Posts for: October, 2013
If you've recently had a dental implant placed, congratulations! You have made a good investment in your smile that should last for a lifetime — if you take proper care of it. This is easy to do with a good oral hygiene routine and regular professional cleanings. Here are some important things to keep in mind about implant care:
- Implants can last as long as teeth. A dental implant made of titanium will fuse to the bone surrounding it and function just like a natural tooth. It is a highly successful method of tooth replacement that succeeds more than 95% of the time.
- Implants and natural teeth attach to surrounding bone and gums very differently. A natural tooth does not actually fuse to the bone that surrounds it. Instead, it is held in place by a periodontal ligament (“peri” – around; “odont” – tooth) made up of tiny fibers that insert into the bone on one side and into the tooth on the other. Farther up, these collagen fibers attach the tooth to the gum tissue. Implants and the crowns that go on top of them are not anchored to the gum in this way. An understanding of this biology is important for maintaining good periodontal health when implants are present. We will go over this with you so can care for your implants correctly.
- Infection is the enemy. Bacterial infection is a concern with both natural teeth and implant-supported teeth. A bacterial biofilm (plaque) builds up daily on implant teeth, just as it does on natural teeth. If it is not regularly cleared away, various oral infections can develop. In the case of natural teeth, this might result in tooth decay, gum disease, and the loss of tooth-supporting bone. Implants can't decay, but they can be threatened by a rapidly progressing infection known as peri-implantits (“peri” – around; implant “itis” – inflammation), which can lead to a well-like or dish-shaped loss of bone around the implant. The implant can become loose as greater amounts of bone is lost.
- Good oral hygiene is as important as ever. Daily removal of bacterial biofilm is key to preventing peri-implantitis. You'll want to make sure you brush your teeth twice daily with a soft brush and fluoride toothpaste, and floss gently at least once per day.
- Your dental hygienist has an important role to play. Professional cleanings here at our dental office are also still as necessary as ever, if not more so. Dental hygienists have special instruments they use to clean areas around your implant that can't be reached by your brush or floss — without scratching the surfaces of your implant components.
From its development and first use over a century ago, radiography — the use of x-rays to view internal images in the body — has revolutionized how dentists diagnose and treat patients. Now, a new technology known as Cone Beam Computing Tomography (CBCT) promises to take us “light years” beyond even today's most modern conventional x-ray devices.
X-rays expose images on special film after passing through a mass, like the human body. Because they pass more easily through soft tissues than through hard structures like teeth or bone, the softer tissues will appear darker. This property can reveal even subtle distinctions in density such as might be the case with a fracture or a tooth cavity.
Standard radiography, though, has its limitations. It takes extensive training and experience for a dentist to interpret exactly what they're seeing in an x-ray. Their two-dimensionality (like a photograph) limits the amount of information we can derive from the physical structures being examined. And due to radiation exposure to patients, we must limit the amount of their use for each individual patient.
CBCT improves on those limitations. The device projects a cone-shaped beam of x-rays as it rotates around a patient's head. During this rotation it records hundreds of images that a computer can later digitally format in a variety of ways. The result: instead of a two-dimensional flat view, we can now three-dimensionally view the mouth from a variety of different angles and in greater detail. Best of all, one scan can provide enough imagery data to view in detail the entire skull or a jaw, or something as minute as a single root canal within a tooth.
CBCT is already improving the accuracy of diagnostics and treatment in a variety of dental specialties, including orthodontics, implantation and oral surgery. And properly set, the radiation exposure is no more or less than a full-mouth series of x-rays, and up to ten times less than CT scanning.
Advances like CBCT increase the range and accuracy of diagnostics and improve treatment for a variety of conditions. As they grow in use, the result will be more successful dental outcomes for you and your family.
If you would like more information on CBCT diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”
If you wince while eating certain foods and beverages, you're not alone — one in three Americans suffer from the pain of tooth sensitivity. Fortunately, there are ways to treat it and reduce the pain.
Dentinal hypersensitivity occurs when dentin loses its protective cover. Dentin, a living tissue within a tooth, is composed of tiny tubules that act as conduits for transmitting sensations from the surface of the tooth to the nerves in the inner pulp. These tubules are protected by cementum, a hard, outer layer that covers the tooth root. But when the root becomes exposed, the cementum is easily stripped from the root. The tubules become more sensitive to sensations of temperature or pressure.
Receding gums are the main culprit for root exposure. This condition can result from periodontal disease, which arises mainly from poor oral hygiene. At the other end of the spectrum, over-aggressive brushing can lead to receding gums. Brushing may also contribute to another source of dentinal hypersensitivity: enamel erosion. The minerals in enamel begin to soften and erode as the acidic level of the mouth rises. Saliva neutralizes the acid and can restore a neutral balance in about thirty minutes to an hour after eating. If you brush before this process completes, you could brush away some of the softened enamel.
To properly treat tooth sensitivity, our first step is to find the cause. If it stems from improper or premature brushing, we can counsel you on proper technique. If periodontal disease is a factor, we would first treat the disease and then work with you on a proper oral hygiene regimen to reduce bacterial plaque, the main cause of the infection.
There are treatments as well to reduce nerve sensitivity and thereby ease the pain. Toothpastes and other mouth products with fluoride help reduce sensitivity, as well as products containing potassium nitrate or potassium citrate. We can also apply a varnish containing a concentrated dose of fluoride directly to tooth surfaces. Another approach is to block the tubules using bonding agents or sealants; this will reduce their capacity to receive and transmit sensations.
If you would like more information on the causes and treatment of tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
When Cat Cora is not doing battle as the first female chef on the Food Network's hit series Iron Chef America, she is busy caring for the needs of her four active young sons. This includes monitoring the food they eat and their oral hygiene habits.
The busy chef, restaurateur, author, philanthropist and television personality recently revealed in an interview with Dear Doctor magazine that it all started when her four sons were little. She got rid of bottles and sippy cups as soon as possible to prevent tooth decay. She also started exposing her boys to a wide variety of spices and foods when they were infants — for example, by putting cinnamon in their baby cereal. Cat limits the amount of sugar in their diet by using fruit puree in baked goods and BBQ sauces, or the natural sugar substitute Stevia. Furthermore, Cat reports, “my kids have never had fast food.”
Cat is right on target with her approach to her children's oral health. In fact, we are often asked, when is the right time to schedule a child's first dental appointment? Our answer surprises some people — especially those expecting their first child.
The ideal time to take your child to the dentist is around age 1. Why so young? A baby's first visit to the dentist sets the stage for lifelong oral health. Besides, tooth decay can start very early. Baby Bottle Tooth Decay (BBTD), as the name suggests, impacts children who often go to sleep sipping a bottle filled with a liquid containing natural or added sugars, such as formula, fruit juice or a fruity drink mix. Another condition, Early Childhood Caries (ECC), is often found in children who continuously use sippy cups (again, filled with sugary liquids), children who breast feed at will throughout the night, children who use a sweetened pacifier, and children who regularly take sugar-based oral medicine to treat chronic illness.
To learn more about this topic, continue reading the Dear Doctor magazine article “Age One Dental Visit.” Or you can contact us today to schedule an appointment. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”
You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.
This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.
We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.
Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.
The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.
Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.
If you would like more information on the various causes of tooth pain, 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 “Confusing Tooth Pain.”