Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.
One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.
Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.
Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.
The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.
Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.
The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.
Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.
If you would like more information on loose teeth and gum 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 “Treatment for Loose Teeth.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
As a parent you want your child to have the best possible start in life. One of the greatest gifts you can provide them is a positive experience in dental care—especially visiting the dentist.
Unfortunately, not all children are so lucky. Visiting the dentist for them is foreign and forbidding; it leaves such a negative impression they may avoid the dentist later in life even when faced with acute problems.
It doesn’t have to be like that. Here are 3 ways you can help your child have a great experience at the dentist.
Start dental visits early. The best time to begin dental visits is before your child’s first birthday as their teeth begin to erupt. Dental diseases like tooth decay can begin as early as two months so it’s vital to detect any problems as soon as possible. Establishing an early relationship with your child’s dentist benefits you too with helpful tips and advice from them on dental care at home. And, children visiting the dentist early are more likely to become accustomed to it as a routine part of life, and more likely to continue the habit on their own.
Find the right dentist. The right dental practice can make all the difference in the world for your child’s comfort level. Parents often choose a pediatric dentist who specializes not only in dental care for children and adolescents but in how to engage with them and put them at ease. The key, though, is to find a dentist and staff who work well with children and understand how to make them feel at home in their office.
Display a positive attitude. You’ve probably already noticed how your child picks up on your feelings in different situations—which often affect how they feel and act too. So be sure when you visit the dentist with them you have a positive, proactive attitude, ready to partner with their provider in treatment and prevention measures. And above all display a calm and relaxed manner: your child will be more apt to follow your cue and relax too.
If you would like more information on providing great 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 “Taking the Stress out of Dentistry for Kids.”
A root canal treatment is a highly effective way to save a deeply decayed tooth. Sometimes, though, complications make it difficult or even impossible to perform the traditional procedure. In those cases, we may need to use a different option.
Tooth decay becomes an imminent threat to a tooth's survival if it works its way into the pulp, the innermost layer of a tooth. It's only a short advancement from there into the roots by way of the root canals.
In a typical root canal treatment, we access the pulp by drilling a small hole in the biting surface of a back tooth or the back side of a front tooth. We remove all the tissue within the pulp and fill it and the root canals with a special filling to prevent re-infection. After sealing the access hole, we cap the tooth with a crown to further protect it.
Although root canal treatments have a high success rate, re-infection can still occur. Often, a second root canal will save the tooth from the new infection.
In some cases, though, using the traditional procedure might do more harm than good. It's possible we may find extra canals previously undetected branching out from the primary canal at the root end. Canals can calcify and narrow, making them extremely difficult to fill. Subsequent dental work may also prove troublesome: we would have to take the restoration apart, which could further weaken the tooth.
The alternative is a procedure known as an apicoectomy. Instead of accessing the pulp through the crown, we access the root end through the gum tissue. We then focus on removing infected tissue at the tooth's root end, along with a tiny amount of the root tip. We then place a small filling at the end of the root canal (essentially plugging it up) to prevent further infection. We may also perform grafting to encourage bone growth in any voids left by the procedure.
Endodontists, specialists in root canals, have the advanced training and specialized equipment to perform an apicoectomy. With their expertise, they may be able to save your tooth with this specialized procedure when a root canal treatment won't work.
If you would like more information on options for treating decayed 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
Saliva probably doesn’t rate high on your amazement meter. You’re more likely to notice its absence and the dry irritation that results.
But you might be more impressed with this unsung bodily fluid if you knew all the things it does. It’s definitely a multi-tasker, performing a number of jobs (including aiding in digestion) that not only keep your oral health on track, but your general well-being too. And there are even new testing methods where saliva may even tell us when you’re not doing so well.
Here are 3 more tasks your saliva is doing for your mouth right now that truly makes it amazing.
Cleansing. Your teeth’s chewing action shreds food so it’s easier to digest. But that also leaves behind tiny particles in your mouth. Bacteria feast on these particles (especially carbohydrates like sugar) and produce acid as a byproduct, which can increase your risk of tooth decay. Saliva serves as a kind of “rinse cycle” for your mouth, helping to wash a good bit of these errant particles down your throat and away from hungry bacteria.
Defense. Speaking of bacteria, your mouth is home to millions of them. While most are harmless or even beneficial, a fraction can harm your teeth and gums. Saliva is your first line of defense, emitting an antibody known as Immunoglobulin A that targets these bacteria. Saliva also produces an antibacterial substance called lyzozyme that prevents bacteria from growing.
Enamel Protection. Although it’s the strongest substance in the body, your teeth’s enamel can’t withstand the effects of mouth acid, the by-product of bacterial feeding and growth. Acid levels naturally rise after eating; but even this sudden rise can begin the process of demineralization where minerals in enamel dissolve. Saliva saves the day by first neutralizing the acid and restoring the mouth’s normal pH in about thirty minutes to an hour. It also helps restore minerals in enamel, a process called remineralization. It’s all in a day’s work for this remarkable fluid.
If you would like more information on the importance of saliva to oral 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 “Saliva: How it is used to Diagnose Disease.”
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