While mouth pain can certainly get your attention, what exactly hurts may be difficult to identify. It might seem to emanate from a single tooth, or a group of teeth. Then again, it might not be clear whether it's coming from teeth or from the gums.
Still, it's important to pinpoint the cause as much as possible to treat it correctly. One of the main questions we often want to answer is whether the cause originates from within a tooth or without.
In the first case, tooth decay may have entered the pulp at the center of the tooth. The pulp contains nerve bundles that can come under attack from decay and transmit pain signals. Incidentally, if the pain suddenly goes away, it may simply mean the nerves have died and not the infection.
The decay can also spread into the root canals leading to the root and supporting bone, and then make the jump into the gum tissues. One possible sign of this is the one mentioned earlier—you can't quite tell if the pain is from the tooth or the surrounding gums.
The root canals could also serve as a transportation medium for infection in the other direction. In that case, gum disease has advanced into the bone tissues around a tooth near its roots. The infection can then cross into the tooth. Again, both a tooth and the gum tissue around it can become diseased.
We have effective treatments for individual occurrences of interior tooth decay or gum disease: The former usually requires a root canal treatment to remove infected tissue and fill and seal the tooth from future infection; we alleviate gum disease by removing the dental plaque causing it and helping the gum tissues to heal. But combined tooth and gum infection scenarios are more difficult to treat, have a poorer prognosis and may require specialists.
To reduce the risk of either tooth decay or gum disease developing into this greater problem, it's best to take action at the first sign of trouble. So, see your dentist as soon as possible when you encounter oral pain or if you notice swollen or bleeding gums. The earlier we treat the initial outbreak of disease, be it tooth decay or gum disease, the better your chances of a successful and happy outcome.
If you would like more information on tooth pain, 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 “Confusing Tooth Pain.”
It's been a rough year for all of us, but especially for Simon Cowell. The famous entrepreneur and brutally honest talent judge on American Idol and America's Got Talent underwent emergency back surgery in August after an accident on a new electric bike. But the good news is he's well on his way to recovery—and well enough in October to undergo another, less-stressful, procedure: a smile makeover with dental veneers.
This latest trip to the dentist wasn't Cowell's first experience with the popular restoration, wanting this time to update his smile to more closely resemble what he had when he was younger. He even brought along some older photos for reference.
Veneers aren't exclusive to celebrities like Simon Cowell, as thousands of people who get them every year can attest. These thin wafers of porcelain bonded to teeth can mask a wide range of defects, from chips, wear or discoloration to slight tooth gaps or misalignments. And every veneer is custom-made to match an individual patient's dental dimensions and coloring.
If you're thinking about a smile upgrade, here are a few reasons to consider dental veneers.
More bang for your buck. Compared to other transformative cosmetic options, veneers are relatively affordable, with the cost dependent largely on the extent of your dental needs. Still, dental veneers are an investment that can give long-lasting yields of a more attractive smile and even a completely new look.
Little to no tooth alteration. In most veneer cases, we need only remove a small amount of enamel so the veneers don't appear bulky (the alteration is permanent, though, so you'll need a veneer on the tooth from then on). It's also possible to get “no-prep” veneers requiring little to no alteration.
Durable and long-lasting. Continuing improvements in porcelain and other dental ceramics have led to stronger forms that can better withstand the biting forces your teeth encounter every day. Although you'll still need to be careful biting into hard items, your veneers can last for several years.
Easy to maintain. Veneer cleaning and maintenance is much the same as with natural teeth—daily brushing and flossing, and regular dental cleanings and checkups. Outside of that, you'll need to watch what you chomp down on: Veneers are strong, but not indestructible, and they can break.
As Simon Cowell knows, getting veneers isn't difficult. It starts with an initial visit so we can evaluate your dental health and needs. From there, we can present options on how to update your smile.
If you would like more information about dental veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “No-Prep Porcelain Veneers.”
At what age should you begin treating a poor bite? Many might say with braces around late childhood or early adolescence. But some bite problems could be addressed earlier—with the possibility of avoiding future orthodontic treatment.
A crossbite is a good example. In a normal bite, all of the upper teeth slightly cover the lower when the jaws are shut. But a crossbite occurs when some of the lower teeth, particularly in back, overlap the upper teeth. This situation often happens when the upper jaw develops too narrowly.
But one feature of a child's mouth structure provides an opportunity to intervene and alter jaw development. During a child's early years, the palate (roof of the mouth) consists of two bones next to each other with an open seam running between them. This seam, which runs through the center of the mouth from front to back, will fuse during puberty to form one continuous palatal bone.
An orthodontist can take advantage of this separation if the jaw isn't growing wide enough with a unique device called a palatal expander. This particular oral appliance consists of four, thin metal legs connected to a central mechanism. The orthodontist places the expander against the palate and then uses the mechanism to extend the legs firmly against the back of the teeth on both sides of the jaw.
The outward pressure exerted by the legs also widens the seam between the two palatal bones. The body will respond to this by adding new bone to the existing palatal bones to fill in the widened gap. At regular intervals, the patient or a caregiver will operate the mechanism with a key that will continue to widen the gap between the bones, causing more expansion of the palatal bones until the jaw has grown to a normal width.
The palatal expander is most effective when it's applied early enough to develop more bone before the seam closes. That's why it's important for children to undergo bite evaluation with an orthodontist around age 6. If it appears a bite problem is developing, early interventions like a palatal expander could slow or stop it before it gets worse.
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 “Palatal Expanders.”
Besides straight and translucent teeth, an attractive smile has another important component: balance. In a great smile, the visible areas of the teeth and gums are in balanced proportion to one another.
But what is the ideal proportion between teeth and gums? Although aesthetic appeal is largely “in the eye of the beholder,” dental professionals typically consider a properly sized tooth to be around 10 mm in visible length. As for the upper gums, no more than 4 mm of tissue should show when smiling. Teeth appearing shorter than 10 mm or the gums displaying more than 4 mm can create an effect called a “gummy smile.”
Fortunately, there are different approaches for correcting a gummy smile, depending on what's causing the appearance of gumminess. Not only are there different causes, but they can be diverse in nature.
Obviously, an actual excess of gum tissue can cause a smile to look gummy—but so can shortened teeth. One possible solution called crown lengthening could help correct either possibility. During the procedure, we remove any excess gum tissue or reposition the gums after reshaping the underlying bone to reveal more of the tooth crown. Worn or shortened teeth can also be made to look longer with porcelain veneers.
A gummy smile could also be caused by a hypermobile lip, in which the lip rises higher than normal while smiling. We may be able to prevent this temporarily by injecting Botox into the lip muscles, which paralyzes them and inhibits their ability to move upward. A more permanent approach is to surgically restrict the upward movement of the lip muscles.
The gums may also seem too prominent if the upper jaw is longer in proportion to the face. One way to correct this is orthognathic surgery, a procedure that moves the upper jaw to a higher position on the skull. This can reduce the jaw profile with the face and subsequently affect how much of the gums show while smiling.
These solutions range from relatively minor to significantly invasive. The first step, though, is to find out what's really behind your gummy smile before taking the next step to make it more attractive.
If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”
If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.
As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.
Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.
But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.
Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.
So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.
In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.
If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.