Posts for: November, 2019
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss.
Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose.
This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility.
If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences.
If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan.
If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth.
If you would like more information on loose 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 “Loose Teeth.”
Thanksgiving is an appropriate time to spotlight an often unsung group: individuals providing primary care for another family member. During November, National Family Caregivers Month recognizes those caring for children with special needs or senior adults with life challenges—and part of that ongoing care includes watching out for their loved one's oral health.
Keeping teeth and gums healthy requires a concerted personal effort to prevent dental disease. While most of us can handle this on our own, some need assistance. If you're caring for someone like this, be sure you focus on two main areas: daily hygiene and regular dental visits. These are the two foundation stones for preventing tooth decay and gum disease.
The relatively simple tasks of brushing and flossing are crucial for disease prevention—but they can pose a challenge for someone with diminished physical, mental or behavioral capacity. In some cases, you as a caregiver may have to perform the task for them.
But even someone with severe limitations may be able to do these tasks for themselves with some adaptations. For one, choose a place for brushing and flossing that's most comfortable for the person (not necessarily the bathroom) and keep to a routine schedule. Above all, approach the task in a positive and playful way, especially for children.
Choose a toothbrush and flosser that your loved one can easily handle. Flossers are also available with toothbrush-sized grips for those with less manual dexterity. An older person with arthritis may need an extra-large grip or a toothbrush modified with a bicycle handle. As an alternative, both children and older adults may benefit from using an electric toothbrush. Some special needs children can have a gag response to toothpaste, so you may wish to use less or substitute it with a diluted fluoride mouthwash on the brush.
Dry mouth is a concern among many older adults, often due to the medications they take. In fact, hundreds of medications can have dry mouth as a side effect. Saliva serves the important oral health function of washing away food debris and neutralizing acid in the mouth, but when saliva production is low, it is not only uncomfortable—it greatly increases the risk of tooth decay. To help with dry mouth, encourage your loved one to drink more water during the day and ask us to recommend a product that will boost their saliva production. You can also ask their physicians about drug alternatives without dry mouth side effects.
To make dental visits easier, be sure we know about any needs or conditions that might affect their care. If possible, accompany your older family member during their visit: Because health problems often increase with age, even routine visits may be more involved.
We understand that caring for family members who need assistance can be demanding, with needs often being prioritized. We urge you to keep dental care on the high-priority list—it could make a difference with the rest of their health and overall quality of life.
If you would like more information about oral care for a family member with special needs, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Aging and Dental Health.”