Common St. Petersburg Dental Conditions

Here are some of the most common St. Petersburg dental conditions we treat at our office.  We provide this information as a courtesty to our patients so they can understand why it is so important to get these conditions treated as soon as possible.  If you are experiencing any of these St. Petersburg Dental Conditions, call our office immediately for the the treatment you need before your conditions worsens.

A Dark Tooth

A dark-colored tooth in an adult usually indicates that the nerve of the tooth has become infected and the normal flow of blood in and out of the tooth has stopped…

Treatment
In most cases, the tooth will need a root canal. Sometimes the tooth will “die,” yet not need a root canal. To restore the tooth to its natural color, you might consider bonding, veneers, a crown, or single-tooth whitening, a procedure in which a whitening agent is placed inside the tooth after root canal treatment.

Bad Breath

Bad breath can be caused by tooth decay, gum disease, lack of saliva (xerostomia), certain foods and drinks, tobacco, medications or illness…

Treatment
Schedule a dental appointment to find out if your bad breath is being caused by tooth decay, gum disease, or a medical condition that should be treated by a physician. If you have a dental problem, your dentist will recommend a course of treatment to stop any infection, clean and restore your teeth, and improve the health of your gums. Your dentist may also recommend that you take a hard look at your daily dental hygiene. Remember, you should be brushing at least twice a day and flossing at least once daily. If your bad breath is not a dental problem, your dentist may suggest changes to your eating and drinking habits or refer you to a physician.

Advantages of Tooth-Colored Restorations

There are many advantages when resin—or tooth-colored—onlays are used to restore teeth…

Resin onlays are bonded to the teeth. This creates a tight, superior fit, and restores the tooth to nearly its original strength. Resin onlays can be used in cases where much of the tooth structure has been lost, so a crown might have been necessary. This keeps your tooth intact and stronger. Resin onlays wear like natural teeth. And since resin onlay margins are invisible, they don’t have to be placed below the gum line. This is healthier for your gums.

Resin onlays often also contain fluoride. This fluoride may help prevent new decay at the edges of the fillings. The improved appearance of your smile is immediately evident. Whether you replace one or all of your fillings, it’s simply amazing how beautiful and natural resin onlays look!

Air Abrasion - Drill-Free Dentistry

Think of an air abrasion system as a mini-sandblaster. Instead of turning on a whirring drill, a dentist gives you a pair of goggles and then directs a thin, high-speed stream…
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of air-blown microscopic particles that gently remove decay from your tooth. (View air abrasion in action – Quicktime movie – 38K)

Advantage: There’s no heat, no vibration, and many times it’s all done without numbing your mouth. You’ll feel some coolness but it won’t hurt. A suction hose removes the gritty particles, which are made from aluminum oxide, a tasteless substance commonly found in toothpaste. It’s harmless if accidentally swallowed, although your dentist may place a thin rubber sheet (called a rubber dam) in your mouth to keep you from breathing the particles.

An air abrasion system works best on small cavities that will be filled with non-metallic materials. It’s generally used to repair early tooth decay before it spreads. Because this system can be precisely directed, there’s less tooth structure lost in preparing for a filling. And unlike regular dental drills, air abrasion systems won’t produce tiny fractures in tooth structure. A more recent application of air abrasion is in the relatively new field of MicroDentistry. Thanks to the successful introduction of fluoride into water supplies and toothpastes, tooth surfaces have become more resistant to decay. But decay is still around. Only now it’s concentrated in tiny, hidden parts of the teeth, where it can easily be missed until it has broken into the softer inner portion of the tooth (dentin or pulp).

Because it can precisely remove very tiny layers of tooth structure, air abrasion is a major part of MicroDentistry techniques. Special dyes locate tiny pockets of decay, air abrasion gently opens and cleans out the decay, and then the tooth is bonded in place with one of the new, white filling materials or a tooth-colored sealant.

Disadvantages: Air abrasion doesn’t work for amalgam (silver) fillings, and the aluminum oxide powder can be messy. Because it uses a high-pressure air stream, there’s a minor danger of injecting air into the cheeks or gums. And since an air abrasion system can be costly, only about ten percent of US dentists have air abrasion systems in their offices.

All-Porcelain Bridge

Instead of placing a bridge made of porcelain with a metal base, which, years later, can often result in unsightly dark lines at the gum line, your dentist can now restore your smile with an all-porcelain bridge.
An all-porcelain bridge still uses adjacent teeth for support, but will not show a dark line where the bridge meets the gums. Many all-porcelain bridges can be bonded in place, which gives a tighter seal and more accurate fit.

All-Porcelain Bridges

Tooth-colored bridges used to be made only of porcelain and metal. But with the new technology available today, they can be made entirely of porcelain.
To have enough strength to withstand biting forces, porcelain bridges used to be built upon a metal core. Unfortunately, this created a noticeable dark line at the edge of the bridge. New breakthroughs in adhesives and stronger porcelain materials now make it possible to create bridges entirely from porcelain. All-porcelain bridges maintain a translucency that makes them difficult to tell from real teeth.

Without metal, the dark line at the edge of the gums is eliminated. This allows the edge of the bridge to be placed above the gum line, which is healthier for your teeth and gums. When you want to improve your smile, an all-porcelain bridge is an excellent choice!

All-Porcelain Crowns

Tooth-colored crowns used to be made of porcelain and metal. But with the new technology available today, they can be made entirely of porcelain.
To have enough strength to withstand biting forces, porcelain crowns used to always be built upon a metal core. The dark metal inside the porcelain/metal crown causes a dark blue line to show at the edge of the crown. New breakthroughs in adhesives and stronger porcelain materials now make it possible to make crowns entirely out of porcelain, which then can be bonded to the teeth.

All-porcelain crowns maintain a translucency that makes them hard to tell from natural teeth. Without metal, the problem of the dark blue line at the edge of the gums is eliminated. This allows your dentist to place the edge of the crown above the gum line, which is healthier for your tooth and gums. When you want to improve your smile, all-porcelain crowns are a beautiful and natural-looking choice!

All-porcelain crowns (also called caps) are a beautiful, long-lasting choice. The procedure involves reducing and carefully shaping the supporting tooth, creating an impression from which a model of the prepared tooth is made, and having the crown fabricated (usually in a dental lab), then fitting and permanently cementing or bonding the crown in place.

Crowns made of porcelain with a metal base do not look as natural and may eventually result in a noticeable dark line at the gums.

A Lower-Jaw Implant

Restoring your lower jaw with dental implants is accomplished in two phases. The first phase is the surgical placement of the implants.
They’re left under the gums for several months while the bone attaches to them. After healing, the second phase begins. The implants are re-exposed and the new teeth are made.

For the surgical placement of the implant, you’ll be given nitrous oxide or intravenous sedation to relax you. Then your mouth is numbed.

An incision is made in the gums and a hole is made in the bone to receive the implant. After the implant is snugly in place, the gums are closed over the implant with a stitch or two. Over the course of the next few months, the implant attaches securely to the bone. The second phase starts with surgical exposure of the implant. Another incision is made in your gums, and a small extension is placed to raise it above the gum line.

Your dentist will then start a series of appointments to create your new teeth. Though some of the steps might be different in your case, they usually include making impressions of your mouth. From these impressions, your dentist makes precise working models of your mouth, which are carefully mounted for proper alignment. The last step is the placement of the teeth. The ultimate success of implants depends on the care you provide at home, and the support they receive through regular checkups and cleanings.

Alternatives to a Root Canal

Once the pulp of a tooth has become infected, your choices are limited. You could choose to delay treatment, you could choose to have the tooth extracted, or you could choose to save your tooth with root canal treatment.

The problem with delaying treatment is that an infected tooth will never heal on its own, and this can lead to some very serious problems. As the infection spreads down the tooth and into your jawbone, the pain may become excruciating. It could even put you in the hospital and threaten your life.

An extraction is only a short-term solution. While it does remove the source of infection, it sets off a chain reaction of shifting teeth and other dental problems. The only way to save your tooth and keep it in your mouth is to remove the infection with root canal treatment.

Alternatives to Braces

There are many types of dental work that might work as an alternative to orthodontic treatment, such as.

Crowns
Bridges
Bonding

Leaving teeth as they are is another option. You will need to consider the choices presented to you, then decide what treatment is best for your situation.

Alternatives to Bridges

When you’re missing one or more teeth, you have several options…

  • Delay treatment
  • Implants
  • Partial denture
  • Space maintainer
  • Bridge

Delaying treatment is the least desirable option. Things will only get worse. An implant with a crown might be a good choice. Treatment time is much longer, but your dentist wouldn’t have to modify the teeth next to the space. A partial denture could work well if several teeth are missing throughout the mouth. It fills in the spaces and restores your natural bite.

A space maintainer is used as a temporary solution when a child loses a tooth. It keeps the teeth from shifting as it holds a space for the emerging permanent teeth.

Alternatives to Crowns

After a lot of tooth structure has been lost, your alternatives are limited. You can delay treatment, have the tooth extracted, try another filling or have a crown put on the tooth. …

Whether tooth structure has been lost due to breakage or cavities, if treatment is delayed, the problem just gets worse. If the tooth breaks more, it’s going to be hard to fix, and there may be no choice but to extract the tooth. Unfortunatlely, an extraction is only a short-term solution. Teeth need each other for support. A missing tooth sets off a chain reaction of shifting teeth and other dental problems.

When treatment is delayed, cavities just get bigger and bigger. They grow slowly while still in the hard outer enamel. But if a cavity is allowed to reach the softer inner dentin, it grows much more quickly. Then the race is on to fill the cavity before it reaches the pulp chamber. If it reaches the pulp chamber, the tooth will require root canal treatment.

A filling may be an alternative, but fillings don’t add strength to the tooth. They simply fill in the damaged part of the tooth lost to decay. There has to be enough tooth to hold the filling in place and keep the tooth from breaking when you chew. Putting a crown on the tooth strengthens it and protects it from breaking.

Alternatives to Extracting a Single Tooth

Sometimes a tooth can be saved by performing root canal therapy and placing a crown. Other times, there is no suitable alternative to extraction. Your tooth may have to be removed…

Delaying treatment is always an alternative, but it is not recommended. The problem will only worsen over time. If the tooth is decayed, the cavity will get deeper and move into the nerve. And if the bone around the tooth is degrading, this condition will also worsen. When decay has progressed to the point where the tooth has to be removed, it is crucial to treat the problem as soon as possible. Otherwise, the infection will spread to other teeth, or worse yet, to the rest of your body. Jaw infections can even be life-threatening. Remember, it’s important to replace a tooth after it’s been extracted. A missing tooth can set off a chain reaction in your mouth, resulting in many new problems.

Alternatives to Extracting Wisdom Teeth

The alternative to having wisdom teeth removed is to keep them…

A few lucky people are able to keep their wisdom teeth and care for them as they would their other teeth. But for most of us, this isn’t possible, and a delay in their removal can cause serious problems. An impacted wisdom tooth may push on other teeth. It can be very painful when a wisdom tooth that has started to erupt becomes infected. This is a common dental emergency that can cause pain for days, even after antibiotics are started.

A misaligned tooth can also cause cavities. This x-ray shows a wisdom tooth coming in sideways and causing a cavity in the second molar. And wisdom teeth are nearly impossible to keep free of plaque.

Plaque caused the cavity in this wisdom tooth. Plaque also causes periodontal disease, which may start near the wisdom teeth and spread throughout the mouth. Sometimes cysts form around impacted wisdom teeth. Cysts can destroy a tremendous amount of bone before they’re even noticed and may require surgery to remove.

As time passes, the roots of wisdom teeth may grow around a nerve in the jaw. When this happens, the nerves entwined in the roots of the wisdom teeth can be damaged during extraction. This could leave your lip and chin permanently numb. Because of these many serious problems, it’s usually better to remove wisdom teeth early, even before they break through the gums.

Alternatives to Fillings

When you have a cavity, you really only have two choices: postpone treatment or get a filling…

The problem with postponing treatment is that a cavity will never go away on its own. It just gets bigger and bigger. It grows slowly while it’s still in the hard outer enamel. But if a cavity is allowed to reach the softer inner dentin, it grows much more quickly.

Then, the race is on to fill the cavity before it infects the pulp chamber. If it gets into the pulp chamber, you’ll need root canal treatment to save the tooth. A filling stops decay in its tracks. Your dentist removes the decay and seals the tooth with filling material. This restores the tooth and keeps your mouth healthy.

Alternatives to Gum Disease Treatment

If you have periodontal (gum) disease, your choices are limited. You may either choose to treat the problem, or to delay treatment. ..

Treatment involves a combination of root planing, new homecare techniques, more frequent dental cleanings, and in severe cases, surgery. Delaying treatment will never make periodontal disease go away. Periodontal disease is an ongoing, degenerative condition. Bone lost never grows back. If too much bone is lost, teeth get loose and have to be removed. This means you may end up wearing partial dentures, or even full dentures.

You don’t have to lose your teeth to periodontal disease! Treatment removes the infection and keeps the disease under control.

Alternatives to Immediate Dentures

If you have periodontal (gum) disease, your choices are limited. You may either choose to treat the problem, or to delay treatment. Treatment involves a combination of root planing, new homecare techniques, more frequent dental cleanings, and in severe cases, surgery…

Delaying treatment will never make periodontal disease go away. Periodontal disease is an ongoing, degenerative condition. Bone lost never grows back. If too much bone is lost, teeth get loose and have to be removed. This means you may end up wearing partial dentures, or even full dentures.

You don’t have to lose your teeth to periodontal disease! Treatment removes the infection and keeps the disease under control.

Alternatives to Implants

Implants are often used to replace missing teeth. If you decide against implants, there are a few other options….

  • partial dentures
  • bridges
  • full dentures
  • delaying treatment

If you have some remaining teeth, a partial denture may be an appropriate alternative. A partial denture is held in place by clips or other special attachments. It can do a nice job of replacing missing teeth.

A bridge might also be a good alternative if there are teeth remaining next to the affected tooth. There are several types of bridges, but they all use the neighboring teeth as anchors.

If you now wear a denture, replacing or relining it may allow you to continue to use it.

Delaying a decision is always an alternative, although it’s often not the best one. But you may decide to wait while you consider your options.

Alternatives to Overdentures

The alternatives to an overdenture are: immediate dentures implants partial dentures delaying treatment Removing all of your teeth and making an immediate denture is an alternative to an overdenture…

The alternatives to an overdenture are:

  • immediate dentures
  • implants
  • partial dentures
  • delaying treatment

Removing all of your teeth and making an immediate denture is an alternative to an overdenture. Implants are another alternative. An implant is a small metal cylinder that’s surgically inserted into the bone of the jaw to replace the roots of missing teeth. Implants would make your new denture much more stable; they also slow the bone loss that occurs after teeth are removed. Your dentist can also use your remaining teeth to anchor a partial denture.

You can also delay treatment, but be aware that infected teeth and gums never heal on their own. They just keep getting worse. If you’re not in a lot of pain, you might decide to leave your teeth as they are, at least for now. But infections of the teeth and gums can weaken your body’s immune system, which can affect your overall health.

Whenever teeth are removed, the bone in your jaw begins to recede. If we leave some of the roots of the teeth in place, and place an overdenture, we can slow bone loss significantly and give you a more stable denture.

Alternatives to Partial Dentures

Some of the alternatives to a partial denture are: bridges implants dentures delaying treatment In some cases, bridges are an alternative to partial dentures. Sometimes, when we don’t have enough teeth to place a bridge, we can solve the problem…

Some of the alternatives to a partial denture are:

  • bridges
  • implants
  • dentures
  • delaying treatment

In some cases, bridges are an alternative to partial dentures.

Sometimes, when we don’t have enough teeth to place a bridge, we can solve the problem by placing an implant. A dental implant is a small titanium cylinder that’s surgically inserted into the bone of the jaw to replace the root of a missing tooth. Removing the rest of your teeth and making a denture is another alternative.

You can also delay treatment, but be aware that infected teeth and gums never heal on their own. They just keep getting worse. If you’re not in a lot of pain, you might decide to leave your teeth as they are, at least for now. But that could be risky; infections of the teeth and gums can weaken your body’s immune system and that could affect your overall health.

Sometimes, when you’re missing teeth, a partial denture is the best alternative to fill in spaces and keep you chewing comfortably and effectively.

Ankylosis

Ankylosis is a dental term for a condition where a primary tooth loses its normal ligament connection to the bone, and becomes fused directly to the bone…

This is a fairly common occurrence and is most often seen with lower first molars. When a primary tooth becomes ankylosed, three problems result:

  • First, when the tooth root fuses to the bone, it no longer grows out at a normal rate with the other teeth. Because of this, it appears submerged when compared with the other teeth.
  • Second, the upper teeth need the lower teeth for support. With a lower tooth “submerged,” the opposing upper tooth grows out of the socket and also loses it normal alignment.
  • The third, and more serious problem has to do with the roots of the ankylosed tooth. About 50 percent of the time, the roots of the ankylosed tooth fail to dissolve normally as the permanent tooth grows in, and the permanent tooth is blocked out of position.

A Single-Tooth Implant: The Procedure

Restoring the mouth with a dental implant is accomplished in two phases. The first phase is the surgical placement of the implant…

t is left under the gums for several months so the bone can attach to it. After healing, the second phase begins; the implant is re-exposed, and the new crown is made.

For the surgical placement of the implant, you will be given nitrous oxide or intravenous sedation to relax you. Then your mouth is numbed.

An incision is made in the gums and a hole is made in the bone to receive the implant. After the implant is snugly in place, the gums are closed over the implant with a stitch or two. Over the course of the next few months, the implant attaches securely to the bone.

The second phase starts with surgical exposure of the implant. Another incision is made in the gums and a small extension is placed to raise it above the gum line. Your dentist will then begin a series of appointments to create your new crown. Though some of the steps might be different in your case, they usually include making impressions of your mouth. From these impressions, your dentist will make precise working models of your mouth, which are carefully mounted for proper alignment. The last step is the placement of the new crown.

The success of the implant depends on the care you provide at home, and the support you receive through regular checkups and cleanings.

A Two-Implant Bridge

Restoring the mouth with implants and a dental bridge is accomplished in two phases. The first phase is the surgical placement of the implants…

hey’re left under the gums for several months while the bone attaches to them. After healing, the second phase begins. The implants are re-exposed and the new teeth are made.

For the surgical placement of the implant, you’ll be given nitrous oxide or intravenous sedation to relax you. Then your mouth is numbed.

An incision is made in the gums, and a hole is made in the bone to receive the implant. After the implant is snugly in place, the gums are closed over the implant with a stitch or two. Over the course of the next few months, the implant attaches securely to the bone.

The second phase starts with surgical exposure of the implant. Another incision is made in your gums and a small extension is placed to raise it above the gum line.

Though some of the steps might be different in your case, they usually include making impressions of your mouth. Your dentist then begins a series of appointments to create your new teeth.

From the impressions, your dentist will make precise working models of your mouth, which are carefully mounted for proper alignment. The last step is the placement of the bridge.

The ultimate success of the implants depends on the care you provide at home, and the support you receive through regular checkups and cleanings.

Bleeding Gums

Your gums may bleed: when you brush or floss when you eat from one spot above a single tooth after tooth removal…

Your gums may bleed:

  • when you brush or floss
  • when you eat
  • from one spot above a single tooth
  • after tooth removal

When you brush or floss

It’s not normal for your gums to bleed when you brush or floss (unless you recently began brushing or flossing). If bleeding persists, you have either gingivitis (early gum disease with no bone loss yet) or periodontitis (more advanced gum disease with bone loss).

Treatment

See your dentist or hygienist. You’ll need some combination of teeth cleaning, root planing, and new homecare techniques. Once all the tartar, the hard deposit of calcium salts and bacteria, has been removed from your root surfaces and you’re keeping all the plaque, the soft film of food particles and bacteria, off of your teeth, all bleeding will go away.

When you eat

It’s not normal for your gums to bleed when you eat. Bleeding indicates that your gums are swollen and that you have either gingivitis (early gum disease) or periodontitis (more advanced gum diseases with bone loss).

Treatment

See your dentist or hygienist. You’ll need some combination of tooth cleaning, root planing, and new homecare techniques. First, all the tartar, the hard deposit of calcium salts and bacteria, will be removed from the root surfaces of your teeth. Then it will be your job to keep all the plaque, the soft deposit of food particles and bacteria, off your teeth with regular brushing and flossing. All bleeding will then go away.

From One Spot above a Single Tooth

A tooth infection causes pus to build up at the tip of the root and makes a hole in the bone. This infection may work its way to the surface of your gums and form a gumboil, which may bleed.

Treatment

See your dentist to have the tooth checked. Infected teeth can be repaired by root canal treatment, often followed by a crown (also called a cap). If you wait too long, you may have a major toothache as well as a dangerous infection that could ultimately be life threatening.

After tooth removal

If you’ve recently had a tooth removed, it’s common for the extraction site to seep a little blood for a day or two. But it’s not normal for the area to bleed substantially. Treatment To reduce bleeding, apply pressure to the extraction site with a rolled-up gauze pad; your dentist will provide them. Some dentists recommend that you also bite on a moist tea bag for 5 to 10 minutes. The tannic acid in the tea bag helps to stop the bleeding. Contact your dentist immediately if bleeding persists or if there is substantial bleeding.

Bonding

Bonding enables your dentist to: close spaces between your teeth lengthen small or misshapen teeth whiten stained or darkened teeth A single tooth can be shaped and colored, or your entire smile can be changed!..

Bonding enables your dentist to:

  • close spaces between your teeth
  • lengthen small or misshapen teeth
  • whiten stained or darkened teeth

A single tooth can be shaped and colored, or your entire smile can be changed! When teeth are chipped or beginning to wear, bonding can protect them from damage and restore their original look. Bonding your teeth with resin is a one-appointment procedure:

First, teeth are roughened and a conditioning gel is applied. Then a tooth-colored material called resin is placed on the teeth, and is sculpted to the desired shape. A harmless high-intensity light hardens the resin, bonding it to the teeth.

Once in place, bonded restorations are very strong. Bonding can greatly improve the appearance of your teeth, resulting in a more beautiful, natural looking smile!

Braces

Isn’t an eight-year-old a little young for braces? Not really. Some conditions, such as an excessive overbite or underbite, are far more easily treated in the growing child. There are two kinds of devices used to re-position or hold the position of teeth…

Isn’t an eight-year-old a little young for braces?

Not really. Some conditions, such as an excessive overbite or underbite, are far more easily treated in the growing child. There are two kinds of devices used to re-position or hold the position of teeth, braces and functional dental appliances. Braces are usually cemented directly to all of the upper or lower tooth surfaces, and then connected by a stainless steel wire.

Functional appliances are usually applied to fewer teeth, often to correct misalignment or an over/underbite, or to hold the space created when a tooth is lost or extracted. These devices may be fixed in the mouth and worn for extended periods, or they may be removable and worn only for short periods. By applying a functional appliance to an eight-year-old’s protruding upper front teeth, which are very susceptible to injury, an orthodontist can more easily move them back into a less vulnerable, more attractive position. If you wait until your child is older, this is a more difficult task.

Will the gap between by child’s teeth close on its own?

If your child is under 10 years old, the normal growth of their permanent teeth will occasionally push the upper front teeth back together. Have your dentist x-ray these teeth to determine if the gap will close on its own.

Braces (orthodontics)

Braces are often the ideal way to straighten teeth—especially when teeth are severely crowded—but you must be willing to wear braces for one to three years…

Orthodontics is now a very common procedure for adults; in fact, 40 percent of orthodontic treatments are on adults.

In addition to the standard silver brackets, braces are now available with small, clear or gold brackets that are bonded directly to the front of the teeth. These new small brackets eliminate that “metal mouth” look previously associated with braces.

Brushing Your Teeth

Proper tooth brushing involves four things: a soft toothbrush toothpaste with fluoride the correct brushing angle brushing in a pattern…

Proper tooth brushing involves four things:

  • a soft toothbrush
  • toothpaste with fluoride
  • the correct brushing angle
  • brushing in a pattern

It’s important to brush at least twice a day using a soft toothbrush. The flexible bristles of a soft toothbrush are gentler on the gums and make it much easier to remove the plaque below the gum line, where periodontal disease starts. Use a toothpaste that contains fluoride. Fluoride hardens the outer enamel layer of the teeth. It might stop a cavity in its tracks and give you more resistance to future cavities.

Angle the bristles of the brush along the gum line at a 45-degree angle. Apply firm but gentle pressure so the bristles slide under the gum line. Move the brush over the entire surface of two or three teeth at a time in small, circular motions. Allow some overlap as you move to the next teeth. Tilt the brush and use the tip to brush the backs of the front teeth.

It’s fine to brush in any regular pattern you choose, but since the insides of the teeth tend to get less attention, you might start with the insides of the upper teeth, then go to the insides of the lower teeth. Switch to the outsides of the upper teeth, and then the outsides of the lower teeth. Brush the chewing surfaces of the upper teeth, then the lower teeth. End by gently brushing your tongue and the roof of your mouth. This removes germs to help keep your breath fresh.

Cavities

My son never eats any sugar. How can he have so many cavities?My other children never had any cavities. Why does my youngest have six?…

My son never eats any sugar. How can he have so many cavities?

There are many hidden sugars in bread, potatoes or even milk that can cause the same sort of decay produced by white sugar. For example, fruit rollups and raisins contain sugars that can stick to tooth surfaces far longer than those in a soft drink. Drinks in a baby bottle, even milk, can cause tooth decay if a baby is allowed to keep the bottle in her mouth for extended periods. If your child is an infant and still nursing, his upper front teeth are being bathed in milk sugars for extended periods. These sugars are nutrients for the oral bacteria that cause early infant decay. You can avoid this decay by carefully cleaning his teeth with a soft infant toothbrush or by wiping his teeth clean at the end of each feeding. Use a washcloth, cotton swab, or cotton ball to do this.

My other children never had any cavities. How can Nicole have six?

Nicole may be getting more cavities because her teeth are closer together, so food gets trapped between them and causes decay. Or she may be eating more sugary treats than her brothers or sisters. Do some detective work. A likely culprit is Nicole’s dental hygiene. See how often she is really brushing and flossing.

Cracked Teeth

New cracks accompanied by pain when chewing Treatment Hurry to the dentist. The pain is the flexing of the tooth underlying the crack. A significant portion of the tooth may soon break away. Worst case scenario The crack extends into the nerve and a root…

New cracks accompanied by pain when chewing
Treatment

Hurry to the dentist. The pain is the flexing of the tooth underlying the crack. A significant portion of the tooth may soon break away.

Worst case scenario

The crack extends into the nerve and a root canal will become necessary. Most cracked teeth that hurt will need to be crowned. Occasionally, small cracks can be fixed with fillings.

New cracks that hurt constantly

The crack probably extends well into the inner dentin layer of the tooth (near the nerve center of the tooth, called the pulp chamber, which lies just below the dentin).

Treatment

Constant pain increases the chance that the nerve is affected and a root canal will be necessary prior to crowning. While crowning is usually necessary, a filling or onlay filling, which covers the tops or cusps of the teeth, may solve the problem.

Old cracks in teeth

Old cracks that run parallel to the length of the teeth and appear on several teeth, but are not accompanied by pain

Treatment

There’s a high probability that these teeth are fine. Surface cracks commonly appear as part of the aging process and often do not cause any problems.

Crown Lengthening

When a tooth is broken down due to decay or fracture, a crown is an excellent way to cover and protect it…

But when damage is severe, there may not be enough remaining tooth structure to support a crown.

Years ago, a tooth like this would have to be extracted. But today, by using a procedure called crown lengthening, your dentist can increase the amount of available tooth structure, and save the tooth. The first step in the procedure is thoroughly numbing the entire area. Incisions are made, and the gums are gently pulled back. The area is then reshaped and sculpted to the desired shape.

The gums are replaced and a couple of stitches are placed to speed healing. After a few weeks of healing, a crown is placed to cover and protect the damaged tooth. Crown lengthening is a minor surgical procedure that is a predictable and effective way to save a tooth that might otherwise be lost.

Crown or Bridge Fell Out

Temporary crown fell out A temporary crown or bridge covers and protects the involved teeth and serves as an anchor that keeps adjacent teeth from moving. Temporary crowns or bridges are generally cemented in place with temporary cement. This cement allow…

Temporary crown fell out

A temporary crown or bridge covers and protects the involved teeth and serves as an anchor that keeps adjacent teeth from moving. Temporary crowns or bridges are generally cemented in place with temporary cement. This cement allows your dentist to easily remove the temporary crown or bridge once the permanent bridge is ready to be placed. Unlike most of the permanent cements your dentist uses, temporary cements may eventually be dissolved by your saliva. If this happens, your temporary bridge or crown (which is precisely fitted) may come loose.

Treatment

If a temporary comes off, it’s very important that it be replaced immediately to prevent shifting of the teeth next to the crown or bridge and the opposing teeth that chew against it. This shifting, which can happen in only a few hours, can permanently change your bite and make it impossible to place the permanent crown or bridge. If your temporary crown or bridge comes off, be sure to save it, and call your dentist immediately to have it re-cemented. Warning: don’t try to replace it yourself. Your bridge or crown may come off and cause more problems, particularly when you are asleep. Never use any glue, especially Super Glue, in your mouth.

Permanent crown fell out

Some kinds of permanent dental cements over time may be dissolved by the water in your saliva and allow your crown or bridge to come off. Sticky foods such as gum, caramels or suckers may also pull crowns off of your teeth, even though they were properly cemented with permanent dental cements.

Treatment

When a crown or bridge comes off, take great care to save it! In many cases it can be cleaned up and re-cemented. It’s very important that a crown, bridge or inlay that has come off be replaced immediately. Taking immediate action will prevent shifting of the teeth next to the affected area and those that they chew against.

This shifting, which can happen in only a few hours, can permanently change your bite and make it impossible for your permanent restoration to be re-cemented. If your crown, bridge or underlying teeth have been damaged, a new restoration may have to be fabricated.

Crowns

We don’t want crowns on our child’s teeth. Can’t his problems be solved with fillings? Deciding whether a crown is the optimum treatment depends on several factors: the age of your child, the size of the cavity, and how much of the tooth is decayed. Let…

We don’t want crowns on our child’s teeth. Can’t his problems be solved with fillings?

Deciding whether a crown is the optimum treatment depends on several factors: the age of your child, the size of the cavity, and how much of the tooth is decayed.

Let’s consider age. Since most of the baby teeth in the back of a child’s mouth will remain until they are ten to thirteen years old, it is important to restore a decayed tooth with materials that are durable. A cavity in a nine-year-old might be treated with a filling, while the same cavity in a three-year-old is best handled with a crown.

The choice also depends on the likelihood of future decay in the treated tooth. Placing a crown may be the best way to avoid re-treatment in the future.

Size of the cavity is another factor. When a cavity becomes so large that there’s not enough of the tooth left to hold the filling a place, then a crown is the best option.

Dental Implants: Are They Right For You?

Remember the excitement of losing a tooth when you were six years old? Well, that excitement fizzled somewhere on the road to adulthood. Losing a tooth as an adult is hardly a cause for celebration. …

But there is a silver lining to the lost-tooth storm cloud—dental implants. Made from titanium posts that attach directly to the jawbone and anchor a permanent artificial tooth, implants are becoming increasingly popular restorations to replace one or a few teeth. Record numbers of Americans are paying upwards of $2000 out-of-pocket per implant. In fact, over the last ten years the number of patients receiving dental implants has tripled, according to an American Dental Association survey.

Implants are lifelike and practically indistinguishable from natural teeth, and they fit so securely that you won’t even notice them when you chew and speak. In essence, they’re the next best thing to your natural teeth. And implant dentistry has advanced to the point that dentists can place implants with the same confidence and skills they’ve used in the past for crowns and bridges.

“Implants today are user- and patient-friendly,” said Scott D. Lingle, DDS. However, you still need to be sure that the dentist—or team of dentists—that you choose to place your implants has a good deal of experience and expertise in the procedure.

In many cases, one dentist places the implant and another makes and fits the replacement tooth. Both general dentists and specialists—oral and maxillofacial surgeons, prosthodontists or periodontists—can perform the procedure. But implant dentistry in itself is not an ADA-recognized specialty, so there is no uniform method for verifying a dentist’s training and experience. It’s up to you to screen any dental professionals you are considering.

How are implants placed?

Most implants are surgically placed directly into the jawbone. First, x-rays are taken to make sure there is adequate bone in the jaw to support the titanium cylinders. Then, models of your mouth are created so precise measurements can be made. Once the exact location of the implant has been pinpointed, it is surgically placed into the jawbone. This usually requires two procedures—one to place the titanium cylinders and another after the implants have healed completely to re-expose the cylinders and connect a post to the implant. The artificial tooth is then connected to the post.

Start-to-finish, the procedure can take as long as nine months to a year. The lengthy part is called osseointegration, which is the fusing of the implant to the bone tissue; this can take as long as six months.

Do implants work for everyone?

Even if you’re the most patient person in the world, implants won’t work for you if you aren’t in good general health. You also have to have healthy gums and enough bone in your jaws to support the implants, and you must be willing to be meticulous about regular dental visits and your dental hygiene. Implants also aren’t advised if you suffer from a chronic illness such as diabetes, as this can interfere with healing. And if you’re a smoker, you’re not a good candidate for implants; smokers are at greater risk for gum disease than non-smokers, and gum disease weakens the gum and bone tissue needed to support implants. If you’re interested in implants to replace a missing or lost tooth, your dentist will perform a thorough evaluation to determine if your health and lifestyle are conducive to this type of restoration.

Eat, smile and talk with confidence and comfort

People are living longer and healthier lives, and because more people are recognizing the benefits of preventive care, more people are keeping most of their teeth for a lifetime. But sometimes, despite the best of efforts, a tooth is lost. “As we age, we don’t do many of the things we did when we were younger,” Lingle said. “But the three things everyone wants to do throughout their lifetimes are eat, smile and talk. Implants can help patients do all three, and they appear very natural,” he said. “Looking good has no age limit.”

Sources – The American Dental Association CAESY Patient Education Systems

Dental Lasers

Lasers are in smart-bombs, CD players, and bar-code readers at the grocery checkout counter. Now they’re showing up in your dentist’s office…

What Is a Laser?

A laser is a device that creates a dense, powerful beam of light. The beam from a low-power laser can play the music on a CD or read those weird bar codes on your box of corn flakes. High-power lasers can make precise cuts through thick steel or blow up a guided missile. It’s the low-power lasers that dentists are starting to use.

How They’re Used:

Experimental dental lasers have been around since the 1960s, but have only recently been approved for treating the dental consumer. There are basically four uses for the dental laser. First, it can cut and remove gum tissue. The procedure, say proponents of the laser, promotes faster healing, lowers the risk of infection, reduces pain after treatment and it’s quiet. In the chair all you hear is the hissing of the air jet that cools the spot where the beam is focused. Interestingly, its opponents say the laser is no better than conventional dental tools. One of these, a device that uses an electric current to cut and remove dental tissue, is silent, fast, and not as expensive as a laser. The second use for a dental laser is in hardening filling materials. Conventional hardening lights will work in about 30 seconds. The laser reduces hardening time to five or ten seconds.

The third use shows up in the practice of cosmetic dentistry. The concentrated heat of a laser, say some dentists, is ideal for speeding the process of bleaching teeth. Others use various other high intensity lights.

A fourth application for dental lasers is in cutting through tooth structure. Instead of the whine of the dental handpiece (drill), patients hear a series of rapid popping sounds as the beam interacts with the natural water in your tooth to systematically create tiny holes in it. Dental lasers don’t really shine here. They’re slower and less precise than dental handpieces and they can’t be used to remove old fillings or prepare teeth for crowns.

Do they hurt?

Here is where they have the edge over the traditional handpiece. Though it depends on the extent of the treatment, many patients report little or no discomfort, even without anesthetic.

Survey Says Dental lasers are hot technology, but they’re also expensive. With typical costs for one laser ranging from $15,000 to $50,000, many dentists are postponing their purchases until prices drop. But dentists are buying laser systems.

If your dentist asks you to put on dark glasses while you’re in the dental chair, they’re probably not trying to help you hide from the glamour photographers. Chances are, you’re being introduced to a dental laser.

Discolored Teeth

Front teeth There are many causes of discolored front teeth. Genetics, drugs taken while the teeth are forming (such as tetracycline and fluoride), infected teeth, root canal treatment, smoking, and certain foods may contribute to dark or stained teeth…

Front teeth

After a root canal
For stains or discoloration caused by foods or smoking

Treatment after Root Canal

After a root canal, if the tooth isn’t broken, whitening may solve the problem. Your dentist makes a small opening in the back of the tooth and inserts a cotton pellet that contains a whitening agent, also called a bleach. Sometimes a heated instrument is applied to activate the bleach. The procedure may be repeated through a series of appointments to achieve the desired result. Periodic re-whitening (once a year or once every several years) may be necessary to maintain the tooth’s whiteness.

If the tooth has had a root canal and is broken or chipped, it may be necessary to crown the tooth. A crown covers and protects a tooth from further damage. Crowns made of porcelain or porcelain-covered metal can correct the discoloration that often occurs after root canal therapy.

If a front tooth is only minimally damaged and discolored, it may be possible to whiten it with the use of a porcelain veneer or with whitening followed by a veneer. A porcelain veneer is a thin shell of porcelain that generally covers the front and top of a front tooth. Because veneers are translucent, it may be necessary to periodically bleach the tooth to keep it looking white and natural.

Stain or discoloration caused by foods or smoking
Treatment

A whitening solution may be applied during a series of appointments in the dental office (this is called “power whitening”). The solution is activated with a special light or by a laser.

Home whitening has become extremely popular in recent years. A whitening tray is custom-fabricated, filled with whitening solution and then worn for several hours each day. Home whitening is generally more predictable, less expensive, and longer lasting than in-office whitening procedures. Note that over-the-counter whitening kits have whitening solutions that are generally much weaker than those provided by a dentist. For a one-appointment solution to discolored teeth, bonding may be the answer. After lightly roughening the teeth, the dentist places a plastic bonding material on the teeth, sculpts and shapes it, and then hardens it with a high-intensity light.

Back teeth

A number of factors can contribute to tooth discoloration in back teeth, including genetics, drugs taken during tooth formation, infected teeth, root canal treatment, smoking and consumption of certain foods. However, silver amalgam fillings are the primary cause. Silver fillings contain copper, mercury, tin, and silver that can, over time, blacken the teeth and the gums.

Treatment

Dentists have several white filling materials they can use to replace dark silver fillings.

1 Direct resins: These can be placed directly on the tooth in a single appointment. The correct shade of resin is selected, pressed into place, sculpted, hardened with a special light, and finally adjusted and polished. Direct resins are economical, strong, and adequate restorations but are generally less durable than the other white fillings in this category
2 Indirect resins: The term “indirect” means that the restoration is constructed on a model in a lab rather than directly in a patient’s mouth. Involving a lab makes this a two-appointment procedure. A dental lab uses additional techniques to harden these restorations and make them significantly more durable.
3 Indirect hybrid resins: Recently developed materials, indirect hybrid resins, combine the durability of porcelain with the flexibility of resin (plastic). Like indirect resins, these restorations are fabricated in a laboratory under heat and light. Two or more appointments are necessary, but the result is an extremely high-quality restoration.

Extracting a Single Tooth

To make the entire extraction procedure comfortable for you, the first thing your dentist will do is make sure you’re thoroughly numb…

Your dentist will use instruments called elevators and forceps to remove the tooth. Elevators are placed next to the tooth and are used to gently roll the tooth out of the socket. Forceps are used to more firmly grip the tooth.

Though you’ll continue to feel pressure when a tooth is removed, you shouldn’t feel any pain. If you do, let your dentist know. He will stop and give you more anesthetic. Nobody enjoys having a tooth removed, but using modern dental techniques, it should be a comfortable procedure.

Extracting Wisdom Teeth

Before we explain precisely how wisdom teeth are removed, here are some suggestions to make the procedure easier and more comfortable for you…

You probably won’t feel like driving home after your surgery appointment, so arrange to have a friend or family member come with you.
If you plan to have intravenous sedation, remember not to eat or drink after midnight the night before surgery. If you forget, you’ll either have to be awake or reschedule the appointment.
Schedule some time off from work or school. You’ll probably want to take it easy for several days after your appointment.
If you choose intravenous sedation, remember to wear comfortable, loose-fitting clothes with sleeves that can roll up.

An appointment to have all four wisdom teeth removed normally only takes an hour or two. You’ll have gas or intravenous sedation to relax you, and then your dentist will numb the entire area around your teeth. The procedure will not begin until you are completely numb.

Though you’ll feel pressure when a tooth is removed, you shouldn’t feel any pain. If you do, let your dentist know. He will stop immediately and give you more anesthetic. Sometimes it’s easier for your dentist to remove the tooth if he cuts it in half before removal.

If your tooth is below the gum line, it will be removed through a small incision in the gums. A couple of stitches will close the incision.

Having your wisdom teeth extracted will prevent many future problems. And with modern dental techniques, the procedure should be completely comfortable.

Fillings

I don’t want my child to have any silver fillings. Can’t all fillings be done with white filling materials?Yes. If you strongly prefer white fillings, seek a second opinion if your dentist does not or will not use them…

Yes. If you strongly prefer white fillings, seek a second opinion if your dentist does not or will not use them.

Flap Surgery

Periodontal flap surgery is necessary when pockets and infection still remain after root planing. After making sure the entire area is completely numb, your dentist gently separates the gums from the tooth…

This creates a flap and gives us access to the infected areas. Your dentist then removes any plaque and tartar from the root surfaces. The area is reshaped, and the gum line is adjusted to make it easier for you to keep your teeth plaque-free.

Any soreness after surgery can usually be handled with mild pain medication. Periodontal flap surgery removes the source of infection, reduces the size of the pockets, makes cleaning easier, and raises your overall level of health.

Fluorosis

What is fluorosis and how did my child get it? Fluorosis shows up as multiple snow-white specks or a brownish stain on permanent teeth. …

Treatment

our child may have ingested too much fluoride during the years when his teeth were forming. The excess can come from swallowing too much fluoride toothpaste (kids often like the way it tastes), drinking canned or bottled drinks that contain fluoridated water, and taking too many of the fluoride drops or tablets prescribed for infants.

Your water supply also may have contained high levels of fluoride, which added to the problem. As a precaution, have your water supply checked. To find out about at-home testing of your tap water, call 1-800-445-3386, or go to www.omniiproducts.com. Fluoride test kits from this vendor cost $16, including postage.

Gingivectomy (Gum Removal)

Healthy gums, tight against the necks of the teeth, are an important part of a beautiful smile. But sometimes, a problem like this can develop…

As the gums extend onto the front surface of the teeth, the natural balance between the length of the teeth and the height of the gums was lost. The first step in a gum-reduction procedure is making sure that all of the involved areas are completely numb. Your dentist then carefully makes a small incision and removes the excess gum tissue. After a couple of weeks the area will be completely healed. Notice how much more natural this area looks after the procedure.

A gum reduction procedure is a safe and predictable way to remove excess gum tissue and improve the natural appearance of your smile.

Grafting

When your mouth is healthy, your gums are snug against your teeth and the root doesn’t show…

Unfortunately, in some cases the gums have pulled away from the tooth and some of the root surface is exposed. This apparent lengthening of the teeth can really age a person’s smile. If left uncorrected, the loss of protective gum tissue may also mean even more severe problems down the road.

Fortunately, a procedure called grafting can correct this problem. The first step in placing a graft is to thoroughly numb the involved areas. Then the graft is taken from the donor site on the palate (the roof of your mouth).

In some cases, the incision heals on its own; it can also be closed with a stitch or two.

At the site of the graft, your dentist gently separates the gums from the tooth. This creates a flap and gives us access to the area. Your dentist then carefully removes any plaque and tartar from the root surfaces.

The graft is strategically placed and carefully stitched in place. After healing for a few weeks, the grafted tissue blends in beautifully. The results? The gums have been restored and strengthened, the root surface is covered and protected, and the tooth now has a much more natural and pleasing appearance.

Grinding Your Teeth (Bruxism)

Bruxism is the clenching or grinding of the teeth, which occurs primarily while you are sleeping. The symptoms of bruxism are…

a sore, tired jaw
difficulty opening and closing your mouth
sensitive teeth
earaches or pain in your jaw joint

The pressure on your teeth is many times greater during bruxism than during normal chewing. If left untreated you may experience:

flattened or worn-down teeth
teeth chipped at the gum line
loose teeth
damage to the bone around your teeth
damage to your jaw joint, the TMJ

Though all the causes of grinding are not known, stress is often a factor. There are a variety of stress-reduction techniques that may be helpful, or medication might be recommended to temporarily reduce stress or to reduce pain and soreness. Spaces, worn teeth, or teeth that are out of alignment may cause grinding and clenching. Crowns, bridges, or other dental restorations can restore your bite and eliminate the pattern of grinding and clenching.

One of the most common and effective ways to stop the damage caused by grinding and clenching is the use of a nightguard. A nightguard is a plastic device that fits over your teeth and is worn at night to protect them from the damage caused by grinding. There are many types and styles of nightguards. Some are hard and some are soft; they may be worn on the top or the bottom teeth.

To make a nightguard, on the first appointment your dentist takes impressions. From these impressions, models are made of your teeth. It’s on these models that the custom nightguard is made. On your second appointment you will try on the nightguard, and your dentist will carefully adjust its fit.

Without treatment, the constant clenching and grinding of your teeth can cause widespread damage in your mouth. Dealing with the problem early on can restore harmony and prevent many future problems.

Gum Disease and Heart Attacks—Is There a Connection?

There is growing evidence that the presence of periodontal (gum) disease can be linked to the incidence of coronary heart disease…

Gums infected with periodontal disease are toxic reservoirs of disease-causing bacteria. The bacteria hide in pockets next to the teeth, where the gums have pulled away from the tooth surface. When gums are this infected, they frequently bleed.

Researchers at the University of Minnesota in Minneapolis recently discovered that bleeding gums common in severe gum disease provide an open doorway for plaque bacteria to enter the bloodstream. This bacteria, Streptococcus sanguis, can cause blood clots that block arteries and trigger heart attacks.

“Severe periodontitis is the equivalent of about nine square inches of chronic wound around the teeth,” said Dr. Mark Herzberg, director of the study. “It offers considerable opportunity over time for these bacteria to enter the blood.”

In the study, researchers injected the plaque bacteria into rabbits’ veins and then monitored their hearts. Clots formed immediately, and within 30 minutes, the blood flow to the rabbits’ hearts was reduced, reported Herzberg.

Researchers caution that they don’t know whether these results can be reproduced in humans. Nevertheless, this emerging research strengthens the strong link between poor dental health and heart disease.

More heartache from gum disease

Other studies have shown that plaque bacteria entering the bloodstream through infected gums might also cause a potentially fatal heart disease called infective endocarditis. This is a bacterial infection that causes the sac around the heart to become inflamed. Herzberg has shown that the S. sanguis plaque bacteria is one of the most frequent causes of endocarditis.

More than just speculation

In a study of 400 older men, researchers in Michigan found that those with severe gum disease were four and one-half times more likely to have coronary heart disease than those without gum disease.

The University of Michigan study, conducted by Dr. Walter Loesche, analyzed a sample of 400 men in long-term care at the Ann Arbor VA Medical Center. All men were over 60 years of age, and those whose gum disease correlated with heart disease had bleeding from nearly every tooth and had 14 or fewer teeth remaining.

Findings from the same study also revealed a possible relationship between regular dental exams and a reduced risk of stroke. “Patients who saw a dentist at least once a year were four times less likely to have a history of (stroke),” Loesche said.

The lesson to be learned? Brush, floss, and see your dentist regularly. Because we now know that good oral health can prevent more than just gum disease.

Sources:
Dr. Walter Loesche, “The Link Between Systemic Conditions and Diseases and Oral Health,” University of Michigan. Dr. Eugene J. Whitaker, Temple University School of Dentistry.
The Academy of General Dentistry
The American Academy of Periodontology
The American Dental Association
American Academy of Neurology – 51st Annual Meeting in Toronto, Canada, April, 1999.

Implants

If you prefer not to have a partial denture or bridge attached to adjacent teeth, you might consider an implant,..

which is a metal cylinder surgically inserted into the bone of the upper or lower jaw. A crown or modified denture may be attached to the implant.

An additional benefit: Implants may stop or slow down the bone loss that occurs once teeth have been lost.

What is an implant?

An implant is thin metal cylinder surgically implanted into the bone of the jaw to replace the root of a missing tooth. One kind of implant has a metal frame and one or more posts. The frame is positioned on the jawbone, then covered with gum tissue so that the pin(s) protrude into the mouth.

Another kind of implant has a metal “root” that is anchored in the jawbone and a pin that protrudes into the mouth. Pins for both kinds of implants can secure a single crown or a complete denture. Since the success of an implant is directly related to the skill of the dentist, be sure to ask your dentist if she has had implant training.

Infant Tooth Decay

Bottle syndrome, or early childhood caries, is the severe decay of baby teeth caused by the constant presence of milk, formula or juice in a child’s mouth…

Bottle syndrome can cause a lot of damage in a short amount of time. Every time a child drinks anything containing sugar, bacteria in the mouth produce acids that attack the tooth enamel for at least thirty minutes. The most common source of sugar is a bottle left in the child’s mouth for long periods, especially at night or during naps.

What most people don’t realize is that even milk and unsweetened fruit juices contain sugar, lactose and fructose. By switching to a pacifier or a bottle of plain water at these times, and by gently cleaning your child’s teeth after she eats, you can avoid bottle syndrome and the damage and suffering it causes.

Infection Control

In a dental office, the professional staff takes pride in adhering to the highest possible infection control standards…

The staff members scrub their hands before and after each appointment and always put on a new pair of disposable gloves. Your dentist wears a mask and protective eyewear. All instruments are sterilized with an autoclave. The handpieces are always heat sterilized between patients.

Your dentist uses disposable supplies and protective barriers on exposed surfaces and disinfects all other surfaces according to government standards. She disposes of biodental waste and sharp instruments in safe containers provided through a biomedical disposal company.

All staff members are vaccinated for hepatitis B and are regularly updated in infection control procedures. Dental professionals adhere to these infection control procedures because your health and welfare are extremely important to them.

Jaw-Joint Pain

When Chewing Jaw-joint pain when chewing is a symptom of temporomandibular disorder (TMD), which is more commonly called TMJ syndrome. Most common in women between the ages of 25 and 40, TMD can be caused by a bad bite, misaligned teeth, missing teeth, arthritis or emotional stress..

After Sleeping

Jaw-joint pain in the morning is a sign that you’re grinding and clenching your teeth during the night. This is one of the causes of temporomandibular disorder (TMD), which is more commonly called TMJ syndrome. Most common in women between the ages of 25 and 40, this grinding can be caused by a bad bite, misaligned teeth, missing teeth, arthritis or emotional stress. Constant TMJ Pain
Jaw-joint pain is a symptom of temporomandibular disorder (TMD), which is more commonly called TMJ syndrome. Most common in women between the ages of 25 and 40, TMD can be caused by a bad bite, misaligned teeth, missing teeth, arthritis or emotional stress. Treatment
Have a complete diagnosis of the problem by your dentist or by a dentist who focuses on this disorder (there is no official specialty in dentistry for TMJ problems). A wide range of treatments is available. For a more comprehensive explanation see Take this Book to the Dentist with You by Charles B. Inlander.

Lingual Braces

Braces behind the teeth—also called lingual appliances—have been used by orthodontists all over the world since the early 1980s…

Treatment time is comparable to standard braces (18 to 24 months), and the quality of treatment is excellent. Lingual appliances are the finest aesthetic option for an individual who wants truly invisible braces

Loose Filling or Crown

It’s important to deal quickly with a loose or broken filling or crown. Once a filling or crown has lost its seal, a cavity will quickly form. A cavity in the area of a restoration is already past the first line of defense of the tooth…

aiting beyond a few days may allow the decay to reach the nerve. Then, the only treatment option is a root canal. Another risk of waiting is that the filling or crown might fall completely out of your tooth during the night. If it enters your windpipe, you may be headed for surgery in the hospital.

Loose Teeth

Caused by gum disease Following a dental injury After braces…

Caused by Gum (Periodontal) Disease

If you have one or more loose teeth as a result of gum (periodontal) disease, it’s important to have a thorough evaluation by a dentist.

Treatment

There are many treatments that can save your teeth even after they’ve become noticeably loose. Your dentist will first take x-rays and measure the depth between the tooth and the gums with a periodontal probe. The probe measures the distance from the top of the gums to the bottom of the gum pocket next to the tooth. Healthy gum pockets are two or three millimeters deep. Depths exceeding three millimeters indicate gingivitis (early gum disease) or periodontitis (more advanced gum disease accompanied by bone loss).

Treatment options include a combination of root planing (removing the tartar and polishing the root surfaces), splinting (using materials to secure loose teeth to each other) and surgery (pulling the gums back to gain proper access to the root surfaces, re-sculpting the bone and gums, and placing several stitches to aid healing). Some general dentists perform these treatments in their offices. Others refer patients to periodontists, who are specialists concentrating on gum-related problems.

Following a Dental Injury

A blow to a tooth may cause a tooth to be loose. If it’s still properly aligned, it will generally tighten back up on its own (in days or several weeks). It’s important to know that a tooth may tighten up and appear normal only to later die because the nerve and blood supply are severed. If this occurs, you may notice a gum boil (a tooth abscess that has worked its way to the surface), a toothache, darkening of the tooth, or no symptoms at all.

Treatment

Get to the dentist right away if you have an injury-related loose tooth. The tooth will need to be re-checked for a year or more to make sure that it’s still healthy and has an intact nerve and blood supply. Enter your zip code in the blue box below for a dentist in your area who can see you immediately for a dental emergency due to a dental injury.

After Braces (Orthodontics)

It’s common for some teeth to be slightly loose during and after braces. In response to the pressure exerted by the brackets and wires on your teeth, special cells remove bone on one side of each tooth and build bone on the opposite side. This process allows teeth to move through bone. Until all the bone has filled back in, teeth may be noticeably loose.

Treatment

Contact your orthodontist.

Missing Tooth

Here’s an “insider tip”: If you have recently lost a tooth because of long-standing problems or an accident, it’s important to obtain a temporary replacement. It’s also important for you to know that not replacing a…

missing tooth can start a chain reaction of dental problems that can affect your entire mouth. Problems include shifting of the adjacent teeth, collapse of your bite, extrusion (growing out of the socket) of teeth on the opposite arch (teeth in the upper or lower jaw), jaw-joint problems, and an increased likelihood of gum disease around teeth that have tilted or shifted.

Temporary (with no involvement of adjacent teeth)

A “flipper” is a plastic partial denture with a tooth bonded to its front edge. On the upper arch, it covers all or part of your palate and is an adequate, temporary solution. Disadvantages It tends to feel bulky and make speaking difficult, it gets loose, and it may fall out of place. If you have a high smile line (your lip comes up fairly high when you smile), it may not look as natural as you would like. Flippers are widely used by dentists as a temporary replacement for missing teeth.They tend to work more effectively on the upper teeth. Though some people attempt to wear them as if they were permanent repairs, they’re definitely short-term solutions.

Long-term (involves adjacent teeth)

Installing a resin-bonded Maryland bridge requires light reduction of the backs of the adjacent teeth. The bridge, which includes a replacement tooth with small “wings” attached, is bonded in place. It’s an aesthetically-pleasing missing-tooth replacement that requires only minimal tooth reduction. But it can’t be used if your bite is off or if you grind heavily on your front teeth.

Long-term (does not involve adjacent teeth)

If you do not want any part of your adjacent teeth reduced to help support a dental bridge, then you only have two options: implants or partial dentures.

Implants

A dental implant is a small metal cylinder that’s surgically implanted in the bone of the jaw to replace the root of a missing tooth. A crown can then be attached to the implant with a screw, or the crown may be directly cemented onto an extension that is threaded into the implant.

Advantages

An implant doesn’t involve grinding or reduction of the adjacent teeth. It looks natural and helps to reduce the bone and ridge loss that often occurs after a tooth has been removed.

Disadvantages

An implant requires three to nine months to complete (the implant requires several months to fuse to the bone), it is the most expensive of all options, and it requires surgical placement (a minor surgical procedure).

Notches or Slots at the Gum Line

Notches or slots in your teeth at the gum line usually mean that your bite is off and the notched teeth are not aligned with the rest of your teeth…

A hard toothbrush or your brushing pattern is usually not the cause of notching.) Teeth that are under unusual pressure tend to flex. This flexing causes tooth structure to be shed at the gum line.

Treatment

In most cases, the tooth will need a bonded resin filling. If the notching is severe, the tooth may need to be crowned.

Periodontal Involvement

There are two reasons why it takes new tools and techniques to clean the plaque off of your teeth when you’ve lost bone due to periodontal disease…

First, in a healthy mouth, the space between the tooth and gums (called the sulcus) is normally two to three millimeters deep. And that’s how far below the gums you can effectively clean with a toothbrush and floss. But with periodontal disease, the sulcus deepens; it’s now greater than three millimeters, and it is called a pocket. Pockets are notorious hiding places for plaque and bacteria.

The second problem in periodontal disease has to do with the shape of the roots. If there is no periodontal disease, the bone level is high and the gums attach firmly at the necks of the teeth. You can wrap floss around this surface and do a thorough job of keeping plaque off of your teeth.

In periodontal disease, the attachment shifts and you lose bone. Now you have root surfaces to contend with, and they have indentions. Floss stretches across these indentions and can’t remove the plaque hiding inside.

Special tools are necessary to reach down beyond the normal three millimeters to thoroughly clean the indentions in the sides of the roots. Each tool is useful in different areas of your mouth.

Your dentist will be happy to work with you to customize a plaque-removal program using these special tools and techniques.

Placing a Cantilever Bridge

It takes two appointments to replace a missing tooth with a cantilever bridge. That’s because a bridge is custom-crafted in a dental laboratory to precisely fit your teeth…

To make the entire procedure comfortable for you, the first thing your dentist will do is make sure you’re thoroughly numb. Then, any decay is removed and the teeth are shaped with the handpiece.

Sometimes, to make a more accurate impression, a small piece of string is placed in the space between the tooth and the gums. This gently pushes the gums away from the tooth. Impressions give an accurate working model of your mouth, including the prepared teeth. This lets your dentist re-create your natural bite. For the week or two that it takes the dental lab to fabricate your new bridge, you’ll have a temporary bridge in your mouth.

At your next visit, the temporary bridge will be removed and you’ll try out your new bridge. Your dentist will check the fit and your bite. When everything looks good, the new bridge is cemented in place.

Placing a Filling

To make the entire procedure comfortable for you, the first thing your dentist will do is make sure you’re thoroughly numb…

Depending on the size of the filling and the tooth being worked on, a rubber dam may be used. It fuctions like a safety net, preventing debris from falling to the back of your throat. Then your dentist removes the decay and shapes the tooth with the handpiece. To mold the filling to the shape of the tooth, your dentist first surrounds it with a thin, flexible band. A small wooden wedge between the teeth holds it snugly in place. Next, your dentist presses the filling material into the tooth.

White fillings harden when they’re exposed to a special high-intensity light, while silver filllings harden on their own. Your dentist checks the bite with a colored tape, which shows where your teeth are coming together. She also glides a piece of floss between the teeth to make sure there are no tight spots. The procedure is then complete.

Placing a Gold Bridge on Back Teeth

It takes two appointments to replace a missing tooth with a gold bridge. That’s because a bridge is custom-crafted in a dental laboratory to precisely fit your teeth…

To make the entire procedure comfortable for you, the first thing your dentist will do is make sure you’re thoroughly numb. Then any decay is removed and the teeth are shaped with the handpiece.

Sometimes, to make a more accurate impression, a small piece of string is placed in the space between the tooth and the gums. Impressions give an accurate working model of your mouth, including the prepared teeth. This lets your dentist re-create your natural bite.

For the week or two that it takes the dental lab to fabricate your new bridge, you’ll have a temporary bridge in your mouth. At your next visit, the temporary bridge will be removed, and you’ll try out your new bridge. Your dentist will check the fit and your bite. When everything looks good, your new gold bridge will be cemented in place.

Placing a Gold Crown on a Back Tooth

It takes two appointments to restore your teeth with a crown. That’s because a crown is custom-crafted in a dental laboratory to precisely fit your tooth…

Treatment

To make the entire process comfortable for you, the first thing your dentist will do is make sure the affected area is thoroughly numb. Then any decay is removed with the handpiece, and the tooth is shaped.

Sometimes, to make a more accurate impression of the tooth, a piece of string is placed between the tooth and the gums. This gently pushes the gums away from the tooth.

Impressions create an accurate working model of the mouth, including the prepared tooth. This helps to re-create your natural bite.

For the week or two that it takes the dental lab to fabricate your new crown, you’ll have a temporary crown. At your next visit, the temporary crown is removed, and you’ll try out your new crown. Your dentist will check the fit and your bite. When everything looks good, your new crown crown will be cemented into place to complete the procedure.

Placing a Maryland Bridge

It takes two appointments to replace a missing tooth with a Maryland bridge. That’s because a bridge is custom-crafted in a dental laboratory to precisely fit your teeth…

To make the entire procedure comfortable for you, the first thing your dentist will do is make sure you’re thoroughly numb. Then any decay is removed and the teeth are shaped with the handpiece.

Sometimes, to make a more accurate impression, a small piece of string is placed in the space between the tooth and the gums. This gently pushes the gums away from the tooth. Impressions give an accurate working model of your mouth, including the prepared teeth. This lets your dentist re-create your natural bite. For the week or two that it takes the dental lab to fabricate your new bridge, you’ll have a temporary bridge in your mouth.

At your next visit, the temporary bridge will be removed, and you’ll try out your new bridge. Your dentist will checks the fit and your bite. When everything looks good, your new Maryland bridge will be cemented in place.

Placing a Porcelain Bridge on Back Teeth

It takes two appointments to replace a missing tooth with a porcelain bridge. That’s because a bridge is custom-crafted in a dental laboratory to precisely fit your teeth…

To make the entire procedure comfortable for you, the first thing your dentist will do is make sure you’re thoroughly numb. Then any decay is removed, and the teeth are shaped with the handpiece.

Sometimes, to make a more accurate impression, a small piece of string is placed in the space between the tooth and the gums. This gently pushes the gums away from the tooth. Impressions give an accurate working model of your mouth, including the prepared teeth. This lets your dentist re-create your natural bite.

For the week or two that it takes the dental lab to fabricate your new bridge, you’ll have a temporary bridge in your mouth.

At your next visit, the temporary bridge is removed and you’ll try out your new bridge. Your dentist will check the fit and your bite. When everything looks good, your new porcelain bridge will be cemented in place.

Placing a Porcelain Crown on a Back Tooth

It takes two appointments to restore your tooth with a crown. That’s because a crown is custom-crafted in a dental laboratory to precisely fit your tooth…

To make the entire process comfortable for you, the first thing your dentist will do is make the affected area thoroughly numb. Then any decay is removed with the handpiece and the tooth is shaped.

Sometimes, to make a more accurate impression of the teeth, a piece of string is placed between the tooth and the gums. This gently pushes the gums away from the tooth.

Impressions create an accurate working model of the mouth, including the prepared tooth. This helps to recreate your natural bite.

For the week or two that it takes the dental lab to fabricate your new crown, you’ll have a temporary crown. At your next visit, the temporary crown is removed and you’ll try out your new crown. Your dentist will check the fit and your bite, and when everything looks good, the crown is cemented into place, and the procedure is complete.

Placing a Silver Amalgam Filling

To make the entire procedure comfortable for you, the affected area is numbed with a local anesthestic…

Treatment

Depending on the size of the filling and the tooth being worked on, a rubber dam may be used. It functions like a safety net, keeping debris from falling to the back of your throat.

Then the decay is removed and the tooth is shaped with the handpiece. To mold the filling to the shape of the tooth, the tooth is surrounded with a thin, flexible band. A small wooden wedge between the teeth holds the band snugly in place. The filling material is pressed into the tooth and is carved into the proper shape.

The dentist then checks your bite with a colored tape, which indicates where your teeth are coming together. Your dentist will also gently floss between the teeth to make sure there are no tight spots. Then your new silver filling is completed.

Placing a Three-Unit Bridge on Front Teeth

It takes two appointments to replace a missing front tooth with a three-unit bridge. That’s because a bridge is custom-crafted in a dental laboratory to precisely fit your teeth…

To make the entire procedure comfortable for you, the first thing your dentist will do is make sure you’re thoroughly numb. Then any decay is removed, and the teeth are shaped with the handpiece.

Sometimes, to make a more accurate impression, a small piece of string is placed in the space between the tooth and the gums. This gently pushes the gums away from the tooth.

Impressions give an accurate working model of your mouth, including the prepared teeth. This lets your dentist re-create your natural bite. For the week or two that it takes the dental lab to fabricate your new bridge, you’ll have a temporary bridge in your mouth.

At your next visit, the temporary bridge will be removed and you’ll try out your new bridge. Your dentist will check the fit and your bite. When everything looks good, your new bridge is cemented in place.

Placing a Tooth-Colored Filling on a Front Tooth

To make the entire procedure comfortable for you, the affected area is numbed with a local anesthetic. Depending on the size of the filling and the tooth being worked on, a rubber dam may be used. It functions like a safety net, preventing debris from falling to the back of your throat…

Then the decay is removed, and the tooth is shaped with the handpiece. A gel chemically etches the tooth so the bonding material really adheres to the tooth.

The tooth is prepared, and a resin is chosen to match your tooth color. After the resin is placed into your tooth, a special high-intensity light is used to harden the filling. After the filling is set, it is smoothed and polished.

Then your dentist checks your bite with a colored tape, which indicates where your teeth are coming together, and floss is placed between the teeth to make sure there are no tight spots. Your new resin filling is now complete.

Placing a Tooth-Colored Restoration

It takes two appointments to replace a silver filling with a resin onlay. On the first appointment, the old filling and any additional decay is removed….

Then your dentist takes an impression of your teeth. A temporary onlay is then placed in your tooth. Models of your teeth are made from the impression and are sent to the lab.

At the laboratory, resin material is carefully placed into the model. The onlay is individually designed or characterized to make it look natural and lifelike. On your second appointment, the temporary onlay is removed. A conditioning gel is placed on your tooth to prepare it for bonding to the new onlay.

Then bonding cement is placed in the tooth, and a harmless, high-intensity light bonds the resin onlay to the tooth. Excess cement is removed and the onlay is polished to a high luster. Resin onlays look great! And since they’re bonded in place, they strengthen and protect the tooth

Placing Braces on Adults

Teeth can be straightened at any age. In fact, one out of four orthodontic patients in the United States today is an adult…

Until the 1980s, a steel band went around each individual tooth like a ring. The wire that pulled the teeth into line was attached to a little bracket on the front of the steel bands. This looked like a mouth full of metal!

Fortunately, today these bands have been replaced with brackets that are bonded with an adhesive right to the front of the teeth. They’re much more comfortable, smaller than an unpopped popcorn kernel, and much less noticeable than the bands. Clear sapphire brackets are also available, but they’re usually more expensive and tougher to keep clean.

A stainless steel wire still connects the brackets; different sizes of wire provide the pressure to move the teeth. Elastics that come in many different colors hold the wire in place. Special elastic bands may be added to speed up tooth movement. Other wires and attachments are used in more difficult cases. It’s pretty amazing how far teeth can move through bone. Your bone responds to the tension created by these brackets and wires by making special cells on each side of the tooth. These cells remove bone on one side of the tooth and make bone on the opposite side. That’s what allows the tooth to move.

It’s harder to clean your teeth once braces are on, so regular cleaning appointments will be more important than ever. Permanent white stains may form on teeth if plaque isn’t removed regularly. After treatment, retainers are used to hold the teeth in their new alignment. Some retainers are designed to be removable, while others are cemented in place. It’s nice to know that with orthodontic treatment you’re never too old to improve your smile and the health of your mouth.

Placing Braces on Children

Until recently, orthodontics was used mainly to straighten crooked teeth. Now, when problems are caught early enough, it’s possible to actually alter the facial development of a growing child by using functional appliances on his teeth…

Other orthodontic appliances don’t work with facial development but do move teeth and correct malocclusions. One kind of appliance called a space maintainer is used after a baby tooth has been lost when the permanent tooth isn’t due to come in soon.

Braces are used to correct a bad bite once most of the permanent teeth are in. Until the 1980s, a steel band was placed around each tooth like a ring. A wire pulled the teeth into line and was attached to a little bracket that was on the front of the steel bands. You may remember what this looked like: a mouth full of metal!

Fortunately, today these bands have been replaced with brackets that are bonded with an adhesive right to the front of the teeth. They’re much more comfortable, smaller than an unpopped popcorn kernel, and much less noticeable than the steel bands.

Clear sapphire brackets are also available, but they’re usually more expensive and tougher to keep clean. A stainless steel wire still connects the brackets, and different sizes of wire provide the proper pressure to move the teeth. Elastics that now come in many colors hold the wire in place. Special elastic bands may be added to speed up tooth movement. Other wires and attachments are used in more difficult cases.

It’s pretty amazing how far teeth can move through bone. Your bone responds to the tension created by these brackets and wires by making special cells on each side of a tooth. These cells remove bone on one side of the tooth and make bone on the opposite side. That’s what allows the tooth to move.

The time a child spends in braces depends on the severity of the malocclusion, but it’s usually between one and three years. It’s hard for children to clean their teeth once braces are on, so regular cleaning appointments are more important than ever. Permanent white stains may form on teeth if plaque isn’t regularly removed.

After treatment, retainers are used to hold the teeth in their new alignment. Some retainers are designed to be removable, while others are cemented in place.

Successful orthodontic treatment is a partnership of effort between everyone involved. Through a cooperative effort, the final goal can be reached—a healthy mouth and a beautiful smile.

Placing Stainless Steel Crowns on Primary Teeth

Small cavities in primary teeth can be fixed with fillings, because there’s still plenty of supporting tooth structure. However, large cavities need to be fixed with crowns. A crown strengthens a damaged tooth by covering and protecting it…

Crowns for primary teeth, unlike crowns for permanent teeth, can be placed in only one appointment. They are relatively easy for children to care for, and they are much less expensive than adult crowns. To ensure the entire procedure is comfortable for your child, the first thing the dentist will do is make sure the tooth is thoroughly numb. Then your dentist removes any decay and shapes the tooth with the handpiece.

A crown is selected, trimmed and shaped, and then it is adjusted until it precisely fits the tooth. Your dentist then cements the crown in place. After double-checking both the fit and the bite, your child will have a new stainless steel crown.

Repairing a Broken Front Tooth

t’s almost always a traumatic experience for both a child and her parents when a front tooth gets broken. Fortunately, new bonding techniques and materials now allow teeth to be beautifully restored back to nearly new condition…

Depending on the size and location of the fracture, it’s sometimes wise to restore the tooth in two appointments. On the first appointment, your dentist bonds an insulating base to the tooth. This protects the nerve and reduces sensitivity.

On the second appointment, if the tooth has been symptom-free, your dentist will first roughen the surface of the tooth and apply a conditioning gel. Then a tooth-colored material called resin is placed, sculpted to the desired shape and hardened with a high-intensity light.

It’s important to watch for symptoms of nerve damage after a tooth has been damaged. Let us know right away if you see signs of:

  • discoloration
  • changes in your child’s eating or sleeping habits
  • any new swelling, looseness, or pain (especially sensitivity to cold)
  • any sign of abscesses or gum boils next to the tooth

Once in place, bonded restorations generally last three to seven years. Bonding is a great way to restore a broken tooth. The final result is a strong, natural-looking restoration.

Root Canals

Some people say root canals are painless, while others say they hurt like crazy. What’s the truth? If I have a root canal, will I need a crown, too? How many office visits will it take to complete a root canal?…

Some people say root canals are painless, while others say they hurt like crazy. What’s the truth?

Since you’re numb when a root canal is performed, you probably won’t feel anything during the procedure. Most people (about 75 percent) experience no discomfort after this procedure. The discomfort experienced by the remaining 25 percent is usually caused by the infection that made the root canal necessary, not by the root canal. You should receive medication to stop the infection and relieve any associated discomfort.

If I have a root canal, will I need a crown, too?

Once the pulp of a tooth is removed, the remaining tooth structure is brittle and easily fractured. You will probably need a crown to protect the underlying tooth.

How many office visits will it take to complete a root canal?

It depends on the location of the tooth, the number of root canals in the tooth, and how much infection is present. Root canal therapy generally takes between one and three appointments to complete. Since most root canals require the placement of a crown, you may need one or two more additional visits to have the crown fitted.

Root Canal Treatment

Root canal treatment and subsequent tooth restoration usually involves three steps…

First, your dentist removes the infection to promote healing.
Next, he places a post to strengthen the tooth.
Finally, he crowns the tooth to protect it.

Your dentist wants the entire procedure to be comfortable for you, so the first thing he’ll do is make sure you’re thoroughly numb. Then, he will place a rubber dam around your tooth to isolate it from the rest of your mouth. It protects you by keeping debris from falling to the back of your throat. It also keeps the tooth dry and accessible so your dentist can do a better job. To get at the infection, he makes an opening through the top of the tooth down into the pulp chamber. With a dental file, your dentist (or endodontist) carefully cleans out the infected tissue and shapes the canals to receive the filling material. X-rays are taken to make sure that all of the infected pulp is removed. Sometimes it’s necessary to strengthen a tooth with a post. The post is cemented down inside one of the root canals. Making a crown is the last step in restoring your tooth. It protects your tooth and gives you back your smile.

Root Planing

The goal of root planing is to eliminate the source of periodontal infection by removing the plaque, tartar and bacterial toxins from surfaces of the roots…

Tartar shows up on an x-ray as small white lumps on the sides of the teeth. Routine cleanings remove plaque and calculus from above the gum line. Root planing removes plaque and calculus from below the gum line.

To keep you comfortable, the dentist usually numbs you before root planing begins. Then, a dental assistant carefully and meticulously planes the root surfaces with special hand tools.

Once the source of infection is removed, your gums begin to heal. As they heal, your gums will tighten around your teeth. Homecare is the key to maintaining the healing process. Since brushing and flossing only go about three millimeters below the gum line, something more is needed to clean the deeper pockets that come from periodontal disease.

A dental hygienist or assistant will give you the tools and techniques to use at home as part of your treatment. Normally, root planing is spread across several appointments. That way the hygienist can track the healing and help you fine-tune your homecare efforts.

Short or Worn Teeth

Porcelain Veneers Bonding Crowns…

Porcelain Veneers

Porcelain veneers are a natural looking solution to a wide range of cosmetic problems. Porcelain veneers are thin shells of porcelain (about as thick as fake fingernails) that are typically bonded to the front and tops of the teeth. Because they are thin, light can shine through them and they take on the natural color of the underlying tooth structure. Only a minimal amount of tooth structure has to be removed.

Advantages

They are beautiful, strong (once bonded in place) and durable. Minimal tooth reduction is needed to install them, and they can often be repaired in the mouth with bonding techniques.

Disadvantages

Their placement requires some tooth reduction, and the procedure is non-reversible, making you dependent on veneers or replacement veneers for the rest of your life. Your dentist must have the technique, experience, and artistic talent to place veneers. This is a two-appointment procedure.

Bonding

Bonding is a three-step procedure. First, the fronts of the teeth are treated with a mild acid. Next, the plastic bonding material (it has a consistency of bread dough) is placed and sculpted to the desired shape. Finally, the material is hardened with a high-intensity light.

Advantages

Bonding produces strong, natural-looking restorations, it allows in-the-mouth repairs, and it’s a one-appointment procedure.

Disadvantages

Some tooth reduction is required, and it’s generally considered a non-reversible procedure that makes you dependent on bonding for the rest of your life. Your dentist must have the proper technique, experience, and artistic talent to perform bonding. Note that relatively few dentists have adequate training in bonding.

Crowns

Crowns are made of porcelain, porcelain and metal, or entirely out of metal. They are best used in cases where teeth are broken down and need structural support and protection. They might also be appropriate if gaps are extremely wide. If your teeth are intact and you merely want to close spaces, stick with bonding, veneers, or orthodontics.

Advantages

Crowns can repair structural damage, they’re very strong, and they can be made from several different materials.

Disadvantages

Crowns require a relatively large amount of tooth reduction, they are less natural-looking than veneers or bonding, and they may show a dark blue line where they meet the gums, if your gums recede. Porcelain crowns may wear down opposing teeth.

Silver Fillings or White?

Silver amalgam and composite resin are the two most common materials used to restore teeth damaged by decay. There are situations where one material is preferable over the other,..

and similarly, there are disadvantages to both of these filling materials. Additionally, there are some health experts who question the safety of amalgam fillings and say they should not be used under any circumstances.

Silver amalgam—a health hazard?

The American Dental Association’s official position regarding silver amalgam is that it is a “safe, durable and cost-effective material that dentists have used in tooth restorations for more than 150 years.” But there are some practitioners who have expressed serious concern over the safety of amalgams, and the controversy over its use continues.

What is causing such concern?

It’s the fact that amalgam is composed of 35 percent silver, 15 percent tin or tin mixed with copper, a trace of zinc, and 50 percent mercury—a highly toxic heavy metal.

Anti-amalgam dentists point out that the amalgam releases mercury vapor when there is friction on the surface of the filling, such as when you chew. Mercury vapor is cyto-toxic, which means that it kills cells, even when the exposure is minute.

Mercury is absorbed through the lungs and into the arterial blood and is stored by your body, primarily in your kidneys, liver and brain. And no level of this mercury vapor is considered safe. However, the ADA counters that, once bound to the other metals, the mercury in dental amalgam is completely harmless.

While “it is highly unlikely that such small concentrations of mercury can or do harm the typical human, there is a remote chance that persons who have immunocompromised systems could have some negative influence from this mercury presence, or the presence of other metals,” said Gordon J. Christiansen, D.D.S., M.S.D., Ph.D. Also, those allergic to mercury should not have amalgam fillings placed in their mouths.

It’s important to note that no controlled scientific studies have been conducted that demonstrate ill effects to human health resulting from amalgam fillings. The evidence, to date, is all anecdotal. The World Health Organization has stated that it recognizes the importance of continued monitoring of the safety and effectiveness of all dental restorative materials, including dental amalgam.

Amalgam’s advantages

  • Silver amalgam is a more durable tooth filling material than composite resin in teeth that are subjected to a lot of biting pressure.
  • An amalgam filling costs considerably less than a comparable composite filling.

The disadvantages of amalgam

  • Silver fillings are less attractive than tooth-colored composite resin fillings; for this reason, they’re typically not placed in teeth located near the front of your mouth.
  • The mercury in amalgam fillings expands and contracts with heat and cold (think of the mercury in a thermometer). This can eventually cause the filling to fracture your tooth, so a crown will be required to restore its functionality.
  • Silver fillings will eventually corrode and leak, which can cause new decay to develop underneath the filling. The leakage can also give a gray appearance to the entire tooth.

Tooth-colored composite resins—the pros and cons

Resin fillings result in a natural-looking smile. The color can be closely matched to your natural teeth, so the restorations are nearly undetectable. And because the resin compound actually bonds to your tooth, the seal is tighter and the restored tooth can be even stronger than it was before.

Composite resin fillings can also be made much smaller than an amalgam filling used to restore the same amount of decayed tooth, so less natural tooth structure is lost. The durability of resin tooth-filling material has not been time-tested, but continual improvements in the product have made resins nearly as durable as amalgam fillings.

So where’s the catch?

In the cost. A resin filling costs about 150 to 200 percent more than a comparable silver filling. Most insurance benefits don’t cover the additional cost of composite fillings, so you must pay the difference.

Which to choose?

Overall, resin fillings are a more conservative treatment, because less of your natural tooth structure needs to be removed in preparation for their placement. They also do a better job of protecting your tooth in the long run, as there’s less chance that your tooth will fracture and require a crown in the future.

Ultimately, the choice is a personal one for both dentists and patients. Do amalgam’s benefits outweigh the possible risks? Are tooth-colored fillings worth the significant extra cost? Which filling material will prove to be most cost-effective in the long run? We recommend that you research your options, discuss them with your dental healthcare providers, and choose the filling material that’s right for you, based on what you’ve learned.

Sources:
The American Dental Association
The World Health Organization
“The Use of Mercury Containing Restorations (Fillings) in Dentistry”, by Gordon J. Christensen, D.D.S., M.S.D., Ph.D.

Soft Teeth

My child’s teeth came in rotten. Does she have “soft teeth”? No. Tooth decay is usually caused by a lack of dental hygiene uring breast or bottle feeding, infant teeth are bathed in milk sugars. If not cleaned regularly, infant teeth will develop cavities.

Were your child’s teeth discolored when they appeared? If so, you may have been exposed to harmful chemicals while you were nursing. A recent study in Finland has established a connection between discoloration of children’s teeth and the exposure of their nursing mothers to the chemical dioxin. Dioxin is breathed in as fumes from trash burning, industrial wastes, oil and metal refining, paper production and cigarette smoke. Let your dentist examine her teeth and determine how best to treat them.

Bad Breath

Bad breath can be caused by tooth decay, gum disease, lack of saliva (xerostomia), certain foods and drinks, tobacco, medications or illness…

Treatment

Schedule a dental appointment to find out if your bad breath is being caused by tooth decay, gum disease, or a medical condition that should be treated by a physician. If you have a dental problem, your dentist will recommend a course of treatment to stop any infection, clean and restore your teeth, and improve the health of your gums. Your dentist may also recommend that you take a hard look at your daily dental hygiene. Remember, you should be brushing at least twice a day and flossing at least once daily. If your bad breath is not a dental problem, your dentist may suggest changes to your eating and drinking habits or refer you to a physician.

Sore inside the Mouth

Canker Sores White Sores on Tongue or Inside of Cheek Gum Boil Other Sores inside the Mouth Special Advisory…

Canker Sores (not caused by a virus)

Canker sores (also called apthous ulcers) are small, circular, white or gray inside, and bordered in red. They occur inside the mouth and shouldn’t be confused with cold sores, which occur outside the mouth. Their exact cause is still uncertain, but they often start when the inside of the jaw or lip is accidentally bitten or there is an increase in stress or a change in diet. Unlike cold sores, canker sores are not contagious. Canker sores can remain for as long as two weeks.

Treatment

Use over-the-counter medications such as Kank-Aid? or Orajel? that numb the pain and lay a thin protective film over the sore. Avoid hot, spicy or acidic foods

White Sores on Tongue or Inside of Cheek (accompanied by pain)

There are several causes of white oral sores. One of the most common is an autoimmune disorder called lichen planus.

Treatment

A thorough checkup by your dentist is a must.

Gum Boil

An infection of the pulp of the tooth can spread into the tissues adjacent to the root tips and erupt into the outer surface of the gums as a red, fluid-filled swelling called a gum boil. In many cases, the infection will actually produce a hole in the jawbone. Left untreated, this condition could be life threatening.

Treatment

See your dentist immediately. The infection must be controlled, the infected pulp must be cleaned out via a root canal, and the weakened tooth needs to be repaired with a crown.

Other Sores inside the Mouth

Sores may result from chewing, punctures, and loose dentures.

Treatment

If the sore is bleeding significantly, control the bleeding with a rolled up piece of sterile gauze or a clean cloth, and then contact your dentist. For smaller, non-bleeding sores, apply an over-the-counter, film-forming product such as Kank-Aid? or Orajel? that will numb the injured area.

Special Advisory

Persistent mouth sores could be symptoms of a serious condition. Most dentists recommend you contact them about any mouth sore that does not heal within two weeks.

Sore outside the Mouth

Cold Sores or Fever Blisters Caused by Herpes Type I Virus These are painful, fluid-filled blisters on the lips, under the nose and on the chin. Cold sores are caused by a virus and are very contagious. They are often triggered by a fever, illness, skin.injury, sunlight, menstruation or stress. After they erupt on the skin, they dry up and form scabs that eventually fall off. Fever blisters usually last about seven to ten days.

Treatment

Keep the sore clean and do not squeeze or pick it. Wash your hands before touching your eyes, genitalia, or another person. You can infect another person even if you have no visible sores. Avoid sharing eating utensils or drinking cups. Apply an over-the-counter cold-sore medication. In some cases your dentist may prescribe an anti-viral medication (such as acyclovir).

The Basics of TMD (Temporomandibular Disorder)

TMD, temporomandibular disorder, is not one condition, but a group of conditions that affect the temporomandibular joint (the TMJ). The symptoms arise when there is a conflict between the biting surfaces of the teeth, the muscles…

in the jaw, and the jaw joint. TMD symptoms can range from a mild jaw clicking and minor discomfort to searing pain in the temple, ear, jaws and teeth. Some people with TMD can’t open their mouths all the way; others’ mouths lock wide open or dislocate.

Researchers don’t know specifically how many people suffer from TMJ disorders, but the statistics seem to indicate that about twice as many women suffer from the condition as men. However, for most people suffering from TMD symptoms, the discomfort is temporary and does not indicate the development of a serious problem. Only a small percentage of people suffer from chronic, significant TMD symptoms.

What is the temporomandibular joint?

The TMJ is the joint that joins the lower jaw with the temporal bone of the skull. It is located just to the front of your ear on each side of your head. The joint is lined with a rubbery, slippery tissue called cartilage, which allows the joint to glide smoothly as it works.

To feel your TMJ at work, put your index finger on the hard triangular tissue next to the front of your ear opening. Press down as you open and close your mouth. The motion you feel is the TMJ doing its job, and it shouldn’t hurt. If it does, chances are you have a TMD; you should see your dentist or your physician for a diagnosis.

What causes TMD?

Jaw-joint pain occurs when the cartilaginous tissue wears down to the nerve endings. Many things can cause the cartilage to wear away, but the scientific community is in disagreement as to what these causes are. Currently, most experts agree that it’s a combination of behavioral, psychological and physical factors that bring on the symptoms associated with TMD. However, dental professionals are in agreement that severe injury to the jaw is a definite cause of TMD.

What can you do to prevent TMD?

Although the specific causes of TMD—other than jaw injury—have not yet been clearly identified, many dentists recommend taking the following steps to put as little stress on the TMJ area as possible:

  • Pay attention to how you chew. Have you gotten into the habit of chewing only on one side of your mouth? If so, is there an uneven or uncomfortable area on your teeth or gums that is causing you to favor one side over the other? If that’s the case, you need to have the problem corrected by your dentist. If it’s just a habit to chew on one side only, you need to make a conscious effort to chew on both sides of your mouth. No matter what the cause of the lopsided chewing, it inflicts too much wear on the jaw joint on that side of your mouth.
  • Do you clench or grind your teeth, either during the day or at night while you sleep? Ask your spouse or roommate to let you know if you grind your teeth when you’re sleeping. This is a condition called bruxism and many people have it but don’t realize it. Bruxism is not only damaging to your jaw joint, but to your teeth as well. If you have bruxism, your dentist can fit you with a night guard that will prevent your teeth from grinding together.
  • Clenching or grinding during the day is usually a subconscious response to stress. Pay attention to your body’s reaction to stress; is clenching your teeth one of them? If so, you will have to consciously “tell” your jaw to relax. Try to always keep your teeth a little bit apart; resting your tongue between your teeth often helps.
  • Give your jaw frequent rests from chewing and avoid gum and hard, chewy food.

Sources
The National Institute of Dental Research
The American Academy of Orofacial Pain

The Disadvantages of Metal Fillings

Here is the human mouth in its ideal form. No cavities, no fillings, and no sign of dental disease. Unfortunately, teeth often don’t look quite this good…

At right, you can see how dark, unsightly silver fillings detract from the appearance of the teeth.

Fortunately, dentists now have a new filling material called resin. This material can replace dark silver fillings and make your teeth look beautiful and natural again.

In the past, when an old filling wore out or you had a cavity, your only option was to get another silver filling. But silver fillings have several drawbacks. For example, the edges of silver fillings can wear down and become weak. When fillings break, they no longer seal the tooth. This lets cavities get started again. A cavity can grow under a filling! And silver fillings act like a wedge inside the tooth, frequently splitting it as the metal contracts and expands with age. Silver fillings can corrode and leak, causing unsightly stains on the teeth and gums. And finally, silver fillings contain 50 percent mercury; this causes concern in some people because of mercury’s toxicity.

Thankfully, you’ll experience none of these drawbacks with resin fillings.

TMJ: Jaw-Joint Problems

TMJ syndrome is a cycle of pain, muscle spasms, and joint imbalance in the area where the jaw meets the skull…

TMJ is an acronym for “temporomandibular joint.” This joint connects the temporal bone of the skull with the mandible bone of the jaw. Cushioning these two bones is a thin disc of cartilage. Five muscles support this joint.

When the balance of these bones, cartilage, and muscles is lost, the result can be:

headaches and/or earaches
difficulty in opening and closing your mouth
clicking or popping in the joint
dull aching pain around the ear that spreads into the face

Millions of people suffer from TMJ disorder. Treatment and lifestyle changes can break the TMJ disorder cycle and restore comfort to the joint.

Toothache

Constant Throbbing Pain when Chewing After Routine Dental Work Wisdom Teeth…

Constant Throbbing There are two primary sources of tooth pain: the nerve inside the tooth (contained in the pulp) and the ligament surrounding the tooth. If either is damaged, irritated or inflamed, then constant throbbing may be the result. Damage or infection of the pulp may be caused by a cavity, a blow to the tooth, traumatic biting forces, or something unknown.

Treatment

If the tooth pulp is irreversibly damaged or has become infected, then root canal therapy and/or antibiotics may be needed to stop the pain.

Pain when Chewing

A cracked tooth or filling, a bad bite that causes inflammation of the ligament surrounding the tooth, or infection or damage to the pulp of the tooth are the most common causes of pain when chewing.

Treatment

After the specific diagnosis is made by your dentist, a new filling or crown, root canal therapy, or periodontal therapy may solve the problem.

After Routine Dental Work

Some discomfort is common after routine dental work, especially after the anesthetic wears off. However, throbbing pain is not normal after routine dental work.

Treatment

Contact your dentist for advice; he may prescribe stronger medication.

Wisdom Teeth

Wisdom teeth first appear in the mouth in the late teen years. As they come into the mouth, food may collect around the tooth and cause the gums around the tooth to become infected. This is one of the most common dental emergencies.

Treatment

Visit your dentist immediately. Though the long-term solution may be having your wisdom teeth removed, thorough rinsing of the area and appropriate antibiotics may eliminate your pain for the short term.

Tooth-Colored Restorations

Silver and gold fillings used to be your only choices for fillings, especially for back teeth. Today, silver fillings can be replaced with tooth-colored fillings for a much more natural look…

One of the new strong synthetic resins or porcelain is used as the filling material. Since these materials are bonded to the teeth, they are very strong and durable. Silver fillings can really darken a smile. Replacing them with tooth-colored fillings will make a dramatic difference! The new resin fillings are nearly invisible; they restore teeth to their original, natural beauty and help you look your best.

Tooth Grinding at Night

This is common in adults and children, especially during times of unusual life stress…

Treatment

If grinding becomes a long-term pattern, consult your dentist to prevent damage to your teeth and temporomandibular joint (TMJ).

Tooth Sensitivity

Many conditions can cause your tooth to be sensitive to heat, cold or pressure. ..

These include broken fillings, cracked teeth, and early infections of the nerve. Careful examination and evaluation by your dentist can keep problems from worsening.

Upper-Jaw Implants—The Procedure

Restoring the upper jaw with dental implants is accomplished in two phases. The first phase is the surgical placement of the implants…

They’re left under the gums for several months to allow the bone to attach to them. After healing, the second phase begins. The implants are re-exposed and the new teeth are made.

For the surgical placement of the implant, you will be given nitrous oxide or intravenous sedation to relax you. Then your mouth will be numbed.

An incision is made in the gums and a hole is made in the bone to receive the implant. After the implant is snugly in place, the gums are closed over the implant with a stitch or two. Over the course of the next few months, the implant attaches securely to the bone.

The second phase starts with surgical exposure of the implant. Another incision is made in your gums, and a small extension is placed to raise it above the gum line. Your dentist will then begin a series of appointments to create your new teeth.

Though some of the steps might be different in your case, they usually include making impressions of your mouth. From these impressions, your dentist will make precise working models of your mouth, which are carefully mounted for proper alignment. The last step is the placement of the teeth.

The ultimate success of implants depends on the care you provide at home, and support you receive through regular checkups and cleanings.

Using a microscope to find infections

A microscope is a new tool in dentistry that really helps in the treatment of periodontal disease…

The bacteria that cause periodontal disease thrive below the gumline. To look at the bacteria from your mouth, your dentist takes a small plaque sample from a pocket and places it on a slide.

This is a slide from a mouth with active periodontal disease. These are spirochete bacteria and they’re one sign that periodontal disease is present.

You’ll see your own slides when your dentist uses the microscope to help you judge the success of your own periodontal treatment. That way, you may be able to see the return to health in your own mouth after root planing.

White (tooth-colored) Fillings

Until recently you had no choice about the color of your fillings. Now you can have old silver or gold fillings replaced with nearly invisible porcelain or resin restorations. ..

Another advantage – they can be bonded to the teeth which gives a tighter seal and adds more strength to the tooth.

Wisdom Teeth – Why are They Often so Troublesome?

Wisdom teeth, also called third molars, are the last of the teeth to erupt. And usually, they’re the most troublesome. By the time they grow in – typically between the ages of 15-25 – the teeth are already crowded in the mouth, leaving little room for four additional molars…

When a wisdom tooth doesn’t have room to grow in properly, it becomes impacted; this means that it’s wedged against the adjacent teeth, surrounding bone or soft tissue. Left untreated, an impacted wisdom tooth can be trouble-free. However, it’s more likely that it will develop any of a wide range of problems, which could include:

  • Infection
  • Jaw pain and stiffness
  • Periodontal disease and tooth decay
  • Tumors and cysts
  • Damage to the adjacent second molars

Early removal of wisdom teeth is often recommended to avoid these problems altogether. It’s just not a good idea to wait until the areas surrounding the impacted teeth become swollen or painful.

Typically, we track wisdom tooth development with the help of X-rays. Then, if we determine that the troublesome third molars won’t grow in to an acceptable position, we’ll recommend their removal.

How are wisdom teeth removed?

Removing impacted wisdom teeth is a surgical procedure. First, the gums over the tooth are removed, and the connective tissue attached to the tooth is peeled back. The tooth is then carefully removed, and the gum is sutured (stitched).

We will evaluate your situation to determine the proper level of anesthesia, so that you will be completely comfortable throughout the procedure – both physically and emotionally. We can also prescribe a sedative for you to help you relax if you are particularly nervous about the procedure.

You’ll need to take a few days off work or school to allow yourself time to recover. Wear comfortable, loose clothing, and arrange for someone to drive you home following surgery. We’ll provide you with specific post-operative instructions after the extraction has been completed, and we’ll see you for a follow-up visit about a week after the surgery to make sure the extraction site is healing well.

Why isn’t there enough room for my wisdom teeth?

Thousands of years ago, early humans had large, powerful jaws. As they evolved, and learned to use crude blades and fire to prepare and cook their food, the workload of their jaws was lightened. Consequently, through the course of evolution, the human jaw has decreased in size, but the number of teeth remains the same. So when it’s time for the wisdom teeth to make their appearance, there’s usually just not enough room to accommodate them properly.

Worn Resin Fillings on Back Teeth

Everything wears out; resin fillings are no exception. They have to endure an incredible amount of biting force, and as time passes, they will slowly wear out or break. ..

The edges of the filling pictured to the right are breaking away, and a space is opening up between the filling and the tooth. When this happens, the filling loses its seal and no longer protects the tooth from decay.

When a restoration is recommended to replace a worn-out filling, both the size of the filling and the amount of remaining tooth structure are considered. When a worn-out filling is fairly small, like this one, you could safely replace it with another resin filling.

However, it will eventually wear out and have to be replaced again. When a worn filling is larger, and less tooth structure remains, fractures can become a problem. In the example above, the yellow arrow points to where a large piece of the tooth broke away.

By switching to a gold or porcelain overlay or crown, we can strengthen the tooth and prevent the occurance of problems such as this.

Worn White Fillings on Front Teeth

Everything wears out eventually, and white plastic fillings are no exception. As white fillings in front teeth age, they absorb moisture, swell, and begin to leak…

This filling has lost its seal and no longer fully protects the tooth from cavities. When they’re small like this, it’s easy to replace them with new plastic fillings. But sometimes, front fillings fail in another way. There’s a tremendous amount of force on the edges of teeth when you bite together. If some of the tooth broke away from the biting edge as a result of biting pressure. To strengthen the tooth and protect it from future damage, crowning or bonding may be necessary.

If You Are Experiencing Any of These Common St. Petersburg Dental Conditions, Call Our Office Immediately For an Evaluation and Treatment

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