Posts for: January, 2017
Children have a lot of energy that's often channeled through physical activities and sports. Unfortunately, this also increases their risk of injuries, particularly to their teeth.
Injuries to the mouth can endanger permanent teeth's survival. For an older tooth, a root canal treatment might be in order. Not so, though, for a pre-adolescent tooth, even if it is permanent.
A young permanent tooth is still developing dentin, the large layer just below the enamel. This growth depends on the connective tissue, blood vessels and nerves within the pulp in the center of the tooth. Because a root canal treatment removes all of this tissue, it could stunt dentin and root growth and endanger the tooth's future.
Instead, we may need to treat it with one of a number of modified versions of a root canal, depending on what we find. If the tooth's pulp is unexposed, for example, we may need only to remove the damaged dentin, while still leaving a barrier of dentin to protect the pulp. We then apply an antibacterial agent to minimize infection and fill in the area where we've removed tooth structure.
If some of the pulp is exposed, we may perform a pulpotomy to remove just the affected pulp and any overgrown tissue. We then place a substance that encourages dentin growth and seal it in with a filling. If we go deeper toward the root end, we might also perform procedures that encourage the remaining pulp to form into a root end to stabilize the tooth.
If the entire pulp has been damaged beyond salvage, we may then turn to a procedure called an apexification. In this case we clean out the pulp chamber; at the root end we place mineral trioxide aggregate (MTA), a growth stimulator that encourages surrounding bone to heal and grow. We then fill in the root canals and chamber with a special filling called gutta percha to seal the tooth.
The deeper we must penetrate into the pulp, the higher the chances the young tooth's dentin and roots won't form properly, leading to later problems and possible loss. But by employing the appropriate one of these methods, we can minimize the risk and give your child's damaged tooth a fighting chance.
If you would like more information on children and dental injuries, 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 “Saving New Permanent Teeth after Injury.”
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods. Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please
You've seen the ads for obtaining a new tooth in one day with a dental implant. Those aren't exaggerated claims — you can leave the dental office the same day with a new tooth that looks and functions like the old one.
But the dramatic marketing aside, there is a bit more to the story. Same day tooth replacement isn't appropriate in every situation. And even when it is, there are risks for failure.
We can minimize those risks, however, by focusing on certain goals during the three distinct phases in the process: removing the natural tooth; placing the metal implant into the jawbone; and affixing the visible, crown.
It's crucial during tooth extraction that we avoid damaging the socket bone that will ultimately support the implant's titanium post. If the socket walls break down it could set up future gum recession or cause us to abort the implant procedure altogether that day.
When placing the implant, we want to focus on achieving a strong hold. Due to its special affinity with titanium, bone cells gradually grow and adhere to the post to firmly anchor the implant in time. But since we're immediately loading a crown rather than allowing the bone to fully integrate first, we need to ensure the implant has a secure hold from the get-go. We can only achieve this with precise placement based on careful examination and planning, as well as adequate bone.
Even so, the implant still needs to integrate with the bone for a lasting hold, and that takes time. Even with normal biting forces the implant risks damage during this integration period. That's why we place a temporary crown a little shorter than the surrounding teeth. Those adjacent teeth will take the brunt of the biting force and not the implant.
Once the bone has fully integrated, we'll replace the temporary crown with a permanent one the proper height proportional to the other teeth. Even with the temporary crown, though, you'll still have a life-like tooth the day we removed the older one.
The key to success is planning — first determining if you meet the criteria for a same-day implant and then mapping out and carefully executing each succeeding step. Doing this will ensure your same-day implant is a success from day one.
If you would like more information on same-day tooth replacement, 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 “Same-Day Tooth Replacement with Dental Implants.”
Exchanging passionate kisses with big-screen star Jennifer Lawrence might sound like a dream come true. But according to Liam Hemsworth, her Hunger Games co-star, it could also be a nightmare… because J.Law’s breath wasn’t always fresh. “Anytime I had to kiss Jennifer was pretty uncomfortable,” Hemsworth said on The Tonight Show.
Lawrence said the problem resulted from her inadvertently consuming tuna or garlic before the lip-locking scenes; fortunately, the two stars were able to share a laugh about it later. But for many people, bad breath is no joke. It can lead to embarrassment and social difficulties — and it occasionally signifies a more serious problem. So what causes bad breath, and what can you do about it?
In 9 out of 10 cases, bad breath originates in the mouth. (In rare situations, it results from a medical issue in another part of the body, such as liver disease or a lung infection.) The foul odors associated with bad breath can be temporarily masked with mouthwash or breath mints — but in order to really control it, we need to find out exactly what’s causing the problem, and address its source.
As Lawrence and Hemsworth found out, some foods and beverages can indeed cause a malodorous mouth. Onions, garlic, alcohol and coffee are deservedly blamed for this. Tobacco products are also big contributors to bad breath — which is one more reason to quit. But fasting isn’t the answer either: stop eating for long enough and another set of foul-smelling substances will be released. Your best bet is to stay well hydrated and snack on crisp, fresh foods like celery, apples or parsley.
And speaking of hydration (or the lack of it): Mouth dryness and reduced salivary flow during the nighttime hours is what causes “morning breath.” Certain health issues and some medications can also cause “dry mouth,” or xerostomia. Drinking plenty of water can encourage the production of healthy saliva — but if that’s not enough, tell us about it: We may recommend switching medications (if possible), chewing xylitol gum or using a saliva substitute.
Finally, maintaining excellent oral hygiene is a great way to avoid bad breath. The goal of oral hygiene is to control the harmful bacteria that live in your mouth. These microorganisms can cause gum disease, tooth decay, and bad breath — so keeping them in check is good for your overall oral health. Remember to brush twice and floss once daily, stay away from sugary foods and beverages, and visit the dental office regularly for checkups and professional cleanings.
So did J.Law apologize for the malodorous makeout session? Not exactly. “[For] Bradley Cooper, Christian Bale, yeah, I’ll brush my teeth,” she laughed.
Hemsworth jokingly agreed: “If I was kissing Christian Bale I probably would have brushed my teeth too. With you, it’s like, ‘Eh. Whatever.’”
If you would like more information about bad breath and oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Bad Breath: More than Just Embarrassing.”