Our primary aim as dentists is to preserve teeth. There are times, however, when preserving a tooth is no longer worth the effort and we must recommend removing it. Fortunately, extracted teeth can be replaced with a functional and attractive restoration.
Today's top tooth-replacement option is the dental implant. Composed of a titanium metal post imbedded into the jawbone, a single dental implant can replace an individual tooth or a series of implants can support other restorations for multiple teeth. Besides being incredibly life-like, dental implants are highly durable and can last for decades.
But dental implants aren't an optimal choice for everyone. Their cost often matches their status as the premier tooth replacement method. And because they require a minimum amount of bone for proper implantation, they're not always feasible for patients with extensive bone loss.
But even if dental implants aren't right for you, and you want a fixed restoration rather than dentures, you still have options. What's more, they've been around for decades!
One is a bonded crown, which works particularly well for a tooth excessively damaged by decay, excessive wear or fractures. After removing all of the damaged portions and shaping the remaining tooth, we cement a life-like crown, custom created for that particular tooth, over the remaining structure.
Besides improving appearance, a crown also protects the tooth and restores its function. One thing to remember, though, is although the crown itself is impervious to disease, the remainder of the natural tooth isn't. It's important then to brush and floss around crowned teeth like any other tooth and see a dentist regularly for cleanings.
Dental bridges are a fixed solution for extracted teeth. It's composed of prosthetic teeth to replace those missing bonded together with supporting crowns on both ends. These crowned teeth are known as abutments, and, depending on how many teeth are being replaced, we may need to increase the number of abutments to support the bridge.
Although durable, crowns or bridges typically don't match the longevity of an implant. And, implants don't require the permanent alteration of support teeth as is necessary with a bridge. But when the choice of implants isn't on the table, these traditional restorations can be an effective dental solution.
If you would like more information on crown or bridge restorations, 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 “Crowns & Bridgework.”
For some, the excitement over their braces coming off gets dampened a bit with the prospect of now having to wear a retainer. But it has to be—newly realigned teeth have a tendency to revert to their previous positions out of a kind of “muscle memory.” A retainer prevents that from happening.
But as essential as it is, the standard retainer is almost as noticeable as braces, a major reason why many patients are less than enthusiastic about wearing them. And, because it's common for them to become lost when out of the mouth, replacing one becomes an added expense.
But there's another option—the bonded retainer. This retainer consists of a metal wire bonded to the back of the teeth to prevent them from moving. Because it's fixed in place, only a dentist can remove it.
The bonded retainer addresses the previous two issues associated with a removable retainer. Because it's behind the teeth rather than in front, it's out of sight to others. And, because it's fixed in place, there's no danger of losing it.
But unlike its removable cousin, which can be taken out for oral hygiene, the bonded retainer can make flossing more difficult. And, by nature, a bonded retainer must be worn all the time; a removable retainer allows for a more flexible schedule later in the treatment of a few hours a day.
So, which retainer option is best for you or another family member? A bonded retainer may be more attractive for appearance's sake, if it must be worn indefinitely, or if there's a high probability of the teeth moving out of alignment. And, it might be the right choice where there's a concern about a patient's ability to keep up with a removable retainer.
If you do decide to go with a bonded retainer, ask your dental hygienist for training on using floss with the fixed appliance—this can help improve oral hygiene. Whatever you choose, bonded or removable, your retainer will help you keep that new, beautiful, straightened smile.
If you would like more information on orthodontic retainers, 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 “Bonded Retainers.”
During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.
With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”
That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.
Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.
Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.
Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.
But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.
This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.
Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.
Preventing tooth decay from developing in your child's teeth requires a strong commitment to daily oral hygiene. But if you have a child with a chronic physical or behavioral condition, you might find it difficult to keep that commitment in the light of other pressing health needs.
But tooth decay is just as important a health issue as the others with which you may contend. Because primary teeth guide incoming permanent teeth to erupt properly, losing them prematurely can lead to a poor bite and other associated problems. This could further diminish their quality of life already compromised by their chronic condition.
Helping your special needs child avoid tooth decay isn't easy—but it can be done. Here's how!
Brush and floss for them. Normally, a parent's goal is to help their children learn to care for their teeth on their own. But depending on the nature of your child's chronic disease, that may not be possible. Instead, you may need to take an active role in their daily hygiene for the foreseeable future, even brushing and flossing for them if necessary.
Model proper dental care. Even so, it's still a good idea to guide them toward performing oral hygiene tasks without assistance, according to their abilities. This could be a long road, though, one that requires your active participation. You can ease this process by continuously modeling good dental care behavior for them through brushing and flossing together.
See an understanding dentist. Although caring for a special needs child can be isolating, you don't have to go at it alone. That includes taking care of their teeth and gums: A dentist who has both training and experience in treating children with chronic health conditions can become an important partner in your efforts to fight tooth decay.
Communicate between all care providers. Likewise, having everyone involved in your child's care on the same page can make decay prevention a much easier process. Be sure then to share your concerns about your child's needs, including dental care, with attending physicians, therapists and, of course, dentists.
If you would like more information on dental care for special needs children, 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 “Managing Tooth Decay in Children With Chronic Diseases.”
The red and puffy gums that sometimes accompany the onset of periodontal (gum) disease don't always catch your attention. You may not even get any symptoms at all, in fact, until the disease has become well advanced.
That's why regular dental visits are so important for gum health: For while you may not notice anything abnormal about your gums, we have a simple procedure known as periodontal probing that can help diagnose the condition of your gums.
Gum disease is a common bacterial infection that affects millions of people worldwide. It most often begins with plaque, a filmy, bacterial buildup on teeth. These bacteria feed and multiply on the remnant food particles in the film, increasing the chances for an infection.
As it grows—as well as the inflammation the body initiates to fight it—the infection weakens the gum attachment to teeth. This can cause the miniscule gap between gums and teeth at the gum line to widen, forming a void called a periodontal pocket. The deeper and wider the pocket, the more advanced the gum infection.
We may be able to verify the presence of a periodontal pocket by using a long, thin probing instrument with millimeter gradations. We gently insert the probe at various locations around a tooth as far as it will comfortably go. We then record the depth by reading the gradation measures lined up with the top of the gums, as well as observing how snug or loose the probe feels within the gum space.
One to three millimeters signifies a healthy attachment between the tooth and gums—anything more than that usually indicates gum disease. Measurements of 5mm indicates a problem, the higher the number, the more advanced is the periodontal disease.
We use these probe readings and other factors to guide our treatment approach in individual cases of gum disease. With a less-advanced infection we may only need to remove plaque and calculus adhering to the crown and just below the gum line. More advanced gum disease infecting the root area may require surgical access through the gums.
All in all, keeping up with regular dental visits can increase the chances of early diagnosis, when the disease is still in its initial stages. And daily oral hygiene to remove harmful plaque may help you avoid gum disease altogether.
If you would like more information on treating gum disease, 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 “Understanding Periodontal Pockets.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.