Posts for: April, 2014

By Sarah J. Morris, DDS, PLLC
April 28, 2014
Category: Dental Procedures
Tags: root canal   whitening  
Non-VitalBleachingRemovesUnsightlyToothDiscolorationFromWithin

Root canal treatments are an important method for stopping the disease process within an infected tooth and ultimately saving it. However, one of the few side effects could have an aesthetic impact on your smile. Leftover blood pigments or the filling materials themselves can cause a darkening of the tooth — the tooth could eventually stand out in an unsightly way from surrounding teeth.

There is, however, one possible solution: a whitening technique known as internal or non-vital bleaching can lighten a darkened, non-vital tooth. For this procedure, we would insert a bleaching mix (usually sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a short period of time. The chemical reaction of the mix whitens the tooth from within.

Our first step is to make sure by x-rays that the root canal filling in the tooth is still intact and still has a good seal. We then create a small opening in the rear of the tooth just above the root canal filling, irrigate it with water to remove any debris, and then add a special cement at the point where the root canal filling begins to seal it from any leakage of the bleaching solution into the root canal filling.

We then insert the bleaching solution into the empty pulp chamber. This is covered with a cotton pellet, which is then sealed in with a temporary filling. We repeat this application over a number of days until we see a noticeable change in the tooth color (normally after one to four visits). At this point, we would remove any residual solution and apply a permanent filling to seal the tooth.

This procedure can be performed instead of more extensive procedures such as veneers and crowns as a cover for the discolored tooth, or as a way to lighten teeth before applying a veneer or crown to help prevent discoloration from showing through. Either way, non-vital bleaching can help remove unsightly discoloration and restore vibrancy to your smile.

If you would like more information on internal or non-vital bleaching, 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 “Whitening Traumatized Teeth.”


By Sarah J. Morris, DDS, PLLC
April 25, 2014
Category: Oral Health
KeepanEyeonYourChildsPrimaryToothLoss

When children begin losing their primary (“baby”) teeth, it’s a rite of passage — a sign that childhood is transitioning to future adulthood. And while it’s a normal part of dental development, it does bear watching for abnormalities.

Primary teeth are like deciduous tree leaves in that it’s their nature to shed and give way for new growth. They serve a purpose not only in providing children a means to bite and chew food, but also as guides for the permanent teeth that will soon erupt in their place.

As it reaches the end of its development within the jaw, the permanent tooth will begin to exert pressure on the primary tooth. This stimulates a process known as resorption where the primary’s roots begin to dissolve. This weakens its attachment to the jaw and the tooth becomes loose to the touch. At the end of this process, it doesn’t take much coaxing for the tooth to finally come out of its socket, with occasional minor bleeding and tenderness around the site. You will notice if you look at the bottom of the lost tooth that the roots have completely dissolved, leaving only a small indention.

This natural process, however, can run into complications. In their roles as permanent teeth guides, there’s a natural sequence for the loss of primary teeth; the permanent teeth develop along this sequence, which helps them erupt in the proper position. If a primary tooth is lost early and out of sequence (notably because of decay), the premature space can cause misalignment of the permanent teeth as they erupt.

That’s why it’s important for your child to have regular dental checkups, beginning sometime around their first birthday. This allows us to monitor primary tooth loss to make sure its progressing normally, as well as treat any condition such as tooth decay that could lead to premature loss. Regular checkups along with good oral hygiene practices will help ensure that the transition from primary to permanent teeth goes just as nature intended.

If you would like more information on the process of losing primary teeth in children, 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 “Losing a Baby Tooth.”


By Sarah J. Morris, DDS, PLLC
April 17, 2014
Category: Dental Procedures
Tags: root canal  
DoesRootCanalTreatmentLastForever

Perhaps you’ve been told that you need to have root canal treatment in order to save one or more of your teeth. By now, you know that the procedure itself is essentially pain-free, and that it has an excellent chance of success. But you may be wondering — just how long can you expect that “saved” tooth to last?

The short answer is: decades… or even a lifetime. But in just the same way that no two fingerprints are exactly identical, neither are any two teeth with root canals. There are some factors that could result in one tooth having a greater longevity after root canal treatment (RCT) than another — but before we go into them, let’s look at what RCT actually involves.

When infection and inflammation is allowed to get a foothold deep inside a tooth — usually due to uncontrolled decay or trauma — the nerves, blood vessels and connective tissue that make up the tooth’s pulp begin to die. If left untreated, the infection can spread out of the tooth and into the bone of the jaw. This may lead to further problems, including the development of a painful abscess, and eventual loss of the tooth.

Root canal treatment involves gaining access to the infected pulp tissue through a tiny hole made in the tooth, and then removing it. Next, the space inside the tooth is disinfected and filled with sterile material, and the access hole is closed. Afterward, a crown or “cap” is often needed to protect the tooth and restore it to full function in the mouth.

One factor that can influence how long a treated tooth will last is how soon the tooth is restored following the root canal procedure: The sooner it receives a permanent filling or crown, the longer it is likely to last. Another factor is whether or not the underlying infection has spread into the bone of the jaw: A tooth that has received RCT promptly, before the infection has had a chance to spread, is likely to have greater longevity.

Some of the other factors that may influence the longevity of a tooth after RTC are: the location of the tooth (front teeth are easier to treat and receive less biting force than back teeth); the age of the individual (teeth become more brittle over time); and what other work needs to be done on the tooth (such as the placement of posts, which may in time weaken the tooth’s structure.) In general, however, there’s no dispute that a tooth which has received a quality root canal treatment should last for many years to come — if not an entire lifetime. And to many people, there’s simply no substitute for having your own natural teeth.

If you would like more information about root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment: How Long Will It Last?


By Sarah J. Morris, DDS, PLLC
April 09, 2014
Category: Oral Health
TreatmentOptionsForStainedTeeth

Do your teeth stain easily? Are you worried that your new white fillings won't remain white for very long? Staining generally falls into one of two categories — extrinsic (external) staining, which affects the outside of the teeth, and intrinsic (internal) staining, which is discoloration of the tooth structure itself. The good news is that both can be treated and, once we determine the exact cause, there are a number of options to remedy it. You can have whiter teeth in almost no time!

External staining is generally caused by beverages or foods like red wine, tea, coffee and some spices, or even substances like tobacco. Stain that is brown, black or gray can become even worse in the presence of dental bacterial plaque and when the mouth is dry. On the other hand, internal tooth staining can make the teeth appear more yellow as a natural result of aging, or after root canal treatment when tooth structure can become more brittle and dry.

Treatment for external (extrinsic) staining includes:

  • Lifestyle modification: You can help put a stop to your staining problem by reducing or eliminating the habits that cause it, such as smoking and drinking red wine.
  • Practicing efficient oral hygiene: Preventing extrinsic staining can be as simple as brushing twice a day with toothpaste that contains tooth-whitening agents or other solutions to reduce the appearance of stains. Don't be embarrassed to ask our office about brushing and flossing because most people do it wrong until they're properly instructed.
  • Professional Cleaning: We can remove some extrinsic staining with ultrasonic cleaning followed by polishing with an abrasive prophylactic paste.

Other treatment options to reverse either intrinsic or extrinsic staining include:

  • Whitening by bleaching: Bleaching for extrinsic stains can be performed either in our office or at your home using a whitening kit. Bleaching for internal (intrinsic) stains can only be conducted in our dental office because it typically involves bleaching the tooth or teeth from the inside.
  • Fillings and restorations: For teeth that have been stained due to decay, or for fillings that are old and discolored we can remove the decay and restore the teeth, which will restore them to their natural brighter color.

If you are ready to say goodbye to your stained teeth, call our office today to make an appointment. For more information about treating stained teeth, read the Dear Doctor magazine article “Tooth Staining: Getting To The Cause Of Tooth Discoloration Is The First Step Toward Successful Treatment.”


By Sarah J. Morris, DDS, PLLC
April 01, 2014
Category: Oral Health
Tags: oral health   x-rays  
RadiationExposurefromDentalX-RayImagingIsntaCauseforConcern

Your dental care would be much more limited without our ability to see “below the surface” with x-ray imaging. But since x-rays passing through the body are a form of radiation, could your exposure from them be hazardous to your health?

It depends on exposure dosages and, of course, the amount you have been exposed to over your lifetime. But, decades of research have demonstrated that exposure to dental x-rays during your regular office visits are only a fraction of the radiation you normally encounter from the natural environment every year.

X-rays have the ability to pass through body tissues, but at different rates for soft tissue like skin and muscle and hard tissue like bone. This effect creates shadows on exposed film; the differentiation is in such detail that a trained technician can interpret not only internal structures, but defects such as fractured bone or, in the case of dentistry, signs of tooth decay and bone loss from gum disease.

But like other energy sources in our environment, x-rays do emit radiation that in high doses can be dangerous to living tissue. The amount of exposure is measured in millisieverts (mSv), a unit that allows for comparison of doses from different sources of radiation. Scientists have calculated that we’re normally exposed to between 2 and 4.5 mSv every year.

By contrast, a single digital periapical image taken of a tooth is equal to 1 microsievert (μSv), or one thousandth of an mSv; a full mouth series (between 18 and 20 images) creates an exposure of 85 μSv, or 85/1000 of one mSv. In addition, advances in technology have further reduced the radiation exposure from x-ray imaging. For example, digital imaging has reduced exposure during full mouth x-rays from seven to ten days of equal exposure from normal background radiation to half a day, and with no loss in image quality.

In effect, dental x-rays pose little to no risk for patients. Still, understanding that x-ray imaging does expose patients to radiation, dentists follow certain protocols and safety precautions. For example, dentists will place a lead apron around their patients’ chest area during an x-ray exposure.

As your dentist, we’re happy to address any concerns you may have about x-ray radiation exposure. But rest assured, the x-ray devices used in your dental care, so necessary in the fight against tooth decay and other diseases, are safe and reliable.

If you would like more information on the use of x-ray technology and safety, 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 “X-Ray Frequency and Safety.”




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

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