As a new permanent tooth develops, the roots undergo a process of breakdown and growth. As older cells dissolve (a process called resorption), they’re replaced by newer cells laid down (deposition) as the jaw develops. Once the jaw development ends in early adulthood, root resorption normally stops. It’s a concern, then, if it continues.
Abnormal root resorption most often begins outside of the tooth and works its way in, beginning usually around the neck-like (or cervical) region of the tooth. Also known as external cervical resorption (ECR), the condition usually shows first as pink spots where the enamel is being undermined. As these spots continue to erode, they develop into cavity-like areas.
While its causes haven’t been fully confirmed, ECR has been linked to excessive pressure on teeth during orthodontic treatment, periodontal ligament trauma, teeth-grinding or other excessive force habits, and bleaching techniques performed inside a tooth. Fortunately, ECR is a rare occurrence, and most people who’ve had these problems won’t experience it.
When it does occur, though, it must be treated as quickly as possible because the damage can progress swiftly. Treatment depends on the size and location of the resorption: a small site can often be treated by surgically accessing the tooth through the gum tissue and removing the offending tissue cells. This is often followed with tooth-colored dental material that’s bonded to the tooth to replace lost structure.
A root canal treatment may be necessary if the damage has extended to the pulp, the tooth’s interior. However, there’s a point where the resorption becomes too extensive to save the tooth. In these cases, it may be necessary to remove the tooth and replace it with a dental implant or similar tooth restoration.
In its early stages, ECR may be difficult to detect, and even in cases where it’s been diagnosed more advanced diagnostics like a CBCT scanner may be needed to gauge the extent of damage. In any case, it’s important that you have your teeth examined on a regular basis, at least twice a year. In the rare chance you’ve developed ECR, the quicker it’s found and treatment begun, the better your chances of preserving the tooth.
People often put a premium on appearance when deciding whether or not to replace a missing tooth. There's more motivation to replace one in the “smile zone,” where the teeth are more visible, than one that's not.
But even if your missing tooth is in the back out of sight, there are still good reasons to replace it. That's because even one lost tooth can have a cascading ill effect on other teeth, the underlying bone or eventually your entire facial structure.
The chief problems caused by a missing tooth occur first with the bone. The act of chewing generates pressure around the teeth. The teeth transmit this pressure through the roots to the bone, which stimulates the bone to grow and remain strong in support of the teeth. When you lose a tooth, the bone no longer receives this growth stimulation.
In time, the replacement rate for older bone cells will slow down and cause the bone volume to decrease. It's possible to detect a change just months after losing a tooth: you can lose an estimated 25% of bone width in the first year.
As the bone diminishes, the jaw loses height and then more width. The gum tissues will also gradually decrease. As a result you may not be able to chew or even speak as well as you once could. Depending on the number of teeth you've lost, the foundational portion of the jawbone — the basal bone — may also decline. The distance between nose and chin may decrease and the cheeks sink in. Without bone support in the rear, the bite can collapse and push the teeth forward out of their normal position.
The best way to avoid this debilitating spiral is to replace a tooth as soon as practical. There are many options, but perhaps the best choice is a dental implant: not only will it provide a life-like appearance, but its affinity with bone will stop bone loss and even encourage new growth.
So, don't neglect replacing that “invisible” tooth if it's lost. Your mouth and ultimately your appearance will be better for it.
If you would like more information on tooth loss and restoration options, 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 “The Hidden Consequences of Losing Teeth.”
When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.
“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”
The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”
A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.
It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.
So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!
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.”
Like a second New Year’s Day, the month of September offers its own chance to make a brand new start: It’s back-to-school season! This can be an exhilarating time—a chance to meet new friends, face new challenges and set new goals. It’s also a great time to get started on the things that can keep your children healthy all year long…like a routine visit to the dental office.
Preventive dental visits are one of the most important ways to help keep a smile in top condition—not just for kids, but for people of any age. They are also one of the best values in health care, because so much can be accomplished in such a short time. What exactly happens at a routine visit? Here’s a brief run-down:
- A professional teeth cleaning clears sticky plaque and hardened tartar from places where your brush can’t reach. These deposits can harbor the bacteria that cause tooth decay and gum disease, and removing them helps prevent more serious problems from getting started.
- A complete dental exam involves a check for cavities, but it’s also much more: It includes screening for gum disease, oral cancer, and other potential maladies. X-rays or other diagnostic tests may be performed at this time; any changes can be observed, and the need for preventive or restorative treatments can be evaluated.
- The growth and development of children’s teeth is carefully monitored, from the first baby teeth to the third molars. If orthodontic work or wisdom teeth removal could benefit your child, this is a great time to discuss it. Adults may also benefit from ongoing evaluation for gum recession and other potential issues.
- Keeping your teeth and gums healthy also depends on how you take care of them at home. A routine office visit is a great opportunity to “brush up” on proper techniques for tooth brushing and flossing, and to ask any questions you may have about oral hygiene.
So if you have youngsters starting a new school year—or if you’re looking to make a fresh start toward good oral health yourself—make it a point to stop in to the dental office for a routine visit this season!
If you would like more information about maintaining good oral health, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “Dental Hygiene Visit: A True Value in Dental Healthcare.”
We all have habits: things we do every day often without consciously thinking. Some of them are good; some not so much. And many of them took root in childhood.
That's why it's important to help your children form good habits in their formative years, especially regarding oral health. Here are 4 areas to focus on developing good dental habits — and avoiding bad ones.
Keep teeth and gums clean. The best defense against dental disease is stopping plaque, a thin film of bacteria and food particles, from building up on tooth surfaces. That means brushing and flossing each day, along with regular dental cleanings and checkups. You should begin cleaning your child's teeth as soon as they appear in the mouth with a clean towel or rag at first and later brushing them. Eventually, teach your children to brush and floss for themselves. Dental visits should also begin around their first birthday.
A nutritious diet equals healthy teeth. The saying, “You are what you eat,” is especially true about teeth. Help your child form a nutritious diet habit by providing meals rich in fresh fruits and vegetables, quality protein and dairy products. You should also restrict their sugar intake, a primary food for bacteria that cause tooth decay; try to limit sweets to mealtimes and avoid constant snacking.
Avoid habits with hidden dangers. Actually, this one is about you — and what you might be doing to increase your child's risk for dental disease. Avoid actions that increase the chances of transmitting oral bacteria from you to your infant, like kissing on the lips or licking a pacifier to clean it. You should also avoid giving your child night-time bottles or sippy cups filled with milk, formula or any sweetened liquid — likewise for pacifiers dipped in something sweet.
Steer them away from future bad habits. As children become teenagers, they're eager to stretch their wings. While this is normal and good, they can get into habits with dire consequences for oral health. You should by all means steer them away from tobacco use or oral piercings (tongue and lip bolts especially can wreak havoc on tooth structure) that can harm their teeth and gums.
If you would like more information on dental care for children, 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 “Dentistry & Oral Health for Children.”
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