My Blog

Posts for: September, 2019

EvenThoughnotintheSmileZoneYouShouldReplacethatBackTooth

People often put a premium on appearance when deciding whether or not to replace a missing tooth. There's more motivation to replace one in the “smile zone,” where the teeth are more visible, than one that's not.

But even if your missing tooth is in the back out of sight, there are still good reasons to replace it. That's because even one lost tooth can have a cascading ill effect on other teeth, the underlying bone or eventually your entire facial structure.

The chief problems caused by a missing tooth occur first with the bone. The act of chewing generates pressure around the teeth. The teeth transmit this pressure through the roots to the bone, which stimulates the bone to grow and remain strong in support of the teeth. When you lose a tooth, the bone no longer receives this growth stimulation.

In time, the replacement rate for older bone cells will slow down and cause the bone volume to decrease. It's possible to detect a change just months after losing a tooth: you can lose an estimated 25% of bone width in the first year.

As the bone diminishes, the jaw loses height and then more width. The gum tissues will also gradually decrease. As a result you may not be able to chew or even speak as well as you once could. Depending on the number of teeth you've lost, the foundational portion of the jawbone — the basal bone — may also decline. The distance between nose and chin may decrease and the cheeks sink in. Without bone support in the rear, the bite can collapse and push the teeth forward out of their normal position.

The best way to avoid this debilitating spiral is to replace a tooth as soon as practical. There are many options, but perhaps the best choice is a dental implant: not only will it provide a life-like appearance, but its affinity with bone will stop bone loss and even encourage new growth.

So, don't neglect replacing that “invisible” tooth if it's lost. Your mouth and ultimately your appearance will be better for it.

If you would like more information on tooth loss and restoration options, 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 Dr. Kris O'Neill
September 14, 2019
Category: Oral Health
Tags: teeth grinding   bruxism  
StopTeethGrindingNowBeforeitCreatesDentalProblemsLater

Chronic stress is like a tea kettle on the boil—all that “steam” has to go somewhere. We often do this through behaviors like biting our nails, binging on comfort food—or grinding our teeth. That latter habit, however, could have a detrimental effect on teeth, including excessive enamel wear or even fractures.

Also known as bruxism, teeth grinding is the forceful and often involuntary contacting of teeth that often generates abnormally high chewing forces. While not considered a relatively big problem with young children, it can be if you’re an adult. While there could be other causes, chronic stress is often a ┬áprime factor for adults with bruxism.

While teeth grinding can occur during the day when you’re awake, it often occurs at night during sleep and may be associated with other sleep disorders like snoring. Although you might not be consciously aware of a grinding episode as it happens, you may notice its effects the next morning, including sore jaws or headaches. Over time, your dentist may begin noticing its effects on your teeth.

So, how can you lessen teeth grinding? For starters, if you’re a tobacco user, quit the habit. Many studies indicate tobacco users report twice the incidence of teeth grinding as non-users. Excessive caffeine, alcohol or drug use can also contribute.

People have also found it helpful to address chronic stress through a number of relaxation techniques like meditation, more relaxing bedtime preparation, bio-feedback or therapy to “de-stress.” Although there’s not a lot of empirical evidence for these techniques’ effectiveness, there’s much anecdotal data from people who’ve found stress relief from them.

There’s also a dental treatment using an occlusal guard that, while not stopping bruxism, can help prevent dental damage. Usually worn during sleep, the custom-made guard fits over the teeth of one jaw, usually the upper. Its high impact plastic prevents the teeth from making solid contact, thus reducing the biting force. You may also be able to reduce bruxism effects through dental work and orthodontics,

You and your dentist can explore the options to find the right treatment strategy for you. By taking action now, you may avoid much more extensive—and expensive—problems with your teeth down the road.

If you would like more information on teeth grinding and what to do 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 “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”


By Dr. Kris O'Neill
September 04, 2019
Category: Dental Procedures
Tags: crown  
AStainlessSteelCrownCouldExtendtheLifeofaPrimaryMolar

One of the key elements in a child’s development is their first set of teeth. Although primary (“baby”) teeth last only a few years, they’re critically important for enabling a child to eat solid foods, speak and smile.

But they also provide one more important benefit—they hold the space in the jaw reserved for the permanent teeth developing just under the gums until they erupt. But if a child loses a primary tooth prematurely because of disease or injury, other teeth may drift into the vacant space and crowd it out for the intended permanent tooth. It may then come in misaligned or remain stuck within the gums (impaction).

To avoid this, we try to treat and preserve a diseased primary tooth if at all practical. For a primary molar, one of the large teeth in the back of the mouth, this might include capping it with a stainless steel crown.

Why a metal crown? Primary molars normally don’t fall out until around ages 10-12, so it may be years for a younger child before their permanent molars erupt. All during that time these particular teeth will encounter heavier biting forces than teeth in the front.

A steel crown is often the best solution for a molar given their longer lifespans and encountered biting forces. The crown’s metal construction can stand up to these forces while still protecting the tooth from re-infection from decay. And because molars are typically outside of the “smile zone” occupied by more visible front teeth, the crown’s metal appearance isn’t usually an aesthetic issue.

Crowning a molar usually takes one visit, a dentist typically performing the procedure with local anesthesia and possibly a mild sedative like nitrous oxide gas (“laughing gas”). After removing any decayed structure from the tooth, the dentist will then fit a pre-formed crown over the remaining structure, sized and shaped to match the original tooth as close as possible.

A stainless steel crown is a cost-effective way to added needed years to a primary molar that could otherwise be lost prematurely. Preserving it may help a child avoid bite problems and expensive future treatments.

If you would like more information on dental care for primary 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 “Stainless Steel Crowns for Kids: A Safe and Effective Way to Restore Primary Molars.”