The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.
Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).
Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.
A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.
CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.
But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.
And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.
If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”
While anyone can lose a permanent tooth, the cause often varies by age group. Adults usually lose their teeth to disease, while those under twenty lose a tooth to accidents.
For adults, a dental implant is usually the best way to replace a missing tooth. Teenagers and younger, on the other hand, must wait to get implants until their jaws fully develop. An implant placed on an immature jaw will eventually look and feel out of place.
For most, their jaws won't reach full maturity until their early twenties. Even so, they still have a couple of good options for restoring their smiles in the meantime, albeit temporarily.
One is a removable partial denture or RPD, a device with the replacement prosthetic (false) tooth or teeth set in a gum-colored acrylic base. Of the various types of RPDs, most teenagers do well with a rigid but lightweight version called a “flipper,” called so because it can be flipped in and out of place with the tongue.
These RPDs are affordable, their fit easily adjusted, and they make cleaning the rest of the teeth easier. But they can break while biting down hard and—because they're dentures—aren't always well accepted among teenagers.
The other option is a bonded bridge. Unlike a traditional bridge secured with crowns cemented to natural teeth, a bonded bridge uses a strip of dental material affixed to the back of the prosthetic tooth with the ends of the strip extending outward horizontally. With the prosthetic tooth inserted into the empty space, these extended ends are bonded to the backs of the natural teeth on either side.
Though not as secure as a traditional bridge, a bonded bridge is more aesthetic and comfortable than an RPG. On the other hand, patients who have a deep bite or a teeth-grinding habit, both of which can generate abnormally high biting forces, run a higher risk of damaging the bridge. A bridge can also make hygiene tasks difficult and time-consuming, requiring a high degree of self-discipline from the patient.
Whichever you choose, both options can effectively replace a teenager's missing tooth while waiting for dental implants. Although temporary, they can make the long wait time for a teenager more bearable.
Teenagers can have the same smile-disrupting tooth flaws as adults. But not all cosmetic treatments available to adults are appropriate for teenagers—at least not until they get a little older. Dental veneers fall into that category.
A veneer is a thin porcelain shell custom-made by a dental lab, and bonded by a dentist to the face of a tooth to mask chips, stains, gaps or other imperfections. Because they're less invasive than other measures, veneers are highly popular as a cosmetic dental solution. They do, however, usually require some enamel removal so that they'll appear more natural.
This enamel removal typically won't impact an adult tooth other than it permanently requires it to have veneers or other restorations after alteration. But there is a risk of damage to a teenager's tooth, which hasn't fully developed.
Adolescent teeth usually have a larger pulp chamber (filled with an intricate network of nerves and blood vessels) than adult teeth. And because the enamel and dentin layers may not yet be fully developed, the pulp is much nearer to the tooth's surface.
We must be very careful then in removing enamel and dentin for veneers or we may penetrate the pulp and risk damaging it. Alternatively, there is the possibility of no-prep veneers which are very conservative but often are unable to be done because of the need to often remove tooth structure to make the veneers look natural.
Another cosmetic problem can occur if we place veneers on a patient's teeth whose jaws and mouth structures are still growing. Eventually, the gums could recede and an unsightly gap form between the veneer and the adjacent natural tooth.
Fortunately, there are other techniques we can use to improve a tooth's appearance. Mild chipping can be repaired by bonding composite resin material to the tooth. Some forms of staining may be overcome with teeth whitening. These and other methods can address a teenager's smile appearance until their teeth are mature enough for veneers.
Whether or not a tooth is ready for veneers will depend on its level of development, something that can often be ascertained with x-rays or other diagnostic methods. And if a tooth has already undergone a root canal treatment, there isn't as much concern. In the meantime, though, it may be better for your teen to wait on veneers and try other techniques to enhance their smile.
If you would like more information on dental restoration for teenagers, 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 “Veneers for Teenagers.”
Emma Roberts, star of American Horror Story (and niece of actress Julia Roberts), welcomed her first child at the end of 2020. She confessed that her love of sweets made pregnancy challenging. She couldn't get enough of cupcakes with sprinkles and a Salt & Straw ice cream flavor called The Great Candycopia. But Roberts isn't unique. Hormonal changes in pregnancy often bring heightened cravings for certain foods. Unfortunately, this can increase an expectant mother's risk for dental disease, especially if they're consuming more sugary foods.
In fact, around four in ten expectant women will develop a form of periodontal disease called pregnancy gingivitis. It begins with dental plaque, a thin film that forms on tooth surfaces filled with oral bacteria that can infect the gums. And what do these bacteria love to eat? Yep—sugar, the same thing many women crave during pregnancy.
So, if you're expecting a baby, what can you do to minimize your risk for dental disease?
Practice oral hygiene. Removing dental plaque by brushing and flossing daily is the most important thing you can do personally to prevent both tooth decay and gum disease. It's even more important given the physical and hormonal changes that occur when you're pregnant. Be sure, then, that you're diligent about brushing and flossing every day without fail.
Control your sugar intake. If you have strong cravings for sweets, cutting back may be about as easy as stopping an elephant on a rampage through the jungle. But do give your best effort to eating more dairy- and protein-rich foods rather than refined carbohydrates like pastries or candies. Not only will reducing sugar help you avoid dental disease, these other foods will help strengthen your teeth.
Maintain regular dental visits. Seeing us for regular cleanings further reduces your disease risk. We can clean your teeth of any plaque deposits you might have missed, especially hardened plaque called tartar that's nearly impossible to remove with brushing and flossing. We'll also monitor your teeth and gums for any developing disease that requires further treatment.
Undergo needed treatments. Concerned for their baby's safety, many expectant mothers are hesitant about undergoing dental procedures. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association endorse necessary dental treatments during pregnancy, even if they include local anesthesia. We will make you have only a safe type of anesthesia, and we can advise you when it is prudent to postpone certain treatments, such as some elective procedures, until after the baby is born.
Emma Roberts got through a healthy pregnancy—cravings and all—and is now enjoying her new baby boy. Whether you're a celebrity like Emma Roberts or not, expecting a baby is an exciting life moment. Follow these tips to keep your teeth and gums healthy throughout your pregnancy, and be sure to let the dental team know of your pregnancy before any treatment.If you would like more information about dental care during pregnancy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Pregnancy and Oral Health.”
Tooth decay is a destructive disease that could rob you of your teeth. But it doesn't appear out of nowhere—a number of factors can make it more likely you'll get cavities.
But the good news is you can be proactive about many of these factors and greatly reduce your risk of tooth decay. Here are a few questions to ask yourself to point you in the right direction for preventing this destructive disease.
Do you brush and floss every day? A daily habit of brushing and flossing removes buildup of dental plaque, a bacterial film on teeth that's the top cause for tooth decay and periodontal (gum) disease. Hit or miss hygiene, though, can greatly increase your risk for developing a cavity.
Do you use fluoride? This naturally occurring chemical has been proven to strengthen tooth enamel against decay. Many locations add fluoride to drinking water—if your area doesn't or you want to boost your fluoride intake, use toothpastes, mouthrinses or other hygiene products containing fluoride.
Do you smoke? The nicotine in tobacco constricts blood vessels in the mouth so that they provide less nutrients and antibodies to the teeth and gums. Your mouth can't fight off infection as well as it could, increasing your risk of dental diseases like tooth decay.
Do you have dry mouth? This isn't the occasional bout of “cotton mouth,” but a chronic condition in which the mouth doesn't produce enough saliva. Saliva neutralizes mouth acid, so less of it increases your risk for decay. Chronic dry mouth can be caused by medications or other underlying conditions.
Do you snack a lot between meals? Sugary snacks, sodas or energy drinks can increase oral bacteria and acidity that foster tooth decay. If you're snacking frequently between meals, your saliva's acid neutralizing efforts may be overwhelmed. Coordinate snacking with mealtimes to boost acid buffering.
You can address many of these questions simply by adopting a daily habit of brushing and flossing, regular dental cleanings and checkups, and eating a healthy, “tooth-friendly” diet. By reducing the risk factors for decay, you can avoid cavities and preserve your teeth.
If you would like more information on preventing tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”
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