Posts for category: Oral Health
While wearing braces is the path to a healthier and more attractive smile, it can be a difficult journey. One of your biggest challenges will be keeping your teeth clean to avoid a higher risk of tooth decay.
Tooth decay starts with dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Daily brushing and flossing clear this accumulation. But the hardware of braces makes it difficult to access all tooth surfaces, and can even become a haven for plaque.
One sign in particular of tooth decay while wearing braces is the appearance of chalk-like spots on the teeth known as white spot lesions (WSLs). WSLs occur because the minerals in the enamel beneath them have begun to break down in response to decay. The spots can eventually cause both structural and cosmetic problems for a tooth.
The best approach to WSLs is to prevent them from developing in the first place. You'll need to be extra vigilant with daily oral hygiene while wearing braces to reduce plaque buildup. To help with the increased difficulty you might consider using a special toothbrush designed to maneuver more closely around orthodontic hardware. You may also find using a water flosser to be a lot easier than flossing thread.
Preventing tooth decay and WSLs also includes what you eat or drink to reduce the effects of enamel de-mineralization. The bacteria that cause decay thrive on sugar, so limit your intake of sweetened foods and beverages. And to avoid excessive demineralization cut back on acidic foods as well.
If despite your best preventive efforts WSLs still form, we can take steps to minimize any damage. For one, we can give your enamel a boost with fluoride applications or other remineralization substances. We can also inject a tooth-colored resin beneath the surface of a WSL that will make it less noticeable.
With any of these and other treatments, though, the sooner we can treat the WSL the better the outcome. Practicing good hygiene and dietary habits, as well as keeping an eye out for any WSL formations, will do the most to protect your new and improved smile.
If you would like more information on preventing dental disease while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.
While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.
To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.
That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.
If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.
These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.
If you would like more information on caring for your child's teeth, 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.”
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.
But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.
Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.
To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.
With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.
You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.
To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.
If you would like more information on caring for your dental restoration, 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 “Oral Hygiene for Fixed Bridgework.”
A toothache means a tooth has a problem, right? Most of the time, yes: the pain comes from a decayed or fractured tooth, or possibly a gum infection causing tooth sensitivity.
Sometimes, though, the pain doesn't originate with your teeth and gums. They're fine and healthy—it's something outside of your tooth causing the pain. We call this referred pain—one part of your body is sending or referring pain to another part, in this instance around your mouth.
There are various conditions that can create referred pain in the mouth, and various ways to treat them. That's why you should first find out the cause, which will indicate what treatment course to take.
Here are a few common non-dental causes for tooth pain.
Trigeminal Neuralgia. The trigeminal nerves situated on either side of the face have three large branches that extend throughout the face; the branch to the jaw allows you to feel sensation as you chew. When one of the nerve branches becomes inflamed, usually from a blood vessel or muscle spasm pressing on it, it can refer the pain to the jaw and seem like a toothache.
Temporomandibular Joint Disorder (TMD). These two joints that connect the lower jaw to the skull can sometimes become dysfunctional for a variety of reasons. This can set up a cycle of spasms and pain that can radiate throughout the jaw and its associated muscles. The pain can mimic a toothache, when it actually originates in the jaw joints.
Teeth Grinding. This is an unconscious habit, often occurring at night, in which people clench or grind their teeth together. Although quite common in children who tend to grow out of it, teeth grinding can continue into adulthood. The abnormally high biting forces from this habit can cause chipped, broken or loosened teeth. But it can also cause jaw pain, headaches and tenderness in the mouth that might feel like a toothache.
These and other conditions unrelated to dental disease can seem like a tooth problem, when they're actually something else. By understanding exactly why you're feeling pain, we can then focus on the true problem to bring relief to your life.