The American Dental Association (ADA) recommends visiting the dentist at least once every six months for a
professional exam and cleaning. Regular dental visits are
necessary for the maintenance of healthy gums and teeth.
Your dentist may recommend more frequent visits, depending
on the state of your oral health.
Bridges
When one or more teeth are missing, the remaining teeth
can shift out of position. This can lead to a change in
your bite, the loss of additional teeth, decay and gum
disease.
When missing multiple teeth, your dentist may recommend
the placement of a bridge. A permanent bridge is one or more
replacement teeth anchored by one or more crowns on each
side. A removable bridge - or removable partial denture - usually consists of replacement teeth attached to pink or
gum-colored plastic bases, which are connected by a metal
framework.
Bruxism – "Tooth Grinding"
Patients are often concerned about grinding
their teeth while asleep (bruxism). The first indication of bruxism is usually the noise
created by grinding your teeth. Or, you
may notice wear on your teeth, like getting shorter.
One theory is that stress causes grinding. Another
theory suggests that pressure in the inner ear is the cause.
The majority of bruxism cases do not require any
treatment. If excessive teeth wear - attrition - is
present, then a bed-time mouth guard may be prescribed.
Crowns
Crowns strengthen and protect the
remaining tooth structure and can improve the appearance of
your smile. A crown can be used to cover a fractured tooth, a tooth
with an old filling, or a tooth that is severely
damaged by decay. Crowns are also used to cover teeth that are
discolored or badly shaped, or to conceal an older dental implant.
Types of crowns include the full porcelain crown, the
porcelain-metal crown, and the all-metal crown. Your
dentist will recommend the crown that is best for you.
Fitting a crown requires at least two visits to your
dentist. First, the dentist removes decay and shapes the
tooth. Then, she makes an impression and fits a temporary or
transitional crown made of plastic or metal. On the next visit,
your dentist will remove the temporary crown, fit and adjust
the final crown and then cement it into place.
Emergencies
Toothache:
Clean the area of the affected tooth thoroughly. Rinse your mouth vigorously with warm water, or use dental floss to
dislodge impacted food or debris. DO NOT place aspirin on
the gum or on the aching tooth. If your face is swollen, apply
a cold compression and contact your dentist immediately.
Cut Tongue, Lip or Cheek: Apply ice to the affected area(s). If
there is bleeding, apply firm but gentle pressure with a
gauze or cloth. If the bleeding cannot be controlled by simple pressure,
call a doctor or visit the emergency room.
Knocked Out Permanent Tooth: If possible, find the tooth. Handle the tooth by
the crown, and be careful not to touch the root portion. You may rinse the tooth but
DO NOT clean or handle the tooth excessively. Inspect the
tooth for fractures. If it is sound, try to reinsert it in
its socket. Hold the tooth in place by
gently biting on a gauze or clean cloth. If you cannot reinsert the tooth,
place the tooth in a cup containing the saliva
of the person that lost it, or use milk, but NOT water. The tooth may also be carried in the
mouth beside the cheek. The person who lost their tooth must see a dentist IMMEDIATELY! Time is a
critical factor in saving the tooth.
Implants
Tooth
loss can have an effect on your dental health and personal
appearance if not dealt with properly. When you lose one or more permanent teeth, your remaining teeth
can drift out of position. This can lead to a change in your
bite, decay and gum disease, as well as a change
in your personal appearance.
Dental implants are an effective method to replace one
or several teeth. Each implant consists of a metal post that
is inserted into the jawbone beneath your gums. The bone then grows around the post during a short healing period. Then, the
post is outfitted with an artificial tooth, which is similar
to your natural tooth. Implants can also support a bridge,
replace a partial denture, or secure a fixed denture.
Oral Cancer
According to the American Dental Association (ADA), oral
cancer kills more people nationwide than either cervical
cancer or skin cancer. Currently, only half of all
patients diagnosed with oral cancer survive more than five
years. The good news is that it is now easier than ever to
detect oral cancer early, when the benefits of treatment are greater.
Regular dental check-ups are essential in the early
detection of cancerous and pre-cancerous conditions. You may
have a very small, but dangerous, oral spot or sore and not
be aware of it. In about 10% of patients, the dentist may
notice a flat, painless, white or red spot or a small sore.
Although most of these are harmless, some are not. To ensure
that a spot or sore is not dangerous, your dentist may
perform a simple test - a biopsy - which can detect
potentially dangerous cells when the disease is still at an
early stage.
Signs of oral cancer that you may want to be aware of may include:
a sore that bleeds easily or does not heal.
a color change of the oral tissue.
a lump.
a thickening, rough spot, rust or small eroded
area.
pain, tenderness, or numbness anywhere in the mouth
or on the lips.
Although oral cancer occurs most often in those who use
tobacco in any form, more than 25% of oral cancers occur in
people who do not smoke and have no other risk factors.
Remember to see your dentist regularly because they are most the most equipped professional to see a small spot
or sore you may not notice. If you do notice any of the above signs,
you should call your dentist as soon as possible.
Root Canal Treatment (Endodontics)
To understand endodontic treatment, it helps to know
something about the anatomy of the tooth. Inside the tooth,
under the enamel and a hard layer called the dentin,
is a soft tissue called pulp. The pulp contains blood
vessels, nerves, and connective tissue and creates the
hard tissues surrounding the tooth during development.
The pulp extends from the crown of the tooth to the tip of
the roots - where it connects to the tissues surrounding the
root. The pulp is important during a tooth's growth and
development. However, once a tooth is fully mature, it can
survive without the pulp because the tooth continues to be
nourished by the tissues surrounding it.
Endodontic
treatment is necessary when the pulp becomes inflamed or
infected. The inflammation or infection can have a variety
of causes: deep decay, repeated dental procedures on the
tooth, or a crack or chip in the tooth. In addition, a blow
to a tooth may cause pulp damage even if the tooth has no
visible chips or cracks. If pulp inflammation or infection
is left untreated, it can cause pain or lead to an abscess.
Signs of pulp damage include pain, prolonged sensitivity
to heat or cold, discoloration of the tooth, and swelling
and tenderness in the nearby gums. Sometimes, there are no
symptoms.
When a root canal is necessary, the dentist, or
endodontist removes the inflamed or infected pulp, carefully
cleans and shapes the inside of the tooth, then fills and
seals the space. Afterwards, you will return to your dentist
to get a crown or other restoration on the tooth to
protect and restore it. After restoration, the tooth
continues to function like any other tooth.
Tooth Eruption
Children's teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.
Adults have 28 permanent teeth, or up to 32, including the third molars - called wisdom teeth.
Tobacco Use
Tobacco in any form can jeopardize your health and cause
incurable damage. Smokeless tobacco, also called dip, chew
or snuff, is often used by teens who believe that it is a
safe alternative to smoking cigarettes. This is an
unfortunate misconception. Studies show that spit tobacco
may be more addictive than smoking cigarettes and may be
more difficult to quit. People who use it need to understand that one can of snuff delivers as much
nicotine as 60 cigarettes. In as little as three to four
months, smokeless tobacco use can cause periodontal disease
and produce pre-cancerous lesions called leukoplakias.
If you are a tobacco user you should watch for the
following that could be early signs of oral cancer:
A sore that won't heal.
White or red leathery patches on your lips, and on
or under your tongue.
Pain, tenderness or numbness in the mouth or lips.
Difficulty chewing, swallowing, speaking or moving
your jaw or tongue; or a change in the way your teeth
fit together.
Because the early signs of oral cancer usually are not
painful, people often ignore them. If it's not caught in the
early stages, oral cancer can require extensive, sometimes
disfiguring, surgery. Even worse, it can kill.
The best advice is to avoid tobacco in any form. By doing
so, you will avoid bringing cancer-causing chemicals in
direct contact with your tongue, gums and cheek.
Tongue Piercing
You might not be surprised anymore to see people with
pierced tongues, lips or cheeks, but you might be surprised
to know just how dangerous these piercings can be.
There are many risks involved with oral piercings,
including chipped or cracked teeth, blood clots, or blood
poisoning. Your mouth contains millions of bacteria, and
infection is a common complication associated with oral piercings. Your
tongue could swell large enough to close off your airway!
Common symptoms after piercing include pain, swelling,
infection, an increased flow of saliva and injuries to gum
tissue. Difficult-to-control bleeding or nerve damage can
result if a blood vessel or nerve bundle is in the path of
the needle.
So follow the advice of the American Dental Association
and give your mouth a break – skip the mouth jewelry.
Wisdom Teeth
Wisdom teeth - or third molars - are the final teeth to
develop in the back of your mouth. Most people have four
wisdom teeth, which erupt during their late teens or early
twenties.
Fixable problems often develop that require the removal of
your wisdom teeth. When the jaw isn't large enough to
accommodate them, they can become trapped or impacted.
Wisdom teeth may grow sideways, emerge only part way from
the gum, or remain trapped beneath the gum and bone. In most
cases, it is recommended that impacted wisdom teeth are
removed.
Wisdom tooth surgery is usually performed under local
anesthesia in your dentist's or oral surgeon's office, an
outpatient surgical facility, or a hospital.
Prevention
Fluoride
Fluoride is a naturally occurring element which has shown to prevent tooth decay by as much as 50-70%. For children younger than 8 years old, fluoride actually helps strengthen the adult teeth that are developing beneath their gums. With little or no fluoride, teeth aren’t strengthened enough to help them resist cavities. Excessive fluoride ingestion by young children can lead to dental fluorosis, which is a white discoloration (brown in advanced cases) of the permanent teeth.
The two primary sources of fluoride are fluoridated water and toothpaste. Fluoridated water is most commonly found in local tap water. Dentists encourage drinking tap water from the sink because a number of water dispensing refrigerators filter out up to 90% of fluoride found in local water. However, charcoal and carbon type water filters such as a Britta filter retain fluoride levels found in local water while still providing filtered drinking water.
For children beneath 3 years of age, use a smear of fluoride toothpaste (the size of a grain of rice) to brush their teeth. For children 3 to 6 years old, use a “pea-size” amount of toothpaste and perform or assist your child’s tooth brushing. To ensure that your child’s toothpaste contains the optimal amount of fluoride, look for the ADA seal of acceptance somewhere on the packaging. Children should not swallow excess toothpaste after brushing, in order to avoid fluorosis. Be sure to follow your pediatric dentist’s instructions on suggested fluoride use and possible supplements.
Awareness of a child's potential sources of
fluoride can help parents prevent the possibility of dental
fluorosis.
Some sources of fluoride are:
Fluoridated toothpaste.
Fluoride supplements.
Tap water.
Two and three-year olds may not be able to spit out toothpaste when brushing. As
a result, younger children may ingest an excessive amount of
fluoride when brushing. Toothpaste ingestion during
this period of permanent tooth development is the
greatest risk factor for developing of fluorosis.
Excessive intake of fluoride
supplements may also contribute to fluorosis. Fluoride drops
and tablets, as well as fluoride fortified vitamins should
not be given to infants younger than six months of age.
After that time, fluoride supplements should only be given
to children after all of the sources of ingested fluoride
have been accounted for and upon the recommendation of your
pediatrician or pediatric dentist.
Certain foods contain high levels of fluoride,
especially: powdered concentrate infant formula, soy-based
infant formula, infant dry cereals, creamed spinach, and
infant chicken products. Please read the label or contact
the manufacturer to learn more about the fluoride levels in specific foods.
Some beverages also contain high levels of
fluoride, especially: decaffeinated teas, white grape
juices, and juice drinks manufactured in fluoridated cities.
Soft drinks served at restraurants may also contain fluoride, depending upon the fluoridation levels in their local water supply.
Parents can take the following steps to decrease the risk
of fluorosis in their children's teeth:
Use baby teeth cleanser on a toothbrush in very young children.
Use only a pea-sized drop of children's toothpaste
when brushing.
Account for all of the sources of ingested fluoride
before requesting fluoride supplements from your child's
physician or pediatric dentist.
Avoid giving any fluoride supplements to
infants until they are at least 6 months old.
Obtain fluoride level test results for your drinking
water before giving fluoride supplements to your child. To do this, check with local water utilities.
Good Diet
Healthy eating habits lead to healthy teeth. Like the
rest of the body, teeth, bones and the soft tissues in
the mouth need a well-balanced diet. In order to promote
good dental health, you should eat a variety of foods from
the five major food groups. Most pre-packaged snacks can lead
to cavity formation. How long food remains in
the mouth also plays a role in cavity development. For example, hard candy and
breath mints can stay in the mouth for a long time, which can cause
longer acid attacks on tooth enamel. If you must snack,
choose nutritious foods such as vegetables, low-fat yogurt,
and low-fat cheese, which are healthier and better for your
teeth.
Mouth Guards
Oral injuries can occur if you participate in recreational activities and
organized sports. Which makes a properly fitted
mouth guard - or mouth protector - an important piece of
athletic gear that can help protect your smile. A mouth guard should
be used during any activity that could result in a blow to
the face or mouth.
Mouth guards help prevent broken teeth, injuries to
the lips, tongue, face, and jaw. A properly fitted mouth guard
will stay in place while you're wearing it, making it easy
for you to talk and breathe.
Ask your dentist about custom and store-bought mouth
protectors.
Seal Out Decay
A sealant is a clr or shaded plastic material that is applied to the chewing surfaces of the back molars, where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
Cosmetic or Esthetic Dentistry
Bonding
Bonding restores chipped, cracked, miscolored or
misaligned teeth by rebuilding the surface with a resin
material. To place the bond, your dentist prepares your
tooth with an etching solution. Then, special resin materials
are blended in colors carefully chosen to match your own
teeth. These materials are applied and then
shaped into the right contours. Finally, they're
hardened or bonded in place. Bonding provides wonderful
results at an affordable cost.
Inlays and Onlays
Inlays and onlays are tooth-colored restorations that are used on the chewing
surfaces of the back teeth. They can be placed instead of
silver fillings or to replace existing silver fillings.
Invisalign ®
The invisible way to straighten your teeth, without braces.
Invisalign® can give you the beautiful straight teeth
you've always wanted. It works through a series of
invisible, removable, and comfortable aligners that no one
can tell you're wearing so you can smile more during - and after -
treatment. Invisalign® has been proven
effective in clinical research, and in dental and orthodontic
practices nationwide.
How Does Invisalign® Work?
You wear each set of aligners for about 2 weeks,
removing them only to eat, drink, brush, and floss.
As you replace each aligner with the next in the
series, your teeth will move – little by little, week by
week – until they have straightened to the final
position your orthodontist or dentist has prescribed.
You'll visit your orthodontist about once every 6 weeks to ensure
that your treatment is progressing as planned.
Total treatment time averages 9-15 months and the
average number of aligners worn during treatment is
between 18 and 30, but both will vary from case to case.
Veneers
Veneers are thin, custom-made shells crafted of tooth-colored materials designed to cover the front side of teeth. Porcelain laminate veneers are commonly used to correct teeth that are stained or discolored, badly shaped or crooked, or damaged due to an injury.
Placing a veneer is usually an irreversible process, because it's necessary to remove a small amount of enamel from your teeth to accommodate the shell.
Whitening (Bleaching)
Several options are available to help make your smile
brighter and whiter. In-office bleaching, at-home bleaching,
or whitening toothpastes. Ask your dentist which technique
is the best suited for you.
Zoom! Teeth Whitening h2
Zoom is a bleaching process widely used throughout the country and around the world to lighten discoloration of enamel and dentin. The Zoom in-office tooth whitening procedure uses the Zoom Advanced Power Chairside Lamp – said to accelerate the bleaching process – to activate the hydrogen peroxide whitening. As the hydrogen peroxide is broken down, oxygen enters the enamel and dentin to bleach the stained substances, leaving the structure of the tooth unchanged.
Before deciding whether Zoom in-office teeth whitening is right for you, your dentist will conduct a comprehensive examination of your teeth and gums to ensure proper health, as well as talk with you about your oral hygiene and lifestyle habits to determine if you will benefit from whitening.
The complete procedure takes less than an hour, but a regular teeth cleaning is recommended prior to the actual Zoom teeth whitening session. The dentist or dental assistant applies the Zoom hydrogen peroxide whitening gel, which works together with the Zoom light to penetrate the teeth and break up the stains and discoloration. The gel is applied for three 15-minute sessions of light activation, for a total treatment time of 45 minutes.
Sensitivity during treatment may occur in some people. The Zoom light produces minimal heat, which is usually the source of discomfort. Rarely, minor tingling is experienced immediately after the procedure, but always dissipates. Ask your dentist for an anti-sensitivity toothpaste prior to treatment to lessen sensitivity.
Ask your dentist about Zoom! Whitening to see if it is right for you.
Tyson Bross is a pediatric dentist in Annapolis, MD serving infants children and teens. The office also serves the surrounding cities of Arnold, Crofton, and Severna Park, MD.
