The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.
Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.
Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.
But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.
The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.
There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.
In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting. The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.
Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.
If you would like more information on treating gum recession, 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 “Periodontal Plastic Surgery.”
A Malocclusion—better known as a poor bite—can have far-ranging consequences that could follow a child into adulthood. Bite abnormalities make it more difficult to chew and digest food. And, misaligned teeth are also harder to keep clean, increasing the risk of dental disease.
But the good news is that we can often curb these long-term effects by discovering and treating a malocclusion early. A poor bite generally develops slowly with signs emerging as early as age 6. If you can pick up on such a sign, interventional treatment might even prevent a malocclusion altogether.
Here are 5 possible signs that might indicate your child is developing a poor bite.
Excessive spacing or crowding. A poor bite may be developing if the gaps between teeth seem unusually wide or, at the opposite spectrum, the teeth appear crooked or "bunched up" from crowding.
Underbite. In a normal bite the teeth on the upper jaw arch slightly cover the lower. If the opposite is true—the lower teeth are in front of the upper—then an underbite could be forming.
Open bite. Normally, when the jaws are shut, there is no open space between them. But if you notice a space still present between the upper and lower teeth when the jaws are shut, it may indicate an open bite.
Crossbite. This abnormal bite occurs when some of the lower teeth bite in front of the upper, while the remaining lower teeth are properly aligned behind the upper. Crossbites can occur with either the front or the back teeth.
Front teeth abnormalities. Front teeth especially can indicate a number of problems. In a deep bite, the upper front teeth extend too far over the lower teeth. Protrusion occurs when the upper teeth jut too far forward; in retrusion, the lower teeth seem to be farther back than normal.
See your dentist if you notice these signs or anything else unusual with your child's bite. Better yet, schedule a bite evaluation with an orthodontist when your child reaches age 6. Getting a head start on treating an emerging malocclusion can save them bigger problems down the road.
If you would like more information on malocclusions and their impact on your child's oral health, 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 “Problems to Watch For in Children Ages 6 to 8.”
Here's some good news: Teenagers are less likely than adults to lose teeth to dental disease. But there's also a flip side. Teens can still lose teeth, more likely from traumatic injury.
Fortunately, there are several options for replacing lost teeth like dentures or bridges. But the choice considered best by most dentists and patients is a dental implant. An implant tooth looks and functions like the real thing—and it's durable, capable of lasting for years, if not decades.
But there's a hitch with teens getting an implant: Even though they may have all their permanent teeth by adolescence, their jaws are still growing and developing. Natural teeth, with their attachment to the jaws by way of a periodontal ligament, can keep pace with this growth—but implants can't.
That's because an implant doesn't have this attachment to gum tissue like natural teeth, but to the jawbone alone. Hence, an implant tooth can't keep up with jaw development, and may eventually look like it's "sunk" into the gums in relation to the teeth around it.
It's best, then, to wait until a teen's jaws have fully developed before attempting an implant. In the meantime, though, they don't have to endure a smile marred by missing teeth, but can replace them with a temporary restoration. The two most common options are a partial denture or a modified bridge.
The partial denture is a lightweight version that's quite affordable. Although not as durable as other types of dentures, the appliance is only intended to last until the patient is old enough for a permanent implant.
The modified bridge is a prosthetic tooth with strips of dental material extending behind it that are bonded to the backs of the teeth on either side to hold it in place. It's likewise not as durable as a traditional bridge, but it can fill the bill until time to place an implant.
Although this adds an additional step in a teen's restorative journey after losing a tooth, it's necessary—waiting to place an implant after jaw maturity will help ensure a long-lasting result. In the meantime, a temporary tooth replacement will help them to enjoy a normal smile.
If you would like more information on dental restorations for teens, 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 Implants for Teenagers.”
Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they're still giving us something to watch via virtual interviews. In the process, we're given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon's daughter Winnie interrupted with breaking news: She had just lost a tooth.
It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it's not an uncommon experience. Nevertheless, it's still good to be prepared if your six-year-old is on the verge of losing that first tooth.
Primary teeth may be smaller than their successors, but they're not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That's why it's optimal for baby teeth to remain intact until they're ready to come out.
When that time comes, the tooth's roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness, though, doesn't automatically signal a baby tooth's imminent end. But come out it will, so be patient.
Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.
Here's some advice from your dentist: Don't. Trying to pull a tooth whose root hasn't sufficiently dissolved could damage your child's gum tissues and increase the risk of infection. It could also cause needless pain.
Left alone, the tooth will normally fall out on its own. If you think, though, that it's truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it's ready, it should pop out. If it doesn't, leave it be for another day or two before trying again.
Your child losing a tooth is an exciting moment, even if it isn't being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.
If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”
Root canals often get a bum rap. Although the procedure saves millions of teeth every year, it's often erroneously portrayed as an unpleasant experience. And if that wasn't enough, a long-discredited medical theory has found new life on the internet asserting root canals are a health danger.
First off, root canals play an immensely important role in treating teeth with advanced decay. If not promptly treated, a cavity can turn into a major infection of the interior tooth pulp and root canals, and ultimately the supporting bone. Teeth with this level of decay are not long for this world.
A root canal treatment stops this disease process in its tracks. After numbing the tooth and surrounding gums, we drill a small hole into the tooth's interior and then remove all of the infected tissue within the pulp and root canals. After disinfecting these areas, we fill them with a rubber-like substance called gutta percha.
After sealing off the access hole—and later capping the tooth with a life-like crown—the tooth is secure from further decay. And, by the way, the procedure doesn't hurt, thanks to local anesthesia. If anything, any pain caused by the decay attacking the tooth's nerves has now been alleviated.
So, what about the idea floating on the Web that root canals are dangerous? The "root" for this conjecture is a theory by Weston Price, an early 20th Century dentist, that leaving a "dead" body part in the body leads to various health problems (including cancer). That would include a root-canaled tooth, which has had the living tissue in the pulp removed.
There's just one problem—Weston's theory was fully investigated in the 1950s and overwhelmingly discredited. The supposed cancer threat was also reviewed in a 2013 study, which found no link between root canals and increased cancer risk. In fact, dental patients who had undergone several root canals had a diminished risk.
Like all other health procedures, root canals have some risks of complication. But those complications are far from life-threatening—it's tooth-saving benefits are often worth the risk. So, fear not if your dentist says you need a root canal. It won't hurt and it won't endanger your health—and it could save your tooth.
If you would like more information on root canal therapy, 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 “Root Canal Safety.”
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