The sooner you get treated for tooth decay, the less likely you'll lose your tooth. That could mean a simple filling—or you might need a root canal treatment if decay has reached the inner pulp.
There's also another procedure for advanced decay called pulp capping. It's a bit more involved than filling a cavity but less so than a root canal. We can use it if decay has exposed or nearly exposed the pulp, but not yet infected it—otherwise, you may still need a root canal treatment to remove the diseased pulp tissue.
There are two types of pulp capping methods, direct and indirect. We use direct pulp capping if the pulp has been exposed by decay. After isolating the tooth to protect other teeth from contamination, we remove all of the decayed dentin up to the pulp. This may cause some bleeding, which we'll stop, and then clean and dry the tooth area.
We'll then apply a protective biocompatible material directly over the pulp to promote healing and protect it from further infection. We then restore the tooth's appearance and function with a life-like filling.
We use the indirect method, a two-part process separated by six to eight months, when the pulp tissue is close to the surface but not yet exposed. We initially remove the majority of decayed tooth structure, but leave some of it in place next to the pulp chamber. Although this remaining dentin is softened and decayed, we'll treat it with antibacterial chemicals, then cover it with a biocompatible material and a temporary filling.
Over the next several months the treated structure has a chance to re-mineralize as it heals. We then remove the temporary filling and assess the level of healing progress. If the regenerated dentin appears healthy, we can then remove any remaining decay and restore the teeth as we would after a direct pulp capping.
At the very least, pulp capping could buy your affected tooth time before a root canal will finally be needed. Under the right circumstances, it's an effective way to save an otherwise lost tooth.
If you would like more information on tooth decay treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Pulp Capping: A Procedure that may Save a Decayed Tooth.”
Human beings have known for millennia the importance of keeping teeth clean. Although we've only come to more fully understand dental plaque's role in dental disease in the last century, our ancestors seemed to know instinctively this gritty biofilm on teeth had to go.
People from the past once used a variety of substances like ground oyster shells or leftover fire ashes to remove plaque from their teeth. Today, most of the world has replaced these substances with toothpaste, a mainstay of daily oral hygiene.
So, why is toothpaste better than other substances used in the ancient past? Besides the many other ingredients found in the typical tube of toothpaste, here are the top 3 that make it the ultimate tooth cleaner.
Abrasives. While your toothbrush does most of the mechanical work loosening plaque, toothpaste has ingredients called abrasives that give an added boost to your brushing action. The ideal abrasive is strong enough to remove plaque, but not enough to damage tooth enamel. If you look at your toothpaste's ingredient list, you'll probably see an abrasive like hydrated silica (made from sand), hydrated alumina, calcium carbonate or dicalcium phosphates.
Detergents. Your toothpaste's foaming action is a sign of a detergent, which helps loosen and break down non-soluble (not dissolvable with plain water) food substances. While similar to what you may use to wash your clothes or dishes, toothpaste detergents are much milder, the most common being sodium lauryl sulfate found in many cosmetic items. If you have frequent canker sores, though, sodium lauryl sulfate can cause irritation, so look for a toothpaste with a different detergent.
Fluoride. The enamel strengthening power of fluoride was one of the greatest discoveries in dental care history. Although not all toothpastes contain it, choosing one with fluoride can improve your enamel health and help protect you from tooth decay.
These and other ingredients like binders, preservatives and flavorings, all go in to make toothpaste the teeth-cleaning, disease-fighting product we've all come to depend upon. Used as part of daily oral hygiene, toothpaste can help brighten and freshen your smile, and keep your teeth and gums healthy.
If you would like more information on using the right toothpaste, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Toothpaste: What's in It?”
Do you grind your teeth? If you're not sure, ask your family—sometimes the sound of teeth grinding against teeth might make enough noise to be keeping them up at night. You might also be waking with sore jaw muscles and joints.
If you suspect you have this habit of involuntarily grinding, gnashing or clenching your teeth, it's a good idea to get it checked. Here are 3 things you should know about this odd habit.
Teeth-grinding more prevalent among children. Children are more likely than adults to grind their teeth in their sleep, thought to be a consequence of their developing swallowing mechanism, but usually grow out of it without any long-term effects. Adults with the habit seem to grind their teeth for different reasons, one of the most significant being a response to high stress. Tobacco could be another factor: users are twice as likely as non-users to grind their teeth. Adult teeth-grinding may also be associated with high caffeine consumption, illicit drug use or Parkinson's Disease, which impairs brain nerve function.
Sleep apnea can be an underlying cause. There's one other major underlying cause to add to that list: obstructive sleep apnea. One international study of thousands of patients from different countries found both high anxiety or stress and sleep-related breathing disorders were two of the most significant risk factors for adult teeth-grinding. It's believed the physical stress generated by these temporary episodes of breathing obstruction occurring several times a night could trigger teeth-grinding.
Teeth-grinding can cause dental problems. While having a teeth-grinding habit doesn't automatically mean you'll have dental issues, your risk can increase dramatically. Due to its chronic nature, teeth-grinding can lead to excessive tooth wear, dental work damage or jaw joint dysfunction. In some extreme cases, it could cause tooth fracture.
If you grind your teeth, your dentist may be able to help by creating a custom-made occlusal guard that can reduce biting forces while you're wearing it. You might also minimize teeth-grinding by quitting tobacco and other lifestyle changes, or getting a better handle on stress management. And if you're also diagnosed with obstructive sleep apnea, getting treatment for that condition will not only improve your overall health, it could help put an end to your teeth-grinding habit.
If you would like more information on bruxism, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
Wearing braces will probably never make your list of Most Pleasurable Life Experiences: you'll have to avoid certain foods and habits, endure some occasional discomfort, and perhaps feel some embarrassment about your appearance. The good news, though, is that at worst, these are mostly no more than inconveniences and additionally they're well worth the straighter, more attractive smile you'll achieve.
But there's one downside to braces that can lead to something more serious. The braces hardware makes brushing and flossing more difficult—and that could increase your risk of dental disease.
The principal goal of oral hygiene is to remove dental plaque, a thin film of accumulated bacteria and food particles that can cause tooth decay or periodontal (gum) disease. Without effective brushing and flossing, plaque can build up quickly and make the chances of having either of these two diseases more likely.
Not only does the braces hardware hinder your toothbrush's or floss's access to the parts of the teeth it covers, but it can also create "hiding places" for plaque build-up. Several studies have found that braces wearers on average have up to two to three times the plaque build-up of non-braces wearers.
There are ways, though, to make hygiene easier while wearing braces, particularly with flossing. Floss threaders or interproximal brushes can both be used to access between teeth while wearing braces. Another option is a water flosser or irrigator that sprays pressurized water between teeth (and beneath brackets and wires) to remove plaque. And braces wearers can get a prevention boost with topical fluoride applications or antibacterial mouth rinses to reduce disease-causing bacteria.
Besides taking a little extra time with brushing and flossing, you can also boost your mouth's health with good nutrition choices, less sugar consumption and keeping up regular dental visits. And, you should also see your dentist promptly if you notice any signs of tooth or gum problems—the sooner you have it checked and treated, the less damage any dental disease is likely to cause.
It's not easy keeping your teeth and gums plaque-free while wearing braces. But with a little extra time and effort, a few helpful tools and your dentist's support, you can maintain a healthy mouth during orthodontic treatment.
If you would like more information on best hygiene practices while wearing braces, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Caring for Teeth during Orthodontic Treatment.”
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