There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.
But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.
But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.
After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.
As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.
This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.
If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”
Most dental problems arise from tooth decay and periodontal (gum) disease. But they aren't the only source of danger to your teeth—gastroesophageal reflux disease (GERD) could be just as damaging to your tooth enamel as dental disease.
GERD usually occurs when a ring of muscles at the top of the stomach weaken, allowing stomach acid to enter the esophagus. This resulting acid reflux can make life unpleasant and pose potential health dangers—over time it can damage the lining of the esophagus and cause ulcers and pre-cancerous cells. It can also erode tooth enamel if acid enters the mouth and raises its level of acidity.
This can be a problem because acid can soften and dissolve the mineral content of tooth enamel. This is the primary cause of tooth decay as acid produced by oral bacteria attack enamel. The more bacteria present, often thriving in dental plaque, the higher the potential levels of acid that can damage enamel. Stomach acid, which is strong enough to break down food, can cause similar harm to enamel if it causes higher than normal acidity in the mouth.
There are some things you can do to protect your teeth if you have GERD, namely manage your GERD symptoms with lifestyle changes and medication. You may need to avoid alcohol, caffeine or heavily acidic or spicy foods, all known to aggravate GERD symptoms. Quitting smoking and avoiding late night meals might also ease indigestion. And your doctor may recommend over-the-counter or prescription drugs to help control your acid reflux.
You can also boost your teeth's enamel health by practicing daily brushing and flossing—but not right after a reflux episode. The enamel could be softened, so brushing can potentially remove tiny particles of mineral content. Instead, rinse with water mixed with or without a little baking soda to help neutralize acid and wait about an hour—this will give saliva, the mouth's natural acid neutralizer, time to restore the mouth's normal pH level.
And be sure you're using a fluoride toothpaste. Fluoride strengthens enamel—in fact, your dentist may recommend topical fluoride applications to boost the effect.
These and other tips can help minimize the effects of GERD on your dental health. With an ounce of prevention, you can keep it from permanently damaging your teeth.
If you would like more information on managing your dental health with GERD, 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 “GERD and Oral Health.”
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.
But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.
Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.
To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.
With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.
You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.
To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.
If you would like more information on caring for your dental restoration, 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 “Oral Hygiene for Fixed Bridgework.”
If you're over 30 your chances for developing periodontal (gum) disease are better than half. And it's not a minor matter—untreated gum disease can lead not only to tooth loss, but to an increased risk of cardiovascular disease and other inflammatory conditions.
Fortunately, we have effective ways to treat gum disease, even in advanced stages. But the best approach by far in avoiding a devastating outcome for your teeth is to prevent gum disease from developing in the first place.
It helps first to know how gum disease begins. The most common cause is dental plaque, a thin biofilm of food particles on tooth surfaces that harbors the bacteria that triggers the disease. If you keep your teeth clean of built-up plaque and tartar (calcified plaque) with daily brushing and flossing and regular dental cleanings, you'll minimize the growth of disease-causing bacteria.
If you don't practice effective oral hygiene, however, within a few days you could develop an initial infection called gingivitis. This form affects the outermost layers of the gums and triggers a defensive response from the body known as inflammation. Ordinarily, inflammation helps protect surrounding tissues from infection spread, but it can damage your gums if it becomes chronic. Your weakened gums may begin to detach from the teeth, forming voids filled with inflammation known as periodontal pockets. Eventually, the infection can spread to the supporting bone and lead to tooth loss.
In addition to a dedicated oral hygiene and dental care program, you should also be on the lookout for early signs of gingivitis. Infected gums can become red, swollen and tender to the touch. You may notice they bleed easily while brushing and flossing, or a foul taste or breath that won't go away even after brushing. And if some of your teeth feel loose or don't seem to bite together as they used to, this is a sign of advanced gum disease that deserves your dentist's immediate attention.
Practicing preventive hygiene is the best way to stop gum disease before it starts. But if gum disease does happen, catching it early can be a game-changer, both for your teeth and your smile.
If you would like more information on preventing and treating 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 “How Gum Disease Gets Started.”
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