At your child's latest dental visit, you found out one of their primary (“baby”) teeth has become decayed and in danger of loss. Of course, you may think, it's only a primary tooth — it's going to come out sooner or later.
But a primary tooth lost “sooner” rather than “later” can create long-term negative consequences for your child's dental health. For the sake of the future permanent tooth, the best treatment strategy could be to put forth the effort and expense to save it.
Besides its role in eating and chewing, a primary tooth's most important function is as a “trailblazer” for the permanent tooth developing below it. A primary tooth doesn't normally loosen and let go until the new permanent tooth is ready to erupt. Until then they hold the new tooth's space in the jaw.
But if the primary tooth is lost prematurely, nearby teeth can drift into and crowd the space so that the permanent tooth comes in out of position. This can result in a malocclusion, or poor bite.
Depending on the state of your child's jaw development, it may be advisable to attempt saving the tooth through a filling or, in the case of deep decay, a modified root canal treatment. If the tooth can't be saved, then placing an orthodontic appliance known as a space maintainer might be necessary. Cemented to a tooth next to the empty space, this appliance has a looped band of metal that butts against the tooth on the other side of the gap, and prevents both teeth from drifting into the space.
Intervening for a decayed primary tooth can seem a waste of time and money since it has a limited lifespan to begin with. But for the health of its companion permanent tooth, as well as possibly avoiding orthodontic treatment, it could be well worth it for your child's long-term dental health.
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 “Importance of Baby Teeth.”
September is National Gum Care Month, an ideal time to talk about how to keep your gums healthy. Unfortunately, nearly half of adults have gum disease, which can damage the soft tissue and bone supporting the teeth. In fact, advanced gum disease is the number one reason for tooth loss among adults, and it’s associated with other health problems, including cardiovascular disease, diabetes and pregnancy complications. But there’s good news—gum disease is preventable and, in its early stages, even reversible. Here are some tips for taking care of your gums:
Keep up a good oral hygiene routine
Gum disease begins with plaque buildup, so attack the plaque in your mouth with good dental hygiene. Spend two minutes morning and night brushing all surfaces of your teeth, and floss once a day to get rid of plaque that forms between teeth.
Use a soft toothbrush
The American Dental Association recommends brushing gently with a soft toothbrush. Hard bristles can damage your gums and cause them to pull away from the teeth.
Swish with a mouth rinse
Consider using a mouth rinse. Over-the-counter and prescription oral rinses are available to help wash away food debris, reduce plaque and fight gum inflammation.
Say no to tobacco
Smoking is one of the biggest risk factors for developing gum disease. And it’s not just cigarettes but all forms of tobacco, including e-cigarettes, pipes and chewing tobacco, that raise your risk of gum disease.
Eat a healthy diet
For the best gum health, avoid refined carbohydrates (sugary and starchy foods) and make sure you are getting enough vitamin C, vitamin D and antioxidants (found in berries and green tea, for example). In addition, studies suggest that a diet rich in omega-3 fatty acids may reduce your risk of gum disease and other inflammatory conditions. These healthy fats are found in many fish, nuts, seeds, soy products and vegetable oils.
Come in for regular cleanings
Professional dental cleanings can remove plaque from the tiny spaces that are difficult to reach by simply brushing and flossing. And once plaque hardens to form calculus (tartar), it cannot be removed during your regular oral health care routine at home. Further, at the dental office we can detect gum disease in its early stages—and the earlier gum problems are caught, the more easily they can be reversed.
Often as children grow older, their participation in sports or similar activities increases. While generally encouraged, this greater activity does increase injury risk, especially to the mouth.
In fact, the late childhood to early adulthood demographic is the most prone portion of the population to incur dental injuries. To complicate matters, their dental development is often incomplete, posing a number of treatment obstacles for an injured tooth.
For example, the primary means for preserving an injured adult tooth is a root canal treatment: damaged or diseased tissue within the pulp, the tooth’s innermost layer, is removed and the empty chamber and root canals filled and sealed to prevent infection. But while a fully matured tooth can function without the nerves and blood vessels of the pulp, a developing tooth needs these tissues for continued tooth formation. Otherwise, tooth development can stall and cause problems later on.
The most common solution for younger teeth is to remove any damaged tooth structure without disturbing the pulp if at all possible followed by a filling. That’s contingent, though, on whether we find the pulp unexposed or undamaged—if it is, we’ll try to remove only damaged or diseased pulp tissue and leave as much healthy tissue intact as possible. To aid with healing and tissue re-growth, we may also place medicinal stimulators between the pulp and the filling.
Jaw development may also pose a challenge if the injured tooth is too far gone and must be removed. Our best choice is to replace it with a dental implant; but if we install the implant while the jaw is still growing, it may eventually appear out of place with the rest of the teeth. It’s best to postpone an implant until full jaw maturity in early adulthood.
In the meantime we could provide a temporary solution like a removable partial denture or a modified bonded bridge that won’t permanently alter nearby teeth. These methods can adequately restore the function and appearance of missing teeth until the jaw is mature enough for an implant.
While injuries with young permanent teeth do pose extra challenges, we have effective ways to address them. With the right approach, the outcome can be just as successful as with a mature tooth.
If you would like more information on dental care in the formative years, 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 “Saving New Permanent Teeth after Injury.”
Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.
In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.
For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.
Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.
It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.
That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”
We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?”
Summer is a great time to go outdoors and get your game on—no matter whether your court is set up for tennis or basketball, whether you’re on the diamond or on the greens. Regular physical activity can help you maintain your optimal weight, reduce your risk for certain diseases, and even lower stress levels. But many of our favorite outdoor sports also carry a risk of accidental injury…and frequently this involves injuries to the mouth.
Because they’re front and center, the incisors (front teeth) are the ones most often affected by accidental injuries. While serious damage is relatively rare, chips and cracks are not uncommon. Fortunately, dentistry offers a number of good ways to restore chipped or broken teeth. Which one is best for you depends on exactly what’s wrong—but a procedure called cosmetic bonding is one of the most common ways to repair small to moderate chips where the tooth’s soft pulp isn’t exposed.
In dental bonding, a tooth-colored material is applied directly to the tooth’s surface to fill in the chip or crack. The material itself is a high-tech mixture of tough plastic resins, translucent glass-like fillers, and other substances. Strong, durable and lifelike in appearance, these composite resins can be matched to the natural shade of your teeth.
Bonding is a conservative procedure, meaning that it requires little or no preparation of the tooth. It can be done right in the dental office, often in a single visit and without the need for anesthesia. Unlike porcelain veneers or crowns (caps), it usually doesn’t involve removing significant amounts of healthy tooth structure.
While the results can last for years, bonded restorations aren’t as durable as porcelain veneers or crowns, which are made in a dental laboratory. Bonding also isn’t suitable to repair major damage, or in cases where the tooth’s pulp could become infected; in this situation, you may need a root canal and a crown. However, for moderate chips or cracks, bonding can be an appropriate and economical way to restore your teeth to full function and aesthetic appearance.
Of course, it’s often said that an ounce of prevention is worth a pound of cure. That’s why it’s best to wear a protective mouthguard whenever you’re on the field. We can provide a custom-made mouthguard that’s comfortable to wear and offers maximum protection against dental injury—just ask!
If you have questions about cosmetic bonding or mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Artistic Repair of Front Teeth with Composite Resin” and “Athletic Mouthguards.”
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