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By Glen M. Applebaum, DDS
April 14, 2019
Category: Dental Procedures
Tags: root resorption  
CatchRootResorptionEarlyforBestChancesofSavingYourTooth

As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.

Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb).  It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.

It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.

We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.

Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.

At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.

If you would like more information on diagnosing and treating root resorption, 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 Resorption: An Unusual Phenomenon.”

By Glen M. Applebaum, DDS
April 04, 2019
Category: Dental Procedures
YourAgeDoesntHavetoKeepYoufromaStraighterSmile

Bite problems are quite common—as many as 75% of adults may have some form of orthodontic issue. Unfortunately, there's also something else just as common: that many people believe they're too old to correct it.

This belief is a myth—while there are factors that could prevent orthodontic treatment, age isn't necessarily one of them. If your teeth, gums and bone are sound and you're in reasonably good general health, you most likely can have a bite problem corrected even beyond middle age.

Why worry about it, though, if you've lived this long with misaligned teeth? For one thing, straightening teeth with braces or clear aligners can boost your dental health. Teeth that are in normal alignment are easier to keep clean of disease-causing bacterial plaque. You'll also find it easier to chew than if your bite is out of line.

A more attractive, straighter smile can also impact your social and professional life. Having a smile you're not embarrassed to show can boost your self-confidence and image. Research on people who've undergone orthodontic treatment in adulthood have found improvements in social connection and even expanded career opportunities.

Orthodontic treatment can make a difference with your health and life, no matter your age. But while the number of years you've lived won't necessarily make a difference, what those years have brought could rule it out.

If, for example, you've lost significant bone structure due to diseases like periodontal (gum) disease, your teeth may not be able to sustain the new position created by braces or aligners without a form of permanent fixation. If you have systemic conditions like severe cardiovascular disease, bleeding problems, leukemia or uncontrolled diabetes, orthodontic treatment could worsen those conditions. And certain prescription drugs may pose similar problems as well.

That's why you'll need to undergo a thorough dental exam, as well as provide a complete medical history to your orthodontist. If nothing prevents you from treatment, though, you may be able to regain a new smile, better health and a new confidence in life.

If you would like more information on adult orthodontics, 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 “Orthodontics for the Older Adult.”

By Glen M. Applebaum, DDS
March 25, 2019
Category: Dental Procedures
HeresWhatyouNeedtoKnowaboutaRootCanalTreatment

A root canal treatment is a common procedure performed by dentists and endodontists (specialists for inner tooth problems). If you're about to undergo this tooth-saving procedure, here's what you need to know.

The goal of a root canal treatment is to stop tooth decay within a tooth's interior and minimize any damage to the tooth and underlying bone. This is done by accessing the tooth's pulp and root canals (tiny passageways traveling through the tooth roots to the bone) by drilling into the biting surface of a back tooth or the "tongue" side of a front tooth.

First, though, we numb the tooth and surrounding area with local anesthesia so you won't feel any pain during the procedure.  We'll also place a small sheet of vinyl or rubber called a dental dam that isolates the affected tooth from other teeth to minimize the spread of infection.

After gaining access inside the tooth we use special instruments to remove all of the diseased tissue, often with the help of a dental microscope to view the interior of tiny root canals. Once the pulp and root canals have been cleared, we'll flush the empty spaces with an antibacterial solution.

After any required reshaping, we'll fill the pulp chamber and root canals with a special filling called gutta-percha. This rubberlike, biocompatible substance conforms easily to the shape of these inner tooth structures. The filling preserves the tooth from future infection, with the added protection of adhesive cement to seal it in.

Afterward, you may have a few days of soreness that's often manageable with mild pain relievers. You'll return for a follow-up visit and possibly a more permanent filling for the access hole. It's also likely you'll receive a permanent crown for the tooth to restore it and further protect it from future fracture.

Without this vital treatment, you could very well lose your tooth to the ravages of decay. The time and any minor discomfort you may experience are well worth the outcome.

If you would like more information on treating 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 “Root Canal Treatment: What You Need to Know.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Stephen J. Oustatcher, DDS
March 05, 2019
Category: Oral Health
Tags: dry mouth  
ChronicDryMouthCouldIncreaseYourRiskforDentalDisease

When your mouth is dry, you know it: that sticky, uncomfortable feeling when you first wake up or when you're thirsty. Fortunately, it usually goes away after you eat or drink. But what if your mouth felt like that all the time? Then, it's no longer an irritation—chronic dry mouth could also increase your risk of dental disease.

Chronic dry mouth occurs because of inadequate saliva flow. Saliva plays an important role in preventing dental disease because it neutralizes acid, which can cause the mineral content in tooth enamel to break down and lead to tooth decay. The mouth becomes more acidic right after eating, but saliva can restore its normal pH levels in about an hour—as well as some of the enamel's lost mineral content. Without saliva, your tooth enamel is at greater risk from acid.

While a number of things can potentially interfere with normal saliva production, medication is the most common. More than 500 prescription drugs, including many antihistamines, diuretics or antidepressants, can cause dry mouth. Cancer radiation or chemotherapy treatment and certain metabolic conditions like diabetes or Parkinson's disease can also increase symptoms.

If you are experiencing unusual dry mouth symptoms, see your dentist first for a full examination. Your dentist can measure your saliva flow, check your prescriptions and medical history, and examine your salivary glands for abnormalities. With this more accurate picture of your condition, they can help direct you to the most effective remedies and treatments for the cause.

If medication is the problem, you can talk to your doctor about alternative prescriptions that have a lesser effect on saliva flow. You can also drink more water before and after taking oral medication and throughout the day to help lubricate your mouth. Chewing gums or mints with xylitol, a natural alcohol sugar, can also help: xylitol helps reduce the mouth's bacterial levels, as well as stimulate saliva flow.

Easing your dry mouth symptoms can make your life more pleasant. More importantly, it can reduce your risk of future dental problems caused by a lack of saliva.

If you would like more information on dealing with chronic dry mouth, 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 “Dry Mouth: Learn about the Causes and treatment of this Common Problem.”





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