While we often associate tooth decay with cavities forming in a tooth’s visible or biting surfaces, the occurrence of this all too common disease isn’t limited to those areas. Cavities can develop in any part of a tooth exposed to bacteria.
Gum recession, the shrinking back of the gums from the teeth, can cause such exposure in areas normally covered by the gums. Because these areas are usually more vulnerable to infection when exposed, cavities can develop at or right below the gum line. Because of their location it can be difficult to fill them or perform other treatments.
One way to make it less difficult is to perform a crown lengthening procedure. While the term sounds like we’re increasing the size of the tooth, we’re actually surgically altering the gums to access more of the affected tooth surface for treatment. It’s typically performed in a dental office with local anesthesia by a general dentist or a periodontist, a specialist in the gums.
During the procedure, the dentist starts by making small incisions in the gums to create a tissue “flap” that can be lifted out of the way. This exposes the underlying bone, which they then reshape to support the gum tissue once it’s re-situated in its new position. The dentist then sutures the gums back in place. Once the gums heal, the decayed area is ready for treatment.
Crown lengthening is also useful for other situations besides treating cavities. If a tooth has broken off at the gum line, for example, there may not be enough remaining structure to support a crown. Crown lengthening can make more of the underlying tooth available for the crown to “grab” onto. It’s also useful in some cases of “gummy smiles,” in which too much of the gum tissue is visible in proportion to the tooth size.
Because crown lengthening often involves removing some of the bone and is thus irreversible, you should discuss this procedure with your dentist in depth beforehand. It could be, though, this minor procedure might make it easier to preserve your teeth and even make them look more attractive.
When you're first startled awake in the middle of the night by a loud, gritting sound emanating from your child's room, you may have two questions: how can such a loud racket not be harmful to their teeth? And, how can they sleep through it?
While it sounds earth-shattering, teeth grinding (medically known as bruxism) is a common habit among children. It involves an involuntary grinding, clenching or rubbing of the teeth together, either during the day or during night sleep.
While certain medications or conditions could be factors, it's believed most teeth grinding arises from the immaturity of the part of the neuromuscular system that controls chewing. It's believed to trigger a night episode as the child moves from deeper to lighter stages of sleep toward waking. Older children and adults typically handle these sudden shifts without incident, but a young child's under-developed chewing response may react with grinding.
If a child's teeth are normal and healthy, teeth-grinding typically won't create any lasting damage. But because grinding does generate pressures greater than the teeth normally encounter, it can be harmful to decayed teeth or those with enamel erosion due to high acid from consumption of sports and soda drinks. And it's also a cause for concern if the habit continues into later childhood or adolescence.
To avoid these problems, it's best to keep your child's teeth as healthy as possible by practicing daily brushing and flossing, and regularly seeing a dentist for cleanings, treatments and preventive measures like topical fluoride or sealants. And be sure to limit sugar and acidic foods and drinks in their diet to protect against decay and erosion.
You can also take steps to minimize teeth grinding and its effects. Consult with your physician about any medications they're taking that might contribute to the habit. If there are psychological issues at play, seek therapy to help your child better manage their stress. Your dentist can also fashion a custom night guard worn while they sleep that will prevent their teeth from making solid contact during grinding episodes.
Most importantly, let your dentist know if your child grinds their teeth. Keeping an eye on this potentially harmful habit will help lead to appropriate actions when the time comes.
If you would like more information on teeth grinding, 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 Children Grind Their Teeth: Is the Habit of 'Bruxism' Harmful?”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
There are instances when a general dentist will remove (extract) a problem tooth. At other times, though, the same dentist may refer a patient needing an extraction to an oral surgeon. Why the difference?
The procedure performed by a general dentist is referred to as a “simple tooth extraction.” “Simple” doesn’t mean easy and requiring no skill or expertise — it certainly does. In this case, the term refers to the anatomy of the tooth being extracted, particularly its roots.
Teeth that respond well in a simple extraction have an uncomplicated root system. The path of removal, usually with a single root involved, is fairly straight and without extreme angles. In the hands of a skilled and experienced dentist, it can be removed with little to no discomfort.
Dentists actually must use finesse to remove a tooth from its socket. The tooth is held in place with tiny collagen fibers that extend from a tough, elastic gum tissue known as the periodontal ligament, which lies between the teeth and the bone. With some manipulation, a dentist can loosen these fibers, which then makes removing the tooth much easier. All of this can usually be performed with local anesthesia.
Of course, to determine if a tooth can be removed this way, we must conduct a thorough dental examination first, including x-ray imaging to determine the exact nature and location of the roots. If the exam reveals the root system is more complex, or that there are defects to the bone or the tooth that could make a simple extraction difficult (resulting, for example, in not removing the crown and root in one piece), then the tooth may need to be removed surgically.
Such situations require the skill and resources of an oral surgeon. These specialists perform a number of surgical procedures related to the mouth and face; as procedures go, extraction is among the most routine. Using local anesthesia and post-operative pain management, undergoing a surgical extraction involves only minimal discomfort and a very short recovery time.
After examining your tooth we’ll recommend the best course for extraction, whether simple or surgical. In either case, we’ll see that your problem tooth is extracted as efficiently and painlessly as possible.
If you would like more information on tooth extractions, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?”
The arrival of spring often serves as inspiration to clean house and create an environment that’s bright and fresh. Here at the dental office, we can do the same for your mouth as well! Having clean teeth, healthy gums and fresh breath helps you look and feel your best. Here are some ways we can help you freshen up your smile:
Dental Exam. The best place to start is with a dental exam. Finding and treating tooth decay in its earliest stages will help you avoid more costly and invasive dental treatments later on. It could even save a tooth that might otherwise be lost! Plus, oral cancer screenings are important for everyone—even young, non-smokers. Regular dental exams also give you a chance to bring up any issues you may be concerned about, and to ask for pointers on hygiene.
Professional Cleaning. Having a good oral hygiene routine at home goes a long way towards keeping your mouth healthy. But routine professional cleanings are still very important. Your dental hygienist uses specially designed tools to reach into places where your brush and floss can’t, and remove disease-causing dental plaque and tartar. A polishing provides the finishing touch for a squeaky-clean feeling.
Teeth Whitening. Teeth tend to get duller with age; that’s why teeth whitening treatments can give you a more youthful appearance. Bleaching your teeth is safest when supervised by a dental professional. We recommend two methods: either a professional treatment at the dental office, or a take-home kit we can provide, which includes custom-fitted bleaching trays. The first way will give you the fastest results, while the second is more economical.
Smile Makeover. Sometimes whitening alone is not enough to fix what’s keeping you from flashing a big, bright smile. For example, maybe your teeth aren’t straight, or they have been worn down over the years. Perhaps a tooth is chipped or is missing entirely. Or maybe there are multiple cosmetic issues. If this is the case, we can help you figure out what’s really bothering you about your teeth and how you can achieve the smile of your dreams.
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