Posts for: February, 2014

By Arnold Cutler, D.D.S.
February 24, 2014
Category: Oral Health
Tags: tooth sensitivity  
UnderstandingToothSensitivity

Tooth sensitivity is an all too common problem among dental patients. If eating certain foods or simply touching a tooth causes you pain, you should know why this may be happening and what can be done about it.

Tooth sensitivity occurs in most cases because the portion of the tooth known as the dentin has been exposed. The dentin contains nerve fibers that inform and alert the brain about the current environment of the tooth (temperature or pressure changes). The enamel protects the tooth from environmental extremes.

Receding gums are the most common cause for dentin exposure — the enamel only protects the crown of the tooth and is not present on the root of the tooth. Acids in certain foods can then begin to erode the dentin around the roots and expose nerves. Sweet items (mainly sugar) and temperature shifts irritate the nerve endings, causing pain.

While receding gums (most commonly caused by brushing too hard and too often) may be the most common cause for sensitivity, it isn't the only one — tooth decay may also lead to it. Untreated, decay works its way into the tooth pulp and irritates the nerves. Treating the decay and filling the tooth may also cause sensitivity unless the dentist places a lining designed to minimize it temporarily while the area heals.

Alleviating pain from sensitivity begins with how you brush your teeth. Remember: the goal of brushing is to remove plaque, which does not require vigorous action. Brush gently with a soft-bristled brush and not too often. We might even recommend not brushing a very sensitive tooth for a few days to give the tooth a rest. You should also brush with a toothpaste containing fluoride, which will help strengthen the tooth surface against the effects of acids and sweets.

During an office visit, we can also apply a fluoride varnish or use certain filling materials that will serve as a barrier for the sensitive area. For cases where decay has irreversibly damaged the tooth pulp, a root canal may be the best treatment.

Tooth sensitivity isn't necessarily something you have to live with. There are treatments that can relieve or lessen the pain.

If you would like more information on tooth sensitivity and what can be done about it, 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 “Sensitive Teeth.”


By Arnold Cutler, D.D.S.
February 21, 2014
Category: Oral Health
DealingWithDentalEmergenciesWhileTravelingAbroad

Traveling to faraway places is the stuff of daydreams for many people, and even more exciting when the dream comes true. But that excitement could be dampened should you ever be faced with the reality that your medical treatment options abroad can be quite different from what you enjoy at home in the United States.

Dental care is no exception. If you have a dental emergency abroad, you may be unpleasantly surprised at the lack of available care at the level of quality you’re accustomed to at home. It’s prudent, therefore, to take a few precautions before you go and do a little research on sources of dental care where you’ll be traveling.

Before your trip you should schedule a dental visit, especially if you have some lingering issues that need attending; you should also be sure to plan this well enough in advance to allow time for any subsequent treatment and convalescence. It’s especially important that you have damaged or cracked teeth treated, as well as complete any recommended root canals. You should also schedule a cleaning, and have any teeth with sensitivity issues checked for possible periodontal (gum) disease.

While you can significantly reduce your risk of a dental emergency before you travel, you can’t eliminate it all together — a problem could still arise during your trip. It’s advisable, then, that you bring along contact information for people or organizations that could assist you with obtaining medical or dental treatment. Your hotel concierge, the U.S. Consulate or Embassy, or even other Americans living or stationed in the country you’re visiting can be helpful sources of information. You might also contact the International Association for Medical Assistance to Travelers (www.iamat.org) or, if in Europe, the American Dental Society of Europe (ADSE) (www.adse.co.uk) for recommendations on care.

A dental emergency during foreign travel could turn that dream vacation into a nightmare. You can lessen the chance of that by taking these few precautions before you go.

For a copy of A Traveler’s Guide to Safe Dental Care, visit www.osap.org. If you would like more information on dental concerns when you are traveling, 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 “Traveling Abroad? Tips for Dealing with Dental Emergencies.”


By Arnold Cutler, D.D.S.
February 13, 2014
Category: Oral Health
Tags: tooth decay  
SavingaDiseasedPrimaryToothCouldBenefitFutureOralHealth

Dentists go to great lengths to save an adult permanent tooth. Even though restoration technology is incredibly advanced, none can completely replace the biological function of natural teeth. Treating a diseased tooth to preserve it is a high priority in dentistry.

It would seem, though, that a child’s primary (baby) tooth might not warrant the same treatment. Since the tooth eventually detaches from the jaw to make way for a permanent tooth, why save it?

It is worth the effort, because primary teeth provide more than a chewing function: they also serve as guides for their permanent successors. When they’re lost prematurely, the permanent teeth may not come in correctly, leading to a malocclusion (poor bite). Other areas of development, like speech and dental bone growth, may suffer as well from the longer time gap between the premature loss and the permanent tooth eruption.

Saving an infected primary tooth should be considered, especially if significant time remains in its lifespan. Due to differences between primary and permanent teeth, though, the treatment approach isn’t the same. For example, the body gradually absorbs the roots of a primary tooth (a process called resorption) as the permanent tooth beneath erupts applying pressure to the primary roots (this is what enables its eventual detachment). Dentists must factor this process into their diagnosis and treatment plan for a primary tooth.

The level of treatment may vary depending on how deep the infection has advanced. If the decay is limited to the tooth’s outer layers and only partially affects the pulp, the innermost layer of the tooth, a dentist may remove as much soft decay as possible, apply an antibacterial agent for any remaining hardened infection, and then restore the tooth with filling materials.

For deeper infection, the dentist may remove some or all of the pulp, disinfect and clean the area, and then fill and seal the empty space with a filling. A filling material like zinc oxide/eugenol paste should be used that’s capable of resorption by the body to coincide with the natural root resorption. After treatment, the tooth should continue to be monitored for changes in appearance or gum swelling, just in case the infection returns or advances.

Although it may seem counterintuitive, treating a primary tooth as you would its successor is worth the effort. Your child will reap the health benefits, both now and long after the primary tooth is gone.

If you would like more information on endodontic treatment for children, 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 Arnold Cutler, D.D.S.
February 05, 2014
Category: Dental Procedures
Tags: denture  
ImmediateDenturesBridgetheGapBetweenToothLossandRestoration

Losing all of your teeth can be both physically and emotionally traumatic. Patients in this condition may need a period of transition from this loss to their permanent restoration. That’s the purpose of “immediate” dentures.

An immediate denture is a tooth appliance available for placement immediately after the final extraction so the patient’s ability to eat and speak isn’t unduly hampered (it also helps preserve their facial appearance). An immediate denture is a temporary measure until a more permanent replacement is achieved; hence, they’re not intended for long-term use.

Over time an immediate denture’s fit will deteriorate. This is because as the gums heal after extraction, and without the natural teeth present, the underlying bone and gum tissues will shrink significantly. The denture fit becomes looser, which leads to movement of the denture within the mouth. This can cause a good deal of discomfort emotionally and physically, and make it more difficult to eat and speak. It’s possible, however, to reline the immediate denture to fit the gum shrinkage and gain more service from it.

At some point, though, it’s necessary to transition from the immediate denture to the permanent restoration. If the permanent solution is a removable denture, we will need to wait until the gums have completely healed. At that time we will make a new and accurate impression of your mouth that reflects any changes since extraction. Even with this high level of accuracy, though, the final fit will depend on the amount of remaining bone and gum tissue needed to support the denture.

There are other options besides a removable denture. We can install a pair of implants in conjunction with a removable denture that can stabilize and retain it in the mouth; implants can also support a fixed bridge. You should weigh all the advantages and disadvantages to these options (including cost), to determine which one is the best solution for you.

In the meantime, the immediate denture will enable you to function in a normal manner, as well as aid with your appearance. Remember, though, it’s only meant for a short period of time — at some point you will need to transition from “immediate” to a more permanent and satisfying replacement.

If you would like more information on dentures, 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 “Immediate Dentures.”




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