Posts for: January, 2016
A loose baby tooth is normal and expected; a loose permanent tooth is quite another matter: it’s an advanced sign of disease that could lead to losing the tooth.
The reasons for its looseness may vary. You may have experienced “primary occlusal trauma,” in which the teeth have experienced a prolonged excessive biting force beyond their tolerance. This can be caused by habitual grinding or clenching the teeth.
You may have also experienced “secondary occlusal trauma”: although the biting forces are within normal ranges, the teeth still can’t handle the stress due to degraded bone support and gum tissue detachment. Clenching habits combined with weakened bone and gums will only accelerate and worsen the damage.
The most frequent cause in adults for loose teeth is secondary trauma from periodontal (gum) disease. Bacterial plaque built up on teeth from poor oral hygiene causes a chronic infection that eventually weakens gum attachment to the teeth. A loose tooth is a late sign of this damage.
Treatment for disease-based loose teeth has a twofold approach. First, we thoroughly clean the tooth, root and gum surfaces of all plaque and calculus (hardened plaque deposits) to reduce the infection and inflammation and restore tissue health. This is often accompanied by antibiotic treatments to reduce bacteria below the gum tissue.
For the loose teeth themselves, we may need to modify the forces against them while the gums and bone heal. One way to lessen the biting force on a tooth is to reshape its and the opposing tooth’s biting surfaces. For extensive looseness we can also splint the affected tooth or teeth with other teeth. Temporarily, we can apply splinting material to the outside of both the loose and stable teeth or cut a small channel into them and apply bonding material to join them. A permanent option is to crown both the affected teeth and nearby stable teeth and fuse the crowns together.
These and other stabilizing techniques, like occlusal night guards to reduce the effects of teeth grinding or orthodontic treatment, will help secure the teeth. Coupled with disease treatment and renewed dental care and hygiene practices, you may be able to keep that loose tooth from being lost.
If you would like more information on treating loose teeth, 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 for Loose Teeth.”
Have you started orthodontic treatment recently? Are you having a little trouble getting used to your braces? If so, you are not alone: Everybody goes through an adjustment period during which they momentarily wonder if they’ll really ever get used to this. Don’t worry — you will! And we’ve never heard anyone say, on the day their braces come off and their new smile is revealed, that they aren’t glad they went the distance. Just ask Houston Rockets all-star center Dwight Howard, who discussed his own orthodontic treatment in a recent interview.
“I’m sure I was no different than anyone else who has ever had braces,” he told Mediaplanet. “At first I hated them so much… That changed once I got used to them and I actually grew to love them.” What’s Howard’s advice? “Do exactly what your orthodontist says and know that the outcome is well worth it in the end.” We couldn’t agree more! Here are some tips for wearing braces comfortably:
- Hard & Chewy Foods: If you love fresh fruits and vegetables, that’s great; there’s no reason to give them up, just the really hard ones. You don’t want to bite into an apple or carrot or any other hard foods like bagels and pizza that have any “size” to them. Small pieces may be ok as long as they can’t bend your wires. Chewy, sticky candy should really be avoided completely. Same with soda, sports drinks and so-called energy drinks because they contain acids that promote tooth decay and can cause a lot of damage around the braces.
- Effective Oral Hygiene: Keeping your teeth clean is more important than ever, but also more challenging than ever. It’s easy for food to get stuck under wires and around brackets, but failing to remove it can cause tooth decay, gum irritation and soreness. Therefore, the cleaner your teeth and your braces are, the healthier you will be. Use interdental cleaning brushes and/or a floss-threader to get behind your wires. A mouthrinse can also help strengthen teeth and keep bacteria in check. If you have any questions about how to clean between your teeth, please ask for a demonstration at your next visit.
- Pain Relief: Some soreness at the beginning of orthodontic treatment is normal. To relieve it, you can use an over-the-counter pain reliever and/or a warm washcloth or heating pad placed on the outside of the jaw. If brackets or wires are rubbing against the inside of your cheeks or lips, try applying wax to these areas of your braces. If this does not offer enough relief, we may be able to trim the end of a poking wire. Call us if you need help with this.
Our goal is to make your orthodontic treatment as comfortable as possible on the way to achieving your all-star smile. If you have questions about adjusting to braces, contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”
Undergoing regular dental cleanings is an essential part of periodontal (gum) disease prevention. While a daily habit of brushing and flossing cleans bacterial plaque from most tooth surfaces, it’s difficult to remove from places your brush or floss can’t access well. That, as well as hardened plaque deposits known as calculus, must be removed by a hygienist or dentist with a technique known as scaling.
Scaling is traditionally performed manually using specialized hand instruments known as scalers. Although hand scalers are quite effective, they must be used carefully to avoid damage to gum tissue or, during deeper cleaning known as root planing, the tooth roots. A different method for plaque removal known as ultrasonic scaling has grown in popularity as an alternative to manual scaling.
Ultrasonic scaling uses equipment emitting vibrational energy that crushes and loosens plaque and calculus, and disrupts growing bacterial colonies in biofilm. Plaque particles are then washed away using water irrigation. The most recent models of ultrasonic scalers have matched the effectiveness of hand scaling in removing plaque and calculus in shallow gum pockets, and surpassed the manual technique in cleaning out pockets greater than 4 mm. In experienced hands, they’re kinder to tooth structure and other tissues. Water irrigation also improves healing by removing bacteria and scaling by-products, which also makes the area easier to view by the hygienist.
On the other hand, any type of power scaler must be used with caution with patients who have pacemakers, and are not recommended for those with hypersensitive teeth or teeth that are in the early stages of de-mineralization. The technique may also produce an aerosol of finely misted particles (with possible contamination) that requires added measures to contain them.
For most patients, though, ultrasonic scalers are an effective tool for plaque and calculus removal. As ultrasonic devices continue to evolve, patients will ultimately benefit from greater comfort and reduced treatment times.
If you would like more information on plaque removal with ultrasonic scalers, 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 “Dental Cleanings Using Ultrasonic Scalers.”