Typically, If you describe someone as being ‘long in the tooth’, you are saying derisively or humorously that they are old or aging.
However, there may be more at stake than hurt feelings.
Clinically speaking, having an unusually long tooth or teeth can be symptomatic of a much bigger problem. Gum disease.
My Tooth Became Really Big. Can You Help Me?
I saw this new patient last week, and she was correct. When you looked at her, all that you saw was one tooth. I don’t mean that one tooth was all that was present. She has many teeth that show when she smiles and talks. What I am referring to is one tooth that stands out more prominently than all of those around it. She was literally ‘long in the tooth’.
How did it stand out? First of all, it was much longer than the teeth on either side. It was her cuspid, or “eye tooth” as people commonly refer to it. The tooth is a large tooth, to begin with, but this was even larger and more prominent than we usually see.
The tooth was also pushed forward. When a front tooth is pushed forward, two things can result. First of all, the tooth may bite on the lower lip and therefore feel strange. It also causes a protrusion of the upper lip.
To top off these calls to attention by the tooth, the color of this tooth was whiter than the rest.
Gum Disease Spreading to the Bone
I recently wrote about shorter teeth. Shorter teeth come as the result of years and decades of wear of the biting surface as we get older. I also mentioned some teeth could do just the opposite. They appear to get longer as the gum and bone shrink a little away from the tooth.
My new patient was not an example of either scenario. Her tooth got much “longer” because of gum disease.
Gum disease starts in the gums and then spreads to the bone. This condition is a bacterial infection that will destroy the bone in which the tooth rests. If the disease damages all of the bone, then the tooth will become loose. If you are lucky enough, you won’t experience any pain, and one day, the tooth will fall out of your head. More likely than not, you will have swelling and discomfort requiring help from a professional to either save the tooth or remove it, depending on the severity of the situation.
A Good Analogy
Once the bone is attacked and slowly is destroyed, the tooth loses its primary stability. Let me give you an analogy. Think of a post implanted in the ground. If the earth is covering a good portion of the post, then the post remains stable. If the ground erodes away from the post and more post is above the surface than in the earth, instability will appear. The post will become movable, and if pressure is applied, it will no longer stand perfectly straight. It will start to lean to one side or the other.
The same thing happens to a tooth with gum disease, and this is what I saw in the mouth in question. Fortunately for her, the bone destruction did not extend significantly to the adjacent teeth. I recommended removing the tooth and replacing it.
As for the fact that this tooth was also whiter than the rest is because she had an old crown on the tooth. That crown matched her teeth years ago and was thus whiter. No matter how I replace the tooth, I would correct the color and make it match its neighbors.
So how did I plan on replacing the tooth after removal? Our choices were either a single implant or a permanent bridge which can’t come out.
After an evaluation, I recommended a bridge for two main reasons.
1. The first reason centers on the fact that the bone loss was resulting in the bone moving upwards. If I placed an implant, the resultant tooth would be very long.
Remember that was one of her initial concerns. A permanent bridge would deal with this long tooth issue better.
2. Secondly, I would utilize my “Same Day-Immediate Bridge” technique that I developed. It allows me to remove a tooth and provide a replacement in usually less than an hour. We did that, and she left with a stunning and much-improved smile.
Taking Advantage of Our “Better Than Insurance” Program
Best of all, she took advantage of our “Better than Insurance” program that I mentioned in the last couple of columns. Rules do apply, but she met all of the criteria and saved 20% of the fee. She looked terrific, and we saved her money! Another happy customer and a healthy smile!
Call Megan today at 440.951.7856 and find out about our “Better Than Insurance” initiative to save you money and preserve your smile for a lifetime.
The subject of tooth problems during the holiday season seems to come up every year, and I address this issue in the office with my patients.
Whenever I respond to a question, it is vital for me to clarify the scope of the problem.
Christmas and New Years coincide with the influx of cold weather. Cold weather effects are enough by itself to cause my phone to ring off the hook. However, I hope to address that unique problem in another column.
Today, I want to focus on the overuse, abuse, and neglect that our teeth get this time of the year.
I want to offer a few tips to reduce the need the for a call to me in the short run and help keep your mouth healthy in the long term.
I want to teach you how to avoid tooth problems during the holiday season.
The December sugar rush
Sugar abounds in December. The closer we get to Christmas, the more the sugary treats flood into our lives. Don’t worry; I am not going to preach avoidance of those treats.
Cookies, candies and special baked goods are all part of the festive atmosphere that is so much fun. Having said that, what can we do to limit the damage that these foods cause?
Sugar is the lifeline for cavity-causing bacteria
Remember, that sugar is the lifeline of the bacteria that attach to our teeth and gums. These bacteria congregate where sugar collects on the teeth and produce acid and other damaging waste products. These chemicals eat away at our teeth and cause cavities.
Control your exposure
One key to minimizing the adverse effects of sugar is to control how much exposure we have to it. The frequency of exposure will determine how detrimental our sugar indulgences are for us.
Sitting in the office all day long and munching on a can of cookies and treats is the worst thing that you can do. It is far better to eat all that you want in a shorter interval than to graze this food all day long. The bugs in your mouth have a field day with this as they’re partaking of a non-stop buffet of sugar.
Nuts. The healthy holiday snack alternative!
But you are going to tell me that part of the fun is eating all day long. Trust me; I get it. I would like to suggest that you break up the sugar gorging with other foods. Nuts abound this time of year. Every store that I walk into has a display of “holiday nuts.” It would be a great idea to bring these into work. You can either bring them for your stash or contribute to the greater good.
Walnuts are a great resource to keep cholesterol in check and act as an anti-inflammatory component benefiting our entire body. They are also shown to help with moods. So many people have stress and family issues around the holidays that any help that we can find is a plus.
Let’s not forget chestnuts. Remember Nat King Cole’s ‘The Christmas Song’! Chestnuts are lower in calories when compared to other nuts, an excellent source of fiber for your diet and rich in Vitamin C. Their hypoglycemic index is low which makes them perfect for people who struggle to maintain proper blood sugar levels.
Macadamia nuts and Pecans
What about nuts that are high in calories like macadamia nuts and pecans?
According to Michael Greger, M.D., one of the leading nutrition physicians today, nuts, in general, do not cause weight gain. This is true even though they are composed of fats and therefore loaded with calories. He states that
“ Part of the trick seemed to be that nuts boost fat burning within the body. It could have something to do with the amino acid arginine or the phytonutrients found in nuts…”
Nuts and seeds are linked to lower heart disease and longer life. Personally, I snack on nuts and seeds every day. My patients know that I do not have a weight issue.
How to offset all that sugar!
Lastly, what can we do to help mitigate some of our overeating and indulgences? You all know where I am going with this. Let’s be extra diligent in our oral care at home. Spend more time brushing, flossing or using a water-jet device. In fact, this would be a great time to buy an electric toothbrush for you and the family. Oral hygiene can fix and erase some bad activities during the day and not give bacteria a foothold in our mouths. Don’t let a tooth issue ruin your fun in the upcoming days.
Now that you know how to avoid tooth problems during the holiday season, practice proper prevention techniques to control the problems.
If you develop a problem, we are working and not taking any time off. Please call me at 440.951.7856 so that I make sure that you enjoy every moment of the season.
As the Fall and Winter months come upon us, let’s discuss how proper nutrition and specifically Vitamin D can help us achieve and maintain excellent oral health, even as the days grow shorter.
Is There A Pill That I Could Take To Improve My Teeth?
Would it only be that simple? In fact, I would keep it in my drawer next to my diet and exercise pill. However, let’s talk about some simple methods that may make a positive impact on our mouths.
It is somewhat amusing that this subject came up now, near the end of October. We are fast approaching our semi-annual activity of clock changing. This Saturday night we will move our clocks one hour backward as Daylight Saving Time is over for 2017.
(By the way, even though Daylight and Savings (with an “s” at the end) rolls beautifully off of our tongues, the correct term is Saving without the “s” at the end.)
Changing the clock, together with the advance of winter, creates a particular challenge for those of us who live in the Northern Hemisphere. Winter is a fast approaching and the available hours of daylight are dwindling. More darkness is the theme of the day.
Many studies talk about depression in the winter as related to less sunshine. I am not going to focus on that in this column. I want to talk about one of the latest trends in medicine. The idea of Vitamin D levels and their role in our general health.
Vitamin D is a misnomer
The truth is, Vitamin D is a misnomer. In fact, it is a hormone, not a vitamin. A vitamin is something that is part of our diet. If we don’t eat foods that contain a particular vitamin, we will be deficient in that vitamin and develop a disease. At one time beriberi was an incurable disease until it was found to come from a vitamin deficiency. Vitamins are compounds that the body can not make on its own, but instead, relies on our diet to supply these essential chemicals.
Michael Holick, Ph.D., M.D., who is one of the leading authorities in the science of Vitamin D, explains the difference. A hormone is something that the body makes if given the right ingredients. This hormone then goes to other parts of the body where it regulates many various functions. As such, Vitamin D is not a vitamin. It is a hormone.
Vitamin D production requires sunlight
Vitamin D manufacture relies on an outside source to start the process. That external source is sunlight. The ultraviolet B portion of sunlight initiates a mechanism to create pre-vitamin D3, which then turns into Vitamin D.
So Vitamin D is made in the skin with the addition of sunlight. We now understand why the levels of Vitamin D are so low in the winter. We are missing our precious sunshine.
How Vitamin D affects our oral health
An article from the Journal of the Tennessee Dental Association in 2011 tells us that Vitamin D deficiency “may place patients at risk for not only low bone density, (i.e., osteopenia and osteoporosis) but all infections and chronic inflammatory diseases”. So not only does Vitamin D affect the strength of our bones around the teeth, but it also may protect the gums from developing periodontal disease.
I have seen many patients who don’t have the most excellent health habits, yet their gums are remarkably stable. I always referred to this as the hidden genetic protection that was present in those patients. It is also possible due to resistance to the disease process because of proper levels of Vitamin D.
More and more healthcare professionals are recommending taking Vitamin D supplements to aid in our low levels because of where we live. Many physicians that I speak with talk about 2000 IU of Vitamin D and go up to 4000 IU taken daily. Personally, I ingest 3000 IU on a daily basis. Of course, the correct way to proceed is to get your Vitamin D levels checked and if low (which they probably will be in Northeast Ohio) take a supplement and recheck in 3 months to make sure that you are on the right path.
There is a pill to help improve our oral health!
So one pill that we can take to help our mouths is Vitamin D. This is not a substitute for outstanding oral care which includes proper brushing and flossing techniques. Reduction of candies and sweets (yes, Halloween is this week) is also very important.
Professional cleanings from our excellent hygiene staff and periodic exams to keep you on track are all crucial.
Call Megan today at 440.951.7856 and find out about our “Better Than Insurance” initiative to save you money and preserve your teeth for a lifetime.
Why did I buy dental insurance if it doesn’t cover this procedure?
Have you ever needed a dental procedure done only to find out your insurance doesn’t cover it? In dismay and frustration you ask the obvious question – ‘ What’s the point of dental insurance if it doesn’t cover this necessary procedure?’ I have been asking my patients that question for decades. The answer goes to the heart of the insurance industry and revolves around why we buy insurance.
Insurance companies prey on the uncertainty
Insurance, whether life, disability or health care insurance all thrive due to the fear factor. We are all, and rightfully so, concerned about some unseen event which will alter our way of life. This event usually has a financial impact on our families and us. Along comes the insurance company and offers us a solution to the problem. They say: “Give us some money, and we will take the uncertainty out of your future. You or your family will not have to worry about going down this road. We will take care of you.”
Insurance companies are like Vegas casinos
We must remember that insurance companies are big business. They have two items on the agenda. First of all, they have to be there when you need them. Secondly, they have to turn a profit like all businesses must do. To reach these goals, they create products based on extensive data. Much like going to Las Vegas, you can never beat the house. Of course, someone will win on occasion, but this does not usually make a dent in the overall picture. As in Vegas, there are more losers than winners in the insurance gamble.
However, despite this knowledge, we still search for a product that will cover us. We believe the sales pitch and buy the product. Insurance companies take our money, and we rarely see results. This is all a function of numbers and what is being paid for a premium.
Ways the insurance company avoid paying for your dental procedures
There are many ways for an insurance company to avoid paying for a dental procedure. Usually, it comes in the form of two clauses in the contract.
The Alternate Benefit Clause
The first is called the Alternate Benefit Clause. This exception is very common and is found almost universally. It states that if there is a less expensive way to do a treatment, that is all that they will cover. Much like an adjuster on a car or house damage claim. The insurance company will adjust downwards the amount that you think that they should pay. Remember, what I mentioned earlier that insurance companies need to turn a substantial profit to stay in business. One such way is to limit the amount that they pay for a claim. That limitation has a direct impact on you. So, in a dental example, if you are missing teeth on both sides of your mouth and chose wisely to replace them, you will be limited in your choice of placement. The insurance company will only pay a portion (that’s another story) of a removable partial denture even if you desire, and your doctor recommends, something permanent and not removable. So now you have dutifully paid your premium and get pennies on the dollar in return for these monies that you gave them. Sure sounds like Vegas to me.
The Missing Tooth Exclusion
The next clause that we see often is a called a ‘Missing Tooth Exclusion’. This paragraph in your policy says that if you are missing teeth before going with this insurance company, there are no funds to improve your health with their help. They will not pay at all for your replacement teeth. This is true even if you and your doctor choose an inexpensive treatment. So with this clause, not only do they downgrade your benefits, they go even a step further. They refuse to pay anything towards improving your health.
Almost all insurance companies will help you on cleanings and checkups. Only a handful will make a meaningful contribution to the real reason that you purchased dental insurance.
I met a new patient yesterday who finally made up her mind to restore her mouth to a state of health. Some of her teeth were broken, and a number of them were missing. Much to her surprise, because of the Alternate Benefit Clause and the Missing Tooth Exclusion, she had ZERO coverage for her needs. Just imagine her shock and amazement. Premiums paid but real benefits are not there.
How to get the best dental coverage for your money
So what does one do to cover the expense of needed dentistry?
First of all, find a dental office that understands your insurance products and can guide and advise you if you do decide to purchase dental insurance.
Better yet, I would suggest that you take the money that you would pay for premiums and put it in a separate bank account so that you do not touch it. You are creating your own fund to handle unforeseen dental expenses.
Lastly, find a dentist that you can work with financially. Payment plans and discounts make life easier and allow you to reach our goal of dental health.
The “Better Than Insurance” deal of the year
We are already in October. I want to help you reach your optimal dental health by the time the holidays roll around.
To that end, we are offering the following “Better Than Insurance” Deal of the Year.
Anyone who comes in and begins a newly diagnosed treatment from now until the end of the November will receive an unlimited 20% discount. No procedure will be excluded. Rules do apply. Call Megan today at 440.951.7856 and schedule your appointment for the “Better Than Insurance” deal of the year.
Does it ever seem that your tooth size is longer or shorter than it was when you were younger? In this article, we explore the various reasons and causes of the changes in our tooth size.
Do our teeth get longer as we age?
There is an expression that I don’t hear that often anymore. The idiom is “long in the tooth.” This phrase is usually referring to someone getting older. It is based on the thought that teeth grow longer as we age.
Well, this is true when we are children and teens. As teeth start to come in or erupt, as we term it in dentistry, they appear to be growing.
They are not growing. In fact, when teeth are developing in the gums as children, they are adult size. As we get into our teen years, the teeth grow into the mouth. It appears that they are growing bigger, but in reality, they are just uncovering themselves from the gum tissue from which they were buried.
Less gum tissue = longer teeth
Teeth, for the most part, do not grow or move anymore once we reach our late teens. However, with time, gum tissues may shrink away from the tooth. Sometimes, we become very hard brushers and wear away our gum tissue. Gum tissue is fragile right around the tooth and can be easily brushed away. Now we see more enamel than we saw previously.
Other times, due to gum disease, a shrinkage of gum tissue may occur. This reduction happens as bacteria destroy the underlying bone and there is nothing to support the gum tissue.
In any of these cases, we see more tooth enamel. Making it appear that our teeth are longer than before. This condition occurs because more tooth is exposed above the gum line than what we may have observed in previous years.
Okay, I get it. As we get older, and our gums shrink, our teeth “appear” to get longer than they were in our youth. That’s what the idiom, “long in the tooth” means.
Why Are My Teeth So Short?
But wait! As we age, many of us see our teeth shorten. This phenomenon isn’t supposed to happen, is it? Well if the gum does not shrink away from the tooth, then the pseudo-growing phenomenon will not occur. That explains lack of getting bigger, but where does the shortness come from? Are the teeth shorter or do they just appear that way? Does it fool us as the tooth growing act fools us?
Our teeth DO shrink!
In reality, the teeth get shorter. It is not an optical illusion. The more we chew, the more our teeth wear.
Teeth are the hardest tissue in the body. They are denser than bone. It needs to be this hard as it is the first tissue encountered during the eating process. It needs to be very dense as it tears and grinds at food.
Ah, there is the answer to your question. We use our teeth to grind.
With modern dental care and a better understanding of what causes disease, we can keep our teeth for many years longer than previous generations. Because of this, we grind more food for more years. Over time, our teeth slowly wear away. If we are missing teeth, then the remaining ones work harder, grind more and end up wearing away more. This is how we get short teeth.
This condition is even more noticeable in the front of our mouths. Let me explain why this is so. The patient who asked me that question had their upper front teeth meet their lower front teeth. The teeth touched each other tip to tip. In dentistry, we call it “edge to edge.” Every time they chewed their food, not only did their back teeth grind, but their front teeth were grinding too.
Sounds great. After all, more teeth grinding is more efficient -right? Wrong!
The problem stems from the fact that the front teeth are narrow-edged. They are designed to tear, not to crush. When we use them to grind, they wear away very quickly. Grinding with our incisors creates short teeth and a loss of healthy cosmetics.
We identified the problems. Any solutions?
How do we fix this issue? I will give you some answers in our next column. Until then, if things are starting to change in your mouth and just don’t look right, please give me a call and ask me a question. I will do my best to help you. You can reach me at 440.951.7856
As a dentist, my primary concern for my patients is for the general health and durability of your teeth. Since they get used on a daily basis masticating, the obvious question of their ability to withstand wear, pressure, or damage comes to mind.
How long should my teeth last?
That’s a great question. Those of you who are regular readers probably know the answer to that. So let me put that aside for right now and ask you a question.
“How Long Will You Last”?
Not to be morbid, but of course, it is a legitimate question. In the Global Burden of Disease 2015 Study, dietary factors were the biggest cause of mortality in the U.S. That’s right! In the richest and most prosperous country, the way we eat was the most significant cause of death! In fact, according to a 2013 report from the Union of Concerned Scientists, an organization that has been around since 1969, increasing our consumption of fruits and vegetables could save more than 100,000 lives and $17 billion in health care costs each year from heart disease alone!
The foods that age us
Foods that age us are typically acidic. We in the United States can call these fun foods. They are fun and appealing because we have made them the main foods in our diet. Sugary foods and refined grains, processed foods, and red meat. All of these foods are showing up in association with many diseases.
The ‘Epidemic of Plenty’
Our biggest epidemic…the epidemic of plenty has resulted in too many people being too obese. In fact, the medical community has classified obesity as an ailment in and of itself.
Following along the same lines, heart disease and diabetes with their associated problems have changed happy and productive lives to a treadmill of doctor and hospital visits. Daily pills are the norm, not the exception.
Aging better is possible
We can’t stop aging, but we can control to an extent the quality of life as we age. We can see this addressed in many societies around the world who age much differently than we do.
Dr. Michael Gregor, a leading physician who emphasizes nutrition as the best medicine, echoes this sentiment. He discusses and recommends plants and fruit to stave off many diseases. Many plants have an antiplatelet effect on our system. Platelets cause the blood to become sticky and clot. Clots in our arteries cause heart attacks and strokes. One of the reasons that many of my patients take a baby aspirin daily is to counteract this clotting effect. The aspirin reduces the platelet activity and makes the blood thinner. Isn’t it amazing that plants will do this also, without any possible stomach issues as are those associated with aspirin? Strawberries and other berries will lower activated platelets. These activated platelets are loaded with inflammatory chemicals. So just by eating more fruits and vegetables we can potentially reduce or limit many debilitating disorders the ‘epidemic of plenty’ causes.
Your teeth should last a lifetime.
A plant-based diet can make sure of it.
Now we know the answer to our initial question. Your teeth should last your entire life. The reason is obvious. If we want to live a long and vital life, we need to have a diet that is plant-centric.
We need to be filling the majority of our plates with whole grains, vegetables, legumes, nuts, and berries. However, to consume these, we need strong, durable and healthy teeth.
First of all, a plant-based diet eliminates most foods that attack our teeth via their associated stickiness. Sticky foods attract a load of bacteria and the acid that they produce. That’s a fast track to dental cavities. It’s no secret that tooth decay is the number one thing that will compromise the durability of your teeth. Non-inflammatory foods allow our bodies to have greater resistance to disease in general. Including such plant-based foods into your diet translates into healthy gums and strong supporting bone.
Proper tooth maintenance is required
Grinding and chewing these fiber-filled foods efficiently & correctly requires healthy teeth and gums. Therefore, if you break a tooth, you need to have it fixed. In the event a tooth is lost, you need to replace it. Our mouth can be a very efficient device if we take care of it correctly. Unfortunately, many people take care of other machines in their lives better than their mouths. Not only is this disastrous for our oral health, but it is also detrimental to our general health. Proper nutrition can ensure you enjoy both for many healthy years to come.
If it has been a while since you had your teeth checked and evaluated to ascertain their level of health, don’t hesitate to call me. You can reach me at 440.951.7856. Megan will answer the phone and point you in the right direction.
I Hate Shots. I Wish That You Would Have Something Else!
Many years ago, just the opposite was stated. Dental anesthesia simply didn’t exist! There was really nothing to numb or deaden a tooth so it could be treated. The first local anesthetic used was actually cocaine. It worked but of course, it was addictive and toxic. It wasn’t until the beginning of the last century that our famous Novocaine came on the scene. In fact, it was so popular that many people today use the word to mean a local anesthetic.
Pain-free dentistry is now a reality!
We really don’t use Novocaine anymore in dentistry as it has been replaced by better anesthetics with fewer side issues. These newer products give better numbing, which we call “anesthesia” and work quicker. It would be an understatement to say that local anesthetic has revolutionized dental care. We can now perform a variety of procedures, whether simple or sophisticated with the patient being totally pain-free.
Before local anesthetic, the only treatment available was the removal of a troublesome tooth and of course was not a pleasant experience for any one. The ability to numb a tooth has led to more people keeping teeth for their entire lives, rather than being toothless in their twenties. So that’s great! We can do a dental procedure in a pain-free environment using a local anesthetic. The problem with this from the patient perspective is how we have to administer it. Of course, I am referring to the dreaded shot.
What is dental anesthetics?
Let’s talk a little about this. The method of action of a local anesthetic is to bathe the nerves that transmit sensation from the tooth to the brain in this numbing liquid. When the nerves come in contact with the solution they shut down and no longer do their job of sending a pain signal. This closed for lunch sign is effective until the anesthetic leaves the area of the nerve and sensation comes back to the tooth.
Different locations of the mouth have different requirements for giving the anesthetic. For the upper teeth, it is given one way. For the lower teeth, it is given another way. The upper jaw is much more porous than the lower jaw. Therefore, simply placing the anesthetic under the gum next to an upper tooth will cause the tooth to numb. The lower jaw is much denser and if you put anesthetic next to a tooth it will not penetrate the jaw and reach the nerves of the tooth. To numb a lower tooth, you have to find the nerve that supplies the entire side of the mouth and numb that. That is why we numb the back of the mouth when we work on lower teeth even though we may be working more towards the front of the mouth.
Did you know? There is now a nasal spray dental anesthetic!
The human body is a marvel of complication, sophistication, and crossovers when it comes to its various parts. Because of this, we now can actually numb many upper teeth without a shot. Yes, that is not a typo! We DO NOT need a shot for a number of upper teeth. Just last year the FDA approved a product called Kovanaze for use in dentistry for upper teeth. The product is a nasal spray that is given prior to performing dental work. It can numb the upper front teeth without the side effect of numbing the lips and cheeks. It is not for all teeth, but one of the most sensitive injections is in the front of the mouth. With this nasal spray anesthetic, those days are history.
Topical dental anesthetic for pain-free cleanings
Many people are sensitive to having their teeth cleaned. Because of this, they skip their very important dental cleanings and checkups and only come when it is too late. I use another product which can be squirted around a tooth without the use of a needle to numb the area. This can make your cleaning totally pain free.
Unlike the nasal spray, I can use this any place in the mouth. It doesn’t make a difference if it is an upper tooth with its porous jaw or a lower tooth with a dense jaw. This product simply works without having to use a shot. This product is called Oraqix (pronounced Ora-Kicks) and I have used it for a number of years to make routine procedures more comfortable and easier. When you are at ease, our work goes faster and is done much better. It is a win-win for all involved.
Today, Dental Anesthesia does not have to mean shots
So although needles have not left medicine, and dentistry, in particular, there are a number of innovations that work towards my goal in interacting with my patients. That goal is providing the best care with the most comfort. Needle free anesthesia is an example of that approach and desire. If these or other dental topics are intriguing and you want to learn more about new techniques and products, please call me. I can be reached at 440.951.7856 and look forward to hearing from you.
When one’s tooth is in need of repair it’s interesting to see how as doctor & patient, we each have different concerns when faced with a cracked/chipped tooth restoration procedure.
I’m Leaving Town Next Week. What Can You Do For My Broken Front Tooth?
This was asked to me by a patient that I have been privileged to serve for 38 years. Yes, we know each other very well and I am proud to say that she has all of her teeth. This is the result of she and I working together to maintain her oral health.
Her particular dilemma last week was that she was going away for a few weeks and her front tooth had fractured. She thought that time was the biggest issue in this case. “How will you get this done in time?” I had some other concerns. Let’s talk about her anxiety and later on my thoughts and worries on the matter.
Dental treatment and Tooth Restoration repair times
At times, certain types of dental treatment can take a long time to accomplish. If I can fix something in the office, then I am usually done in one visit. Problems of time develop when I need to collaborate with one of my dental treatment partners. Most notably, this is the dental laboratory One of the biggest things that slow us down can be laboratory time to make a dental replacement. Tooth restoration could involve crafting a crown, a denture or a variety of other dental devices that are custom made for your mouth. They could require a multitude of visits, impressions, phone calls and emails to the lab. This just slows everything down.
However, new digital technology can speed up a number of procedures and make long waits not relevant to many cases. They are not for everyone and every situation but when we can use them, they are fantastic. This was actually the case with my patient. We were able to use a special type of metal-free material and in just a few days get our final beautiful result.
A temporary and permanent solution
In the office, I tended to her needs and immediately began to fix her broken front tooth. With new in-office materials, I was able to obtain an acceptable temporary result before she left. The final, long lasting and highly aesthetic result needed my dental laboratory’s involvement. We chose a type of very cosmetic crown which can be made in a day. It turns out, that time, which she thought was a major issue, was really not a concern at all. Her new front tooth came back from the lab in plenty of time for her to catch her flight.
What I as a cosmetic dentist worries about when repairing a front tooth
I began this column with the comment that I had other concerns besides the time factor. My biggest worry was due to the fact that we were dealing with one of her smile teeth. Let me rephrase that. We were dealing with her very front teeth.
Matching a front tooth to its ‘twin’
One of the hardest things to do in dentistry from a cosmetic standpoint is matching a front tooth to its paired tooth. What do I mean by a “paired tooth”? Let’s draw an imaginary line right through the center of our nose in a vertical direction. Half of our teeth are on the right side of this line and half of the teeth are on the right side of this line. We call this line, the “midline”. All of our front teeth have a pair or a twin. One of these teeth is on the left side of the midline and one is on the right side of the midline. These two sides meet smack dab in the center. Our large front teeth, which we call central incisors are right next to each other.
When we need to fix one of them, the slightest difference between them in color or shape will be very noticeable. This is because this tooth’s partner or twin is right next to it. We spend a lot of time brushing our front teeth and see this pair of teeth the most. Matching them can be a real challenge. Sometimes, we are forced to treat both teeth in an effort to create a stunning result.
Both our concerns resolved to our mutual satisfaction
When I finally tried in her new front tooth, she said that I had a twinkle in my eye and a smile on my face. She knew that I had successfully dealt with my concern. I had created a natural look that both she and I were proud of.
The longer that I practice and see new innovations in the field, the happier I am for my patients. Dentistry can offer so many solutions to problems of the past.
If you have a cosmetic or tooth restoration concern, don’t hesitate to educate yourself. Call your dentist or call me, and let’s talk about your issues. I can be reached at 440.951.7856 and look forward to speaking to you.
There was a folk song that was popular many years ago that was entitled “If I Had A Hammer”. The lyrics began with “If I had a hammer, I’d hammer in the morning, I’d hammer in the evening, All over this land….” I thought of this song as I saw an ad in the paper for the use of mini-implants. The ad seemed to imply that instead of using conventional (whatever that may mean) implants, anyone can use mini-implants and get all the same results. The commercial said that these mini-implants were easier to place, took less time, involved faster healing, and were half the cost. It would seem anyone is a good candidate for mini-implants.
Sounds great right? Unfortunately, mini-implants are not the magic bullet some make them out to be. Let’s take a few minutes to learn together about this subject and why not just anyone is a good candidate for mini-implants.
What are Mini-Implants?
Mini-Implants are pretty self-descriptive. They are miniature versions of their big brother – traditional dental implants.
We all like small. We like items to be petite. Our phones have become miniature computers. There is even a brand of car that is becoming more popular call the Mini Cooper. In an era of super-sizing, being smaller and more compact is still a very positive attribute to have.
So it sounds like smaller, miniature implants are the new and improved implant. We have moved forward to this compact era. I can use a mini-implant wherever I previously used a conventional implant. Just like the song says: I would hammer in the morning…….” I would use my hammer everywhere and all the time.
Size – The Biggest Advantage and Disadvantage of Mini-Implants
The ad went on to say that healing is faster and the teeth can go in faster and the results are immediate. We all want this. Right? As with many things in life, if something was really true then everyone would be doing that thing. We need to talk about this. The biggest advantage to mini-implants is their size. The biggest disadvantage to mini-implants is their size! That’s right, the best thing about them is actually the worst thing about them.
Implants serve as a foundation for teeth in the mouth
Many years ago a wise oral surgeon told me that he always over-engineered his implant cases. He used the biggest and most implants wherever he possibly could. The reason was very simple. Implants serve as a foundation for teeth in the mouth.
When we build a house, for example, do you ever hear that the contractor uses mini-supports? Where we need to use studs every sixteen inches, do we put them every three feet? Of course not. We need to construct a structure that is solid and will endure the weight and other forces that may be put on it.
So I will ask you: Why do we think that we can skimp on support for teeth? We chew meat….we chew bread…we chew nuts. These and many other foods put many heavy forces on our teeth. We need support. We have at least twenty-eight teeth. Why do we need so many? Let us develop a few big teeth on some small roots and that’s it. These mini roots would make it easier to brush and floss. Our dental cleanings would go faster as there are fewer and smaller roots to develop tartar to clean.
The answer is obvious. It wouldn’t work. From a structural standpoint, it is faulty. We need enough teeth and large enough roots to handle all the forces of chewing. People with a full compliment of teeth and a healthy supporting gums and bone can exert the greatest biting forces. These forces are needed to properly eat our food and allow us to be nutritionally fit.
Where the greater force is exerted, the greater the support needed
Where we have the greatest forces, we need the biggest implants to support these tremendous forces. Back teeth is NOT an area where we use mini-implants. The biting and chewing forces of our large molars will overload a miniature implant. You can’t put a top-heavy crown on a little tiny implant and expect the support to last. This will overload the situation and cause the implant to fail. I have written extensively on how detrimental to natural teeth excessive biting and grinding can be. In the case of an undersized implant, even normal biting is too much!
Where mini-implants are best used
So, after all, is said and done, where would I use a mini-implant? Who is a good candidate for mini-implants? I have used them for years, but the need to pick and choose the right candidate for mini-implants is important. I would not “use my hammer to hammer all over the land”.
Mini-Implants are best used to support a denture that already has a reduced biting force. It should bite against another denture, not against natural teeth. This will produce excessive forces for the mini-implant. Because they are smaller in diameter, one needs more of them to support a denture. Where I could use 2 normal size implants, with mini-implants, I need at least double that.
You still need to evaluate the patient and the remaining bone to place these properly. I have seen too many inexperienced dentists place mini-implants in the wrong area or missed the bone because they used shortcuts in their techniques. When I teach my students, I emphasize proper preparation before ever beginning any treatment.
So yes, mini-implants are a valuable adjunct to all the other tools and techniques that I have. Proper preparation and planning are crucial as with all things in life. If you ever wondered if you are a good candidate for mini-implants or any other type of implant, please call me at 440.951.7856. I will be more than happy to talk to you and advise you to the best of my ability. I look forward to hearing from you.
Oral Hygiene and the risk of stroke. On the surface, these two concepts do not seem interrelated. In reality, along with a proper diet, your oral hygiene can be very instrumental in preventing a stroke.
I Had A Stroke in My Eye Last Weekend!
That was the statement that I heard from a patient when asking about anything new in his medicines or medical conditions. I needed an education on this topic so I asked the patient to explain what that was. The reality of the term is really no different than any other type of stroke. According to the American Academy of Ophthalmology, an eye stroke’s most common symptom is sudden, painless vision loss. Depending on the location, it could result in total loss of vision for the entire affected eye or as in my patient’s case, it affected only part of his eye.
The Academy goes on to say that men in their sixth decade of life are the most likely to experience this. Patients with diabetes, high cholesterol, heart disease, and narrowing of the carotid artery will increase the likelihood of this happening. So what does this have to do with teeth? I will explain that soon.
The following is part of a news release from the American Heart Association: “Saturated fats are found in meat, full-fat dairy products and tropical oils such as coconut, palm, and others. Other types of fats include polyunsaturated fats, found in corn, soybean, peanut and other oils, and monounsaturated fats, found in olive, canola, safflower, avocado and other oils.” They went on to discuss these types of fats. Here are some highlights of their statements:
1. Randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by approximately 30 percent –similar to that achieved by cholesterol-lowering drugs, known as statins.
2. Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of cardiovascular disease.
3. Replacement of saturated fat with mostly refined carbohydrate and sugars is not associated with lower rates of cardiovascular disease(heart disease).
Dr. Kahn went on to say that this ended decades of misinformation that tried to state that this is not necessarily true. Over a century of solid scientific research has pointed to eating more fruits, vegetables and whole grains, while eliminating meat and dairy, will improve the chances of having a better quality of life for decades.
Get through your 60’s without a major health issue, & you’re in good shape
I have always said that if you can get through your 60’s without a major health issue, you were in good shape. It is this decade that years of bad habits and diets show up.
These bad habits build up plaques in the arteries. When these plaques break off and get lodged somewhere they stop the blood flow to that part of the body. In my patient’s case, it was his eye. If it gets stuck in your head, you could die or be permanently impaired due to loss of brain function. In the heart, you will get a heart attack. By eating saturated fats, these are some of the consequences associated with all of this.
A Plant-Based Diet, Oral Hygiene and The Risk Of Stroke
The game plan is obvious. Reduce the intake of these fats and replace this diet with one loaded with fruits and vegetables.
How does one enjoy all these varieties of food? It all starts with my good friends…the back molars. We need to keep our back teeth in great shape in order to ingest and digest these foods properly. Consequently, apples, walnuts, carrots etc are impossible to eat unless we can mash and smash these foods as the first step of digestion. Frequent checkups followed by being receptive to advice will keep our teeth for decades.
“It’s just a back tooth and I don’t really care” is the wrong approach. Wherever possible do everything to save your back teeth. In the event that is not a possibility for whatever reason, then replace them with something strong and stable.
The bottom line is this. Oral hygiene & the risk of stroke are related to one another. You need to incorporate good oral hygiene along with a plant-based heavy diet to reduce your risk for stroke and other related ailments. It’s not just your teeth that benefit. Your whole body does!
If you want to talk to me more about any of this information, please call me at 440.951.7856. I look forward to hearing from you.