Posts for: June, 2017

By Edward Joseph, D.D.S.
June 22, 2017
Category: Dental Procedures
IfatAllPossiblePrimaryTeethareWorthSaving

Primary (baby) teeth might not last long, but their impact can last a lifetime. Their first set of teeth not only allows young children to eat solid foods, but also guide permanent teeth to form and erupt in the proper position.

Unfortunately, primary teeth aren't immune to tooth decay. If the decay is extensive, the tooth may not last as long as it should. Its absence will increase the chances the permanent teeth won't come in correctly, which could create a poor bite (malocclusion) that's costly to correct.

If a primary tooth is already missing, we can try to prevent a malocclusion by installing a “space appliance.” This keeps nearby teeth from drifting into the empty space intended for the permanent tooth. The best approach, though, is to try to save a primary tooth from premature loss.

We can often do this in much the same way as we would with a permanent tooth — by removing decayed material and filling the prepared space. We can also perform preventive applications like topical fluoride or sealants that strengthen or protect the tooth.

It becomes more complicated, though, if the pulp, the interior of the tooth, becomes decayed. The preferred treatment for this in a permanent adult tooth is a root canal treatment. But with a primary tooth we must also consider the permanent tooth forming below it in the jaw and its proximity to the primary tooth. We need to adapt our treatment for the least likely damage to the permanent tooth.

For example, it may be best to remove as much decayed structure as possible without entering the pulp and then apply an antibacterial agent to the area, a procedure known as an indirect pulp treatment. We might also remove only parts of the pulp, if we determine the rest of the pulp tissue appears healthy. We would then dress the wound and seal the tooth from further infection.

Whatever procedure we use will depend on the extent of decay. As we said before, our number one concern is the permanent tooth beneath the primary. By focusing on the health of both we can help make sure the permanent one comes in the right way.

If you would like more information on caring for children's primary teeth, 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 for Children's Teeth.”


By Edward Joseph, D.D.S.
June 14, 2017
Category: Oral Health
DontletPeriodontalDiseaseCauseYourGumstoRecede

Although your smile wouldn't be the same without them, there's more to your gums than their looks. Besides helping to hold your teeth in place, they're also an important protective barrier for their roots.

Unfortunately, gums aren't immune to disease, especially periodontal (gum) disease. This bacterial infection, triggered by built-up dental plaque on teeth due to insufficient oral hygiene, can cause the gum tissues to detach from teeth and shrink back (recede). This can make your teeth more sensitive to hot or cold foods and beverages, as well as put them at even greater risk for tooth decay.

To treat gum recession, our first priority is to stop any ongoing gum disease through aggressive plaque removal. Depending on severity, this could require clinical procedures like scaling or root planing to remove plaque and tartar (hardened plaque deposits) at or below the gum line. This is especially crucial for improving gum tissue healing and stimulating potential reattachment.

Revitalizing gum tissues this way naturally has a better chance of occurring if we're able to prevent recession before it reaches the roots. If that does happen and we have sufficient gum tissue attachment remaining, we may need to give the gum tissue a helping hand through gum grafting surgery. There are a number of techniques depending on the circumstances, but they all use either tissue from another location in the patient's mouth or prepared tissue from another human donor. This type of surgery requires great skill and expertise, not to mention an aesthetic sense, to achieve a result that's both functional and attractive.

Other than daily brushing and flossing, the most important thing you can do for gum health is to see us as soon as you notice any signs of gum problems like swelling, bleeding or tooth sensitivity. The sooner we can diagnose and begin treating the problem, the less likely any gum recession will have a long-term impact on your health.

If you would like more information on gum health, 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 “Gum Recession.”


By Edward Joseph, D.D.S.
June 06, 2017
Category: Oral Health
3DentalSignsofanEatingDisorder

Sometimes dental conditions point to health problems beyond the teeth and gums. An astute dentist may even be able to discern that a person’s oral problems actually arise from issues with their emotional well-being.  In fact, a visit to the dentist could uncover the presence of two of the most prominent eating disorders, bulimia nervosa or anorexia nervosa.

Here are 3 signs dentists look for that may indicate an eating disorder.

Dental Erosion. Ninety percent of patients with bulimia and twenty percent with anorexia have some form of enamel erosion. This occurs because stomach acid — which can soften and erode enamel — enters the mouth during self-induced vomiting (purging), a prominent behavior with bulimics and somewhat with anorexics. This erosion looks different from other causes because the tongue rests against the back of the bottom teeth during vomiting, shielding them from much of the stomach acid. As a result, erosion is usually more severe on the upper front teeth, particularly on the tongue side and biting edges.

Enlarged Salivary Glands. A person induces vomiting during purging by using their fingers or other objects. This irritates soft tissues in the back of the throat like the salivary glands and causes them to swell. A dentist or hygienist may notice redness on the inside of the throat or puffiness on the outside of the face just below the ears.

Over-Aggressive Brushing. Bulimics are acutely aware of their appearance and often practice diligent hygiene habits. This includes brushing the teeth, especially after a purging episode. In doing so they may become too aggressive and, coupled with brushing right after purging when the minerals in enamel are softened, cause even greater erosion.

Uncovering a family member’s eating disorder can be stressful for all involved. In the long run, it’s best to seek out professional help and guidance — a good place to start is the National Eating Disorders Association (www.nationaleatingdisorders.org). While you’re seeking help, you can also minimize dental damage by encouraging the person to rinse with water (or a little baking soda) after purging to neutralize any acid in the mouth, as well as avoid brushing for an hour.

If you would like more information on the effect of eating disorders on oral health, 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 “Bulimia, Anorexia & Oral Health.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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