Posts for: September, 2014
Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.
Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.
Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.
There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.
If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.
In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.
Periodontal (gum) disease is a bacterial infection that can eventually lead to tooth loss if not treated. The infection typically arises from plaque, a thin film of bacteria and food particles that build up on tooth surfaces every 8-12 hours and not removed due to poor oral hygiene.
There is always an increased risk of gum disease when a person doesn’t practice effective oral hygiene. But there are certain conditions that could also heighten risk: in particular, women who are pregnant (especially during the first trimester) or taking certain types of birth control pills. During pregnancy, female hormones known as estrogens become elevated, causing changes in the gums’ blood vessels. These changes make the tissues fed by these vessels more susceptible to the effects of bacteria. This increased susceptibility even has a term — “pregnancy gingivitis.”
Gum disease during pregnancy can also affect other areas of a woman’s health, as well as the health of her baby. Recent studies have shown a possible link between pre-term low weight babies and mothers with severe gum disease, especially among those with limited dental healthcare. There’s a stronger link, however, between gum disease and diabetes; in fact, diabetes should be checked for in pregnant women who are diagnosed with gum disease.
If you’re pregnant, it’s especially important that you not neglect oral hygiene. Daily brushing and flossing is essential for removing the bacterial plaque that causes gum disease. You should also visit us for regular checkups and cleanings to remove hard to reach plaque and calculus (hardened deposits), as well as to detect any signs of periodontal disease.
You should also be aware of other factors, and take steps to minimize their effect. Smoking can cause greater plaque accumulation as well as adversely affect your immune system, which can inhibit healing in infected tissues. Stress can also affect your immune system, so be sure you’re getting enough rest.
Gum disease in any individual has the potential to cause great damage to teeth and gums. If you notice any abnormalities, particularly bleeding or swelling gums, you should see us as soon as possible for proper diagnosis. In the case of gum disease, the sooner treatment begins the better the chances of protecting both your health and your baby’s.
If you would like more information on periodontal disease and pregnancy, 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 “Pregnancy & Birth Control.”
While dental implants are considered the gold standard for tooth replacement, removable dentures are still a viable choice, especially for patients with edentulism (complete tooth loss). Removable dentures have also undergone considerable advancement to improve their function, appearance and longevity.
But even with these advancements, dentures still require a fair amount of skill, experience and — of utmost importance — a sense of art. If you’re considering this option, long-term success depends on a careful process of construction, fit adjustment and regular checkups to maintain that fit.
Our first step is to determine exact tooth placement on each denture. Using facial features (or photos before tooth loss) we establish placement landmarks so that corresponding upper and lower teeth align properly. We also consider tooth size, their orientation in relation to the lip, and the needed space to leave between the upper and lower teeth when they are at rest. We make these determinations based on accepted standards of beauty, but also taking into account your particular comfort level with any features that might alter your appearance.
The denture’s gums must also look realistic when you smile, especially if your upper lip rises above the teeth to expose more gum tissue. We also want to match the color and texture of your natural gums, as well as incorporate palatal rugae, the little ridges behind the upper front teeth that aid with speech and chewing food.
When we first place the new dentures in your mouth, we may need to adjust them for balance between the upper and lower sets when they come together. An imbalanced fit could have an adverse effect on your ability to bite, chew and speak normally.
Your dentures should have a good, comfortable fit. Over time, however, you will encounter some degree of bone loss because you no longer have your natural teeth to stimulate bone growth and absorb the forces created during function when your teeth contact. This and other factors may cause your dentures to become loose and uncomfortable to wear. For that reason, it's important for you to visit us regularly to maintain that good fit and check the health of underlying tissues and bone.
Careful planning and denture construction help ensure your new dentures successfully restore form and function to your mouth. Regular monitoring will also ensure they continue to serve you well for as long as possible.
If you would like more information on removable 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.”
If a glance in the mirror reveals stained or discolored teeth that are detracting from your self-confidence, it's time to do something about it. The first step is to make an appointment for an office visit to find out how we can help you.
External (extrinsic) stains that form on the surfaces of teeth are usually caused by beverages such as red wine, tea, coffee as well as unhealthy habits like tobacco use. Extrinsic stains generally come in shades of browns, black or grays, but may even be orange or green from color producing bacteria.
Internal (intrinsic) stains are part of the structure of the tooth and cannot be removed by polishing. Among their causes are excessive fluoride levels or tetracycline antibiotics given in childhood and during tooth formation. Teeth do become more yellow and discolored as we age. Discoloration of individual teeth may be indicative of tooth decay, or teeth that have had root canal treatment and have literally lost their vitality tend to darken over time. Internal discoloration comes in a variety of shades and hues from yellows, grays, browns, and even some reds or pink.
Five Ways to lighten, whiten and brighten stained or discolored teeth
- Change your habits. Reduce or stop consuming or using foods, drinks or tobacco if they are staining your teeth.
- Improve your daily oral hygiene. Make sure to brush your teeth well, twice a day. Change to a toothpaste that contains a mild abrasive. Some toothpastes also contain tooth whiteners.
- Visit our office for a professional cleaning and polish. Routine scaling and polishing will remove most superficial external stain and discoloration. Sometimes ultrasonic cleaning (by high frequency vibration) and polishing with slightly abrasive pastes may just do the trick.
- Treatment for internal stain and discoloration. Brown colored decaying teeth need to have the decay removed and the teeth restored. Stained old and leaking fillings may also need to be replaced.
- Tooth whitening by bleaching. Bleaching or tooth whitening is a safe and effective way to brighten stained teeth. Internal tooth bleaching can whiten even discolored root canal treated teeth. Ask us for more information about this technique.
If your mirror tells you that your smile needs attention, there's no time like the present to get started. Get back your bright, white smile and your self-confidence as well.
There was a time when most adults with a bad bite or misaligned teeth considered it too late in their lives for corrective treatment. Fortunately, times have changed — today, one in five orthodontic patients is an adult.
There are solid reasons for considering corrective treatment for bite problems at any age. Poorly aligned teeth are harder to clean, which raises the risk for tooth decay or gum disease. Correcting alignment may also improve your chewing ability, making eating more comfortable with less joint pain. And, last but not least, orthodontic treatment could greatly improve your smile — with potential benefits to your self-confidence, social life and career.
So, should you consider orthodontic treatment? That will depend on three factors: your periodontal (gum-related) health; your general health; and what type of orthodontic problem needs to be corrected.
If you have gum disease, you are at risk of losing supporting bone — since treatment involves gently moving teeth within the bone that supports them, the inflammation may cause bone loss and may not lend itself to a successful outcome. Moreover, besides aggravating and worsening your periodontal condition, the treatment may result in teeth that may not stay where they were moved and could continue to stay mobile long afterward.
There are certain medical conditions that could make orthodontic treatment difficult or even prohibitive: heart-valve disease; bleeding disorders; leukemia; severe diabetes; and taking medications for arthritis or osteoporosis, or those that increase mouth dryness. If you have serious medical conditions or you take prescription drugs, it’s wise to first consult with your medical doctor before considering orthodontic treatment.
The last consideration is whether the misalignment could involve more of your jaw’s skeletal structure than just misaligned teeth. If, for example, the malocclusion (bad bite) is related to the way your jaws fit together, you may need orthognathic surgery to straighten the jaws’ alignment while having orthodontic treatment.
There may be an additional roadblock to treatment — many adults feel self-conscious about wearing braces. If this bothers you, you may have another option: clear aligners. These transparent trays that fit over teeth have been a popular choice among adults because they’re not as noticeable as braces.
In any event, orthodontic treatment can be a little inconvenient, but only for a relatively short time. The lifetime benefits — better health, improved function and a more attractive smile — are well worth the inconvenience.
If you would like more information on adult orthodontics treatment, 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 “Orthodontics for the Older Adult.”