Posts for: June, 2016
The traditional way to restore a tooth with an artificial crown takes several weeks and multiple office visits: from tooth preparation and impression molding to crown production by a dental laboratory, followed by adjustments and cementing. Now, there’s an alternative that reduces this process to a fraction of the time, and all from your dentist’s office.
Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) is a digital system that enables dentists to create dental restorations with laboratory-grade materials in minutes rather than weeks. As it continues to innovate, you’ll see more and more dentists investing in the new technology for their patients.
A crown restoration with CAD/CAM begins like any other with decay removal and preparation of the tooth. It diverges, though, from the traditional in how an impression of your teeth and gums is obtained: instead of rubber-like molding materials to create a physical impression, we lightly dust the mouth interior with a reflective powder. Using a scanning wand, the reflective powder allows us to capture multiple, detailed images of your mouth that the CAD/CAM computer transforms into an accurate three-dimensional model.
We use the model to first assess if the tooth has been effectively prepared for a restoration. If so, the design feature of the system will provide us with thousands of tooth forms to choose from to match with your natural teeth. You’ll be able to view the proposed size and shape of the new crown via computer simulation before signing off on the design.
Next is the actual manufacture of the crown that takes place right in the dentist’s office. A pre-formed block of ceramic material is inserted in the milling equipment where, following the pre-determined computer design, the milling heads carve the ceramic block. After milling, we fine-tune the crown surface and apply stains or glazes fired to create a life-like color and texture that matches your natural teeth. We can then adjust the crown in your mouth and permanently affix it to the tooth.
While much of the CAD/CAM system is automated, ultimate success still depends on the dentist’s expertise and artistry. CAD/CAM enhances those skills with greater precision and in much less time than traditional crowns. It’s certainly a growing option for many people to restore the form and function of decayed teeth.
If you would like more information on computer-aided dental 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 “Creating In-Office Dental Restorations with Computers.”
People who’ve lost all their teeth have benefitted from a solution that’s been around for generations: removable dentures. These appliances have helped millions of people chew and eat food, speak, and smile confidently.
But for all their benefits (including affordability) there’s still some things you need to do to get the most out of them like cleaning them daily or having us check them regularly for damage and wear. And, there’s one thing you shouldn’t do: wear them around the clock. Not removing them when you sleep at night can harm your oral health and reduce your dentures’ longevity.
Dentures are fitted to rest on the gums and the bony ridges that once held your natural teeth. This exerts pressure on the underlying bone that can cause it to gradually dissolve (resorb). This loss in bone volume eventually loosens your denture’s fit. If you’re wearing them all the time, the process progresses faster than if you took them out each night.
The under surfaces of dentures are also a prime breeding ground for bacteria and fungi. Besides unpleasant odors and irritation, these microorganisms are also the primary cause for dental disease. Research has found that people who sleep in their dentures have higher occurrences of plaque, a thin film of bacteria and food remnants that cause periodontal (gum) disease. They’re also more prone to higher levels of yeast and the protein interleukin-6 in the blood, which can trigger inflammation elsewhere in the body.
To avoid these and other unpleasant outcomes, you should develop a few important habits: remove and rinse your dentures after eating; brush them at least once a day with dish or anti-bacterial soap or a denture cleanser (not toothpaste, which can be too abrasive); and take them out when you sleep and place them in water or an alkaline peroxide-based solution.
Be sure you also brush your gums and tongue with an extra soft toothbrush (not your denture brush) or wipe them with a clean, damp washcloth. This will help reduce the level of bacteria in the mouth.
Taking these steps, especially removing dentures while you sleep, will greatly enhance your well-being. Your dentures will last longer and your mouth will be healthier.
That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”
Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.
ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.
Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes.Â We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.
We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.
It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.
If you would like more information on ANUG and other periodontal gum conditions, 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 “Painful Gums in Teens & Adults.”
Despite everyone’s best efforts, one of your child’s primary (“baby”) teeth has become decayed to the point it might be lost prematurely. Saving it would require extensive treatment like capping it with a crown or performing a pulpotomy, similar to a root canal treatment.
You may be thinking: since it’s going to come out eventually, why go to the expense of trying to preserve it longer? Actually, there are good reasons to save a baby tooth depending on your child’s age — for now and for the future. Here are 4 of them.
They’re important for nutrition. Baby teeth are quite similar to permanent teeth — not only do they look like them, they perform like them too, enabling a growing child to chew and digest food needed to boost their development. Even the loss of one tooth for an extended period makes effective chewing harder.
They’re important for speech development. With their first words, children develop speech patterns rather quickly. Their baby teeth play an important role in this: just like permanent teeth, they provide the tongue with points of contact for making a variety of sounds. A missing tooth for a prolonged period could interfere with making certain sounds and could have a stunting effect on their speech development.
They’re important for permanent teeth eruption. Baby teeth also serve as placeholders for their successors, the permanent teeth that are in development just under the gums. A baby tooth normally remains until the permanent tooth is ready to erupt within the path set by the primary. If they’re lost prematurely, the permanent tooth may not erupt as it should; and adjacent permanent teeth can drift toward the empty space and out of alignment.
They’re part of their smile. Baby teeth help children fit in socially with adults and other children — they help them look normal. A missing tooth stands out when they smile — and not in a good way. This could impact the way they interact socially with others, extending even into adulthood.
If you would like more information on dental care for your child, 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 “Importance of Baby Teeth.”
Making sure children are comfortable when visiting the dentist is an essential part of creating a lifetime habit of dental care. We recommend children start dental visits around their first birthday.
But for some children this may not be enough — despite parents’ and dentists’ best efforts they may still develop an inordinate fear of dental visits and even routine procedures. This kind of anxiety could inhibit them now and later in life from receiving needed dental care.
To relieve this anxiety, dentists have developed sedation therapy for children. Not to be confused with anesthesia, which numbs pain, sedation uses drugs to place a patient in a relaxed state. Depending on the drugs and dosage used, we’re able to achieve anywhere from a light state of relaxation to a deep suppression of consciousness. The approach is similar to one used with adults, although drug dosages and applications will differ with children.
Â If we’re planning to use sedation with your child we recommend you feed them a low-fat dinner the night before and then refrain from any other foods or liquids until after treatment the next day.Â Just before the procedure (and after we’ve evaluated them physically to be sure they’re healthy enough for the sedation medication), we’ll administer the sedative, usually Midazolam and Hydroxyzine. Taken by mouth in a syrup form, this places them in a mildly relaxed state.
During the procedure a designated staff member will continually monitor their pulse, breathing, blood pressure and other vital signs. We may also take other protective measures like special chair positioning or immobilization to keep movement to a minimum.
After the procedure, your child will remain in the office until their vital signs return to pre-sedation levels. Once at home, you should keep an eye on them for the rest of the day. They should not return to school or regular activities until the next day.
As sedation medication and techniques continue to advance, they’re becoming a routine part of dental care. If your child experiences anxiety, this can help make dental visits more pleasant and more likely to become part of their life from now on.
If you would like more information on taking the anxiety out of children’s dental care, 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 “Sedation Dentistry for Kids.”