Some things in life are almost guaranteed to make you go, "Uh, oh"—your car won't start, your a/c goes out, or, worse yet, you get an unexpected letter from the IRS.
Here's another: One of your teeth is loose. And, if you don't act quickly, that loose tooth may soon become a lost tooth.
But first, we need to find out why it's loose. It's usually due to one of two types of injury related to your bite. One type is called primary occlusal trauma. This results from your teeth encountering higher than normal biting forces. This often happens if you habitually gnash or grind your teeth together outside of normal functions like eating or speaking.
The other type is secondary occlusal trauma. In this case, the supporting gum tissues and bone have been weakened or lost by disease, with the gum tissues possibly becoming detached. Without this support, even normal biting forces could loosen a tooth.
Our treatment approach for a loose tooth may differ depending on which of these is the cause. For primary occlusal trauma, we want to reduce the biting forces that have contributed to loosening the tooth. One way to do this is to create a mouthguard that when worn prevents teeth from making solid contact during grinding episodes.
For secondary trauma, we want to first focus on treating any gum disease responsible for weakening the gum tissues. Once we have it under control, the gums and bone tissues can heal and possibly regain and strengthen their attachment with the tooth.
At the same time, we may also need to stabilize a loose tooth to prevent its loss. This usually involves splinting, whereby we use neighboring healthy teeth to support the loose tooth. One way to do this is to attach a metal strip across the backs of the loose tooth and its more stable neighbors, or by way of a channel cut through the top biting surfaces of the teeth.
If a loose tooth regains its attachment with the gums and bone, it may stabilize and any splinting can be removed. If not, splinting may become a permanent solution. Either way, prompt treatment can help us save your loose tooth.
If you would like more information on treating loose 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 “Loose Teeth: Biting Forces Can Loosen Teeth.”
There are few things sweeter to hear than for your dentist to tell you your periodontal (gum) disease is under control. Depending on how deep the infection may have advanced, your treatment journey may have been a long one.
Unfortunately, while the battle may be over, the threat still lingers—once you've experienced a gum infection, you're at higher risk for a recurrence. To minimize that risk, you may need to undergo dental cleanings on a more frequent basis than before.
The average patient typically sees their dentist for cleanings every six months. The aim of these visits is to remove dental plaque, a thin film of bacterial-laden particles that is the prime source for gum disease. These cleanings are meant to supplement a daily habit of brushing and flossing, which should remove the bulk of plaque that builds up throughout the day.
After gum disease treatment, though, you may need to have these cleanings more frequently, and of a more involved nature than the normal cleaning. For patients who've overcome advanced gum disease, that frequency could initially be every other week, every couple of months or every three months. This frequency may change depending on the status of your gum health.
Besides a thorough cleaning, a specialized periodontal maintenance visit may include other interventions. For example, your dentist may apply topical antibiotics or other anti-bacterial products to keep bacterial growth under control.
Protecting you from further gum infection isn't totally on your dentist's shoulders—you also have a role to play. You'll need to brush and floss your teeth thoroughly every day, along with using any other hygiene products prescribed or recommended by your dentist. Daily hygiene will help prevent the buildup of dental plaque and subsequent bacterial growth.
You'll also need to keep a watchful eye on your gums for any emerging signs of infection. If you begin to notice swelling, pain or bleeding, contact your dentist as soon as possible to initiate remedial treatment.
Gum disease treatment can bring your gums back to a reasonable state of good health. But that state could be reversed with a returning gum infection. Only vigilance practiced by both you and your dentist can stop that from happening.
It's not unusual for serious actors to go above and beyond for their roles. They gain weight (or lose it, like Matthew McConaughey for True Detective). They grow hair—or they shave it off. But perhaps nothing tops what Brad Pitt did to assume the character of Tyler Durden in the movie Fight Club—he had his dentist chip his teeth.
While a testament to his dedication to the acting craft, Pitt's move definitely falls into the category of "Kids, don't do this at home." Fortunately, people deliberately chipping their teeth isn't a big problem. On the other hand, accidentally chipping a tooth is.
Chipping a tooth can happen in various ways, like a hard blow to the jaw or biting down on something too hard. Chipping won't necessarily endanger a tooth, but the missing dental structure can put a damper on your smile.
But here's the good news: you don't have to live with a chipped tooth. We have ways to cosmetically repair the damage and upgrade your smile.
One way is to fit a chipped or otherwise flawed tooth with a dental veneer, a thin wafer of dental porcelain bonded to the front of a tooth to mask chips, discolorations, gaps or other defects. They're custom-made by a dental lab to closely match an individual tooth's shape and color.
Gaining a new smile via dental veneers can take a few weeks, as well as two or more dental visits. But if you only have slight to moderate chipping, there's another way that might only take one session in the dentist's chair. Known as composite bonding, it utilizes plastic-based materials known as composite resins that are intermixed with a form of glass.
The initial mixture, color-matched for your tooth, has a putty-like consistency that can be easily applied to the tooth surface. We apply the composite resin to the tooth layer by layer, allowing a bonding agent in the mixture to cure each layer before beginning the next one. After sculpting the composite layers into a life-like appearance, the end result is a "perfect" tooth without visible flaws.
Unlike Brad Pitt, it's pretty unlikely you'll ever find yourself in a situation requiring you to purposely damage your teeth. But chips do happen—and if it happens to you, we have more than one way to make your teeth as good as new.
If you would like more information about repairing dental flaws with veneers or composite bonding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”
Even masterpiece paintings need an appropriate frame. Likewise, our gums help bring out our teeth's beauty.
But gums are more than enhancements for our smile appearance—they're also critical to good oral health. In recognition of National Gum Care Month, there are a couple of reasons why you should look after your gums just like you do your teeth.
For one, the gums are primarily responsible for holding teeth in place. With healthy gums, the teeth won't budge even under chewing stress (although this attachment does allow for micro-movements). Diseased gums, however, are another story: Advancing gum disease weakens gum attachment, causing teeth to loosen and eventually give way.
The gums also protect the root end of teeth from pathogens and oral acid, just as enamel protects the crown. Gum disease can also foul up this protective mechanism as infected gums have a tendency to shrink away from the teeth (also known as gum recession). This exposes the roots to an increased risk for disease.
So, taking care of your gums is an essential part of taking care of your teeth. And, the basic care for them is the same as for your pearly whites: daily brushing and flossing and regular dental cleanings. These habits remove the buildup of dental plaque, a thin film of food and bacteria that cause gum disease.
It's also important to keep a watchful eye for any signs of gum abnormalities. Be on the alert for unusual gum redness, swelling and bleeding. Because these may be indicators of an infection already underway, you should see us for an examination as soon as possible.
If we find gum disease, we can begin immediate treatment in the form of comprehensive plaque removal. If the disease has advanced to the root, we may need to access this area surgically to remove any infection. So, the sooner we're able to diagnose and treat an infection, the less likely that scenario will occur.
Ironically, something meant to protect your gums could also damage them. You can do this with excessive and overly aggressive brushing. Putting too much "elbow grease" into brushing, as well as doing it more than a couple of times a day, could eventually cause the gums to recede. Instead, apply only the same degree of pressure to brushing as you would while writing with a pencil.
As we like to tell our patients, take care of your mouth, and your mouth will take care of you. Something similar could be said about your gums: Take care of these essential soft tissues, and they'll continue to support and protect your teeth.
At what age should you begin treating a poor bite? Many might say with braces around late childhood or early adolescence. But some bite problems could be addressed earlier—with the possibility of avoiding future orthodontic treatment.
A crossbite is a good example. In a normal bite, all of the upper teeth slightly cover the lower when the jaws are shut. But a crossbite occurs when some of the lower teeth, particularly in back, overlap the upper teeth. This situation often happens when the upper jaw develops too narrowly.
But one feature of a child's mouth structure provides an opportunity to intervene and alter jaw development. During a child's early years, the palate (roof of the mouth) consists of two bones next to each other with an open seam running between them. This seam, which runs through the center of the mouth from front to back, will fuse during puberty to form one continuous palatal bone.
An orthodontist can take advantage of this separation if the jaw isn't growing wide enough with a unique device called a palatal expander. This particular oral appliance consists of four, thin metal legs connected to a central mechanism. The orthodontist places the expander against the palate and then uses the mechanism to extend the legs firmly against the back of the teeth on both sides of the jaw.
The outward pressure exerted by the legs also widens the seam between the two palatal bones. The body will respond to this by adding new bone to the existing palatal bones to fill in the widened gap. At regular intervals, the patient or a caregiver will operate the mechanism with a key that will continue to widen the gap between the bones, causing more expansion of the palatal bones until the jaw has grown to a normal width.
The palatal expander is most effective when it's applied early enough to develop more bone before the seam closes. That's why it's important for children to undergo bite evaluation with an orthodontist around age 6. If it appears a bite problem is developing, early interventions like a palatal expander could slow or stop it before it gets worse.
If you would like more information on interceptive orthodontics, 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 “Palatal Expanders.”
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