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Posts for: December, 2015

TreatingaBabyToothwithInnerDecaycanbeComplicated-butStillNecessary

Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.

If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.

If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.

If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.

A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.

These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.

If you would like more information on treating decay in 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 “Root Canal Treatment for Children’s Teeth.”


By Cosmetic Dental & Implant Center
December 14, 2015
Category: Oral Health
EvenCelebritiesLikeJenniferLawrenceArentImmuneFromBadBreath

Exchanging passionate kisses with big-screen star Jennifer Lawrence might sound like a dream come true. But according to Liam Hemsworth, her Hunger Games co-star, it could also be a nightmare… because J.Law’s breath wasn’t always fresh. “Anytime I had to kiss Jennifer was pretty uncomfortable,” Hemsworth said on The Tonight Show.

Lawrence said the problem resulted from her inadvertently consuming tuna or garlic before the lip-locking scenes; fortunately, the two stars were able to share a laugh about it later. But for many people, bad breath is no joke. It can lead to embarrassment and social difficulties — and it occasionally signifies a more serious problem. So what causes bad breath, and what can you do about it?

In 9 out of 10 cases, bad breath originates in the mouth. (In rare situations, it results from a medical issue in another part of the body, such as liver disease or a lung infection.) The foul odors associated with bad breath can be temporarily masked with mouthwash or breath mints — but in order to really control it, we need to find out exactly what’s causing the problem, and address its source.

As Lawrence and Hemsworth found out, some foods and beverages can indeed cause a malodorous mouth. Onions, garlic, alcohol and coffee are deservedly blamed for this. Tobacco products are also big contributors to bad breath — which is one more reason to quit. But fasting isn’t the answer either: stop eating for long enough and another set of foul-smelling substances will be released. Your best bet is to stay well hydrated and snack on crisp, fresh foods like celery, apples or parsley.

And speaking of hydration (or the lack of it): Mouth dryness and reduced salivary flow during the nighttime hours is what causes “morning breath.” Certain health issues and some medications can also cause “dry mouth,” or xerostomia. Drinking plenty of water can encourage the production of healthy saliva — but if that’s not enough, tell us about it: We may recommend switching medications (if possible), chewing xylitol gum or using a saliva substitute.

Finally, maintaining excellent oral hygiene is a great way to avoid bad breath. The goal of oral hygiene is to control the harmful bacteria that live in your mouth. These microorganisms can cause gum disease, tooth decay, and bad breath — so keeping them in check is good for your overall oral health. Remember to brush twice and floss once daily, stay away from sugary foods and beverages, and visit the dental office regularly for checkups and professional cleanings.

So did J.Law apologize for the malodorous makeout session? Not exactly. “[For] Bradley Cooper, Christian Bale, yeah, I’ll brush my teeth,” she laughed.

Hemsworth jokingly agreed: “If I was kissing Christian Bale I probably would have brushed my teeth too. With you, it’s like, ‘Eh. Whatever.’”

If you would like more information about bad breath and oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Bad Breath: More than Just Embarrassing.”


By Cosmetic Dental & Implant Center
December 06, 2015
Category: Oral Health
Tags: antibiotics  
SomePatientsMightNeedAntibioticsBeforeRoutineDentalWork

Office cleanings and other minor procedures are a routine part of regular dental care. For some people, though, a routine visit could put them at slight risk for a serious illness.

The reason for this concern is a condition known as bacteremia. This occurs when bacteria, in this case from the mouth and conceivably during an office cleaning or other routine dental procedure, enters the bloodstream. Although for most people this isn’t a great issue, there’s been concern that bacteremia could further compromise the health of patients with or susceptible to other conditions like endocarditis (heart inflammation), prosthetic joints or compromised immune systems.

This concern grew out of a number of studies in the early 20th Century that seemed to show a link between dental bacteremia and infective endocarditis. At about mid-century it became a common practice to administer antibiotics before dental work (usually 2 grams of amoxicillin or an equivalent about an hour before) to high risk patients as a way of protecting them against infection. The practice later expanded to other health issues, including many heart conditions.

Beginning in 2007, however, guidelines developed jointly by the American Heart Association and the American Dental Association reduced the number of conditions recommended for antibiotic therapy. Based on these guidelines, we now recommend pre-procedure antibiotics if you have a history of infective endocarditis, artificial heart valves, certain repaired congenital heart defects, or heart transplant that develops a subsequent heart valve problem. Patients with prosthetic joints or immune system problems are no longer under the guidelines, but may still undergo antibiotic therapy if believed necessary by their individual physician.

If you have a condition that could qualify for antibiotic therapy, please be sure to discuss it with both your dentist and physician. We’ll work together to ensure any dental work you undergo won’t have an adverse effect on the rest of your health.

If you would like more information on antibiotic therapy and dental care, 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 “Antibiotics for Dental Visits.”