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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.”
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
When planning for your new smile, we look at more than the condition of individual teeth. We also step back for the bigger “bite” picture: how do the teeth look and interact with each other?
If we have a normal bite, our teeth are aligned symmetrically with each other. This not only looks aesthetically pleasing with the rest of the face, it also contributes to good function when we chew food. A bad bite (malocclusion) disrupts this mouth-to-face symmetry, impairs chewing and makes hygiene and disease prevention much more difficult.
That's where orthodontics, the dental specialty for moving teeth, can work wonders. With today's advanced techniques, we can correct even the most complex malocclusions — and at any age. Even if your teen years are well behind you, repairing a bad bite can improve both your smile and your dental health.
The most common approach, of course, is braces. They consist of metal or plastic brackets bonded to the outside face of the teeth with a thin metal wire laced through them. The wire attaches to an anchorage point, the back teeth or one created with other appliances, and placed under tension or pressure. The gradual increasing of tension or pressure on the teeth will move them over time.
Â Braces are versatile and quite effective, but they can be restrictive and highly noticeable. Many people, especially older adults, feel embarrassed to wear them. There is an alternative: clear aligners. These are a series of clear, plastic trays that you wear in sequence, a couple of weeks for each tray. When you change to the next tray in the series, it will be slightly different than its predecessor. As the trays change shape guided by computer-enhanced modeling, the teeth gradually move.
If you're interested in having a poor bite corrected, the first step is a comprehensive orthodontic examination. This looks closely at not only teeth position, but also jaw function and overall oral and general health.
With that we can help you decide if orthodontics is right for you. If so, we'll formulate a treatment plan that can transform your smile and boost your dental health.
If you would like more information on the cosmetic and health benefits of 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 “The Magic of Orthodontics.”
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
Anybody can contract periodontal (gum) disease if they don't brush and floss every day. Inadequate hygiene allows a thin film of disease-causing bacteria and food particles called plaque to build up.
But while we're all at risk for gum disease, some people are more so. This is especially true for those with diabetes, heart disease or other systemic conditions. The common denominator among all these conditions is inflammation, the body's defensive response to disease or injury.
When tissues become infected or damaged, the body causes swelling at the site to isolate the affected tissues, clear out diseased or dead cells and start tissue repair. Inflammation also produces redness, pain and, particularly with gum tissues, bleeding.
Inflammation is an important part of the body's ability to heal itself. It's possible, though, for the inflammatory response to become chronic. If that happens, it can actually begin doing more harm than good.
We're learning that chronic inflammation is a factor in many systemic diseases. For example, it can interfere with wound healing and other issues associated with diabetes. It also contributes to fatty deposit buildup in arterial blood vessels, which can lead to heart attacks or strokes. And in gum disease, chronic inflammation can cause gum detachment, followed by bone and tooth loss.
We're also learning that inflammation can create connections between these various health conditions. If you have an inflammatory disease like heart disease or diabetes, your risk for gum disease not only increases but it may also be difficult to bring under control. Likewise, if you have persistent gum disease, the associated inflammation could aggravate or even increase your risk for other systemic diseases.
Researchers hope continued discoveries about the interrelationship of inflammation with various conditions will lead to better treatment strategies, including for gum disease. In the meantime, getting prompt treatment for any inflammatory condition, especially gum disease, could help your treatment prospects with other conditions.
If you would like more information on connections between dental disease and other health conditions, 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 “The Link between Heart & Gum Diseases.”
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