Thursday, March 31, 2011

My Child Just Knocked Their Tooth Out!

Okay. First of all, as in most traumatic situations.
Do not panic.
Its likely that your child has never gone through this before.
Therefore, they are fairly unaware whether what just happened
to them is simply a minor thing or whether they will soon be in the hospital.
The way they will be able to tell how severe the situation
is is by looking at their parent.
If you are flipping out then they will too.

The first thing to do is to educate yourself BEFORE something like this happens.
It is very important to know when your child's baby teeth will come out naturally.
Here is a chart of, about, when that will happen.
This is important because if the tooth that was just knocked out was about to
come out anyway then there is much less to worry about.
If it's still a year or so away, or you know that its already the permanent tooth
that just got knocked out then there is much more to worry about.

So lets say your child is 8 or 9 years old and it is the adult tooth that just got knocked out.
First thing is to do is obviously check your child for signs of significant injury.
If they hit their face hard enough to knock a tooth out
you need to check for signs of a concussion.
If they seem to be alright except for the tooth then the next step is to find the tooth.
Once the tooth is found treat it very gently.
The tooth is attached to the bone by ligaments.
Parts of those ligaments will still be attached to the tooth and must not be damaged.
First carefully pick off any large pieces of debris.
Secondly the smaller pieces need to be rinsed off.
This is best accomplished by gently rubbing the tooth against the inside of your child's cheek.
This will get all the small particles off and still treat the tooth gently.

Then, are you ready for this..... you need to stick the tooth back in.
That's right, you need to gently place the tooth back into the socket from which it came.
Its pretty simple.
The Skinny part goes in first.
Just simply slide it back into place.
Don't force it. Simply get it as close as you can.
If it wont go or you don't have the stomach for it then place the tooth
into your child's mouth in the bottom jaw in between the cheek and gums.
Holding the tooth there will give it the best chance for survival.

Then finally, in all cases, get to a dentist ASAP.
The dentist will know what to do and will give you options depending on the
severity of the accident and the condition of the jaw and tooth.

Wednesday, March 30, 2011

My Crown has a little black line near the gums. what's wrong?

Nothing is wrong.
What you are seeing is simply the metal that your crown is
made out of showing out from underneath.
I know I know, you thought that your crown was white and that
there wasn't any metal in it.
Well, there is. You have what is referred to as a porcelain
fused to metal crown of (PFM).
The crown is made of a metal substructure to give it it's strength and
then porcelainis layered over the top to make it look like a tooth.
The PFM has been used for years and has had remarkable success.
The only draw back to these types of crowns is the metal line showing through
and the fact that the porcelain layers can begin to separate from each other
and cause the pieces of porcelain to fall off the crowns.

Today there are new advances in crown technology that have
eliminated both of these problems.

There is a new material, to the world of dentistry that is, called zirconium.
Zirconium crowns are milled from a solid block and are very very strong.
This milling process means that they are not put together piece by piece.
Therefore there are no pieces to come apart. The crown is one solid unit.
Zirconium is also white so the color is that of most teeth and will never show a
metallic line because there is no metal.

Tuesday, March 29, 2011

What is Cleft Lip and Palate?

The word "cleft" simply means a crack or divide. A cleft lip is simply the body incorrectly or incompletely closing the facial structures during development. This incomplete closing leaves a cleft, or divide, in the lip and/or palate of the new born. Below is an ultrasound showing a cleft lip

The word "cleft" simply means a crack or divide. A cleft lip is simply the body incorrectly or incompletely closing the facial structures during development. This incomplete closing leaves a cleft, or divide, in the lip and/or palate of the new born. Below is an ultrasound showing a cleft lip
Clefts are normally very repairable and the scare can be almost unrecognizable.

Thursday, March 24, 2011

Tooth implant completed today

Today we delivered the crown to an implant that we did several months ago.
The patient came in with a broken lower molar.
She decided that instead of trying the heroic measures necessary to save her own tooth that she would get an implant placed.
The extraction and immediate implant placement went very well.
The healing took place over an 8 week period.
The abutment was in for an additional 2 weeks.
The crown was then placed this morning.
Wonderful alternative to root canals, posts, core buildups, etc.

Wednesday, March 23, 2011

Does my child need to see a pediatric dentist?

Like many things in this world...... it depends.
Pediatric dentists are an amazing tool in the dental community.
I send children to them all the time.
However, there are many many more children
that I never send to them.

Almost everything that a pediatric dentist can do for your child can be done by a general dentist. Placing fillings, straightening teeth, placing space maintainers, extracting teeth,
doing pulpotomies (baby root canals), cleaning teeth, etc.
All of these services are offered by both a pediatric dentist and the general dentist.

So what does a pediatric dentist for?
The thing that, I feel, pediatric dentists are best for is to treat the nervous child.
Children just don't like dentists, doctors, nurses, etc.
We are always the ones giving shots and swabbing throats and so on.
The pediatric dentist is licensed to sedate children.
Whether through I.V. or orally your child can be put to sleep at a pediatric dentists office.

Now, this service will cost more money for the overall treatment but if it is the only way that your child can be treated due to them being scared to death then that is the best thing.

I suggest starting to bring your child to the dentist with you when they are about 3 years old.
Bring the child in for your cleaning. Let them sit in the corner and see that its not such a bad thing to be seen by the dentist. Do the same thing for you next cleaning. At that next appointment we typically will ask to see inside the child's mouth as they sit on the chair in the corner. We simply look around and get the child used to use being in their mouth. After that is done we congratulate the child for being so good and give them a prize. This exercise clears the way for them to be seen for their own cleaning and not be too scared about it because they have already been into the dentist on numerous occasions.

Tuesday, March 22, 2011

Progression of tooth decay

Cavities don't just get big all of a sudden.
If you go to your dentist with a toothache, chances are that your
tooth has been decaying for some time.

This picture shows a chart of how a cavity grows.

The top row shows an example of cavities that you get when you
don't floss as much as you should.

The next row shows the cavities that you would get if
you do not brush as often as you should.

The last row shows cavities that can happen underneath
older fillings.

Monday, March 21, 2011

Teeth Whitening

Teeth whitening is a very hot topic these days.
It seems as though everybody and their dog is offering to have your
teeth whitened for life, by tomorrow.

So what is real and what is hype?
As a disclaimer let me just say that tooth whitening can be accomplished successfully with ANY of these methods and that the following is based on fact with my opinion thrown in for flavor.

There are basically 3 ways to whiten your teeth.

#1 With the whiteners you buy in the stores.
This includes strips, trays, paint on stuff, etc.
Couple of things to consider here. The strength of the bleach has to be over the counter strength which is going to be less then bleach you can get form your dentist. Its like buying Tylenol from the store vs getting Lortab from the dentist. Next is the way the bleach is delivered. Below is a picture of a bleaching strip. Since this strip is sold to everyone it then, by nature, fits no one. Administering bleach to the masses can be a very inexact science that could lead to burned gums or uneven bleaching of the teeth.

#2 Is custom trays made by your dentist and you do the bleaching at home.
This way of bleaching has a lot of up side.
First the strength of bleach is prescription strength which will allow you to bleach faster. Second while bleaching faster it is still slow enough to stop when you begin feeling too much sensitivity. Lastly the trays are made specifically for you. They will fit no one else and thus deliver the bleach right to where it is needed.
#3 In office light whitening.
This option is nice because it is the fastest. But there are some draw backs. The machines to do the bleaching are expensive so the cost must be passed on the the patient. Next, you can't stop bleaching when you begin to feel sensitive. You will lay back being one shade and be several shades lighter when you sit up. If you happen to have lightened up too much and your teeth are very sensitive to even breath you are kind of out of luck.
So again, there are probably many of you reading this that have gotten your teeth whitened by any of the ways just mentioned and it has worked well for you. And that is great. I personally have chosen to offer only the 2nd option in my office as I feel it is the best bang for the buck and offers the least chance of complications for my patients.

Thursday, March 17, 2011

Does your child look like a shark?

Does it look like your child is getting a second row of teeth?Do you think that he may be part human and part shark?
Your child is not getting a second row of teeth, nor is he part shark. The adult tooth has simply "missed" the baby tooth and is coming up (or down) next to the baby tooth instead of pushing it out of the way. The baby tooth will, more then likely, not become much more loose on its own. Baby teeth become loose due to the pressure exerted on them by adult teeth. You will need to bring your kid into the dentist and have the baby tooth taken out.

Wednesday, March 16, 2011

Does it matter what toothpaste I use?

Sure doesn't.

Now, if you or someone you know is a dental toothpaste salesmen please don't get all bent out of shape. No matter what anyone says most toothpastes are pretty much the same. There are a few products that your Aunt Betty makes in her back yard out of bees wax and real maple syrup. But other then that they are all pretty close.

In fact in a 4 week study the American Dental Association found very little, if no, difference between folks who brushed with toothpaste vs straight water.
Here is a link to the study.

And what they are made out of is not even really the important thing anyway. The important thing is that you actually pick up the brush and use it. And then pick up the floss and use that. If you do these two things, regardless of what types of toothpaste or floss, you will be in the 95th percentile of people in this country.

Moral to the story is this......
don't be so worried about what you put on the brush,
just put the brush against your teeth.

Tuesday, March 15, 2011

Are fluoride supplements important for your child?

In my humble opinion the answer to that is, yes.

Below you will see an artistic rendering of the skull of a child
between the ages of 2-5. The baby teeth are fully
erupted into the mouth and are in white.
The adult teeth, that will erupt later, are in blue.

As you can see the adult teeth are still in the process of forming. At this time the body is looking for the building blocks needed to form strong healthy teeth and placing those building blocks in an appropriate configuration. If the body can not find the proper materials that does not mean that the teeth will not be formed. It simply means that the teeth will be formed in an inferior fashion. The teeth will be more prone to decay and fracture over time.

Fluoride is an important part of the forming tooth.
Whether or not you get enough fluoride naturally is up to you to find out.
Check you local city or county to find out where your water
comes from and what the natural concentrations of fluoride is.
Then check to see if they are adding fluoride to it.

Monday, March 14, 2011

Open only if you are not squeamish.

This post is not for the faint of heart.
This is however, one of the most serious posts that I have ever done.

If you smoke or chew, please stop.
Oral cancer is very very real.
I realize that everyone knows someone that has smoked for
80 years and nothing has ever happened to them.
That is all well and good, until its you that it happens to.

These pictures are of a complete jaw bone removal due to oral cancer.
And yes, if the jaw bone comes out then the teeth must come with it.

Bottom Jaw.

After the jaw bone is removed a new one must be made.
It is fairly typical to make the new jaw out of Metal.
the new metal jaw is lined with one of your ribs that has been taken from you and bolted to the metal. Hopefully, later on some type of implants can be fastened to the metal jaw and you can get teeth back. Until that time you are on pretty much liquid.
X-ray of the new lower jaw.
Hope this scares anyone enough to lick the habit.

Wednesday, March 9, 2011

Why should I get my teeth checked? Nothing hurts.

This is a question we get asked all the time.
"Are you sure I have a cavity. Because it doesn't hurt."

Well, saying that is like saying, "Why do I need to change my oil when my car is
running just fine?"

Your car may be running fine and you could save yourself $49.99 by not changing your oil.
However, when you engine seizes up your repair bill is now about $4,000 for a new motor.
You didn't end up saving a lot in the end.

Same is true with teeth and cavities.
you could save yourself the small cost of getting a cavity filled but then when it starts to hurt you will need to get a root canal and a crown. That means that your cost, and your discomfort, will be significantly more.

Save yourself the money and the discomfort.
Get your cavities filled when they are small.

Tuesday, March 8, 2011

My tooth just tipped over!!!

Most people think that its no big deal to get just one tooth taken out. they will say things like "its just one tooth" and "I've got a ton more". Well, you do have a lot more teeth then just that one but this does NOT mean that getting a tooth out will not create many other problems in the mouth.
Some of the problems that can occur are as follows.

#1 The tooth that chews against the tooth you just took out could move up, or down, into the spot just vacated by the extracted tooth.

This top tooth is moving down into the mouth because the one below it was removed.

#2 The teeth right next to the extracted one may begin to tip into the spot just vacated by the extracted tooth. These next two pictures were taken 5 years apart. The patients tooth tipped completely over and needed to be extracted.

Both of these can cause your bite to be thrown completely off and make chewing uncomfortable.

#3 As you chew hard and crunchy foods, they will pinch up against the gums where the tooth used to be.
Moral to the story is this.
If you can fix your teeth, then do it.
If you can't, then get the hole filled where the tooth used to be ASAP.

Monday, March 7, 2011

You are never too old.

You are NEVER too old to get a new smile.

This patient is 74 years old and finally decide that she wasn't happy with her teeth.

It was a really neat project to see her so excited to smile again. Even at 74.

Thursday, March 3, 2011

What is your favorite myth?

There are lots of myths out there.
The Lochness Monster, Bigfoot, etc.etc.

Mine is the myth of the cosmetic dentist.

There is no such thing as a cosmetic dentist.

Here is a list of the specialties that are recognized by the ADA. Orthodontics and Dentofacial Orthopedics, Endodontics, Dental Public Health, Oral and Maxillofacial Pathology, Oral and Maxillofacial Radiology, Oral and Maxillofacial Surgery, Pediatric Dentistry, Periodontics, and Prosthodontics.
Each one of these specialties is strictly regulated. Each doctor that practices in one of these fields must go through advanced licensure requirements and advanced schooling even beyond dental school. These doctors carry with them advanced knowledge that is strictly regulated by the ADA.
If you noticed none of those specialties that I just mentioned was called the specialty of cosmetic dentistry. That's because it doesn't exist. And as a matter of fact it is illegal to advertise yourself as a cosmetic dentist.
The idea of being "cosmetic" simply means that you try to make things look better. Well, there isn't a dentist, or specialist, out there who DOESN'T do this. Everyone in the dental field has the goal to make things look better. Its what we do.
Now, is it true that a dental professional can go to courses, after dental school, that focus solely on cosmetic procedures? Absolutely. And I have been to many of them. But that does not mean that I am a specialist in cosmetic dentistry. Because, once again, no one can be. It doesn't exist.
If you have things that you would like to see changed about your teeth then ask around. Find a dentist that has a good reputation for that kind of thing. Then when you meet him/her ask to see some of their work. If it looks good then you are probably at the right place.

Here is a case that we did in our office.


Tuesday, March 1, 2011

What are dental implants?

The teeth that you see in your mouth are connected to you by the root of the tooth.

An implant is simply replacing the natural root with an artificial one and then attaching a tooth to the new artificial one.

Implants can replace single teeth, multiple teeth, or be the way of attaching a loose denture in the mouth with a more firm grip.

Almost anyone is a candidate for implants. Certain medical conditions and drugs that people are taking may present problems but other then that implants are getting to be a pretty universal from for replacing missing teeth.

Most insurances cover implants. Occasionally there are some insurances that are still in the dark ages and don't cover implants so you need to check with your particular company first.

There is no dental specialty that is in charge of placing implants. They are done by general dentists, periodontists, and oral surgeons. Just make sure that the person placing your implants can show you some before and after pictures of work they have done and then can adequately explain the procedure you will be going through so that you will fell comfortable with what will be happening in your mouth.