Posts for category: Dental Procedures
One of the key parts to an effective oral disease prevention plan is practicing daily oral hygiene to remove dental plaque. Both brushing and flossing are necessary for cleaning your teeth of this thin biofilm of bacteria and food particles most responsible for tooth decay and periodontal (gum) disease.
But as important as they are, these two essential hygiene tasks aren’t the end-all-be-all for lowering your disease risk. For the best protection, you should also visit your dentist at least twice a year for thorough dental cleanings. That’s because plaque you might have missed can turn into something much more difficult to remove: calculus.
Also known as tartar, calculus is hardened deposits of plaque. The term comes from the Latin word meaning “small stone,” an apt description of its texture on tooth surfaces. Although not the same as the branch of mathematics that bears the same name, both derive from the same Latin word: Merchants and traders centuries ago used small stones to “calculate” their various transactions.
Over time soft and pliable dental plaque hardens into calculus, in part due to a reaction with saliva. Because of the difficulty of accessing all tooth surfaces, calculus can form even if you have an effective daily hygiene practice.
Once formed, calculus can adhere to teeth so tenaciously, it’s impossible to remove it with brushing and flossing. But dentists and hygienists can remove calculus safely with special tools called scalers.
And it should be removed or it will continue to foster bacterial growth. This in turn increases the chances for infections that attack the teeth, gums or underlying bone. Keeping it under control will therefore diminish your risk for developing dental disease.
Although there are other factors like heredity that can affect your disease risk, keeping your mouth clean is the number one thing you can do to protect your teeth and gums. A daily hygiene practice and regular dental visits will help ensure plaque and its calcified form calculus won’t be a problem.
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.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.
Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.
While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.
Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.
There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).
If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.
Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.
If you would like more information on treating loose 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 “Treatment for Loose Teeth.”
If you've had periodontal (gum) disease, you've no doubt experienced gum inflammation, bleeding or pain. But your gums may not be the only mouth structures under assault — the disease may be damaging the underlying support bone.
Although easing soft tissue symptoms is important, our primary focus is to protect all your teeth's supporting structures — the gums, the attaching ligaments and, of course, the bone. To do so we must stop the infection and reduce the risk of reoccurrence.
Stopping gum disease depends on removing its source — plaque, a thin biofilm of bacteria and food particles accumulating on tooth surfaces, due to poor oral hygiene. We must remove it mechanically — with hand instruments known as scalers or ultrasonic equipment that vibrates the plaque and calculus (hardened plaque deposits) loose.
It's not always a straightforward matter, though, especially if the diseased gum tissues have pulled away from the teeth. The slight natural gap between teeth can widen into voids known as periodontal pockets; they fill with infection and can extend several millimeters below the gum line. We must thoroughly cleanse these pockets, sometimes with invasive techniques like root planing (removing plaque from the roots) or surgical access. You may also need tissue grafting to regenerate gum attachment to the teeth.
One of the more difficult scenarios involves pockets where roots divide, known as furcations. This can cause cave-like voids of bone loss. Unless we treat it, the continuing bone loss will eventually lead to tooth loss. Besides plaque removal, it may also be prudent in these cases to use antimicrobial products (such as a mouthrinse with chlorhexidine) or antibiotics like tetracycline to reduce bacterial growth.
Perhaps the most important factor is what happens after treatment. To maintain gum health and reduce the chances of re-infection, you'll need to practice diligent daily hygiene, including brushing, flossing and any prescribed rinses. You should also keep up a regular schedule of office cleanings and checkups, sometimes more than twice a year depending on your degree of disease.
If you would like more information on treatments for gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”