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Posts for category: Dental Procedures

PracticeDailyHygienetoAvoidGumSwellingWhileWearingBraces

Straightening your smile doesn't happen overnight—it can involve months or even years of orthodontic treatment. And although the end result is well worth it, the long process can make it difficult to keep your gums healthy, especially while wearing braces.

Gum swelling in particular is a common problem for braces wearers with two potential sources. First, orthodontic hardware makes it difficult to keep teeth clean of dental plaque, a thin bacterial film that can cause gum disease. Plaque and its hardened counterpart tartar can trigger a gum infection, which in turn triggers inflammation. As a result, affected gums appear swollen and red, and can easily bleed.

Gum tissues may also react to braces pressing against them and develop hypertrophy (or hyperplasia), an increase in individual tissue cell growth. If this overgrowth occurs, it may not get resolved until after your braces have been removed.

As long as the hypertrophy doesn't appear to have weakened gum attachment with the teeth, it's usually not a big concern. But what is a concern is that hypertrophy could increase a braces wearer's difficulties with oral hygiene and give rise to a true gum infection that could endanger dental attachment. Advanced cases could require surgical correction or removal of the braces altogether to adequately treat the infection.

The best way to avoid a worst case scenario is to be as diligent as possible with daily brushing and flossing. Fortunately, there are several tools that can make it easier with braces. Interproximal brushes, tiny brushes that can fit into the narrow spaces between the teeth and the braces, can be used in conjunction with your regular toothbrush.

Flossing is also easier if you use a floss threader or a water flosser. The latter utilizes a pump to emit a pulsating jet of water to break loose plaque between teeth and flush it away. Clinical studies have shown the effectiveness of water flossers for removing plaque in braces wearers as opposed to not flossing at all.

A faithful daily hygiene practice and twice-a-year cleanings and checkups with your regular dentist can help minimize your chances of gum swelling. Doing so will help ensure you'll complete your orthodontic treatment on the way to healthier and more attractive smile.

If you would like more information on teeth and gum care while wearing braces, 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 “Gum Swelling During Orthodontics.”

CrazyLittleThingCalledHyperdontia

The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.

The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.

Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces).┬áSome people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.

Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.

After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.

Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.

If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”

YouMayNeedanEndodontistforaToothWithInteriorDecay

You depend on your family dentist for most of your oral care. There are some situations, though, that are best handled by a specialist. If you or a family member has a deeply decayed tooth, for example, it might be in your long-term interest to see an endodontist.

From the Greek words, endo ("within") and odont ("tooth"), endodontics focuses on dental care involving a tooth's interior layers, including the pulp, root canals and roots. While general dentists can treat many endodontic problems, an endodontist has the advanced equipment and techniques to handle more complex cases.

The majority of an endodontist's work involves teeth inwardly affected by tooth decay. The infection has moved beyond the initial cavity created in the enamel and dentin layers and advanced into the pulp and root canals. The roots and underlying bone are in danger of infection, which can endanger the tooth's survival.

The most common treatment is root canal therapy, in which all of the infected tissue is removed from the pulp and root canals. Afterward, the empty spaces are filled and the tooth is sealed and crowned to prevent future infection. General dentists can perform this treatment, primarily with teeth having a single root and less intricate root canal networks. But teeth with multiple roots are a more challenging root canal procedure.

Teeth with multiple roots may have several root canals needing treatment, many of which can be quite small. An endodontist uses a surgical microscope and other specialized equipment, as well as advanced techniques, to ensure all of these inner passageways are disinfected and filled. Additionally, an endodontist is often preferred for previously root-canaled teeth that have been re-infected or conditions that can't be addressed by a traditional root canal procedure.

While your dentist may refer you to an endodontist for a problem tooth, you don't have to wait. You can make an appointment if you think your condition warrants it. Check out the American Association of Endodontists webpage www.aae.org/find for a list of endodontists in your area.

Advanced tooth decay can put your dental health at risk. But an endodontist might be the best choice to overcome that threat and save your tooth.

If you would like more information on endodontic dentistry, 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 an Endodontist?

AnOrthodonticRetainerInsuranceWellSpentforKeepingYourNewSmile

You’ve invested a lot of time and money in orthodontic treatment to improve your smile. If you’re not careful, though, your teeth could actually move back to their old positions. The reason why is related to the same natural tooth-moving mechanism we use to straighten teeth in the first place.

Teeth are held in place by an elastic, fibrous tissue called the periodontal ligament lying between the teeth and the jawbone and attaching to both with tiny collagen fibers. The periodontal ligament allows for incremental tooth movement in response to pressure generated around the teeth, as when we chew (or while wearing braces).

Unfortunately, this process can work in reverse. Out of a kind of “muscle memory,” the teeth can revert to the older positions once there’s no more pressure from the removed braces. You could eventually be right back where you started.

To avoid this, we have to employ measures to hold or “retain” the teeth in their new positions for some time after the braces come off. That’s why we have you wear a dental appliance called a retainer, which maintains tooth position to prevent a relapse. Depending on what’s best for your situation, this could be a removable retainer or one that’s fixed to the teeth.

Patients typically wear a retainer around the clock in the immediate period after braces, and then eventually taper off to just nighttime wear. Younger patients must wear one for several months until the new teeth positions become more secure and the chances of a rebound diminish. For older patients who’ve matured past the jaw development stage, though, wearing a retainer may be a permanent necessity to protect their smile.

Retainer wear can be an annoyance, but it’s an absolute necessity. Think of it as insurance on your investment in a new, more attractive smile.

If you would like more information on improving your smile through 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 Importance of Orthodontic Retainers.”

ARootCanalTreatmentWillImproveYourHealthNotHarmIt

If you’ve ever read online that root canal therapy causes cancer, don’t be alarmed—it doesn’t. What it does do is save a deeply decayed tooth that might otherwise be lost.

Tooth decay is caused by acid produced by bacteria, which dissolves enamel to create a hole or cavity. But it doesn’t stop there: decay can move on to infect the tooth’s innermost layer, the pulp filled with nerves and blood vessels. Unchecked, the resulting infection can travel through the root canals to eventually infect the bone.

A root canal treatment stops the infection before it goes this far. After administering a local anesthetic, we drill a small hole into the tooth to access the pulp chamber and root canals. We then remove all the diseased tissue, disinfect the space and then place a filling within the empty chamber and root canals to prevent further infection. We then seal the access hole and later crown the tooth to further protect and stabilize it.

It’s no exaggeration, then, to say that root canal treatments have saved millions of teeth. So, for all its beneficial effect, why is it considered by some to pose a health danger?

The germ for this notion comes from the early 20th Century when a dentist named Weston Price theorized that leaving a “dead” organ in place would harm the body. Since a root-canaled tooth with the pulp’s living tissue removed is technically no longer viable, it fit the category of “dead” tissue. Thus, according to this theory, maladies like cancer could arise because of the “dead” tooth.

Unfortunately, this theory has found a somewhat new life recently on the internet, even though it was thoroughly investigated and debunked in the 1950s. And as late as 2013, a study published in a journal of the American Medical Association found no increased cancer risk after root canal treatment, and even some evidence for a reduced risk.

So, if your dentist recommends root canal treatment, rest assured it’s needed to save your tooth. Rather than harm your health, it will improve it.

If you would like more information on root canal treatment, 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 Canal Safety.”