Posts for: May, 2018
You don’t have to be a dental professional to appreciate a beautiful smile. Likewise, you’ll also know when something’s not quite right with one.
Such can be the case when a tooth fails to erupt properly, causing most or all of the crown to remain below the gum line, a condition known as impaction. Upper canines (or “eyeteeth,” for their location in the arch under the eyes) are especially susceptible to impaction: located on either side of the lateral incisors, which are on either side of the central incisors (the two center front teeth).
The upper canines are important both for function and appearance. Working with their lower counterparts they help cut through food as we chew, so you lose some of that efficiency when they don’t erupt properly. Impacted teeth are susceptible to abscesses and cysts, and can impinge upon and damage the roots of other teeth. And just as importantly, their absence also disrupts the smile as nearby teeth tend to move or “drift” toward the open space.
Rather than remove the impacted canines as is often done with back teeth, it may be more advantageous for both function and appearance to “coax” them into full eruption. This requires first pinpointing their exact location below the gums using x-rays or cone beam 3-D imaging.
If the teeth are in reasonably good position we must first prepare them for orthodontic treatment by surgically exposing the crown from the gums and bonding a small bracket to it. We then attach a small gold chain to the bracket that extends outside of the gums when we suture them back into place. The chain is attached to orthodontic hardware that exerts pressure on the impacted tooth for several months to “pull” it out into the arch.
This procedure has the best chance of success if undertaken before the end of jaw development in early adulthood. Otherwise, it may be better to remove the impacted canines and replace them with dental implants, followed by orthodontic treatment of other teeth to restore their proper position and bite relationships. In either case, your impacted upper canines don’t have to be a problem — we can restore both your mouth function and your smile.
If you would like more information on impacted teeth and treatment options, 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 “Exposing Impacted Canines.”
Your gums aren’t just for show—they also play an important role in supporting and protecting your teeth. Healthy gums are essential for healthy teeth.
Your gums can take a lot from daily chewing or other environmental factors. Unfortunately, disease or trauma can weaken their resilience. This weakening could lead to gum recession.
Gum recession occurs when the tissues covering a tooth begin to lose their attachment and shrink back (recede). As a result, the tooth appears “longer” as more of it that’s normally below the gum line becomes visible. Not only is gum recession unattractive, it also exposes more of the tooth to disease-causing bacteria.
The most common cause for gum recession is periodontal (gum) disease, an infection arising from the accumulation of a thin bacterial biofilm on the teeth called plaque. Infected gums become inflamed, a normal defensive response to isolate diseased or damaged tissues from the rest of the body. Chronic inflammation, however, weakens affected tissues over time and results in bone loss.
Other factors can also contribute to gum recession. A tooth that didn’t erupt properly and has come in away from the center of its protective bony housing can impede adequate gum coverage. Your gum tissue thickness, which you genetically inherit, can also increase the risk of gum recession. People with thinner gum tissues are more susceptible to recession than with thicker tissues.
You can also damage your gums (ironically) while trying to care for them. Over-aggressive brushing over time may traumatize the gums to the point that they recede. While it’s essential in removing disease-causing dental plaque, brushing only requires a gentle scrubbing action covering all portions of tooth surfaces. The brush bristles and mild abrasives in the toothpaste do most of the work of plaque removal.
To minimize the chances of gum recession, you should practice proper oral hygiene and visit your dentist regularly for professional cleanings and checkups. And you might also consider orthodontics for improperly positioned teeth that could not only improve your smile, but also your gum health.
And by all means see your dentist if you notice any signs of gum infection like swollen, reddened or bleeding gums. The sooner you begin gum disease treatment, the less likely your gums will recede in the future.
If you would like more information on recognizing and treating gum recession, 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 “Gum Recession: Getting Long in the Tooth.”
Although dental visits are routine for most people, it’s a different experience for a few. About one in ten adults have high anxiety or fear of going to the dentist and may avoid it altogether—even when they have an acute situation.
If you’re one of those with dental visit anxiety there’s good news—we may be able to help you relax and have a more positive experience. Here are 3 things you need to know about reducing your anxiety at the dental office.
It starts with the dentist. While every patient deserves a compassionate, understanding dentist, it’s especially so if you suffer from dental visit anxiety. Having someone who will listen to your concerns in a non-judgmental way is the first step toward feeling more comfortable in the dentist’s chair. It also takes a sensitive practitioner to work with you on the best strategy for relaxation.
Relaxation often begins before your visit. There are various degrees of sedation (which isn’t the same as anesthesia—those methods block pain) depending on your level of anxiety. If you experience mild to moderate nervousness, an oral sedative an hour or so before your appointment could take the edge off and help you relax. Oral sedatives are also mild enough for use with other forms of sedation like nitrous oxide gas, and with local anesthesia.
High anxiety may require deeper sedation. If your level of anxiety is greater, however, we may recommend IV sedation to induce a much more relaxed state. The sedation drugs are delivered directly into your blood stream through a small needle inserted into a vein. Although you’re not unconscious as with general anesthesia, we can place you into a “semi-awake” state of reduced anxiety. The drugs used may also have an amnesiac effect so you won’t remember details about the procedure. This can help reinforce positive feelings about your visit and help reduce future anxiety.
If you’re anxious about dental visits, make an appointment with us to discuss your concerns. We’re sure we can work out a strategy to reduce your anxiety so you can receive the dental care you need.
If you would like more information on sedation therapy, 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 “IV Sedation in Dentistry.”