There’s a potential threat lurking in your young child’s mouth—tooth decay. This destructive disease can not only rob them of teeth now, it could also impact their dental health long into their adult years.
That’s why we focus heavily on decay prevention measures even in primary (“baby”) teeth, as well as early treatment should it still occur. It’s a straightforward treatment strategy: minimize the factors that contribute to disease and maximize those that protect against it.
We can represent the disease-causing factors with the acronym BAD. Bad bacteria top the list: they produce oral acid that erodes tooth enamel. Couple that with an Absence of healthy saliva function, necessary for acid neutralization, and you have the potential opening for tooth decay. Poor Dietary habits that include too much added sugar (a prime food source for bacteria) and acidic foods help fuel the decay process.
But there are also SAFE factors that can help counteract the BAD. Promoting better Saliva function helps control acid levels, while Sealants applied to chewing surfaces strengthen these vulnerable areas against decay. We can prescribe Antimicrobials in the form of mouth rinses that reduce abnormally high bacterial concentrations. Fluoride applied directly to the enamel bolsters its mineral content. And an Effective diet high in nutrition and low in sugar or acidic foods rounds out our protective measures.
Promoting SAFE factors greatly reduces the risk of childhood tooth decay. To keep on track it’s important to start regular, six-month dental visits beginning around your child’s first birthday. These visits are the most important way to take advantage of prevention measures like sealants or topical fluoride, as well as keeping an eye out for any signs of decay.
And what you do at home is just as important. Besides providing a teeth-friendly diet, you should also brush and floss your child’s teeth every day, teaching them to do it for themselves when they’re old enough. Playing it “SAFE” with your child’s dental health will help ensure your child’s teeth stay decay-free.
If you would like more information on dental care for your child, 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 “Taking the Stress out of Dentistry for Kids.”
The vast majority of teeth and gum problems stem from two dental diseases: dental caries (tooth decay) and periodontal (gum) disease. But although these dental diseases are all too common in our society, there’s a good chance you can prevent them from harming your own dental health.
That’s because we know the primary cause for both of them—dental plaque, a thin film of bacteria and food particles that can build up on tooth surfaces usually as a result of poor oral hygiene. Remove this plaque build-up daily and you dramatically decrease your risk for disease.
The primary way to do this is with a daily habit of brushing and flossing. While regular dental cleanings remove plaque and tartar (calcified plaque) from hard to reach places, it’s your regular practice that removes the bulk of daily buildup. Interrupting plaque buildup helps keep disease-causing bacteria at bay.
That also means performing these two hygiene tasks thoroughly. For example, you should brush all tooth surfaces, especially in the rear and along the entire gum line (a complete brushing should take at least 2 minutes). And by the way, “thorough” doesn’t mean “aggressive”—a gentle circular motion is all you need. If you scrub too hard, you run the risk over time of damaging your gums.
And while many people discount flossing as a hard and unpleasant task, it’s still necessary: at least half of the plaque in your mouth accumulates between the teeth where brushing can’t reach effectively. If you find flossing too difficult, you can take advantage of tools to make the task easier. A floss threader will make it easier to get floss through your teeth; you could also use an oral irrigator, a device that emits a pressurized spray of water to loosen and flush away some plaque.
Along with dental visits at least twice a year, daily brushing and flossing is the best way to reduce your risk of both tooth decay and gum disease. Avoiding these two diseases will help ensure your smile is attractive and healthy throughout your life.
If you would like more information on preventing dental 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
About one-quarter of people have teeth that never developed. While most of these congenitally missing teeth are wisdom teeth, they can also include premolars or lateral incisors (the teeth right next to the two front teeth, the central incisors).
Missing teeth can have an adverse effect on smile appearance. But that’s not all: because each type of tooth performs a specific function, one or more missing teeth can lead to bite problems and disruption of dental function. In the case of missing lateral incisors, the canines (eye teeth) normally positioned beside and toward the back of the mouth from them may begin to drift into the empty space and grow next to the central incisors. This can result in greater difficulty chewing and a smile that “doesn’t look right.”
To correct this situation, we must often first attempt to orthodontically move any out of place teeth to their normal positions. This re-establishes the space needed for the missing teeth to be replaced, which we can then restore with prosthetic (artificial) teeth. If the permanent restoration of choice involves dental implants, we’ll usually need to wait until the completion of jaw development around early adulthood. In the mean time, we can use a retainer appliance to hold the teeth in their new positions with prosthetic teeth attached to fill the empty space for a better smile appearance in the interim.
The real issue is timing—beginning orthodontic treatment when appropriate to a person’s oral development, as well as completing the implant restoration when the mouth has matured sufficiently. There are other considerations such as bone volume, which may have diminished due to the missing teeth. At some point we may need to consider grafting to build up the bone sufficiently to support dental implants.
This all may entail a team approach by various specialties like orthodontics, periodontics and implantology. Working together and coordinating within a timely schedule, a mouth and smile marred by undeveloped teeth can be transformed.
If you would like more information on treating smiles with underdeveloped permanent 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 “When Permanent Teeth Don’t Grow.”
The “magic” behind a dental implant’s durability is the special affinity its imbedded titanium post has with bone. Over time bone grows and attaches to the titanium surface to produce a strong and secure hold.
But there’s one important prerequisite for ultimate implant success—there must be an adequate amount of bone available initially to properly position the post during implantation. Otherwise, the implant may not have enough support to position it properly or cover the implant surface completely with bone.
Inadequate bone can be a problem for patients who lost teeth some time before and now desire to an implant restoration. This happens because when teeth are missing, so are the forces they generate during chewing. These forces stimulate new bone growth around the tooth root to replace older, dissolved bone at a healthy rate. If that replacement rate is too slow, the volume and density of bone may gradually diminish.
There is a way, though, to build up the bone for future implantation. Known as bone preservation procedure or a ridge augmentation, it’s a surgical procedure in which the dentist adds bone grafting material to the extraction socket or the bony ridge. The graft serves as a scaffold for new bone cells to grow and multiply. If successful, there will be enough new bone volume after several months of healing to support proper implant placement.
Bone grafting can add more time to the implant process. It may also mean you will not be able to undergo immediate crown placement after implantation (a “tooth in one day” procedure). Instead we would probably suture gum tissue over the implant to protect it and allow for full integration with the bone over a few more months. In the meantime, though, we could fit you with a temporary restoration like a removable partial denture (RPD) or a bonded bridge to improve the appearance of the space while the bone continues to heal.
After several months, your implant will have a better chance of a secure hold and we can then attach a life-like crown. Even if you’ve suffered bone loss, you’ll then have the benefit of not only a durable implant but also a new smile.
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