36075 Utica Rd. #200, Clinton Twp., MI 48035, (586) 792-4600

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Posts for: January, 2019

By Eric Romano DDS
January 27, 2019
Category: Oral Health
Tags: tooth pain  
BeforeweExtractThatProblemToothLetsConsiderSavingit

Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.

We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.

While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.

Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.

Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.

But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.

These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.

If you would like more information on the best treatment choices for your dental 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 “Save a Tooth or Get an Implant?


By Eric Romano DDS
January 17, 2019
Category: Dental Procedures
Tags: teeth whitening  
StainsfromWithinaToothRequireProfessionalWhitening

Whether performed in a dental office or using a home kit, teeth whitening applications are quite effective for bleaching exterior (extrinsic) stains on enamel surfaces. But what if your discoloration comes from inside the tooth? In this case, extrinsic teeth whitening won’t work — you’ll need to undergo an “internal bleaching” method, which can only be performed in a dentist's office.

There are a number of causes for “intrinsic” staining, including too much fluoride exposure or tetracycline use during childhood. One of the more common causes, though, occurs from root canal treatments used to remove the remnants of the pulp tissue inside a tooth’s pulp chamber and root canals. Certain cements used during the procedure to help seal in the filling material and leftover blood pigments can cause the tooth to darken over time.

To alleviate this discoloration, we use a bleaching agent, usually sodium perborate mixed with a diluted solution of hydrogen peroxide to achieve a safe, accelerated color change. After determining that the root canal filling is still intact and the bone is healthy, we create a small cavity in the back of the tooth to access the pulp chamber. The chamber is cleaned of any debris or stained material and then thoroughly irrigated. The original root canal filling is then sealed off to prevent leakage from the bleaching agent.

We then place the bleaching agent in the cleaned-out space with a cotton pellet and seal it in with a temporary adhesive. This step is repeated for several days until we achieve the desired shade of white. Once that occurs we then seal the dentin with a more permanent filling and then restore the cavity we created with a composite resin bonded to the enamel and dentin.

If we’re successful in achieving the desired color, intrinsic whitening could help you avoid more costly options like veneers or crowns for an otherwise healthy and attractive tooth. The end result would be the same — a beautiful smile without those unsightly stains.

If you would like more information on treating internal tooth stains, 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 “Whitening Traumatized Teeth.”


By Eric Romano DDS
January 07, 2019
Category: Oral Health
Tags: fluoride  
ModerateFluorideUsePackstheBiggestPunchforDecayPrevention

In the battle against tooth decay, fluoride is an important weapon. Since the discovery of its dental health benefits a century ago, fluoride has been credited with saving countless teeth.

But over its history in dental care, this natural-occurring chemical has also had its share of controversy with concerns raised from time to time on potential health dangers. These run the gamut from “conspiracy theory” speculations to credible research like a 2006 National Research Council study that suggested a possible increased risk of bone fracture or cancer from over-consumption of fluoride.

Even so, there is actually little evidence or even record of incidence for such dire consequences. The only definitive health effect from fluoride found after decades of copious research is a condition called fluorosis, a permanent staining effect on the teeth. Fluorosis poses a cosmetic problem but does not harm the health of the teeth.

Moderation in fluoride use seems to be the key to gaining its health benefits while avoiding fluorosis. One influential fluoride researcher, Dr. Steven Levy, estimates 0.05-0.07 milligrams of fluoride per one kilogram of body weight (about a tenth the weight of a grain of salt for every two pounds) is sufficient to gain the optimum dental benefit from fluoride.

The real question then is whether your family’s current consumption of fluoride is within this range. That will depend on a number of factors, including whether your local water utility adds fluoride to your drinking water supply and how much. You may also be ingesting fluoride through processed foods, juices and even some bottled waters. And you can encounter fluoride in dental care including toothpastes and clinical treatments.

One way to moderate your family’s fluoride intake is to be sure all your family members are using the correct amount of fluoride toothpaste for their age while brushing. Infants need only a slight smear on the end of the brush, while older children can brush adequately with just a pea-sized amount. For other tips and advice, talk to your dentist about your family’s fluoride intake and how you might adjust it.

Even with the possibility of fluorosis, fluoride still provides an incredible benefit in preventing tooth decay. By understanding fluoride and keeping your intake within normal ranges you can maximize its benefit for healthier teeth and minimize the fluorosis risk.

If you would like more information on the role of fluoride in dental 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 “Fluoride & Fluoridation in Dentistry.”