Dental Arts of Wyomissing Blog
Replacing missing teeth can do wonders for a smile. And you have solid options for doing so, from a partial denture to state-of-the-art dental implants. But there might be a roadblock to your restoration plan—literally. Some of your other teeth may be in the way.
When a tooth has been missing for a while, the teeth on either side of a tooth gap will naturally begin to move or “drift” into the space. This could result in an inadequate amount of available space for a prosthetic (false) tooth.
If that happens, we'll first need to move the errant teeth back to where they belong, either with traditional braces or removable clear aligners. If we're successful, we can then proceed with the missing tooth restoration.
But before starting orthodontic treatment, there may be another problem that needs our attention first. If your missing teeth are the result of periodontal (gum) disease, your gums and supporting bone may not be as healthy as they need to be. This can interfere with orthodontics, which often depends on the gums and bone around a tooth being healthy enough to reform as the tooth moves. That may not be possible if they're still infected with gum disease or you've suffered significant bone loss.
If that's the case, it may be necessary to first treat any gum disease present and rebuild the bone. The latter can often be done by grafting bone material to the area of loss. The graft then serves as a scaffold of sorts upon which new bone can grow and accumulate. And reducing gum disease, mainly by removing bacterial plaque, allows the gums to heal and regain attachment with the teeth.
Once your gums and bone are healthy again, we can then proceed with orthodontics. After the teeth are reasonably aligned, we can then complete the restoration for replacing your missing teeth, and any other cosmetic enhancements for your remaining teeth like veneers or crowns.
The entire process may take some time and multiple treatment visits. But gaining a more attractive smile in the end is well worth it.
For one out of three Americans, a bite of ice cream or a sip of hot coffee can set off a sudden jolt of pain. Fortunately, there are ways to reduce these painful episodes of tooth sensitivity and their severity.
To understand the primary reasons that people experience tooth sensitivity, we must first consider a little tooth anatomy. Just below a tooth's outer enamel is a layer of tooth structure called dentin, composed of tiny tunnels or tubules that transmit sensations of temperature or pressure to the nerves in the central pulp. These tubules are analogous to conduits through which electrical wires pass.
Enamel on the crown, along with gum tissue and a thin material called cementum covering the roots, help muffle sensations so as to prevent an overload on the nerves. But if either of those protective areas become compromised the nerves could in turn experience the full brunt of these sensations.
As such, softened and eroded enamel from tooth decay could expose the dentin. Receding gums, commonly caused by gum disease, can also expose dentin near the roots since the remaining cementum offers little protection. In either case, nerves in the pulp may become subject to extreme sensations caused by temperature or while biting down, which then causes them to fire off pain signals to the brain.
Thus, to treat sensitive teeth we must first determine whether it's the result of tooth decay, gum disease or some other condition, and then treat any underlying disease. If it's decay-related, we'll want to repair any cavities with a filling, or perform a root canal if the infection has spread deeper into the tooth.
For receded gums, we'll first want to treat any lingering gum disease. Once we've brought the infection under control, it's possible then for the gums to heal and regenerate, eventually treating the roots with desensitizing products. In some cases, though, we may have to surgically graft new tissue to the receded area to cover the roots.
The good news is that you can lower your chances of tooth sensitivity by preventing these dental diseases. To do that, be sure you're brushing and flossing daily to remove disease-causing plaque, and visiting your dentist at least twice a year for professional cleanings and checkups.
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.”
Although braces can eventually lead to a healthier mouth, your teeth and gums could become less healthy while wearing them. That's because the attaching brackets and wires can obstruct brushing and flossing, making it easier for disease-causing dental plaque to accumulate in hard-to-reach places.
But although difficult, it's not impossible to take care of your teeth and gums while wearing braces. Here are a few tips for making it easier to maintain your oral health during orthodontics.
Take more time to brush and floss. Under normal circumstances, it usually takes about two minutes to adequately brush and floss your teeth. While wearing braces, however, you'll need to expand that time to be sure you've worked your brush thoroughly into areas around the brackets and between the wires.
Use specialized hygiene tools. Regular toothbrushes or flossing thread aren't well-suited for maneuvering around braces hardware. An interproximal brush with a narrower head may work better accessing those tight spaces. You may also have more success with a water flosser, which directs a pressurized spray to remove plaque, than with regular floss.
Avoid sugar and processed foods. You already know you need to avoid certain foods like popcorn or chips while wearing braces. Additionally, you should also cut back on foods with added sugar or other refined carbohydrates. Sugar especially feeds the bacteria within dental plaque, which further increases your chances for tooth decay or gum disease.
Boost your fluoride intake. This naturally-occurring chemical has been well-documented to strengthen enamel. Be sure, then, that you're using toothpaste and other oral hygiene products with fluoride. You might also talk to your dentist about a topical fluoride treatment that they can directly apply to your teeth for added protection.
Use antibacterial rinses. To reduce bacterial plaque, your dentist can also prescribe special mouthrinses containing an antibacterial agent called chlorhexidine. Because it can cause staining, however, it's best to only use it on a temporary basis, and under the guidance of your dentist.
In the end, your newly straightened teeth will be easier to clean, which can lower your disease risk over the long-term. But for now, while wearing braces, you'll need to pay closer attention to your teeth's care to keep them healthy.
If you would like more information on dental care while undergoing orthodontic treatment, 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 “Caring for Teeth During Orthodontic Treatment.”
It doesn't take much—some staining, a chipped tooth or a slight gap—for you to lose confidence in your smile. But you may be able to regain your smile confidence with porcelain veneers.
A veneer is a thin, tooth-colored shell of dental porcelain that we bond to the face of a tooth. As the name implies, a veneer covers mild to moderate imperfections in such a life-like fashion that it's difficult to tell a veneered tooth from a natural one.
Although veneers can't correct every dental appearance problem, they do have a wide range. Here are 4 situations where veneers could be a great choice for improving your smile.
Discoloration. People often turn to teeth whitening to help brighten dull or dingy teeth. But this technique may not work as well with heavy staining, or not at all if the discoloration originates from inside of a tooth. Veneers offer a permanent solution for heavily stained or discolored teeth.
Shaping and size. Teeth look best when they're in proper proportion to other oral or facial features. But congenitally small or odd-shaped teeth, as well as inordinate tooth wearing, could cause your smile to look out of place. Veneers can improve the appearance of small or worn teeth and restore proper balance to your smile.
Dental defects. Teeth with chips, craze lines (vertical cracks) or other dental flaws can distract from your smile. As with discoloration, veneers can mask mild to moderate dental flaws and restore teeth to their beautiful perfection.
Misalignments. We often correct bite misalignments that affect appearance with braces or clear aligners. But if it's a mild orthodontic problem like a slight tooth gap between the front teeth or a slight rotation, it's often possible to cover the misalignment with the help of dental veneers.
So, could veneers make a difference in your smile? There's only one way to find out—see your dentist for a complete dental assessment. Depending on the nature of the problems disrupting your appearance, veneers could be a great way to transform your smile.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”
Dental implants are considered by both dentists and patients as the top choice for teeth replacement, with a fixed bridge a close second. Implants and bridges, however, can be financially challenging for many people. Fortunately, there's another effective and affordable choice: a removable partial denture or RPD.
Like full dentures, RPDs are oral appliances that are generally supported by the bony ridge of the gums. They differ, though, in that they replace one or more teeth among the existing natural teeth rather than all the teeth on a jaw. In general, RPDs are designed to hook on to the adjacent dental teeth so that they stay in place during function inside the mouth.
We should also make a distinction between two types of RPDs. One is a lighter version known commonly as a "flipper" because a wearer can easily "flip" it out of the mouth with their tongue. These are only intended for short-term use until a dentist can install a more permanent restoration like an implant or bridge. As an example, a teenager with lost teeth may wear a flipper until their jaw has matured enough for implants.
The other RPD is heavier and designed to be a permanent tooth replacement. These RPDs have a rigid frame made of a strong metal alloy called vitallium, to which a dentist attaches artificial teeth made of porcelain, resins or plastics. The frame may also have colored resins or plastics attached to mimic gum tissue. To hold the RPD in place in the mouth, they may have tiny vitallium clasps that grip onto the natural teeth.
RPDs are precisely engineered to match not only the position and placement of the artificial teeth, but the balance of the frame within the mouth. The latter is important because an unbalanced frame could rock during biting and chewing, which could reduce the longevity of the denture and cause wearing of the bone beneath the gum ridge.
A well-designed and maintained RPD can last for many years. They can, however, harbor bacteria, so they and the rest of the teeth and gums must be cleaned daily to prevent dental disease. They also can't stop or slow bone loss at the missing teeth sites, one of the benefits of dental implants.
But even with these drawbacks, an affordable RPD can still be a sound choice for replacing missing teeth and restoring an attractive smile.
If you would like more information on removable partial dentures, 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 “Removable Partial Dentures.”
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