Posts for: February, 2019
A loose permanent tooth is not a good thing—and not something you should put off having examined. That’s because a loose tooth could soon become a lost tooth.
How we treat it depends on its underlying cause, which could be one of two types. One is primary occlusal trauma, meaning the affected tooth has experienced accidental trauma or higher biting forces than it normally encounters. This usually happens because of teeth grinding habits.
It could also be secondary occlusal trauma. Unlike primary trauma where the supporting gums and bone may be reasonably healthy, secondary trauma occurs because these structures have been severely damaged by periodontal (gum) disease. As the gums begin to detach from a tooth and its underlying bone deteriorates, even normal biting forces can loosen it.
If gum disease is present, our first priority is to bring it under control. We do this primarily by removing all dental plaque (a thin film of bacteria and food particles that triggers the infection and sustains it) and calculus or tartar (calcified plaque). This can take several sessions and, in the case of deep infection, may require a surgical procedure.
On the other hand, if teeth grinding is the primary cause, we’ll focus on minimizing the habit and its effects. One way is to create a custom-fitted guard worn to prevent upper and lower teeth from making solid contact. You may also need to improve your management of stress—another factor in teeth grinding—through medication, therapy or biofeedback.
In either case, improved periodontal health will help the gums naturally regain their strong attachment with help, if necessary, from gum tissue or bone grafting surgery. But this healing process can take time, so we may need to secure a loose tooth in the interim by splinting it to neighboring stable teeth. This usually requires bonding rigid material or metal across the back of all involved teeth or in a channel cut along the teeth’s biting surfaces. In this way the more stable teeth support the loose one.
Splinting may be temporary as the mouth heals from disease or trauma and the teeth regain their stability. In some cases, though, it may be permanent. Either way, dealing promptly with a loose tooth can help ensure it’ll survive—so see your dentist as soon as possible.
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.”
Dental implants are the ideal tooth replacement with their life-like appearance, high success rate and durability. If you have significant dental issues, they may seem like the perfect answer. But before you choose to replace a problem tooth with an implant, it might be to your benefit — financially and health-wise — to consider saving the tooth first.
Tooth decay can be a formidable enemy, destroying both tooth structure and the tooth’s connectivity to the jaw. But there are treatment options even for heavily decayed teeth, including cavity filling with composite resins or porcelain that look and function like natural teeth. For decay deep within a tooth’s interior, root canal therapy can rid the pulp chamber and root canals of decay and seal them from future occurrences. The treatment’s success rate is comparable to and less expensive than implants.
While decay damage can be significant, adult teeth are more at risk from periodontal (gum) disease, a gum infection caused by bacterial plaque on tooth surfaces. This disease can weaken gum tissues until they eventually detach from the teeth and lead to loss. Gum disease, though, can often be brought under control by techniques called scaling and root planing that deep clean tooth and root surfaces of plaque and calculus (hardened plaque deposits).
Scaling may require multiple sessions and will require a greater effort from the patient in performing daily oral hygiene and visiting the dentist regularly to closely monitor gum health. And more advanced cases may require surgery to access deep pockets of infection or repair damaged tissues. But even with this effort, treating gum disease rather than replacing a tooth could be much less costly — and you’ll be able to preserve your own teeth.
On the other hand, the disease process may have gone on too long and caused too much damage for the tooth to be saved. In these cases, the best option is to remove it and install a restoration like an implant. By first completing a complete dental examination, we’ll be better able to advise you whether your best course is a “tooth rescue” or a replacement.
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”