While most tooth loss stems from dental disease or injury, another major cause is a condition known as cracked tooth syndrome. What begins as a microscopic crack in an individual tooth’s enamel could ultimately grow to a fracture that endangers its survival.
Most often related to age-related brittleness, expansion and contraction of the enamel surface because of hot foods followed by cold foods and beverages, or grinding habits, cracked tooth syndrome usually occurs in three phases. The first phase is the emergence of miniscule cracks in the outer enamel known as craze lines. These can be very difficult to detect even with x-rays, and usually calls for specialized detection methods such as probing with a sharp instrument (an explorer) or fiber-optic lighting with dye staining to highlight enamel abnormalities. If you have pain symptoms, we may ask you to bite down on a bite stick or rubber pad to locate the area by replicating the sensation.
In the next phase, the craze line grows into a crack that penetrates below the enamel into the tooth’s dentin. Pain becomes more prominent and the risk of infection increases. Left untreated, the crack may enter the third phase, a full break (fracture) occurring deep within the inner layers of the tooth. The deeper the fracture occurs, the more serious the danger to the tooth, especially if the pulp is exposed.
The best treatment approach is to attempt to detect and treat a crack as early as possible. Craze lines and moderate cracks can usually be repaired with restorative materials like composite resins. A deeper crack extending into the pulp may require a root canal treatment and the tooth covered with a permanent, protective crown.
If, however, the fracture is too deep, the tooth may be beyond repair and will need to be extracted and replaced with a dental implant or permanent bridge. In any event, the sooner a cracked tooth is discovered and treated, the greater your chance of avoiding pain, discomfort, and, ultimately, tooth loss.
If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”
You have a winning smile except for one small flaw — one of your front teeth is chipped. In functional terms the defect is insignificant: your tooth is healthy and can still do its job. But with regard to your smile that chip is like a smudge on a masterpiece painting: it stands out — and not in a good way.
The good news is you have options to repair the chip and vastly improve your appearance. One option is to bond a custom porcelain veneer to the outside of the tooth to cover the chip. But that would also mean removing a slight bit of tooth enamel so the veneer won't appear too bulky. Although not as much as with a crown, the alteration still permanently affects the tooth — it will always require a restoration of some kind.
There's another choice that doesn't involve removing any of your enamel: composite resin. This treatment is a mixture of materials with a glass-like binder in liquid form that we apply to a tooth in successive coats. As we build up the layers we can match the tooth's shape, texture and various shades of its natural color. We're able to fill in the defect and make the tooth appear as natural as possible.
Unlike porcelain restorations, composite resins don't require a dental lab or a period of weeks to prepare. We can transform your simile in our office in as little as one visit.
Composite resin isn't the answer for every tooth defect. Teeth that have become worn, fractured or have undergone a root canal treatment are best treated with a porcelain restoration such as a veneer or crown. But where the defect is relatively minor, composite resin may be the answer.
To learn if you can benefit from a composite resin restoration, you'll need to undergo a dental exam. If we determine you're a candidate, we can use this state-of-the-art dental material to make your teeth look flawless.
If you would like more information on composite resins, 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 “Artistic Repair of Front Teeth with Composite Resin.”
It may begin as an itching or burning feeling on your skin, followed by numbness or sensitivity to touch. But then you develop a painful red rash that forms crusty lesions. Fever and fatigue may follow.
These are the common symptoms for a form of chicken pox called shingles, a contagious disease from the human herpes group of viruses. While anyone can contract the shingles virus, it most often lies dormant in a person’s nervous system for decades after an earlier bout of chicken pox. It then breaks out (sometimes repeatedly), usually in patients over fifty.
A shingles outbreak can be miserable. It could also affect your dental care, especially if you have a rash on your face and neck. Here are 3 things you should do if you have shingles in regard to your dental care and overall health.
Tell your dentist you have shingles. A shingles outbreak is highly contagious in its early stages and can spread from direct contact with blisters or through airborne secretions from the infected person’s respiratory system. Even a simple teeth cleaning (especially with an ultrasonic device) at this stage could spread the virus to staff and other patients. So inform your dentist if your appointment coincides with an outbreak—it may be necessary to re-schedule your visit.
Start antiviral treatment as soon as possible. If you’re diagnosed with shingles, more than likely your doctor or dentist will recommend immediate antiviral treatment (typically acyclovir or famciclovir) within 3 days of symptom onset. This can help speed up healing, alleviate pain and possibly prevent more serious complications.
Get the shingles vaccine. Of course, you don’t have to wait for shingles to occur—there is an effective vaccine that could help prevent an outbreak. If you’ve had chicken pox (over 90% of American adults have) or you’re over sixty with or without previous chicken pox, the U.S. Centers for Disease Control recommends you get vaccinated.
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”
Brushing and flossing every day are important for preventing dental disease. The object is to remove as much bacterial plaque, the thin biofilm most responsible for disease, from your teeth and gums as possible.
But how do you know your hygiene efforts are that effective? You can of course do the “tongue test” â?? feel your teeth with your tongue after brushing and flossing and see if they feel smooth and “squeaky” clean. We can also give you a “report card” at your regular cleaning appointment. There is, however, a more precise way you can find out at home by using a plaque disclosing agent.
A plaque disclosing agent is a formulation that when applied to the teeth will temporarily dye any bacterial plaque present a distinct color. While dental hygienists occasionally apply them, they’re also available over the counter for use at home. They’re usually found in a solution, tablet or swab form in various flavors.
To use the product you first brush and floss, then swish the disclosing liquid around in your mouth for about 30 seconds before spitting it out (or chew the tablet or apply the swab as directed). The agent will react with any remaining plaque and dye it a bright color. There are even two-tone agents available that can differentiate between old and new plaque and dye them different colors.
Examining your teeth in a mirror will give you a good idea where you need to concentrate your attention when brushing and flossing. If, for example, you see dyed plaque more along the gum line and less in other places, then that’s where you should focus your hygiene efforts.
While the dye will eventually wear off on its own, you should take the opportunity to brush and floss again to remove any remaining dyed plaque. Not only does this provide a more thorough cleaning at that moment, you’ll also get a better sense of how “thoroughness” feels for future brushing and flossing.
It’s always good to know how well you’re doing with your dental hygiene efforts. A plaque disclosing agent can give you just the right feedback to help you improve.
If you would like more information on proper oral hygiene habits, 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 “Plaque Disclosing Agents.”
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