Posts for: September, 2019

By Edward Joseph, D.D.S.
September 29, 2019
Category: Oral Health
Tags: gum recession  
DontDelaySeeingtheDentistIfYouSuspectGumRecession

Calling someone "long in the tooth" is an unflattering way of saying they're getting old. The phrase refers to the effects of gum recession, in which the gums pull away from the teeth and cause them to appear longer. The problem, which makes the teeth vulnerable to disease as well as look unattractive, is a common problem for older people.

The most common cause for gum recession is periodontal (gum) disease. Bacteria and food particles, which make up dental plaque, trigger an infection. The deposits of plaque and calculus (hardened plaque) continue to fuel the infection as it continues to weaken gum tissue attachments.

As a result, the gums begin to lose their attachment to the teeth and pull away, exposing the root areas normally covered by the gums. Unlike the enamel-protected crowns (the parts of teeth you can see), the root is covered by a thin layer of material called cementum.

Although cementum offers less protection than enamel, this normally isn't a problem because the gums also act as a barrier against bacteria and other harsh aspects of the mouth environment. But without gum coverage, the root area becomes vulnerable to disease and is more prone to painful sensitivity.

Because gum disease is the main culprit, you can reduce your chances of gum recession by keeping your teeth clean of plaque through brushing and flossing, and regularly undergoing professional cleanings. If gum disease does occur, it's important to seek treatment as soon as possible: The earlier it's treated the more likely that any recessed gum tissues can regenerate.

If the recession is extensive, however, you may need clinical intervention to assist with its regrowth. This can be done by grafting tissue at the site that then serves as scaffold for new tissue to grow upon. Though effective, these microsurgical techniques are quite complex and involved.

So, if you suspect you have gum disease or recession, see your dentist as soon as possible for a full examination. It may be possible to restore your gums and enhance your smile.

If you would like more information on protecting your 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.
September 24, 2019
Category: Dental Procedures
Tags: cosmetic dentistry  
4WaysYouCanTakeYearsoffYourSmile

There are ways you can look younger, including eating a better diet and getting physically fit. Cosmetic enhancements can also take years off your appearance.

But while looking for a more youthful appearance be sure you include a "smile update." Your teeth and gums age like the rest of the body—even more so if you've contended with dental disease. Here are 4 ways you might be able to take years off your smile.

Teeth whitening. Teeth naturally yellow as we age, so it's not uncommon for older teeth to look dull. But your dentist can brighten your smile with teeth whitening, the application of a controlled bleaching solution to lighten them. It only works with enamel discoloration and it does fade over time. But it can temporarily change the dynamic of your smile for the better.

Dental enhancements. You can "put a new face" on unattractive older teeth with a number of life-like materials and techniques. Dentists can apply and sculpt composite resin material to fix small chips in teeth. Dental veneers, thin wafers of porcelain bonded to the front of teeth, can mask chips, heavy staining or slight gaps, and can make worn teeth look longer. And life-like crowns can completely cover teeth with major disfigurement.

Dental work updates. Many people have dental work—fillings, crowns, bridges and the like—from earlier in life. It might be time to "revisit" those with a fresh update. For example, a dark grey metal amalgam filling could be replaced with a newer tooth-colored restoration made of composite material or porcelain.

Gum treatments. Your teeth might not be the only elements of your smile needing attention. Gums that have shrunk back or receded from the teeth can ruin your smile. In some cases, treating any underlying gum disease could help them heal and regain their tooth attachment. For major recession, though, you may need grafting surgery to regenerate lost gum tissue, improving both your oral health and your smile.

These and other techniques can turn back the clock on your smile. The best way to maintain a youthful smile, though, is to take care of your teeth and gums through daily brushing and flossing and regular dental visits. Healthy teeth and gums make beautiful smiles.

If you would like more information on rejuvenating your smile, 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 “How Your Dentist Can Help You Look Younger.”


By Edward Joseph, D.D.S.
September 19, 2019
Category: Oral Health
Tags: oral health  
PreservingthePulpisPriorityOnewithaNewlyEruptedPermanentTooth

The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.

While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.

To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.

That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.

If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.

These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.

If you would like more information on caring for your child's 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 “Saving New Permanent Teeth after Injury.”


By Edward Joseph, D.D.S.
September 14, 2019
Category: Oral Health
Tags: tooth decay  
NewMinimallyInvasiveTechniquesareImprovingToothDecayTreatment

Although techniques and materials have changed, dentists still follow basic principles for treating tooth decay that date from the late 19th Century. And for good reason: They work. These principles first developed by Dr. G.V. Black—the "father of modern dentistry"—are widely credited with saving millions of teeth over the last century.

One of the most important of these treatment protocols is something known as "extension for prevention." In basic terms, it means a dentist removes not only decayed tooth structure but also healthy structure vulnerable to decay. But although effective in saving teeth, practicing this principle can result in loss of otherwise healthy tissue, which can weaken the tooth.

But with new advances in dentistry, decay treatment is getting an overhaul. While Dr. Black's time-tested protocols remain foundational, dentists are finding new ways to preserve more of the tooth structure in a concept known as minimally invasive dentistry (MID).

Better diagnostic tools. Because tooth decay can ultimately infect and damage the tooth's interior, roots and supporting bone, the best way to preserve more of the tooth structure is to treat it as early as possible. Now, new diagnostic tools like digital x-rays, microscopic magnification and optical scanning are helping dentists detect and treat decay earlier, thus reducing how much tissue is removed.

Better prevention methods. Oral hygiene and regular dental care are our basic weapons in the war with tooth decay. In addition, utilizing topical fluoride in combination with a milk-derived product called CPP-ACP dentists can get more of the cavity-fighting organic compound into the tooth enamel to strengthen it against acid attack.

Better treatment techniques. Using air abrasion (a fine particle spray that works like a miniature sandblaster) and lasers, dentists can now remove decayed structure with less harm to healthy tissue than with a traditional dental drill. And new, stronger dental fillings like those made with composite resins require less structural removal to accommodate them.

With these innovative approaches, dentists aren't just saving teeth, they're preserving more of their structure. And that can improve your overall dental health for the long-term.

If you would like more information on minimally invasive dentistry, 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: When Less Care is More.”


TopicalFluorideOffersaProtectiveBoosttoChildrenatHighRiskforDecay

You're doing all the right things helping your child avoid tooth decay: daily brushing and flossing, regular dental visits and a low-sugar diet. But although occurrences are low, they're still getting cavities.

Some children still struggle with tooth decay even with proper dental care. If this is happening to your child, your dentist may be able to give them an extra preventive boost through topical fluoride.

Fluoride has long been recognized as a proven cavity fighter. Often added in small amounts to toothpastes and drinking water, fluoride strengthens tooth enamel against acid attacks that create cavities. With topical fluoride, a dentist applies a varnish, foam or gel containing a more concentrated amount of the chemical directly to the teeth.

The effectiveness of this method in reducing tooth decay is well-founded: A number of scientific studies involving thousands of children and adolescents found an average 28% reduction in occurrences of decay among those who received the treatment compared to those who didn't.

Still, many parents have concerns about the higher fluoride concentrations in topical applications. But even at this greater amount, fluoride doesn't appear to pose any long-term health risks. The most adverse effects—vomiting, headaches or stomach pain—usually occur if a child accidentally ingests too much of the solution during treatment.

Dentists, however, go to great lengths to prevent this by using guards to isolate the solution during an application. And in the case of a foam or gel application, parents can further lower the risk of these unpleasant side effects by not allowing their child to eat or drink for at least thirty minutes after the procedure.

The evidence seems to indicate that the benefits of regular topical fluoride applications for children at high risk outweigh the possible side effects. By adding this measure to your prevention strategy, you can further protect your child from this danger to their current and future dental health.

If you would like more information on tooth decay prevention 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 “Fluoride Gels Reduce Decay.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
Burbank, CA 91505
(818) 842-7628

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