Your teeth’s hard, enamel coating protects them from environmental dangers or disease. But although it’s made of the hardest substance in the human body, enamel isn’t invincible — prolonged exposure to acid can cause dental erosion, a condition in which the enamel’s mineral content permanently dissolves, a process known as de-mineralization.
De-mineralization occurs anytime our mouth environment becomes too acidic due to eating or drinking items with high acid content. Saliva normally neutralizes mouth acid in thirty minutes to an hour after we eat, as well as restores mineral content to the enamel (re-mineralization). Danger arises, though, if the saliva’s buffering action is overwhelmed by chronic acidity, caused mainly by constant snacking or sipping on acidic foods and beverages throughout the day — in this situation, saliva can’t complete the process of buffering and re-mineralization.
As a result, the enamel may permanently lose its mineral content and strength over time. This permanent dental erosion leads to serious consequences: the teeth become more susceptible to decay; the dentin becomes exposed, which causes pain and sensitivity to pressure and temperature changes; and changes in the teeth’s size and color can negatively alter your appearance.
It’s important to take action then before dental erosion occurs. Along with daily oral hygiene, restrict your consumption of acidic foods and beverages to meal times and cut back on between-meal snacks. Rather than a sports drink after exercising, drink nature’s hydrator — water. You should also alter your brushing habits slightly — rather than brush right after you eat, wait thirty minutes to an hour. This gives saliva time to restore the mouth to its normal pH and re-mineralize the enamel. Brushing right after can remove even more of the minerals in softened enamel.
If significant erosion has occurred, there are a number of treatment options we can undertake to preserve remaining tooth structure and enhance your appearance. In moderate cases, we can reshape and cover damaged teeth using dental materials like composite resins or porcelain to fill decayed areas or cover teeth with veneers or crowns.
The key of course, is to identify dental erosion through clinical examination as soon as possible to minimize damage. Your enamel plays a critical role in protecting your teeth from disease — so take the right steps to protect your enamel.
If you would like more information on protecting your enamel, 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 Erosion.”
The National Safety Council has designated June as National Safety Month. A key component of staying safe is being prepared for emergencies, and this includes dental emergencies. Would you know what to do if you suffered any of the following dental mishaps?
Chipped tooth: One common dental injury is a chipped tooth. If this happens to you, save the missing chip if possible because we may be able to bond it back onto the tooth—but don’t be tempted to glue the chip back on by yourself! However, even without the missing chip, the tooth can most often be repaired with bonding material.
Cracked tooth: If you crack a tooth, rinse your mouth with warm water. If it is bleeding, hold a clean washcloth or gauze to the area until the bleeding stops, but don’t wiggle the tooth around or bite down hard. Keep in mind that the sooner your tooth is repaired, the better. Depending on how bad the crack is, if the tooth can be treated, it will most likely continue to function pain-free for years to come.
Displaced (“luxated”) tooth: If an injury causes your tooth to become loose, shoves it sideways or pushes it into or out of its socket, don’t try to force the tooth back into position on your own. Instead, call the dental office right away and leave it to us to bring the tooth back into its proper place and determine the extent of the injury.
Knocked out tooth: If a permanent tooth is knocked out of your mouth, pick it up without touching the root and rinse it off with cold water, but do not scrub. For the best chance of saving the tooth, place it firmly back in its socket within five minutes and hold it in position for a few minutes. If this is not possible, keep the tooth between your cheek and gum or in a glass of cold milk so that it doesn’t dry out. Call the dental office immediately.
If a baby tooth is knocked out, there is no need to place it back in the socket since baby teeth are not reattached. However, it is still important to have us examine the injury.
Being prepared for dental emergencies can help save a tooth as well as avoid more costly dental treatment down the road. But no matter what type of dental injury you have, it is important to come in for a consultation as the injury may extend beyond the part of the tooth that is visible. With today’s materials and technology, there’s a very good chance your smile can look as good as before—and often even better!
If you have questions about dental injuries, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Artistic Repair of Front Teeth with Composite Resin.”
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”
If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.
The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.
Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.
The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.
If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.
If you would like more information on cracked mouth corners, 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 Corners of the Mouth.”
Although we’ve made great strides over the last century making dental visits more pleasant and comfortable, many people still feel a little apprehension about them at one time or another. For a few, though, this apprehension escalates into high anxiety — so high they may even avoid important dental treatment altogether.
If you have a significant phobia regarding dental visits and treatment, here are some things you can do to reduce your anxiety and feel more comfortable when you undergo treatment.
Let us know about your feelings of anxiety. We’re conditioned by society to regard such fears as irrational or “silly,” and so we tend to hide our negative emotions. Dentists, however, have been trained to work with fearful patients to reduce their anxiety levels. Being honest with us about your fears and nervousness is the first step to developing an anxiety-reducing strategy that will make your visits more pleasant.
Counteract bad experiences with good. For most people the fear they have during dental visits stems from earlier unpleasant experiences at the dentist. The fear can be so ingrained that simply trying to convince yourself or to be told “there’s nothing to be afraid of” will have little to no effect. Instead, build a memory collection of positive and pleasant dental visit experiences that serve to counteract the unpleasant. To do this we might first get you acclimated to routine visits and then gradually transition to more invasive procedures. This may increase the normal time for dental treatment, but the reduction in anxiety is worth the extra time.
Consider sedation therapy. In addition to modifying your experiences, you may also benefit from sedation medications that reduce anxiety, especially in the early stages of treatment. Depending on your medical history and current status, we can prescribe a sedative for you to take an hour or so before your appointment to help you relax. We can also increase the level of anesthesia (from local to intravenous or gas anesthesia, for example) if your anxiety is especially acute.
Taking proactive steps to minimize dental visit anxiety will increase the probability that you’ll obtain needed dental care. Your teeth and gums will be healthier for it.
If you would like more information on coping with dental visit anxiety, 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 “Overcoming Dental Fear & Anxiety.”
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