Your child has had braces for a few months and making good progress with correcting a poor bite (malocclusion), but you’ve also noticed something else: his gums are becoming red and swollen.
These are symptoms of gingivitis, a periodontal (gum) disease. It’s an infection that arises when plaque, a thin film of bacteria and food particles, isn’t adequately removed from teeth with daily brushing and flossing. The braces increase the risk for gingivitis.
This is because the hardware — metal or plastic brackets cemented to the teeth and joined together by metal bands — makes it more difficult to reach many areas of the teeth with a brush or floss string. The plaque left behind can trigger an infection that causes inflammation (swelling) and bleeding.
To exacerbate the situation, gums don’t always take well to braces and can react by overgrowing. Wearing braces may also coincide with a teenager’s surge in hormones that can accelerate the infection. Untreated, gingivitis can develop into advanced stages of disease that may eventually cause tooth loss. The effect is also heightened as we’re orthodontically putting stress on teeth to move them.
You can stay ahead of gingivitis through extra diligence with daily hygiene, especially taking a little more time to adequately get to all tooth surfaces with your brush and floss. It may also help to switch to a motorized brush or one designed to work around braces. You can make flossing easier by using special threaders to get around the wires or a water flosser that removes plaque with a pulsating water stream.
And don’t forget regular dental visits while wearing braces: we can monitor and treat overgrowth, perform thorough dental cleanings and treat occurrences of gingivitis. In some cases you may need to visit a periodontist, a specialist in gums and supporting teeth structures, for more advanced treatment. And if the disease becomes extensive, the braces may need to be removed temporarily to treat the gums and allow them to heal.
Orthodontic treatment is important for not only creating a new smile but also improving your teeth’s function. Keeping a close eye out for gum disease will make sure it doesn’t sidetrack your efforts in gaining straighter teeth.
If you would like more information on dental care during orthodontics, 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 “Gum Swelling During Orthodontics.”
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.”
Most of us have no clue how the ancient holiday tradition of kissing under the mistletoe originated—but it sure doesn't stop us from keeping the tradition alive! Yet although eager to join a certain someone under the hanging twig, you still might hesitate to apply the old smackeroo out of fear your breath isn't as fresh as it should be.
Bad breath has tormented us humans long before we started osculating (kissing) under trimmings of viscum album (the scientific name for mistletoe). Our resulting discomfort has inspired a myriad of remedies, from ancient Egyptian toothpastes containing natron (also used in embalming mummies) to 19th Century American breath mints made of ingredients like cardamom, essence of rose and licorice root.
Today, we're much better at relieving common bad breath because we've uncovered its primary source: bits of food and mucus accompanied by oral bacteria on undisturbed areas the mouth, particularly the tongue. As the debris interacts with the bacteria, it releases chemical compounds called VSCs (volatile sulfur compounds) that emit a classic rotten egg smell.
The key then is to remove the source of these VSCs. You might think that means doing a better job of brushing and flossing, and you're right. But it can involve more.
Keeping your tongue clean. Since the tongue is a prime collecting point for debris and bacteria, it makes sense to keep it clean. That might simply mean brushing its surface when you brush your teeth. You might, however, benefit from using a tongue scraper if you have more stubborn accumulations.
Maintaining your dentures. These and other dental appliances can accumulate food debris that if not removed can cause a “stink.” You should clean dentures daily using a denture cleaner or mild antibacterial soap and then rinse them off thoroughly. It also helps to take them out at bedtime.
Seeking dental care. Another source of bad breath could be tooth decay or gum disease, or even older dental work in need of repair. Treating these and other conditions (like an oral yeast infection) not only improves your dental health, it could do wonders for your breath.
There are also other sources of foul breath unrelated to the mouth—and some can be serious diseases like diabetes, cancer or lung infections. If your chronic bad breath doesn't respond to your hygiene efforts, it's a good idea to get checked medically.
Now as to holiday traditions, we can't help you maneuver your prospective sweetheart under the mistletoe with you—you're on your own, pal (or gal). But by following these tips for sound oral care, we're sure you'll have the “fresh breath” confidence to follow through from there.
The fast-paced world of sports and entertainment isn’t all glitz and glamour. These high-profile industries create a unique kind of emotional and mental stress on celebrities. For many of them, a way to “let off steam” is an oral habit known as teeth grinding.
Teeth grinding is an involuntary habit in which a person bites and grinds their teeth outside of normal activities like eating or speaking. It’s common among young children, who usually grow out of it, but it can also affect adults, especially those who deal with chronic stress. If not addressed, teeth grinding can eventually wear down teeth, damage gum attachments or fracture weaker teeth. It can even contribute to tooth loss.
A number of well-known personalities in the spotlight struggle with teeth grinding, including actress Vivica Fox, model and TV host Chrissy Teigen, and star athletes Tara Lipinski and Milos Raonic of ice skating and tennis fame, respectively. The habit represents not only a threat to their dental health, but also to one of their most important career assets: an attractive and inviting smile. Fortunately, though, they each use a similar device to manage their teeth grinding.
Besides seeking ways to better manage life stress, individuals with a teeth-grinding habit can protect their teeth with a custom mouthguard from their dentist. Made of slick plastic, this device is worn over the teeth, usually while sleeping, to minimize dental damage. During a grinding episode, the teeth can’t make contact with each other due to the guard’s glossy surface—they simply slide away from each other. This reduces the biting forces and eliminates the potential for wear, the main sources of dental damage.
Chrissy Teigen, co-host with LL Cool J on the game show Lip Sync Battle, wears her custom-made guard regularly at night. She even showed off her guard to her fans once during a selfie-video posted on Snapchat and Twitter. Vivica Fox, best known for her role in Independence Day, also wears her guard at night, and for an additional reason: The guard helps protect her porcelain veneers, which could be damaged if they encounter too much biting force.
Mouthguards are a prominent part of sports, usually to protect the teeth and gums from injury. Some athletes, though, wear them because of their teeth grinding habit. Tara Lipinski, world renowned figure skater and media personality, keeps hers on hand to wear at night even when she travels. And Milos Raonic, one of the world’s top professional tennis players, wears his during matches—the heat of competition tends to trigger his own teeth-grinding habit.
These kinds of mouthguards aren’t exclusive to celebrities. If you or a family member contends with this bothersome habit, we may be able to create a custom mouthguard for you. It won’t stop teeth grinding, but it could help protect your teeth—and your smile.
If you would like more information about protecting your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”
Do you remember when one of your baby teeth began to wiggle? You knew it wouldn't be long before it came out, followed by a little something from the “tooth fairy” under your pillow.
Those were the days! But a loose permanent tooth is something else entirely: Often a sign of advanced periodontal (gum) disease, you may be on the verge of losing the tooth forever.
This sad affair begins with dental plaque, a thin biofilm found on tooth surfaces and the ideal haven for oral bacteria that can trigger a gum infection. You might not notice such an infection in its early stages, other than a few initial signs like gum redness, swelling, or bleeding. If these occur, it's imperative you seek treatment promptly.
Without treatment, the infection can spread below the gum line, weakening gum attachments to teeth (which actually hold teeth in place) and eventually doing the same to underlying bone. All of this damage can lead to a tooth becoming loose and eventually falling out.
But it's not inevitable a loose tooth will eventually be lost, though it may require long-term efforts to save it. We may first need to do a bite adjustment, which will often allow a tooth to decrease its mobility. If the mobility has not been reduced enough, we may recommend stabilizing the teeth through splinting: These are techniques used to join the loose tooth to more stable teeth, usually with a thin strip of metal or other dental material.
We'll also need to treat the underlying cause, which in the case of gum disease requires aggressive plaque removal. Our goal is to manually remove all plaque and tartar (calcified plaque) deposits, particularly below the gum line. It may also require surgery to fully access deep pockets of infection. But once we remove the offending plaque, the gums can begin to heal.
The best strategy, though, is to avoid gum disease altogether. You can substantially lower your infection risk by brushing and flossing daily and getting a dental cleaning every six months. Dental visits also allow us to check your gums for any signs of infection that might require prompt action.
A loose tooth for a kid is a cause for celebration. It's the exact opposite for an adult loose tooth. Taking care of your gums with daily hygiene and receiving prompt treatment for any emerging infection could help you avoid it.
If you would like more information on treating gum disease, 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 “When Permanent Teeth Become Loose.”
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