Today’s dentist can not only treat most dental diseases and conditions, but can almost prevent disease completely. Our true needs as a society, however, go beyond the dentist’s chair — to the lack of availability and affordability of care for every American.
That’s of grave concern to dentists — so much so that dentistry itself is already changing to meet these challenges.
In one of the most visible changes, we’re seeing accelerated technological advancement that could lower costs and extend our range of care. Advances in 3-D digital imaging are giving dentists amazingly detailed views of patients’ mouths that surpass the accuracy of traditional imaging. Telecommunications and the internet are enabling dentists in distant locations to examine patients and even review dental x-rays to guide treatment, providing a new level of care access for patients.
The means for delivering that care are also changing as the traditional paradigm of the solo practice becomes more difficult for new dentists to achieve. With educational debt and practice setup costs reaching as high as $1 million — before earning their first dollar — many dentists are joining larger groups or dental corporations. In these arrangements, practitioners don’t have the burden of overhead expenses and can concentrate mainly on their clinical work. On the downside, patients seeing multiple providers may not easily build that all important dentist-patient relationship that’s the hallmark of a solo practice. This alternative model could, however, increase the number of practicing dentists over time, making dental care more widely available.
Finally, we’re beginning to see greater collaboration between physicians and dentists. There’s an emerging understanding of the true interconnection of the body’s various systems: diseases of the mouth can affect other diseases of the body, and vice-versa. We’re also experiencing a growing development in salivary diagnosis, using this vital oral fluid to detect conditions and disease in other parts of the body. Dentists and physicians will be working more closely than ever to treat the whole person, not just individual systems — a collaboration that will improve patient care all around.
As these changes continue to emerge in dentistry, you may soon see their effects during your visits. One thing, however, won’t change — the commitment of dentists to provide the highest level of care, for both your oral and general health.
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
“Don’t panic” is your first priority when faced with a sudden mouth injury. Of course, that may be easier said than done when you or a family member has just experienced a chipped, fractured or even dislodged tooth.
It helps, therefore, to have some idea beforehand on what to do and, especially, when to do it. You should think in terms of immediate, urgent and less urgent injuries: a tooth completely knocked out of its socket requires immediate action — within 5 minutes of the injury; a tooth that’s moved out of its normal position but still in the socket is an urgent matter that needs professional attention within 6 hours; and a chipped tooth is less urgent, but still needs to be seen by a dentist within 12 hours.
As you may have gathered, the most important thing you can do when a dental injury occurs is to contact our office as soon as possible. If for some reason you can’t, you should visit the nearest emergency center.
There are also some actions you should take for a knocked-out permanent tooth because there’s a chance it can be replanted in the socket if you act within 5 minutes of the injury. First, rinse the tooth with cold, clean water (bottled or tap) if it’s dirty. Be sure to handle it gently, avoiding touching the root. Grasping the crown-end with your thumb and index finger, place the tooth into the empty socket and push it firmly into place. Apply light but firm pressure with your hand or a wad of wet tissue to make sure it doesn’t come out. Don’t worry about correct alignment — we can adjust that later during examination.
If the tooth is chipped or broken, try to locate the broken pieces — it may be possible to re-bond them to the tooth. You should store them in a container with milk or the injured person’s saliva (the same can be done for a knocked out tooth if reinserting it isn’t practical). The broken pieces should then be transported with the injured person to emergency treatment.
Taking these actions may not ultimately save a traumatized tooth, but they will certainly raise its chances for survival.
If you would like more information on preventing and treating dental injuries, 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 Field-Side Guide to Dental Injuries.”
If you ever get out of the habit of daily brushing and flossing, you’re setting yourself up for dental disease. Neglecting oral hygiene allows bacterial plaque to build up on tooth surfaces, which can give rise to aggressive gum infections known collectively as periodontal (gum) disease.
Gum disease may first manifest itself as gingivitis, an inflammation of the outer gum tissues around teeth. Resuming hygiene habits could help reduce the infection if it’s detected early enough. If the infection has spread deeper below the gum line, though, brushing and flossing won’t be able to reach and remove the offending plaque — you’ll need our help with that.
The objective of any such treatment is the same as your daily brushing and flossing — remove plaque as well as hardened deposits (calculus) that cause disease. The most basic technique is called scaling in which we use specialized hand instruments (scalers) or ultrasonic equipment to loosen and remove the plaque and calculus from all tooth and gum surfaces.
For deeper plaque, we may need to use a technique called root planing. As its name implies, we use equipment similar to scalers to shave or “plane” plaque, calculus, bacteria or other toxins from the roots that have become ingrained in their surfaces.
These procedures are often carried out with local anesthesia to ensure patient comfort and allow us to be as meticulous as possible with plaque and calculus removal. It’s imperative that we remove as much plaque and calculus as possible, and which often involves more than one session. This is because as the gum tissues become less inflamed it allows us to access more plaque-infested areas during subsequent sessions.
Hopefully, these techniques will arrest the infection and restore good health to gum tissues. It’s then important for you to recommit and follow through on a renewed daily hygiene regimen to reduce the chances of re-infection that could lead to more serious problems and potential tooth loss.
If you would like more information on treating periodontal (gum) 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 “Root Planing.”
For over half a century, dentists have promoted a proven strategy for sound dental health. Not only is this strategy effective, it’s simple too: brush and floss every day, and visit your dentist at least twice a year or as soon as you see a problem.
Unfortunately, this strategy isn’t resonating well with people between the ages of 18 and 34, known more commonly as the “millennials.” A recent survey of 2,000 members of this age bracket found a startling number: over one-third didn’t brush their teeth as often as recommended, some going as long as two days between brushings. About the same number also reported fear of dental visits. Given all that, the next statistic isn’t surprising: tooth decay affects one in three people in the millennial age group.
This isn’t to pick on millennials, but to point out that good oral hygiene naturally leads to good oral health, regardless of age, gender or ethnicity. Here’s more about the dental care basics for better health.
Brush twice, floss once daily. The American Dental Association (ADA) recommends a thorough brushing with toothpaste containing fluoride twice a day. You also shouldn’t neglect a once a day flossing between teeth to remove plaque from areas brushing can’t effectively reach. Keeping plaque accumulation to a minimum is the best way to prevent diseases like tooth decay or periodontal (gum) disease.
Visit your dentist at least twice a year. Dental visits every six months (or more if your dentist recommends it) accomplish two things: a professional dental cleaning removes any buildup of plaque and tartar (calcified plaque) missed by daily hygiene. It also allows your dentist to inspect your teeth and gums for any signs of disease that may require treatment.
See your Dentist ASAP if you notice problems. You should also see your dentist sooner if you notice anything abnormal like unusual spotting on the teeth, tooth pain or sensitivity, or swollen, reddened or bleeding gums. These are all signs of disease, and the sooner it’s treated the less chance your teeth and gums will suffer serious harm.
Like other age groups, millennials know the importance of a healthy smile, not only for social and career interaction, but also for their own personal well-being. Sticking to a regular dental care program is the primary way to keep that healthy smile.
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