What If? Wednesday

Space Maintainers

If your child's bite becomes irregular from early tooth loss, an option is available to ensure proper tooth formation in the future. Space maintainers are a valuable investment in the success of your child's oral health for years to come.

Why are baby teeth important?

Normally, as a permanent tooth comes in under a baby tooth, the roots of the baby tooth dissolve away, and the permanent tooth replaces the baby tooth. In addition to being important for chewing, the baby tooth holds the adjacent teeth in place. When a baby tooth is lost early, due to decay or injury, the adjacent teeth may drift together, causing loss of space in the dental arch.

Placing a space maintainer

When a baby tooth is lost early, this shifting and loss of arch space can be prevented by placing a space maintainer. It generally takes two appointments to complete a space maintainer. During the first appointment, an orthodontic band is carefully placed and an impression is taken. A model of the child’s mouth is made from this impression so that the dental laboratory can form the space maintainer to the exact contours of the mouth. During the next appointment, the space maintainer is tried in, adjusted if necessary, and then cemented in place.

Caring for a space maintainer

Space maintainers are used until the permanent teeth begin to break through the gums. While wearing a space maintainer, it is important to avoid chewing gum, sticky candies, and hard foods like nuts or ice. Following up with periodic checks of the space maintainer here in our office will make sure it’s still functioning properly and keeping all the teeth in their proper position.

What If? Wednesdays

If you think you have a soft spot in a tooth, or an area that is sensitive to hot/cold or sweet foods - you may have a cavity. Only your dentist can make this diagnosis, but follow the guide below to help you determine if your increased pain and sensitivity are the result of a cavity or something else.

What are cavities?

Plaque, a sticky film of food and bacteria that is constantly forming on your teeth, is the culprit when it comes to tooth decay. Bacteria that naturally exist in plaque break down the starches and sugars in the food you eat. A chemical reaction occurs, and as a result, an acid is produced. Like all acids , the acid produced in your mouth is corrosive, which means that it dissolves other materials. Your teeth are the victims of this corrosive action. The acid dissolves their protective outer enamel layer, eventually creating holes in your teeth, also known as cavities.

Regular checkups are a must

Cavities first form in the hard, protective enamel layer of your teeth. Beneath the enamel is a softer layer called dentin. If a cavity wears through the enamel and reached the dentin, it can grow much more quickly and threaten the inner layer of the tooth, containing its nerves and blood vessels. This part of your tooth is called the pulp chamber.

If the decay is allowed to penetrate the enamel and dentin gets into the pulp chamber, it’s likely that we’ll need to perform root canal treatment. That’s why regular checkups and professional cleanings are so important. They allow us to restore your tooth while the cavity is still small and confined to the outer enamel layer.

Diagnosing cavities

Sometimes, we can detect cavities just by looking at your teeth, but to find cavities in their early stages when they are very small, we use a dental explorer and x-rays. A dental explorer finds cavities on the surfaces of your teeth, and the explorer catches or sticks in the tiny pits created by cavities. X-rays locate cavities between teeth where the explorer can’t reach.

Repairing and preventing cavities

To repair a tooth with a cavity, we usually remove the decayed portion of the tooth and replace it with a filling, provided the damage is not extensive and there is still plenty of healthy tooth structure remaining. However, preventing tooth decay in the first place is the preferred solution. We’ll be happy to work with you, so you’ll learn to keep your teeth free of plaque and decay.

What If? Wednesdays: Failing Resin Fillings

What if my filling fails?

Fillings eventually fail. A common misconception is that a filling will last forever. Composite resin fillings are durable, but they eventually will fail and need to be replaced. We consider a filling to be failing when it no longer seals out bacteria and allows them to infect the inner layers of the tooth.

Replacing a failing resin filling with a new restoration can prevent more decay form developing and keep your mouth healthy.

What causes a resin filling to fail?

Resin fillings have to endure an incredible amount of biting force. Over time, they become worn, and their edges can wear away.

In a few cases, the resin material may shrink after it’s placed. This can open a space where the filling meets the tooth, allowing bacteria into the tooth. The shrinkage can also force the filling to pull on tooth structure as the resin shrinks, stressing the tooth.

Replacing the filling

When we discover a failing resin filling, it’s important to replace it with another restoration as soon as possible to protect your tooth. There are several types of restorations, including fillings, inlays, onlays and crowns, and these can be fabricated from a variety of different materials. After doing a thorough exam, we’ll recommend the best restoration for your situation.

What If? Wednesdays

Whatif my child's front tooth breaks?

Repairing a Broken Front Tooth

It can be traumatic when your child breaks a front tooth, but today a broken tooth can be restored to nearly new condition, function and appearance, thanks to new bonding techniques and materials.

Bonding is the artistic placement of a tooth-colored plastic material to restore a misshapen, discolored, or broken tooth. Bonding is a flexible and adaptable means for repairing teeth, as it can restore the appearance and function of one tooth or a number of teeth. And the effects are not merely cosmetic. Bonding protects your child’s teeth from additional wear and damage.

The procedure

Bonding is usually a single-appointment procedure. The first step is the careful selection of the color and type of tooth-colored bonding material, called composite resin, to match the color of your child’s teeth. Next, we lightly reduce the tooth with a dental handpiece, and a conditioning solution is applied to roughen the tooth surface and ensure that the resin will bond to it. Then, we apply the bonding material, sculpt and contour it to the proper shape, and then harden it with a harmless, high-intensity light. Lastly, we smooth and polish the new restoration to a high luster.

What are the alternatives?

Broken front teeth are a common problem among children. They can be unsightly, and may have a negative impact on your child’s self-esteem. The problems don’t end there; a broken tooth may be more susceptible to fractures and decay. Alternative treatments include crowns and veneers, but bonding conserves a maximum amount of tooth structure while providing a terrific-looking result.

What If? Wednesdays

What if my teeth are sensitive?

Tooth sensitivity is a common problem among many different types of people. Fortunately, this is a treatable and manageable condition with proper attention and thorough homecare.

Sensitive Teeth

The reasons to treat sensitive teeth

One of the most common problems in dentistry is sensitive teeth. If you have sensitive teeth, you may feel discomfort when they are exposed to cold air, hot or cold food and beverages, or sweets. Left untreated, tooth sensitivity can have far-reaching effects. Sometimes it stops people from properly brushing and flossing. This can lead to more sensitivity, decay, infection, and even loss of teeth and jawbone. With proper treatment and care, your sensitive teeth can once again be healthy and comfortable.

The causes of sensitive teeth

There are many possible causes, including improper stresses on teeth, loss of the tooth’s protective enamel layer, and occasionally some dental procedures. One of the major sources of improper stresses is the unconscious habit of grinding and clenching the teeth. Another source of stress occurs when teeth do not come together properly. Some teeth always hit sooner than the rest, and they become sensitive. Teeth also become sensitive when they lose their protective outer layer which exposes the dentin. The dentin is the middle layer of the tooth, and it is normally protected by enamel (above the gumline) and cementum (below the gumline). Dentin contains millions of tiny tubes that extend from the nerves at the center of the tooth to the outer layer. When the dentin is exposed, these tubes are left open. Any stimulation at the surface of the dentin is transmitted through the tubes to the nerves, causing pain. The dentin can become exposed through various processes, such as abfraction, erosion, and abrasion. Abfraction occurs when one tooth hits sooner than the rest, causing the tooth to flex. Over time, this continual flexing causes the enamel to separate from the dentin. Erosion occurs when acids dissolve the enamel. This is often caused by frequent sipping of acidic soft and sports drinks or exposing the teeth to stomach acids through acid reflux disease. Abrasion takes place when the protective layer is worn away. This can happen when you brush too hard, use a medium- or hard-bristled tooth brush, or use an abrasive “tartar control” or “whitening” toothpaste. Lastly, some dental procedures, such as bleaching and placing restorations, may sometimes lead to short-term sensitivity.

Diagnosis and treatment

To determine the cause of your tooth pain, we do a thorough examination. Then we perform the most appropriate treatment for the situation. Short-term sensitivity can often be handled by using a desensitizing toothpaste or mouthwash. If the problem is improper stress on the teeth, we may adjust you bite or recommend that you wear a mouthguard. If the problem is exposed dentin, we may present a plan for improved brushing techniques, counsel you about your diet, treat the area with fluoride, or apply a protective coating, bonding agent, or restoration.

What If? Wednesdays

What if I have a lot of plaque and tartar buildup on my teeth?

If you notice your teeth have a lot of build-up on the surface, we can help you remove a lot of the excess tartar from your mouth. Plaque and tartar can be incubators of bacteria, causing serious problems like periodontal disease and gingivitis. It is important for your oral health to remove this build-up and continue a preventative homecare regimen.

Full Mouth Debridement

When heavy plaque and tartar deposits have built up on your teeth, we often recommend a procedure called full mouth debridement to remove that build up.

The benefits of debridement

Plaque is a sticky, colorless film of food and bacteria that constantly forms on your teeth. If it is not removed every day, plaque hardens and turns into tartar. Over time, this plaque and tartar builds up on your teeth. A heavy build up blocks our ability to clearly see and examine your teeth and gums. It is also important to remove the accumulation of plaque and tartar because they are the main cause of tooth decay and gum disease. Many factors can contribute to heavy build up, including:

• Dry mouth, also called xerostomia
• Tobacco use
• Certain health conditions
• Wearing braces
• Poor oral homecare
• Not getting regular professional dental cleanings

The debridement procedure

Depending on the situation, we may begin the procedure by recommending a numbing gel or offering nitrous oxide to make you more comfortable. Next, we use a variety of instruments to carefully remove the plaque and tartar above and around the gumline. We may also apply an antimicrobial rinse. Then, we finish the procedure by carefully reviewing your homecare routine. A full mouth debridement is an important initial step in the ongoing evaluation and treatment of your oral health.

What if? Wednesdays

What if I break a tooth?

When you break a tooth, several things can happen. You may have simply chipped the tooth, which requires minimally invasive repair. However, you can crack your tooth, through the enamel and into the pulp, which can be a painful experience. When a fractured tooth exposes the tooth root, the tooth is not able to be saved. The following is a guide to cracked and fractured teeth, outlining the steps and precautions you should take to protect your oral health.

When is an extraction necessary?

When the root of a tooth is fractured and cannot be saved, extracting the tooth can be the best choice for relieving pain and preventing infection.

Some fractured teeth cannot be saved

Many cracked teeth can be treated successfully with root canal therapy and a crown, especially those whose cracks are located above the gumline only. However, these treatments may not save the tooth when a fracture has extended into the root.

Diagnosis and treatment

You may suspect you have a fractured tooth because

• The tooth is sensitive to hot or cold
• You feel a sharp pain when you chew

To determine if an extraction is right for your situation, we’ll perform a thorough exam, which typically includes x-rays. However, x-rays may not reveal the crack, so we may analyze your bite to isolate the problem or examine your gums for signs of the fracture. If the tooth cannot be saved, it’s important to extract it as soon as possible to prevent pain and infection in the tooth and jawbone. With modern dental techniques, the procedure should be a comfortable one for you. In many cases, we also recommend replacing an extracted tooth to preserve the jawbone and stabilize your bite, so we’ll talk with you about your replacement options.