with a rigid but lightweight version called a “flipper,” called so because it can be flipped in and out of place with the tongue.
These RPDs are affordable, their fit easily adjusted, and they make cleaning the rest of the teeth easier. But they can break while biting down hard and—because they're dentures—aren't always well accepted among teenagers.
The other option is a bonded bridge. Unlike a traditional bridge secured with crowns cemented to natural teeth, a bonded bridge uses a strip of dental material affixed to the back of the prosthetic tooth with the ends of the strip extending outward horizontally. With the prosthetic tooth inserted into the empty space, these extended ends are bonded to the backs of the natural teeth on either side.
Though not as secure as a traditional bridge, a bonded bridge is more aesthetic and comfortable than an RPG. On the other hand, patients who have a deep bite or a teeth-grinding habit, both of which can generate abnormally high biting forces, run a higher risk of damaging the bridge. A bridge can also make hygiene tasks difficult and time-consuming, requiring a high degree of self-discipline from the patient.
Whichever you choose, both options can effectively replace a teenager's missing tooth while waiting for dental implants. Although temporary, they can make the long wait time for a teenager more bearable.