Posts for: June, 2016
All crowns are designed to restore functionality to a damaged tooth. But crowns can differ from one another in their appearance, in the material they’re made from, and how they blend with other teeth.
A crown is a metal or porcelain artifice that’s bonded permanently over a decayed or damaged tooth. Every crown process begins with preparation of the tooth so the crown will fit over it. Afterward, we make an impression of the prepared tooth digitally or with an elastic material that most often is sent to a dental laboratory to create the new crown.
It’s at this point where crown composition and design can diverge. Most of the first known crowns were made of metal (usually gold or silver), which is still a component in some crowns today. A few decades ago dental porcelain, a form of ceramic that could provide a tooth-like appearance, began to emerge as a crown material. The first types of porcelain could match a real tooth’s color or texture, but were brittle and didn’t hold up well to biting forces. Dentists developed a crown with a metal interior for strength and a fused outside layer of porcelain for appearance.
This hybrid became the crown design of choice up until the last decade. It is being overtaken, though, by all-ceramic crowns made with new forms of more durable porcelain, some strengthened with a material known as Lucite. Today, only about 40% of crowns installed annually are the metal-porcelain hybrid, while all-porcelain crowns are growing in popularity.
Of course, these newer porcelain crowns and the attention to the artistic detail they require are often more expensive than more traditional crowns. If you depend on dental insurance to help with your dental care costs, you may find your policy maximum benefit for these newer type crowns won’t cover the costs.
If you want the most affordable price and are satisfied primarily with restored function, a basic crown is still a viable choice. If, however, you would like a crown that does the most for your smile, you may want to consider one with newer, stronger porcelain and made with greater artistic detail by the dental technician. In either case, the crown you receive will restore lost function and provide some degree of improvement to the appearance of a damaged tooth.
Preventing tooth decay is mostly about the basics: daily brushing and flossing followed by regular dental cleanings and checkups. But there’s also a bigger picture: your own personal risk profile for decay based on factors you can modify directly — and those you can’t.
The first type of factor usually involves habits and behavior that either work with your mouth’s natural defenses to fight decay or against it. Besides regular hygiene, your diet is probably the most important of these you can modify for better dental health.
A diet rich in fresh vegetables, protein and dairy products boosts strong, healthy teeth resistant to decay. Conversely, bacteria thrive on the sugar in many snack foods, while sodas, sports or energy drinks elevate acid levels that soften and erode the minerals in your teeth’s enamel.
Lifestyle habits like tobacco use or excessive alcohol consumption also increase your decay risk. Not only do they promote plaque buildup (the thin film of bacteria and food particles that feeds the decay process), but tobacco especially can impede the body’s natural prevention and healing properties.
Conscientious hygiene practices, a dental-friendly diet and modified lifestyle habits all can help you prevent decay. But diligence may not be enough — there are other possible factors you can’t control or may find difficult to change. For example, you may have a genetic propensity toward certain bacteria that cause decay. You may have a condition like gastric reflux that increases the mouth’s acid level. You may also be taking medications that reduce saliva flow, the mouth’s natural acid neutralizer.
But if we know which of these indirect risk factors affect you, we can compensate with extra measures. If enamel strength is a problem we can topically apply fluoride; we can also reduce chronic bacterial levels with prescription rinses. If you have restricted saliva flow, we can attempt to modify your prescriptions through your doctor or prescribe aids that increase saliva.
The key is to investigate your complete risk factor profile through a thorough dental examination. Once we know everything about your mouth, life and health that increases your decay risk, we can put in place a balanced strategy of prevention and treatment just for you. Doing so will greatly increase your chances for keeping your teeth decay-free and healthy.
If you would like more information on preventing and treating 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 “Tooth Decay: How to Assess Your Risk.”
Finally — your braces are off! A look in the mirror reveals a straighter, more attractive smile. Unfortunately, it may also show something not so attractive — tiny, chalky spots on your teeth.
These “white spot lesions” are created by acid remaining too long in contact with the enamel, causing it to lose minerals at those places. The acid comes from plaque (a thin film of bacteria and food particles) that brushing and flossing fail to remove. Snacking on foods and beverages with added sugar or high acid content may also make it worse.
Besides their unattractiveness, these spots can lead to tooth decay — so it’s important to try to prevent it. Limiting sugar-added snacks and acidic beverages to mealtimes will help, but the main key to preventing lesions is more thorough brushing and flossing.
Because of the braces, this can take longer to do than if you weren’t wearing them. It’s also more difficult maneuvering your toothbrush or floss around the orthodontic hardware. You can improve thoroughness and access by using a powered brush or one specially designed for use with braces. And, a water flosser that removes plaque between teeth with a pulsating spray of water is an effective alternative to string floss.
Even if (despite your best efforts) some lesions form, we can still treat them. Resuming normal hygiene practices after braces may take care of it — if not, we can strengthen the affected areas of the enamel with pastes, gels, or other topical fluoride applications. We can also use a technique called caries infiltration that injects tooth-colored resin (often used for cosmetic dentistry) beneath the white spot to harden it, and leave it more translucent in resemblance of normal enamel. If these fail to produce satisfactory results, we can use cosmetic bonding that permanently covers the tooth with resin or veneers.
It’s best, though, if you can prevent the lesions while you’re wearing braces. Besides daily hygiene, be sure to keep up regular dental visits for teeth cleaning. Your efforts will go a long way toward keeping your newly aligned teeth bright and blemish-free.
If you would like more information on dental care and hygiene while wearing braces, 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 “White Spots on Teeth during Orthodontic Treatment.”
While you do all you can to provide your child healthy meals and snacks at home, they still face tempting choices for unhealthy fare when they’re away. Unfortunately, their school campus could be one of those places with food choices that raise their risk for dental disease.
Thankfully, that situation is beginning to change. The U.S. Department of Agriculture (USDA) issued regulations a few years ago tightening minimum health standards for snacks available on school grounds. Called the Smart Snacks in Schools initiative, it promotes whole grains, fruits, vegetables and low-fat dairy products, while discouraging snacks with empty calories, fat, sugar and excessive salt. This is good news in particular for preventing tooth decay in children and teenagers.
Unfortunately, the initiative may not go far enough. There are a few “loopholes”: it allows for chocolate milk with added sugar as long as it’s fat-free; high schools can also sell beverages like sports and energy drinks, which are low in sugar but high in enamel-harming acid. So, although the general nutrition of snacks in schools may be improving, you should still remain alert to poor choices that may fall through the cracks.
For one thing, you can advocate for better nutrition policies in your child’s school. The USDA initiative is a minimum standard — schools can exceed them and eliminate borderline snacks allowed under the federal regulations.
You can also provide your child snack alternatives to the school vending machine. A little creativity and fun can go a long way: a dash of cinnamon or parmesan cheese on popcorn instead of butter; finger sandwiches made of real cheese on whole-grain bread (with some whimsical shaping with a cookie-cutter); or bite-sized fruits and vegetables like grapes, baby carrots or nuts. The more healthy (and enjoyable) snacks you can send with them, the less chance they’ll turn to a less nutritious choice in the vending machine.
A healthier approach to snacking depends on setting good examples, providing ample selections and accentuating the positive about healthy foods. Choosing nutritious foods, at home and away, is a key building block for healthy teeth and gums.
If you would like more information on nutrition and dental health, 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 “Snacking at School.”
As a parent you’re always on the lookout for dangers to your toddler’s well-being: sharp corners on furniture, uneven walks or the occasional stomach bug. But a situation could be brewing in their mouth you might not be aware of until it’s become a full-blown problem.
The silent danger is tooth decay, which could be developing as early as infancy. Undiagnosed and untreated, it could ultimately cause premature loss of primary (“baby”) teeth with adverse effects on the eruption of incoming permanent teeth.
Tooth decay arises from certain strains of mouth bacteria, often passed down from parent to child. These bacteria produce acid as a byproduct after feeding on carbohydrates (especially sugars). The more food available, the more acid they produce. This wreaks havoc on tooth enamel, the teeth’s outer protective covering by softening and dissolving its mineral content. This gives decay an opening to infect the interior of a tooth.
Combine inadequate hygiene practices (especially brushing) with poor dietary habits, and you have the conditions for a perfect disease storm in your child’s mouth. That’s why you should begin oral hygiene as soon as you notice their first teeth. Wiping them with a clean, wet cloth is sufficient in the beginning, but you should start daily brushing (with fluoridated toothpaste to strengthen young enamel) by their first birthday.
You should also practice good dietary habits. For example, avoid giving an infant or toddler a bottle filled with juice, milk or formula to sleep with through the night — the constant sipping bathes the mouth in sugars bacteria feed on. Instead, use plain water.Â You should also focus on nutrition from the get-go to help build overall good health as well as strong teeth and gums.
As an added measure, begin regular dental visits by their first birthday. A checkup and cleaning every six months will help us detect early tooth decay and lessen its impact. We can also provide sealants and topical fluoride to give added protection against decay.
Catching and treating decay early before it gets too far is the best way to prevent early tooth loss. Your child’s future dental health might depend on it.
If you would like more information on your child’s dental care, 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.”