Posts for: October, 2018
Teeth are naturally strong and durable — if we can prevent or control dental disease like tooth decay or gum disease, they can last a lifetime. Still, teeth do wear gradually as we age, a fact we must factor into our dental care as we grow older.
Sometimes, though, the wear rate can accelerate and lead to problems much earlier — even tooth loss. There are generally four ways this abnormal wear can occur.
Tooth to tooth contact. Attrition usually results from habitual teeth grinding or clenching that are well beyond normal tooth contact. Also known as bruxism, these habits may occur unconsciously, often while you sleep. Treatments for bruxism include an occlusal guard worn to prevent tooth to tooth contact, orthodontic treatment, medication, biofeedback or psychological counseling to improve stress coping skills.
Teeth and hard material contact. Bruxism causes abrasion when our teeth regularly bite on hard materials such as pencils, nails, or bobby pins. The constant contact with these and other abrasive surfaces will cause the enamel to erode. Again, learning to cope with stress and breaking the bruxism habit will help preserve the remaining enamel.
Chronic acid. A high level of acid from foods we eat or drink can erode tooth enamel. Saliva naturally neutralizes this acid and restores the mouth to a neutral pH, usually within thirty minutes to an hour after eating. But if you’re constantly snacking on acidic foods and beverages, saliva’s buffering ability can’t keep up. To avoid this situation, refrain from constant snacking and limit acidic beverages like sodas or sports drinks to mealtimes. Extreme cases of gastric reflux disease may also disrupt your mouth’s pH — seek treatment from your medical doctor if you’re having related symptoms.
Enamel loss at the gumline. Also known as abfraction, this enamel loss is often caused by receding gums that expose more of the tooth below the enamel, which can lead to its erosion. Preventing and treating gum disease (the leading cause of receding gums) and proper oral hygiene will lower your risks of receding gums and protect tooth enamel.
If you would like more information on tooth wear, 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 and Why Teeth Wear.”
For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.
Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.
Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.
Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.
In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.
Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.
Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.
There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.
When your favorite baseball team wins, it's hard not to get excited — especially if you're right there in the stadium. It's even better when a player tosses the ball to fans. But sometimes, in the heat of the moment, things can go awry.
That's what happened during a recent game at New York's Yankee Stadium. After catching the ball that ended the game in an 8-2 Dodgers win, Los Angeles outfielder Yasiel Puig tossed it into a cheering crowd of supporters. “I saw it coming at me and I remember thinking, 'I don't have a glove to catch this ball,'” Dodgers fan Alyssa Gerharter told the New York Daily News. “I felt it hit me and I could feel immediately with my tongue there's a hole. And I looked down at my hand and saw there's a tooth in my hand.”
Ouch. Just like that, one fan's dream became… a not-so-good dream. But fortunately for the 25-year-old software engineer, things went uphill from there. Ushers quickly escorted her into a first-aid room at the stadium. She was then rushed to a nearby hospital, where the upper front tooth was re-inserted into her jaw. After a follow-up appointment at her dentist's office the next day, Gerharter said she remains hopeful the re-inserted tooth will fuse with the bone, and won't require replacement.
We hope so too. And in fact, she has as good a chance of a successful outcome as anyone, because she did everything right. If you're not sure what to do about a knocked-out tooth, here are the basics:
- locate the tooth, handle it carefully (don't touch the root surface), and if possible gently clean it with water
- try to open the person's mouth and find the place where the tooth came from
- carefully re-insert the tooth in its socket if possible, making sure it is facing the right way
- hold the tooth in place with a soft cloth as you rush to the dental office or the nearest urgent care facility
- if it can't be replaced in its socket, place the tooth in a special preservative solution or milk, or have the person hold it between the cheek and gum (making sure they won't swallow it) — and then seek immediate care at the dental office
- follow up at the dental office as recommended
In general, the quicker you perform these steps, the more likely it is that the tooth can be preserved. How quick is quick? The best outcomes are expected when re-implantation occurs in no more than five minutes. So if you're in this situation, don't wait: get (or give) appropriate first aid right away — it just might save a tooth!
If you would like more information about what to do in a dental emergency, contact us or schedule an appointment for a consultation. You can learn more the Dear Doctor articles “Knocked Out Tooth,” and “The Field-Side Guide to Dental Injuries.”