Posts for: May, 2015
Dental cleanings are an important part of regular dental office visits. Performed by a dental hygienist or dentist, cleanings serve two purposes: to remove bacterial plaque and calculus (hardened deposits of plaque) from tooth surfaces missed during daily brushing and flossing; and to remove stains that can dull your smile.
There are different degrees of cleaning, including root planing that removes plaque and calculus deep below the gum line, usually for patients affected by periodontal (gum) disease. For patients in good oral health, the basic cleaning approach is known as prophylaxis, a term derived from the Greek for guarding or preventing beforehand. The techniques used in a prophylaxis remove both “coronal” (tooth surfaces visible above the gum line) plaque and staining, providing both therapeutic and cosmetic benefits.
A typical prophylaxis includes a procedure known as scaling. Hygienists use special instruments known as scalers to remove plaque and calculus by hand, or an ultrasonic device that vibrates plaque loose and is flushed away with water. The procedure removes that rough coating you often feel as you rub your tongue against your teeth, leaving the tooth surfaces feeling smooth.
Tooth polishing is a subsequent procedure to scaling that also removes plaque and surface stains. Polishing is carried out with a motorized instrument with a rubber cup in which a polishing (or “prophy”) paste is contained. The hygienist moves the rapidly rotating cup filled with the paste over the tooth surface to remove plaque and stains. The end result is a highly smooth surface and a much shinier appearance.
People with dental insurance plans are often concerned tooth polishing may be viewed strictly as a cosmetic procedure, and thus not fully qualify for benefits. This should not be the case if coded properly: tooth polishing is part of the overall prophylaxis to remove plaque and staining. The primary purpose is therapeutic and preventive; the cosmetic effect is a by-product. Most dental plans will cover one or two prophylaxes (scaling and tooth polishing) a year, but there are variations so individuals should check their plans.
If you would like more information on dental cleaning, 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 “Tooth Polishing.”
For most people, raising kids is an expensive proposition. (A recent estimate by the U.S. Department of Agriculture puts the average tab at almost a quarter of a million dollars before they turn 18.) But if you’ve been keeping up with parenting news lately, you may have come across an even more jaw-dropping fact: According to a survey by the Sunstar group, a maker of oral hygiene products, when the tooth fairy makes a pickup in New York City, she (or her parental surrogate) leaves an average of $13.25 per tooth!
That compares to $9.69 per tooth in Los Angeles, $5.85 in Chicago and $5.02 in Boston — and it’s a far higher rate than most other polls have shown. But it brings up a good question: What's a baby tooth really worth? Ask a dentist, and you may get an answer that surprises you: A lot more than that!
A child’s primary (baby) teeth usually begin coming in around the age of 6 to 9 months, and start making their exits about the time a child reaches six years; by the age of 10 – 13, they’re usually all gone. But even though they will not last forever, baby teeth are far from disposable — and they deserve the same conscientious care as adult teeth. Here’s why:
Primary teeth play the same important roles in kids’ mouths as permanent teeth do in the mouths of adults: they allow kids to bite and chew effectively, speak normally and smile brightly. Their proper functioning allows children to get good nutrition and develop positive social interactions as they grow toward adolescence — and those are things it’s difficult to put a price tag on.
But that’s not all baby teeth are good for. Each one of those little pearly-whites serves as a guide for the permanent tooth that will succeed it: It holds a space open in the jaw and doesn’t let go until the grown-up tooth is ready to erupt (emerge) from beneath the gums. If primary teeth are lost too soon, due to disease, decay or accidents, bite problems (malocclusions) can develop.
A malocclusion (“mal” – bad; “occlusion” – bite) can result when permanent teeth don’t erupt in their proper locations. “Crowding” is a common type of malocclusion that can occur when baby teeth have been lost prematurely. The new, permanent teeth may come in too close together because neighboring teeth have shifted into the gap left by the prematurely lost tooth, creating an obstruction for the incoming teeth. In other cases, the permanent teeth may emerge in rotated or misplaced positions.
Bite problems make teeth harder to clean and thus more prone to disease; they may also cause embarrassment and social difficulties. The good news is that it’s generally possible to fix malocclusion: orthodontists do it every day. The bad news: It will almost certainly cost more than $13.25 per tooth. Alternatively, baby teeth in danger of being lost too soon can often be saved via root canal treatment or other procedures.
We’re not advocating giving big money to toddlers — but we do want to make a point: The tooth fairy’s payout: a few dollars. A lifetime of good checkups and bright smiles: incalculable.
If your tooth sustains damage that compromises its structure — typically through decay or trauma — you have several options depending on the extent of the damage: One of them is a crown. This method saves the tooth and its root and completely conceals the visible portion of the tooth, or crown, under a natural-looking cap made to mimic as closely as possible the size, shape and color of the original tooth.
Crowns also hide imperfections in the original tooth like discoloration, chipping, fractures, excessive wear (from bruxism, or tooth grinding, for example), or abnormalities in the way the tooth formed. And they’re used following root canal treatments, which treat infected pulp at the center (canal) of a tooth root by removing the pulp and replacing it with an inert, rubber-like material.
Saving the natural tooth has long been the goal of dentistry because normal micromovements of the tooth root, which is suspended in its jawbone socket by elastic ligaments, stimulate the surrounding bone to rejuvenate. Without that stimulation, the bone continues to lose old cells, but no longer replaces them. Crowns are also designed to restore tooth function.
The function and location of the damaged tooth can determine what material the crown will be made of. If the damaged tooth is clearly visible when you smile, porcelain, the most realistic-looking material, is almost always used. If the tooth receives significant bite force, a stronger material is considered — either, a gold/porcelain combination, or a high-strength ceramic. If you are restoring a second molar, an all-gold crown may be considered.
With the advent of dental implants, saving a damaged tooth is no longer the only option for preserving the health of the bone surrounding the tooth root. The implant — a tiny biocompatible, titanium screw-like artificial root — is placed in the jawbone and is then capped with a natural-looking crown of course!
If you would like more information about dental 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 article “Crowns & Bridgework.”
Periodontal (gum) disease is an aggressive bacterial infection caused by built-up plaque on tooth surfaces. Gum disease results in bone loss and causes loss of attachment from the teeth, leading to eventual tooth loss.
The goal of any gum disease treatment is to remove as much plaque and calculus (hardened deposits of plaque) from the gums and teeth as possible. Scaling with special hand instruments or ultrasonic equipment is the basic technique for plaque and calculus removal above and below the gum line. As the infection spreads below the gum line, it can widen the natural gap between teeth and gums to form voids known as periodontal pockets that fill with infection. Accessing and cleaning these pockets, which can occur as deep as the tooth roots, will require more invasive procedures.
Pockets that form at a depth greater than 5 mm below the gum line will most likely require surgical access through the gum tissue. But for pockets not quite that deep there’s an intermediary technique called root planing without surgical intervention. As the name suggests, the roots are physically “planed,” much like shaving a wooden board to remove minute layers of wood.
Using similar instruments as with scaling, root planing removes calculus, bacteria and other infected matter adhering to the root surfaces. It’s best to perform the procedure with local anesthesia to numb the gum tissues, which may be quite sensitive depending on the degree of infection. Working in a pain-free environment also helps us to be as thorough as possible in detecting and removing every bit of plaque and calculus we can find.
In advanced cases, it may be necessary to perform this procedure during multiple visits. As plaque and calculus are removed the inflammation in affected tissues will begin to subside, revealing more deposits of plaque and calculus. It’s also important to begin and maintain a daily habit of effective brushing and flossing to lessen the chances of a recurring infection.
Treating gum disease is an ongoing effort that requires constant monitoring and sustained efforts to remove plaque and calculus, including root planing. Saving your teeth, however, is well worth the effort.
If you would like more information on treating periodontal disease, 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 Planing.”