Posts for category: Dental Procedures
As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.
Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb). It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.
It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.
We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.
Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.
At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.
If you would like more information on diagnosing and treating 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: An Unusual Phenomenon.”
Untreated tooth decay can destroy your teeth; prompt action as soon as its diagnosed will help prevent that undesirable outcome. And even if decay has advanced into the tooth's pulp and root canals, there's still a good chance we can stop it with a root canal treatment. Using this procedure, we can clean out the infection and refill the tooth's interior space with a special filling to protect it from further infection.
Although root canal treatments have gained an unwarranted reputation for pain, they rarely cause even the mildest discomfort. More importantly, they work, which is why they're the go-to treatment dentists use for advanced decay.
But sometimes a unique dental situation might make performing a root canal extremely difficult—possibly even doing more harm than good. For example, trying to access the interior of a tooth with a crown restoration might require removing the crown, which could further weaken or damage the tooth. In other cases, the root canals might have become calcified due to trauma or aging and become too narrow to access.
Even so, we may still be able to save a tooth through a minor surgical procedure called an apicoectomy. Rather than access the diseased area through the tooth crown as with a root canal treatment, an apicoectomy makes access to the infected tissue at the root end.
An apicoectomy also differs from a root canal treatment in that we'll need to surgically go through the gum tissue. After numbing the area with a local anesthetic, we'll make a small incision through the gums at the level of the infection. After removing any infected tissue, we would then fill the space with a small filling to prevent re-infection. We then close the incised gum tissues with sutures and allow them to heal.
With the help of fiber optic lighting and surgical microscopes, endodontists (specialists in interior tooth problems) can perform an apicoectomy quickly and with very little trauma at the surgical sight. If you undergo an apicoectomy, you should be back to normal activity in a day or two at the most. And like its sister procedure the root canal, an apicoectomy could help preserve your teeth for many years to come.
If you would like more information on this and other treatments for tooth decay, 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
A toothache might mean you have tooth decay—or maybe not. It could also be a sign of other problems that will take a dental exam to uncover. But we can get some initial clues about the underlying cause from how much it hurts, when and for how long it hurts and where you feel the pain most.
Let's say, for instance, you have a sharp pain while consuming something cold or hot, but only for a second or two. This could indicate isolated tooth decay or a loose filling. But it could also mean your gums have receded and exposed some of the tooth's hypersensitive root surface.
While over-aggressive brushing can be the culprit, gum recession is most often caused by periodontal (gum) disease. Untreated, this bacterial infection triggered by accumulated dental plaque could eventually cause tooth and bone loss, so the sooner it's attended to the better.
On the other hand, if the pain seems to linger after encountering hot or cold foods and liquids, or you have a continuous throbbing pain, you could have advanced tooth decay that's entered the inner pulp where infected tooth nerves are reacting painfully. If so, you may need a root canal treatment to remove the diseased pulp tissue and fill the empty pulp and root canals to prevent further infection.
If you have this kind of pain, see a dentist as soon as possible, even if the pain stops. Cessation of pain may only mean the nerves have died and can no longer transmit pain; the infection, on the other hand, is still active and will continue to advance to the roots and bone.
Tooth pain could also indicate other situations: a cracked tooth, an abscess or even a sinus problem where you're feeling the pain radiating through the teeth. So whatever kind of pain you're feeling, it's your body's alarm signal that something's wrong. Promptly seeing your dentist is the best course of action for preserving your health.
If you would like more information on treating tooth pain, 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 “Tooth Pain? Don't Wait!”
As a member of the best-selling pop group Spice Girls, Mel C (AKA Sporty Spice) enjoyed her share of musical superstardom. At the band’s peak in the Nineties, the young singer’s signature look featured baggy sweatpants, an assortment of tattoos, a nose stud and a gold-capped incisor, front and center in her mouth. Today, Melanie Chisholm is still singing — but now she’s a mom, an amateur triathlete… and that gold tooth is just a memory. Not only that, her smile looks more evenly spaced and whiter than it did when she was referred to as the “tomboy” of the group.
What happened? In our view, it all boils down to changing tastes — plus a little bit of help from dental professionals. As the “wannabe” singer proves, there’s no single standard when it comes to making your teeth look their best. Your own look is unique to you — and your smile can reflect that individuality.
For example, crowns (caps) are substantial coverings that may be placed on teeth when they are being restored. They are available in three types: gold, all-porcelain, or porcelain-fused-to-metal. The latter two are tooth-colored, while the gold is — well, shiny like gold bling. Which one is right for you? In many cases, it’s your choice.
Likewise, dental veneers — wafer-thin shells that can correct cosmetic issues by covering the surface of your teeth — can be made in a variety of shades. Their hues may range from natural ivory to Hollywood white, and everything in between. What’s the best color for you? Only you can say.
Some people opt for a “smile makeover” that uses small irregularities in the spacing and color of teeth to create a more “natural” look. Other folks want a perfectly even, brilliant white smile that dazzles the eye. Still others are looking to match or restore the smile they once had — perhaps even re-creating a signature gap between the teeth. As long as there are no other dental issues involved, the choice is yours.
So if you’re unhappy with your smile — or if you feel it doesn’t reflect the person you “wannabe” — why not talk to us about a smile makeover? Just call our office to schedule a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”