Each part of the human body is an intricate wonder. Take your teeth, for example: they’re so woven into everyday life we don’t notice them, yet they each work seamlessly with the jaws and mouth so we can eat, speak and even smile.
Here, then, are a few facts to help you understand — and appreciate — these tiny, amazing wonders we call teeth.
Layer Upon Layer. Rather than one solid mass, teeth are composed of different layers of slightly different tissues each with a unique role in protecting and enabling a tooth to function. Innermost is the pulp filled with connective tissue encasing blood vessels and nerves that transmit sensations to the brain. The next layer out is the dentin, a bone-like material sensitive to touch and other stimuli, which also absorbs some of the forces generated when biting or chewing. The outermost layer is enamel, the hardest material in the body and the tooth’s first defense against infection and other dangers.
Front and Center. Teeth perform different functions depending on their type and location. Front teeth are our “onstage performers” — they help us to speak and enunciate words clearly and, of course, contribute to our smile. They’re also adept at cutting through food when it first enters our mouths.
The Support Team. In keeping with our theater analogy, back teeth are our “backstage crew”: they help support our facial height, provide balance for the jaws as we swallow and protect the front teeth from too much vertical force. They’re also able to crush food before we finally swallow, which aids in the digestive process.
Intended for a Lifetime. If you consider all the environmental factors our teeth face — acidic foods, biting forces and temperature swings to name a few — you then can appreciate their resiliency. Of course, teeth have their enemies: decay, infection and trauma. With daily brushing and flossing and at least a couple of visits a year to our office for cleanings and checkups, you can help thwart many of those enemies. With both our efforts we can make sure your teeth really do last a lifetime.
Dental cleanings are an important part of regular dental office visits. Performed by a dental hygienist or dentist, cleanings serve two purposes: to remove bacterial plaque and calculus (hardened deposits of plaque) from tooth surfaces missed during daily brushing and flossing; and to remove stains that can dull your smile.
There are different degrees of cleaning, including root planing that removes plaque and calculus deep below the gum line, usually for patients affected by periodontal (gum) disease. For patients in good oral health, the basic cleaning approach is known as prophylaxis, a term derived from the Greek for guarding or preventing beforehand. The techniques used in a prophylaxis remove both “coronal” (tooth surfaces visible above the gum line) plaque and staining, providing both therapeutic and cosmetic benefits.
A typical prophylaxis includes a procedure known as scaling. Hygienists use special instruments known as scalers to remove plaque and calculus by hand, or an ultrasonic device that vibrates plaque loose and is flushed away with water. The procedure removes that rough coating you often feel as you rub your tongue against your teeth, leaving the tooth surfaces feeling smooth.
Tooth polishing is a subsequent procedure to scaling that also removes plaque and surface stains. Polishing is carried out with a motorized instrument with a rubber cup in which a polishing (or “prophy”) paste is contained. The hygienist moves the rapidly rotating cup filled with the paste over the tooth surface to remove plaque and stains. The end result is a highly smooth surface and a much shinier appearance.
People with dental insurance plans are often concerned tooth polishing may be viewed strictly as a cosmetic procedure, and thus not fully qualify for benefits. This should not be the case if coded properly: tooth polishing is part of the overall prophylaxis to remove plaque and staining. The primary purpose is therapeutic and preventive; the cosmetic effect is a by-product. Most dental plans will cover one or two prophylaxes (scaling and tooth polishing) a year, but there are variations so individuals should check their plans.
If you would like more information on dental cleaning, 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 Polishing.”
Although we’ve made great strides over the last century making dental visits more pleasant and comfortable, many people still feel a little apprehension about them at one time or another. For a few, though, this apprehension escalates into high anxiety — so high they may even avoid important dental treatment altogether.
If you have a significant phobia regarding dental visits and treatment, here are some things you can do to reduce your anxiety and feel more comfortable when you undergo treatment.
Let us know about your feelings of anxiety. We’re conditioned by society to regard such fears as irrational or “silly,” and so we tend to hide our negative emotions. Dentists, however, have been trained to work with fearful patients to reduce their anxiety levels. Being honest with us about your fears and nervousness is the first step to developing an anxiety-reducing strategy that will make your visits more pleasant.
Counteract bad experiences with good. For most people the fear they have during dental visits stems from earlier unpleasant experiences at the dentist. The fear can be so ingrained that simply trying to convince yourself or to be told “there’s nothing to be afraid of” will have little to no effect. Instead, build a memory collection of positive and pleasant dental visit experiences that serve to counteract the unpleasant. To do this we might first get you acclimated to routine visits and then gradually transition to more invasive procedures. This may increase the normal time for dental treatment, but the reduction in anxiety is worth the extra time.
Consider sedation therapy. In addition to modifying your experiences, you may also benefit from sedation medications that reduce anxiety, especially in the early stages of treatment. Depending on your medical history and current status, we can prescribe a sedative for you to take an hour or so before your appointment to help you relax. We can also increase the level of anesthesia (from local to intravenous or gas anesthesia, for example) if your anxiety is especially acute.
Taking proactive steps to minimize dental visit anxiety will increase the probability that you’ll obtain needed dental care. Your teeth and gums will be healthier for it.
If you would like more information on coping with dental visit anxiety, 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 “Overcoming Dental Fear & Anxiety.”
For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.
This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.
In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.
One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.
If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.
If you would like more information on forming new bone for implants through sinus surgery, 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 “Sinus Surgery.”
You've probably heard of the relatively new method of straightening teeth with thin, plastic orthodontic appliances (“ortho” – to straighten; “odont” – teeth) known as clear aligners. Here are some reasons you might want to consider them for your orthodontic treatment:
- Appearance. Looks aren't everything, as the saying goes. But it may be that metal-covered teeth will not give you a look you want to sport for perhaps a year or more. Adults in particular find that metal braces don't always fit in with their self-image. Because clear aligners are virtually invisible, your teeth will look as they always do and it will not be obvious that you are undergoing orthodontic treatment.
- Control. When you have traditional braces, you cannot take them out of your mouth yourself. They must be professionally removed when your treatment is completed. With clear aligners, however, you can take them out to eat and also for important social occasions. Of course, that means you are also responsible for wearing them as often as needed — a minimum of 22 hours a day. It's a good bargain if you can live up to it, and most find that they can.
- Hygiene. One of the challenges of traditional braces is to learn to clean around them so that your teeth and gums stay healthy throughout treatment. It's not always so easy to do. With clear aligners, you can maintain your usual oral hygiene routine — and also clean the aligners themselves.
- Comfort. Sometimes the rigid brackets and wires of traditional braces can press into sensitive tissues of the mouth. It's something that you will eventually get used to, but it can be uncomfortable temporarily. The material of clear aligners is flexible, so this type of irritation is not an issue.
- Versatility. In recent years, the clear alignment system has been improved to handle more serious malocclusions (“mal” – bad; “occlusion” – bite). Enhancements have also been made to accommodate additional growth of molar teeth in the case of teenagers.
While there are some cases in which traditional braces are still the best option, clear aligners have more applications than ever before. They also have some clear advantages that are worth considering.
If you would like more information about clear aligners, please contact us or schedule an appointment for a consultation. You can also learn more about clear aligners in general by reading the Dear Doctor magazine article “Clear Aligners For Teenagers.”
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