If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.
This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.
Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.
First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.
After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.
If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.
After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.
This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.
If you would like more information on dealing with impacted 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 “Exposing Impacted Canines.”
Half of all children will injure at least one tooth before adulthood. That's why we're joining with other health professionals this June to promote National Safety Month. As dentists, we want to call particular attention to potential dental injuries and what parents and caregivers can do to help their child avoid them.
The source for a dental injury usually depends on a child's age and development level. Younger children learning to walk and run are more apt to fall, and may hit their mouth on hard or sharp surfaces. Later on, most dental injuries tend to come from contact during sports play or other physical activities.
Your prevention strategy should therefore adjust to your child's age and activity level. If you have an infant starting to walk, for example, don't allow them to move around carrying a bottle, cup or other hard object that could be a source of injury if they fall. Also, keep an eye out for hard furniture or sharp-edged surfaces as they toddle around.
If you have a highly mobile toddler, discourage them from climbing and jumping on furniture, tables or other hard surfaces. If feasible, pad these surfaces and sharp edges to minimize the force of impact from a collision.
To prevent sports-related mouth injuries in older children and teens, your primary defense is an athletic mouthguard. Mouthguards cushion and absorb much of the force generated during hard sports contact. They should be worn for any physical activity with a potential risk for mouth injury, including practice sessions and informal play like a pick-up basketball game.
A type of athletic mouthguard known as “boil and bite” is readily available in retail sporting goods stores. After purchase, it is softened in very hot water; the wearer then places it in their mouth and bites down to form a permanent impression. Boil and bite mouthguards offer protection, but they can be bulky and uncomfortable to wear.
For a higher level of protection along with a more accurate and comfortable fit, a custom mouthguard created by a dentist is a more desirable option. These are based on a detailed impression of the wearer's bite, so the fit can't be beat. Both types of mouthguard need upgrading periodically in young wearers to accommodate dental development as they age.
Accidents can happen, but there's much you can do to reduce the likelihood of injury to your child's teeth. Protective measures and equipment—as well as a watchful eye—can go far to help them emerge from these active, early years dentally unscathed.
If you would like more information about dental safety, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Top 10 Oral Health Tips for Children” and “Athletic Mouthguards.”
Over the last few months, federal, state and local officials have taken extraordinary measures to slow the spread of COVID-19. Thankfully, some of these measures are beginning to ease. But for many of us, lingering concerns about exposure to the virus will continue to affect our daily lives—including routine activities like dental visits.
We may be asking the question “Is it safe?” for our everyday activities for some time to come. But in regard to seeing your dentist, the answer to that question is an unequivocal “Yes.” That's due not only to enhanced precautions put in place because of COVID-19, but also to longstanding practices in the dental profession to minimize the chances of infection.
In recognition this June of National Safety Month, we'd like to put your mind at ease that resuming dental care won't put you at undue risk of COVID-19 or any other infectious disease. Here's how:
Protocols. Everything we do to protect patients and staff from infection is part of an overall plan. This isn't optional: Both governments and professional organizations require it of every dental practitioner. Our plan, based on best practices for infection control, details the procedures we'll use to keep everyone involved in dental treatment, including you, safe from infection.
Barriers. Wearing masks, gloves or other protective equipment isn't a new practice arising from the current crisis—barrier protection has been a critical part of infection control protocols for many years. Rest assured that even during the most routine dental procedures, our staff will wear appropriate barrier equipment to reduce the possibility of infection during treatment.
Disinfection. Viruses and other infectious agents can live for some time on surfaces. To close this possible route of infection, we clean all clinical surfaces between patient visits with approved disinfectants. Instruments and equipment are thoroughly sterilized after each use. And any waste generated during treatment is separated from common waste and disposed of carefully following hazardous waste removal protocols.
It may be a slow return to many aspects of life we once took for granted. Your dental care doesn't have to be one of them. We were prepared before this crisis, and we'll continue to be prepared when it's over to keep you safe from infection.
If you would like more information about dental office safety, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Infection Control in the Dental Office” and “Dental Hygiene Visit.”
As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."
The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"
Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.
Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.
Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.
Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!
If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
Advanced tooth decay is a serious dental problem that can threaten an affected tooth's survival. But for decades now dentists have reliably used root canal treatment to better a decayed tooth's odds. This routine procedure performed with dental drill and special hand tools removes infected tissue inside a tooth and replaces the voids with a filling to prevent future infection.
But now there's a new way to perform a root canal—with a surgical laser. Lasers, amplified and focused light beams, aren't new to healthcare—they're an integral feature of many routine medical treatments and surgeries. But their use is relatively new to dentistry, and to endodontics (treating the interior of teeth) in particular.
Lasers can be used in root canal treatment to perform a number of tasks. They can remove diseased tissue and other debris from the innermost tooth pulp. They can be used to clean and shape root canal walls in preparation for filling. And they can also be used to soften and mold the filling material to fit more precisely within a tooth's particular root canal network.
Although laser-assisted root canal therapy isn't yet widespread, laser's limited use to date has given us a fair picture of both their advantages and disadvantages. As with other medical laser applications, lasers are very precise in removing diseased tissue without too much disruption of healthy tissue. There's less need for anesthesia than with dental drills, and lasers are a lot less noisy and jarring. Patients by and large experience less bleeding, as well as less discomfort or infection afterward.
But because laser light can only travel in a straight line, they're difficult to use in many tightly curved root canals. In these cases, the traditional methods are better suited, although a laser can be used in conjunction with other tasks. Temperature with lasers must also be carefully managed lest the high heat that's often generated damages natural tissues.
Although lasers won't be replacing traditional treatment methods for decayed teeth in the foreseeable future, there's hope they'll become more commonplace as technology and techniques continue to advance. Lasers can only improve what already is an effective means of saving teeth.
If you would like more information on treatments for advanced 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 “Laser-Assisted Root Canal Treatment.”
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