Posts for: November, 2013

By Sarah J. Morris, DDS, PLLC
November 26, 2013
Category: Oral Health
Tags: gum disease   loose teeth  
TreatingLooseTeethandtheUnderlyingCauses

Adult teeth aren’t meant to be loose — it’s a sign that something is wrong. And while there are treatments, time is of the essence before permanent tooth or bone loss occurs.

Loose teeth can occur for many different reasons. Bite-related problems are fairly common, referred to as occlusal trauma (“occlusal” – bite; “trauma” – injury). This could be the result of excessive force placed on otherwise normal teeth and jaws — chronic clenching or grinding habits, for example. On the other hand, even normal biting or chewing can cause teeth to loosen if bone loss from gum disease has become excessive, reducing the remaining attachment to bone to inadequate levels. In some cases it can be a result of both excessive force and weakened bone levels.

Of these reasons, the most common cause is the weakened attachment of the teeth to the bone due to gum disease. If this is the case, it’s important first to treat the gum disease by an appropriate strategy for the disease present and then implement an effective dental hygiene program to inhibit reoccurrence.

As for the problem of loose teeth, there are measures to address it. Occlusal bite adjustment reduces the degree of force when biting or chewing by reshaping the biting surfaces through selective grinding. Splinting is another technique in which the teeth are joined together to make them more rigid and to redistribute the biting force among several teeth. This can be done with material bonded across the outside of several teeth or with a metal splint affixed within a pre-cut channel across the teeth. A more permanent option is to create a series of crowns to affix to the teeth and then fuse them together.

Although more complex, orthodontics to correct misaligned teeth is another option. Not only will it improve the bite and potentially reduce bite forces, it may also improve the health of the supporting periodontal attachment.

Before undertaking any treatment, you should first undergo a thorough exam to determine the true cause of your loose teeth and any underlying conditions. From there we can recommend the best approach for treating and preserving your teeth.

If you would like more information on treatments for 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.”


By Sarah J. Morris, DDS, PLLC
November 18, 2013
Category: Oral Health
TheresaBattleGoingOn-AndItsInYourMouth

Your teeth are under constant attack from bacteria that normally live in your mouth. When these bacteria thrive, they create acid that begins to dissolve the minerals in your enamel (the outer layer of your teeth). In your defense, your saliva protects against these bacteria and adds minerals back to your enamel. Let's take a look at this ongoing battle, and what you can do to sway it in a positive direction.

The outer covering of your teeth, the enamel, is made mainly of the minerals calcium and phosphate. The enamel protects the interior layer of your teeth, the dentin, which is similar in composition to bone. Although it is the hardest substance in your body, the enamel is still vulnerable to attack.

Your mouth is normally full of saliva, which washes over your teeth and maintains a balance between acids and bases. The terms “acids” and “bases” refer to a scientific measurement, the pH scale. Your mouth's pH is usually in the middle of the scale — neither acidic nor basic, but neutral. This is important in controlling the bacteria in your mouth.

You may be surprised to know how many bacteria live in everyone's mouth. More bacteria live in a single mouth than the number of people who have ever lived on earth. Some of these bacteria can cause tooth decay. Let's call them “bad bacteria.”

When the bad bacteria attach themselves to dental plaque — a film that builds up on your teeth every day — they begin to consume sugars that are in your mouth from foods that you have eaten. As the bacteria break down these sugars and turn them into energy, acid is produced as a by-product. This turns the saliva from neutral to acidic.

At a certain level of acidity, minerals in your enamel start to dissolve. This is called “de-mineralization.” It means that more calcium and phosphate are leaving the tooth's surface than are entering it. Early de-mineralization of the enamel shows up as white spots on a tooth.

Fortunately, healthy saliva can return calcium and phosphate to the enamel, or re-mineralize it. De-mineralization and opposing re-mineralization are constantly battling in your mouth. However, if too much enamel is de-mineralized, bacterial acid can go on to attack the next layer of your teeth, the dentin. As this process continues, you develop a dental cavity.

How can you protect your teeth? The first level of defense is regular removal of plaque, so that the bad bacteria do not get a foothold. In an office visit we may also recommend products such as sealants, antibacterial agents, topical fluoride, calcium and phosphate supplements, pH neutralizers, special toothpaste and rinses, which may help your particular situation.

Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay — The World's Oldest & Widespread Disease.”


By Sarah J. Morris, DDS, PLLC
November 15, 2013
Category: Oral Health
Tags: oral health   gluten  
YourBodysIntolerancetoGlutencanCauseDentalProblems

If you have noticed white spots or enamel pitting on your teeth, something in your diet may be the cause. If accompanied by other general symptoms, these dental problems may stem from a possible intolerance to gluten.

Gluten is a protein found in grains like wheat, barley or oats. Some people (an estimated one in 130 Americans) have a condition called Celiac Disease (CD) in which their immune system mistakenly treats gluten as a threat and initiates an attack of antibodies (individual proteins made by the immune system to target and kill specific foreign substances) against it. Tiny hair-like structures in the small intestine called cilia that aid in nutrient absorption may be destroyed in the process. As a result, the body can't properly absorb nutrients.

CD can be difficult to diagnose because its symptoms resemble other conditions like Irritable Bowel Syndrome. Typically, though, CD causes digestive issues like diarrhea, bloating and stomach aches, as well as fatigue, growth abnormalities and vitamin deficiencies. In the mouth, the most common symptoms are enamel defects like spotting and pitting. Patients may also lose a portion of their enamel in the grooves of the central incisors where the enamel may appear chalky or opaque rather than shiny, evidence of a condition called decalcification. CD may also cause canker sores.

Determining if you have CD is a two-step process. You must first undergo a blood test to see if antibodies are present for gluten. If the test returns positive confirming you have CD, the next step is a biopsy in which a small amount of intestinal tissue is removed and analyzed. This measures the degree of damage to the stomach lining, which will indicate whether or not you should remove foods containing gluten from your diet.

While research is ongoing to develop counteracting medications, removing gluten from your diet remains the most effective treatment for CD. Enamel defects caused by CD can also be treated with fluoride toothpastes and other aids to foster re-mineralization (restoring calcium and other mineral content to the enamel), and with cosmetic techniques to reduce any discoloration effect. CD patients should continue with normal oral hygiene efforts, with one exception: hygiene products (including polishing pastes and fluoride gels used in professional cleanings) should be gluten-free.

If you would like more information on how gluten may affect your oral 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 “Gluten & Dental Problems.”


By Sarah J. Morris, DDS, PLLC
November 06, 2013
Category: Dental Procedures
Tags: root canal   endodontics  
FrequentlyAskedQuestionsAboutRootCanals

If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.

Q: What is a root canal?

A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.

Q: Why do I need to get a root canal?

A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.

Q: What happens if I don't get a root canal?

A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.

Q: Will it be painful?

A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.

Q: What happens after that?

A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.

Q: Is there an alternative?

A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.

If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”




Dentist - Fort Worth
2551 River Park Plaza
Fort Worth, TX 76116
817-732-4419

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