Posts for category: Dental Procedures

By Daniel Mashni, DDS & Associates, PLLC
October 09, 2018
Category: Dental Procedures
Tags: gum disease   tooth decay  
StopRootCavitieswithPreventionandPromptTreatment

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, 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 Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”

By Daniel Mashni, DDS & Associates, PLLC
September 29, 2018
Category: Dental Procedures
NewFrontTeethforaTeenagedDavidDuchovny

In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?

“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.

How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.

With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.

In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.

While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.

Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”

By Daniel Mashni, DDS & Associates, PLLC
August 30, 2018
Category: Dental Procedures
Tags: dental implants  
ImmediateImplantsHelpyouAvoidDisruptionsinYourAppearance

Dental implants are widely recognized as the best tooth replacement option available. For most people, though, it’s a long process: after a tooth is extracted the socket is allowed to heal and fill in with new bone before implant surgery: that can take anywhere from two to five months. Afterward, there’s usually a two– to three–month period after the implant is placed before the permanent crown (the visible tooth) can be attached.

Without adequate bone present the implant’s long-term stability might be compromised. Furthermore, the implant’s durability is dependent upon bone growth around and attaching to its titanium post after surgery in a process known as osseo-integration. These two considerations indeed serve a critical function in the implant’s ultimate success.

In recent years, however, a variation to this traditional implant process has emerged that allows for immediate implantation right after extraction. Besides combining extraction and implantation into one surgical procedure, immediate implants minimize the disruption to a person’s appearance (especially with visibly prominent front teeth) when combined with a provisional crown.

Immediate implants joined together that replace a full arch of teeth can receive biting forces and succeed. Individual implants that replace single teeth, however, won’t work in all situations and must be undertaken with care to ensure long-term success. Because there may be less available bone, the implant must fit snugly within the socket to maintain as secure a hold as possible. The surgeon must also take care not to damage too much of the gum and bone tissue when extracting the tooth, which could affect both the integrity of the implant and its appearance in the gum line.

Temporary crowns may be attached during the implant surgery, but they’re installed for appearance’ sake only. For individual crowns, they must be designed not to make contact with the teeth on the opposing jaw to avoid generating biting forces that will cause the implant to fail and stop the bone-healing process that occurs with osseo–integration.

If you’re considering dental implants, it’s important to discuss with us which type of procedure, traditional or immediate, would be best for you, and only after a comprehensive examination of your mouth and jaw structure. Regardless of the approach, our goal is to provide you with a smile-transforming restoration that will last for many years to come.

If you would like more information on the dental implant process, 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 Implants.”

By Daniel Mashni, DDS & Associates, PLLC
July 21, 2018
Category: Dental Procedures
Tags: dental implants  
MoreThananewSmile-DentalImplantsHelpStopBoneLossasWell

Since their introduction over three decades ago, dental implants have evolved into dentistry’s premier tooth replacement choice. While their primary purpose is to replace missing teeth and rejuvenate a patient’s smile, they’re also regarded for another important benefit: they can slow or stop bone loss accelerated by the loss of teeth.

Like all living tissue, bone has a life cycle. Older bone dissolves and is absorbed by the body, a process called resorption. New bone forms and grows to replace the resorbed bone in response to stimuli occurring within the body. In the jaw, this stimulation comes from the forces the teeth receive when we bite or chew.

When a tooth is lost, however, it no longer transmits these force stimuli to the adjacent bone. This results over time in less new growth to replace resorbed bone, and the overall bone mass shrinks. In fact, about a quarter of the normal bone width will diminish in the first year alone after tooth loss. Other serious problems follow, like gum recession or chewing and speaking difficulties. A person’s appearance may also suffer, because as resorption continues unchecked, the underlying foundational bone will continue to shrink. As more teeth are lost, a decrease in the distance between the nose and chin may result causing the lower third of the face to become smaller in size.

Dental implants can interrupt this process by encouraging bone growth around the implant. Implants are made of “osseophilic” titanium, meaning the metal has a natural affinity with bone. After implantation, bone cells will begin to grow and attach to the titanium post. The enhanced growth stabilizes bone loss by providing stimulation to the bone as teeth once did, thereby maintaining bone levels and minimizing potential effects on the patient’s appearance.

Ironically, too much bone loss could make the installation of implants more difficult, since they require a minimum level of bone mass for anchorage. Receiving an implant as soon as is practical once a tooth is lost will minimize the chances of that occurring — and a better chance of improving bone health overall.

If you would like more information on how dental implants improve bone 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 “The Hidden Consequences of Losing Teeth.”

By Daniel Mashni, DDS & Associates, PLLC
June 11, 2018
Category: Dental Procedures
TreatingSmallEnamelCracksCouldHelpyouAvoidaDangerousToothFracture

Teeth can take a lot of force over a lifetime of biting and chewing, thanks to enamel, their outer layer made of the strongest substance in the human body. Unfortunately, they’re not invincible: it’s even possible for you to break or “fracture” a tooth while biting or chewing normally.

Although such a fracture might seem to occur out of the blue, it’s usually related to a condition known as cracked tooth syndrome. It usually occurs in three stages: in the first, miniscule cracks in the outer enamel known as craze lines develop. They’re not immediately dangerous since they only involve the enamel surface; but left untreated they could deepen and progress to the next stage, a larger crack that penetrates the tooth’s underlying dentin.

If allowed to grow, this crack in turn can lead to the third stage, a full fracture that could extend down to the root. A fracture can put the tooth in danger of loss, especially if its inner pulp becomes exposed. To avoid this worst case, it’s best to treat the tooth at the earliest stage possible when craze lines are just developing.

There is a difficulty, though, with detecting craze lines — they’re small, too small to detect normally with x-rays. We, therefore, rely on other methods such as using an instrument called an explorer to feel for cracks, having the patient bite on a stick or rubber pad to replicate pain symptoms or using fiber-optic lighting with special dye stains to highlight possible cracks. Endodontists, specialists in root canals, can use microscopic equipment that’s quite adept at detecting craze lines.

There are also some signs you can be on alert for that might indicate a craze line or crack. If you feel a short, sharp pain — a “wince” — when chewing and releasing food, you could have a crack that hasn’t yet affected the nerves. If a true fracture occurs, the pain will intensify and you may notice pieces of the tooth coming off. If the crack extends to the root, the pain will become greater and more chronic.

It’s important then that you see us for any recurring pain symptoms as soon as possible. If it’s a crack, the sooner it’s treated the better your tooth’s chances for survival.

If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”