Posts for category: Dental Procedures
Your baby is turning one year old—and it's time for their first dental visit! Both the American Dental Association (ADA) and the American Academy of Pediatrics recommend your child first see the dentist around this milestone birthday.
You'll also have a decision to make: do you see your family dentist or a pediatric dentist? While your family dentist can certainly provide quality care for your child, there are also good reasons to see a dentist who specializes in children and teenagers.
The "fear factor." Children are more likely than adults to be anxious about dental visits. But pediatric dentists are highly trained and experienced in relating to children one on one and in clinical techniques that reduce anxiety. Their offices also tend to be "kid-friendly" with bright colors and motifs that appeal to children. Such an atmosphere can be more appealing to children than the more adult environment of a general dentist's office.
The "development factor." Childhood and adolescence are times of rapid physical growth and development, especially for the teeth, gums and jaw structure. A pediatric dentist has extensive knowledge and expertise in this developmental process. They're especially adept at spotting subtle departures from normal growth, such as the early development of a poor bite. If caught early, intervention for emerging bite problems and similar issues could lessen their impact and treatment cost in the future.
Special needs. The same soothing office environment of a pediatric clinic that appeals to children in general could be especially helpful if your child has special needs like autism or ADHD. Some children may also be at risk for an aggressive and destructive form of tooth decay known as early childhood caries (ECC). Pediatric dentists deal with this more commonly than general dentists and are highly trained to prevent and treat this aggressive form of tooth decay.
Seeing a pediatric dentist isn't a "forever" relationship: Once your child enters early adulthood, their care will continue on with a general dentist. But during those early years of rapid development, a pediatric dentist could give your child the insightful care they need to enjoy optimum dental health the rest of their lives.
If you would like more information on pediatric 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 “Why See a Pediatric Dentist?”
Among dental restorations, implants are the closest prosthetic we have to real teeth. They not only replace the visible crown, but the titanium post imbedded in the jawbone adequately substitutes for the tooth root. Because of their unique design, implants are not only life-like, they’re highly durable and could potentially last for decades.
But while their success rate is remarkably high (more than 95% exceed the ten-year mark), they can fail. Ironically, one possible cause for implant failure is periodontal (gum) disease. Although an implant’s materials are themselves impervious to disease, the tissues and underlying bone that support the implant aren’t. If these natural tissues become infected, the secure hold the implant has can weaken and fail.
A gum infection usually begins with dental plaque, a thin biofilm of bacteria and food particles that builds up on tooth surfaces. Certain strains of bacteria within plaque can infect the gums. One particular form of the disease known as peri-implantitis starts as an initial infection and ensuing inflammation of gum tissues around an implant. The disease can quickly spread down to the bone and destroy the integration between the bone and the implant that helps keep the implant in place.
That’s why it’s important for you to keep the implant and the tissues around it clean of plaque, just as you would the rest of your natural teeth. This requires daily brushing and flossing around the implant and other teeth, and visiting your dentist regularly for more thorough dental cleanings.
You should also be alert to any signs of disease, especially around implants: gum redness, swelling, bleeding or pus formation. Because of the rapidity with which peri-implantitis can spread, you should see your dentist as soon as possible if you notice any of these signs.
Preventing gum disease, and treating it promptly if it occurs, is a key part of implant longevity. Preserving your overall dental health will help make sure your implant doesn’t become a loss statistic.
A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.
Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.
While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.
Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.
There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).
If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.
Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.
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 “Treatment for Loose Teeth.”
Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.
Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.
Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).
But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.
Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.
But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.
Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.
If you would like more information on treating complex bite problems, 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.”
You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?
The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.
Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.
And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.
Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.
Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.
Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.
An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.