Posts for category: Dental Procedures
Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.
To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.
One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.
In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.
These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.
As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.
If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.
If you would like more information on getting dental implants, 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 “Implants & Antibiotics.”
Each year millions of people endure repeated episodes of congestion, coughing and headaches, all the miseries that come with a sinus infection. Although it seems like all the action is occurring around the nose and upper face, the actual cause could be emanating from somewhere else—your teeth.
It can all begin with decay forming a small cavity in one of the upper back teeth. If it isn't caught and treated early, the decay can spread into the tooth pulp and root canals, tiny passageways to the root and bone. This may or may not cause a severe toothache or sensitivity as the tooth's nerves respond to the infection. These nerves, though, most often eventually die and the pain, if present, will subside—but not the infection.
Left untreated, the infection may then advance into the bone around the root tip, breaking it down and giving bacteria an entryway into the floor of the maxillary sinus that rests just above the upper jaw. Here bacteria can take up residence, occasionally flaring into a sinus infection. This chronic infection could go on for years with allergies mistakenly taking the blame.
If you have frequent bouts of sinusitis, a possible dental connection may be worth investigating. And in the dental profession, there may be no better “detective” for this than an endodontist. Specializing in interior tooth problems and treatments, an endodontist has the diagnostic equipment like CT or 3-D cone beam scanning to accurately image the teeth and upper jaw. With their advanced diagnostics, they're in the best position to uncover hidden tooth decay contributing to sinus problems.
Endodontists are also skilled in treating advanced tooth decay. The main procedure is known as root canal treatment, in which the dentist drills into the tooth's interior to remove infected tissue from the pulp and root canals. They then fill these empty spaces, seal and then crown the tooth for added protection.
After treatment and following up with your physician, you may find your sinus infections are less frequent. And by promptly seeking treatment at the first sign of tooth pain or sensitivity, you might prevent chronic sinusitis from even developing.
If you would like more information on how dental disease can affect overall health, 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 “Sinusitis and Tooth Infections.”
Most babies come into the world ready and able to nourish at their mother's breast—no training required! About one in ten children, though, may have a structural abnormality with their tongue or lip that makes it difficult for them to breastfeed.
The abnormality involves a small strip of tissue called a frenum or frenulum, which is found in the mouth connecting soft tissue to more rigid structures. You'll find a frenum attaching the upper lip to the gums, while another connects the underside of the tongue to the floor of the mouth.
Frenums are a normal part of oral anatomy and usually don't pose a problem. But if the frenum tissue is too short, thick or tight, it could restrict lip or tongue movement. If so, a baby may not be able to achieve a good seal on their mother's nipple, causing them to ineffectively chew rather than suck to access the mother's milk. Such a situation guarantees an unpleasant experience for both mother and baby.
The problem can be addressed with a minor surgical procedure performed in a dentist's office. During the procedure, the dentist first numbs the area with an anesthetic gel. The frenum is then snipped with scissors or a laser.
With very little if any post-procedure care, the baby can immediately begin nursing. But although the physical impediment may be removed, the child may need to “relearn” how to nurse. It may take time for the baby to readjust, and could require help from a professional.
Nursing isn't the only reason for dealing with an abnormally shortened frenum. Abnormal frenums can interfere with speech development and may even widen gaps between the front teeth, contributing to poor bite development. It's often worthwhile to clip a frenum early before it creates other problems.
It isn't absolutely necessary to deal with a “tongue” or “lip tie” in this manner—a baby can be nourished by bottle. But to gain the physical and emotional benefits of breastfeeding, taking care of this particular problem early may be a good option.
If you would like more information on the problem of tongue or lip ties in infants, 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 “Tongue Ties, Lip Ties and Breastfeeding.”
Orthodontics, veneers and other cosmetic dental techniques can turn a less than perfect smile into a beautiful one—but not always very quickly. For example, porcelain veneers can take weeks from planning to installation, including the meticulous work of an outside dental lab to produce veneers that look natural as well as beautiful.
But you may be able to take advantage of another approach, one that often takes no more than a couple of dental visits. Called direct veneers, it's actually a process of bonding and sculpting life-like composite materials to teeth that are heavily stained, chipped or that contain tiny crevices called “craze lines.”
Unlike the similarly-named traditional method, direct veneers don't involve the creation of layered porcelain veneers fashioned by a dental lab. But this newer process is similar to the older one in that some of the enamel must be removed from the teeth in question to provide a suitable surface for the composite material to adhere. This alteration will be permanent, requiring a restorative covering on the treated teeth from then on.
Right before this preparation, though, a dentist typically makes an impression of the patient's mouth. This will be the basis for creating the procedural plan for the dental work, particularly a “trial smile” from similar composite material that can be applied to the patient's teeth before actual restoration work begins. This temporary application gives both patient and dentist an opportunity to visualize the final look, and make needed adjustments in color and shaping.
Once the work plan is finalized, the patient then returns for the actual restoration procedure. The dentist begins by applying and bonding the composite material to the prepared teeth. Then, using a drill and manual instruments, the dentist shapes and smooths the material into a tooth-like appearance that blends with other teeth. The procedure can take a few hours, but it can usually be completed during a single visit.
Although direct veneers may not last as long as porcelain veneers, the process is less costly and requires less time to complete. Direct veneers could be an economical solution for achieving a more attractive smile.
If you would like more information on direct veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic with a firsthand patient account by reading the Dear Doctor magazine article “A New Smile With Direct Veneers.”
It's not an exaggeration to say the modern root canal treatment has saved millions of teeth over the last century. Without this procedure, there's not a lot we can do to stop advanced tooth decay from infecting and destroying a tooth.
What's more, a root canal treatment could extend the life of a tooth for decades. Notice we said could—although most root canals do have satisfactory outcomes, there's still a chance a tooth may become re-infected. Here are 3 possible causes for an unsuccessful root canal treatment, and what you can do to lessen their impact.
The severity of the infection. Tooth decay usually begins at the enamel layer, softened by the acid produced by bacteria. Untreated, the infection can then spread through the next tooth layer of dentin until finally infecting the innermost pulp. From there the infection can move through the root canals to the bone, dramatically increasing the danger to the tooth. Root canal treatments have a higher chance of success the earlier they're performed in the disease progression, so see your dentist at the first sign of pain or other tooth abnormality.
The root canal network. An effective root canal procedure eliminates all dead or diseased tissue in both the pulp chamber and the root canals (these are then filled to prevent future infection). But this may prove difficult with teeth that have intricate root canal networks because of a higher risk of overlooking some of the canals. It may be best in such cases for an endodontist, a specialist in treating interior tooth issues, to perform the procedure using their advanced techniques and microscopic equipment.
The age of the tooth. Root canal treatment can weaken a tooth's structural integrity, especially with older teeth. This can make them more susceptible to fracture and a higher chance of infection. We can avoid this outcome by placing crowns on root-canaled teeth: The crown provides structural strength to the tooth and can add further protection against infection. Older teeth may also benefit from the placement of a small support post within it to further add stability before applying the crown.
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 Treatment: How Long Will It last?”