Posts for: June, 2019
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.”
Dental implants to replace teeth are a popular choice as much for their durability as their life-likeness. Most implants last for decades, which can result in lower long-term maintenance costs than other replacement options.
But to achieve this longevity, you must take care of your implants. You should brush and floss them daily right along with your remaining natural teeth — and continue regular semi-annual dental visits for cleanings and checkups.
You may be wondering, though: if they're made of inorganic materials, why worry with brushing them? It's true that bacterial plaque, the thin film of food particles most responsible for dental disease, doesn't affect them.
Your implants, though, don't exist in a bubble: they're imbedded in real bone, surrounded by real gum tissue and placed next to real teeth. All these other living tissues are susceptible to infection caused by plaque, even from plaque on non-organic implants.
The bone and tissues around an implant can even have a higher susceptibility to infection. This is because an implant's attachment in the jaw differs from that of natural teeth. An implant is imbedded directly into the bone; a natural tooth, on the other hand, maintains its hold through an elastic gum tissue between it and the bone called the periodontal ligament. Tiny fibers from the ligament attach to the tooth on one side and to the bone on the other.
Besides holding the tooth in place, the ligament also contains blood vessels that supply the tooth and surrounding tissues not only with nutrients but also antibodies that help fight infection. Due to the absence of a ligament connection, an implant doesn't enjoy the same level of protection from infection. Â It's much easier for tissues and teeth around an implant to become infected, and harder to stop it.
That's why prevention through daily hygiene is so important. So, be sure to brush and floss all your teeth — including implants — every day, and keep up your regular dental visits. And at the first sign of a possible infection — swollen, red or bleeding gums — see us as soon as possible for an examination.
Consider your implants a long-term investment in both your smile and dental health. Taking care of them will pay dividends for many years to come.
If you would like more information on taking care of your dental implants, 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 “Dental Implant Maintenance.”
Although costly in the beginning, dental implants often turn out to be the least expensive tooth replacement option. That's because their enviable record for longevity often outpaces dentures or bridges. Over the long-term you might spend less for implants than these other restorations.
But even with the high success rate of dental implants (greater than 95% survive the ten-year mark), we can't guarantee they won't fail. And if you're a tobacco smoker, the risk of failure might be even higher. One study, for example, found early implant failures were twice the rate for smokers over non-smokers. Although implant failures overall are low, smoking seems to be a factor in those that do.
There are a number of reasons to account for this. For one thing, inhaled smoke can damage salivary glands, reducing the flow of this important fluid. Saliva helps control bacterial growth and neutralize mouth acid, so without it you're more susceptible to tooth decay or periodontal (gum) disease. Either infection could ultimately weaken implant-supporting bone.
The nicotine in tobacco can also restrict oral blood vessels and lower their ability to supply antibodies and nutrients to the teeth and gums. This slows healing, which could have one particular effect on implant durability.
During the intervening weeks between implant placement and crown attachment, the implant's titanium post attracts bone cells that grow and adhere to its surface. The effects of nicotine on healing, especially right after implant surgery, can interfere with this integration process so that the implant doesn't anchor in the bone as well as it should.
If you're a smoker, you can increase your chances of implant success—and have a healthier mouth overall—by quitting smoking beforehand with the help of a cessation program. Or at the least, consider stopping smoking for one week before implant surgery and for two weeks afterward.
And be sure to brush and floss your teeth daily and visit your dentist regularly to keep your teeth and gums as healthy as possible. Stopping smoking and practicing effective oral hygiene could make a big difference in the success or failure of your implant.
If you would like more information on smoking and your dental 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 “Dental Implants & Smoking.”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
People improve their smiles for a lot of reasons: to better their career prospects, to put some juice in their social lives or just to do something special for themselves. But you may have an even stronger reason: a once-in-a-lifetime event—maybe your wedding day—is coming up soon.
You have several options for transforming your smile for the big day—and some are even quite economical. Here are 4 affordable ways to make your smile beautiful for that forever moment.
Cleanings. While dental cleanings should already be part of your regular dental care, scheduling one right before a big event can do wonders for your smile. Not only can your hygienist remove any lingering dull and dingy plaque and tartar, but they can polish your teeth for a brighter shine. Remember, though: dental cleanings support your own hygiene efforts, they don't replace them. Your own daily practice of brushing and flossing will also help you maintain a beautiful smile.
Teeth Whitening. You can also get an extra boost of brightness with a tooth whitening procedure. Using a professional bleaching solution and other techniques, your dentist can lighten your smile to your tastes, from a more natural hue to dazzling white. The whitening effect, though, is temporary, so plan to see your dentist no more than a few weeks before your big day.
Bonding. Perhaps a tiny chip is all that stands between you and a knockout smile. Your dentist may be able to repair that and other minor defects by bonding tooth-colored materials to the chip site. These composite resin materials have the shine of enamel and can be color-blended to match your tooth's natural shade. Composite resins are also fairly rugged, although you should avoid biting down on hard foods or objects.
Veneers. Although more expensive than the previous options mentioned, veneers are still affordable compared to crowns or bridgework. Usually made of thin layers of dental porcelain, dentists bond veneers to the front of teeth to mask mild to moderate problems like heavy staining, disfiguration and minor gaps. But because veneers are custom-fabricated by a dental lab, you'll need to plan them with your dentist at least six months before your event. The resulting change to your smile, though, may well be worth the wait.
If you would like more information on transforming your smile for a special event, 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 “Planning Your Wedding Day Smile.”