We can do a great many things to preserve diseased teeth, from filling cavities to crowning damaged but still viable teeth to protect them and restore their attractiveness. But there may come a point where continued treatment just isn't worth it, and it may be time to remove and replace your troubled teeth.
Dental implants have become the premier restoration for missing teeth. But they have some anatomical limitations and may not work for some situations like excessive bone loss or close nerve proximity. And while a removable partial denture is a solid option, perhaps you'd rather have a fixed solution.
You might then want to consider a fixed bridge to replace one or more missing teeth. This tried and true option has been a mainstay in dentistry for several decades; and while implants may have surpassed them in popularity, they're still available and effective as a restorative option.
A traditional fixed bridge is composed of three or more life-like crowns that are fused together like pickets in a fence. The crown or crowns in the middle fill the empty tooth space; the outside crowns fit over and are bonded to the natural teeth on either side of the empty space to support the bridge. These natural teeth must be reduced in size to accommodate the crowns to fit over them.
Depending on how many teeth are missing, fixed bridges can be a more affordable alternative to dental implants and can achieve life-like results in both form and dental function. But the alterations required for the supporting teeth are permanent and can weaken them. The interface between the natural teeth and the bridge crowns has a higher risk of decay and periodontal disease, so you'll need to be extra vigilant with daily hygiene and regular dental cleanings and checkups.
And even though implants can be more expensive in the short-term, they typically have better durability and less maintenance costs than other restorations. Over the long-term, an implant restoration might actually incur less cost than a fixed bridge.
Still, a fixed bridge can be an effective way to replace missing teeth. Depending on your finances and your overall dental health, a bridge could help you regain an attractive smile.
If you would like more information on options for replacing missing 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 “Crowns & Bridgework.”
Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.
Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!
Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?
The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.
Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.
Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.
Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
If you're the principal caregiver for an older person, you may have already faced age-related health challenges with them. Good preventive care, however, can ease the impact of health problems. This is especially true for their teeth and gums: with your support you're loved one can have fewer dental problems and enjoy better health overall.
Here are a number of things you should focus on to protect an older person's dental health.
Hygiene difficulties. With increased risk of arthritis and similar joint problems, older people may find brushing and flossing more difficult. You can help by modifying their toothbrush handles with a tennis ball or bicycle grip for an easier hold, or switch them to an electric toothbrush. A water flosser, a device that uses a pressurized water spray to remove plaque, may also be easier for them to use than thread flossing.
Dry mouth. Xerostomia, chronic dry mouth, is more prevalent among older populations. Dry mouth can cause more than discomfort—with less acid-neutralizing saliva available in the mouth, the risk for dental diseases like tooth decay or periodontal (gum) disease can soar. To improve their saliva flow, talk with their doctors about alternative medications that cause less dry mouth; and encourage your loved one to drink more water and use products that help boost saliva flow.
Dentures. If your older person wears dentures, be sure these appliances are being cleaned and maintained daily to maximize their function and reduce disease-causing bacteria. You should also have their dentures fit-tested regularly—chronic jawbone loss, something dentures can't prevent, can loosen denture fit over time. Their dentures may need to be relined or eventually replaced to ensure continuing proper fit and function.
Osteoporosis. This common disease in older people weakens bone structure. It's often treated with bisphosphonates, a class of drugs that while slowing the effects of osteoporosis can cause complications after certain dental procedures. It's a good idea, then, for an older person to undergo any needed dental work before they go on osteoporosis medication.
Keep alert also for any signs of dental disease like unusual spots on the teeth or swollen or bleeding gums. Visiting the dentist for these and regular dental cleanings, checkups and oral cancer screenings could prevent many teeth and gum problems.
If you would like more information on senior dental care, 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 “Aging & Dental Health.”
Children's permanent teeth normally erupt over several years after first forming below the gum line. All their permanent teeth should come in by the time they reach early adolescence.
Unfortunately, this process doesn't always happen as it should. If the erupting teeth become crowded due to a poor bite (malocclusion), teeth still to come in may not have enough room to fully erupt. They become impacted, a condition in which the visible crown remains partially or completely submerged below the gum line.
Impacted teeth create consequences for other teeth and dental health overall. They more readily cause abscesses (a localized infection within the gum tissue) and can damage the roots of nearby teeth. Impacted front canine (eye) teeth can interfere with bite function and their visual absence mars an otherwise attractive smile.
If your child's canine teeth have failed to erupt properly, there is a way to help them fully come in if you act before their mouth structure fully matures. The first step is an orthodontic evaluation of their entire bite. This will determine if there's enough space to move other teeth to make room for the impacted canines.
If so, we would then find the exact position of the impacted teeth using x-rays and possibly cone beam CT scanning for a detailed three-dimensional image. The teeth could be in a variety of positions, such as angled toward the roof of the mouth or cheek or buried high in the jawbone. If the teeth are too far out of position the best course of action may be to remove them and replace them later with a dental implant.
If the impacted teeth, though, are in a feasible position for retrieval, we first expose each tooth through the gums with a minor surgical procedure and bond a small bracket to it. We then attach a small gold chain to the bracket that loops over an orthodontic appliance attached to other teeth. The appliance will exert pressure over several months to pull the tooth into proper position.
If successful, your child will gain the use of these important teeth and a more attractive appearance. But don't delay — this desired outcome will become much harder if not impossible to attain as their teeth and jaws continue to develop.
If you would like more information on treating impacted 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 “Exposing Impacted Canines.”
Brushing and flossing your teeth provides a lot of benefits, including a brighter smile and fresher breath. But the primary benefit—and ultimate goal—is removing dental plaque. This biofilm of bacteria and food remnants on tooth and gum surfaces is the number one cause for dental disease.
Brushing and flossing can effectively keep plaque under control. Unfortunately, plaque can be a stubborn foe, hiding in areas easily missed if you're not thorough enough.
So how do you know you're doing a good job brushing and flossing? One quick way is to use your tongue or dental floss to feel for any grittiness, a possible sign of remaining plaque. Ultimately, your dentist or hygienist can give you the best evaluation of your hygiene efforts during your three or six-month checkup.
But there's another way to find out more definitively how well you're removing plaque in between dental visits: a plaque disclosing agent. These over-the-counter products contain a dye solution that stains plaque so it stands out from clean tooth surfaces.
A disclosing agent, which can come in the form of tablets, swabs or a liquid, is easy to use. After brushing and flossing, you apply the agent according to the product's directions. The dye reacts with plaque to stain it a distinct color. You may also find products with two-tone dyes that stain older and newer plaque different colors to better gauge your overall effectiveness.
You then examine your teeth in the bathroom mirror, looking especially for patterns of missed plaque. For example, if you see dyed plaque running along the gum line, you'll know you need to concentrate your hygiene there.
After observing what you can do to improve your future efforts, you can then brush and floss your teeth to remove as much of the dyed plaque as you can. The staining from the dye is temporary and any remaining will fade over a few hours.
Using a disclosing agent regularly could help you improve your overall hygiene technique and reduce your risk of disease. Ask your dentist for recommendations on products.
If you would like more information on improving your oral hygiene, 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 “Plaque Disclosing Agents.”
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