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Posts for: December, 2018

By Crabapple Family Dentistry
December 21, 2018
Category: Oral Health
Tags: oral hygiene   braces  
EffectiveHygieneisKeytoPreventingEnamelWhiteSpotsWhileWearingBraces

Finally — your braces are off! A look in the mirror reveals a straighter, more attractive smile. Unfortunately, it may also show something not so attractive — tiny, chalky spots on your teeth.

These “white spot lesions” are created by acid remaining too long in contact with the enamel, causing it to lose minerals at those places. The acid comes from plaque (a thin film of bacteria and food particles) that brushing and flossing fail to remove. Snacking on foods and beverages with added sugar or high acid content may also make it worse.

Besides their unattractiveness, these spots can lead to tooth decay — so it’s important to try to prevent it. Limiting sugar-added snacks and acidic beverages to mealtimes will help, but the main key to preventing lesions is more thorough brushing and flossing.

Because of the braces, this can take longer to do than if you weren’t wearing them. It’s also more difficult maneuvering your toothbrush or floss around the orthodontic hardware. You can improve thoroughness and access by using a powered brush or one specially designed for use with braces. And, a water flosser that removes plaque between teeth with a pulsating spray of water is an effective alternative to string floss.

Even if (despite your best efforts) some lesions form, we can still treat them. Resuming normal hygiene practices after braces may take care of it — if not, we can strengthen the affected areas of the enamel with pastes, gels, or other topical fluoride applications. We can also use a technique called caries infiltration that injects tooth-colored resin (often used for cosmetic dentistry) beneath the white spot to harden it, and leave it more translucent in resemblance of normal enamel. If these fail to produce satisfactory results, we can use cosmetic bonding that permanently covers the tooth with resin or veneers.

It’s best, though, if you can prevent the lesions while you’re wearing braces. Besides daily hygiene, be sure to keep up regular dental visits for teeth cleaning. Your efforts will go a long way toward keeping your newly aligned teeth bright and blemish-free.

If you would like more information on dental care and hygiene while wearing braces, 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 “White Spots on Teeth during Orthodontic Treatment.”


RegardlessofWhatYouveSeenOnlineDontFearaRootCanalTreatment

With smart phone in hand, you can instantaneously find out just about anything. Unfortunately, online search results aren’t always accurate. Case in point: there’s an idea floating on the World Wide Web that root canal treatments cause cancer.

Sounds ludicrous? Yes, but like other strange ideas this one has historical roots (pardon the pun). In the early 20th Century, a dentist named Weston Price propagated the idea that leaving a “dead” organ in the body caused health problems. By his view, a root canal-treated tooth fell into this category and could potentially cause, among other things, cancer.

But concern over root canal treatment safety is on shaky ground: dentistry examined Dr. Price’s ideas over sixty years ago and found them wanting. But first, let’s look at what a root canal treatment can actually do for your health.

Tooth decay is an infection that first attacks the outer tooth enamel and then continues to advance until it infects the inner pulp. It can then travel through the root canals to the roots and bone. Without intervention, the infection will result in tooth loss.

We use a root canal treatment to save the tooth from this fate. During the procedure we remove and disinfect all of the diseased or dead tissue within the pulp and root canals. We then fill the empty chamber and canals with a special filling and seal the tooth to prevent any further infection. And while technically the procedure renders a tooth unable to respond to thermal sensitivity or tooth decay, the tooth is still alive as it is attached to the periodontal ligament and its blood supply and nerve tissue. The tooth can still “feel” if you bite on something too hard and it doesn’t affect the tooth’s function or health, or a patient’s overall health for that matter.

As to Dr. Price’s theory, extensive studies beginning in the 1950s have examined the potential health risk of root canal treatments. The latest, a 2013 patient survey study published in a journal of the American Medical Association, not only found no evidence linking root canal treatment to cancer, but a lower risk of oral cancer in 45% of patients who had undergone multiple root canal treatments.

While root canal treatments do have potential side effects, none are remotely as serious as this online “factoid” about cancer. It’s far more likely to benefit your health by saving your tooth.

If you would like more information on root canal treatment, 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.”


By Crabapple Family Dentistry
December 01, 2018
Category: Dental Procedures
HowtoTreattheProblemofTeeththatNeverDeveloped

About one-quarter of people have teeth that never developed. While most of these congenitally missing teeth are wisdom teeth, they can also include premolars or lateral incisors (the teeth right next to the two front teeth, the central incisors).

Missing teeth can have an adverse effect on smile appearance. But that’s not all: because each type of tooth performs a specific function, one or more missing teeth can lead to bite problems and disruption of dental function. In the case of missing lateral incisors, the canines (eye teeth) normally positioned beside and toward the back of the mouth from them may begin to drift into the empty space and grow next to the central incisors. This can result in greater difficulty chewing and a smile that “doesn’t look right.”

To correct this situation, we must often first attempt to orthodontically move any out of place teeth to their normal positions. This re-establishes the space needed for the missing teeth to be replaced, which we can then restore with prosthetic (artificial) teeth. If the permanent restoration of choice involves dental implants, we’ll usually need to wait until the completion of jaw development around early adulthood. In the mean time, we can use a retainer appliance to hold the teeth in their new positions with prosthetic teeth attached to fill the empty space for a better smile appearance in the interim.

The real issue is timing—beginning orthodontic treatment when appropriate to a person’s oral development, as well as completing the implant restoration when the mouth has matured sufficiently. There are other considerations such as bone volume, which may have diminished due to the missing teeth. At some point we may need to consider grafting to build up the bone sufficiently to support dental implants.

This all may entail a team approach by various specialties like orthodontics, periodontics and implantology. Working together and coordinating within a timely schedule, a mouth and smile marred by undeveloped teeth can be transformed.

If you would like more information on treating smiles with underdeveloped permanent 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 “When Permanent Teeth Don’t Grow.”