Archeologists can tell us quite a bit about our primitive ancestors. For example, because of their coarse, abrasive diet and a primitive understanding of oral hygiene, their teeth had a rough go of it. They simply wore out faster — a contributing factor, no doubt, to their short life spans of thirty or forty years.
But thanks to improvements in lifestyle, healthcare and diet, people live much longer today. And so do their teeth, thanks to advances in dental care and disease prevention. While teeth still wear to some degree as we age, if we care for them properly with daily oral hygiene and regular dental visits, we can keep that wear to a minimum. Teeth truly can last a lifetime.
Unfortunately, it's still all too common for people to lose their teeth prematurely. The main reason: the two most prevalent dental diseases, tooth decay and periodontal (gum) disease. Tooth decay arises from high concentrations of mouth acid that erode enamel, teeth's irreplaceable protective shell. Gum disease is an infection that damages the bone supporting tissues as it infiltrates deep below the visible gum line.
While they occur by different mechanisms, the two diseases have some commonalities. They both, of course, can lead to tooth loss. And, they're both triggered by oral bacteria found in dental plaque, a thin film of food particles built up on tooth and gum surfaces. Multiplying bacteria feed on plaque and produce acid as a by-product. And certain bacterial strains infect gum tissues.
Both of these diseases can be treated successfully, especially if detected early. But the better approach is to prevent them in the first place. This introduces another commonality — they share the same prevention strategy of daily, comprehensive brushing and flossing for plaque removal, regular dental cleanings and checkups, and a sharp eye for any signs of disease like bleeding gums or tooth pain.
With diligent dental care and close attention to your oral health, you increase your chances of avoiding the full threat of these diseases.Â And with healthy teeth, you have a better chance of living a long and healthy life.
If you would like more information on minimizing tooth wear, 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 “How and Why Teeth Wear.”
Accidents happen, especially to teenagers involved with sports or similar activities. In an instant they can lose one or more teeth and permanently alter their smile.
Fortunately we can restore a teenager’s lost teeth, but often not immediately as a permanent restoration with a dental implant requires maturity of their jaw structure. Our focus then turns to the age of the patient and the condition of the underlying bone. A future dental implant, your best choice for tooth replacement, depends on bone for support, but also the age of the patient as it relates to jaw development.
There are a couple of ways an accidental tooth loss can harm supporting bone: first and foremost, the impact of the accident itself can damage the bony socket. To find out for sure we may need to perform a cone beam scan, a type of x-ray that allows us to view the area three-dimensionally. If we do find damage, we can attempt to repair the socket through bone grafting.
Bone can also suffer from the long-term absence of a tooth. Bone has a growth cycle in which older cells dissolve and new ones form to take their place. The force generated by teeth when we eat or chew helps stimulate this growth. Without stimulation, as with a missing tooth, the bone may not grow at a healthy rate. In time, it could lose some of its volume and density and not be able to support an implant.
Installing an implant right after tooth loss could help avoid this situation. Bone has a natural affinity with the titanium post imbedded in the jaw and will naturally grow and adhere to it. But we can’t place an implant with a teenager. This is because the jaw is still developing so an implant would gradually become misaligned as the jaw grows. It’s best to install an implant later after full jaw development in early adulthood.
Today, we can place a bone graft in the empty socket right after tooth loss. The graft serves as a scaffold for bone cells to grow on and will help keep the bone volume at a healthy level until we can install an implant.
Timing is everything in restoring a teenager’s accidental tooth loss. But with coordination and care for the supporting bone, a teenager can eventually enter their adult years with their smile intact.
If you would like more information on restoring your teenager’s smile after tooth loss, 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 “Dental Implants for Teenagers.”
Do-it-yourself (DIY) whitening kits are a popular option for restoring a healthy shine to stained and dulled teeth. They're relatively safe and generally live up to their packaging claims.
But a home kit might not always be your best option. Here are 4 reasons why DIY whitening might not be right for you.
You're on the early side of your teen years. Tooth whitening at home is quite popular with teenagers. For older teens it doesn't really pose a dental risk as long as you use the product appropriately (more on that in a moment). However, the immature enamel of younger teens' permanent teeth is still developing and can be vulnerable to damage by whitening processes.
You don't follow instructions well. Not to say you have this particular character quirk — but if you do you may run into trouble with DIY whitening. Home kits are safe if you follow their instructions carefully. If you use them to excess as one 13-year old boy was reported to have done, you could severely (and permanently) erode your teeth's protective enamel.
Your teeth are in need of dental work. Tooth whitening can't fix everything that may be contributing to an unattractive smile. It's always better to have issues like dental disease or chipped teeth addressed first before whitening. And, if your tooth discoloration originates from inside your tooth, a whitening kit won't help — they're only designed for staining on the enamel's outside surface. You'll need a special dental procedure to whiten internal (or intrinsic) tooth staining.
You want to control the amount of brightness. Home kits don't have the level of fine-tuning that a clinical procedure can achieve. While the bleaching agent in a professional whitening solution is much stronger than a home kit, your dentist is trained in techniques that can vary the amount of bleaching, from a softer white to dazzling “Hollywood” bright. And clinical whitening usually takes fewer sessions and may last longer than a home kit.
If you're interested in teeth whitening, see your dentist for a dental examination first before purchasing a DIY kit. Even if you decide to do it yourself, your dentist can give you buying advice for whitening kits, as well as how-to tips.
If you would like more information on tooth whitening, 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 Whitening Safety Tips.”
“To gain something, sometimes you have to give up something else.”
No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.
In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.
Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).
Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.
We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.
As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.
The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.
If you would like more information on correcting a poor bite, 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 Removal for Orthodontic Reasons.”
All eyes were on Boston Celtics point guard Isaiah Thomas in Game 1 of the second-round NBA Playoff series against the Washington Wizards — and not just because he scored a game-high of 33 points! Even more dramatic was the moment his jaw collided with an opponent’s elbow, sending one of his front teeth flying out of his mouth and onto the floor.
Press reports said the Celtics’ team physician attempted to reinsert the tooth, but it didn’t remain in place when Thomas resumed playing the game. Over the next several days, he reportedly underwent a total of ten hours of oral surgery, and was fitted with a four-piece temporary bridge. A statement from the team noted that Thomas suffered “a complete fractured tooth and two other subluxed/shifted teeth… [He] will receive a permanent bridge at a future date.” So what does all that mean?
When we say a tooth is fractured, it means the crown (visible part) of the tooth has broken off from its roots, either above or below the gum line. Depending on the severity of the fracture, it is sometimes possible to save the natural tooth by performing a root canal to prevent bacterial infection, and then placing a crown (cap) on the tooth to restore its appearance and function. In more severe cases, however, the tooth can’t be saved and must be extracted.
Unfortunately, that isn’t Thomas’ only problem. He also has two subluxed teeth — that is, teeth that have shifted from their original position, but haven’t been knocked out of their sockets. Subluxed teeth often result from a severe blow to the mouth, and may be treated by stabilization or splinting. Team officials haven’t said exactly what was done during Thomas’ dental treatment, but it could very well have involved extracting the roots of any teeth that couldn’t be saved, and possibly placing dental implants in his jaw for future tooth restoration.
A dental implant is a small screw-shaped titanium post that is inserted directly into the bone of the upper or lower jaw in a minor surgical procedure. In time, it becomes fused with the bone itself, offering a sturdy anchorage for replacement teeth. One implant can support one replacement crown; two or more implants can support a number of replacement teeth joined together as a unit. This is called a dental bridge.
Bridges can also be supported by adjacent healthy teeth — but first, the outer surfaces of the crown must be prepared (reduced in size), so that the bridge can be attached over the remaining part of the crown. In many instances, implants are preferred because they do not compromise the structure of healthy teeth nearby.
Dental difficulties didn’t end Isaiah Thomas’ season — but an earlier hip injury that became aggravated finally did.Â As unfortunate as this is, maybe now at least the NBA star will have a chance to let those injured teeth heal, and show up next season with a smile that’s as good as new.
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