While most tooth loss stems from dental disease or injury, another major cause is a condition known as cracked tooth syndrome. What begins as a microscopic crack in an individual tooth’s enamel could ultimately grow to a fracture that endangers its survival.
Most often related to age-related brittleness, expansion and contraction of the enamel surface because of hot foods followed by cold foods and beverages, or grinding habits, cracked tooth syndrome usually occurs in three phases. The first phase is the emergence of miniscule cracks in the outer enamel known as craze lines. These can be very difficult to detect even with x-rays, and usually calls for specialized detection methods such as probing with a sharp instrument (an explorer) or fiber-optic lighting with dye staining to highlight enamel abnormalities. If you have pain symptoms, we may ask you to bite down on a bite stick or rubber pad to locate the area by replicating the sensation.
In the next phase, the craze line grows into a crack that penetrates below the enamel into the tooth’s dentin. Pain becomes more prominent and the risk of infection increases. Left untreated, the crack may enter the third phase, a full break (fracture) occurring deep within the inner layers of the tooth. The deeper the fracture occurs, the more serious the danger to the tooth, especially if the pulp is exposed.
The best treatment approach is to attempt to detect and treat a crack as early as possible. Craze lines and moderate cracks can usually be repaired with restorative materials like composite resins. A deeper crack extending into the pulp may require a root canal treatment and the tooth covered with a permanent, protective crown.
If, however, the fracture is too deep, the tooth may be beyond repair and will need to be extracted and replaced with a dental implant or permanent bridge. In any event, the sooner a cracked tooth is discovered and treated, the greater your chance of avoiding pain, discomfort, and, ultimately, tooth loss.
If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
Dental implants are widely recognized as the best tooth replacement option available. For most people, though, it’s a long process: after a tooth is extracted the socket is allowed to heal and fill in with new bone before implant surgery: that can take anywhere from two to five months. Afterward, there’s usually a two– to three–month period after the implant is placed before the permanent crown (the visible tooth) can be attached.
Without adequate bone present the implant’s long-term stability might be compromised. Furthermore, the implant’s durability is dependent upon bone growth around and attaching to its titanium post after surgery in a process known as osseo-integration. These two considerations indeed serve a critical function in the implant’s ultimate success.
In recent years, however, a variation to this traditional implant process has emerged that allows for immediate implantation right after extraction. Besides combining extraction and implantation into one surgical procedure, immediate implants minimize the disruption to a person’s appearance (especially with visibly prominent front teeth) when combined with a provisional crown.
Immediate implants joined together that replace a full arch of teeth can receive biting forces and succeed. Individual implants that replace single teeth, however, won’t work in all situations and must be undertaken with care to ensure long-term success. Because there may be less available bone, the implant must fit snugly within the socket to maintain as secure a hold as possible. The surgeon must also take care not to damage too much of the gum and bone tissue when extracting the tooth, which could affect both the integrity of the implant and its appearance in the gum line.
Temporary crowns may be attached during the implant surgery, but they’re installed for appearance’ sake only. For individual crowns, they must be designed not to make contact with the teeth on the opposing jaw to avoid generating biting forces that will cause the implant to fail and stop the bone-healing process that occurs with osseo–integration.
If you’re considering dental implants, it’s important to discuss with us which type of procedure, traditional or immediate, would be best for you, and only after a comprehensive examination of your mouth and jaw structure. Regardless of the approach, our goal is to provide you with a smile-transforming restoration that will last for many years to come.
If you would like more information on the dental implant process, 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 “Immediate Implants.”
Do you wake up in the morning still feeling tired? Are you drowsy, irritable or have difficulty concentrating? And is your snoring habit a running joke around your household?
If you mostly answered yes, you may have obstructive sleep apnea (OSA). This condition is more than an irritation—it could also have major health implications if not addressed.
OSA occurs when the airway becomes temporarily blocked during sleep. The tongue (or other mouth structures like tonsils or the uvula) is often the cause as it relaxes and covers the back of the throat. Although you’re asleep, the brain notices the drop in oxygen and initiates arousal to unblock the airway. As this action usually only takes a few seconds, you may not fully awake every time; but because it can occur several times a night, it can rob you of the deep sleep you need for well-being.
If you’re diagnosed with OSA, your doctor may recommend continuous positive airway pressure therapy (CPAP). This treatment uses a pump device to supply continuous pressurized air through a hose connected to a face mask worn during sleep. The elevated pressure helps keep the airway open.
While this approach is quite effective, many people find wearing the equipment uncomfortable or confining, and may choose not to use it. If that describes you, a qualified dentist may be able to provide you with an alternative called oral appliance therapy (OAT).
OAT uses a custom-made plastic oral appliance you wear while you sleep. The most common snaps over the teeth and uses a hinge mechanism to move the lower jaw (and the tongue with it) forward.
OAT is recommended for people with mild to moderate OSA, or those with severe symptoms who can’t tolerate CPAP. If you’d like to see if an OAT appliance could help you, contact us for a complete oral examination. Either treatment can improve your sleep and daily lifestyle, as well as help prevent certain health issues in the future.
If you would like more information on treatments for sleep apnea, 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 “Oral Appliances for Sleep Apnea.”
Tooth loss is a problem that affects many seniors—and since May is Older Americans Month, this is a good time to talk about it. Did you know that more than a quarter of adults over age 75 have lost all of their natural teeth? This not only affects their quality of life, but poses a significant health risk.
According to a study in The Journal of Prosthodontics, significant tooth loss is associated with increased risk for malnutrition—and also for obesity. If this seems like a contradiction, consider that when you have few or no teeth, it’s much easier to eat soft, starchy foods of little nutritional value than it is to eat nutritious fresh fruits and vegetables.
That’s just one reason why it’s important to replace missing teeth as soon as possible. There are several ways to replace a full set of missing teeth including removable dentures, overdentures, and fixed dentures.
Removable dentures are the classic “false teeth” that you put in during the day and take out at night. Dentures have come a long way in terms of how convincing they look as replacement teeth, but they still have some disadvantages: For one thing, they take some getting used to—particularly while eating. Also, wearing removable dentures can slowly wear away the bone that they rest on. As that bone gradually shrinks over time, the dentures cease to fit well and require periodic adjustment (re-lining).
Overdentures are removable dentures that hook onto a few strategically placed dental implants, which are small titanium posts placed in the bone beneath your gums. Strong and secure, implants prevent the denture from slipping when you wear it. Implants also slow the rate of bone loss mentioned above, which should allow the denture to fit better over a longer period of time. But overdentures, too, are not meant to be worn all of the time.
Fixed dentures are designed to stay in your mouth all the time, and are the closest thing to having your natural teeth back. An entire row of fixed (non-removable) replacement teeth can usually be held in place by 4-6 dental implants. Dental implant surgery is an in-office procedure performed with the type of anesthesia that’s right for you. After implants have been placed and have integrated with your jaw bone—generally a period of a few months—you can enjoy all of your favorite foods again without worry or embarrassment.
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