Posts for: September, 2014
A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.
Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.
Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.
Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.
In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.
If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.
If you would like more information on loose 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 “Loose Teeth.”
When it comes to dental health, you might say celebrity interior designer and television host Nate Berkus is lucky: Unlike many TV personalities, he didn't need cosmetic dental work to achieve — or maintain — his superstar smile. How did he manage that? Nate credits the preventive dental treatments he received as a youngster.
“I'm grateful for having been given fluoride treatments and sealants as a child. Healthy habits should start at a young age,” he told an interviewer from Dear Doctor magazine. We couldn't have said it better — but let's take a moment and examine exactly what these treatments do.
Fluoride treatment — that is, the topical (surface) application of a concentrated fluoride gel to a child's teeth — is a procedure that's often recommended by pediatric dentists. Although tooth enamel is among the hardest substances in nature, fluoride has been shown to make it more resistant to tooth decay. And that means fewer cavities! Studies show that even if you brush regularly and live in an area with fluoridated water, your child could still benefit from the powerful protection of fluoride treatments given at the dental office.
Another potent defense against cavities is dental sealants. Despite your child's best efforts with the toothbrush, it's still possible for decay bacteria to remain in the “pits and fissures” of the teeth — those areas of the molars, for example, which have tiny serrated ridges and valleys where it's easy for bacteria to grow. Dental sealants fill in and protect vulnerable areas from bacterial attack, greatly decreasing the risk that future dental treatment will be required.
Why not take a tip from our favorite celebrity interior designer, and ask about cavity-preventing treatments for your children's teeth? If you would like more information about fluoride treatments or dental sealants, please contact us for a consultation. You can learn more in the Dear Doctor magazine articles “Topical Fluoride” and “Sealants for Children.”
If you’re apprehensive about visiting the dentist, you’re not alone. Studies show a majority of us — as high as 75% — have experienced some form of anxiety about dental treatment. Between 10% and 15% of those have a high degree of anxiety that may cause them to avoid visiting the dentist altogether.
If you’ve experienced this level of anxiety, you weren’t born with it. Such fears develop from early experiences with dentistry, or from stories or attitudes relayed to us by others. While this undue emotional stress could adversely affect your general health, the greater threat is to your oral health, if it causes you to avoid dental care altogether.
Fortunately, anxiety from the thought of dentistry can be overcome. The best approach is relatively simple — counteract the bad experiences of the past with new, more positive experiences. Moderate dentistry should be able to completely eliminate any discomfort during treatment. And with each new good experience, your feelings and attitudes will gradually change over time for the better.
The first step is to discuss your anxiety about dental care with us. It’s important to establish trust with your care provider from the outset if you want to successfully overcome your anxiety. We will listen and not discount or diminish the reality of your fears and their emotional and physical effect; instead, we will work with you to include overcoming anxiety as a part of your treatment plan.
The next step is to proceed with treatments and procedures you feel you can easily undergo, so that at the end of each visit you’ll have a more positive view of that particular treatment (and that you could undergo it again). We won’t rush to complete treatments until you’re ready for them. Although this may extend the duration needed to complete a procedure, it’s important for us to proceed at a pace more conducive to creating and reinforcing new positive feelings and attitudes about dental visits.
In the end, we want to do more than treat an immediate or emergency-related dental condition. We want to help you overcome the anxiety that has kept you from seeking long-term dental care — and thus better dental health — a part of your life.
If you would like more information on overcoming dental treatment anxiety, 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 “Overcoming Dental Fear & Anxiety.”
Periodontal (gum) disease is a bacterial infection that can eventually lead to tooth loss if not treated. The infection typically arises from plaque, a thin film of bacteria and food particles that build up on tooth surfaces every 8-12 hours and not removed due to poor oral hygiene.
There is always an increased risk of gum disease when a person doesn’t practice effective oral hygiene. But there are certain conditions that could also heighten risk: in particular, women who are pregnant (especially during the first trimester) or taking certain types of birth control pills. During pregnancy, female hormones known as estrogens become elevated, causing changes in the gums’ blood vessels. These changes make the tissues fed by these vessels more susceptible to the effects of bacteria. This increased susceptibility even has a term — “pregnancy gingivitis.”
Gum disease during pregnancy can also affect other areas of a woman’s health, as well as the health of her baby. Recent studies have shown a possible link between pre-term low weight babies and mothers with severe gum disease, especially among those with limited dental healthcare. There’s a stronger link, however, between gum disease and diabetes; in fact, diabetes should be checked for in pregnant women who are diagnosed with gum disease.
If you’re pregnant, it’s especially important that you not neglect oral hygiene. Daily brushing and flossing is essential for removing the bacterial plaque that causes gum disease. You should also visit us for regular checkups and cleanings to remove hard to reach plaque and calculus (hardened deposits), as well as to detect any signs of periodontal disease.
You should also be aware of other factors, and take steps to minimize their effect. Smoking can cause greater plaque accumulation as well as adversely affect your immune system, which can inhibit healing in infected tissues. Stress can also affect your immune system, so be sure you’re getting enough rest.
Gum disease in any individual has the potential to cause great damage to teeth and gums. If you notice any abnormalities, particularly bleeding or swelling gums, you should see us as soon as possible for proper diagnosis. In the case of gum disease, the sooner treatment begins the better the chances of protecting both your health and your baby’s.
If you would like more information on periodontal disease and pregnancy, 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 “Pregnancy & Birth Control.”
When you’re trying to maintain a good oral hygiene routine, your toothbrush is bound to see a lot of action. Day in and day out, it gets used about twice a day, every day — morning and night, whether you’re feeling great or under the weather, in a hurry or not. And it's stored in the bathroom: a moist environment with the potential for exposure to plenty of bacteria (and not just the ones that live in your mouth). So after all of that service, does your toothbrush itself need any particular care or cleaning — and do you need to worry about getting sick from brushing?
Let’s answer the last question first. It’s very unlikely that you can re-infect yourself with an illness (a cold, for example) from using your own toothbrush. That’s because once you’ve been infected, the antibodies that are built up in response to the invading germs will generally prevent you from getting the same disease for some time afterward. Using someone else’s toothbrush, however, is a never a good idea — especially if they are sick (whether they show any symptoms or not), and doubly so if the bristles are still wet. It’s very possible to transfer all kinds of bacteria — even the bacteria that cause tooth decay — from person to person this way.
Can bacteria really survive for any length of time on your toothbrush? The short answer is yes, as they can (and do) live almost everywhere. But for people in a normal state of health, there’s no real reason to worry: Through long exposure, your body is generally quite capable of defending itself from these microorganisms. The American Dental Association states, “[T]here is insufficient clinical evidence to support that bacterial growth on toothbrushes will lead to specific adverse oral or systemic health effects.”
However, if you or a family member have a compromised immune system (due to radiation treatment, chemotherapy or disease, for example), it might make sense to take some precautions. Using an antibacterial mouthrinse before you brush can reduce the amount of bacteria in your mouth — and on your toothbrush. Washing the brush afterward with an antimicrobial cleaner or sanitizer can also decrease the level of bacteria that remains on the toothbrush.
For everyone else, it’s best to follow a few common-sense steps for toothbrush care: Rinse your brush with tap water after you use it, to remove any remaining toothpaste and debris; store it upright, where it can air-dry before it’s used again (not in a closed container, where bacteria can thrive); and get a new brush every three months. Your toothbrush is a major weapon in the fight against tooth decay — keeping it in good shape will help you maintain a healthy mouth and a healthy body.
If you have questions about toothbrushing or oral hygiene care, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine article “Oral Hygiene Behavior.”