It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.
Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.
Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.
Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.
For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.
If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.
As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.
If you would like more information on caring for primary 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 “Root Canal Treatment for Children’s Teeth.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
Famed educator Maria Montessori once said, “Play is the work of the child”—and most kids take their “work” very seriously. But their avid enthusiasm might also raise the risk of blunt force injuries, particularly to the mouth.
While you should certainly take steps to protect their mouth (like a custom-made guard for contact sports), you can’t completely erase the risk. You should know, therefore, what to do in case of a mouth injury.
The lips, tongue, and other soft oral tissues often get the brunt of any contact injury, ranging from minor bruising and swelling to severe cuts that require medical attention. First, clean the area as thoroughly as possible to remove trapped dirt or debris in the wound. If bleeding occurs, apply continuous gentle pressure with a clean cloth or gauze for 10-15 minutes until it stops, and cold compresses for any swelling. If the wound looks deep or severe, take them to an emergency room.
Blunt force can also impact teeth in a variety of ways. If part of a tooth chips, attempt to find the pieces and see a dentist as soon as possible—they may be able to bond the pieces back to the tooth. If a tooth gets moved out of place, call your dentist immediately or go to an emergency room after hours.
If a permanent tooth gets completely knocked out, find it and rinse off any debris with clean water. Then, place it gently back into its socket, or alternatively between the child’s cheek and gum or in a glass of cold milk. You’ll need to see a dentist as soon as possible to have the tooth replanted. With this kind of injury, time is of the essence.
A hard impact can also fracture the jawbone, which may be suspected if the face appears distorted or the teeth can’t make contact with each other when the jaws are shut. Control any bleeding, apply cold compresses or mild pain relievers to ease any pain or swelling, and go to an emergency room immediately.
A traumatic injury can heighten everyone’s emotions, including yours. You can avoid your emotions turning into panic, though, by following these common sense guidelines to help your child get through this unfortunate event.
Chronic stress is like a tea kettle on the boil—all that “steam” has to go somewhere. We often do this through behaviors like biting our nails, binging on comfort food—or grinding our teeth. That latter habit, however, could have a detrimental effect on teeth, including excessive enamel wear or even fractures.
Also known as bruxism, teeth grinding is the forceful and often involuntary contacting of teeth that often generates abnormally high chewing forces. While not considered a relatively big problem with young children, it can be if you’re an adult. While there could be other causes, chronic stress is often a prime factor for adults with bruxism.
While teeth grinding can occur during the day when you’re awake, it often occurs at night during sleep and may be associated with other sleep disorders like snoring. Although you might not be consciously aware of a grinding episode as it happens, you may notice its effects the next morning, including sore jaws or headaches. Over time, your dentist may begin noticing its effects on your teeth.
So, how can you lessen teeth grinding? For starters, if you’re a tobacco user, quit the habit. Many studies indicate tobacco users report twice the incidence of teeth grinding as non-users. Excessive caffeine, alcohol or drug use can also contribute.
People have also found it helpful to address chronic stress through a number of relaxation techniques like meditation, more relaxing bedtime preparation, bio-feedback or therapy to “de-stress.” Although there’s not a lot of empirical evidence for these techniques’ effectiveness, there’s much anecdotal data from people who’ve found stress relief from them.
There’s also a dental treatment using an occlusal guard that, while not stopping bruxism, can help prevent dental damage. Usually worn during sleep, the custom-made guard fits over the teeth of one jaw, usually the upper. Its high impact plastic prevents the teeth from making solid contact, thus reducing the biting force. You may also be able to reduce bruxism effects through dental work and orthodontics,
You and your dentist can explore the options to find the right treatment strategy for you. By taking action now, you may avoid much more extensive—and expensive—problems with your teeth down the road.
If you would like more information on teeth grinding and what to do about it, 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 “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”
There's a lot of emphasis — well-placed, of course — on preventing and treating tooth decay. But there's another dental disease just as dangerous to your oral health and nearly half of U.S. adults have it. It's actually a group of diseases known collectively as periodontal (gum) disease.
Gum disease is similar to tooth decay in one respect: they're both triggered by bacteria. These microorganisms thrive in a thin film of food particles called plaque that collects on tooth surfaces.
Certain bacteria can infect gum tissues and trigger inflammation, a response from the body's immune system to fight it. As the battle rages, bone loss can occur and the gums weaken and begin to detach from the teeth. Without treatment, you could eventually lose affected teeth.
Like tooth decay, the best approach with gum disease is to prevent it, and by using the same techniques of daily brushing and flossing. These actions loosen and remove plaque built up since your last brushing. It's also important you visit us at least twice a year for cleanings that remove hard to reach plaque and calculus (hardened plaque deposits).
If despite your best efforts you do contract gum disease, the sooner you see us for treatment the lower the long-term impact on your health. The treatment aim is the same as your daily hygiene: to remove plaque and calculus. We use specialized hand instruments or ultrasound equipment to mechanically remove plaque; more advanced cases may require the skills of a periodontist who specializes in caring for structures like the gums that support teeth.
So, defend yourself against gum disease by brushing and flossing daily, and visiting us regularly for dental cleanings and checkups. If you notice bleeding, swollen or painful gums, see us as soon as possible for diagnosis and treatment. Don't let tooth decay's evil twin ruin your oral health or your smile.
If you would like more information on the prevention and treatment of gum 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 “When to See a Periodontist.”
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