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Posts for: October, 2016

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Removing a problem tooth (extraction) is a common dental procedure. But not all extractions are alike — depending on the type of tooth, its location and extenuating circumstances, you may need an oral surgeon to perform it.

Fortunately, that's not always the case. Teeth with straight or cone-shaped roots, like an upper front tooth, have a fairly straight removal path. A general dentist first carefully manipulates the tooth loose from the periodontal ligament fibers that help hold it in place (experienced dentists, in fact, develop a “feel” for this process). Once it's loosened from the fibers it's a simple motion to remove the tooth.

But as mentioned before, a “simple extraction” won't work with every tooth or situation. To find out if it can we'll first need to determine the true shape of the tooth and roots, as well as the condition of the supporting bone. We might find any number of issues during this examination that make a simple extraction problematic.

For example, teeth with multiple roots (especially in back) may have complicated removal paths. If the roots themselves are unhealthy and brittle from previous injury or a root canal treatment, they can fracture into smaller pieces during removal. A tooth could also be impacted — it hasn't fully erupted but remains below the gum surface. It's these types of situations that require surgery to remove the tooth.

During a surgical extraction, the oral surgeon will first numb the area with a local anesthetic, as well as a sedative if you have issues with anxiety. They then perform a surgical procedure appropriate for the situation to remove the tooth. More than likely they'll insert bone grafts before closing the site with stitches to deter bone loss (a common occurrence after losing a tooth).

Afterward, your provider may prescribe antibiotics and an antibacterial mouthrinse to ward off infection. You'll also be given care instructions for the extraction site to keep it clean. Any discomfort should subside in a few days and can be managed effectively with a mild anti-inflammatory drug like ibuprofen or aspirin.

It can be overwhelming having a tooth removed. In your dentist's capable hands, however, the experience will be uneventful.

If you would like more information on tooth extraction, 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 “Simple Tooth Extraction?


WecanMinimizeDiscomfortfromCankerSoreswithafewBasicTreatments

They seemingly pop up out of the blue inside your mouth: tiny sores that are sometimes painful — and always annoying. Then, in about a week to ten days these small, irritating lesions are gone.

They're known as canker sores: the most common break out in the linings of the mouth, including the cheeks, lips, under the tongue or even the back of the throat. Medically known as aphthous ulcers, you'll recognize these round lesions by their yellow-gray center surrounded by a red “halo.”

You might feel a tingling sensation a couple of days before an outbreak. Once they appear they usually last a week to ten days; during that time they can cause discomfort especially while eating or drinking.

We don't know fully what causes canker sores, but it's believed they're related to abnormalities in the immune system, the processes in the body that fight infection and disease. High stress or anxiety and certain acidic or spicy foods like citrus fruit or tomato sauce also seem to trigger them.

Most people experience canker sores that range in intensity from slight discomfort to sometimes severe pain. But about 20-25% of people, mostly women, have an acute form known as recurrent aphthous stomatitis (RAS). Thought to be hereditary, RAS produces clusters of ulcers that are almost always painful, and which come and go on a regular basis.

Our main treatment goal with canker sores is to decrease discomfort while the outbreak runs its course and promote rapid healing. There are over-the-counter ointments that often prove effective. For more resistant symptoms we can also prescribe topical or injectable steroids or other medications.

Canker sores are rarely concerning as a significant health issue. You should, however, take an outbreak seriously if it hasn't healed within two weeks, if the outbreaks seem to be increasing in frequency or severity, or you're never without a sore in your mouth. In these cases, we may need to take a tissue sample of the lesion to biopsy for signs of cancer, pre-cancer or some other skin disease.

More than likely, though, the canker sore will be benign albeit annoying. With effective treatment, though, you can get through the outbreak with only a minimal amount of discomfort.

If you would like more information on treating canker sores, 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 “Mouth Sores.”


4BigBenefitsforBeginningEarlyDentalVisitsforYourChild

Your child's dental health is just as important as any other aspect of their physical development. That's why we recommend beginning regular dental visits around their first birthday.

Besides getting them used to and comfortable with visiting the dentist, there are other solid reasons for starting this habit by age one. Here are 4 benefits for regular early childhood dental visits.

Disease prevention. Children's teeth are just as susceptible to tooth decay as adults. Even primary (baby) teeth need protection so they can fulfill their role as guides for incoming permanent teeth. Besides monitoring and treatment for decay, we can also perform measures to protect teeth (especially in children at high risk) through topical fluoride applications or sealants.

Bite development. We can get early clues that a child's teeth are not erupting properly and are on the way to developing a poor bite (malocclusion). If so, we can initiate measures to lessen the impact of a developing malocclusion, like installing spacers to help guide an erupting permanent tooth. Early intervention can lessen the extent and cost of later orthodontic treatment.

Accident prevention. Disease isn't the only danger your child's teeth and mouth face. Even young toddlers can suffer mouth injuries falling onto furniture while playing or learning to walk. And the risk doesn't diminish as they get older, especially if they're active in sports. We can advise you on accident prevention tips and help fashion a custom mouth guard for that budding athlete in your family.

Caregiver assistance. The most important aspect of children's dental care is what happens every day at home. We can serve as your dental “coaches” to help you get on the right track with daily brushing and flossing, as well as give you helpful tips on good dietary habits that promote nutrition and deter dental disease. We'll also help you work through other childhood issues like teething, thumb sucking or teeth grinding.

Think of us as your partners when it comes to your child's dental care. We'll do our part, and help you do your part too.

If you would like more information on children's preventive care, please contact us or schedule an appointment for a consultation.


By Phil Hart, DDS
October 03, 2016
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”


DontletGumDisease-theOtherDentalDisease-RobyouofYourSmile

There's a lot of emphasis — well-placed, of course — on preventing and treating tooth decay. But there's another dental disease just as dangerous to your oral health and nearly half of U.S. adults have it. It's actually a group of diseases known collectively as periodontal (gum) disease.

Gum disease is similar to tooth decay in one respect: they're both triggered by bacteria. These microorganisms thrive in a thin film of food particles called plaque that collects on tooth surfaces.

Certain bacteria can infect gum tissues and trigger inflammation, a response from the body's immune system to fight it. As the battle rages, bone loss can occur and the gums weaken and begin to detach from the teeth. Without treatment, you could eventually lose affected teeth.

Like tooth decay, the best approach with gum disease is to prevent it, and by using the same techniques of daily brushing and flossing. These actions loosen and remove plaque built up since your last brushing. It's also important you visit us at least twice a year for cleanings that remove hard to reach plaque and calculus (hardened plaque deposits).

If despite your best efforts you do contract gum disease, the sooner you see us for treatment the lower the long-term impact on your health. The treatment aim is the same as your daily hygiene: to remove plaque and calculus. We use specialized hand instruments or ultrasound equipment to mechanically remove plaque; more advanced cases may require the skills of a periodontist who specializes in caring for structures like the gums that support teeth.

So, defend yourself against gum disease by brushing and flossing daily, and visiting us regularly for dental cleanings and checkups. If you notice bleeding, swollen or painful gums, see us as soon as possible for diagnosis and treatment. Don't let tooth decay's evil twin ruin your oral health or your smile.

If you would like more information on the prevention and treatment of gum disease, 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 “When to See a Periodontist.”