Posts for: November, 2018
Some things in life look worse than they really are. A condition known as “geographic tongue” is a good example: while it may look serious, it’s not a cause for real concern.
If you’ve never heard of geographic tongue it’s because it’s not a common ailment: it only affects one to three percent of the population. The name comes from patches of redness on the top surface of the tongue surrounded by grayish white borders, which gives the red patches a look similar to land masses on a map.
It’s known formally as “benign migratory glossitis,” which tells us more about the condition: “benign” means the patches aren’t cancerous; “migratory” indicates the patches tend to move and take different shapes along the surface of the tongue. In fact, it’s possible for them to appear, disappear, and then reappear over the course of a few days.
The exact causes of geographic tongue haven’t been fully substantiated. Researchers believe emotional stress, psychological problems or hormonal disturbances (especially women during pregnancy or ovulation) could be triggers for its occurrence. Certain dietary deficiencies like zinc or vitamin B, or acidic foods are also believed to be factors.
While geographic tongue isn’t painful, it can leave your tongue feeling more sensitive with a mild burning or stinging sensation. If you’re prone to having geographic tongue, there are some things you can do to reduce the irritation. Try to avoid eating acidic or spicy foods like tomatoes, citrus fruits or mint, as well as astringent substances like alcohol or certain mouthwashes. We may also prescribe anesthetic mouthrinses, antihistamines or steroid ointments to help ease any discomfort.
The good news, though, is that this harmless condition is more irritating than anything else. With a little care and forethought you won’t even know you have it.
If you would like more information on geographic tongue, 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 “Geographic Tongue.”
Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.
If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.
With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.
Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.
That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).
While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12). And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.
Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.
If you would like more information on caring for primary 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 “Stainless Steel Crowns for Kids.”
Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.
From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.
In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.
The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.
The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.
You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.
If you would like more information on dental implants, 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 “Staging Surgery in Implant Dentistry.”
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.”
There are several reasons why dental implants are so popular. Perhaps the most important, though, is their longevity: if maintained properly implants can last for decades. However, they’re not indestructible—certain mouth conditions could put them at risk for early failure. But if you address emerging problems early, you may be able to prevent that unfortunate outcome.
Your implants may be in danger, for example, if you have a teeth grinding or clenching habit. This occurs when a person involuntarily and repeatedly bites down on their teeth when not chewing or speaking. Usually triggered in adults by high stress, teeth grinding can subject both natural teeth and implants to damaging levels of force. Over time this can cause bone loss around an implant and weaken their support. It could also cause a direct break in an implant.
But there are ways to stop or at least reduce the effects of teeth grinding. One effective way is a custom-made bite guard you wear while you sleep. Made of hard plastic, the guard prevents the teeth from making solid contact with each other, reducing the amount of force generated.
A more prominent problem is periodontal (gum) disease, a bacterial infection caused by built-up dental plaque on tooth surfaces. This can trigger inflammation, a normal defensive response that when it persists for an extended period of time can damage tissues and supporting bone. It can also cause a specific form of gum disease related to implants called peri-implantitis, in which the tissues that support an implant become infected and weaken, leading eventually to possible implant failure.
If you have implants, then, you should brush and floss daily to prevent gum disease, as well as see your dentist at least every six months for cleanings and checkups. And if you notice anything like reddened, swollen or bleeding gums, see your dentist immediately. The sooner you undergo treatment, the better the outcome for your implants as well as your overall health.
Dental implants can give you years of great service and can prove to be well worth the cost. But you’ll have to stay on your guard against gum disease and other mouth conditions that could endanger them down the road.
If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”