As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.
Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb). It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.
It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.
We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.
Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.
At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.
If you would like more information on diagnosing and treating 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.”
We’ve developed a number of effective treatments for periodontal (gum) disease. Depending on how far and deep a patient’s infection has advanced, treatment can be quite invasive and even require surgery. The more invasive, the longer and more uncomfortable the healing process can be.
But using a medical laser could make that less so. Although its use for gum disease treatment is still in its infancy, the latest observations from the field seem to show patients undergoing laser treatment may have less tissue trauma and bleeding, less discomfort after the procedure and quicker healing times.
Gum disease is a bacterial infection mostly caused by dental plaque, a thin film of food particles that build up on teeth in the absence of effective oral hygiene. The infection can advance deep below the gum line, weakening gum attachment to teeth and destroying supporting bone. Ultimately the affected teeth can be lost.
Traditionally, the only way to stop the disease is to manually remove plaque buildup on teeth and gum surfaces, which is continuing to sustain the infection, with special hand instruments called scalers or ultrasonic equipment. Because it’s important to remove as much plaque and diseased tissue as possible, we may need to perform a surgical procedure called flap surgery to move some of the gum tissues out of the way to get to these deeper areas. As with any surgery, this can create tissue trauma that may cause discomfort during the healing process.
Our new alternative is to use an Nd:YAG medical laser in a procedure known as Laser Assisted New Attachment Procedure or LANAP. With light energy delivered through a small fiber no more than the width of three human hairs, the laser can pinpoint diseased tissue and destroy bacteria through intense heat. Because of the laser beam’s tiny width and pulsing action, healthy tissue is at less risk for trauma than with the traditional treatment.
Coupled with other techniques, LANAP procedures could remove as much infected tissue and plaque as traditional methods, but with less healthy tissue trauma. In the future, then, patients with advanced gum disease undergoing laser treatment could have less bleeding and discomfort and faster healing times.
If you would like more information on treating 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.”
On your way to a more attractive smile, you’ll have to deal with some inconveniences while wearing braces like avoiding certain foods or habits or dealing with possible embarrassment about your new “metal smile.” But there’s one consequence of wearing braces that could dramatically affect your dental health: the difficulty they pose for keeping your teeth clean of dental plaque.
Dental plaque is a thin film of bacteria and food particles that if allowed to build up on tooth surfaces could trigger tooth decay or periodontal (gum) disease. Brushing and flossing thoroughly every day helps prevent this buildup.
Unfortunately, metal brackets and wires can get in the way and cause you to miss areas while performing these hygiene tasks. This could cause plaque buildup in those isolated areas that could trigger an infection. And if you (or someone you love) are also a teenager, the natural adolescent surge in hormones can increase your infection risk.
If while wearing braces you notice your gums are reddened, swollen or bleeding when you brush, these are all signs of infection and the body’s inflammatory response to it. The longer the infection continues, the weaker the tissues become, causing them to gradually detach from the teeth. Along with bone deterioration (another effect of the disease), this can ultimately lead to tooth loss.
To prevent this from happening, you’ll need to be as thorough as possible with daily brushing and flossing. To help make it easier, you can use special tools like an interproximal brush that can maneuver around the braces better than a regular brush. For flossing you can use a floss threader to more readily guide floss between teeth or a water flosser that uses a pressurized stream of water rather than floss thread to remove plaque.
This extra cleaning effort while wearing braces can greatly reduce your disease risk. But you’ll still need to keep an eye out for any symptoms like swollen or bleeding gums, and see your dentist as soon as possible. If the symptoms become severe you may need your braces removed until the disease can be brought under control. The health and future vitality of your teeth and gums is what’s of primary importance.
If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”
Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.
Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:
Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.
Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.
Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.
Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.
Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.
After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.
For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”
There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.
But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.
But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.
After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.
As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.
This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.
If you would like more information on treatment options 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”
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