Posts for: September, 2014
Your dental appliance plays a big role in restoring function and improving your appearance. Taking proper care of it will ensure it can do that for a long time.
Cleaning is a top priority. Though it might seem natural to use toothpaste, you should avoid using it on your appliance. The abrasives in toothpaste are necessary to break up plaque on natural teeth’s hard enamel surfaces, but will leave micro scratches on the surface of your appliance that eventually become havens for bacterial growth — a sure recipe for discoloration and unpleasant odors. If you plan to use boiling or hot water to disinfect your appliance, don’t. The heat distorts the plastic and can disrupt its precise mouth fit. You should also avoid using bleach because it can break down the composition of the plastic, can leave a strong odor, and can whiten the pink “gum tissue” areas of the denture.
Instead, use plain liquid detergent or hand soap with warm water to clean your appliance — and use a brush designed for it rather than your toothbrush. If you have a long-term appliance like a denture, you might consider investing in an ultra-sonic cleaner that uses high frequency sound vibrations to clean out small crevices a brush can’t reach.
Remember the old saying, “familiarity breeds contempt?” With dental appliances, too much time in the mouth breeds bacteria. Dentures, for example, should be taken out at night to allow saliva and its antibacterial capacity to work in your mouth. You also should be on the lookout for signs of infection — if anything appears amiss, contact us for an exam as soon as possible to minimize the effects of tooth decay or gum disease.
One final item: be careful where you place your appliance when it’s not in your mouth. Lying out in the open (like on a nightstand) is a tempting lure for the family pet or a curious child. Keep it in its case in accordance with the care instructions given you when you received your appliance.
Doing the right things — and avoiding the wrong things — when caring for your dental appliance will go a long way to increasing its life and reducing problems along the way.
A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.
Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.
Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.
Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.
In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.
If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.
If you would like more information on 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 “Loose Teeth.”
Fans of the classic bumbling-buddies comic film “Dumb and Dumber” will surely remember the chipped front tooth that Jim Carrey sported as simpleminded former limo driver Lloyd Christmas. Carrey reportedly came up with the idea for this look when considering ways to make his character appear more “deranged.” He didn't need help from the make-up department, however… He simply had his dentist remove the dental bonding material on his left front tooth to reveal the chip he sustained in grade school!
Creating a Bond
A dental cosmetic bonding involves application of a composite filling material that our office can color and shape to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed. This is the quickest and lowest-cost option to repair a chip.
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.
A veneer can be used to hide smaller areas of missing tooth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface also may be necessary to fit a veneer.
A chipped tooth makes an impression, but generally not a flattering one. Nearly 20 years after “Dumb and Dumber” hit the theaters, the only thing Jim Carrey had to do recently to hint at a sequel for his nitwitted character was tweet a photo of that goofy grin!
If you would like more information about repairing a chipped tooth, 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 “Artistic Repair of Front Teeth With Composite Resin.”
If you are at all uncomfortable at the thought of getting a dental implant, you might be pleasantly surprised to learn the truth about these marvelous state-of-the-art tooth-replacement systems — and the special role of a relatively new device, the mini-implant. So, first, let's go over some basic facts.
What's a dental implant? Basically, it's just a replacement for the root part of the tooth, the part that lies beneath the gum line. It attaches to a crown, which is a replacement for the visible portion of the tooth. But instead of ceramics or metals, implants are made of titanium, which becomes fused to the surrounding bone. When complete, implants are much stronger and longer-lasting than other methods of tooth replacement, like bridgework and dentures.
Implants are presently regarded as the best way to replace missing teeth, with a success rate of over 95%. They also help prevent bone loss in the jaw, a major goal of modern dentistry. Having one put in is an office procedure that's generally accomplished with local anesthesia, and most patients experience only minor discomfort. Standard dental implants can be used to replace a single tooth, or multiple teeth. The mini-implant, which is just a miniature version of the same technology, is now playing an increasing role in many other phases of dentistry.
Why mini-implants? Because in several situations, this smaller and less expensive alternative offers a solution that's just as good — or better — than any other dental treatment. One area where mini-implants excel is in supporting lower jaw overdentures.
Many people find that lower dentures are far more troublesome than upper dentures. The movement of the tongue muscle, and the smaller area of surface contact (compared to the upper denture, which is supported by the palate) often results in a poor, loose fit, which leads to problems when eating or speaking. These problems can be solved by affixing a lower overdenture (an implant-retained denture) with just two mini-implants.
Not only do mini-implants help prevent bone loss, they also give the denture wearer increased stability, comfort, and confidence. And they do so at a price that's more economical than you might think. In some cases, the mini-implants can be placed in a single one-hour office visit, and your own denture can be modified to fit them — so you can go home and eat a steak that night!
Another area where mini-implants are finding increasing use is in orthodontics. Orthodontic appliances (commonly called braces) move teeth by exerting a light force on them, using a wire which is fixed to a solid anchor point. Traditionally, other teeth are used as anchors — but sometimes these teeth move as well! By using immovable mini-implants as the anchor points, the process is greatly simplified. Strategically placed mini-implants called TADS (temporary anchorage devices) can be used to correct both skeletal (jaw) position and dental (tooth) position problems.
Mini-implants may also be used in upper dentures and temporary bridgework.
If you would like more information about mini-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 articles “Implant Overdentures for the Lower Jaw,” “The Great Mini-Implant,” and “What are TADS?”
Although your teeth feel as if they’re rigidly set in the jawbone, they’re actually capable of movement. In fact, dynamic tooth movement is an essential mechanism in good dental function — it allows your teeth to adapt to changes brought on by age and other factors.
The periodontal ligament is a key component in this mechanism. This elastic tissue actually holds the teeth to the bone through tiny fibers that attach to the tooth root on one side of the ligament and to the jawbone on the other. The teeth move within the ligament to maintain contact with both adjacent and opposing teeth in response to changes like the normal wear that occurs due to aging.
This is a primary reason why a missing tooth should be replaced by an artificial one as soon as possible. Because of the tendency just described, teeth next to the space left by the missing tooth will begin to move (or drift) into the space at an accelerated rate. The end result is teeth out of their normal position and range, which could seriously disrupt their normal function as well as adversely affect your appearance.
This is especially important for back teeth. Because they’re not easily visible to others when we open our mouths, many people will forgo replacement when they’re lost. But missing back teeth can set off a chain reaction of movement that could eventually hinder jaw function.
The best option for a tooth replacement is a dental implant. Life-like and durable, dental implants encourage bone growth at the implant site and adjacent teeth will respond to it as they would a natural tooth. If an implant isn’t feasible, then a fixed bridge is also a viable replacement option that will prevent drift. As a result, tooth movement should continue normally with no adverse effects on function.
If you’ve lost teeth or are about to undergo tooth extraction, it’s in your other teeth’s best interest to consider a permanent replacement. A new implant or bridge will vastly improve your smile and prevent more serious problems in the future.
If you would like more information on the importance of teeth replacement, 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 “Replacing Back Teeth.”