Posts for category: Dental Procedures
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.”
Your gums’ primary role is to protect your teeth and keep them firmly in place. But periodontal (gum) disease can damage your gums to such an extent you could ultimately lose your teeth.
Gum disease is a progressive infection caused by bacterial plaque built up on tooth surfaces from poor oral hygiene. The initial infection triggers inflammation, a defensive response of the body characterized by swelling, redness and bleeding of the gums. An initial form of the disease known as gingivitis occurs in most people after just a few days without brushing or flossing.
Resuming hygienic activities to remove daily plaque, along with regular dental cleanings, may be enough to stop gingivitis and restore healthy gums. If the disease is allowed to advance, however, the infected gum tissues will begin to detach from the teeth, turning the slight normal gaps between teeth and gums into wider voids known as periodontal pockets that fill with bacteria leading to infection. Your hygiene efforts will not be enough to cope with this advanced form of periodontal disease.
At this point professional techniques are required to adequately remove plaque and calculus (hardened plaque deposits), depending on the depth and location of the periodontal pockets. The most basic of these is scaling using specialized hand instruments or ultrasonic equipment to remove plaque and calculus in pockets at or just below the gum line. If plaque and calculus have extended to the roots we may then need to employ root planing, in which we “shave” offending material from root surfaces. In some cases this may require accessing the area surgically beneath the gum tissue.
As plaque removal progresses, inflammation will begin to subside and the gum tissues heal. If, however, swelling, bleeding or pus formation persists, this may indicate bacterial levels remain too high. To decrease these levels we may need to administer antibiotics, or through mouthrinses containing chlorhexidine.
Once under control, it’s crucial from then on for you to maintain a strict daily regimen of brushing and flossing to keep plaque from building up on tooth surfaces. You'll also need to visit us regularly (two or more times a year) for professional cleaning and checkups. Keeping a close eye will help prevent a reoccurrence of this serious disease and prolong the life of your teeth.
If you would like more information on treating periodontal (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.”
Dental implants are today’s closest restorative facsimile to natural teeth. And they’re versatile: not only can they replace single teeth but they can also support bridges or dentures.
But since one of their crucial components is made of metal, are you out of luck obtaining this state-of-the-art dental restoration if you have a metal allergy?
The answer is: probably not—it’s rare for implants to cause an allergic reaction. Still, metal allergies can be a potential problem within your mouth as with other areas of health.
An allergy originates from the body’s necessary response to potentially harmful microorganisms or substances. Sometimes, however, this response becomes chronic and exaggerated, creating an allergy. People can have allergies to nearly anything with responses ranging from a minor rash to a potentially life-threatening multi-organ system shutdown (anaphylactic shock).
A small number of people have allergies to particular metals. One of the most common is nickel, which affects an estimated 17% of women and 3% of men; cobalt and chromium are also known to cause allergies. Consumer exposure, particularly metal contact with the skin through jewelry or clothing, is the most prevalent, but not the most concerning. That’s reserved for metal allergies related to medical devices like coronary stents or hip and knee prostheses. And in dentistry, there are rare occasions of inflammation or rashes from metal amalgam fillings.
Which brings us to dental implants: the main metal post that’s inserted into the jawbone is usually made of titanium. It’s the metal of choice for two reasons: it’s bio-compatible, meaning the body normally accepts its presence; and it’s osteophilic, which means bone cells readily grow and adhere to it, a major reason for implant durability.
While it’s possible for someone to have an allergy and subsequent reaction to implants with titanium, the occurrences appear to be extremely low. In one study of 1,500 patients, titanium allergies were estimated to be a factor in implant failures in less than 1% of those studied.
Even so, if you have known metal allergies you should make sure your dentist knows. Being aware of all the facts will help them recommend the best tooth replacement choice for you—and hopefully it will be dental implants.
If you would like more information on dental implant restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Metal Allergies to Dental Implants.”
After a long struggle with dental disease, you have finally lost the last of your remaining teeth.Â Like over a quarter of Americans in their 60s and 70s, this unfortunate development can have a profound impact on your health and self-image.
While there are a number of advanced methods for replacing lost teeth, there's one tried and true option that's centuries old — the removable denture. It's the option millions of people have chosen to lessen the impact of missing teeth.
Fashioned properly, removable dentures restore the form and function you once had with your natural teeth. The prosthetic (false) teeth are precisely placed in an acrylic, gum-colored base that closely follows the contours of your gums. Because they're removable, they're fairly easy to clean and maintain.
They do have a disadvantage, though, and it's related to bone health after tooth loss. Like other living tissues, bone has a life cycle: as older cells die, new cells form to take their place. The forces your teeth generate when you chew stimulate new bone growth. But without teeth to provide this stimulation, new bone won't keep up the pace of replacement at a healthy rate. As a result you may gradually lose bone, as much as a quarter of its normal width within a year of losing a tooth.
Dentures don't transmit any stimulation to the gum and bone from chewing. Furthermore, the compressive forces transmitted to the gum and underlying bone tissue contributes to bone loss. As the bone continues to diminish, your denture fit becomes looser to the point you will eventually need them relined with new acrylic material or have a new set made.
There is another alternative when patients loose all of their teeth: an implant-supported removable denture. Dental implants can be used to keep the dentures more secure and can also slow or even halt bone loss where the implants are placed. In this case we strategically place a few implants to serve as supports for a removable denture. The denture has connection points that join up with the implants to hold it more securely in place. As few as two implants are needed in the lower jaw, while the upper jaw does better with three or four implants.
Losing all your teeth can be traumatic, but there are effective ways to overcome it. With new technology, the traditional restoration of removable dentures may be the vehicle for achieving that.
If you would like more information on restoring missing teeth with dentures, 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 “Removable Full Dentures.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”