By Uxbridge Dental Center
January 21, 2018
Category: Oral Health
Tags: oral health   gum disease  
BoostYourOverallHealthbyReducingGumInflammation

The human body’s immune system has amazing defensive capabilities. Without it a common cold or small wound could turn deadly.

One of the more important processes of the immune system is inflammation, the body’s ability to isolate diseased or injured tissue from unaffected tissue. Ironically, though, this vital component of the healing process could actually cause harm if it becomes chronic.

This often happens with periodontal (gum) disease, an infection of the gums caused by bacterial plaque built up on teeth due to inadequate hygiene, which in turn triggers inflammation. The infection is often fueled by plaque, however, and can become difficult for the body to overcome on its own. A kind of trench warfare sets in between the body and the infection, resulting in continuing inflammation that can damage gum tissues. Untreated, the damage may eventually lead to tooth and bone loss.

In treating gum disease, our main goal is to stop the infection (and hence the inflammation) by aggressively removing plaque and calculus (tartar). Without plaque the infection diminishes, the inflammation subsides and the gums can begin to heal. This reduces the danger to teeth and bone and hopefully averts their loss.

But there’s another benefit of this treatment that could impact other inflammatory conditions in the body. Because all the body’s organic systems are interrelated, what occurs in one part affects another especially if it involves inflammation.

It’s now theorized that reducing gum inflammation could lessen inflammation in other parts of the body. Likewise, treating other conditions like high blood pressure and other risk factors for inflammatory diseases could lower your risk of gum disease and boost the effectiveness of treatment.

The real key is to improve and maintain your overall health, including your teeth and gums. Practice daily brushing and flossing to remove plaque, and visit your dentist regularly for more thorough cleanings. And see your dentist at the first sign of possible gum problems like bleeding, redness or swelling. You’ll not only be helping your mouth you could also be helping the rest of your body enjoy better health.

If you would like more information on the relationship between gum disease and other systemic conditions, 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 “The Link between Heart & Gum Diseases.”

By Uxbridge Dental Center
January 06, 2018
Category: Oral Health
Tags: tooth pain  
BeforeweExtractThatProblemToothLetsConsiderSavingit

Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.

We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.

While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.

Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.

Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.

But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.

These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.

If you would like more information on the best treatment choices for your dental 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 “Save a Tooth or Get an Implant?

By Uxbridge Dental Center
December 29, 2017
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Uxbridge Dental Center
December 14, 2017
Category: Dental Procedures
Tags: gum disease   loose tooth  
HaveaLooseToothYoullNeedThisTwo-PhaseTreatmenttoSaveIt

Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.

One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.

Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.

Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.

The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.

Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.

The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.

Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.

If you would like more information on loose teeth and gum disease, 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.”

EnsuretheBestOutcomewiththeRightCareforaTeensMissingTooth

While it's possible for a teenager to lose a tooth from decay, it's more common they'll lose one from an accidental knockout. If that happens to your teenager, there are some things you should know to achieve a good outcome.

Our top concern is to preserve the underlying bone following tooth loss. Like other tissues, bone has a life cycle: older cells dissolve and are absorbed by the body (resorption), then replaced by new cells. The biting pressure generated when we chew helps stimulate this growth. But bone around a missing tooth lacks this stimulation and may not keep up with resorption at a healthy rate.

This can cause a person to lose some of the bone around an empty tooth socket. To counteract this, we may place a bone graft at the site. Made of bone minerals, usually from a donor, the graft serves as a scaffold for new bone growth. By preventing significant bone loss we can better ensure success with a future restoration.

Because of its lifelikeness, functionality and durability, dental implants are considered the best of the restoration options that can be considered to replace a missing tooth. But placing an implant during the teen years is problematic because the jaws are still growing. If we place an implant prematurely it will appear to be out of alignment when the jaw fully matures. Better to wait until the jaw finishes development in early adulthood.

In the meantime, there are a couple of temporary options that work well for teens: a removable partial denture (RFP) or a fixed modified bridge. The latter is similar to bridges made for adults, but uses tabs of dental material that bond a prosthetic (false) tooth to the adjacent natural teeth to hold it in place. This alleviates the need to permanently alter the adjacent natural teeth and buy time so that the implant can be placed after growth and development has finished.

And no need to worry about postponing orthodontic treatment in the event of a tooth loss. In most cases we can go ahead with treatment, and may even be able to incorporate a prosthetic tooth into the braces or clear aligners.

It's always unfortunate to lose a tooth, especially from a sudden accident. The good news, though, is that with proper care and attention we can restore your teenager's smile.

If you would like more information on how to treat lost teeth in teenagers, 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.”





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