While out with friends one evening, you take a bite of ice cream. Suddenly, pain shoots through your teeth. It only lasts a second, but it's enough to ruin your good time.
This could be tooth sensitivity, a painful reaction to hot or cold foods. It often occurs when the enamel in prolonged contact with acid has eroded. Acid is a waste product of bacteria found in plaque, a thin film of food particles that builds up on tooth surfaces due to inadequate brushing and flossing. Enamel normally mutes temperature or pressure sensation to the underlying dentin layer and nerves. Loss of enamel exposes the dentin and nerves to the full brunt of these sensations.
Sensitivity can also happen if your gums have shrunk back (receded) and exposed dentin below the enamel. Although over-aggressive brushing can often cause it, gum recession also happens because of periodontal (gum) disease, a bacterial infection also arising from plaque.
The best way to avoid tooth sensitivity is to prevent enamel erosion or gum recession in the first place. Removing accumulated plaque through daily brushing and flossing is perhaps the most essential part of prevention, along with a nutritious diet low in sugar and regular dental cleanings and checkups.
It's also important to treat any dental disease that does occur despite your best hygiene efforts. Gum disease requires aggressive plaque removal, especially around the roots. While receded gum tissues often rebound after treatment, you may need gum grafting surgery to restore lost tissues if the gums have receded more deeply. For enamel erosion and any resulting decay you may need a filling, root canal treatment or a crown, depending on the depth and volume of structural damage.
While you're being treated you can also gain some relief from ongoing sensitivity by using a toothpaste with potassium nitrate or similar products designed to desensitize the dentin. Fluoride, a known enamel strengthener, has also been shown to reduce sensitivity. We can apply topical fluoride directly to tooth surfaces in the form of gels or varnishes.
Don't suffer through bouts of tooth sensitivity any more than you must. Visit us for a full exam and begin treatment to relieve you of the pain and stress.
If you would like more information on the causes and treatment of tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
Tooth decay can wreak more havoc than just producing cavities. It can work its way into the innermost parts of the tooth — the pulp and tiny passageways called root canals that lead to the tooth's connection with the bone.
If that happens, you'll need more than “drilling and filling.” Without intervention, your tooth could be lost. That intervention is a root canal treatment, a procedure that removes the infection from within the tooth and preserves it from re-infection.
You've probably heard the old belief that root canal treatments are painful. With modern anesthetic techniques to deaden pain, that's not true. In fact, root canal treatments stop the pain caused by infected nerves within the pulp and root canals. More importantly, it saves your tooth.
Root canals can be performed by a general dentist. More extensive decay or complex root canal networks may require the services of an endodontist, a dentist who specializes in root canal anatomy and treatments. Endodontists have advanced techniques and equipment to handle even the most difficult case.
Regardless of who performs it, the basic procedure is the same, as is the goal: to completely remove all diseased tissue within the tooth and seal it with a special filling to prevent re-infection. To access the diseased pulp, we first drill an access hole, usually in the biting surface of a back tooth or the back of a front tooth. We then use specialized instruments to remove the infected tissue and flush out the space with antibacterial solutions.
We then insert a filling called gutta percha into the empty pulp chamber and root canals, seal off the filling with adhesive cement, and close the access hole with filling. These fillings and sealants prevent bacteria from reentering the tooth. For added protection against infection and fracturing, we also recommend placing a full-coverage dental crown. This also enhances the appearance of the tooth, which must be modified during the root canal procedure.
The end result: your once endangered tooth has been preserved for hopefully many years to come. So if we recommend you undergo a root canal treatment, don't wait — the tooth you save may be your own.
Your teeth naturally wear as you age, but you may be making it worse if you grind your teeth.
Teeth grinding is a behavior that causes the teeth to gnash, grind or clench against each other generating forces greater than those produced from normal biting. These forces often result in tooth wear that cause not only functional problems but result in a more aged appearance. Grinding occurs while a person is awake, but most often episodes occur while asleep at night.
Teeth grinding is quite common in children, but not usually of great concern since most grow out of it. There's even a school of thought that teeth grinding might even help readjust an uneven bite.
Among adults, though, other factors seem to contribute to teeth grinding. Many researchers believe nighttime grinding occurs as a person passes through different sleep phases including deep REM (Rapid Eye Movement) sleep. It may also have a connection with chronic snoring.
Certain medications seem to contribute to teeth grinding, particularly psychoactive drugs like amphetamines. Nicotine falls in this category, which could be why tobacco users report twice the incidence of the habit compared to non-users. Teeth grinding is also connected to another fact of modern life: stress. People who grind their teeth tend to have higher levels of anxiety, hostility or depression.
Because there are multiple triggers, there are many treatment approaches. Whatever course we take, our aim is to eliminate or minimize those factors that contribute to your habit. For example, we can create a custom mouth guard for night wear to prevent the teeth from making solid contact and thus reduce the biting pressure.
Perhaps the most important thing is to control or reduce stress. This is particularly helpful at night to prepare you for restful sleep by changing some of your behaviors. We also encourage investigating other stress therapies like biofeedback, meditation or group therapy.
Whatever the means, bringing teeth grinding under control not only reduces problems now, but could also help prevent abnormal teeth wearing and future health issues down the road.
If you would like more information on causes and treatments for teeth grinding, 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 “Stress & Tooth Habits.”
You have a winning smile except for one small flaw — one of your front teeth is chipped. In functional terms the defect is insignificant: your tooth is healthy and can still do its job. But with regard to your smile that chip is like a smudge on a masterpiece painting: it stands out — and not in a good way.
The good news is you have options to repair the chip and vastly improve your appearance. One option is to bond a custom porcelain veneer to the outside of the tooth to cover the chip. But that would also mean removing a slight bit of tooth enamel so the veneer won't appear too bulky. Although not as much as with a crown, the alteration still permanently affects the tooth — it will always require a restoration of some kind.
There's another choice that doesn't involve removing any of your enamel: composite resin. This treatment is a mixture of materials with a glass-like binder in liquid form that we apply to a tooth in successive coats. As we build up the layers we can match the tooth's shape, texture and various shades of its natural color. We're able to fill in the defect and make the tooth appear as natural as possible.
Unlike porcelain restorations, composite resins don't require a dental lab or a period of weeks to prepare. We can transform your simile in our office in as little as one visit.
Composite resin isn't the answer for every tooth defect. Teeth that have become worn, fractured or have undergone a root canal treatment are best treated with a porcelain restoration such as a veneer or crown. But where the defect is relatively minor, composite resin may be the answer.
To learn if you can benefit from a composite resin restoration, you'll need to undergo a dental exam. If we determine you're a candidate, we can use this state-of-the-art dental material to make your teeth look flawless.
If you would like more information on composite resins, 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 “Artistic Repair of Front Teeth with Composite Resin.”
Dental implants are all the rage. And why not — not only are these tooth replacements life-like and highly functional, they have an amazing 95% ten-year success rate.
Some of that success is due to their unique design. Technically a root replacement, an implant's metal titanium post is surgically placed in the jawbone, where bone grows and adheres to it over time. This creates a strong connection that stands up well to the forces created by biting and chewing.
But there's more to their longevity than design. Success also depends on a careful, planned process that begins long before surgery.
It starts with a detailed oral examination to determine the best placement for the implant. Besides regular x-rays, we may also perform CT scans to create a three-dimensional view of your jaw. With this we can locate and avoid nerves, sinus cavities or other structures near the implant site.
The examination also helps us determine if you've experienced any bone loss, a normal occurrence after tooth loss. Implants require an adequate amount of bone to achieve the best position. A good position ensures future bone integration and the best appearance result.
The same attention to detail extends to the actual surgery to place the implant. We fashion the site to receive the implant by sequentially drilling larger tapered channels until we achieve the right size fit for the implant. During drilling we avoid overheating the bone, which could ultimately weaken and damage the implant's stability.
We'll also need to provide protection for the implant while it integrates with the bone. In most implantations, we do this by suturing the gum tissue over the implant. We take a different approach with a “Tooth in a Day” procedure where we attach a crown (the visible portion of the tooth) right after implant surgery. In this case we'll install a crown (which is actually temporary) that's a little shorter than the adjacent teeth. The natural teeth around it will absorb the forces produced while chewing and not the implant crown.
Focusing on these and other factors will greatly reduce the risk of implant failure. Paying careful attention to them helps ensure your new smile is a lasting one.
If you would like more information on dental implants to restore your smile, 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 “Dental Implants: A Tooth Replacement Method That Rarely Fails.”
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