Let's say you have a diseased tooth you think might be on its last leg. It might be possible to save it, perhaps with a significant investment of time and money. On the other hand, you could have it replaced with a life-like dental implant.
That seems like a no-brainer, especially since implants are as close as we have to natural teeth. But you might want to take a second look at salvaging your tooth—as wonderful as implants are, they can't beat the real thing.
Our teeth, gums and jaws form an intricate oral system: Each part supports the others for optimum function and health. Rescuing a troubled tooth could be the best way to preserve that function, and replacing it, even with a dental implant, a less satisfying option.
How we save it will depend on what's threatening it, like advanced tooth decay. Caused by bacterial acid that creates a cavity in enamel and underlying dentin, decay can quickly spread into the tooth's pulp and root canals, and eventually threaten the supporting bone.
We may be able to stop decay and save the tooth with a root canal treatment. During this procedure, we remove diseased tissue from the pulp and root canals through a drilled access hole, and then fill the empty spaces. We then seal the access and later crown the tooth to protect it against future infection.
A second common threat is periodontal (gum) disease. Bacteria in dental plaque infect the outer gums and, like tooth decay, the infection quickly spreads deeper into the root and bone. The disease weakens gum attachments to affected teeth, hastening their demise.
To treat gum disease, we manually remove built-up plaque and tartar (hardened plaque). This deprives the infecting bacteria of their primary food source and “starves” the infection. Depending on the disease's advancement, this might take several cleaning sessions and possible gum surgery to access deep pockets of infection around the root.
Because both of these treatment modalities can be quite in-depth, we'll need to assess the survivability of the tooth. The tooth could be too far gone and not worth the effort and expense to save it. If there is a reasonable chance, though, a rescue attempt for your troubled tooth might be the right option.
If you would like more information on whether to save or replace a tooth, 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 “Save a Tooth or Get an Implant?”
During this year's National Public Health Week in April, health issues like vaping and the opioid crisis are taking a back seat to what is front and center on everyone's mind: the novel coronavirus (COVID-19). This highly contagious viral infection is upending business as usual for most of the world in a way unlike anything we've experienced. Nothing is “normal” right now, including dental care.
As with other aspects of daily life, you can expect disruptions in dental care because of COVID-19, especially involving routine visits. But with that said, we're working hard to ensure your teeth and gums aren't overlooked during this global crisis. We are here for you, so please call us for any questions you may have, and especially if you are experiencing dental pain.
If you do need to visit the dentist for treatment, you might be concerned about potentially exposing yourself or others to COVID-19. Like every business that interacts with the public and especially all healthcare providers, dental offices are implementing extra precautions during this time to protect both patients and staff against infection.
This isn't something new: The dental profession as a whole has strict protocols for preventing infection that have been in place for several years. Infection control is a top priority for dentists at all times, not just during outbreaks like COVID-19. Here are some of the things we do—and are expanding because of the novel coronavirus—to keep you safe during dental appointments.
Barrier protection. Dental providers routinely use disposable items like gloves, face masks or eyewear to prevent disease spread during procedures that involve close contact with patients. For extra precautions with COVID-19, we're adding more of this type of barrier protection.
Sterilization and waste disposal. Instruments and equipment that we use repeatedly are thoroughly sterilized to remove all microorganisms, including coronavirus, from their surfaces. For disposable items used during treatment, we keep these separate from common waste and dispose of them according to strict protocols for handling bio-medical waste.
Disinfection. Even though the main pathway for spreading COVID-19 is through respiratory droplets in the air, we're continually disinfecting office and treatment surfaces that the virus might potentially contaminate. In doing so, we're using substances recommended by the U.S. Centers for Disease Control (CDC). By the way, you can find a list of such products at //www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf.
These are uncertain times for all of us. But while we're cooperating with social distancing and other measures to slow the spread of COVID-19, we're still here partnering with you to keep your family's teeth and gums healthy.
If you would like more information about special dental precautions during this time, don't hesitate to contact us. To learn more, read the Dear Doctor magazine article “Infection Control in the Dental Office.”
Oral cancer is one of the more dangerous malignancies people face. But there are ways you can reduce your risk of this deadly disease through changes in lifestyle habits and behaviors.
Two of the better known behaviors for increased oral cancer risk are immoderate consumption of alcohol and the use of tobacco, particularly chewing tobacco and snuff. Eliminating these, especially the latter, can vastly improve your odds of avoiding cancer. Another factor is a strain of the human papilloma virus (HPV 16) that's transmitted sexually, which you can avoid through safe sex practices.
In addition to these lifestyle changes, there's one more you should make to lower your oral cancer risk: adjustments to your diet. Research over the last half century has provided ample evidence of a link between the foods we eat and our risk of all types of cancers, including oral.
The biggest concern is over certain elements in some foods that can damage DNA, the molecular “operating instructions” that regulate the formation and function of our bodies' cells. These elements are collectively known as carcinogens because of their role in cancer formation.
An example of a carcinogen is a group of chemicals called nitrosamines. These form during preservation processes using nitrites in meats like bacon or ham. They're also found in beer or certain preserved fish. To limit your consumption of nitrosamines, you should reduce these and other processed products and replace them with fresh fruits and vegetables, or organic meats and dairy products.
Our DNA can also be damaged by unstable molecules called free radicals that arise during normal cellular function. But there are also substances known as antioxidants that help protect the cells from free radical damage. Many plant-based foods contain nutrients like vitamins C and E that have antioxidant properties, so including them in your diet could help reduce your oral cancer risk.
Several clinical studies over the years have been consistent in their findings that a diet rich in fresh fruits and vegetables can reduce the risk of oral or throat cancers, as well as other forms of cancer. Making changes to your diet in that direction, plus other lifestyle changes, could help you avoid this devastating oral disease.
If you would like more information on preventing oral cancer, 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 “Diet and Prevention of Oral Cancer.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
Because the mouth is one of the most sensitive areas of the body, we go to great lengths to eliminate pain and discomfort associated with dental work. Anesthesia, both local and general, can achieve this during the actual procedure—but what about afterward while you’re recuperating?
While a few procedures may require prescription opioids or steroids to manage discomfort after a procedure, most patients need only a mild over-the-counter (OTC) pain reliever. There are several brands available from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like aspirin or ibuprofen work by blocking the release of prostaglandins into the body, which cause inflammation in tissues that have been damaged or injured.
Unlike their stronger counterparts, NSAIDs have fewer side-effects, cost less and aren’t addictive. And unlike opioids NSAIDs don’t impair consciousness, meaning patients can usually resume normal activities more quickly.
But although they’re less dangerous than opioids or steroids, NSAIDs can cause problems if taken at too strong a dose for too long. Its major side effect is interference with the blood’s clotting mechanism, known as “thinning the blood.” If a NSAID is used over a period of weeks, this effect could trigger excessive external and internal bleeding, as well as damage the stomach lining leading to ulcers. Ibuprofen in particular can damage the kidneys over a period of time.
To minimize this risk, adults should take no more than 2400 milligrams of a NSAID daily (less for children) and only for a short period of time unless directed otherwise by a physician. For most patients, a single, 400 milligram dose of ibuprofen can safely and effectively relieve moderate to severe discomfort for about 5 hours.
Some patients should avoid taking a NSAID: pregnant women, those with a history of stomach or intestinal bleeding, or heart disease (especially if following a daily low dose aspirin regimen). If you have any of these conditions or similar concerns, be sure you discuss this with your dentist before your procedure for an alternative method for pain management.
If you would like more information on managing discomfort after dental procedures, 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 “Treating Pain with Ibuprofen.”
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