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ProtectingPrimaryTeethfromDecayHelpsEnsureFutureDentalHealth

A baby’s teeth begin coming in just a few months after birth—first one or two in the front, and then gradually the rest of them over the next couple of years. We often refer to these primary teeth as deciduous—just like trees of the same description that shed their leaves, a child’s primary teeth will all be gone by around puberty.

It’s easy to think of them as “minor league,” while permanent teeth are the real superstars. But although they don’t last long, primary teeth play a big role in a person’s dental health well into their adult years.

Primary teeth serve two needs for a child: enabling them to eat, speak and smile in the present; but more importantly, helping to guide the developing permanent teeth to erupt properly in the future. Without them, permanent teeth can come in misaligned, affecting dental function and appearance and increasing future treatment costs.

That’s why we consider protecting primary teeth from decay a necessity for the sake of future dental health. Decay poses a real threat for children, especially an aggressive form known as early childhood caries (ECC). ECC can quickly decimate primary teeth because of their thinner enamel.

There are ways you can help reduce the chances of ECC in your child’s teeth. Don’t allow them to drink throughout the day or to go to sleep at night with a bottle or “Sippy” cup filled with milk, formula, or even juice. These liquids can contain sugars and acids that erode enamel and accelerate decay. You should also avoid sharing eating utensils with a baby or even kissing them on the mouth to avoid the transfer of disease-causing bacteria.

And even before teeth appear, start cleaning their gums with a clean, wet cloth right after feeding. After teeth appear, begin brushing and flossing to reduce plaque, the main trigger for tooth decay. And you should also begin regular dental visits no later than their first birthday. Besides teeth cleanings and checkups for decay, your dentist has a number of measures like sealants or topical fluoride to protect at-risk teeth from disease.

Helping primary teeth survive to their full lifespan is an important goal in pediatric dentistry. It’s the best strategy for having healthy permanent teeth and a bright dental health future.

If you would like more information on tooth decay in children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Do Babies Get Tooth Decay?

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Your tooth is in peril if its innermost layer, the pulp, becomes infected and inflamed. Deep tooth decay, repeated dental procedures or fractures can all expose the pulp and ultimately the roots to infection and lead to tooth loss.

But that scenario isn't inevitable — we can often save the tooth with a root canal treatment. By accessing the tooth's interior through a prepared hole, we're able to clean out the infected tissue in the pulp chamber and root canals, and fill the empty space with a special filling. We then cap the tooth with a custom crown to protect it from a re-infection.

Root canal treatments have a very high success rate — chances are good your tooth will survive for many years afterward. But there's a slight chance the tooth may become re-infected; in that case, a second root canal treatment may be in order.

In a few cases, though, a second root canal may not be advisable, and could even accelerate damage to the tooth. For example, if past dental work resulted in an extensive crown restoration, accessing the root canals the conventional way will require disassembling that restoration. This could weaken the tooth significantly.

We can approach the problem from a different route: instead of accessing the tooth's interior through the crown (the visible part of the tooth), we instead perform a surgical procedure called an apicoectomy, which accesses the tooth at the root end through the gums.

In this procedure we numb the area with local anesthesia and then make a small incision through the gums at the level of the affected root. After access, we remove any diseased tissue around the root and a few millimeters of the root tip itself. We then insert a small filling in its place to seal the canal and prevent further infection. In some cases we may also insert a graft to encourage bone growth and aid in healing.

Over time, the affected area will heal and return to normal function. Even if a traditional root canal treatment can't be used, an apicoectomy could be another option for saving your tooth.

If you would like more information on your options for preserving a problem tooth, 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 “Apicoectomy.”

November 20, 2018
Category: Oral Health
Tags: oral health   GERD  
TheConnectionBetweenGERDandOralHealth

Not coincidentally, GERD Awareness Week overlaps with the Thanksgiving holiday. Many people get acid indigestion from time to time, especially during this month of major feasting, but if you suffer from more than occasional acid reflux, you may be among the 20 percent of U.S. adults with gastroesophageal reflux disease, or GERD. For many individuals, painful heartburn often accompanies acid reflux; however, for others there are few or no symptoms. In the latter situation, dentists may be the first to suspect GERD based on what we see during a regular dental exam.

With GERD, acid washes up from the stomach into the esophagus or throat, and even into the mouth. If the condition is not treated, the repeated contact with acid can lead to ulcers and cause pre-cancerous cell changes along the esophagus lining. In addition, the acids can eat away at tooth enamel and harm the soft tissues of the mouth, which may result in severely eroded teeth and chronic gum disease. Unfortunately for those who have relatively minor symptoms, GERD may go undetected until serious damage has been done. For this reason, diagnosis and treatment of GERD is very important.

You can play a big role in managing your GERD symptoms. Besides taking any over-the-counter or prescription medication your doctor recommends, you can help control acid reflux by eating smaller meals, avoiding foods and beverages that trigger heartburn, refraining from eating within three hours of bedtime, and resisting the urge to recline right after eating. Also, quitting smoking and taking off extra weight can help greatly.

Further, it is important to take steps to protect your teeth if you suffer from GERD. Here are some tips:

  • Neutralize acid by chewing on an antacid tablet or rinsing your mouth with half a teaspoon of baking soda mixed into a cup of water.
  • Don't brush your teeth immediately after an episode of acid reflux, as this could damage the weakened tooth enamel. Instead, rinse your mouth with water to dilute the acid and wait an hour before you brush to allow your saliva to rebuild the minerals on the surface of your teeth.
  • Schedule regular dental visits to monitor the health of your teeth and gums. Depending on your specific situation, we may recommend a particular treatment to help strengthen your teeth.

Our goal is to help you preserve your teeth for life, so be sure to tell us if you have been diagnosed with GERD or any other medical condition. If you have questions, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “GERD and Oral Health” and “Tooth Decay: How to Assess Your Risk.”

WhyemBigBangTheoryemActressMayimBialikCouldntHaveBraces

Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.

“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.

Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.

Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.

Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.

Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.

So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!

For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”

YoumayneedaPeriodontisttoFullyTreatYourGumDisease

In the fight against dental disease and other conditions your general dentist is your first line of defense for prevention strategies and treatment. Sometimes, however, your condition may require the services of a dental specialist to restore health to your mouth.

A good example of this is an advanced case of periodontal (gum) disease. While your dentist and hygienist are quite skilled at removing plaque and calculus, there may be extenuating circumstances that may benefit from the knowledge and expertise of a specialist. In the case of gum-related issues that would be a periodontist, a dentist who specializes in the diagnosis and treatment of diseases or disorders related to the gums and bone that support teeth.

There are a number of reasons why you may be referred to a periodontist regarding your gum health. Besides advanced stages of the disease (loose teeth, periodontal pocketing or bone loss) that require surgery or other invasive techniques you may have a particular form that requires advanced treatment, or a secondary condition, like pregnancy or diabetes, which could impact your periodontal condition. There may also be a need for a periodontist’s consultation if you’re preparing for cosmetic restoration, most notably dental implants, that could have a bearing on your gum and bone health.

As your primary oral health “gatekeeper,” your general dentist is largely responsible for determining what you need to achieve optimal health. Likewise, your periodontist or other specialists for other problems will be equally committed to providing you the right care for your situation. Your general dentist and other specialists will work together to ensure that your condition will be cared for, and that you’ll continue to enjoy the highest level of oral health possible.

If you would like more information on the role of periodontics and other dental specialties in oral health, 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 “Referral to a Dental Specialist.”





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