Posts for: April, 2013
A “crown” or a “cap” is the term used to restore a decayed or broken tooth that needs to be completely encased to protect the tooth beneath it. A crown's dual purpose is to restore the tooth's form and function. Decades ago gold was the material of choice for a crown. What we ultimately choose depends on a particular crown's requirements with regard to the tooth's appearance and function, and to some extent what you want.
Gold: Gold crowns last the longest and wear the best (at about the same rate as natural teeth), but they are not used as frequently today, especially if they are visible in a person's smile. Gold crowns are made of cast gold, a technique that has been in use for over a hundred years. They can last for decades, and have been known to last 50 years or more. They tend to cost less per tooth than porcelain or other materials.
All-Porcelain: “All porcelain” crowns have a natural appearance and as technology improves they are gaining popularity. Dental porcelains are composed of ceramic substances that are variations of glass. This gives them their translucent, lifelike appearance — but it makes them brittle and subject to fracture. Therefore all-porcelain crowns may not be a good choice for back teeth because they frequently fail under the biting forces applied during chewing and especially adverse habits like tooth clenching or grinding. Porcelain crowns are made of material that doesn't wear. Consequently, it can cause excessive wear to the teeth they bite against.
Porcelain-Fused-to-Metal (PFM): PFM crowns have been in use for more than 40 years. They combine a substructure of gold or platinum for strength and have porcelain “facings” for the visible surfaces. In some ways they combine the best of both worlds, but they do have some problems; the metal can show through the porcelain, detracting from its life-like appearance. These crowns can have a functional lifespan of about 20 years or more.
New and Future Materials: Newer “pressed-ceramic” restorations and computer-milled ceramics have received good reviews for aesthetics and service. These new materials are being intensively researched. Initial results look good, but we'll have to see how they last over time.
Contact us today to schedule an appointment or to discuss your questions about crowns and other dental restorations. You can also learn more by reading the Dear Doctor magazine article “Gold or Porcelain Crowns?”
Like a shadowy figure hovering at the edge of the movie frame, cancer may be scariest when you can't see it clearly. That's why, instead of looking away, many people have chosen to take a proactive attitude toward the disease. They're learning about the benefits of prevention, early detection and treatment — and so can you. How much do you know about oral cancer? Here are five fast facts.
Oral cancer isn't just an older person's disease.
In the past, people over 40 years of age were the main population group in which oral cancer was found. But in recent years, a growing number of young people have also been diagnosed with the disease. The sexually transmitted Human Papilloma Virus (HPV16) is thought to be responsible for the increase in oral cancer among younger people.
Oral cancer can de deadly.
While it accounts for just 2-3% of all cancers, its survival rate is far lower than lots of cancers you've heard more about. Why? Because its symptoms can be hard to tell from more benign mouth sores, and isn't caught in the early stage often enough. When discovered in its later stages, the 5-year survival rate for this disease is just 58%.
There are several risk factors for oral cancer.
Moderate to heavy drinkers and users of tobacco products — whether smoked or smokeless — are at far greater risk than non-users. Chronic exposure to the sun, besides leading to skin cancer, is also clearly associated with cancers of the lip. And, because of HPV, the same risk factors for other sexually transmitted diseases apply to oral cancer as well. Genetic predisposition also plays a role, as it does in many other diseases.
Lifestyle choices can decrease the odds of getting oral cancer.
Obviously, giving up tobacco, moderating alcohol consumption and avoiding risky sexual behavior will mitigate these risk factors. But you can also lessen your chances of getting the disease by eating a healthy diet. Studies have shown that a high intake of fruits and vegetables is protective against oral cancer — and other cancers as well.
Early detection boosts the survival rate for oral cancer above 80%.
Yet the earliest symptoms of oral cancer are hard for many people to distinguish from common maladies like cold sores. What's the best way to detect it? Do something you should be doing anyway — get regular dental checkups! We're trained to find the signs of a potential problem via a quick, painless screening that can be done at your routine checkup. We can also schedule biopsies or other diagnostic tests if they're needed.
If you have concerns about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”
Your son has fallen and hit his face against a hard surface. Not only is he in pain but now there is also a chip missing from his front tooth. He is worried that his smile will never be the same. What should you do?
Answer: If you can find that missing chip, sometimes we can bond the fragment back on to the tooth. The tooth should be evaluated and repaired as soon as possible, although in the absence of other signs and symptoms of injury, and if your child is not in acute pain, it can probably wait up to 12 hours.
If the fragment can't be found, then the tooth can be restored with tooth-colored filling materials, which are also physically bonded to the natural tooth. Done well, these “composite resin” fillings can last for years and look perfectly natural. They may eventually need to be replaced with something more permanent.
If the chipped tooth is a child's primary (baby) tooth rather than a permanent (adult) tooth, the treatment will be similar.
However, a blow to a tooth can cause damage to the pulp — the living tissue within the tooth, which can become infected and die. If the damage to a primary tooth is too extensive it may be better to remove it to avoid damage to an underlying and developing permanent tooth. A place-holding appliance called a space maintainer may be used. If it is a permanent tooth it may need root canal treatment.
If a tooth is not chipped but is loosened or tender to the touch, it may require temporary stabilization, called splinting, until it has healed. Sometimes no treatment is required. If there has been a fracture to the tooth's root (the part below the gum line) it may heal by itself, or it may require further treatment especially if it is a permanent tooth, depending on the individual situation.
It is important to evaluate teeth that have been hit or damaged as a result of injury to ensure that they remain healthy and functional. We will keep track of the tooth or teeth, with observation, x-rays when necessary and monitoring over time to make sure no permanent damage has been done.
Contact us today to schedule an appointment or to discuss your questions about repairing a chipped tooth. You can also learn more by reading the Dear Doctor magazine article “The Field-Side Guide to Dental Injuries.”
“We all scream for ice cream,” the saying goes. But what if eating ice cream — or any very cold or hot food — literally makes you want to scream because your teeth hurt so much?
What causes sensitivity in teeth?
Understanding the anatomy of a tooth helps explain what happens when a tooth becomes sensitive to heat and cold. A tooth is composed of three types of tissue: a hard outer shell of enamel, the body of the tooth composed of the dentin, and an interior tissue of the pulp.
Enamel: The enamel forms the outside of the crown, the part of the tooth you normally see. Made of densely packed crystals of calcium, it is resistant to wear. It is not living tissue, and does not contain nerves, but it is capable of transmitting temperature like hot and cold.
Dentin: Inside the tooth's crown and root is a living tissue called dentin, which is a porous structure similar to bone. It is composed of microscopic tubules containing living cells, which are encased in a hard substance made of calcium crystals.
Pulp: The living dentin transmits sensation through to the pulp, which is in the center of the tooth and contains the tooth's blood vessels and nerves.
A tooth's enamel normally protects the dentin from exposure to extremes of temperature and pressure. If you wear away the enamel and expose the dentin, it will pass sensation through to the nerves in the pulp more directly. The result can range from a twinge to an excruciating pain.
Sensitivity can be caused by:
- Overzealous tooth brushing resulting in enamel wear and consequently dentin exposure and wear.
- Enamel and dentin erosion by acids in the foods and beverages you eat and drink.
- Tooth decay — the most common cause of sensitivity. Decay destroys enamel and dentin inflaming and infecting the living tissues of the pulp, which become increasingly painful.
What can you do to make your teeth less sensitive?
- Use a soft bristle tooth brush, and brush the affected teeth gently to remove all bacterial plaque. We can advise you on safe and effective brushing techniques.
- Use toothpaste that contains fluoride. Fluoride strengthens tooth surfaces and makes them more resistant to sensitivity and decay.
- Ask us about professionally applied fluoride varnishes or filling materials that can cover and replace sensitive or lost tooth structure.
Of course, if the problem is caused by tooth decay, make an appointment with us to remove the decay and place a filling in the sensitive teeth.