Ask any kid and they'll tell you just how valuable "baby" teeth really are—out of the mouth, of course, and under their pillow awaiting a transaction with the Tooth Fairy. But there's more to them than their value on the Fairy Exchange Market—they play a critical role in future dental health.
Primary teeth provide the same kind of dental function as their future replacements. Children weaned from nursing can now eat solid food. They provide contact points for the tongue as a child learns to speak. And they play a role socially, as children with a "toothsome" smile begin to look more like what they will become when they're fully mature.
But primary teeth also serve as guides for the permanent teeth that will follow. As a future tooth develops below the gum line, the primary tooth preserves the space in which it will erupt. Otherwise, the space can be taken over by other teeth. This crowds out the intended tooth, which may erupt out of position or remain impacted below the gum line.
In either case, the situation could create a poor bite (malocclusion) that can be quite costly to correct. But if we can preserve a primary tooth on the verge of premature loss, we may be able to reduce the impact of a developing malocclusion or even prevent it.
We can help primary teeth last for their intended lifespan by preventing tooth decay with daily oral hygiene or clinically-applied sealants and topical fluoride. If they do become infected, it may be worth the effort to preserve them using procedures similar to a root canal treatment.
If a tooth can't be preserved, then we can try to reserve the empty space for the future tooth. One way is a space maintainer, which is a stiff wire loop attached to metal band bonded around an adjacent tooth. This keeps other teeth from drifting into the space until the permanent tooth is ready to erupt, at which time we can remove the appliance.
Your child may be anxious to get another tooth to put under their pillow. But helping that primary tooth go the distance will be more than worth it for their future dental health.
If you would like more information on the care and treatment of baby 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 “Importance of Baby Teeth.”
The most common side effect of tooth whitening is sensitive teeth or sensitivity around the teeth you are whitening.
Soft Tissue Sensitivity:
Whitening concentrations higher than 15% can irritate your soft tissue. This is usually perceived as stinging or tingling gums or you may see small areas of blanching or tenderness. If this happens:
- check tray for overlap (If you have a dentist made tray they may need to adjust it for you)
- Make sure you are not overfilling your tray with material
- Inspect your mouth for or have your dental professional inspect your mouth for food, floss, or toothbrush-caused cuts or abrasions
This type of sensitivity usually occurs due to dehydration of your tooth and is usually felt as a dull toothache or headache. If you feel this is what is causing your sensitivity, reduce whitening time to 20-60 minutes. 70% of whitening has occurred by the end of the first hour and your saliva can then rapidly rehydrate your teeth. You also may need to take a break from whitening for 1-2 days and then restart whitening using the shorter time.
Acute (severe or intense) Sensitivity:
Usually direct access to dentin is the cause of this type of sensitivity. Some ways dentin is exposed are recession, enamel fracture, chipped tooth, or leaking filling or crown margins. This is usually experienced as a jolt or shock of pain from a single tooth.
For some people, using a toothpaste made for sensitive teeth for 2-3 weeks prior to whitening and throughout the treatment period is enough to help the sensitivity.
Brushing with baking soda on a wet toothbrush for 30-60 seconds may help decrease sensitivity. Pain reliever such as aspirin or ibuprofen is helpful to some people.
Some people cannot whiten due to severe sensitivity.
Professional whitening is better than store bought. Professional materials are different than what you can buy in a store plus you get the advice of your dentist for your mouth. Be aware that if the product is not applied properly you can make your teeth look worse rather than better. Besides, if your teeth are truly discolored, most OTC products are not going to be strong enough to help.
Note: This advice is not intended to replace the clinical judgement of your healthcare professional.
Dr. Jennifer Robb is a general dentist who sees both children and adults at her dental office.
1612 Cooper Foster Park Rd.
Lorain, OH 44053
You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?
The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.
Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.
And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.
Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.
Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.
Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.
An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.
Recently I've seen several references to a documentary named "The Root Cause" and just this week someone at the office asked me about it I have not seen this personally since it appears to have been pulled from the online libraries of most sites where I have a subscription.
"The Root Cause" does appear to be based on the experience of a single person and that person's viewpoints and beliefs. Though he does have "experts" comment on this, I'm sure he chose "experts" to feature in his documentary that agreed with his beliefs. As Americans, we have the right to free speech. We can say almost anything we want--but that doesn't always make it true, just like reading something on the internet doesn't always mean it is true.
I would hate to see someone totally discount a valid dental treatment, such as root canals, based solely on this documentary. To be honest, it seems like these same claims pop up every so many years. Much seems to be based on the work of Dr. Weston Price, whose theory was proven false many years ago.
In fact, very little scientific evidence exists to support most of the claims made in this documentary. So I invite you to take whatever claim you are interested in from this documentary and to do a thorough search of the scientific literature on your own and see what the majority of it says.
If you're not the type to do your own scientific research then here are two reviews that you can read--one by a dentist and one by a dental hygienist:
P.S. In case you're wondering, I do have root canals on my teeth--on multiple teeth in fact--and I would not hesitate to get another one if I had a tooth that needed it. (I also have a dental implant that replaces a tooth that couldn't be saved with a root canal. Since I only have one dental implant surrounded by other teeth, I don't feel I can speak to how well it replaces a tooth and whether it feels different than having my own teeth.)
For many years Fixed Partial Dentures (FPDs or Fixed Bridges) were the high-end standard of care to replace a missing tooth. With the advent of dental implants, that perception has shifted. Why? Because an FPD essentially takes a 1 tooth problem (a missing tooth) and makes it into a 3 tooth problem.
To do an FPD, the teeth on either side of your missing tooth must be ground down to create space for a crown. Sometimes another type of connector to the adjacent teeth is used, but a crown is the most common. The teeth on either side of the missing tooth are called abutment teeth. 80% of abutment teeth have only small or no fillings or other dental restorations before they become the abutment teeth for your FPD—this means we are often taking away healthy tooth structure in order to replace your missing tooth. (You can learn more about FPDs here: Crowns & Bridgework)
The way an FPD is made, the crowns and replacement tooth are all connected together. (If you’ve never seen an FPD, ask your dentist to show you an example of one.) You can brush these FPDs or Fixed Bridges as you normally do, but because they are connected, you cannot floss them like you floss your natural teeth. Flossing them is possible, and your dentist or dental hygienist can show you how to do so. But we know that most people don’t take the time to floss their natural teeth—so are they really going to go through the more time-consuming process to floss their Fixed Bridge or FPD?
The two most common reasons that we need to recommend replacement of a Fixed Bridge or FPD are (1) decay on one of the abutment teeth or (2) periodontal disease (gum disease) around one of the abutment teeth.
So why does the title say “Making a 1 Tooth Problem Into a 3 Tooth Problem”? Because most FPDs will fail after 5-10 years and once the FPD fails, even if the decay or periodontal disease is only on one of the two abutment teeth, you’re looking at dealing with 3 teeth in order to fix it not just one. A problem that greatly increases the cost of fixing it.
Think it won’t happen to you? Studies show that 8-12% of abutment teeth are lost in the first 10 years and 30% are lost after 15 years! Compare that to dental implants which have a success rate of 98% and don’t require you to grind down adjacent teeth. Though dental implants cost more at the beginning, studies show they cost less over time. (By 5-7 years out the dental implants starts earning you money when you don’t have to pay out to replace your failing FPD). One graph I’ve seen shows that at approximately the 7 year mark the expense lines cross and the FPD starts being more expensive than a dental implant. You can learn more about dental implants here: Top Reasons to Choose Dental Implants and Dental Implants FAQs
Of course, the FPD or Fixed Bridge still has a place. There are times when a dental implant cannot be placed or the condition of the adjacent teeth may mean they’d require crowns anyway (though that still doesn’t negate the possibility of it becoming a 3 tooth problem down the road if the abutment teeth fail.)
If you do find that you need to make a decision about replacing a missing tooth, talk with your dentist about your options and don’t be afraid to ask questions about dental implants, FPDs, or removable options—and be sure you understand the pros and cons of each choice.
**Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.
Jennifer G. Robb, DMD is a general dentist who sees both adults and children.
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