By Carol Haddad, DMD
January 19, 2021
Category: Dental Procedures
Tags: tooth decay  
3ReasonsWhyTreatingCavitiesIsBecomingMoreEffective

If you've ever had a run-in with cavities, you know the drill (no pun intended): After getting a local anesthetic for pain, the dentist removes any decayed dental tissue, as well as some healthy tissue, and then fills the cavity to restore the tooth. It's an effective treatment protocol we've been using for well over a century.

It does, however, have its drawbacks. For one, although necessary, removing healthy dental tissue can weaken the overall tooth structure. The dental drill used during the procedure is also unpleasant to many people: Although it doesn't cause any pain thanks to the anesthetic, the sounds and pressure sensations associated with it can be unsettling.

But advances in dental tools, technology and techniques are addressing these drawbacks in traditional tooth decay treatment. In other words, treating a tooth with cavities today is taking on a lighter touch. Here are 3 reasons why.

Earlier detection. The key to effective treatment is to find tooth decay in its earliest stages. By doing so, we can minimize the damage and reduce the extent of treatment needed. To do this, we're beginning to use advanced diagnostic tools including digital x-rays, intraoral cameras and laser fluorescence to spot decay, often before it's visible to the naked eye.

Re-mineralizing enamel. One of the advantages of early detection is to catch tooth enamel just as it's undergoing loss of its mineral content (demineralization) due to contact with acid. At this stage, a tooth is on the verge of developing a cavity. But we can use minimally invasive measures like topically applied fluoride and CPP-ACP (a milk-based product) that stimulates enamel re-mineralization to prevent cavity formation.

Less invasive treatment. If we do encounter cavities, we no longer need to turn automatically to the dental drill. Air abrasion, the use of fine substance particles under high pressure, can precisely remove decayed material with less loss of healthy tissue than a dental drill. We're also using newer filling materials like composite resins that don't require enlarging cavities as much to accommodate them.

These and other techniques—including laser technology—are providing superior treatment of tooth decay with less invasiveness. They can also make for a more pleasant experience when next you're in the dentist's chair.

If you would like more information on effectively treating dental disease, 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 “Minimally Invasive Dentistry.”

By Carol Haddad, DMD
January 09, 2021
Category: Dental Procedures
6SignsYourChildCouldBeDevelopingaPoorBite

If your child has seen the dentist regularly, and brushed and flossed daily, there's a good chance they've avoided advanced tooth decay. But another problem might already be growing right under your nose—a poor dental bite (malocclusion).

A dental bite refers to the way the upper and lower teeth fit together. In a normal bite the teeth are in straight alignment, and the upper teeth slightly extend in front of and over the lower when the jaws are shut. But permanent teeth erupting out of position or a jaw developing abnormally can set the stage for a malocclusion.

Although the full effects of a malocclusion may not manifest until later, there may be signs of its development as early as age 6. If so, it may be possible to identify a budding bite problem and “intercept” it before it goes too far, correcting it or reducing its severity.

Here are 6 signs your school-age child could be developing a malocclusion.

Excessive spacing. If the spacing between teeth seems too wide, it could mean the size of your child's teeth are out of proportion with their jaw.

Underbite. Rather than the normal upper front teeth covering the lower, the lower teeth extend out and over the upper teeth.

Open bite. There's a space or gap between the upper and lower teeth even when the jaws are shut.

Crowding. Due to a lack of space on the jaw, incoming teeth don't have enough room to erupt and may come in misaligned or “crooked.”

Crossbites. Some of the lower teeth, either in front or back of the jaw, overlap the upper teeth, while the rest of the upper teeth overlap normally.

Protrusion or retrusion. This occurs if the upper front teeth or jaw appear too far forward (protrusion) or the lower teeth or jaw are positioned too far back (retrusion).

Besides watching out for the preceding signs yourself, it's also a good idea to have your child undergo a comprehensive bite evaluation with an orthodontist around age 6. If that does reveal something amiss with their bite, intervention now could correct or lessen the problem and future treatment efforts later.

If you would like more information on children's bite development, please contact us or schedule an appointment for a consultation.

By Carol Haddad, DMD
December 30, 2020
Category: Oral Health
HeresWhatToDoIfYourChildComplainsofaToothache

Perhaps the only thing worse than having a toothache of your own is when your child has one. Tooth pain can be a miserable experience, especially for children. It can also be confusing about what to do to deal with it.

Fortunately, a toothache usually isn't a dental emergency, so take a deep breath. Here's what you should do if your child is experiencing tooth pain.

Get the 411 from them. Before you call the dentist, find out more first about the tooth pain from your child with a few probing questions: Where exactly does it hurt? Do you feel it all through your mouth or just in one place? Is it all the time, or just when you bite down? When did it start? You may not get the same level of detail as you would from an adult, but even a little information helps.

Take a look in their mouth. There are a lot of causes for toothache like a decayed tooth or abscessed gums. See if any of the teeth look abnormal or if the gums are swollen. You might also find a piece of food or other particle wedged between the teeth causing the pain. In that case, a little dental floss might relieve the problem.

Ease the pain. While you're waiting on your dental appointment, you can help relieve some of their discomfort by giving them a child-appropriate dose of ibuprofen or acetaminophen. You can also apply an ice pack on the outside of the jaw for five minutes on, then five minutes off to decrease swelling. Under no circumstances, however, should you give your child aspirin or rub it on the gums.

See the dentist. It's always a good idea to follow up with the dentist, even if the pain subsides. In most cases, you may be able to wait until the next day. There are, however, circumstances that call for a visit as soon as possible: if the child is running a fever and/or has facial swelling; or if the tooth pain seems to be related to an injury or trauma.

It can be unsettling as a parent when your child has a toothache. But knowing what to do can help you stay calm and get them the care they need.

If you would like more information on pediatric dental care, 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 “A Child's Toothache.”

KeepYourNewStraightenedSmileStraightWithanOrthodonticRetainer

You can't correct a poor bite with braces or clear aligners overnight: Even the most cut-and-dried case can still require a few years to move teeth where they should be. It's a welcome relief, then, when you're finally done with braces or aligner trays.

That doesn't mean, however, that you're finished with orthodontic treatment. You now move into the next phase—protecting your new smile that took so much to gain. At least for a couple of more years you'll need to regularly wear an orthodontic retainer.

The name of this custom-made device explains its purpose: to keep or “retain” your teeth in their new, modified positions. This is necessary because the same mechanism that allows us to move teeth in the first place can work in reverse.

That mechanism centers around a tough but elastic tissue called the periodontal ligament. Although it primarily holds teeth in place, the ligament also allows for tiny, gradual tooth movement in response to mouth changes. Braces or aligner trays take advantage of this ability by exerting pressure on the teeth in the direction of intended movement. The periodontal ligament and nature do the rest.

But once we relieve the pressure when we remove the braces or aligners, a kind of “muscle memory” in the ligament can come into play, causing the teeth to move back to where they originally were. If we don't inhibit this reaction, all the time and effort put into orthodontic treatment can be lost.

Retainers, either the removable type or one fixed in place behind the teeth, gently “push” or “pull” against the teeth (depending on which type) just enough to halt any reversing movement. Initially, a patient will need to wear their retainer around the clock. After a while, wear time can be reduced to just a few hours a day, usually during sleep-time.

Most younger patients will only need to wear a retainer for a few years. Adults who undergo teeth-straightening later in life, however, may need to wear a retainer indefinitely. Even so, a few hours of wear every day is a small price to pay to protect your beautiful straightened smile.

If you would like more information on orthodontic retainers, 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 Importance of Orthodontic Retainers.”

LocalAnesthesiaMakesforaMorePleasantandPain-FreeDentalExperience

You know you should see the dentist about that nagging tooth or gum problem, but you keep putting it off. Truth be told, you're a little nervous that your treatment visit might be unpleasant.

In one sense, your concern isn't unreasonable: The teeth and gums abound in nerves that are more than effective in signaling pain. Even minor dental procedures can trigger discomfort. In another sense, though, there's no need to worry, thanks to pain-numbing techniques using local anesthesia.

The term “local” is used because the applied anesthetic only affects the area and surrounding tissues needing treatment. The anesthetic drugs temporarily block nerve electrical impulses from transmitting pain signals to the brain. Unlike general anesthesia, which requires placing a patient in an unconscious state, a patient can be awake, yet feel no sensation around the anesthetized tissue.

Dentists typically use a two-step method to prevent patients from feeling any pain during a procedure. First, they apply a topical local anesthetic to the surface of the gums. Once these top layers have been numbed, they numb the underlying tissues by injecting the anesthetic with a needle. The goal of a topical application is to ensure the patient doesn't feel the prick of the needle used for deep tissue anesthesia.

Dentists follow strict protocols using anesthesia that have been developed over several decades. As a result, local anesthesia has revolutionized dental care and greatly reduced patient discomfort safely and effectively. Its effectiveness has in fact led to a common complaint that the numbness may linger long afterwards. But that also has been addressed with better combinations of anesthetic drugs to reduce the duration of the numbing effect.

And not only does local anesthesia make for a more relaxing and pleasant experience, it also benefits the dental provider. Dentists tend to work more efficiently when they know their patients aren't in discomfort, which can result in better treatment outcomes.

If you've been putting off a trip to the dentist because you think it might be painful or uncomfortable, put those concerns to rest. With the help of local anesthesia, dental treatment can be relaxing and pain-free.

If you would like more information on having a pain-free experience at the dentist, 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 “Local Anesthesia for Pain-Free Dentistry.”





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