Posts for: October, 2014
If at all possible, we want to save a tooth — it’s the best outcome for your overall dental health. In many cases, we can achieve this by filling the tooth or installing a crown over it.
Unfortunately, preservation isn’t always possible if the natural tooth has been irreparably weakened by decay or trauma. Replacing the natural tooth with a life-like artificial one is the next best option: the replacement will help you regain lost function and reinvigorate your smile. Filling the missing tooth’s space also prevents neighboring teeth from drifting into it, causing further problems with function and appearance.
Dental implants are widely recognized as the best choice for tooth replacement because of their life-like qualities, durability and positive effect on bone health. Even their biggest drawback, their cost, isn’t that great an issue if you factor in their longevity — they may actually result in less dental expense over the long-term.
A dental implant, however, isn’t always a viable option. Some patients may not have enough bone mass to support an implant. Those with certain systemic diseases like uncontrolled diabetes or a weakened immune system may not be able to undergo dental implant surgery.
Fortunately, many of these patients can benefit from a fixed bridge, a restoration option that’s been used for decades. A bridge is a series of life-like crowns permanently joined like pickets in a fence. The middle crown known as the “pontic” fills the empty space left by the missing tooth. The crowns on either side of the pontic are permanently attached to the natural teeth that border the missing tooth space. Known also as “abutment” teeth, they serve as the support for the bridge.
Bridges do have one downside — the abutment teeth must be prepared by filing them down so the new crowns fit over them properly. This will permanently alter and possibly weaken the teeth. Dental implants, on the other hand, have little to no effect on adjacent teeth.
Still, a bridge remains an effective option for many people. Properly cared for, a bridge can restore function as well as enhance your smile for many years to come.
If you would like more information on bridgework as a restorative option, 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 “Crowns & Bridgework.”
If there was an “Unsung Hero” award for dental procedures, the root canal treatment would win hands-down. Much aligned in popular culture, today’s root canal treatment is actually a valuable tool for saving teeth that would otherwise be lost. And contrary to popular belief, root canal treatments don’t cause pain — they relieve it.
To help you understand its true worth, here are some common questions and answers about the root canal treatment.
What problem does a root canal treatment fix?
A root canal treatment stops a bacterial infection that has invaded the innermost part of a tooth — the pulp — and is advancing toward the end of the root through small passageways known as root canals. Most people first notice the problem as a sharp pain in the affected tooth that may suddenly dissipate in a few days. The infection has attacked the inner pulp tissue, rich in nerve fibers; when the nerve fibers die they stop sending pain signals. The infection, however, hasn’t died: as it advances, you may then begin to experience pain when you bite down or when you encounter hot foods. You may also notice tenderness and swelling in nearby gums.
How does the procedure stop the infection?
A root canal treatment removes all the infected or dead tissue and cleanses the pulp chamber. We enter the pulp chamber through a small access hole created in the tooth’s biting surface. After tissue removal, we then “shape” and prepare the empty chamber and root canals (often with the aid of microscopic equipment) to be filled with a special filling. After filling, the tooth is then sealed to prevent re-infection (most often, we need to install a permanent crown at a subsequent visit for maximum protection).
How much pain can I expect during and after the procedure?
During the procedure, none — the tooth and surrounding gums are fully anesthetized before we begin the procedure. Afterward, you may experience mild discomfort for a few days that can be relieved with over-the-counter medications like aspirin or ibuprofen.
What’s the ultimate value for a root canal treatment?
The procedure can save a tooth severely damaged by the infection. Even covered by an artificial crown, a living tooth continuing to exist and function normally within the mouth is usually more conducive for optimum oral health than an artificial tooth replacement.
If you would like more information on root canal treatments, 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 “Common Concerns About Root Canal Treatment.”
Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.
Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.
Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.
There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.
If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.
In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.