Over the years, dentists have become quite proficient in treating even the most severe periodontal (gum) disease. Many of these positive outcomes are achieved through manual effort using simple hand instruments called scalars and conventional periodontal surgery.
But that might be changing soon: Periodontists (specialists who care for the gums and other supporting dental structures) are starting to use a different kind of tool for gum disease treatment—surgical lasers.
Although lasers are more commonplace in other fields of medicine, recent developments hint at a more prominent future role for them in dentistry. One of these developments is a laser procedure called Laser Assisted New Attachment Procedure (LANAP®) that treats deep spaces of infection called periodontal pockets, which develop advanced gum disease.
These pockets form as infected gums gradually detach from a tooth as the supporting bone is lost. This widens the normally narrow gap between the teeth and gums. The ensuing pocket fills with infection that must be removed to adequately treat the gum disease. As the pocket extends down to the root, it's often necessary to perform a surgical procedure through the adjacent gum tissue to fully access it.
But with the LANAP® procedure, the dentist can use a laser to access a deep pocket without opening the gums. Moving from above into the gap between the tooth and gums, the light from the laser has the ability to remove diseased tissue without damaging healthy tissue.
The dentist follows this with ultrasonic equipment and manual scalers to further decontaminate the tooth root surface. The laser is then employed once again to facilitate the formation of a blood clot between the teeth and gums to seal the area with a fibrin clot. Once treated, the dentist will monitor the tooth to ensure maximum bone regeneration and gum reattachment.
Although outcomes are the same for the most part, this laser technique for periodontal pockets may have some advantages over conventional surgery. Studies so far show that LANAP® causes less tissue removal and bleeding, less potential for gum recession and less discomfort experienced by patients.
It's not likely that lasers will fully replace conventional gum disease treatments any time soon. But if the encouraging evidence thus far continues, the laser will one day become as commonplace alongside the other tools used for gum disease treatment.
If you would like more information on treatments for 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 “Treating Gum Disease With Lasers.”
Dental patients have amazing options for tooth replacement. Dental implants, for example, can replace the entire tooth, root and crown, giving patients a new tooth nearly as good as the old one.
Nearly—but not exact. Even implants can't match the full benefits of a natural tooth, including one in less than perfect shape. Our first goal as dentists, then, is to save a diseased tooth if at all practical before considering replacing it.
That often involves a root canal treatment to address decay threatening a tooth's interior. The procedure requires drilling into the tooth to access its innermost pulp, cleaning out the pulp and root canals, and then filling the empty spaces. Since all dentists are trained in basic root canal treatment, your general dentist may be able to perform it.
But some dental situations call for more advanced endodontics, the dental specialty for treating disease and other problems inside a tooth. So, in what situations would you see an endodontist?
When your dentist refers you. Your dentist wants you to receive the level of treatment necessary to save your tooth. After examination, they may determine your situation would be better served by the advanced training, equipment and techniques (including surgery) of an endodontist.
When your tooth has complications. Patients often need an endodontist when existing factors complicate treatment of advanced tooth decay. A patient may have dental pain that's difficult to pinpoint, requiring the diagnostic resources of an endodontist. It's also common for a tooth's root canal network to be highly intricate, and which respond better to treatment with specialized endodontic tools and techniques.
When root canal treatment fails. Most root canal treatments are successful in protecting the tooth from further infection. That said, it's still possible for a root-canaled tooth to become re-infected or develop more problems. Again, an endodontist and their “tool chest“ re-treating a root-canaled tooth may be the best option for saving it.
You also don't have to wait for a referral—you can see an endodontist if you believe they would be best to treat your decayed tooth. You can find one near you by visiting an online endodontist directory at www.aae.org/find. An endodontist may be the lifesaver your diseased tooth needs.
We can't stop getting older or completely avoid many of the consequences that come with aging. Even so, there are things we can do to age more gracefully.
That includes your smile, which can also suffer the ravages of time. Teeth naturally wear and yellow over the years. We're also more susceptible to both tooth decay and periodontal (gum) disease as we age.
You can help slow some of these age-related dental problems by simply caring for your teeth and gums. This includes not only brushing and flossing every day to remove dental plaque (which can cause disease and dull your smile), but also seeing a dentist every few months for more thorough cleanings.
You can also take advantage of certain cosmetic enhancements to address some of the age-related issues that could keep you from having a more youthful smile.
Discolored teeth. Teeth tend to get darker over time, the combination of stain-causing foods and beverages, habits like smoking and age-related changes in tooth structure. You may be able to temporarily attain a brighter smile with teeth whitening. For a more permanent effect, we can cover stained teeth with porcelain veneers, dental bonding or dental crowns.
Worn teeth. After decades of chewing and biting, teeth tend to wear, with habits like teeth grinding accelerating it. This can cause teeth to appear abnormally small with hard, sharpened edges in contrast to the soft, rounded contours of younger teeth. In some cases, we can restore softer tooth edges with enamel contouring and reshaping. For more severe wearing, veneers or crowns could once again provide a solution.
Recessed gums. Because of gum disease, over-aggressive brushing or a genetic disposition to thinner gums, gums can shrink back or “recede” from normal teeth coverage. This not only exposes vulnerable areas of the teeth to harmful bacteria, it can also make teeth appear longer than normal (hence the aging description, “long in the tooth”). We can address recession by treating any gum disease present and, in extreme cases, perform grafting surgery to help rebuild lost tissue.
Losing your attractive smile isn't inevitable as you get older. We can help you make sure your smile ages gracefully along with the rest of you.
If you would like more information on keeping a youthful smile, 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 “How Your Dentist Can Help You Look Younger.”
Kids get pretty inventive pulling a loose primary (baby) tooth. After all, there's a profit motive involved (aka the Tooth Fairy). But a young Kansas City Chiefs fan may have topped his peers with his method, revealed in a recent Twitter video that went viral.
Inspired by all-star KC quarterback Patrick Mahomes (and sporting his #15 jersey), 7-year-old Jensen Palmer tied his loose tooth to a football with a line of string. Then, announcing “This is how an MVP gets their tooth out,” the next-gen QB sent the ball flying, with the tooth tailing close behind.
It appears young Palmer was no worse for wear with his tooth removal technique. But if you're thinking there might be a less risky, and less dramatic, way to remove a loose tooth, you're right. The first thing you should know, though: Primary teeth come out when they're good and ready, and that's important. Primary teeth play an important role in a child's current dental and speech function and their future dental development. For the latter, they serve as placeholders for permanent teeth developing within the gums. If one is lost prematurely, the corresponding permanent tooth might erupt out of position and cause bite problems.
In normal development, though, a primary tooth coming out coincides closely with the linked permanent tooth coming in. When it's time, the primary tooth lets you know by becoming quite loose in the socket.
If you think one of your children's primary teeth is ready, clean your hands first with soap and water. Then using a clean tissue, you should be able to easily wiggle the tooth with little tension. Grasp the tooth with the tissue and give it a little horizontal twist to pop it out. If that doesn't work, wait a day or two before trying again. If it does come out, be sure you have some clean gauze handy in case of bleeding from the empty socket.
Normally, nature takes its course from this point. But be on the lookout for abnormal signs like fragments of the tooth left behind in the socket (not to be mistaken for the top of the permanent tooth coming in). You should also look for redness, swelling or complaints of pain the following day—signs of possible infection. If you see anything like this, make a prompt appointment so we can take a look. Losing a primary tooth is a signpost pointing the way from childhood to adulthood (not to mention a windfall for kids under their pillows). You can help make it a smooth transition—no forward pass required.
If you would like more information about caring for primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Importance of Baby Teeth” and “Losing a Baby Tooth.”
In looking at options to replace your missing teeth, you might have heard others rave about dental implants. You're almost sold on this innovative restoration method—but you're a little skittish about the upfront cost.
Here are 3 reasons why getting dental implants to restore your missing teeth is a sound investment.
A solid long-term solution. Based on findings from over 3 million implant installations over the last forty years, more than 95% of implants continue to successfully function after ten years—and many are on track to last decades. That's something that can't be said for other forms of restoration. An implant's large upfront cost could in fact even out over the long-term and ultimately cost less than other restorations that may need to be replaced sooner.
A benefit to bone health. One of the more negative consequences of missing teeth is ongoing bone loss, a process that can continue to occur even when teeth are replaced by dentures or bridges. But bone cells readily grow and adhere to the titanium metal implant imbedded in the bone, slowing or even stopping continuing bone loss. If for no other reason, their positive impact on bone health is a top reason for choosing implants.
A range of choices. Replacing multiple missing teeth individually with dental implants can be quite expensive. But individual tooth replacement is only one of the ways implants could benefit you. It's possible to place just a handful of implants along the jaw to support other types of restorations like bridges and partial or full dentures. Not only is this cost-effective, but the implant-supported restoration may be more stable and secure. And these implants may also contribute to bone health.
But before you make your decision, visit us for a complete dental examination. We'll assess if your dental condition makes you a good candidate for implants, and then provide you more information on the process and costs.
If you would like more information on dental implants, 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 “Dental Implants 101.”
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