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SavingaDiseasedToothRatherThanReplacingItCouldBetheBetterOption

"Debit or credit?" "Buy or rent?" "Paper or plastic?"  Decisions, decisions. It's great to have more than one good option, but it can also provoke a lot of thought in making the right choice. Here's another decision you may one day have to face: "Save my tooth or replace it?"

It's hard to pass up replacing a tooth causing you misery, especially when the alternative is a functional and attractive dental implant. But before you do, consider this important message the American Association of Endodontists relay during Save Your Tooth Month in May: Before you part with a tooth, consider saving it as the best option for your oral health.

Even an implant, the closest dental prosthetic we now have to a real tooth, doesn't have all the advantages of the original. That's because your teeth, gums and supporting bone all make up an integrated oral system: Each component supports the other in dental function, and they all work together to fight disease.

Now, there are situations where a tooth is simply beyond help, and thus replacing it with an implant is the better course of action. But if a tooth isn't quite to that point, making the effort to preserve it is worth it for your long-term health.

A typical tooth in peril is one with advanced tooth decay. Decay begins when acid softens tooth enamel and creates a cavity. At this stage, we can often fill it with a tooth-colored filling. But if it isn't caught early, the decay can advance into the tooth's interior pulp, well below the enamel and dentin layers.

This is where things get dicey. As decay infects the pulp, it can move on through the root canals to infect the underlying bone. If this happens, you're well on your way to losing the tooth. But even if the pulp and root canals have become infected, we may still be able to save the tooth with root canal therapy.

Here's how it works: We first drill a tiny access hole into the infected tooth. Using special instruments, we remove all of the infected tissue from within the pulp chamber and root canals. After a bit of canal reshaping, we fill the now empty spaces with a rubber-like substance called gutta percha. After it sets, it protects the tooth from any more infection.

Contrary to what you might think, root canals aren't painful, as your tooth and the surrounding tissue are completely anesthetized. In fact, if your tooth has been hurting, a root canal will stop the pain. Better yet, it could save a tooth that would otherwise be lost—a satisfying outcome to a wise decision.

If you would like more information about tooth decay treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”

ThisOrthodonticDeviceCouldStopaPoorBiteFromDeveloping

“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.

A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.

The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.

Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.

For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.

As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.

These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.

If you would like more information on interceptive orthodontics, 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 “The Herbst Appliance.”

4ReasonsDentalImplantsAreaWiseChoiceforToothReplacement

You've lost some teeth, and now you have to decide how to replace them. A fixed bridge or a partial denture are certainly good options. But the best choice today that dentistry has to offer is dental implants.

Implants have exploded in popularity among both dentists and patients, offering exceptional quality in life-likeness and durability. But they do have one drawback that might cause you to hesitate in choosing them: They're usually more expensive than other common tooth replacement systems, even more so if you're replacing each individual missing tooth with an implant.

But before you pass on them for something more affordable, take another look at dental implants. Here are 4 reasons why implants could be the wiser option for tooth replacement.

Life-like and functional. Other restorations can effectively mimic the appearance of real teeth, and they're reasonably functional. But implants score at the top in both categories because they replace more of the tooth—not just the crown, but the tooth root as well.

Bone friendly. Other restorations can't stop the gradual bone loss often caused by missing teeth, and dentures in particular can accelerate it. But implants are made of titanium, a bio-compatible metal that's also bone-friendly—bone cells readily grow and adhere to its surface. This accumulated growth around the implant site helps slow or stop bone loss.

Long-term savings. The integration of bone and implant creates a durable hold that can last for several years, possibly outlasting other restorations in the same situation. Taking into account all the costs—installation, maintenance and possible replacement—that can occur over the life of a restoration, implants could actually cost less in the long run.

Versatile. Implants can be used for more than single tooth replacements—they can be incorporated with other restorations like bridges or dentures to provide better support. Marrying implants with traditional tooth replacement systems can be less costly than implants individually while enhancing benefits like durability and bone strength.

Dental implants may not be right for everyone, particularly those who've experienced advanced bone loss. But if a thorough dental exam shows you're a good candidate, dental implants could be well worth the investment in your health and appearance.

If you would like more information on dental implant restorations, 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 “Dental Implants: Your Best Option for Replacing Teeth.”

SupermodelAshleyGrahamsUnpleasantDentalEncounterWithaFrozenCookie

Ashley Graham has a beautiful and valuable smile—an important asset to her bustling career as a plus-size model and television host. But she recently revealed on Instagram a “confrontation” between one of her teeth and a frozen oatmeal cookie. The cookie won.

Holding her hand over her mouth during the video until the last moment, Graham explained how she sneaked a cookie from her mom's freezer and took a bite of the frozen treat. Taking her hand from her mouth, she revealed her broken tooth.

Okay, maybe it wasn't an actual tooth that was broken: the denticle in question appeared to have been previously altered to accommodate a porcelain veneer or crown. But whatever was once there wasn't there anymore.

Although her smile was restored without too much fuss, Graham's experience is still a cautionary tale for anyone with dental work (and kudos to her for being a good sport and sharing it). Although dental work in general is quite durable, it is not immune to damage. Biting down on something hard, even as delicious as one of mom's frozen oatmeal cookies, could run you the risk of popping off a veneer or loosening a crown.

To paraphrase an old saying: Take care of your dental work, and it will take care of you. Don't use your teeth in ways that put your dental work at risk, tempting as it may be given your mouth's mechanical capabilities.

 Even so, it's unwise—both for dental work and for natural teeth—to use your teeth and jaws for tasks like cracking nuts or prying open containers. You should also avoid biting into foods or substances with hard textures like ice or a rock-hard cookie from the freezer, especially if you have veneers or other cosmetic improvements.

It's equally important to clean your mouth daily, and undergo professional cleanings at least twice a year. That might not seem so important at first since disease-causing organisms won't infect your dental work's nonliving materials. But infection can wreak havoc on natural tissues like gums, remaining teeth or underlying bone that together often support dental enhancements. Losing that support could lead to losing your dental work.

And it's always a good idea to have dental work, particularly dentures, checked regularly. Conditions in the mouth can change, sometimes without you noticing them, so periodic examinations by a trained dental provider could prevent or treat a problem before it adversely affects your dental work.

We're glad Ashley Graham's trademark smile wasn't permanently harmed by that frozen cookie, and yours probably wouldn't be either in a similar situation. But don't take any chances, and follow these common sense tips for protecting your dental work.

If you would like more information on care and maintenance of cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty as Never Before” and “Dental Implant Maintenance.”

ThisLaserProcedurePromisesBigBenefitsforGumDiseaseTreatment

Over the years, dentists have become quite proficient in treating even the most severe periodontal (gum) disease. Many of these positive outcomes are achieved through manual effort using simple hand instruments called scalars and conventional periodontal surgery.

But that might be changing soon: Periodontists (specialists who care for the gums and other supporting dental structures) are starting to use a different kind of tool for gum disease treatment—surgical lasers.

Although lasers are more commonplace in other fields of medicine, recent developments hint at a more prominent future role for them in dentistry. One of these developments is a laser procedure called Laser Assisted New Attachment Procedure (LANAP®) that treats deep spaces of infection called periodontal pockets, which develop advanced gum disease.

These pockets form as infected gums gradually detach from a tooth as the supporting bone is lost. This widens the normally narrow gap between the teeth and gums. The ensuing pocket fills with infection that must be removed to adequately treat the gum disease. As the pocket extends down to the root, it's often necessary to perform a surgical procedure through the adjacent gum tissue to fully access it.

But with the LANAP® procedure, the dentist can use a laser to access a deep pocket without opening the gums. Moving from above into the gap between the tooth and gums, the light from the laser has the ability to remove diseased tissue without damaging healthy tissue.

The dentist follows this with ultrasonic equipment and manual scalers to further decontaminate the tooth root surface. The laser is then employed once again to facilitate the formation of a blood clot between the teeth and gums to seal the area with a fibrin clot. Once treated, the dentist will monitor the tooth to ensure maximum bone regeneration and gum reattachment.

Although outcomes are the same for the most part, this laser technique for periodontal pockets may have some advantages over conventional surgery. Studies so far show that LANAP® causes less tissue removal and bleeding, less potential for gum recession and less discomfort experienced by patients.

It's not likely that lasers will fully replace conventional gum disease treatments any time soon. But if the encouraging evidence thus far continues, the laser will one day become as commonplace alongside the other tools used for gum disease treatment.

If you would like more information on treatments for 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 “Treating Gum Disease With Lasers.”





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