If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.
Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.
Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush. Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.
Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.
In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.
If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.
Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.
So, you've undergone a root canal treatment to save a decayed tooth. The tooth has a new lease on life — and the pain is gone too. But there's a reality you need to keep in mind — your tooth could become re-infected, putting you back in the same painful circumstance.
Root canal treatments are often necessary when decay works its way deep within a tooth, into the pulp. The excruciating pain a person feels is the infection attacking the bundle of nerves within the pulp tissue. If the infection isn't addressed promptly, it will continue to work its way to the root, eventually damaging the tooth beyond repair.
During a root canal treatment, we drill into the tooth to access the pulp chamber. After clearing it completely of its infected tissue, we then fill the chamber and root canals with a special filling and then seal off the access. A short time later we'll bond a crown over the tooth to protect it and to make it more attractive.
Most of the time, this preserves the tooth for many years. Occasionally, though, re-infection can occur. There are a number of reasons why: the first infection may have been more extensive than thought; the root canal network was more complex and some tinier canals weren't able to be identified; or the protective crown may once again get tooth decay contaminating the root canal.
If infection does reoccur it doesn't mean the tooth is lost. It's possible a second root canal treatment can successfully correct any problems, especially those that may not have been detected the first time. More complex cases might also require the services of an endodontist, a specialist in root canals. They're skilled in advanced techniques and have specialized equipment to handle even the most complicated root canal networks.
In the meantime, if you notice signs of re-infection like pain or swelling around a treated tooth, contact us promptly for an appointment. You should also contact us if the tooth is injured in an accident. The sooner we can treat your tooth, the more likely the second time will be more successful.
If you would like more information on preserving a tooth through root canal treatment, 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: How long will it Last?”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.
If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.
With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.
Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.
That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).
While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12). And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.
Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.
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 “Stainless Steel Crowns for Kids.”
Taking care of your child’s teeth is a high priority, not only for their health now but for the future too. And that means dealing with their teeth’s most common and formidable enemy, tooth decay.
Your focus, of course, should be on preventing decay through good oral hygiene practices, a healthy diet low in foods with added sugar and regular office visits for cleaning and checkups. But some children at higher risk or who’ve already encountered tooth decay may also need a little extra help in the form of dental sealants.
The most common use of sealants addresses a weakness in young teeth that disease-causing bacteria exploit. Deep grooves known as pits and fissures form within the biting surfaces of developing back teeth and in the rear of front teeth.Â It’s very difficult to reach these areas with daily brushing, so some plaque may be left behind (hence the importance of semi-annual office cleanings).
Inside the mouth, these pits and fissures are in a warm and moist environment and are a haven for bacteria that feed on plaque and produce high levels of acid as a by-product. The acid softens enamel to eventually create a hole, or a “cavity” in the tooth. Children’s young enamel is highly susceptible to this process — it hasn’t developed enough strength to resist the adverse effects of acid.
A “pit and fissure” sealant made of resin fills in the grooves in the teeth to inhibit the buildup of plaque — a kind of “mini” filling. It’s an added layer of protection that complements other prevention efforts. But applying them isn’t an automatic practice — we only recommend it for children at high risk, especially where decay is beginning or it appears the conditions are conducive for it. When needed, though, it can be quite effective in preventing decay or minimizing its effects.
The best way to know if your child could benefit from a sealant is to have them undergo a complete dental exam. From there we can advise you on whether a sealant application is an important investment in their current and future health.
If you would like more information on dental disease prevention for 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 “Sealants for Children.”
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