Posts for: August, 2015
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
Periodontal (gum) disease is a progressive bacterial infection caused primarily by bacterial plaque on tooth surfaces not adequately removed by daily oral hygiene. In fact, nearly all of us will develop gingivitis (inflammation of the gum tissues) if we fail to clean our teeth and gums for an extended period of time.
Some people, however, have a greater susceptibility for developing gum disease because of other risk factors not related to hygiene. Patients with diabetes are at particular high risk for acute forms of gum disease.
Diabetes is a chronic condition in which the body can’t adequately regulate the bloodstream’s levels of glucose, the body’s primary energy source. Type 1 diabetes is caused by inadequate production in the pancreas of the hormone insulin, the body’s primary glucose regulator. In Type 2 diabetes the body develops a resistance to insulin’s effects on glucose, even if the insulin production is adequate. Type 1 patients require daily insulin injections to survive, while most Type 2 patients manage their condition with medications, dietary improvements, exercise and often insulin supplements.
Diabetes has a number of serious consequences, including a higher risk of heart disease and stroke. Its connection with gum disease, though, is related to how the disease alters the body’s response to infection and trauma by increasing the occurrence of inflammation. While inflammation is a beneficial response of the body’s immune system to fight infection, prolonged inflammation destroys tissues. A similar process occurs with gum disease, as chronic inflammation leads to tissue damage and ultimately tooth loss.
Researchers have found that patients with diabetes and gum disease may lessen the effects of inflammation related to each condition by properly managing both. If you’ve been diagnosed with either type of diabetes, proper dental care is especially important for you to reduce your risk of gum disease. In addition to effective daily brushing and flossing and a professional cleaning and checkup every six months (more frequent is generally better), you should also monitor your gum health very closely, paying particular attention to any occurrence of bleeding, redness or swelling of the gums.
If you encounter any of these signs you should contact us as soon as possible for an examination. And be sure to inform any dental professional that cares for your teeth you’re diabetic — this could affect their treatment approach.
If you would like more information on dental care for patients with diabetes, 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 “Diabetes & Periodontal Disease.”
A loose baby tooth is normal and expected; a loose permanent tooth is quite another matter: it’s an advanced sign of disease that could lead to losing the tooth.
The reasons for its looseness may vary. You may have experienced “primary occlusal trauma,” in which the teeth have experienced a prolonged excessive biting force beyond their tolerance. This can be caused by habitual grinding or clenching the teeth.
You may have also experienced “secondary occlusal trauma”: although the biting forces are within normal ranges, the teeth still can’t handle the stress due to degraded bone support and gum tissue detachment. Clenching habits combined with weakened bone and gums will only accelerate and worsen the damage.
The most frequent cause in adults for loose teeth is secondary trauma from periodontal (gum) disease. Bacterial plaque built up on teeth from poor oral hygiene causes a chronic infection that eventually weakens gum attachment to the teeth. A loose tooth is a late sign of this damage.
Treatment for disease-based loose teeth has a twofold approach. First, we thoroughly clean the tooth, root and gum surfaces of all plaque and calculus (hardened plaque deposits) to reduce the infection and inflammation and restore tissue health. This is often accompanied by antibiotic treatments to reduce bacteria below the gum tissue.
For the loose teeth themselves, we may need to modify the forces against them while the gums and bone heal. One way to lessen the biting force on a tooth is to reshape its and the opposing tooth’s biting surfaces. For extensive looseness we can also splint the affected tooth or teeth with other teeth. Temporarily, we can apply splinting material to the outside of both the loose and stable teeth or cut a small channel into them and apply bonding material to join them. A permanent option is to crown both the affected teeth and nearby stable teeth and fuse the crowns together.
These and other stabilizing techniques, like occlusal night guards to reduce the effects of teeth grinding or orthodontic treatment, will help secure the teeth. Coupled with disease treatment and renewed dental care and hygiene practices, you may be able to keep that loose tooth from being lost.
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.”
Transforming your smile doesn’t necessarily require complex treatments like orthodontics, dental implants or porcelain veneers. Sometimes a little brightness can mean all the difference in the world.
Bleaching (or teeth whitening) is a proven method for dealing with tooth discoloration and staining. Nearly all whitening products, whether home or professional, contain the bleaching agent carbamide peroxide or its breakdown product hydrogen peroxide. These agents effectively diminish staining deep within a tooth (intrinsic) or on the enamel surface (extrinsic), although intrinsic staining will require a more invasive office procedure.
If you have extrinsic staining you have three basic options: dental office bleaching, a retail home kit or a kit purchased from a dentist. Again, you’ll find the same basic bleaching agents in each of these versions. The difference will be the concentration: home kits contain about 10% agent by volume, while the office application will be a much higher range of 15% to 35% (which may also employ specialized lights or lasers to increase the bleaching effect). As a result, an office bleaching may take only a visit or two to achieve the desired brightness while a home kit about two or three weeks.
Whitening is a more economical route for smile enhancement of otherwise sound teeth than other measures. But there are other considerations you should weigh before undergoing a procedure. Whitening isn’t a permanent fix — the brightness will diminish over time, optimally six months to a year in what dentists call the “fade rate.” You can slow this process by avoiding or limiting foods and habits that cause staining.
If you have other dental work — crowns, bridgework or fillings — it may be difficult to achieve a tint level that matches these restorations, especially at home. And while whitening is relatively safe (as long as you’re using your kit as directed), you may experience tooth sensitivity, gum irritation or other minor oral side effects.
Before you decide on whitening, visit us first for a complete dental examination. From there we can advise you on whether whitening is a good smile enhancement choice for you.
If you would like more information on teeth whitening, 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 “Teeth Whitening.”