If you occasionally experience small sores in the softer tissues of your mouth, you may have aphthous ulcers or better known as canker sores. While rarely a health concern, they can be painful and annoying particularly when you’re eating and drinking.
These breaks in the skin or mucosa (the lining membranes of the mouth) usually occur in the thinner tissues found in the cheeks, lips, under the tongue or in the back of the throat. They tend to be most painful (especially while eating acidic foods like citrus or tomato sauce) between the first few hours of appearing and for a couple of days afterward, and will often occur during periods of anxiety, stress or after a minor injury. The sores will normally heal and fade within a couple of weeks.
Although occasional outbreaks of canker sores are quite common with most people, 20-25% of people (more often women) have a recurring form of painful outbreak known as recurrent aphthous stomatitis (RAS). Another variation called herpetiform aphthae, similar in appearance to herpes simplex virus sores, is characterized by smaller clusters of ulcers. While the specific causes for canker sores are still unclear, there’s some correlation between them and abnormalities with a person’s immune system, as well as with other systemic conditions like gastrointestinal disorders or vitamin deficiencies.
The basic treatment for canker sores is to first soothe the pain and promote quicker healing. Many over-the-counter medications are available for mild cases that numb the area temporarily and provide a protective covering while the sore heals. For more severe cases, there are also prescription medications (like steroids) that can be applied topically or through injection.
While canker sores are not contagious and usually benign, there are some situations that call for a dental examination: sores that haven’t healed within 2 weeks; increasing occurrences and severity of the sores; and never being completely free of a sore in the mouth. These may indicate some other condition, or be an occurrence of cancer or a pre-cancerous condition.
If you have any concerns, be sure to schedule a visit. We’ll be glad to evaluate any occurrence of the sores and recommend the best course of treatment to ease the pain and annoyance.
If you would like more information on canker sores or other types of mouth ulcers, 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 “Mouth Sores.”
People with missing teeth have more replacement options than ever before, including the ever popular but often more expensive dental implant. But there has also been an expansion of choice on the more affordable side of dental restorations. The flexible removable partial denture (RPD) is one such choice.
Though RPDs have been around for some time, the newer flexible RPD offers some advantages over the more rigid traditional RPD. They’re made of a kind of nylon that’s pliable but also strong and durable. This material is thermoplastic, meaning when heated it can be injected into molds based on a patient’s individual mouth to form an accurate denture base. The gum-colored base can also be formed to cover any receded areas of the gums, which can greatly improve smile appearance.
Older versions of RPDs are made of rigid acrylic plastic that stay in place in the mouth with metal clasps that attach to remaining teeth. The flexible RPD, on the other hand, is secured with finger-like nylon extensions that fit and hold in the natural teeth’s concavities near the gum line. This, along with its relatively light weight, offers a more comfortable fit.
But aside from these benefits, flexible RPDs do have a few drawbacks. Although fracture-resistant, they’re not easy to repair or reline to readjust the fit to accommodate mouth changes. They can stain (though not as much as a traditional RPD), so they require diligent cleaning and maintenance.
We consider the whole category of RPDs as “temporary” restorations, meaning they’re intended as a transitional phase between tooth loss and a permanent restoration like a natural tooth-supported fixed bridge or dental implants. For some, however, the flexible RPD might be a more long-term solution. As mentioned before, to extend their life as much as possible they should be removed daily and cleaned thoroughly. And like any form of denture, they should not be worn overnight.
In either case, flexible RPDs offer an effective way to restore not only dental function diminished by missing teeth but an improved appearance as well. With careful maintenance, they could serve you well for some time to come.
If you would like more information on flexible partial dentures, 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 “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”
Transforming your smile can be a huge undertaking. And while we have the technical skills, experience and understanding of aesthetics to perform a smile makeover, your input is just as necessary to achieve a satisfying result.
Your part really has to do with expectations — what do you see when you look in the mirror — and what do you want to change?
Here are 3 questions to help guide you in shaping your expectations for that new, beautiful smile.
What do you dislike about your teeth? This is really about specifics and not just a general feeling of dissatisfaction. Are your teeth misshapen, chipped or missing? Are they discolored or stained? Is the spacing off or do you have a poor bite (malocclusion)? Getting a sense of what you perceive as unattractive will help us formulate a plan to improve the appearance of those problem areas.
Are you concerned with how much your gums show when you smile? Your teeth may be perfect, but if your gums seem to steal the spotlight when you smile (known as a “gummy” smile), you may need some remedy like veneers, crowns or even corrective surgery. Which procedure depends on whether the crowns of your teeth are too short in proportion to the gums, or the muscles in your upper lip are allowing the lip to rise too high when you smile. A dental examination will tell all.
Do you want a “Hollywood Smile” — or just a more attractive, natural you? Smile makeovers aren’t just about clinical alterations — it’s just as much about your personal perceptions of beauty. Some patients want the perfectly shaped, aligned and dazzlingly white smile that’s the epitome of Hollywood. Others want only to enhance their smile, perhaps even keeping a few unique imperfections they’re comfortable with. It’s important to know which person you are, and to communicate that with us when we’re putting together your makeover plan.
Changing your smile is a big step in your life. You can help make the process more satisfying and successful if you understand what you want to change — and why.
If you would like more information on smile analysis and makeover, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Great Expectations.”
Along with periodontal (gum) disease, tooth decay poses one of the two greatest threats to your teeth. Cavities are just the start: if decay invades the pulp, the tooth’s innermost layer, the infection created can continue to advance through the root canals to the supporting bone. This worst case scenario could cost you your tooth.
But we can stop this advanced decay in its tracks with a procedure called a root canal treatment. A root canal essentially removes all the infected tissue within the tooth and then seals it from further infection. And contrary to its undeserved reputation for being painful, a root canal can actually stop the severe tooth pain that decay can cause.
At the beginning of the procedure, we deaden the affected tooth and surrounding tissues with local anesthesia—you’ll be awake and alert, but without pain. We then isolate the tooth with a dental dam of thin rubber or vinyl to create a sterile environment around it to minimize contamination from bacteria found in saliva and the rest of the mouth.
We then drill a small hole through the enamel and dentin to access the interior of the tooth. With special instruments, we remove and clean out all the diseased or dead tissue in the pulp chamber and root canals. After disinfecting the empty spaces with an antibacterial solution, we’ll shape the root canals to make it easier to perform the next step of placing the filling.
To fill all the root canals and pulp chamber, we typically use a rubber-like material called gutta-percha. Because it’s thermoplastic (“thermo”—heat; “plastic”—to shape), we can compress it into and against the walls of the root canals in a heated state to fully seal them. This is crucial for preventing the empty tooth interior from becoming re-infected. Afterward, we’ll seal the access hole with its own filling; later, we’ll bond a permanent crown to the tooth for additional protection and cosmetic enhancement.
After the procedure you may have some temporary minor discomfort usually manageable with aspirin or ibuprofen, but your nagging toothache will be gone. More importantly, your tooth will have a second chance—and your dental health and smile will be the better for it.
If you would like more information on treating tooth decay, 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 “A Step-By-Step Guide to Root Canal Treatment.”
It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.
Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.
Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.
Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.
For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.
If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.
As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.
If you would like more information on caring for primary teeth, 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 “Root Canal Treatment for Children’s Teeth.”
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