Posts for: August, 2014
If at all possible, we want to save a tooth — it’s the best outcome for your overall dental health. In many cases, we can achieve this by filling the tooth or installing a crown over it.
Unfortunately, preservation isn’t always possible if the natural tooth has been irreparably weakened by decay or trauma. Replacing the natural tooth with a life-like artificial one is the next best option: the replacement will help you regain lost function and reinvigorate your smile. Filling the missing tooth’s space also prevents neighboring teeth from drifting into it, causing further problems with function and appearance.
Dental implants are widely recognized as the best choice for tooth replacement because of their life-like qualities, durability and positive effect on bone health. Even their biggest drawback, their cost, isn’t that great an issue if you factor in their longevity — they may actually result in less dental expense over the long-term.
A dental implant, however, isn’t always a viable option. Some patients may not have enough bone mass to support an implant. Those with certain systemic diseases like uncontrolled diabetes or a weakened immune system may not be able to undergo dental implant surgery.
Fortunately, many of these patients can benefit from a fixed bridge, a restoration option that’s been used for decades. A bridge is a series of life-like crowns permanently joined like pickets in a fence. The middle crown known as the “pontic” fills the empty space left by the missing tooth. The crowns on either side of the pontic are permanently attached to the natural teeth that border the missing tooth space. Known also as “abutment” teeth, they serve as the support for the bridge.
Bridges do have one downside — the abutment teeth must be prepared by filing them down so the new crowns fit over them properly. This will permanently alter and possibly weaken the teeth. Dental implants, on the other hand, have little to no effect on adjacent teeth.
Still, a bridge remains an effective option for many people. Properly cared for, a bridge can restore function as well as enhance your smile for many years to come.
If you would like more information on bridgework as a restorative option, 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.”
When it comes to our overall health, many of us think we’re pretty well-informed. But a recent survey quiz given by the American Dental Association (ADA) revealed something surprising: When it comes to dental health, most people could use plenty of “brushing up.” In fact, the average score on the true/false test was a barely passing D! Among the questions most people answered incorrectly were:
- How often should you brush your teeth? (91 percent got it wrong)
- At what age should you take your child to the dentist for the first time? (75 percent wrong)
- How often should you replace your toothbrush? (65 percent wrong)
- Can cavity-causing germs be passed from person to person? (59 percent wrong), and
- Does sugar cause cavities?
We’ll come back to the last question in a moment — but first, let’s recap some basic dental health information.
While you might think it’s best to brush after every meal, the ADA recommends brushing just twice a day. That’s because excessive brushing can erode tooth enamel (especially if it has already been softened by acidic food or drinks), and can also expose and irritate the root of the tooth. But when you do brush, you should keep at it for at least two minutes each time!
Bring your child in to the dental office within six months after the first tooth appears — but no later than his or her first birthday! The age-one dental visit starts your child off right with proper preventive care and screenings, and sets the stage for a lifetime of good oral health.
Most people think it’s OK to change your toothbrush twice a year — but the ADA recommends that you get a new one every three months; that’s because stiff, frayed bristles just don’t clean your teeth and gums as well as they should. Likewise, most people don’t realize that the bacteria that cause cavities can be passed from one person’s mouth to another — by putting a child’s pacifier in your mouth or sharing a toothbrush, for example.
And speaking of cavities: Technically, they aren’t caused by sugar, as 81 percent of people thought. Tooth decay occurs when certain types of oral bacteria release an acidic byproduct that attacks the tooth enamel and creates small holes (cavities). This occurs after the bacteria have metabolized sugar in your diet. So while sugar doesn’t directly cause cavities, it does lead to tooth decay by feeding harmful bacteria. How about partial credit for that one?
If you have additional questions about your dental health, please call our office to schedule a consultation. For more information, see the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
Porcelain veneers are a proven way to achieve a new smile. Composed of thin layers of dental porcelain and other materials laminated together to form one life-like unit, veneers are applied to the outside of a prepared natural tooth to enhance its appearance. Given the right circumstances, they’re an excellent solution for correcting mild to moderate spaces between teeth, slight deviations in tooth position, and problems with the color and shape of a tooth.
Veneers are very strong and can resist most of the forces you generate when you chew your food. But dental porcelain is also a form of glass — strong but not indestructible. Following a few maintenance guidelines will help you avoid damaging a porcelain veneer and incurring additional dental care costs.
Practice daily oral hygiene. Although veneers aren’t subject to disease or decay, the tooth structure they cover and the surrounding gum tissues are. You should, therefore, brush and floss veneered teeth just as you would any other tooth. And, there’s no need for specially formulated toothpastes — any non-abrasive fluoride brand will work.
Avoid excessive biting or chewing. While it’s a good practice for natural teeth to avoid applying too much biting force to hard materials, it’s especially important for veneers. Attempting to open hard-shell nuts with your teeth or chewing on bones, pencils and other hard objects are just a few of the activities that could lead to a shattered veneer.
Use a bite guard for clenching habits. People who excessively grind or clench their teeth (a condition called bruxism) can also put undue stress on their veneers. We can help alleviate some of this stress by fashioning a bite guard you wear at night. The guard will help protect your veneers from teeth grinding while you sleep.
Limit foods and drinks that cause staining. Tea, coffee, wine and similar substances can leave teeth stained and dingy. Although your new veneers won’t typically stain, the natural teeth around them can — the brighter veneers would then stand out prominently from the dingier natural teeth.
Porcelain veneers are proven “smile changers.” Taking care of them with a few common sense precautions will ensure the change is long-lasting.
If you would like more information on porcelain veneers, 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 “Smile Design Enhanced With Porcelain Veneers.”
Chewing gum, so much a part of modern culture, actually has ancient roots — humans have been chewing some form of it for thousands of years. While gum chewing is a benign habit for the most part, it does raise some dental health concerns.
The good news for jaw function is that chewing gum is unlikely to cause any long-term problems for your joints if you respond to your body’s warning signals. Our joints, muscles and associated nerves have a built-in mechanism of fatigue and pain signaling to help us avoid overuse. Furthermore, the action of chewing stimulates the production and release of saliva. Among saliva’s many beneficial properties is its ability to neutralize acid, which can soften and erode tooth enamel. It also strengthens enamel by restoring some of the calcium and other minerals lost from acid.
That doesn’t mean, however, that the physical act of chewing gum isn’t without risks. Chewing gum “exercises” your jaw muscles and makes them stronger, so they’re able to deliver more force to your teeth. This could lead to future tooth mobility and excessive wear. It’s important then that you don’t chew gum excessively to avoid this kind of damage to your teeth.
Unfortunately, there’s more bad news involving a key ingredient in many brands. Many manufacturers use sugar (sucrose) to sweeten their product, which is a major part of its appeal. Sugar, however, is a prime food source for oral bacteria responsible for tooth decay. The prolonged presence of sugar in the mouth when we chew gum can negate the beneficial effects of increased saliva.
A sweetener called xylitol, though, could be the answer to “having your gum and chewing it too.” This alcohol-based sugar (which, by the way, has almost half the calories of table sugar) has the opposite effect on bacteria — rather than becoming a food source it actually inhibits bacterial growth. Studies have even shown that products like chewing gum, mints or candy sweetened with xylitol can contribute significantly to a reduction in dental caries (cavities) caused by decay.
The better news: you don’t have to give up chewing gum for the sake of your teeth — just be sure to choose products with dental-friendly ingredients and don’t chew excessively. You’ll not only reduce the risks of tooth decay and damage, you’ll also promote a healthier environment in your mouth.
If you would like more information on chewing gum and its effects on 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 articles “Chewing Gum” and “Xylitol in Chewing Gum.”
Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.
A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.
If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.
The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.
Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.
These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.
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.”