Along with tooth decay, periodontal (gum) disease is a primary enemy of oral health. If not caught and treated, a gum infection could spread and eventually cause tooth loss.
But although prevalent among the general population, one demographic in particular is highly susceptible to gum disease—smokers and tobacco users in general. It's estimated over 60 percent of all smokers will contend with a gum infection at some point during their lifetimes. Smokers are also twice as likely as non-smokers to develop advanced gum disease that could lead to serious dental damage.
The high rate of gum disease among smokers (and to some extent, all tobacco users) is connected to the effect that tobacco has on oral health in general. Studies show that nicotine constricts blood vessels in the mouth, which in turn reduces their delivery of antibodies to fight disease-causing bacteria. As a result, smokers have more harmful bacteria in their mouths than non-smokers, which increases their risk of dental disease.
Smokers are also less likely than non-smokers to display inflammation or redness, the initial signs of a burgeoning gum infection. This too has to do with the constricted blood vessels in the gums that can't deliver adequate oxygen and nutrients to these tissues. As a result, the gums can appear pink and healthy, yet still be infected. This could delay diagnosis of gum disease, allowing the infection to become more advanced.
Finally, smoking can interfere with the treatment of gum disease. Because of nicotine, a tobacco users' infections and wounds are often slower to heal. Combined with late diagnoses of gum disease, this slower healing creates an environment where smokers are three times more likely than non-smokers to lose teeth from gum disease.
If you do smoke, it's important to let your dentist know how much and for how long you've smoked, which could be relevant to any dental care or treatment. Better yet, quitting the habit could improve your oral health and lower your risk for teeth-destroying gum disease.
If you would like more information on the effects of smoking on oral health, 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 “Smoking and Gum Disease.”
Accidents do happen, especially if you or a family member has an active lifestyle. One such risk, especially for someone playing a contact sport, is having a tooth knocked out.
But as extreme as this injury can be, it doesn't necessarily mean the tooth is lost forever. Gum (or periodontal) cells remaining on the tooth root can regenerate and regain their attachment with the periodontal ligament that holds teeth in place. But you have to act quickly—the longer the tooth is out of the socket, the more likely these cells will dry out and die.
So, by doing the following within 5-20 minutes of the injury (and the earlier the better), that knocked-out tooth has a reasonable chance of survival.
Locate and clean the tooth. Your first priority is to find the missing tooth and clean it of any debris with clean water. Be sure not to touch the root of the tooth and only handle the tooth by the crown (the visible part of a tooth when it's in the mouth).
Insert the root end into the empty socket. Still holding the tooth by the crown, insert the opposite root end into the empty socket. Orient the crown properly, but don't worry about getting it in just right—the follow-up with the dentist will take care of that. You will, however, need to apply some pressure to get it to seat firmly.
Secure the tooth. Place a piece of clean gauze or cloth between the reinserted tooth and its counterpart on the other jaw. Then, have the person bite down on the cloth and hold it. This will help secure the tooth in place while you travel to the dentist.
Seek dental care immediately. It's important to see a dentist immediately to adjust the tooth's position and to possibly splint the tooth to better secure it while it heals. If a dentist isn't available, then visit a local emergency room instead.
Taking these actions on the scene could mean the difference between saving and losing a tooth. But act quickly—the sooner you initiate first aid for a knocked-out tooth, the better its chances for long-term survival.
If you would like more information on what to do during dental emergencies, 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 a Tooth is Knocked Out.”
For over three decades, Celine Dion has amazed audiences and fans with her powerful singing voice. Best known for her recording of "My Heart Will Go On," the theme song for the movie Titanic, Dion has amassed global record sales topping 200 million. In her early singing days, though, she struggled with one particular career obstacle: an unattractive smile.
The Canadian-born performer had a number of dental defects including crooked and discolored teeth, and—most prominent of all—abnormally large cuspid or "canine" teeth (located on either side of the four front incisors). They were so noticeable that one Quebec celebrity magazine gave her the unflattering nickname "Canine Dion."
This isn't an unusual problem. Since human canines are already the longest teeth in the mouth, it doesn't take much for them to stand out. Our ancient hunter-gatherer ancestors needed these large, pointed teeth to survive. But with the evolution of agriculture and industry, canine teeth have become gradually smaller—so much so that when they're abnormally large, they don't look right in a smile.
So, what can be done if your canines embarrassingly stand out from the rest? Here are some of the options to consider.
Reduce their size. If your canines are just a tad too long, it may be possible to remove some of the enamel layer in a procedure called contouring. Using this technique, we can reduce a tooth's overall size, which we then re-shape by bonding composite resin to the tooth. It's only a good option, though, if your canines have an ample and healthy layer of enamel.
Repair other teeth. The problem of prominent canine teeth may actually be caused by neighboring teeth. When the teeth next to the canines are crooked, the canines can appear more prominent. Alternatively, other teeth around the canines may be abnormally small. Braces or clear aligners can correct crooked incisors, and applying porcelain veneers to smaller teeth could help normalize their length.
Apply dental crowns. In some instances, we can reduce the canines in size and then bond porcelain crowns to them. This is the option that Dion ultimately chose. The natural teeth are still intact, but the crowning process transforms them into properly proportioned, life-like teeth. There is, however, one caveat: The alteration to these teeth will be permanent, so they will need a crown from then on.
Besides crowning her canine teeth, Dion also underwent other dental work to straighten and whiten her other teeth. As a result, this superstar performer now has a superstar smile to match and so can you if your teeth are less than perfect. These or other cosmetic enhancements can give you the look you truly desire. All it takes is an initial visit with us to start you on the road to a transformed smile.
If you would like more information about various cosmetic solutions for your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”
Dental veneers are a popular way to improve teeth with chips, stains, gaps or other defects. They're typically made of dental porcelain, ceramic-like materials prized for their ability to mimic the texture, color and translucency of natural teeth.
But dental porcelain doesn't come in one form—a dentist can utilize variations of it to better match a patient's need. For example, one patient may need a porcelain with added strength, while another may need one that provides better coverage of underlying discoloration.
The foundational materials for veneer porcelain are glass ceramics. Also used for crowns, glass ceramics have been the preferred choice of dentists for some time to achieve life-like results. In terms of veneers, dental technicians first mix the powdered form of the porcelain with water to create a paste. They then use the paste to build up the body of a veneer layer by layer.
But while the high degree of silica (glass) in this type of porcelain best resembles the translucence of natural teeth, early forms of it lacked strength. This changed in the 1990s when technicians began adding a material called leucite to the ceramic mixture that enhanced its strength and durability.
Today, you'll also find lithium disilicate used, which is twice as strong as leucite and is quite useful when creating thinner veneers. Both of these strength materials can be pressed and milled into shape, which helps achieve a more accurate fit. Along with the underlying glass ceramic, the result is a veneer that's both durable and incredibly life-like.
Although today's porcelain veneers are far superior in durability than earlier forms, they can be damaged when biting down on hard objects. To make sure your veneers last as long as possible, you should avoid biting down directly on hard-skinned fruit, or using your veneered teeth to crack nuts or crunch ice (or any other teeth, for that matter).
But with proper care, today's veneers have exceptional longevity. And, thanks to the superior dental materials that compose them, they'll look great for years.
If you would like more information on dental veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”
There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.
Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.
Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.
Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.
To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.
But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.
Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.
The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.
If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”
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