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Losing teeth to tooth decay or periodontal (gum) disease is never easy. But with implant-supported bridgework, you can regain lost function and appearance with a restoration that could last for many years.
Don’t think, though, that dental disease woes are a thing of the past with your new implants. Although your restoration itself can’t be infected, the supporting gums and underlying bone can, often through bacterial plaque accumulating around the implants. The bone that supports the implants could deteriorate, dramatically increasing your chances of losing your restoration.
It’s essential, then, that you keep the area between the bridge and gums clean of plaque through daily hygiene. This definitely includes flossing around the implants.
Flossing with an implant-supported bridge will be different than with natural teeth: instead of flossing between teeth you’ll need to thread the floss between the bridge and gums. Although this is a bit more difficult, it can be done with the help of a floss threader, a device with a loop on one end and a long, thin plastic point on the other—similar to a sewing needle.
To use it, thread about 18” of floss through the loop and then pass the threader’s thin end first through the space between the bridge and gums toward the tongue until the floss threader pulls through. You can then take hold of one end of the floss and then pull the threader completely out from beneath the bridge. Then, you wrap the ends around your fingers as you would normally and thoroughly floss the implant surfaces you’re accessing. You then release one end of the floss, pull out the remainder, rethread it in the threader and repeat the process in the next space between implants.
You also have other hygiene tool options: prefabricated floss with stiffened ends that thread through the bridge-gum space that you can use very easily; or you can purchase an interproximal brush that resembles a pipe cleaner with thin plastic bristles to access the space and brush around the implants.
Some patients also find an oral irrigator, a handheld device that sprays a pressurized stream of water to loosen and flush away plaque, to be an effective way of keeping this important area clean. But that said, oral irrigators generally aren’t as effective removing dental plaque as are floss or interproximal brushes.
Whatever flossing method you choose, the important thing is to choose one and practice it every day. By keeping bacterial plaque from building up around your implants, you’ll help ensure you won’t lose your restoration to disease, so it can continue to serve you for many years to come.
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
Soon after the primary (baby) teeth begin to give way, the teeth a child will have the rest of their lives start erupting into the mouth. But while they’re permanent, they’re not as strong and developed as they will be in adulthood.
That’s why we treat young permanent teeth differently from older adult teeth. For example, a decayed adult tooth may need a root canal treatment; but this standard treatment would often be the wrong choice for a child’s tooth.
The reason why involves the pulp, the innermost layer of a tooth, which plays a critical role in early development. Young permanent teeth continue to grow in sync with the jaws and facial structure. Most of this growth is in the dentin, the layer between the enamel and pulp, which increases proportionally to the other layers as the tooth matures. The pulp generates this new dentin.
A root canal treatment completely removes the diseased tissue of the pulp. This isn’t a major issue for a mature tooth because it no longer needs to generate more dentin. But it can have long-term consequences for an immature tooth whose growth may become stunted and the roots not fully formed. The tooth may thus become brittle and darkened, and might eventually require removal.
Because of these potential consequences, a root canal treatment is a last resort for a young permanent tooth. But there are modified alternatives, depending on the degree of pulp exposure or infection. For example, if the pulp is intact, we may be able to remove as much soft decayed dentin as we can, place an antibacterial agent and then fill the tooth to seal it without disturbing the pulp. If the pulp is partially affected, we can remove that part and place substances that encourage dentin growth and repair.
Our main goal is to treat a young tooth with as little contact with the pulp as possible, so as not to diminish its capacity to generate new dentin. Avoiding a full root canal treatment if at all possible by using these and other techniques will help ensure the tooth continues to develop to full maturity.
If you would like more information on dental care for children, 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 “Saving New Permanent Teeth after Injury.”
If your child begins complaining of tooth pain without an accompanying fever or facial swelling, it’s likely not an emergency. Still, you should have us check it—and the sooner the better if the pain persists or keeps your child up at night. There are a number of possible causes, any of which if untreated could be detrimental to their dental health.
Before coming in, though, you can do a cursory check of your child’s mouth to see if you notice any abnormalities. The most common cause for a toothache is tooth decay, which you might be able to see evidence of in the form of cavities or brown spots on the tooth’s biting surfaces. If you notice swollen or reddened gums around a tooth, this could be a possible sign of a localized area of infection known as an abscess. You should also ask your child if they fell or were hit in the mouth and look for any signs of an injury.
If you don’t see anything unusual, there may be another cause—stuck food like popcorn or candy lodged and exerting painful pressure on the gum tissue or tooth. You may be able to intervene in this case: gently floss around the affected tooth to try to dislodge any food particles. The pain may ease if you’re able to remove any. Even so, if you see abnormalities in the mouth or the pain doesn’t subside, you should definitely plan to come in for an examination.
In the meantime, you can help ease discomfort with a child-appropriate dose of ibuprofen or acetaminophen. An ice pack against the outside jaw may also help, but be careful not to apply ice directly to the skin. And under no circumstances rub aspirin or other painkiller directly on the gums—like ice, these products can burn the skin. If these efforts don’t help you should try to see us the same day or first thing the next morning for advanced treatment.
The main thing is not to panic. Knowing what to look for and when to see us will help ensure your child’s tooth pain will be cared for promptly.
If you would like more information on handling dental issues with 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 “A Child’s Toothache.”
Congratulations—you’re engaged! It’s a stupendous (and hectic) time in your life as you plan your upcoming wedding.
You want to look your best for the big day—which means you may be dieting, exercising or making changes to your hairstyle and makeup. Be sure, though, to consider another important part of your appearance—your teeth and gums. Here are a few options that could help your wedding day smile shine even more.
Cleanings and whitening. While dental cleanings are primarily about removing disease-causing plaque and tartar they can also give your teeth that clean and polished look. And if you want an extra boost in brightness, consider whitening—we may be able to lighten up your teeth’s stain-induced dullness.
Bonding. If your teeth have slight imperfections—chipping, slight gaps or staining that doesn’t respond well to whitening, consider bonding techniques to repair or cover these defects. Composite resin is a dental material that can be shaped and bonded to teeth to reform a deformed tooth—and with color matching as well. For more extensive defects you can cover the front of imperfect teeth with bonded porcelain veneers or completely cap a tooth with a custom crown.
Tooth restorations. If you have missing teeth marring your smile, you have several options. The top choice: dental implants, which replaces the root of the tooth and will be able to have a crown attached to it. An implant can thus restore both better function and appearance. For more affordable options, you can also turn to fixed bridges or removable dentures. The latter can be custom designed to replace all the teeth on a jaw arch or just a few in different locations.
Gum enhancements. Teeth aren’t the only part of your smile that might need a helpful touch—your gums’ appearance might also be a problem. There are cosmetic procedures including plastic surgery and tissue grafting that can help correct overly prominent “gummy” smiles or, at the other end of the spectrum, longer appearing teeth because of gum recession.
Orthodontics. If you have extended time before the wedding date, we may be able to correct crooked teeth or a poor bite (malocclusion) that’s adversely impacting your smile. In some cases, you may be able to choose clear aligners, removable plastic trays that are hardly noticeable to others, over more visible braces to correct your bite.
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