Tooth wear, especially on biting surfaces, is a normal part of aging — we all lose some of our tooth enamel as we grow older. Even primary (“baby”) teeth may show some wear before they’re lost. But there’s also excessive, premature tooth wear caused by disease or abnormal biting habits. This type of wear is cause for concern and action before it leads to tooth loss.
Normal tooth wear occurs because of what teeth naturally do — bite and chew. When teeth come together as we eat they generate a modest amount of force: between 13 and 23 pounds. Our teeth also make brief contacts hundreds to thousands times a day. Again, this produces force, though not to the extent we see with biting and chewing: somewhere between 0.75 and 7.5 pounds. These glancing contacts are actually good for dental health because they provide needed stimulation to the teeth and jaws that help the body maintain healthy bone and tooth attachments.
But parafunctional (outside the normal function) habits like teeth grinding or foreign object chewing can greatly increase the generated force, up to 230 pounds. These may result in noticeable symptoms like fractures or loose teeth, but not always — the damage may not be noticeable until much later in the form of excessive tooth wear.
These parafunctional habits aren’t the only cause for excessive tooth wear; tooth decay can weaken the tooth structure, making it more susceptible to wear. And, some restorative materials used for fillings may also affect the rate of wear.
Because excessive tooth wear may or may not present with immediate symptoms, it’s important to maintain regular dental checkups to monitor the condition of your teeth. Our training and experience helps us identify signs of excessive tooth wear and, depending on the extent of damage, work with you on a treatment plan. You should also keep us informed about oral habits, especially teeth grinding, thumb sucking or foreign object chewing (toys, nails, pencils, etc.).
Your teeth will wear as you grow older. By keeping a close eye on your teeth, we’ll help you keep that wear at a normal rate.
If you would like more information on preventing excessive 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 “When Children Grind Their Teeth.”
When your baby’s first teeth erupt in the mouth, it’s a big step in their development. Unfortunately, you may not have much opportunity to celebrate — you’re too busy tending to your infant whose experience is anything but pleasant.
Commonly known as teething, the eruption process usually begins between six and nine months of age, although some children may begin as early as three months or as late as twelve. Not all teeth come in at the same time: it usually begins with the two lower front teeth, then the two upper front teeth, followed by the molars and then the canines (eye teeth). By age three, most children have all twenty of their primary teeth.
Each child’s teething experience is different and may vary in length of time and intensity. The usual signs are heightened irritability, biting and gnawing accompanied by gum swelling, ear rubbing, drooling and sometimes facial rashes. Babies also may have disturbed sleeping patterns and a decreased appetite. Occasionally, this discomfort can be intense.
There are some things you can do to ease this discomfort. Provide your baby a clean, chilled (not frozen) rubber teething ring, chilled pacifier or wet washcloth to gnaw on. Cold foods, like popsicles for older children can also be soothing, though you should limit sugary foods to lower the risk of tooth decay. You can also finger massage swollen gums to counteract the pressure coming from the erupting tooth, or administer pain relievers like baby acetaminophen or ibuprofen. You can use products with Benzocaine®, a numbing agent, for children two years or older — but you should never use alcohol for children of any age for inflamed gums.
Be sure to also set up a Year One dental examination around their first birthday. This is an important first step in your child’s long-term dental care, and a good opportunity to check their teething progress. And, by all means, if you have concerns about your child’s experience with teething, don’t hesitate to call our office.
Teething is a normal part of your child’s development. There’s much you can do to help make it as comfortable and pain-free as possible.
If you would like more information on teething, 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 “Teething Troubles.”
Regardless of culture, the smile is a universal gesture of friendship and openness, and an important communication tool in your social and career relationships. But what if you’re not comfortable with your smile because of misaligned, damaged or missing teeth? That could have a dampening effect on your interactions with people and your own self-confidence.
Cosmetic dentistry can change all that — we have an arsenal of treatments that can rejuvenate your smile. We must first, though, develop a design plan, often involving multiple dental disciplines. It will definitely involve you — your desires, expectations and choices.
It begins with a thought-provoking discussion with our office. Generalities — “I want a beautiful smile” — aren’t enough. Effective planning begins with a clear perspective about your teeth: What do you like or dislike about them? If you could change anything, what would it be? These initial discussions help us specify your expectations.
While the initial discussion envisions the future, the next step focuses on the present — the current condition of your teeth, mouth and entire facial structure. This requires a comprehensive examination to identify any health issues like tooth decay, periodontal gum disease or bone loss. We must also take in the “big picture,” like the shape of your face, out-of-balance features (asymmetries), skin complexion, eye shape and color, or the form and posture of your lips.
Considering all these factors, we then develop a treatment plan with specifics on how to achieve the desired transformation. We will offer our prognosis for what we believe is achievable and maintainable for your specific situation. Here we provide various models, perhaps even including computer simulation, to depict your future smile. In the end, we create a workable plan that meets both reality and your expectations.
With the design plan completed, we can then harness all the techniques and materials available to achieve it. These range from less invasive procedures like whitening, tooth reshaping, cosmetic bonding or porcelain veneers, to more involved restorations like crowns, bridgework or dental implants. In some cases, orthodontics may be necessary to correct bad bites or other malformations of your oral structures.
Smile design ensures we’re employing the right techniques for your particular situation. It all serves the end goal — a new smile that can transform your life.
If you would like more information on smile design, 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 “Beautiful Smiles by Design.”
A dental implant as a permanent replacement for a missing tooth can match or even look better than your original tooth. How this happens takes knowledge, skill, experience, and even some art.
Here are some of the factors involved:
- Bone quantity and quality: To look and function like an original tooth, an implant must be supported by an adequate base of (jaw) bone and gum tissue. Bone has a tendency to melt away or resorb after a tooth is lost. Using new bone grafting techniques can help minimize the bone loss that occurs during healing at the extraction site. Bone grafting can also be used to rebuild lost bone at the implant site.
- Adequate bone supporting neighboring teeth: If you lose bone that supports teeth on either side of an implant, the papillae (the little pink triangles of gum tissue between the teeth) may not regenerate after the implant is placed.
- Your inborn tissue type: If your gum tissues are thin and delicate rather than thick and robust, they will be more difficult to work with. To ensure that there is sufficient gum tissue support, (gum) grafting may be necessary.
- Using the temporary crown as a template: A dental implant actually replaces a tooth root. Most dental implants are made of commercially pure titanium, which fuses with the bone in your jaw, making it very stable. The crown, the part of the tooth that is visible above the gum line, is attached to the implant; a customized temporary crown can be fitted to the implant. The temporary crown is a trial for the final crown. It can be used to assess color, shape, the appearance of your smile, and the implantâ??s function in your bite and speech. It gives you the opportunity to decide about design adjustments before the final, permanent crown is placed.
- The skill, experience, and collaboration of your dental team: Each situation is different. The final success of your implant depends on your pre-surgical assessment and diagnosis, as well as how the surgical and restorative phases of treatment are performed. The use of an outstanding dental laboratory is vital to a successful result.
Contact us today to schedule an appointment for an assessment or to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”
What and how you eat and drink has a significant impact on the health of your teeth and gums. Therefore, an effective oral hygiene regime must take your diet into account.
Acid is your teeth's enemy; it can erode their protective enamel coating (a process called demineralization). Certain foods and beverages (such as citrus drinks and coffee) contain it, and it's produced by bacteria in your mouth that feed on dietary sugar and release acid as a byproduct (a process called fermentation). Your allies are foods and beverages that neutralize acids, provide minerals and vitamins to repair tooth enamel, and stimulate saliva.
Sugar & Decay
Sugars, the leading promoter of dental decay, exist in many forms in our diet. Some occur naturally, while others — referred to as “free sugars” — are added by the manufacturer, cook or consumer. The latter are most often linked with decay. Soft drinks are the primary source of dietary free-sugars in the U.S.
Sugars in fruit, vegetables, milk and unprocessed, starch-rich foods such as rice, potatoes and whole grains, do not appear to be harmful to teeth. Note, however, that dried fruits contain a highly concentrated sugar level and can stick to tooth surfaces. The sugar substitutes xylitol and sorbitol appear not to promote decay. In fact, there's evidence that chewing xylitol-sweetened gum three to five times daily for at least five minutes (after meals) stimulates saliva flow, which helps protect against decay.
Acids & Erosion
In addition to eroding tooth enamel, acidic foods and beverages create an environment where it's easier for decay-promoting bacteria to flourish. Saliva can reduce acidity but it must have time to work, at least 30–60 minutes. That's why behaviors that maintain acid levels, such as sipping coffee throughout the day, can be harmful.
Saliva is a front-line defense against erosion and decay. It helps remove food particles and contains minerals that help neutralize acid and promote remineralization of the tooth surface. Foods that stimulate saliva and/or contribute essential minerals include:
- Cheese — stimulates saliva and is rich in calcium, contributing to the re-calcification of teeth and protecting against the loss of calcium,
- Cow's milk — contains decay-counteracting calcium, phosphorous and casein,
- Plant foods — are fibrous and require chewing, which mechanically stimulates saliva,
- Water — keeps you hydrated, which is important for saliva production and preventing dry mouth (a condition that promotes acid-producing bacteria), and helps wash away food particles; fluorinated water bestows the protective properties of fluoride (a compound that makes tooth enamel more resistant to acid erosion and promotes re-calcification).
As you can see, brushing and flossing effectively is just part of the oral hygiene equation.
If you would like more information about nutrition and oral hygiene, 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 “Nutrition & Oral Health.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.