Posts for: August, 2013

By Arnold Cutler, D.D.S.
August 29, 2013
Category: Oral Health
TaketheScreamOutofIceCream

“We all scream for ice cream,” the saying goes. But what if eating ice cream — or any very cold or hot food — literally makes you want to scream because your teeth hurt so much?

What causes sensitivity in teeth?

Understanding the anatomy of a tooth helps explain what happens when a tooth becomes sensitive to heat and cold. A tooth is composed of three types of tissue: a hard outer shell of enamel, the body of the tooth composed of the dentin, and an interior tissue of the pulp.

Enamel: The enamel forms the outside of the crown, the part of the tooth you normally see. Made of densely packed crystals of calcium, it is resistant to wear. It is not living tissue, and does not contain nerves, but it is capable of transmitting temperature like hot and cold.

Dentin: Inside the tooth's crown and root is a living tissue called dentin, which is a porous structure similar to bone. It is composed of microscopic tubules containing living cells, which are encased in a hard substance made of calcium crystals.

Pulp: The living dentin transmits sensation through to the pulp, which is in the center of the tooth and contains the tooth's blood vessels and nerves.

A tooth's enamel normally protects the dentin from exposure to extremes of temperature and pressure. If you wear away the enamel and expose the dentin, it will pass sensation through to the nerves in the pulp more directly. The result can range from a twinge to an excruciating pain.

Sensitivity can be caused by:

  • Overzealous tooth brushing resulting in enamel wear and consequently dentin exposure and wear.
  • Enamel and dentin erosion by acids in the foods and beverages you eat and drink.
  • Tooth decay — the most common cause of sensitivity. Decay destroys enamel and dentin inflaming and infecting the living tissues of the pulp, which become increasingly painful.

What can you do to make your teeth less sensitive?

  • Use a soft bristle tooth brush, and brush the affected teeth gently to remove all bacterial plaque. We can advise you on safe and effective brushing techniques.
  • Use toothpaste that contains fluoride. Fluoride strengthens tooth surfaces and makes them more resistant to sensitivity and decay.
  • Ask us about professionally applied fluoride varnishes or filling materials that can cover and replace sensitive or lost tooth structure.

Of course, if the problem is caused by tooth decay, make an appointment with us to remove the decay and place a filling in the sensitive teeth.

Contact us today to schedule an appointment to discuss your questions about sensitive teeth. You can also read the Dear Doctor magazine article “Sensitive Teeth.”


DentalImplantsandNaturalTeeththeSimilaritiesandtheDifferences

You've probably heard about dental implants — today's best option for replacing missing teeth; maybe you even have one or more already. A dental implant is a tiny screw-shaped metal post that sits in your jawbone and supports a lifelike dental crown. Natural teeth and implant-supported teeth have differences and similarities.

The main difference between implants and natural teeth — besides the fact that you were born with one and not the other — is the way they attach to your bone. Implants actually fuse to the bone, becoming part of it. This is a unique property of titanium, the metal from which implants are made. Maintaining that attachment is extremely important; we will discuss how best to ensure that in a moment.

Natural teeth do not ever become part of the bone that surrounds them. Instead, they attach to it via the periodontal ligament (“peri” – around; “odont” – tooth), which is made up of tiny fibers that go into the tooth on one side and the bone on the other. These fibers form a sort of hammock for each tooth.

Another difference is that natural teeth can decay while implant-supported teeth can't. But that doesn't mean you don't have to worry about dental hygiene — far from it! And here's where we get to the main similarity: oral hygiene is extremely important to maintain both teeth and implants. Lax oral hygiene for either can result in bacterial infections that may lead to gum disease, and even bone loss.

The main enemy of a properly fused implant is a bacterial infection known as “peri-implantitis” (“peri” – around; implant “itis” – inflammation), which starts when bacterial biofilm (plaque) is allowed to build up on implant-supported crowns. Peri-implantitis can lead to a well-like or dish-shaped loss of bone around the implant, which in turn can cause the implant to lose its attachment to the bone. If this happens, the implant can no longer function. Fortunately, this infection is preventable with good brushing and flossing techniques at home, and regular professional cleanings here at the dental office.

So another similarity, then, is that natural teeth and implants can last a lifetime with proper care. And that's the result we're aiming for!

If you would like more information about dental implants, please call us or schedule an appointment. You can also read more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”


By Arnold Cutler, D.D.S.
August 14, 2013
Category: Oral Health
WarningSignsofGumDisease

Do you frequently experience bleeding gums during your daily brushing routine? You might assume that you are brushing too hard and that this bleeding is normal. However, you should know that any bleeding of gum tissue is abnormal and should be considered a potential sign of gum disease.

Gum tissues usually bleed because of dental plaque buildup from poor oral hygiene practices. When the plaque is left around the gum line for a long period of time, 24 hours or more, the gum tissues respond by becoming inflamed — this can quickly become a chronic inflammation.

Here are some other warning signs of gum disease:

  1. Bad Breath. Bad breath is one of the most common signs of gum disease. This is especially true for those who do not floss, because plaque collects in the protected areas between the teeth making them especially prone to gum inflammation. This plaque often produces a pungent smell that causes bad breath.
  2. Red or Sensitive Gums. If you look closely in the mirror, you might see redness of the gums. It may also seem as if your gums are swollen, and in more advanced cases, this can lead to receding gums. Finally, you might notice gum sensitivity when you brush or a sensitivity to hot and cold.
  3. Tooth Loss. If this disease goes untreated, over time, bone loss will cause loose teeth, movement or migration of the teeth into a new and unstable position, and ultimately tooth loss. The rate of progression will depend upon the type of gum disease that you have.
  4. Painful Gums. Once you start to feel acute pain and extremely sore gums, this may mean you have developed a periodontal abscess. When this happens, the bacteria are walled off inside a gum “pocket,” and since your body's defenses are overwhelmed, there is a battle between the bacteria in that pocket and your body's defense mechanisms. The result is a collection of pus and extra bone loss. Your gums will be sore, swollen, red and may even discharge pus.

As you can see, the further the disease progresses, the greater the amount of pain and damage that will occur. Therefore, upon the first sign of gum disease, such as bleeding gums, you should schedule an appointment with us immediately.

If you would like more information about gum disease, please contact us. You can also learn more by reading the Dear Doctor magazine article “Warning Signs of Gum Disease.”


By Arnold Cutler, D.D.S.
August 06, 2013
Category: Oral Health
WhyBabyTeethNeedBabying

Even though they eventually fall out, primary (baby) teeth play several vital roles in your child's development. Among other things, they serve as important guides for the developing permanent teeth that will replace them. If any are lost prematurely, the remaining baby teeth start to shift, migrating forward, decreasing the space necessary for the permanent teeth to erupt into their proper positions. This could result in a need for future orthodontics that may have been unnecessary. So it's important to keep primary teeth healthy and in place until they are ready to come out naturally.

Signs & Symptoms of Teething

Primary (baby) teeth typically begin emerging between six and nine months, though as early as three or as late as 12 months can occur. Usually, but not necessarily, the two lower front teeth appear first. All 20 primary teeth are generally in by the age of three.

Some typical signs of teething include: irritability, gum swelling, gnawing, drooling (due to increased saliva production), chin (facial) rash (due to excessive drooling), disrupted sleeping patterns, ear rubbing, and decreased appetite. Symptoms generally start about four days before a tooth emerges, are most intense during the week when the tooth breaks through the gum, and subside about three days following the event.

You may notice small, bluish, translucent “eruption cysts” on your baby's gum where a tooth is breaking through; sometimes blood mixes with the fluid in a cyst, at which point it's called an eruption hematoma. Both generally disappear on their own when the tooth erupts and pops them.

Suggestions for Soothing

To help keep your teething baby as comfortable as possible, try the following:

  • A chilled rubber teething ring, pacifier, or cold wet washcloth
  • Gentle gum massage using a clean finger
  • Cold foods like popsicles when your child is old enough (just be careful about feeding him or her too much sugar, which can cause decay even in newly emerging/emerged teeth)
  • Over-the-counter pain medication such as ibuprofen or acetaminophen in the appropriate dosage

The onset of teething is the perfect time to begin focusing on your child's pediatric dental care. Even though baby teeth eventually fall out, the quality of their care will have a direct and long-lasting impact on the health of the permanent teeth that follow.

If you would like more information about baby teething, 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 “Teething Troubles.”




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