Untreated tooth decay can destroy your teeth; prompt action as soon as its diagnosed will help prevent that undesirable outcome. And even if decay has advanced into the tooth's pulp and root canals, there's still a good chance we can stop it with a root canal treatment. Using this procedure, we can clean out the infection and refill the tooth's interior space with a special filling to protect it from further infection.
Although root canal treatments have gained an unwarranted reputation for pain, they rarely cause even the mildest discomfort. More importantly, they work, which is why they're the go-to treatment dentists use for advanced decay.
But sometimes a unique dental situation might make performing a root canal extremely difficult—possibly even doing more harm than good. For example, trying to access the interior of a tooth with a crown restoration might require removing the crown, which could further weaken or damage the tooth. In other cases, the root canals might have become calcified due to trauma or aging and become too narrow to access.
Even so, we may still be able to save a tooth through a minor surgical procedure called an apicoectomy. Rather than access the diseased area through the tooth crown as with a root canal treatment, an apicoectomy makes access to the infected tissue at the root end.
An apicoectomy also differs from a root canal treatment in that we'll need to surgically go through the gum tissue. After numbing the area with a local anesthetic, we'll make a small incision through the gums at the level of the infection. After removing any infected tissue, we would then fill the space with a small filling to prevent re-infection. We then close the incised gum tissues with sutures and allow them to heal.
With the help of fiber optic lighting and surgical microscopes, endodontists (specialists in interior tooth problems) can perform an apicoectomy quickly and with very little trauma at the surgical sight. If you undergo an apicoectomy, you should be back to normal activity in a day or two at the most. And like its sister procedure the root canal, an apicoectomy could help preserve your teeth for many years to come.
If you would like more information on this and other treatments for 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.”
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
February is National Children's Dental Health month, sponsored annually by the American Dental Association. As important as good oral health is to a child's overall health and development, tooth decay tops the list as the most common chronic childhood disease. In fact, over 40% of children ages 2-11 have had cavities in their baby teeth.
If unchecked, tooth decay can have a profound impact on a child's quality of life. The good news is that tooth decay is preventable, and often reversible if detected early. Here are some things you can do to set your child on the path to good dental health for life:
Get your child in the habit of brushing and flossing every day. Cavity prevention starts at home, so teach your child to brush twice a day with fluoride toothpaste—but use only a smear of toothpaste the size of a grain of rice before age 3, and a pea-sized amount from ages 3-6. Introduce dental floss into the routine when you notice that your child's teeth are starting to fit closely together. Children generally need help brushing until age 6 or 7 and flossing until around age 10.
Encourage tooth-healthy eating habits. Provide your child with a balanced diet with plenty of vegetables, fruits and whole grains. Stay away from sugary snacks and beverages, especially between meals. If children drink juice, they should do so with meals rather than sipping juice throughout the day or at bedtime. Even 100% juice has natural sugars and can be acidic, which can harm teeth with prolonged exposure.
Establish a dental home early. Tooth decay isn't always easy to spot with the naked eye, so regular dental visits should start no later than a baby's first birthday. We can check the development of your child's teeth and spot any issues of concern. The earlier tooth decay is caught, the less damage it can do. Even if there are no dental problems, establishing a dental home early on will help your little one feel comfortable at the dental office.
Ask about preventive dental treatments. Fluoride varnishes or rinses are frequently recommended to help prevent cavities, particularly for children at higher risk of getting cavities. Dental sealants, another preventive treatment, are a coating commonly applied to molars to seal out tooth decay. According to the U.S. Centers for Disease Control, children ages 6-11 with dental sealants have nearly three times fewer cavities than children who do not have sealants.
The key to healthy smiles for life is to start your child at a young age with good habits at home and regular dental visits. If you have questions about your child's dental health, call us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Top 10 Oral Health Tips for Children.”
Periodontal (gum) disease is as common as it is destructive. Almost half of all adults 30 and older have some form—and those numbers increase to nearly three-quarters by age 65.
Fortunately, we have effective ways to treat this bacterial infection, especially if we catch it early. By thoroughly removing all plaque, the disease-causing, bacterial biofilm that accumulates on tooth surfaces, we can stop the infection and help the gums return to normal.
Unfortunately, though, you're at a greater risk for a repeat infection if you've already had gum disease. To lower your chances of future occurrences, we'll need to take your regular dental exams and cleanings to another level.
Although everyone benefits from routine dental care, if you've had gum disease you may see these and other changes in your normal dental visits.
More frequent visits. For most people, the frequency norm between dental cleanings and exams is about six months. But we may recommend more visits for you as a former gum disease patient: depending on the advancement of your disease, we might see you every three months once you've completed your initial treatment, and if your treatment required a periodontist, we may alternate maintenance appointments every three months.
Other treatments and medications. To control any increases in disease-causing bacteria, dentists may prescribe on-going medications or anti-bacterial applications. If you're on medication, we'll use your regular dental visits to monitor how well they're doing and modify your prescriptions as needed.
Long-term planning. Both dentist and patient must keep an eye out for the ongoing threat of another gum infection. It's helpful then to develop a plan for maintaining periodontal health and then revisiting and updating that plan as necessary. It may also be beneficial to perform certain procedures on the teeth and gums to make it easier to keep them clean in the future.
While everyone should take their oral health seriously, there's even greater reason to increase your vigilance if you've already had gum disease. With a little extra care, you can greatly reduce your chances of another bout with this destructive and aggressive disease.
If you would like more information on preventing recurring gum disease, 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 “Periodontal Cleanings.”
While children are less likely than adults to experience periodontal (gum) disease, the same can't be said for tooth decay. One aggressive form of decay called early childhood caries (ECC) can have a profound effect on a child's dental development and future health.
That's why dentists who treat young children often use a variety of preventive measures to reduce the risk of ECC and other dental diseases. One popular method is dental sealants, dental material coatings applied to the biting surfaces of teeth that fill in the naturally occurring pits and crevices. These areas are highly susceptible to plaque formation, a bacterial biofilm of food particles that tends to accumulate on teeth. It's the bacteria that live in plaque that are most responsible for the formation of tooth decay.
Roughly one third of children between the ages of 6 and 11 have received some form of dental sealant. It's a quick and painless procedure applied during a routine office visit. The dentist brushes the sealant in liquid form on the teeth, and then hardens it with a special curing light. It's common for children to begin obtaining sealant protection as their molars begin to come in.
With their increased popularity among dentists, researchers have conducted a number of studies to see whether dental sealants have a measurable effect reducing tooth decay. After reviewing the cases of thousands of children over several years, many of these studies seemed to show that children who didn't receive sealants were more than twice as likely to get cavities as children who did.
As evidence continues to mount for dental sealants' effectiveness protecting young children from decay, both the American Dental Association and the American Academy of Pediatric Dentistry now recommend it for all children. Not only can sealants help preserve children's teeth now, but they can reduce future costs for dental treatment that results from tooth decay.
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