Posts for category: Dental Procedures
If you're an adult, your teeth shouldn't wiggle—not even a little bit. If you have a loose tooth, you need to see your dentist as soon as possible to avoid losing it permanently.
Loose teeth usually happen because of one of two kinds of bite-related trauma. One is known as primary occlusal, which usually happens when the periodontal (gum) structures that help secure teeth encounter higher than normal biting forces. This is usually due to a clenching or grinding habit.
The other and more common kind is secondary occlusal: This happens when the periodontal structures and supporting bone are in a weakened state, usually because of gum disease. In this condition, even normal biting forces can cause damage to a tooth's gum attachment and result in looseness.
To stop a loose tooth from becoming a lost tooth, we'll need to take these immediate steps.
Treat any underlying disease. If a gum infection is the culprit, our first priority is to stop it from doing any more damage. The main treatment for gum disease is to remove dental plaque, a thin film of bacteria and food particles that's the usual cause for the infection. Depending on how much the infection has advanced, this could take several sessions to bring it under control.
Reduce abnormal biting forces. If teeth are loose from abnormally high bite forces, there are a few things we can do. One is to selectively reshape the biting surfaces of teeth so that they receive less force while biting. Another approach is to minimize the effect of teeth grinding with an occlusal guard worn in the mouth: Its slick plastic surface prevents teeth from making solid contact while biting.
Splint loose teeth to secure them. We can secure loose teeth by splinting them to more stable teeth with metal strips or other means. Splinting is often done in conjunction with the aforementioned treatments, and is usually temporary until the tooth regains its periodontal attachments. Sometimes, though, it may be necessary to permanently splint a weakened tooth.
A loose tooth isn't necessarily destined to be lost. But we'll have to act quickly—if you have a loose tooth see us as soon as possible to determine how best to save it.
If you would like more information on saving loose 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 “Treatment for Loose Teeth.”
While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.
Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.
But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.
The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.
While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.
An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.
A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.
If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.
If you would like more information on bonded retainers, 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 “Bonded Retainers.”
Losing your teeth can be a traumatic experience with serious consequences for your overall health. Fortunately, you have great options for replacing lost teeth that can restore both appearance and dental function.
One such option is a fixed bridge supported by dental implants. While implants are best known for single tooth replacement, they can also be used with other restorations like bridges. In this case, the bridge is screwed into a few well-placed implants to support it.
Implants can provide bridges with more security and support, and without the need to alter adjacent teeth that are commonly used for traditional tooth replacement. They may also slow or stop bone loss because the titanium in implants naturally attracts bone cells that grow and adhere to its surface and provide stimulation to the bone cells during function.
Because of these benefits an implant-supported bridge could be a life-changer that provides years of satisfaction. But we can’t simply “set them and forget them”: They require dedicated oral hygiene just like natural teeth.
While the bridge materials and implants themselves are in no danger from disease, the same can’t be said for the implant’s supporting gums and bone. Dental plaque, the main driver in gum disease, can place these tissues at risk for infection that could eventually lead to implant failure.
It’s important, then, for you to floss around your new implants to remove any plaque. This differs from regular flossing in which you work the thread between teeth. Instead, you’ll have to maneuver the floss between the bridge and gums with the help of a floss threader, a small slender tool with a loop at one end and a stiffer plastic edge at the other (similar to a sewing needle).
To use it, first run 18” of floss through the loop until you get equal lengths and then work the tail of the floss threader between the bridge and gums while holding one end of the floss. Once through, you pull the floss threader through so that the floss is on either side of the bridge. Then grab each end of the floss and pull it snug to floss up and down one side of the implant. Go to the next side and repeat this procedure for all the implants.
As an alternative, you could use an oral irrigator, which emits a pulsating spray of water to loosen and wash away plaque. Either way, though, it’s important to floss around implants to get the most life out of your bridge.
If you would like more information on proper care for implant-supported restorations, 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 “Oral Hygiene for Fixed Bridgework.”
Malocclusions (bad bites) may cause more than an appearance problem — with teeth and jaws not working together properly, you’re at higher risk for dental disease or accelerated tooth wear. Fortunately, most malocclusions can be corrected through orthodontics, a specialty for moving teeth to better functioning and more attractive positions.
If you’re considering orthodontic treatment for a malocclusion, here are the basics on 3 of the most common orthodontic appliances used for straightening misaligned teeth.
Metal Braces. These appliances have a proven track record for correcting most forms of malocclusion. Braces consist of metal brackets bonded to the front teeth and an anchor band to the back teeth. A thin metal wire passes through the brackets to attach to the bands in the back. Gradually increased tension in the wire incrementally moves the teeth to the desired position.
Clear Bracket Braces. While metal braces do an effective job of tooth movement, they leave less to be desired in appearance. Made of polymer material rather than metal, clear bracket braces offer a more appealing look. But while they’re similar in construction to the metal version, they’re more susceptible to breakage. Wearers must be extra cautious and avoid hard foods or extreme physical sports contact.
Clear Aligners. The previous appliances are fixed and can’t be removed by the wearer. Clear aligners take a different approach with removable plastic trays that fit snugly over the dental arch. A series of trays are computer generated to carefully match the patient’s mouth structure, each incrementally smaller than the previous one in the series. After wearing the first tray for two or three weeks, the wearer changes to the next (and slightly smaller) tray in the series, repeating the process until all the trays have been worn. Of the three options, the clear aligners offer the best appearance; however, they’re best suited for cases that don’t require complex movements.
We can advise you which option is best for you after a complete evaluation, factoring in age, lifestyle and the complexity of your malocclusion. Regardless of the choice, the aim is the same — achieving a healthier mouth, better function and a more attractive smile.
If you would like more information on orthodontic treatment, 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 “The Magic of Orthodontics.”
Over 26 million Americans have diabetes, a systemic condition that interferes with maintaining safe levels of blood sugar in the bloodstream. Over time, diabetes can begin to interfere with other bodily processes, including wound healing—which could affect dental care, and dental implants in particular.
Diabetes affects how the body regulates glucose, a basic sugar derived from food digestion that's the primary source of energy for cell development and function. Our bodies, though, must maintain glucose levels within a certain range — too high or too low could have adverse effects on our health. The body does this with the help of a hormone called insulin that's produced as needed by the pancreas to constantly regulate blood glucose levels.
There are two types of diabetes that interfere with the function of insulin in different ways. With Type I diabetes the pancreas stops producing insulin, forcing the patient to obtain the hormone externally through daily injections or medication. With Type II diabetes, the most common form among diabetics, the body doesn't produce enough insulin or doesn't respond adequately to the insulin that's present.
As mentioned, one of the consequences of diabetes is slow wound healing. This can have a profound effect on the body in general, but it can also potentially cause problems with dental implants. That's because implants once placed need time to integrate with the bone to achieve a strong hold. Slow wound healing caused by diabetes can slow this integration process between implant and bone, which can affect the entire implantation process.
The potential for those kinds of problems is greater if a patient's diabetes isn't under control. Patients who are effectively managing their diabetes with proper diet, exercise and medication have less trouble with wound healing, and so less chance of healing problems with implants.
All in all, though, it appears diabetics as a group have as much success with implants as the general population (above 95 percent). But it can be a smoother process if you're doing everything you can to keep your diabetes under control.