Posts for: January, 2018

By Thompson Lee & Chalothorn
January 29, 2018
Category: Dental Procedures
EarlyActionNeededtoSaveYourToothfromRootResorption

Along with the gums, your teeth’s roots help stabilize them. Without them your teeth couldn’t handle the normal biting forces you encounter every day. That’s why a rare condition called root resorption must be treated promptly: this gradual breakdown and dissolving of root structure could eventually cause you to lose your tooth.

Resorption is normal in primary (“baby”) teeth giving way for permanent teeth or sometimes during orthodontic treatment. But the form of resorption we’re referring to in permanent teeth isn’t normal, and is highly destructive.

The condition begins in most cases outside the tooth and works its way in, usually at the gum line around the cervical or “neck-like” region of the tooth (hence the term external cervical resorption or ECR). ECR produces pink spots on the teeth in its early stages: these are spots of weakened enamel filled with pink-colored cells that cause the actual damage. The cells create cavity-like areas that can continue to enlarge.

We don’t fully understand what causes ECR, but there seems to be links with excessive force during orthodontics, tooth trauma (especially to the gum ligaments), tooth grinding habits or internal bleaching procedures. However, most people with these problems don’t develop ECR, so the exact mechanism remains a bit of a mystery.

The good news, though, is that we can treat ECR effectively, provided we discover it before it inflicts too much damage. That’s why regular dental visits are important, coupled with your own observation of anything out of the ordinary and immediate dental follow-up.

If the affected area is relatively small, we may be able to remove the cells causing the damage and repair the area with a tooth-colored filling. If it appears the pulp (the tooth’s innermost layer) is involved, we may need to perform a root canal treatment to remove infected tissue and fill the empty space with a special filling. You may also need other procedures to reduce the chances of gum recession around the affected tooth.

Proactive dental care is your best insurance against losing a tooth to root resorption. So keep an eye on your teeth and see your dentist regularly to keep your teeth and gums healthy.

If you would like more information on the signs and treatments for root resorption, 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 “Root Resorption: An Unusual Phenomenon.”


By Thompson Lee & Chalothorn
January 21, 2018
Category: Oral Health
WhyYouShouldStillFlosswithanImplant-SupportedBridge

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.

If you would like more information on caring for your dental work, please contact us or schedule an appointment for a consultation.


By Thompson Lee & Chalothorn
January 06, 2018
Category: Dental Procedures
Tags: orthodontics  
CoaxingImpactedTeethtotheRightPositioncanImproveYourSmile

What makes an attractive smile? Of course, shiny, straight and defect-free teeth are a big factor. But there’s another equally important element: all your teeth have come in.

Sometimes, though, they don’t: one or more teeth may remain up in the gums, a condition known as impaction. And if they’re in the front like the upper canines (the pointed teeth on either side of the front four incisors) your smile’s natural balance and symmetry can suffer.

Impaction usually happens due to lack of space on a small jaw. Previously erupted teeth crowd into the space of teeth yet to come in, preventing them from doing so. As a result the latter remain hidden within the gums.

While impaction can interfere with the smile appearance, it can cause health problems too. Impacted teeth are at higher risk for abscesses (localized areas of infection) and can damage the roots of other teeth they may be pressing against. That’s why it’s desirable for both form and function to treat them.

We begin first with an orthodontic examination to fully assess the situation. At some point we’ll want to pinpoint the impacted teeth’s precise location and position. While x-rays are useful for locating impacted teeth, many specialists use cone beam CT (CBCT) technology that produces highly detailed three-dimensional images viewable from different vantage points.

If the tooth is in too extreme a position, it might be best to remove it and later replace it with a dental impact or similar restoration once we’ve completed other necessary orthodontic treatment. But if the tooth is in a reasonable position, we might be able to “move” the tooth into its proper place in the jaw in coordination with these other tooth-movement efforts to make room for it.

To begin this process, an oral surgeon or periodontist surgically exposes the tooth crown (the normally visible portion) through the gums. They then bond a small bracket to the crown and attach a small gold chain. An orthodontist will attach the other end to orthodontic hardware that will exert downward pressure on the tooth to gradually bring it into normal position.

Dealing with impacted teeth of this nature is often part of a comprehensive effort to correct the bite. If we’re successful, it could permanently transform both the smile and overall dental health.

If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”




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