There’s more to teeth than meets the eye. Hidden beneath the visible crown are the tooth’s roots set within the jawbone, secured and protected by the gums from bacteria and infection. But if the gums shrink back (recede), the roots become exposed and susceptible to disease, especially at the points where multiple roots branch from each other, areas called furcations.
It all begins with periodontal (gum) disease caused by built-up bacterial plaque from insufficient brushing and flossing. The infection triggers inflammation that over time weakens gum tissues. They begin to detach from the teeth, which can eventually lead to gum recession and root exposure.
This also causes bone loss, especially at the furcations. We can detect any loss (known as a furcation invasion) and how far along it may be with x-ray imaging or by manually probing with an instrument called a periodontal probe.
There are three general classes measuring furcation invasions. In the earliest, Class I, we can feel the invasion as a slight groove; in Class II, it increases to two or more millimeters across. In Class III the bone loss extends from one side of the root all the way to the other (a “through and through”).
At this stage a patient is in danger of losing the tooth, so we’ll have to act promptly. This means first removing accumulated dental plaque and calculus (tartar) to stop the infection and allow the gums to heal. With severe damage, we may need to assist healing with bone and gum tissue grafting, in which we place donor grafts to serve as scaffolding for the appropriate tissue to grow upon.
You can help prevent this situation by practicing effective daily hygiene and visiting your dentist for thorough cleanings at least twice a year (or more if recommended). And at the first signs of a gum infection—swollen, reddened or bleeding gums—make an appointment as soon as possible to have it checked. The sooner we can detect and treat gum disease, the less likely a furcation invasion or worse will be in your future.
Dental implants are best known as restorations for single missing teeth. But there’s more to them than that—they can also be used to support and secure removable dentures or fixed bridges.
That’s because a dental implant is actually a root replacement. A threaded titanium post is inserted directly into the jawbone where, over time, bone cells grow and adhere to it. This accumulated bone growth gives the implant its signature durability and contributes to its long-term success rate (95%-plus after ten years). It can support a single attached crown, or serve as an attachment point for a dental bridge or a connector for a removable denture.
The method and design of implants differentiates it from other restoration options. And there’s one other difference—implants require a minor surgical procedure to insert them into the jawbone.
While this might give you pause, implant surgery is no more complicated than a surgical tooth extraction. In most cases we can perform the procedure using local anesthesia (you’ll be awake the entire time) coupled with sedatives (if you have bouts of anxiety) to help you relax.
We first access the bone through small incisions in the gums and then create a small channel or hole in it. A surgical guide that fits over the teeth may be used to help pinpoint the exact location for the implant.
We then use a drilling sequence to progressively increase the size of the channel until it matches the implant size and shape. We’re then ready to insert the implant, which we remove at this time from its sterile packaging. We may then take a few x-rays to ensure the implant is in the right position, followed by closing the gums with sutures.
There may be a little discomfort for that day, but most patients can manage it with over-the-counter pain relievers like aspirin or ibuprofen. It’s what goes on over the next few weeks that’s of prime importance as the bone grows and adheres to the implant. Once they’re fully integrated, we’re ready to move to the next step of affixing your crown, bridge or denture to gain what you’ve waited so long for—your new implant-supported smile.
If you would like more information on dental implants, 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 “Dental Implant Surgery: What to Expect Before, During and After.”
Want to give your kids the best start possible for a lifetime of good dental health? The most important thing you can do is train them in effective brushing and flossing. It's more than having a nice smile and fresh breath: these hygiene tasks remove the daily buildup of bacterial plaque, the primary cause for both tooth decay and periodontal (gum) disease, which are most responsible for poor oral health.
But those aren't the only habits they should be cultivating. Here are 3 tips for helping your child develop great dental health habits.
Encourage healthy eating. Teeth and gums are like other parts of the body: they need the "building blocks" found in nutritious foods to help grow strong, healthy tissues. By focusing on a diet leaner on processed items and richer in whole, less-processed vegetables, meats and dairy products, you'll be helping your child build strong defenses against dental disease.
Keep sugary snacks under control. Of all the items in your child's diet, sugar could have the greatest impact on their teeth. Disease-causing bacteria thrive on this particular carbohydrate, multiplying and producing mouth acid—the main enemy of tooth enamel—as a byproduct. So, limit sugary snacks as much as possible, opting instead for more nutritional between-meal treats. In fact, try to make sure they only consume sugary treats at mealtime, not in between.
Encourage an end to thumb-sucking or pacifiers by age 3. Most infants and very young children suck their thumbs or, alternatively, a pacifier. There's no harm in this habit unless it extends into later childhood where it could affect their bite. You can avoid this outcome by encouraging your child with mainly positive reinforcement to stop sucking their thumbs or other objects before their third birthday. Your dentist can also help with tips and support in those efforts.
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 “Help your Child Develop the Best Habits for Oral Health.”
As a member of the best-selling pop group Spice Girls, Mel C (AKA Sporty Spice) enjoyed her share of musical superstardom. At the band’s peak in the Nineties, the young singer’s signature look featured baggy sweatpants, an assortment of tattoos, a nose stud and a gold-capped incisor, front and center in her mouth. Today, Melanie Chisholm is still singing — but now she’s a mom, an amateur triathlete… and that gold tooth is just a memory. Not only that, her smile looks more evenly spaced and whiter than it did when she was referred to as the “tomboy” of the group.
What happened? In our view, it all boils down to changing tastes — plus a little bit of help from dental professionals. As the “wannabe” singer proves, there’s no single standard when it comes to making your teeth look their best. Your own look is unique to you — and your smile can reflect that individuality.
For example, crowns (caps) are substantial coverings that may be placed on teeth when they are being restored. They are available in three types: gold, all-porcelain, or porcelain-fused-to-metal. The latter two are tooth-colored, while the gold is — well, shiny like gold bling. Which one is right for you? In many cases, it’s your choice.
Likewise, dental veneers — wafer-thin shells that can correct cosmetic issues by covering the surface of your teeth — can be made in a variety of shades. Their hues may range from natural ivory to Hollywood white, and everything in between. What’s the best color for you? Only you can say.
Some people opt for a “smile makeover” that uses small irregularities in the spacing and color of teeth to create a more “natural” look. Other folks want a perfectly even, brilliant white smile that dazzles the eye. Still others are looking to match or restore the smile they once had — perhaps even re-creating a signature gap between the teeth. As long as there are no other dental issues involved, the choice is yours.
So if you’re unhappy with your smile — or if you feel it doesn’t reflect the person you “wannabe” — why not talk to us about a smile makeover? Just call our office to schedule a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”
Tooth decay is one of the most common diseases in the world, nearly as prevalent as the common cold. It’s also one of the two major dental diseases—the other being periodontal (gum) disease—most responsible for tooth and bone loss.
Tooth decay begins with high levels of acid, the byproduct of oral bacteria feeding on food remnants like sugar. Acid can erode tooth enamel, leading to a cavity that will require removal of decayed material around it and then a filling.
Sometimes, though, decay can spread deeper into the tooth reaching all the way to its core: the pulp with its bundle of nerves and blood vessels. From there it can travel through the root canals to the bone. The continuing damage could eventually lead to the loss of the infected tooth.
If decay reaches the tooth interior, the best course of action is usually a root canal treatment. In this procedure we access the pulp through the crown, the visible part of the tooth, to remove all of the diseased and dead tissue in the pulp chamber.
We then reshape it and the root canals to receive a filling. The filling is normally a substance called gutta percha that’s easily manipulated to conform to the shape of the root canals and pulp chamber. After filling we seal the access hole and later cap the tooth with a crown to protect it from re-infection.
Root canal treatments have literally saved millions of teeth. Unfortunately, they’ve gained an undeserved reputation for pain. But root canals don’t cause pain—they relieve the pain caused by tooth decay. More importantly, your tooth can gain a new lease on life.
But we’ll need to act promptly. If you experience any kind of tooth pain (even if it goes away) you should see us as soon as possible for an examination. Depending on the level of decay and the type of tooth involved, we may be able to perform the procedure in our office. Some cases, though, may have complications that require the skills, procedures and equipment of an endodontist, a specialist in root canal treatment.
So, don’t delay and allow tooth decay to go too far. Your tooth’s survival could hang in the balance.
If you would like more information on tooth decay treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Root Canal Treatment: What You Need to Know.”
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