Posts for: March, 2017
Discovering a loose tooth can be exciting — if you're six, that is, and anticipating a windfall from the tooth fairy. If you're an adult, a loose tooth is a different story. You're in real danger of it becoming a lost tooth, and there won't be another one coming in to replace it.
Fortunately, that result isn't inevitable, but we have to take quick action if we're going to save your tooth. The first step is to find out why it's loose.
Tooth looseness occurs primarily because the gum and bone structures that hold teeth in place have been damaged in some way. Otherwise healthy teeth and gums can be injured in an accident or with dental habits like teeth grinding or clenching that increase the biting forces against teeth. The latter could require some intervention like a night guard to prevent teeth from grinding to reduce the abnormal biting force.
But disease is often the root cause for tooth looseness. Periodontal (gum) disease, a bacterial infection triggered by bacterial plaque, can inflame and weaken gum tissues, eventually causing bone loss followed by the gum tissue detaching from the teeth. In this weakened condition even normal biting forces could loosen a tooth.
If gum disease is the primary culprit, our treatment starts there. By aggressively removing plaque and calculus (tartar) from the tooth surfaces, including deep below the gum line around the root, the gum tissues become less inflamed and begin to heal. This in turn can strengthen their attachment to a loose tooth. In more advanced cases, we may need to surgically graft lost bone and gum tissue to rebuild the attachment.
We may also need to stabilize a loose tooth while we're performing these other treatments. The most common way is to join or splint a loose tooth to nearby stable teeth. There are varieties of splints: one type involves rigid dental material bonded across the enamel of the loose tooth and its neighbors. In another, we cut a small channel in the involved teeth, and then insert a metal splint, bonding it within the channel.
Whatever needs to be done, we need to do it promptly — if you notice a loose tooth, contact us as soon as possible. The earlier we begin treatment the more likely we'll save your loose tooth.
If you would like more information on treating loose 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 “Treatment for Loose Teeth.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
If you suspect you have periodontal (gum) disease, it's important to get a correct diagnosis and begin treatment as soon as possible. The sooner you begin treatment the better the long-term outcome.
Gum disease is a bacterial infection that's most often triggered by plaque, a thin film of food particles on tooth surfaces. Plaque buildup most often occurs when a person doesn't practice effective oral hygiene: daily brushing and flossing and professional cleanings at least twice a year.
The most common type of gum disease, gingivitis, can begin within days of not brushing and flossing. It won't always show itself, but you can have symptoms like swollen, red or bleeding gums, as well as bad taste and breath. You could also develop painful abscesses, which are localized pockets of infection within the gums.
If we don't stop the disease it will eventually weaken the gum attachment to the teeth, bone loss will occur and form deep pockets of infection between the teeth and bone. There's only one way to stop it: remove the offending plaque from all tooth surfaces, particularly below the gum line.
We usually remove plaque and calculus (hardened plaque deposits) manually with special hand instruments called scalers. If the plaque and calculus have extended deeper, we may need to perform another procedure called root planing in which we shave or “plane” the plaque and calculus (tartar) from the root surfaces.
In many cases of early gum disease, your family dentist can perform plaque removal. If, however, your gum disease is more extensive, they may refer you to a periodontist, a specialist in the treatment and care of gums. Periodontists are trained and experienced in treating a full range of gum infections with advanced techniques, including gum surgery.
You can also see a periodontist on your own for treatment or for a second opinion — you don't necessarily need a referral order. If you have a systemic disease like diabetes it's highly advisable you see a periodontist first if you suspect gum disease.
If you think you might have gum disease, don't wait: the longer you do the more advanced and destructive the disease can become. Getting an early start on treatment is the best way to keep the treatment simple and keep gum disease from causing major harm to your teeth and gums.
If you would like more information on the diagnosis 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.”