Posts for: January, 2020
A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.
Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.
While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.
Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.
There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).
If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.
Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.
If you would like more information on treating loose teeth, 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 “Treatment for Loose Teeth.”
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
While your teeth and gums can take a lot, they still face dangers like dental disease. Your teeth are also affected by aging-related wear and tear.
And, something else could put your teeth at risk: teeth grinding. This is an involuntary habit afflicting one in ten adults in which they grind or clench their teeth, often while they’re asleep. This generates higher than normal biting forces that can cause sore jaw joints, accelerated teeth wear and damage to the ligaments that hold teeth in place. In the worst case, you could eventually lose teeth.
So how do you know you’re grinding your teeth, especially if you’re asleep? You might notice your jaw being unusually sore after you wake up or your jaw muscles feel tired. Your dentist may also notice higher than normal tooth wear during a regular checkup. One of the best indicators, though, might be your sleeping partner or family: Teeth gnashing together can be loud enough to disturb others’ sleep.
In treating adult teeth grinding, it’s best to first determine the underlying cause. One of the most prominent reasons is chronic stress: If you’re under high pressure from situations at work or at home, pent-up stress can vent through physical outlets like teeth grinding. You can manage high stress through relaxation techniques, biofeedback or group therapy, which could in turn reduce teeth grinding.
Teeth grinding could also be related to a sleep disorder, such as problems with shifting between nightly sleep cycles. Certain psychoactive drugs are often associated with teeth grinding too. And, because of alterations in brain chemistry, tobacco users are twice as likely to grind their teeth as non-users. So, receiving treatment for a medical condition or making certain lifestyle changes could help lessen a grinding habit.
Many of these approaches take time to alleviate teeth grinding. For immediate relief, your dentist can create a custom mouthguard you wear while you sleep to reduce the effects of teeth grinding. The guard prevents the upper and lower teeth from making contact while biting down, which reduces the forces against them.
The damage from teeth grinding is often cumulative. If diagnosed early, though, we may be able to stop or minimize the damage before it goes too far.
If you would like more information on teeth grinding, 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 “Teeth Grinding.”