What happens when you lose a tooth? In the short-run, it can certainly undermine your appearance and ability to efficiently chew and digest food. But a chain of events could also be set in motion that may cause the most harm to your appearance and health—and it all has to do with bone loss.
Our bones aren't just rigid structures providing a frame for our bodies. They're living tissue with other purposes like producing blood cells and regulating the endocrine system. Bone tissue is constantly replenishing itself as older cells die and newer ones take their place.
In the jawbone, the pressure generated by the teeth while biting and chewing travels through the roots to stimulate the growth of new bone. If a tooth goes missing, however, the bone around the tooth also loses this growth stimulus.
This can cause normal bone growth to slow so that dying bone cells aren't sufficiently replaced. The bone may then diminish at an alarming rate—a decrease in width of about 25% in the first year after a tooth loss and several millimeters in height after only a few years.
This bone loss can continue to advance, especially if multiple teeth are lost, until the jaw structure as a whole loses significant height. The bite may then collapse, forcing the front teeth to push forward. In this state, a person may not be able to adequately bite or chew food. It can also damage their appearance—their smile suffers, of course, but their entire face may also appear shrunken.
You may be able to avoid this scenario if you replace missing teeth with dental implants. In addition to their life-likeness and durability, implants can also stop or slow bone loss. This is because titanium, the principle metal used in an implant, has a strong affinity with bone: Bone cells readily grow and attach to the titanium surface and foster new growth.
But don't wait: Bone loss could eventually extend beyond what an implant can accommodate—you may then need grafting to build up the bone or consider a different type of restoration. So, speak with your dentist as soon as possible about an implant restoration for a lost tooth to help avoid significant bone loss.
If you would like more information on how tooth loss can affect your life, 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 “The Hidden Consequences of Losing Teeth.”
Ever have a paper cut or an irritated hangnail? They're not considered major health problems, but, boy, can they sting!
Something similar can occur in the corners of your mouth called angular cheilitis. It's also known as perleche, from the French word “to lick” (a common habit with this type of sore). It can occur at any age, with children or young adults developing it from drooling during sleep or orthodontic treatment.
Older adults, though, are more prone than younger people for a variety of reasons. Age-related wrinkling is a major factor, especially “marionette lines” that run from the mouth to the chin. Dried or thinned out skin due to exposure from cold, windy weather may also contribute to perleche.
Perleche can also develop from within the mouth, particularly if a person is experiencing restricted salivary flow leading to reduced lubrication around the lips. Poorly cleaned dentures, weakened facial supporting structure due to missing teeth, vitamin deficiencies and some systemic diseases can all lead to perleche. And if an oral yeast infection occurs around the cracked mouth corners, the irritation can worsen and prolong the healing process.
To clear up a case of cracked mouth corners, you should promptly see your dentist for treatment. Treatment will typically include some form of antifungal ointment or lozenge applied over a few days to clear up the sores and prevent or stop any infection. You might also need to apply a steroid ointment for inflammation and other ointments to facilitate healing.
To prevent future episodes, your dentist may ask you to use a chlorhexidine mouthrinse to curb yeast growth. If you wear dentures, you'll need to adopt a regular cleaning routine (as well as leaving them out at night). You might also wish to consider updated dental restorations or orthodontics to improve dental support, and help from a dermatologist if wrinkling might be a potential cause.
Cracked mouth corners won't harm you, but they can make for a miserable experience. Take steps to relieve the irritation and any future occurrence.
If you would like more information on angular cheilitis or similar oral conditions, 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 “Cracked Corners of the Mouth.”
For over half a century now, community water systems have been adding fluoride to drinking water to help reduce the risk of tooth decay. Numerous long-term studies have demonstrated the soundness of this practice, prompting the U.S. Centers for Disease Control to call water fluoridation one of the ten most effective public health measures of the 20th Century.
In the 1960s, after years of study into the teeth-strengthening effects of fluoride, the U.S. Public Health Service recommended that drinking water utilities add fluoride at a rate of between 0.7 and 1.20 milligrams per liter (mg/L) or parts per million (ppm) of water. This recommendation held fast until 2015 when the service changed the recommendation to no more than 0.7 mg/L.
Why the change to guidelines that had been in place for over fifty years? The revision was in response to an increasing occurrence of dental fluorosis. This condition happens when the teeth absorb more fluoride than necessary, leading to discoloration of the surface enamel, creating effects like small white spots or brownish “mottling.”
Dental fluorosis is the only known health condition caused by fluoride. As such, it doesn't damage the tooth itself, and is mainly a cosmetic problem. But it can still be avoided if fluoride intake is kept at moderate levels.
The original recommendation was sound science when first introduced. Since then, though, the prevalence of fluoride in everyday life has grown, with the chemical commonly found in dental care products like toothpastes or mouthrinses, as well as many processed foods and beverages and even infant formula. Our society's overall intake of fluoride has been growing as a result.
The new recommendation came after several years of research to verify water fluoridation levels of 0.7 mg/L would still be effective in the fight against tooth decay while lowering the risk of dental fluorosis. With this adjustment, this important and safe measure for keeping your family's teeth protected against disease is safer than ever.
As far as your appearance goes, the most important teeth you have are those in the “smile zone.” These are the teeth most visible when you smile—and the ones that awkwardly stand out if they're chipped, worn or otherwise flawed. More than any other teeth, they determine how inviting your smile is to others.
You might think you'll need extensive cosmetic dental work to fix these kinds of dental defects. But that may not be necessary: We may be able to use a dental material known as composite resin to repair the defects in your “smile zone” teeth in one office visit.
Composite resins are a combination of ceramics and plastics that have been around for some time. They've only recently come into wide use, though, with the development of new techniques to bond them to tooth surfaces. They're ideal for chips, cracks, or decayed areas where front teeth make contact with one another. They may also be used occasionally to reshape irregular or misaligned teeth.
You'll first need a complete dental examination to determine if composite resin bonding is an appropriate approach for your situation. If so, we'll begin by preparing the tooth surface to better accept the resin material. We'll then apply the liquid form of the material in layers, along with other agents to increase the material's strength. Each layer is cured (hardened) before applying the next layer.
As the layers build up, we shape the material to achieve a normal tooth appearance. We'll also incorporate your individual color shadings, so that the prepared tooth blends well with surrounding natural teeth. In effect, the procedure requires as much artistry as technical skill to create a natural look.
Though not as strong as porcelain veneers or crowns, composite resins are durable if not subjected to heavy biting forces. And for a few hours in the dentist's chair with minimal tooth preparation, a composite resin treatment can create a dramatic and exciting change in your appearance.
If you would like more information on composite resin bonding, 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 “Artistic Repair of Front Teeth With Composite Resin.”
On the way to adulthood, permanent teeth steadily erupt until, if all goes normally, you have a full set of teeth. Sometimes, though, one or more teeth may fail to form. This not only can affect your dental health, but it could also diminish your smile.
For example, if the lateral incisors on either side of the central incisors (the two teeth front and center) don't develop, it could create a smile that's “not quite right.” But we can vastly improve such a smile in one of three unique ways.
The first is to fill the resulting gap through canine substitution. This is an orthodontic method in which we use braces to move the pointed canine teeth, which normally position on the other side of the missing laterals, closer to the central incisors. This choice is determined by the size of the canine teeth. If they are slim in width, they can be re-shaped to make them appear more like a lateral incisor, and the gums possibly reshaped as well around them through cosmetic surgery.
We can also install a dental bridge, an appliance that fills the missing lateral space with prosthetic teeth. A traditional bridge requires the teeth on either side of the gap to be reduced in size, which becomes a permanent alteration to accommodate these crowns. This is a disadvantage in a young person. We can also use a “bonded bridge” which uses adhesives to attach extended pieces (or “wings”) of dental material from either side of the prosthetic tooth to one or more supporting teeth. These wings are behind the permanent teeth. Though not as durable as a traditional bridge, it does avoid altering the support teeth.
Finally, we can replace the missing teeth with dental implants. In this method, we install titanium metal posts into the jawbone at the missing tooth locations and then attach a life-like crown to each one. Implants may be more costly than other restorative methods and can take several months to complete. But they are life-like, highly durable, and don't require any alteration to other teeth. A disadvantage is that you should wait until at least 19 years of age to consider this option. What many people do is use a temporary solution until the proper age to do a dental implant.
Each of these methods have their advantages and disadvantages, which should be thoroughly reviewed in consultation with your dentist. And each may also require other dental work, such as initial orthodontics to open adequate space for a restoration. But any of these methods for correcting a missing lateral tooth can be effective and help restore both a healthier mouth and a more attractive smile.
If you would like more information on treating congenital dental defects, 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 Permanent Teeth Don't Grow.”
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