Posts for category: Dental Procedures
Dentists extract millions of teeth each year, mostly because of disease. But sometimes a healthy tooth is removed to gain a more favorable, long-term dental health outcome.
An example of this is extracting teeth for the sake of orthodontic treatment. This is often beneficial when treating bite problems caused by crowding, a condition in which not enough space on the jaw exists to accommodate all of the teeth coming in. When this happens, the limited space can force teeth out of their proper alignment.
Crowding also complicates correcting the bite problem with braces: As with the eruption phase, there's no available room for orthodontic movement. One solution that may arise after a detailed examination is to open up space on the jaw by removing some of the teeth.
Planning this kind of tooth extrication requires careful forethought with the end in mind—ultimately, the dental providers involved want the resulting appearance after braces to look as natural as possible. For that reason, dentists usually choose teeth for extraction that are outside of the "smile zone" (the teeth visible while smiling) like premolars and molars.
Additionally, dentists are concerned about bone loss after extracting the teeth. Bone often diminishes around empty tooth sockets, especially if those sockets were damaged during extraction. This loss in bone can weaken the jaw structure and cause significant problems while moving teeth with braces.
To avoid this, dentists take great care during tooth removal not to damage the socket. Additionally, they may place a bone graft within the socket immediately after removing the tooth, especially if the space will remain vacant for a significant period of time. A bone graft serves as a scaffold upon which new bone cells can form and accumulate.
After the extractions, the orthodontist may then proceed with correcting the bite. Patients may also need some form of prosthetic teeth to fill in the spaces while wearing braces. Often prosthetic teeth can be incorporated with the braces for a more natural look. After braces, any remaining gaps may require further restoration, either with dentures, bridges or, later in adulthood, dental implants.
Complex bite problems like crowding pose unique challenges in correcting them. But using techniques like tooth extraction can help achieve a successful and satisfactory outcome.
If you would like more information on treatments for bite problems, 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 “Tooth Removal for Orthodontic Reasons.”
Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they're still giving us something to watch via virtual interviews. In the process, we're given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon's daughter Winnie interrupted with breaking news: She had just lost a tooth.
It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it's not an uncommon experience. Nevertheless, it's still good to be prepared if your six-year-old is on the verge of losing that first tooth.
Primary teeth may be smaller than their successors, but they're not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That's why it's optimal for baby teeth to remain intact until they're ready to come out.
When that time comes, the tooth's roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness, though, doesn't automatically signal a baby tooth's imminent end. But come out it will, so be patient.
Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.
Here's some advice from your dentist: Don't. Trying to pull a tooth whose root hasn't sufficiently dissolved could damage your child's gum tissues and increase the risk of infection. It could also cause needless pain.
Left alone, the tooth will normally fall out on its own. If you think, though, that it's truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it's ready, it should pop out. If it doesn't, leave it be for another day or two before trying again.
Your child losing a tooth is an exciting moment, even if it isn't being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.
If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”
The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.
Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.
Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.
But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.
The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.
There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.
In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting. The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.
Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.
If you would like more information on treating gum recession, 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 “Periodontal Plastic Surgery.”
During this year's baseball spring training, Minnesota Twins center fielder Byron Buxton got into a row with a steak dinner—and the beefsteak got the better of it. During his meal, the Gold Glove winner cracked a tooth.
Fortunately, he didn't lose it. Buxton's dentist rescued the tooth with a dental procedure that's been around for over a century—a root canal treatment. The dependable root canal is responsible for saving millions of teeth each year.
Dentists turn to root canal treatments for a number of reasons: a permanent tooth's roots are dissolving (a condition called resorption); chronic inflammation of the innermost tooth pulp due to repeated fillings; or a fractured or cracked tooth, like Buxton's, in which the pulp becomes exposed to bacteria.
One of the biggest reasons, though, is advanced tooth decay. Triggered by acid, a by-product of bacteria, a tooth's enamel softens and erodes, allowing decay into the underlying dentin. In its initial stages, we can often treat decay with a filling. But if the decay continues to advance, it can infect the pulp and root canals and eventually reach the bone.
Decay of this magnitude seriously jeopardizes a tooth's survival. But we can still stop it before that point with a root canal. The basic procedure is fairly straightforward. We begin first by drilling a small hole into the tooth to access the inner pulp and root canals. Using special instruments, we then remove all of the infected tissue within the tooth.
After disinfecting the now empty spaces and reshaping the root canals, we fill the tooth with a rubber-like substance called gutta percha. This, along with filling the access hole, seals the tooth's interior from future infection. In most cases, we'll return sometime later and bond a life-like crown to the tooth (as Buxton's dentist did for him) for added protection and support.
You would think such a procedure would get its own ticker tape parade. Unfortunately, there's a cultural apprehension that root canals are painful. But here's the truth—because your tooth and surrounding gums are numbed by local anesthesia, a root canal procedure doesn't hurt. Actually, if your tooth has been throbbing from tooth decay's attack on its nerves, a root canal treatment will alleviate that pain.
After some time on the disabled list, Buxton was back in the lineup in time to hit his longest homer to date at 456 feet on the Twins' Opening Day. You may not have that kind of moment after a root canal, but repairing a bothersome tooth with this important procedure will certainly get you back on your feet again.
If you would like more information about root canal therapy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”
Play a round of word association with "summer," and you'll probably come up with "vacation," "camping," or "beach" just off the top of your head. But the slower pace of this sultry season offers opportunities for other pursuits—like home improvement projects. If you're in a "fixer-upper" mood, you might consider something out of the box: a smile makeover.
Changes to your dental appearance start a lot like the typical home renovation—you're not satisfied with how things look. And, like home projects, you can go little on smile enhancements (akin to maybe repainting the bedroom) or go big (that shiny new addition).
If you're up for this kind of makeover this summer, here are a few suggestions for improving your smile.
Teeth whitening. Stained tooth enamel can make your smile look dull and dingy—but you can reverse this with a professional whitening treatment. Using a precisely formulated bleaching solution, we can give you a brighter smile at just the level of brightness you want. And with good care and occasional touchups, your bright and shiny smile could last for years.
Dental bonding or veneers. Chips, stains that resist whitening or an unsightly gap can detract from an otherwise attractive smile. We can repair many minor defects by bonding tooth-colored composite material to your teeth. For more extensive defects, we can also cover teeth with custom dental veneers, thin layers of porcelain that hide dental flaws.
Orthodontics. Straightening misaligned teeth is primarily beneficial to your long-term dental health. But it can also transform a smile, earning it the title, "The Original Smile Makeover." And braces aren't your only choice—depending on your particular bite problem, you may be able to use nearly invisible clear aligners, which you can also remove for meals and hygiene.
Dental implants. Nothing downgrades a smile like missing teeth. But you can replace those teeth with dental implants, a highly popular and effective restoration. Implants have two outstanding qualities: They provide a life-like appearance that's indistinguishable from a natural tooth and they're quite durable—over 95% are still in place after ten years.
You can receive these and other cosmetic dental measures as standalone procedures or grouped with others in a comprehensive smile makeover. Some—like teeth whitening—can often be done in a single visit, while others—like teeth straightening or implants—can take months or even years.
What's important, though, is that you get the ball rolling with a comprehensive dental exam. From there, we can lay out your options and help you decide on your specific makeover plan. It could be one of your best summer projects ever!