Posts for: August, 2018
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
Like other living tissue, your teeth can feel. Dentin, the layer below the enamel, houses fluid-filled conduits that transmit temperature or pressure sensations to a nerve network within the tooth’s inner pulp. It’s so effective that incoming sensations must be buffered — “toned down”— to avoid a painful overload of the nerves. The enamel above the gum line and a bone-like substance called cementum below help do this.
Unfortunately, if teeth lose this protection they can become hypersensitive. This can cause a flash of sharp pain while eating or drinking something cold or hot or just biting down.
There are a number of causes for tooth sensitivity, any of which can influence how we treat it. While you’ll need a dental exam to know for sure, your hypersensitivity will more than likely stem from one of these 3 problems.
Periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of bacteria and food particles that accumulates on the teeth due to poor oral hygiene. The inflamed gum tissues weaken and detach from the teeth, causing them to shrink back or recede. This leaves the cementum unprotected, which easily erodes and exposes the dentin to acid and bacteria — and hypersensitivity. Clinically removing the plaque helps the affected gums heal. In extreme cases, the gums may need surgical grafting to regenerate.
Overaggressive brushing. While a lack of oral hygiene can contribute to gum recession, ironically too much hygiene — brushing too hard for too long — can damage your gums and cause them to recede. Brushing really doesn’t require a lot of elbow grease — a gentle scrubbing motion over all tooth surfaces is sufficient to remove plaque. Fine-tuning your brushing will help your gums to recover and heal.
Mouth acid. Although quite strong, enamel has one formidable enemy: acid, which can erode enamel and expose the dentin. Over-indulgence in acidic foods and beverages can make your mouth more acidic; more likely, though, bacterial plaque will again be the culprit, because bacteria excrete an acidic waste product. You can reduce mouth acid with daily brushing and flossing and consuming less acidic foods and beverages.
If you’re experiencing any kind of tooth pain, see us for an examination. We’ll determine the cause and initiate the appropriate treatment to regain your oral health.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”
The most important thing you can do for good oral health is brush and floss your teeth daily. But we’re not born knowing how to do either — they’re skills we must learn and practice to be effective in removing disease-causing bacterial plaque.
It helps then to have a good understanding about technique, implements or problem situations you may run into. So then, here are answers to 4 typical hygiene questions that can help you improve your brushing and flossing.
How often should I brush and floss? You should brush and floss at least once a day to prevent a buildup of plaque, the cause for both tooth decay and periodontal (gum) disease; if you have some form of dental disease, we may advise a different frequency. Be sure to use a gentle technique — it doesn’t take much pressure to remove plaque and being too aggressive can harm your gums and tooth enamel.
When should I change my toothbrush? If you use it correctly (gentle vs. aggressive), your toothbrush should last several months. When you begin to notice the bristles becoming worn or splayed, it’s time to get a new, soft bristle brush.
What kind of toothpaste should I use? You may have a preference among the dozens available when it comes to flavor and texture. But from a hygiene standpoint you should choose one that contains fluoride to strengthen enamel and an anti-tartar agent to inhibit the formation of hardened plaque deposits (calculus). While we’re on the subject, don’t rinse out the toothpaste right after brushing — you may be washing away fluoride too early, which takes time to work in contact with tooth enamel. Just spit it out.
What if my teeth are sensitive when I brush? If you encounter problems when you brush, visit us to find out the cause. The most common cause for sensitivity is gum recession, usually due to gum disease, which has exposed the roots. This can cause discomfort when you encounter hot or cold foods, or pressure on the teeth when you brush. You should then receive treatment for the underlying condition; we may also recommend toothpaste that reduces tooth sensitivity. And, of course, be gentle when you brush.
If you would like more information on brushing, flossing and other aspects of oral hygiene, 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 “Oral Hygiene Behavior.”