Posts for: May, 2014
Dentists go to great lengths to save an adult permanent tooth. Even though restoration technology is incredibly advanced, none can completely replace the biological function of natural teeth. Treating a diseased tooth to preserve it is a high priority in dentistry.
It would seem, though, that a child’s primary (baby) tooth might not warrant the same treatment. Since the tooth eventually detaches from the jaw to make way for a permanent tooth, why save it?
It is worth the effort, because primary teeth provide more than a chewing function: they also serve as guides for their permanent successors. When they’re lost prematurely, the permanent teeth may not come in correctly, leading to a malocclusion (poor bite). Other areas of development, like speech and dental bone growth, may suffer as well from the longer time gap between the premature loss and the permanent tooth eruption.
Saving an infected primary tooth should be considered, especially if significant time remains in its lifespan. Due to differences between primary and permanent teeth, though, the treatment approach isn’t the same. For example, the body gradually absorbs the roots of a primary tooth (a process called resorption) as the permanent tooth beneath erupts applying pressure to the primary roots (this is what enables its eventual detachment). Dentists must factor this process into their diagnosis and treatment plan for a primary tooth.
The level of treatment may vary depending on how deep the infection has advanced. If the decay is limited to the tooth’s outer layers and only partially affects the pulp, the innermost layer of the tooth, a dentist may remove as much soft decay as possible, apply an antibacterial agent for any remaining hardened infection, and then restore the tooth with filling materials.
For deeper infection, the dentist may remove some or all of the pulp, disinfect and clean the area, and then fill and seal the empty space with a filling. A filling material like zinc oxide/eugenol paste should be used that’s capable of resorption by the body to coincide with the natural root resorption. After treatment, the tooth should continue to be monitored for changes in appearance or gum swelling, just in case the infection returns or advances.
Although it may seem counterintuitive, treating a primary tooth as you would its successor is worth the effort. Your child will reap the health benefits, both now and long after the primary tooth is gone.
If you would like more information on endodontic treatment for children, 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 “Root Canal Treatment for Children’s Teeth.”
Her parents Will and Jada are Hollywood royalty, who helped her land her first acting role when she was 7. She released a hit single, “Whip My Hair,” before she had quite reached the age of 10; shortly afterward, she was signed to a record label. Yet the young singer and actress Willow Smith has at least one thing in common with plenty of ‘tweens and teens across America: She needed to wear braces to correct problems with the alignment of her teeth.
Why do braces seem to be a part of growing up for so many kids? One answer is because they work so well. Braces apply gentle pressure to the teeth through a thin, flexible wire called an archwire. Attached to the teeth with a metal or ceramic bracket, the archwire exerts a light force which causes teeth to gradually move into better positions. Sometimes, when additional force is needed, elastic bands or other appliances may be used in conjunction with braces.
Most everyone is familiar with the silvery metal “tracks” of traditional braces. But did you know that there are a number of other options too? For a more inconspicuous look, you may be able to have braces with tooth-colored ceramic brackets; then, only the thin archwire will be visible in your mouth. It’s even possible in some cases to place the metal wires and brackets on the tongue side of the teeth. With this system, called lingual braces, the orthodontic hardware is truly invisible.
What if you didn’t need metal braces at all? Some people can get good results using a system of clear plastic aligners instead of braces. The aligners are worn 23 hours a day, but can be taken off for cleaning and for important events. They work best for correcting mild or moderate alignment problems.
Still, plenty of people feel that if they’re going to wear braces, they might as well flaunt them. That’s why some types of braces are available with bands that come in different colors. When Willow’s brother Jayden wore braces, he was reported to favor red and black ones. Jayden, who is about two years older than his sister, had his braces removed just before Willow got hers put on.
So if it turns out that you need braces, remember that lots of your favorite celebrities wore them too. And keep in mind that, depending on your own situation, you may have several options to choose from.
If you would like more information about braces or orthodontic treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics for the Older Adult.”
Q: What exactly are porcelain veneers?
A: The term “veneer” usually means a very thin covering that’s designed to improve the way a surface looks. The porcelain veneers we use in cosmetic dentistry are just like that: They cover up flaws in the natural teeth, while preserving their strength and vitality. Porcelain veneers are wafer-thin layers of super-strong material, which are bonded to the front surfaces of the teeth. Once placed on your teeth, they offer a permanent way to improve a smile that’s less than perfect.
Q: What kinds of smile defects can porcelain veneers fix?
A: Veneers can help with a whole range of issues, including:
- Color: Teeth that are deeply stained or yellowed — even those which can’t be lightened with professional bleaching — can be restored to a brilliant white (or a natural luster) with porcelain veneers.
- Shape and size: If your teeth have become worn down with age, or have chips or roughened edges, veneers can restore them to a more pleasing shape. They can also lengthen teeth that appear too short, for a dramatic enhancement of your smile.
- Alignment and spacing: For closing a small gap between teeth or making other minor adjustments in tooth spacing or position, veneers may be just what you need; more serious issues can be handled with orthodontics.
Q: What's involved in getting porcelain veneers?
A: First, we will talk with you about what aspects of your smile you’d like to improve, and develop a plan to accomplish that. When we’re all agreed, the next step will probably be to remove a small amount of tooth material in preparation for placing the veneers. (Some types of veneers, however, don’t require this step.) Next, we will make a mold of your teeth and send it to the dental lab; you’ll leave our office with a set of temporary veneers. In a few weeks, you’ll return to our office to have the final veneers permanently bonded to your teeth.
Q: Is it possible to preview the results?
A: Yes! The options for a preview range from computer-generated images of your new smile to an accurate, life-sized model of your teeth with veneers applied. It may even be possible to make acrylic “trial veneers” that we can actually place on your teeth to try on! So if your smile could use a little help, ask us about porcelain veneers.
What is tooth wear?
“Tooth wear” refers to a loss of tooth structure that can make your teeth appear shorter or less even than they used to be. Wear starts with loss of outer covering of the teeth, known as enamel. Although enamel is the hardest structure in the human body — even harder than bone — it can wear away over time. If enough enamel is lost, the softer inner tooth structure known as dentin can become exposed, and dentin wears away much faster.
What causes tooth wear?
Tooth wear can be caused by any of the following:
- Abrasion: This is caused by a rubbing or scraping of the teeth. The most common source of abrasion is brushing too hard or using a toothbrush that is not soft enough. A removable dental appliance, such as a partial dentures or retainer, can also abrade teeth. Abrasion can also result from habits such as nail-biting and pen-chewing.
- Attrition: This is caused by teeth contacting each other. Habits that you might not even be aware of — such as grinding or clenching your teeth — can be quite destructive over time. That’s because they can subject teeth to 10 times the normal forces of biting and chewing.
- Erosion: Acid in your diet can actually erode (dissolve) the enamel on your teeth. Many sodas, sports drinks and so-called energy drinks are highly acidic; so are certain fruit juices. Eating sugary snacks also raises the acidity level in your mouth. If you can’t give up these snacks and drinks entirely, it’s best to confine them to mealtimes so your mouth doesn’t stay acidic throughout the day. Swishing water in your mouth after eating or drinking acidic or sugary substances can also help prevent erosion.
- Abfraction: This refers to the loss of tooth enamel at the “necks” of the teeth (the part right at the gum line). This type of wear is not thoroughly understood, though it is believed to result from excessive biting forces. Abrasion and erosion can contribute to this problem.
How is it treated?
The first step in treating any type of tooth wear is to determine the cause during a simple oral examination right here at the dental office. Once the cause has been identified, we can work together to reduce the stresses on your teeth. For example, you may need a refresher course on gentle, effective brushing techniques; or you might benefit from some changes to your diet. If you have a clenching or grinding habit, we can make you a nightguard that will protect your teeth during sleep or periods of high stress. Once we have dealt with the underlying cause, we can make your teeth look beautiful again by replacing lost tooth structure with bonding, veneers, or crowns. This will also allow your bite to function properly again.
It’s rare now to encounter a news story about an infection spreading among a group of dental patients — a rarity thanks to the development of standards and procedures for infection control. As these standards have improved over the last few decades, the prevention of infection stemming from dental treatment has become more effective and easier to perform.
Like other healthcare providers, dentists are held (and hold themselves) to a high legal, moral and ethical standard to stop the spread of infection among their patients, and both governmental authorities and professional organizations mandate safety procedures. The United States Center for Disease Control regularly publishes recommendations for disinfection and sterilization procedures for all healthcare providers and facilities, including dental clinics. Dental and medical licensing bodies in each U.S. state also mandate control procedures and have made continuing education on infection control a condition of re-licensure.
For both medical and dental facilities, blood-borne pathogens represent the greatest risk of infection. These viral infections spread through an infected person’s blood coming in contact with the blood of an uninfected person, via a cut or a needle injection site. One of the most prevalent of these blood-borne diseases is hepatitis. This disease, which can severely impair the function of the liver and could be fatal, is caused by either of two viruses known as HBV and HCV. Any medical facility that encounters blood through needle injection or surgical procedures (including blood transfusion and surgical centers, and dental offices) must have a high degree of concern for controlling the spread of hepatitis and similar viral diseases.
Infection control protocols cover all aspects of potential exposure, including protective wear for workers and patients, proper disposal of contaminated refuse and disinfection of instruments and facilities. These comprehensive procedures not only keep patients safe from viral exposure, they also protect healthcare providers who experience greater exposure and risk for infection than the patients they serve.
Thanks to this strong emphasis on infection control, your dental visits are reliably safe. If you do have concerns, though, about the risk of infection during a dental visit, please let us know — we’ll be happy to discuss all we do to protect you and your family from infection.
If you would like more information on infection control, 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 “Infection Control in the Dental Office.”