The month of May blossoms annually with commencement ceremonies honoring students graduating from high schools, colleges and universities. For each graduate, the occasion represents a major milestone along their road to adulthood. It's also an appropriate time to assess their dental development.
Although our teeth and gums continue to change as we age, the greatest change occurs during the first two decades of life. In that time, humans gain one set of teeth, lose it, and then gain another in relatively rapid succession. The new permanent teeth continue to mature, as do the jaws, up through the time many are graduating from college.
Of course, you don't have to be in the process of receiving a diploma to “graduate” from adolescent to adult. If you are in that season, here are a few things regarding your dental health that may deserve your attention.
Wisdom teeth. According to folklore, the back third molars are called wisdom teeth because they usually erupt during the transition from a “learning” child to a “wise” adult. Folklore aside, though, wisdom teeth are often a source for dental problems: The last to come in (typically between ages 17 and 25), wisdom teeth often erupt out of alignment in an already crowded jaw, or are impacted and remain hidden below the gums. To avoid the cascade of problems these issues can cause, it may be necessary to remove the teeth.
Permanent restorations. Though not as often as in adults, children and teens can lose teeth to disease, injury or deliberate removal. Because the jaw is still in development, dental implants are not generally advisable. Instead, patients under twenty often have temporary restorations like partial dentures or bonded bridges. As the jaws reach full maturity in a young adult's early 20s, it's often a good time to consider a permanent implant restoration.
Smile makeovers. An upcoming graduation is also a great reason to consider cosmetic smile upgrades. When it comes to improving a smile, the sky's the limit—from professional teeth whitening for dull teeth to porcelain veneers or crowns to mask dental imperfections. It's also not too late to consider orthodontics: Braces or the increasingly popular clear aligners can straighten almost anyone's teeth at any age, as long as the person is in reasonably good health.
This may also be a good time to update your own personal care. Regular dental visits, along with daily brushing and flossing, are the foundation stones for keeping your teeth and gums healthy throughout your life. So, as you “commence” with this new chapter in your life, make a dental appointment now to “commence” with a renewed commitment to your dental health.
If you would like more information about adult dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Wisdom Teeth” and “Teenagers & Dental Implants.”
Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.
After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.
More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.
Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.
Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.
Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.
A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.
Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.
If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?”
Root canal treatments are the go-to procedures dentists use to treat a tooth with advanced internal decay that has resulted in the pulp (nerve) dying. And for good reason: root canals are responsible for saving millions of teeth that would otherwise be lost.
In the basic root canal procedure, dentists make access into a tooth's interior with a small hole drilled into the crown. They then remove all diseased tissue within the pulp chamber and root canals. These now empty spaces are then filled, and the tooth is sealed and crowned to prevent further infection.
This is usually a straightforward affair, although it can be complicated by an intricate root canal network. In those cases, the skills and microscopic equipment of an endodontist, a specialist in root canals, may be needed to successfully perform the procedure.
But there are also occasional cases where it may be inadvisable to use a conventional root canal procedure to treat an endodontic infection. For example, it may be difficult to retreat a root canal on a restored tooth with a crown and supporting post in place. To do conventional root canal therapy, it would be necessary to take the restoration apart for clear access, which could further weaken or damage the remaining tooth's structure.
In this and similar situations, a dentist might use a different type of procedure called an apicoectomy. Rather than access the source of infection through the tooth's crown, an endodontist approaches the infection through the gums. This is a minor surgical procedure that can be performed with local anesthesia.
Making an incision through the gums at the level of the affected root, the endodontist can then remove any infected tissue around the root, along with a small portion of the root tip. They then place a small filling and, if necessary, grafting material to encourage bone growth around the area. The gums are then sutured in place and the area allowed to heal.
An apicoectomy is another way to attempt saving a tooth that's well on its way to demise. Without it or an attempt at a conventional root canal treatment, you might lose your tooth.
If you would like more information on treating 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
Let's say you have a diseased tooth you think might be on its last leg. It might be possible to save it, perhaps with a significant investment of time and money. On the other hand, you could have it replaced with a life-like dental implant.
That seems like a no-brainer, especially since implants are as close as we have to natural teeth. But you might want to take a second look at salvaging your tooth—as wonderful as implants are, they can't beat the real thing.
Our teeth, gums and jaws form an intricate oral system: Each part supports the others for optimum function and health. Rescuing a troubled tooth could be the best way to preserve that function, and replacing it, even with a dental implant, a less satisfying option.
How we save it will depend on what's threatening it, like advanced tooth decay. Caused by bacterial acid that creates a cavity in enamel and underlying dentin, decay can quickly spread into the tooth's pulp and root canals, and eventually threaten the supporting bone.
We may be able to stop decay and save the tooth with a root canal treatment. During this procedure, we remove diseased tissue from the pulp and root canals through a drilled access hole, and then fill the empty spaces. We then seal the access and later crown the tooth to protect it against future infection.
A second common threat is periodontal (gum) disease. Bacteria in dental plaque infect the outer gums and, like tooth decay, the infection quickly spreads deeper into the root and bone. The disease weakens gum attachments to affected teeth, hastening their demise.
To treat gum disease, we manually remove built-up plaque and tartar (hardened plaque). This deprives the infecting bacteria of their primary food source and “starves” the infection. Depending on the disease's advancement, this might take several cleaning sessions and possible gum surgery to access deep pockets of infection around the root.
Because both of these treatment modalities can be quite in-depth, we'll need to assess the survivability of the tooth. The tooth could be too far gone and not worth the effort and expense to save it. If there is a reasonable chance, though, a rescue attempt for your troubled tooth might be the right option.
If you would like more information on whether to save or replace a tooth, 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 “Save a Tooth or Get an Implant?”
You've heard it. Your parents heard it—maybe even your grandparents too. Dentists have been alerting people for more than half a century that high sugar consumption contributes to tooth decay.
That message hasn't changed because the facts behind it are the same in the 2020s as they were in the 1950s: The bacteria that cause tooth decay feast on sugar and other leftover carbohydrates in the mouth. This causes them to multiply and increase their production of acid, which softens and erodes tooth enamel.
What has changed though, especially over the last couple of decades, is a growing understanding of how sugar consumption may affect the rest of the body. Just like the evidence of sugar's relationship to tooth decay, current scientific studies are now showing there are strong links between sugar and diseases like diabetes, heart disease and liver disease.
What's startling about what researchers are finding is that cases of these diseases are growing, Especially in younger people. This is a parallel trend to our skyrocketing increases in per capita sugar consumption: the average American now eats the equivalent of 19.5 teaspoons of added sugar every day. Health experts generally agree we should consume no more than 6 teaspoons a day, and children 4.
This is vastly more than we consumed a generation ago. One reason is because processed food manufacturers have increased sugar in their products, hiding under technical, unfamiliar names in ingredient lists. But it's still sugar, and an estimated 74% of processed foods contain some form of it.
But the real surge in sugar has come from our increasing consumption of sodas, as well as energy and sports beverages. These beverages are high in sugar—you can meet your daily allowance with just one 12-oz can of soda. These beverages are now the leading source of sugar in our diets, and, according to experts, a highly dangerous way to consume it.
In effect, dentists of old were on to something: too much sugar is bad for your teeth. It now turns out that it may be bad for your overall health too. Strictly limiting it in your family's diet could help lower your risk of tooth decay and dangerous diseases like diabetes.
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