Most people think of bone as rock-solid, but it's actually a living tissue that's constantly changing. This has significant implications for your oral health, general health, and appearance — if you are one of the 70% of Americans missing at least one tooth.
Throughout the day, your top and bottom teeth make hundreds of fleeting contacts with each other. These small stresses are transmitted though the periodontal ligament (“peri” – around; “odont” – tooth) that supports each tooth in its socket like a hammock. Think of it as a gentle push on the hammock, which causes the tooth to gently bump the underlying bone. The bone then builds up in the spot that's receiving stress to counteract it. This constant remodeling of bone is what allows bone to stay healthy and strong.
When a tooth is lost, the bone does not receive that gentle stress. It reacts by literally melting away. Sometimes this happens fairly quickly — in a matter of months. After the tooth-supporting bone is lost, the jawbone itself begins the same process of deterioration. This could eventually change the shape of the face, as the distance from nose to chin can decrease — even if only a few back teeth are missing. The results aren't pretty. But the good news is, there's a way to prevent all this.
Dental implants, which function as substitute tooth roots, actually save underlying bone when teeth are lost. They do this because they are made of titanium, which fuses to the bone in which it's set, stabilizing it. The implant is topped by a realistic-looking crown, which replaces the part of the missing tooth that was visible in the mouth. Together, they look and function just as your natural tooth did.
If you are missing a lot of teeth, implants can also be used to anchor bridges or even removable dentures while providing that same bone-saving benefit. And when you consider that they are so durable they should never need replacement, implants are a great investment.
You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”
If you are experiencing cracking in the corners of your mouth, you have a common condition called perleche or angular cheilitis. Perleche comes from a French word meaning “to lick,” because people tend to lick the irritated areas of their mouths. Angular cheilitis comes from cheil meaning “lip,” and itis meaning “inflammation.”
Sufferers from perleche are usually young children who drool in their sleep, young adults with braces, and older adults who have developed skin wrinkling with deep lines at the corners of their mouths. Perleche may become worse in the winter, when cold weather and dry air dries out the skin of your lips. You may lick your lips often to keep them moistened. This constant licking of the cracked areas can lead to infection, most commonly from a type of yeast called candida albicans. Sources of infection can also include dentures that are not cleaned frequently enough, missing teeth that cause facial changes and added skin wrinkling, and health conditions such as iron-deficiency anemia, vitamin B deficiency, diabetes and cancer.
Conditions associated with perleche can be treated in a number of ways. Yeast is a type of fungus, so to combat a chronic yeast infection you need antifungal medication. This may be taken orally or applied to the cracking places as an ointment. You may be asked to dissolve a medicated lozenge in your mouth and then swallow it, so that its medicine treats both the mouth surface and the entire body. Antifungal medications may be combined with other medications to lessen inflammation and assist skin repair.
If the skin-cracking is related to serious underlying conditions such as missing teeth, improperly fitting dentures, or systemic health conditions, these must be treated in order to keep the perleche from recurring. We can perform a dental assessment to check the health of your teeth, gums, and lips, and you may also want to visit a dermatologist to see if treatments can improve and rejuvenate the quality and appearance of your facial skin.
Contact us today to schedule an appointment to discuss your questions about cracks at the corners of your mouth. You can also learn more by reading the Dear Doctor magazine article “Cracked Corners of the Mouth.”
Dental decay is an infectious and very common disease, but it's also very preventable. Today's dentistry has many tools at its disposal to accurately determine your risk for tooth decay, lower it, turn it around, and completely prevent it. What's more, we can even reverse early decay. You might never have to see or hear the drill again.
Striking the right balance between factors that promote oral health and those that cause disease is of the utmost importance. And knowing whether or not you have indicators of disease or risk for tooth decay is a great place to start.
We will scientifically calculate your risk for tooth decay by:
- Recording and monitoring your oral and dental health: Our risk assessment/evaluation form allows us to gather information about critical dental health habits. Oral hygiene habits, use of fluoride toothpaste, tobacco smoking, frequent snacking on sugary foods and beverages, and past experience of decay are all examples of disease indicators that will help gauge your level of risk. For example, using fluoride toothpaste decreases your risk, but smoking and between-meal snacking increases it.
- Testing for decay producing bacteria: You've probably heard of dental bacterial plaque, the biofilm that sticks to your teeth, forming in the tiny little grooves on the biting surfaces of the teeth where decay starts (and along the gum line). Today, acid-producing bacteria responsible for causing decay can be tested by simply sampling your biofilm on a swab, and placing it in a meter to accurately determine acid-producing activity. A high number indicates high risk. You can see it for yourself in less than a minute.
- Saliva testing: A simple history will tell us whether your mouth is dry or moist most of the time. A saliva test will tell us if your saliva is acidic or neutral. A dry acidic mouth promotes decay, while a moist neutral mouth with healthy saliva promotes health. Measuring salivary “pH,” the measure of acidity, is another factor for determining your risk for decay and reversing it. Special rinses can help reduce decay-producing bacteria and reduce acidity.
- Very early decay detection: Modern ultra-low-dosage x-ray equipment allows us to determine the very earliest signs of decay. Decay that is detectable with the naked eye (or feel with a dentist's instrument, an explorer) is already at an advanced stage. Catching the disease very early with the help of this sophisticated equipment can allow us to reverse early decay before it has even turned into cavities. It can actually be reversed with remineralizing fluids, rinses that put calcium back into the tooth surfaces reforming and hardening them.
This is a new and exciting era in the fight against tooth decay and we have all the tools to determine your decay risk and reverse it.
If you would like us to determine your risk for tooth decay, please call the office to schedule an appointment. To read more about disease indicators and risk factors for dental caries, read the Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”
The best method for permanently replacing a missing tooth is with a dental implant. But did you know that there are two main techniques for placing implants? Implants can be placed either using a one stage or a two stage surgical technique, and as their names suggests, one is performed in one step while the other requires a second surgery.
With a one-stage procedure, a healing abutment is placed at the time of surgery. An abutment is a connector that attaches the implant from the bone into the mouth and which protrudes through the gum tissues. Following a 3 to 6 month healing period in which the implant fuses to the bone, a crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good, guaranteeing good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.
Under special conditions an implant can be placed and a crown placed on top of it at the same time. However, this is a very special circumstance requiring ideal conditions and surgical experience as well as crown fabrication know-how. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone.
A two-stage procedure is typically used for replacing teeth where there is no immediate need for a cosmetic solution and when more of a margin of safety is required. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. They are not exposed to the mouth, but stay buried and left to heal. Once healed, a second surgery is performed to attach an abutment for securing the crown in place. This approach is used when there is poorer bone quality or quantity. This may make it necessary to regenerate bone around the implant at the time of its placement. There may also be other health considerations dictating that a two-stage approach may be indicated.
Depending on your individual situation and medical status, our implant team will determine which approach is best for you. To learn more about these two procedures, read the Dear Doctor article, “Staging Surgery In Implant Dentistry.” You are also welcome to contact us to discuss your questions or to schedule an appointment.
Protecting your children is one of your most important roles as a parent or caregiver. Dental sealants are one way you can protect your children's teeth from the ravages of tooth decay, drilling and fillings — and they can be applied simply, comfortably and quickly right here in our office.
What is a dental sealant?
A dental sealant is a thin, plastic film that is painted onto the tiny grooves on the chewing surfaces of the back teeth (usually the premolars and molars) to prevent caries (cavities) and tooth decay. And by allowing us to use sealants to seal these little nooks and crannies where your child's toothbrush can't reach, you will dramatically reduce their chances for developing tooth decay. This one, simple and quick office visit could save you both money and time with fewer dental visits and healthier, cavity-free teeth.
So will sealants guarantee no (or no more) cavities?
No, just like life, there are few guarantees. Your child's oral hygiene, regular dental visits, fluoride, sugar consumption and genetics are the other important factors that will determine to what degree your child experiences tooth decay. However, research shows that pit and fissure (chewing surface) decay accounts for approximately 43% of all decayed surfaces in children aged 6 to 7, even though the chewing surfaces (of the back or posterior teeth) constitute only 14% of the tooth surfaces at risk. This demonstrates the vulnerability of the chewing surfaces of the posterior teeth to decay. By placing a protective seal over the areas of teeth at risk, you can effectively and proactively protect your children's teeth.
How long do sealants last?
Research has shown that some sealants can last up to 10 years. However, if you opt for sealants for your children's teeth, we will closely monitor them with each office visit to ensure that they are still doing their job. As needed, we can apply more sealant.
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