Finding out you have a cavity isn't the best of news. But finding out it's a root cavity is even worse: if not treated, the decay can spread more rapidly than a cavity occurring in the tooth's crown surfaces.
Our teeth are basically composed of two parts: the crown, the visible tooth above the gum line, and the roots, the hidden portion beneath the gums. The root in turn fits into a bony socket within the jaw to help hold the tooth in place (along with attached gum ligaments).
A tooth crown is covered by an ultra-hard layer of enamel, which ordinarily protects it from harmful bacteria. But when acid produced by bacteria comes into prolonged contact with enamel, it can soften and erode its mineral content and lead to a cavity.
In contrast to enamel, the roots have a thin layer of material called cementum. Although it offers some protection, it's not at the same performance level as enamel. But roots are also normally covered by the gums, which rounds out their protection.
But what happens when the gums shrink back or recede? This often occurs with gum disease and is more prevalent in older people (and why root cavities are also more common among seniors). The exposed area of the roots with only cementum standing in the way of bacteria and acid becomes more susceptible to cavity formation.
Root cavities can be treated in much the same way as those that occur in the crown. We first remove any decayed tooth structure with a drill and then place a filling. But there's also a scenario in which the cavity is below the gum line: In that case, we may need to gain access to the cavity surgically through the gums.
If you have exposed root areas, we can also treat these with fluoride to strengthen the area against cavity formation. And, as always, prevention is the best treatment: maintain a daily schedule of brushing and flossing and regular dental cleanings to remove bacterial plaque.
Because decay can spread within a tooth, dealing with a root cavity should be done as promptly as possible. But if we diagnose and initiate treatment early, your chances of a good outcome are high.
If you would like more information on treating root cavities and other forms of tooth decay, 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 Cavities.”
Accidents do happen, especially if you or a family member has an active lifestyle. One such risk, especially for someone playing a contact sport, is having a tooth knocked out.
But as extreme as this injury can be, it doesn't necessarily mean the tooth is lost forever. Gum (or periodontal) cells remaining on the tooth root can regenerate and regain their attachment with the periodontal ligament that holds teeth in place. But you have to act quickly—the longer the tooth is out of the socket, the more likely these cells will dry out and die.
So, by doing the following within 5-20 minutes of the injury (and the earlier the better), that knocked-out tooth has a reasonable chance of survival.
Locate and clean the tooth. Your first priority is to find the missing tooth and clean it of any debris with clean water. Be sure not to touch the root of the tooth and only handle the tooth by the crown (the visible part of a tooth when it's in the mouth).
Insert the root end into the empty socket. Still holding the tooth by the crown, insert the opposite root end into the empty socket. Orient the crown properly, but don't worry about getting it in just right—the follow-up with the dentist will take care of that. You will, however, need to apply some pressure to get it to seat firmly.
Secure the tooth. Place a piece of clean gauze or cloth between the reinserted tooth and its counterpart on the other jaw. Then, have the person bite down on the cloth and hold it. This will help secure the tooth in place while you travel to the dentist.
Seek dental care immediately. It's important to see a dentist immediately to adjust the tooth's position and to possibly splint the tooth to better secure it while it heals. If a dentist isn't available, then visit a local emergency room instead.
Taking these actions on the scene could mean the difference between saving and losing a tooth. But act quickly—the sooner you initiate first aid for a knocked-out tooth, the better its chances for long-term survival.
If you would like more information on what to do during dental emergencies, 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 “When a Tooth is Knocked Out.”
Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.
The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").
Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.
The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.
Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.
Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.
It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.
Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.
If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”
The traditional June wedding season hit a bump last year during the COVID-19 pandemic as many couples down-scaled or postponed their ceremonies. But with hopes that the virus is finally waning, this year the early summer tradition shows signs of reviving. If you're one of those happy couples, you're no doubt working right now to look your best—and that would include your smile.
And there's no time like the present to make sure your teeth and gums are spruced up for the big day. True, some cosmetic enhancements can take weeks or even months to complete. But some can give you a brighter, more attractive smile with just a dental visit or two.
Here are 3 procedures that could help your smile match that once-in-a-lifetime moment.
Dental cleaning. The main purpose for visiting us every six months is to remove any harmful plaque and tartar missed with daily hygiene. But an added benefit for these single-visit dental cleanings can be a brighter, fresher smile. To take advantage, schedule a dental cleaning within a week or so of your wedding.
Teeth whitening. If you want to take your smile brightness to another level, you may want to consider professional teeth-whitening. The professional bleaching solutions we use can restore shine and translucence to dull, yellowed teeth that could last for months or, with touch-ups, a few years. We can also fine-tune the level of brightness you're most comfortable displaying to your wedding guests.
Dental bonding. Do you have a chipped or disfigured tooth that puts a damper on your smile? We may be able to make that defect disappear in just one visit with dental bonding. Using a dental resin material matched to your natural tooth color, we can fill in your tooth flaw and then sculpt it to look as natural as possible. The end result is a life-like, durable finish that will have you beaming on your big day.
Like we said, if your wedding is just around the corner, these particular techniques can make a big difference for your smile. If, however, you still have a few months before your wedding, you may be able to take advantage of other therapeutic and cosmetic measures like dental veneers, crowns or even possibly orthodontics.
To learn more about your cosmetic options, see us for a full evaluation of your smile needs. We'll work with you to help you achieve the most attractive smile possible for your once-in-a-lifetime day.
In an ideal world, your family's dental needs would mesh seamlessly with the family budget. Alas, it's not always that way, and it can often be a head scratcher figuring out how to pay for needed dental work.
You can reduce treatment costs with dental insurance, which could conceivably cut your bill in half. But dental policies often have payment caps and coverage limitations on materials and procedures. And unless someone else like an employer is paying for it, you'll have to subtract the premiums you're paying from any benefits you receive to reveal what you're actually saving.
Even with dental insurance, you can still have a remaining balance that exceeds what you can pay outright. You may be able to work out a payment plan with the dentist for extended treatments like braces, but this might not be possible in other cases.
That leaves financing what you owe with loans or credit cards. For the latter, it's highly likely your dentist accepts major credit cards. But since many cards charge high interest rates, you could pay a hefty premium on top of your treatment charges the more you extend your payments on a revolving account over time.
Your dentist may also participate with a healthcare credit card. Although similar to a regular credit card, it only pays for healthcare costs like dental fees. Interest rates may also be high like regular cards, but some healthcare cards offer promotional periods for paying a balance over a designated time for little to no interest. But late payments and overextending the promotional period could nullify this discount.
You might save more on interest with a loan that has a fixed interest rate and payment schedule rather than a credit card with revolving interest (although credit cards may be more suitable for smaller expenditures while a fixed loan works better for larger one-time charges). One in particular is a healthcare installment loan program, one of which your dentist might be able to recommend, which is often ideal for paying dental costs.
Paying for your family's needed dental care can be financially difficult. But you do have options—and your dentist may be able to assist you in making the right choice.
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