While tooth decay is a potential problem at any age, the risk increases as you grow older. Not only are senior adults more susceptible, decay is often more difficult to treat. That’s because cavities can occur at or below the gum line, often due to gum recession.
If that’s the case, we won’t be able to fill the cavity in the usual way because the gum tissue is in the way. To make it possible to treat, we may need to perform a minor surgical procedure known as crown lengthening.
As the name implies, the procedure helps expose more of the crown, the tooth’s visible part, from the surrounding gum tissue. In basic terms, we’re repositioning the gum tissue away from the biting surface of a tooth to make room for a filling. It’s also useful for improving a tooth’s appearance by making it look longer, or creating room for a crown or other dental restoration.
After applying a local anesthesia, the dentist (or periodontist, a specialist in the gums) creates a tiny flap of gum tissue with a series of incisions. This allows the dentist to move the affected gums out of the way to access the underlying bone. The dentist then reshapes the bone to adequately support the gum tissue when it’s finally repositioned to expose the crown. In its new and improved position, the dentist sutures the gum tissue in place.
For a few days afterward, the patient will need to restrict their diet to soft foods, avoid strenuous activities and apply an ice pack to help reduce swelling the day of surgery. They will also prescribe a pain reliever and possibly an antibiotic to reduce the chances of infection.
While most people return to normal activities a few days later, you’ll usually have to wait a few weeks for the gums to heal before undergoing any further treatments for the affected teeth. But even with the wait, crown lengthening could make it possible to not only save your tooth but improve your smile as well.
If you would like more information on treating tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”
Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.
First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.
Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?
Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.
Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.
Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.
So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.
While the term “plastic surgery” might bring to mind face lifts or tummy tucks, not all procedures in this particular surgical field are strictly cosmetic. Some can make a big difference in a person’s health.
One example is periodontal plastic surgery, which corrects gum tissue loss around the teeth. Although these procedures can indeed improve appearance, they more importantly help save teeth.
Gum loss is most often a consequence of periodontal (gum) disease, a bacterial infection arising from a thin film of food particles on the teeth called dental plaque. As the disease weakens the gums’ attachment to teeth, they shrink back or recede, exposing the area around the roots. Without the protective cover the gums provide the roots, they become more susceptible to decay.
In milder cases of gum recession, treating the infection often results in the gums regaining their normal attachment to teeth. But with more advanced recession, natural gum healing may not be enough to reverse it. For such situations grafting donor tissue to the recessed area can help stimulate new tissue growth.
While gum tissue grafts can come from an animal or other human, the most likely source is from the person themselves. In one type of procedure, free gingival grafting, the surgeon locates and completely removes (or “frees”) a thin layer of skin resembling gum tissue, typically from the roof of the mouth, shapes it and then transplants it by suturing it to the recession site. Both donor and recipient sites heal at about the same rate in two to three weeks.
Another technique is known as connective tissue grafting. In this procedure the surgeon partially removes the donor tissue from its site while leaving a portion containing blood vessels intact. The palatal tissue is still used and transported to fit beneath the tissue that’s still attached to the blood supply. This connective tissue graft is then positioned and sutured to the recipient site while still maintaining its blood supply connection at the donor site. Maintaining this connection facilitates healing and increases the chances the graft will “take” and become firmly attached to the new site.
Grafting procedures require advanced techniques and skills. But with them we may be able to restore gum attachment to teeth with an impact on appearance and dental health that’s well worth the effort.
If you would like more information on treating 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 “Periodontal Plastic Surgery.”
What does November make you think of? Pumpkins? Turkeys? Dry leaves and frosty mornings? How about cigarette butts?
If you’re wondering about the last item, remember that November 15 is the date of the Great American Smokeout—a day set aside for those who want to take the first steps toward quitting the tobacco habit. While the percentage of smokers in the U.S. has dropped to less than 16% in recent years, according to the American Cancer Society there are still some 38 million Americans who smoke cigarettes. Smoking causes over 480,000 deaths every year, and is the leading preventable cause of death in the U.S.
Even if it doesn’t kill you, the effects of tobacco use can be devastating to your entire body—including your mouth. Whether you smoke cigarettes or use chewing tobacco, your risk of oral cancer is greatly increased, as is your chance of developing periodontal (gum) disease. What’s more, smoking can mask the symptoms of gum disease, so your condition is actually worse than it appears. Severe gum disease is one reason why smokers tend to lose more teeth than non-smokers.
In addition, because smoking interferes with the natural healing process, smokers have a much greater chance of dental implant failure. Tobacco use also can lead to increased amounts of plaque, which results in tooth decay and other oral health problems. It also stains your teeth, reduces your senses of smell and taste, and gives you bad breath.
Ready to quit yet? If so, there are lots of resources to help you on the road to a healthier life. The American Cancer Society, sponsor of the Smokeout, can help you make a plan to quit tobacco—and stay off it. It’s not easy, but over a million Americans do it every year. See their website for more information, plans and tips on quitting. Your health care professionals are also a great source of information and help when it’s time to get off the tobacco habit. Feel free to ask us any questions you may have.
And here’s the good news: The moment you quit, your body begins to recover from the effects of tobacco use. In just one year, you’ll have cut your risk of heart attack and stroke in half. After 5 to 15 years, your risk of stroke, coronary heart disease, and several other conditions is the same as someone who has never smoked.
If you have questions about smoking and oral health, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Dental Implants and Smoking.”
Nothing grabs your attention like a sharp tooth pain, seemingly hitting you out of nowhere while you’re eating or drinking. But there is a reason for your sudden agony and the sooner you find it out, the better the outcome for your oral health.
To understand tooth sensitivity, we need to first look at the three layers of tooth anatomy. In the center is the pulp filled with blood vessels and nerve bundles: it’s completely covered by the next layer dentin, a soft tissue filled with microscopic tubules that transmit sensations like pressure or temperature to the pulp nerves.
The third layer is enamel, which completely covers the crown, the visible part of a tooth. Enamel protects the two innermost tooth layers from disease and also helps muffle sensations so the tooth’s nerves aren’t overwhelmed. The enamel stops at about the gum line; below it the gums provide similar protection and sensation shielding to the dentin of the tooth roots.
Problems occur, though, when the dentin below the gums becomes exposed, most commonly because of periodontal (gum) disease. This bacterial infection caused by dental plaque triggers inflammation, which over time can weaken gum tissues and cause them to detach and shrink back (or recede) from the teeth. This can leave the root area vulnerable to disease and the full brunt of environmental sensations that then travel to the nerves in the pulp.
Tooth decay can also create conditions that cause sensitivity. Decay begins when certain oral bacteria multiply and produce higher than normal levels of acid. The acid in turn dissolves the enamel’s mineral content to create holes (cavities) that expose the dentin. Not treated, the infection can eventually invade the pulp, putting the tooth in danger of being lost unless a root canal treatment is performed to remove the infection and seal the tooth from further infection.
So, if you begin experiencing a jolt of pain while eating or drinking hot or cold foods or beverages, see your dentist as soon as possible to diagnose and treat the underlying cause. And protect your teeth from dental disease by practicing daily brushing and flossing, as well as seeing your dentist for regular dental cleanings and checkups. Don’t ignore those sharp pains—your teeth may be trying to tell you something.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
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