My Blog

Posts for: October, 2018

TakeStepstoSaveanIncomingToothsPlacetoAvoidaPoorBite

At your child's latest dental visit, you found out one of their primary (“baby”) teeth has become decayed and in danger of loss. Of course, you may think, it's only a primary tooth — it's going to come out sooner or later.

But a primary tooth lost “sooner” rather than “later” can create long-term negative consequences for your child's dental health. For the sake of the future permanent tooth, the best treatment strategy could be to put forth the effort and expense to save it.

Besides its role in eating and chewing, a primary tooth's most important function is as a “trailblazer” for the permanent tooth developing below it. A primary tooth doesn't normally loosen and let go until the new permanent tooth is ready to erupt. Until then they hold the new tooth's space in the jaw.

But if the primary tooth is lost prematurely, nearby teeth can drift into and crowd the space so that the permanent tooth comes in out of position. This can result in a malocclusion, or poor bite.

Depending on the state of your child's jaw development, it may be advisable to attempt saving the tooth through a filling or, in the case of deep decay, a modified root canal treatment. If the tooth can't be saved, then placing an orthodontic appliance known as a space maintainer might be necessary. Cemented to a tooth next to the empty space, this appliance has a looped band of metal that butts against the tooth on the other side of the gap, and prevents both teeth from drifting into the space.

Intervening for a decayed primary tooth can seem a waste of time and money since it has a limited lifespan to begin with. But for the health of its companion permanent tooth, as well as possibly avoiding orthodontic treatment, it could be well worth it for your child's long-term dental health.

If you would like more information on dental care for your child, 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.”


DontStressOverYourChildsTeethGrindingHabitUnlessitPersists

Along with thumb sucking, childhood teeth grinding is one of the top concerns anxious parents bring to their dentists. It’s so prevalent, though, many providers consider it normal behavior—the sleep-disturbing sound it can generate is often the worst consequence for the habit.

But that doesn’t mean you should brush aside all concern, especially if the habit continues into late childhood. Long-term teeth grinding could eventually damage the teeth and gums.

Teeth grinding (or clenching) is the involuntary movement of the jaws when not engaged in normal functions like chewing, speaking or swallowing. The action often produces higher than normal chewing forces, which over time can accelerate tooth wear, cause fractures, or contribute to loose teeth, all of which could increase the risk of dental disease. While it can occur at any time it’s most common among children during nighttime sleep.

While stress is the usual trigger for teeth grinding in adults, with young children the causes for the habit are more complex and less understood. Most doctors hold to the theory that most pediatric teeth grinding arises during shifts from lighter to heavier, rapid-eye-movement (REM) sleep. The child’s immature neuromuscular chewing control may engage involuntarily during this shift. Teeth grinding is also prevalent among children who snore or mouth-breathe, or who take anti-depressant medication.

But as mentioned before, there’s usually no cause for concern unless the habit persists beyond about age 11. If the habit isn’t fading, you should speak to your dentist about ways to reduce it or its effects. One way is with a custom-made night guard worn during sleep. The smooth, plastic surface of the appliance prevents teeth from making solid contact with each other during a grinding episode.

You might also seek treatment from an ear, nose and throat (ENT) specialist if your child is having issues with airway obstruction, which could also relieve teeth grinding. And children experiencing stressful situations or events may find relief both emotionally and physically from psychological therapy.

At younger ages, you can safely regard your child’s grinding habit as normal. But if it persists, it’s worth looking for ways to reduce it.

If you would like more information on your child’s teeth grinding habit, 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 Children Grind Their Teeth: Is the Habit of ‘Bruxism’ Harmful?


3FactorsThatCouldAffecttheSuccessofaRootCanalTreatment

A tooth with deep decay is in real peril. If the disease isn’t stopped, it can eventually infect the bone and greatly increase the risk of losing the tooth. But tooth decay removal and a root canal treatment can stop advancing decay and resulting infection in its tracks.

During this common procedure we first drill into the tooth to access the inner pulp. After removing the infected pulp tissue, we disinfect and fill the empty chamber and root canals with gutta percha. We then seal the tooth and crown it to protect against re-infection.

But while most root canals are successful and long-lasting, sometimes the tooth becomes re-infected. Here are 3 factors that could affect the long-term success of a root canal treatment.

Early treatment. Like many health problems, the sooner we detect decay and treat it, the better the outcome. A tooth in which the infection has already advanced beyond the pulp is at greater risk for re-infection than one in which the infection is localized in the pulp. Keeping up your regular dental visits as well as seeing the dentist at the first sign of abnormality—spots on the teeth or pain—can increase your chances of early diagnosis.

Tooth complications. Front teeth with their single roots and canals are much easier to access and treat than a back molar with an intricate root canal network. Root canals can also be extremely narrow making them easy to miss during treatment. In cases like this the expertise and advanced equipment of an endodontist (a specialist in root canal treatment) could help increase the odds of success in complex situations.

The aging process. Teeth do wear over time and become more brittle, making them increasingly susceptible to fracture. A previous root canal treatment on an aging tooth might also increase the fracture risk. To avoid this, it’s important for the tooth to receive a crown after the procedure to protect the tooth not only from re-infection but undue stress during chewing. In some situations, we may also need to place a post with a bonded composite buildup within the tooth to give it extra support.

Even if a tooth has these or similar complications, a root canal treatment may still be advisable. The benefits for preserving a decayed tooth often far outweigh the risks of re-infection.

If you would like more information on root canal treatments, 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 “Root Canal Treatment.”