Posts for: October, 2018
Baby (primary) teeth look and function much like their permanent counterparts. Besides having a visible crown, they also have roots that maintain contact with the jawbone.
But there are some differences, the biggest one being the normal process whereby primary tooth roots dissolve or, in dental terms, resorb. Root resorption eventually leads to the tooth coming loose to make way for the permanent tooth.
Adult tooth roots can also resorb — but it's decidedly not normal. If adult root resorption isn't promptly treated, it could also lead to tooth loss — but there won't be an incoming tooth to take its place.
Although it can begin inside a tooth, adult root resorption usually begins on the outside. One type, external cervical resorption (ECR), begins around the neck-like area of the tooth not far below the gum line. Its initial signs are small pink spots where the tooth enamel has eroded; those pink cells within the space are doing the damage.
We don't fully understand the mechanism behind ECR, but there are some factors that often contribute. People with periodontal ligament damage or trauma, sometimes due to too much force applied during orthodontic treatment, have a high risk of ECR. Some bleaching techniques for staining inside a tooth may also be a factor.
The key to treating ECR is to detect it as early as possible before it does too much root damage. Regular checkups with x-rays play a pivotal role in early detection. Advanced stages of ECR might require more advanced diagnostics like a cone beam computed tomography (CBCT) scan to fully assess the damage.
If the lesion is small, we can surgically remove the cells causing the damage and fill the site with a tooth-colored filling. If ECR has spread toward the pulp, the tooth's inner nerve center, we may also need to perform a root canal treatment.
Either of these methods intends to save the tooth, but there is a point where the damage is too great and it's best to remove the tooth and replace it with a life-like dental implant or other restoration. That's why it requires vigilance through regular, semi-annual dental visits to detect the early signs of root resorption before it's too late.
If you would like more information on adult tooth root resorption, 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 “Root Resorption.”
Dentures in one form or another have been around for centuries. Although dental implants have earned a well-deserved prominence of late, the denture still remains a viable tooth replacement option.
What's more, dentures aren't reserved for total tooth loss only. Even if you've lost just a few of your teeth, we can fit you with a removable partial denture (RPD). Although mainly considered a temporary solution for missing teeth, some people depend on an RPD for many years due to finances or other issues.
The traditional RPD consists of a rigid acrylic plastic base that resembles gum tissue supported by a metal framework, with prosthetic (false) teeth precisely placed to fill the space of the missing teeth. They're held in place with metal clasps that extend from the metal framework to fit over the remaining natural teeth.
Although they're an effective restoration, traditional RPDs have a few drawbacks. Some people find them uncomfortable to wear or have an allergy to the acrylic plastic. They also have a propensity to stain from beverages like tea, coffee or wine.
But there's a more recent version called a flexible RPD that addresses these and other concerns. It's made of a pliable nylon that's durable, yet comfortable to wear. Rather than metal clasps, they're secured in place with thin, finger-like nylon extensions that fit into the small, natural depressions in the crowns of the teeth around the gum line.
Flexible RPDs are also highly adaptable to appear life-like in many situations. We can fashion the nylon base to cover areas around natural teeth where the gums may have receded due to gum disease.
They do, however, have a few downsides. Unlike traditional dentures, they're difficult to reline or repair. Like any oral appliance, they can suffer from wear and neglect, so you must properly clean and maintain them. And, like any RPD their best role is as a temporary bridge rather than a permanent restoration.
In the meantime, though, you can count on a flexible RPD to restore your ability to eat and speak proficiently, as well as smile with confidence. It's a great affordable way to address a few missing teeth.
If you would like more information on dentures as a restoration option, 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 “Flexible Partial Dentures.”
The vast majority of teeth and gum problems stem from two dental diseases: dental caries (tooth decay) and periodontal (gum) disease. But although these dental diseases are all too common in our society, there’s a good chance you can prevent them from harming your own dental health.
That’s because we know the primary cause for both of them—dental plaque, a thin film of bacteria and food particles that can build up on tooth surfaces usually as a result of poor oral hygiene. Remove this plaque build-up daily and you dramatically decrease your risk for disease.
The primary way to do this is with a daily habit of brushing and flossing. While regular dental cleanings remove plaque and tartar (calcified plaque) from hard to reach places, it’s your regular practice that removes the bulk of daily buildup. Interrupting plaque buildup helps keep disease-causing bacteria at bay.
That also means performing these two hygiene tasks thoroughly. For example, you should brush all tooth surfaces, especially in the rear and along the entire gum line (a complete brushing should take at least 2 minutes). And by the way, “thorough” doesn’t mean “aggressive”—a gentle circular motion is all you need. If you scrub too hard, you run the risk over time of damaging your gums.
And while many people discount flossing as a hard and unpleasant task, it’s still necessary: at least half of the plaque in your mouth accumulates between the teeth where brushing can’t reach effectively. If you find flossing too difficult, you can take advantage of tools to make the task easier. A floss threader will make it easier to get floss through your teeth; you could also use an oral irrigator, a device that emits a pressurized spray of water to loosen and flush away some plaque.
Along with dental visits at least twice a year, daily brushing and flossing is the best way to reduce your risk of both tooth decay and gum disease. Avoiding these two diseases will help ensure your smile is attractive and healthy throughout your life.
If you would like more information on preventing 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”