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.”
When it comes to replacing a missing tooth, you have several options, including a removable partial denture or a fixed bridge. But the premier choice is “the new kid on the block” at just over thirty years old: dental implants. Implants are by far the most popular tooth replacement choice among both patients and dentists.
But they also happen to be the most expensive option, at least initially. So the question is, why invest in dental implants over less costly choices?
Here are 3 reasons why implants could be well worth their price.
More Like a real tooth than other restorations. Implants can match the life-like appearance of any other replacement choice, often utilizing the same types of materials. But where they really excel is in function—how they perform while biting and chewing. This is because the dental implant’s titanium post imbedded in the jawbone replaces the tooth root. No other dental restoration can do that—or perform better when comparing the resulting functionality.
Best long-term solution. As we mentioned before, the initial implant cost is typically higher than either dentures or bridges. But you should also consider their durability compared to other choices. It could be potentially much longer—possibly decades. This is because the titanium post creates an ultra-strong hold in the jawbone as bone cells naturally grow and adhere to this particular metal. The resulting hold can withstand the daily forces generated during eating and chewing. With proper care they might even last a lifetime, and actually cost you less in the long run over other choices.
Adaptable to other types of restoration. Implants have greater uses other than as individual tooth replacements. A few strategically placed implants can also be used to support removable dentures or a fixed bridge for multiple teeth or an entire dental arch. As the technology continues to advance, implants are helping to make other restoration options stronger, more stable and longer lasting—and adding more value to your investment.
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 Implants 101.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
There’s a lot to like about dental implants for replacing missing teeth. Not only are they life-like, but because they replace the root they also function much like a natural tooth. They also have another unique benefit: a track record for long-lasting durability. It’s estimated more than 95% of implants survive at least ten years, with a potential longevity of more than 40 years.
But even with this impressive record, we should still look at the few that didn’t and determine the reasons why they failed. We’ll soon find that a great number of those reasons will have to do with both oral and general health.
For example, implants rely on adequate bone structure for support. Over time bone cells grow and adhere to the implant’s titanium surface to create the durable hold responsible for their longevity. But if conditions like periodontal (gum) disease have damaged the bone, there might not be enough to support an implant.
We may be able to address this inadequacy at the outset with a bone graft to encourage growth, gaining enough perhaps to eventually support an implant. But if bone loss is too extensive, it may be necessary to opt for a different type of restoration.
Slower healing conditions caused by diseases like diabetes, osteoporosis or compromised immune systems can also impact implant success. If healing is impeded after placement surgery the implant may not integrate well with the bone. An infection that existed before surgery or resulted afterward could also have much the same effect.
Oral diseases, especially gum disease, can contribute to later implant failures. Although the implant’s materials won’t be affected by the infection, the surrounding gum tissues and bone can. An infection can quickly develop into a condition known as peri-implantitis that can weaken these supporting structures and cause the implant to loosen and give way. That’s why prompt treatment of gum disease is vital for an affected implant.
The bottom line: maintaining good oral and general health, or improving it, can help keep your implant out of the failure column. Perform daily brushing and flossing (even after you receive your implant) and see your dentist regularly to help stop dental disease. Don’t delay treatment for gum disease or other dental conditions. And seek medical care to bring any systemic diseases like diabetes under control.
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 Implants: A Tooth-Replacement Method that Rarely Fails.”
Periodontal (gum) disease causes more than simple gum swelling—this bacterial infection can harm and destroy your teeth’s supporting structures, including the bone. Its aggressiveness sometimes requires equally aggressive treatment.
Gum disease usually begins with dental plaque, a thin film of bacteria and food particles on tooth and gum surfaces. Without proper oral hygiene plaque builds up with large populations of bacteria that can trigger an infection.
The growth of this disease is often “silent,” meaning it may initially show no symptoms. If it does, it will normally be reddened, swollen and/or bleeding gums, and sometimes pain. A loose tooth is often a late sign the disease has severely damaged the gum ligaments and supporting bone, making tooth loss a distinct possibility.
If you’re diagnosed with gum disease, there is one primary treatment strategy—remove all detected plaque and calculus (tartar) from tooth and gum surfaces. This can take several sessions because as the gums begin responding to treatment and are less inflamed, more plaque and calculus may be discovered.
Plaque removal can involve various techniques depending on the depth of the infection within the gums. For surfaces above or just below the gum line, we often use a technique called scaling: manually removing plaque and calculus with specialized instruments called scalers. If the infection has progressed well below the gum line we may also use root planing, a technique for “shaving” plaque from root surfaces.
Once infection reaches these deeper levels it’s often difficult to access. Getting to it may require a surgical procedure known as flap surgery. We make incisions in the gums to form what looks like the flap of an envelope. By retracting this “flap” we can then access the root area of the tooth. After thoroughly cleansing the area of infection, we can do regenerative procedures to regain lost attachment. Then we suture the flap of gum tissue back into place.
Whatever its stage of development, it’s important to begin treatment of gum disease as soon as it’s detected. The earlier we can arrest its spread, the less likely we’ll need to employ these more invasive procedures. If you see any signs of gum disease as mentioned before, contact us as soon as possible for a full examination.
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 “Treating Difficult Areas of Periodontal Disease.”
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