Posts for: June, 2018

DoyouneedSimpleToothRemovalorSurgeryItDependsonafewFactors

Removing a problem tooth (extraction) is a common dental procedure. But not all extractions are alike — depending on the type of tooth, its location and extenuating circumstances, you may need an oral surgeon to perform it.

Fortunately, that's not always the case. Teeth with straight or cone-shaped roots, like an upper front tooth, have a fairly straight removal path. A general dentist first carefully manipulates the tooth loose from the periodontal ligament fibers that help hold it in place (experienced dentists, in fact, develop a “feel” for this process). Once it's loosened from the fibers it's a simple motion to remove the tooth.

But as mentioned before, a “simple extraction” won't work with every tooth or situation. To find out if it can we'll first need to determine the true shape of the tooth and roots, as well as the condition of the supporting bone. We might find any number of issues during this examination that make a simple extraction problematic.

For example, teeth with multiple roots (especially in back) may have complicated removal paths. If the roots themselves are unhealthy and brittle from previous injury or a root canal treatment, they can fracture into smaller pieces during removal. A tooth could also be impacted — it hasn't fully erupted but remains below the gum surface. It's these types of situations that require surgery to remove the tooth.

During a surgical extraction, the oral surgeon will first numb the area with a local anesthetic, as well as a sedative if you have issues with anxiety. They then perform a surgical procedure appropriate for the situation to remove the tooth. More than likely they'll insert bone grafts before closing the site with stitches to deter bone loss (a common occurrence after losing a tooth).

Afterward, your provider may prescribe antibiotics and an antibacterial mouthrinse to ward off infection. You'll also be given care instructions for the extraction site to keep it clean. Any discomfort should subside in a few days and can be managed effectively with a mild anti-inflammatory drug like ibuprofen or aspirin.

It can be overwhelming having a tooth removed. In your dentist's capable hands, however, the experience will be uneventful.

If you would like more information on tooth extraction, 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 “Simple Tooth Extraction?


By Sarah J. Morris, DDS, PLLC
June 21, 2018
Category: Oral Health
Tags: oral health  
3ReasonsforBloodPressureChecksDuringDentalVisits

You may have been surprised by a new addition to your regular dental appointment routine—we took your blood pressure at the start. While you might expect this at a medical clinic, it seems unusual at the dentist’s office.

But not anymore: blood pressure checks at dental offices are quickly becoming routine, including during regular cleanings and checkups. Here are 3 reasons why checking your blood pressure is now part of your dental visit experience.

Your blood pressure could be an issue during dental work. While we do everything possible to make you comfortable, undergoing dental work can create stressful feelings. Blood pressure normally increases when stress occurs, including before dental procedures. If you already have issues with hypertension (high blood pressure), any circumstance that might increase it could lead to health problems or even an emergency like a stroke. If your blood pressure is high, we may forgo any planned procedures and refer you to a physician for further examination.

Local anesthesia can affect blood pressure. Local anesthesia is an important part of dental work—without it we couldn’t provide maximum comfort during procedures. But many anesthetics include epinephrine, which helps prolong the numbing effect. Epinephrine also constricts blood vessels, which in turn can elevate blood pressure. We may need to adjust the anesthesia drugs and dosages we use in your case if you have high blood pressure.

It could save your health—and your life. The symptoms for hypertension can be subtle and often go unnoticed. A blood pressure screening check is often the first indication of a problem. That’s why blood pressure screenings in a variety of healthcare settings are so important. A routine blood pressure check at your dentist (who hopefully sees you at least every six months) is one more opportunity to find out. Discovering you may have high blood pressure is the first step to controlling it and hopefully avoiding more serious conditions like diabetes or cardiovascular disease.

If you would like more information on monitoring vital signs during dental visits, 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 “Monitoring Blood Pressure.”


By Sarah J. Morris, DDS, PLLC
June 16, 2018
Category: Oral Health
Tags: dental injury  
JuneIsNationalSafetyMonthBePreparedforDentalEmergencies

The National Safety Council has designated June as National Safety Month. A key component of staying safe is being prepared for emergencies, and this includes dental emergencies. Would you know what to do if you suffered any of the following dental mishaps?

Chipped tooth: One common dental injury is a chipped tooth. If this happens to you, save the missing chip if possible because we may be able to bond it back onto the tooth—but don’t be tempted to glue the chip back on by yourself! However, even without the missing chip, the tooth can most often be repaired with bonding material.

Cracked tooth: If you crack a tooth, rinse your mouth with warm water. If it is bleeding, hold a clean washcloth or gauze to the area until the bleeding stops, but don’t wiggle the tooth around or bite down hard. Keep in mind that the sooner your tooth is repaired, the better. Depending on how bad the crack is, if the tooth can be treated, it will most likely continue to function pain-free for years to come.

Displaced (“luxated”) tooth: If an injury causes your tooth to become loose, shoves it sideways or pushes it into or out of its socket, don’t try to force the tooth back into position on your own. Instead, call the dental office right away and leave it to us to bring the tooth back into its proper place and determine the extent of the injury.

Knocked out tooth: If a permanent tooth is knocked out of your mouth, pick it up without touching the root and rinse it off with cold water, but do not scrub. For the best chance of saving the tooth, place it firmly back in its socket within five minutes and hold it in position for a few minutes. If this is not possible, keep the tooth between your cheek and gum or in a glass of cold milk so that it doesn’t dry out. Call the dental office immediately.

If a baby tooth is knocked out, there is no need to place it back in the socket since baby teeth are not reattached. However, it is still important to have us examine the injury.

Being prepared for dental emergencies can help save a tooth as well as avoid more costly dental treatment down the road. But no matter what type of dental injury you have, it is important to come in for a consultation as the injury may extend beyond the part of the tooth that is visible. With today’s materials and technology, there’s a very good chance your smile can look as good as before—and often even better!

If you have questions about dental injuries, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Artistic Repair of Front Teeth with Composite Resin.”


By Sarah J. Morris, DDS, PLLC
June 11, 2018
Category: Dental Procedures
Tags: dental implants   bone graft  
BoneGraftingMightbeNecessaryBeforeYouObtainanImplant

Every year dentists place over 5 million dental implants for lost teeth, often removing the problem tooth and installing the implant at the same time. But getting a “tooth in a day” depends on a number of health factors, especially whether or not there’s adequate bone available for the implant. Otherwise, the implant’s placement accuracy and success could be compromised.

Bone loss can be a similar problem when a tooth has been missing for a long period of time. If this describes your situation, you may have already lost substantial bone in your jaw. To understand why, we need to know a little about bone’s growth cycle.

When bone cells reach the end of their useful life, they’re absorbed into the body by a process called resorption.  New cells then form to take the older cells’ place in a continuous cycle that keeps the bone healthy and strong. Forces generated when we chew travel through the teeth to the bone and help stimulate this growth. But when a tooth is missing, the bone doesn’t receive this stimulus. As a result, the bone may not replace itself at a healthy rate and diminish over time.

In extreme cases, we may need to consider some other dental restoration other than an implant. But if the bone loss isn’t too severe, we may be able to help increase it through bone grafting. We insert safe bone grafting material prepared in a lab directly into the jaw through a minor surgical procedure. The graft then acts like a scaffold for bone cells to form and grow upon. In a few months enough new bone may have formed to support an implant.

Bone grafting can also be used if you’re having a tooth removed to preserve the bone even if you’re not yet ready to obtain an implant. By placing a bone graft immediately after extraction, it’s possible to retain the bone for up to ten years—enough time to decide on your options for permanent restoration.

Whatever your situation, it’s important that you visit us as soon as possible for a complete examination. Afterward we can assess your options and hopefully come up with a treatment strategy that will eventually include smile-transforming dental implants.

If you would like more information on obtaining dental implants, please contact us or schedule an appointment for a consultation.


SavingaDiseasedPrimaryToothCouldMeanBetterOralHealthLaterinLife

It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.

Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.

Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.

Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.

For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.

If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.

As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.

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




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

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