If you’ve ever had a child with a cavity that needed to be filled, you’re probably asked “Why? Isn’t that tooth going to fall out anyway?” This is a wonderful question that most parents have asked to their child’s dentist. While baby teeth are made to eventually fall out, they also play an important role in the development of the permanent tooth forming underneath.
Baby teeth act as a placeholder for the tooth underneath. When a tooth is lost prematurely, the adjacent teeth can shift into the space, making it too small for the underlying tooth to erupt into. This causes crowding or impacted teeth requiring orthodontic intervention to correct. In some cases where the tooth is decayed too badly and must be extracted, a temporary space maintainer should be put in place.
Because baby teeth are less dense than permanent teeth, they decay at a much faster pace. Even a small cavity that is not addressed early on can quickly become an abscessed tooth requiring treatment involving the nerve and the placement of a temporary crown in order to retain the tooth. Early intervention allows treatment to be smaller and less expensive.
When decay is left untreated, it can cause the dental infection to spread into the area of the permanent tooth as well as other areas of the body. In rare cases, dental abscesses that are not treated can contribute to other conditions such as pneumonia, endocarditis and abscesses of the brain.
The best way to prevent severe dental problems in your children’s teeth is to have them checked early on and regularly to address any needs. Young children should be seen by a pediatric dentist. The AAPD recommends a dental screening for your child by age 1 or when the first tooth erupts.
It can be a bit overwhelming when you’re trying to select a toothpaste on the oral care isle in the supermarket. Just between brands alone there are options in for different ages of people, flavors, ingredients and extras such as whitening or tartar control. How do you decide which toothpaste is best for you to buy?
Let’s address toothpaste for children first, because that is a much shorter answer. Until children are physically coordinated to rinse and spit any toothpaste out of their mouth, they should stick to fluoride-free training toothpaste. This prevents any internal fluoride absorption that could cause fluorosis of the developing teeth.
If your teeth are sensitive due to teeth whitening or if you have problems with your teeth in regard to staining or heavy tartar buildup, then choose a brand option that offers a paste for one of these needs. Most sensitivity toothpastes reach their full effectiveness within 2 weeks, but must be continually used to benefit. On the other hand, whitening toothpastes can repel heavy stain from coffee or tea, but they can also be increasing the sensitivity of your teeth. Tartar control toothpaste is useful for patients who, even with dedicated oral hygiene, are more prone to developing large amounts of tartar buildup (usually noticeable behind the lower front teeth.)
When it comes down to it, toothpaste is useful in helping the mouth feel fresher and delivering small amounts of fluoride to the tooth surface to prevent decay. When it comes to cleansing action, the real work is up to you and your toothbrush. In general, you can’t go wrong with an ADA approved, fluoridated toothpaste. The rest is just up to your own personal preference.
We’ve all heard that Acid Reflux Disease (GERD) can damage your esophageal tissue, but did you know it could also damage your tooth enamel? While this might not be a surprise at first, what is surprising is how abrasive it is when you consider that enamel is the hardest tissue in the entire human body!
The erosion from acid reflux disease typically causes small, pitted areas on the cusps of the back teeth. It can also cause overall erosion of tooth enamel on smooth tooth surfaces as well. When left untreated, erosion may be so severe that it causes complications with existing dental treatment like fillings or crowns. Not only does the acidity damage the teeth, but it can also make appliances such as braces have difficulty adhering to the tooth. Acid erosion can also occur in patients that suffer from eating disorders such as bulimia, due to the constant purging that exposes the front teeth to stomach acids.
When you allow your medical practitioner to help you manage your acid reflux condition it benefits all of your body. Whether it is by an altered diet, prescription medication, or even GI surgery, preventing acid erosion to your gastrointestinal tract is much more important than you may think. Simply covering up your reflux symptoms with over the counter medication does not correct the problem it just hides it.
While you work with your medical professional to address the needs of your condition, you can protect your teeth by using supplemental fluoride toothpaste or rinses. This allows the fluoride to help add minerals back into damaged tooth enamel, stunting the acid erosion that occurs on a daily basis.
Chances are if you’ve ever stepped foot inside of a dental office, your dentist or hygienist has told you that you should be flossing your teeth. Unfortunately, it’s just one of those things that nobody likes to do. But here’s the thing…your dentist or hygienist doesn’t tell you do floss just for the kicks of it, it really is important. Here’s why:
What is the correct way to floss? Simply snapping the floss up and down between the teeth won’t do it. Instead, wrap the floss tightly around each tooth in a “c” shape. Slide the floss up and down under the gums several times against each tooth. You won’t go too far. This allows for optimal plaque biofilm removal in areas that cause gum disease and tartar buildup.
Most people say they don’t floss because when they do, their gums bleed. The truth is, gums are almost always likely to bleed if you don’t floss, and it may take flossing every day for up to 2 weeks before your gums don’t bleed anymore. This is because of conditions such as gum disease or gingivitis that require time to reverse. Cleaning an infected wound on your arm won’t reduce the swelling or discomfort in a single day.
If you need help flossing, or physically can’t do it, ask your hygienist for help. There are a variety of options and accessories available that she can assist you with! Choices such as water flossers or threaders may be all you need to floss more efficiently.
The area around the teeth and under the detached gum tissue is referred to as a gingival pocket. When chronic gum disease and bone loss are present, these pockets harbor disease bacteria, further complicating the disease condition. In some cases the pocket is so deep that normal brushing and flossing is not even effective. This allows the condition to worsen, and can ultimately lead to tooth loss.
Gum Disease Management
In order to reduce the depth of the pocket, crown lengthening may be performed. Simply put, crown lengthening is removing excess gum tissue from around the tooth, lengthening the appearance of the crown (the part that shows above the gums) and shortening the depth of the gingival pocket. This allows oral hygiene and disease management to be more efficient
As an Aesthetic Procedure
Crown lengthening is also sometimes referred to as gingival recontouring. Recontouring is typically used for aesthetic improvements to reduce the appearance of gummy smiles, or irregularly shaped, uneven gumlines. Sometimes lengthening is a necessary part of smile-makeovers to allow for optimal fabrication of dental porcelain veneers or crowns. It allows more tooth enamel to show, creating a beautiful, even smile. Recontouring is minimally invasive and a relatively short procedure which requires only a small amount of desensitizing to be performed.
In Restorative Therapy
Having enough tooth structure present is important in order to place restorative treatments such as crowns. If a tooth has broken down to the point where there is not enough crown structure left to restore, it may be appropriate to expose a portion of the tooth through crown lengthening. This allows crowns to have a stable foundation in order to withstand normal functions.
Routine dental x-rays allow your dentist and hygienist to evaluate areas that are not visible during a clinical examination. Some things that your dentist looks for on routine x-rays include:
Conditions such as bone loss, tartar buildup and tooth decay may not be visible when looking directly at the teeth. It is important to diagnose these conditions early on so that proactive measures can be taken to prevent the further advances of dental disease. When early care is taken, it enables your dentist to treat the problem while it is still small and inexpensive. Delaying much needed dental care enables the disease condition to progress into something that is more invasive and costly when it comes to corrective care.
When left untreated, some conditions can lead to tooth loss and the complication of other systemic health conditions. Routine x-rays enable your dentist to provide proactive care when conditions first arise. Most dental offices now use digital X-rays which are easier to use and store and can be easily shared with a specialist.
Not all x-rays are the same. Different types of films are taken in order to view different angles of the mouth and teeth, and may not show anatomy that another does.
Below are the most common films taken in a dental office:
Panoramic x-rays – Enable your dentist to evaluate the eruption and formation of the permanent teeth, including wisdom teeth.
Bitewing x-rays – Used primarily to screen for decay and bone loss.
Periapical x-rays – Include the root tip for diagnosis of abscess, or when treating specific teeth.
Occlusal x-rays – Used to evaluate the development of the anterior permanent teeth.
Bad breath is a sensitive subject, but one that many dental patients are concerned with. This is understandable, as it can affect your friendships and professional commitments. 90% of bad breath odor originates on the tongue. Gently brushing the tongue or using a tongue scraper can remove some of these bacteria. Avoid alcohol or peroxide based mouth-rinses that may dry out the mouth or alter the natural flora. Also refrain from the use of mints or sugar containing gums that can contribute to decay.
While there is not one specific answer to address this concern, there are several common causes:
Don’t be afraid to ask your dentist or hygienist about your breath concerns. They will help run through different scenarios to determine what factors may be contributing to the condition, as well as perform a visual inspection for possible causes. If dental disease conditions exist such as decay, periodontal disease or dental abscesses, these will need to be addressed. Sometimes taking a simple over the counter allergy medication can prevent nasal drainage that often causes malodor. Systemic health conditions like diabetes or GERD need to be properly managed with the care of your primary care physician, as underlying factors can affect the health and future of your teeth and gums, regardless of whether or not they contribute to your bad breath. In some cases even prescription drugs can cause malodor.
In many cases, re-vamped oral hygiene is the best answer. Natural remedies such as the use of probiotics, zinc, Xylitol and chlorine dioxide supplements can also help.
Many systemic health conditions affect your teeth, but did you know that your teeth can affect your systemic health conditions? Patients with diabetes may have an increased rate of periodontal disease (also called gum disease) when their blood sugar levels are uncontrolled. Likewise, it is also more difficult for diabetic patients to control their blood sugar levels when their periodontal disease goes untreated.
When periodontal disease progresses or is left untreated, it ultimately leads to the destruction of bone in the mouth, as well as the loss of teeth. In order to effectively treat the oral disease conditions, it is important for diabetic patients to stick to a routine preventive care routine that involves cleanings and disease screening with their dentist or hygienist.
Oral hygiene habits should include flossing or water flossing to effectively remove plaque biofilm that congregates under the gum tissue. When plaque is removed effectively, it prevents the build up of tartar deposits under the gums. Once calcified, tartar can only be removed by your dental hygienist or dentist during a professional cleaning. If tartar forms and is allowed to persist, then the immune system becomes strained as it destroys disease bacteria along with the structural support tissues around the diseased tooth.
Most preventive care appointments are scheduled every 6 months for routine deposit removal. Patients that experience a higher rate of buildup or have active gum disease may be seen more frequently such as every 3 or 4 months. If gum disease is moderate to severe, a deep cleaning may first be needed to assist in the disease reversal process. Dental patients with diabetes have an even bigger reason to be proactive in their preventive dental care.
Tooth sensitivity can make everyday things like tooth brushing or drinking iced tea nearly unbearable. Different types of tooth sensitivity tell you and your dentist different things. While some sensitivity is normal, others may be a red flag for underlying dental problems.
Cold Sensitivity – This symptom is often caused by gum recession, toothbrush abrasion from aggressive brushing, tooth grinding, or teeth whitening.
Sweet – Sensitivity to sweet is typically a classic symptom of tooth decay. If the sensation happens several times, please see your dentist in order to treat the cavity while it is still small.
Hot – When a tooth is sensitive to heat, there is a likely chance that the tooth has had nerve damage or infection requiring root canal therapy.
Pressure – Swelling around the root of the tooth due to trauma, fractures or abscess can cause pain when chewing or pressure is applied to the tooth.
Other factors that contribute to tooth sensitivity include conditions such as an acidic diet, uncontrolled GERD, and fractured teeth. When sensitivity persists, it is important to seek dental care to address the condition as early as possible. Dental treatment often becomes more invasive and costly the longer it is delayed.
When sensitivity is suspect due to products such as whitening toothpastes or whitening gels, most dentists recommend using desensitizing toothpaste such as Sensodyne. Over about two weeks of daily use, these toothpastes help block the pores on the tooth surface that are sensitive to cool food or mechanical action like tooth brushing. Discontinuing the use of desensitizing toothpaste will allow for the symptoms to return. Over the counter fluoride rinses are also helpful.
Recent generations have benefitted greatly from fluoride use as a means to decrease overall decay rates. Fluoride works to reduce dental decay by remineralizing any areas of the tooth that have become decalcified. While many people think of fluoride as being in the water supply or from the dental office, fluoride is also found naturally in some foods. The FDA has approved the use of fluoride for preventive care purposes.
Most over the counter toothpastes contain fluoride. Small children who are unable to rinse or expectorate should use a training toothpaste that is fluoride-free, to prevent excess consumption of the mineral.
Supplemental fluoride treatments may be necessary for people who are at an increased risk for decay. Examples of increased risks include:
In-office fluoride application is usually done with a gel or varnish. Varnish is much thicker and is brushed onto the teeth. The low viscosity increases the contact time and makes it more effective for decay reduction. Most dentists prefer to only apply topical fluoride up to the age of 14 while permanent teeth are still erupting and forming. In some cases at-risk patients may continue to need fluoride applications.
Prescription strength fluoride may be needed for patients with persistent dental decay needs. Only a small pea-sized amount is needed and is applied, usually in the evening, after normal brushing and flossing. It is recommended to not eat or drink for at least 30 minutes after the application. Routine use can greatly decrease the risk of persistent tooth decay.
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