Posts for: April, 2016
In the fight against dental disease and other conditions your general dentist is your first line of defense for prevention strategies and treatment. Sometimes, however, your condition may require the services of a dental specialist to restore health to your mouth.
A good example of this is an advanced case of periodontal (gum) disease. While your dentist and hygienist are quite skilled at removing plaque and calculus, there may be extenuating circumstances that may benefit from the knowledge and expertise of a specialist. In the case of gum-related issues that would be a periodontist, a dentist who specializes in the diagnosis and treatment of diseases or disorders related to the gums and bone that support teeth.
There are a number of reasons why you may be referred to a periodontist regarding your gum health. Besides advanced stages of the disease (loose teeth, periodontal pocketing or bone loss) that require surgery or other invasive techniques you may have a particular form that requires advanced treatment, or a secondary condition, like pregnancy or diabetes, which could impact your periodontal condition. There may also be a need for a periodontist’s consultation if you’re preparing for cosmetic restoration, most notably dental implants, that could have a bearing on your gum and bone health.
As your primary oral health “gatekeeper,” your general dentist is largely responsible for determining what you need to achieve optimal health. Likewise, your periodontist or other specialists for other problems will be equally committed to providing you the right care for your situation. Your general dentist and other specialists will work together to ensure that your condition will be cared for, and that you’ll continue to enjoy the highest level of oral health possible.
If you would like more information on the role of periodontics and other dental specialties in oral health, 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 “Referral to a Dental Specialist.”
Home whitening kits are a popular way to turn a dull smile into a dazzling one. But these self-applied products only work for teeth with outer enamel stains — if the discoloration originates inside a tooth, you’ll need professional treatment.
Known as “intrinsic staining,” this type of discoloration most often occurs within a tooth’s pulp or dentin layers. There are a number of causes like tooth trauma or tetracycline use at an early age. A root canal treatment used to remove infection from deep within a tooth can also cause discoloration: sometimes blood pigments left after tissue removal or the filling materials themselves can stain a tooth’s interior.
Intrinsic staining can often be treated by placing a bleaching agent, usually sodium perborate, into the tooth’s pulp chamber. But before undertaking this procedure on a tooth that’s undergone a root canal treatment,Â we want to first ensure the filling is intact and still adequately sealing the tooth from infection. We also want to make sure the supporting bone is also healthy.
If all’s well, we access the pulp in the same way as the root canal treatment, and preferably through the same access hole. We then clean out the pulp chamber of any stained matter and then ensure the root canals remain filled and sealed off from the pulp chamber.
We can then place the bleaching agent into the pulp, a process that will need to be repeated every three or four days to achieve the desired level of brightness. After each session we place a cotton pellet over the opening and held in place with a temporary adhesive; we can easily remove and re-apply this covering during subsequent sessions. Once we’ve achieved the desired color change, we seal the tooth with a permanent filling and restore the access cavity with a tooth-colored composite resin material bonded to the enamel and dentin.
There are other options for an intrinsically stained tooth like veneers or crowns that outwardly cover the discoloration. Internal bleaching, however, is a more conservative approach that causes less alteration of the tooth. If successful, it can restore a stained tooth to a brighter, more attractive shade.
If you would like more information on internal bleaching, 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 “Whitening Traumatized Teeth.”
There are two basic facts about tooth decay: 1) next to the common cold, it’s the world’s most prevalent infectious disease; and 2) with modern dentistry, it’s preventable.
Getting from Fact 1 to Fact 2 requires the daily hygiene habits of brushing and flossing. You probably learned these tasks when you could barely peer over the bathroom sink; but the real question is: are you getting the most benefit from your efforts? It’s not merely doing them, but doing them the right way.
For example, bearing down on your teeth and brushing vigorously isn’t just unhelpful, it’s damaging. Instead, you should hold your brush with perhaps just two fingers at a 45-degree angle relative to your gum line and “gently” scrub with short circular or “wiggly” strokes. Continue this action around each arch brushing all tooth surfaces, which should take about two minutes.
Your toothbrush itself is also important: most people (unless otherwise directed by their dentist) should use a multi-tufted brush with soft bristles. If you brush with the proper pressure it should last 4 to 6 months before replacing it. You should also replace it if the bristles become worn or splayed.
Flossing once a day is important for removing the plaque between teeth your toothbrush bristles can’t reach. The best technique is to form a “C” with the floss that wraps around each tooth and move it up and down gently three or four times until you hear a squeaky clean sound on both sides of the tooth.
The ultimate test of your efforts comes during your regular dental checkups. You can get a check now, though, on how you’re doing by using your tongue to feel your teeth at the gum line. If they feel smooth and slick, you’re probably doing a good job of plaque removal; but if they feel a bit rough and gritty, you’re missing some of the plaque and need to be more thorough when brushing. You can also use floss by running it up and down the tooth surface — if it squeaks, they’re clean!
Your particular dental condition may require specific treatment or the use of other dental products like antibacterial mouthrinses. But learning and practicing proper brushing and flossing is key to keeping teeth and gums healthy and disease-free.