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When should a filling be replaced?

August 4th, 2021

There is no substitution for a natural healthy tooth. Dental fillings are intended to replace tooth structure and restore a tooth damaged by decay (a cavity) back to its normal function and shape. Silver (amalgam) and tooth-colored (composite) fillings last a long time, though they can develop decay when the integrity is compromised by open margins, fracture, or recurrent decay. In this blog, we discuss the signs and symptoms that indicate your filling may need to be replaced in order to prevent further complications.

Amalgam fillings are made of an alloy (mixed metals) that expands and contracts. They have no bonding properties, and so to place an amalgam filling, the hole in the tooth may need to be larger. Because of these two factors, fractures frequently occur. There are three types of cracks that are commonly associated. Craze lines are superficial with no treatment needed. Fractures extend along other parts of the tooth and may require a filling replacement or crown. Cracks extend toward the root and can require a root canal and crown or, if too severe, extraction.

A filing needs to be sealed to the tooth. If the seal between the tooth and the filling breaks down, food debris and bacteria can seep down under the filling and cause recurrent decay. If the decay is treated early, replacing the filling is adequate. If not, a crown and even a root canal may be needed. The biggest mistake you can make is waiting to do something about a broken or unsealed filling until it is painful. Doing this will only make the treatment more involved and often times more expensive.

Regular dental exams and X-rays are used to evaluate dental fillings. You will not be able to tell on your own when your fillings start to fail. Just as a car mechanic will change the oil, correct your alignment, or change your tires, a dental checkup will help you identify small concerns to fix as you go in order to avoid a critical emergency.

Pay attention to any bite or temperature sensitivity in teeth that have fillings. This can be an indicator for some of the problems listed above. You know your teeth better than anyone. Your observations are most valuable when evaluating a filling for replacement. If replacement is needed, know you are doing what is best to prevent future dental calamities and make an appointment to see Dr. Robert Farber, Dr. Corey Farber, Dr. Harry Morris, Dr. Henry Bryan, and Dr. Mark Isler.

Is a Loose Tooth a Lost Tooth? Not Necessarily!

July 28th, 2021

When we were small, a loose tooth wasn’t a reason to be worried. On the contrary! It was a time to celebrate: A permanent tooth on the way. A sign that you were growing up. Perhaps even a lucrative visit from the Tooth Fairy. Losing a baby tooth had quite a few benefits.

Now that we’re grown, no such benefits are in store for us, because a lost adult tooth is gone for good. That’s why any time you notice a loose tooth you need to call your dentist immediately. With prompt dental care, that tooth might be saved.

But first, a word about how our teeth stay firmly rooted in the jaw.

  • The visible part (crown) of a tooth is protected by a layer of enamel. The root below is covered with a protective layer called cementum.
  • There is a socket for each tooth in the alveolar bone of the jaw, where each root is firmly attached within the socket by the periodontal ligament which surrounds it.
  • This ligament is made up of connective tissue, which attaches both to the cementum covering the root and to the alveolar bone. It not only holds the tooth in place, it cushions the tooth from the daily pressure of biting and chewing.
  • The gums surround the teeth and bone, protecting them from bacteria.

If the tooth, bone, ligament, or gums suffer damage, the result can be a loose tooth.

Treating a loose tooth

The treatment you receive will depend on the reason your tooth is loose. There are many situations which can lead to a loose tooth or teeth, and many treatment options available to you. Some of the common causes and potential treatments include:

  • Accident or Trauma

If you have suffered a tooth or jaw injury as a result of an accident or trauma, it’s very important to see your dentist or doctor immediately. You should be carefully examined to determine whether there is damage to other teeth or the jaw.

Often, dental or bone injuries are best treated by an oral surgeon. Oral and maxillofacial surgeons are the specialists in facial trauma, with years of surgical training and experience in the diagnosis and treatment of traumatic injuries. Any time surgery is recommended for bone or tooth trauma, ask for a referral to an oral surgeon.

In some cases of damage to the periodontal ligament or tooth, even if your tooth is loose or extruded (partially out of its socket), it can be stabilized in place so that the ligament and tissue around it has time to heal.

If the root, nerves, and blood vessels are still intact, the tooth can be placed back in its socket, and then anchored to the adjacent teeth with a flexible splint for several weeks. In the case of an alveolar or a root fracture, a rigid splint may be used.

Splinting gives the periodontal ligament and bone surrounding it time to heal while keeping your injured tooth from further displacement.

  • Bite problems & Bruxism

Your teeth are designed to withstand a lot of pressure—in fact, in some ways, pressure is essential for healthy teeth and bone. The normal pressure of chewing and biting stimulates bone tissue in the jaw. When a tooth is lost, that stimulation is gone and the result is gradual bone loss in the area underneath the lost tooth.

But sometimes, the pressure exerted by a malocclusion (bad bite) or bruxism (tooth grinding) is too forceful. The connective tissue which holds the teeth in place is damaged by these forces, and loose teeth can be the result.

If you grind your teeth, a night guard can be custom fitted to provide relief from the pressures and impact of tooth clenching and grinding. This special kind of mouth guard is known as an occlusal splint.

  • Osteoporosis

Osteoporosis causes a loss of bone density throughout the body. Studies suggest that this disease can affect bone in the jaw, leading to weaker bone and looser teeth. Your physician will provide your best medical alternatives, and be sure to let us now if you are taking medication for osteoporosis before we plan your dental treatment.

  • Periodontal Disease

Gum disease is one of the major causes of loose—and lost—teeth. Early gum disease, called gingivitis, should be treated promptly to avoid a more serious condition called periodontitis. Periodontitis can cause the gums to pull away from the teeth, creating pockets for bacterial growth and infection. Left untreated, this infection results in connective tissue and bone loss.

Oral surgeries such as flap surgery or bone and tissue grafting can help reverse the effects of periodontitis. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

  • Pregnancy

Hormonal changes can cause the ligaments and bone around your teeth to loosen, which can lead to loose teeth. While this might be an alarming development, it’s generally a temporary condition. Talk to your dentist about how to take care of your teeth and gums during your pregnancy.

Hormonal changes can also make your gums more vulnerable to irritation and infection. In fact, swollen and tender gums are often one of the first signs of pregnancy. That’s another reason it’s very important to keep up with dental hygiene during pregnancy. If your gums are red, swollen, bleeding, or tender, give your dentist a call.

What to do if you have a loose tooth?

  • Call your dentist immediately. Timely professional care can mean the difference between saving your tooth and losing it.
  • Avoid wiggling the tooth. This could loosen it further.
  • Protect your loose tooth. Eat soft foods, and try not to chew near the affected area. And while a liquid diet might sound like a good idea, no straws, please. Straws require suction, which can further dislodge your tooth.
  • Keep the area clean, gently.

What to do if a tooth can’t be saved

Baby teeth become loose and fall out because the permanent teeth coming in erode the smaller roots holding them in place. That’s why it’s so easy for parents to help their child’s wiggly baby tooth find its way from mouth to Tooth Fairy.

Adult roots, however, involve alveolar bone, ligaments, blood vessels, and nerves, so an extraction is often best performed by an oral surgeon. Dr. Robert Farber, Dr. Corey Farber, Dr. Harry Morris, Dr. Henry Bryan, and Dr. Mark Isler will also examine you carefully to discover the reason for the tooth loss, and to prevent further damage with additional treatment as needed.

Finally, if you do lose a permanent tooth, there is still much that can be done to restore your smile. Modern implants are almost indistinguishable from natural teeth, and, what’s more, they function just like natural teeth to stimulate the bone beneath them.

If you have any worries about your teeth, give our Dearborn office a call. A loose tooth is never a cause for celebration, but, with proper dental care, a loose tooth doesn’t always lead to a lost tooth. Restoring a firm bite and a heathy and confident smile? That’s a reason to celebrate!

Should You Get Dental Veneers?

July 21st, 2021

Dental veneers are a popular treatment to improve the appearance of your smile. Dr. Robert Farber, Dr. Corey Farber, Dr. Harry Morris, Dr. Henry Bryan, and Dr. Mark Isler and our team want to help you understand whether this dental option is right for you.

Veneers, also known as laminates, are custom-made shells that cover the front of your teeth. They can change the color, size, or length of each individual tooth. The process can require between one and three trips to our Dearborn office to complete.

This treatment is usually done for people who want to change the appearance of their smile: they can get rid of stains, gaps, or chips. Here at Dearborn West Dental, we know how getting veneers can dramatically change your smile and help improve your confidence.

Your initial appointment entails preparing the teeth and creating an impression. The impression will help us design each veneer to the exact shape and color you desire. You’ll come back in a week or two to have the veneers placed. Your veneers should last about ten years, as long as you practice proper care and hygiene.

There are plenty of benefits to getting veneers, but you should be aware of the potential downsides of this procedure. This process is irreversible and the veneers cannot usually be fixed. If they chip or crack, they’ll need to be replaced.

It is also possible for veneers to fall off due to excessive pressure from nail biting or chewing on ice. If you grind your teeth a lot, you’re more likely to expose your veneers to damage, which can be costly to repair.

In order to know whether veneers are right for you, schedule an appointment at our Dearborn office for a consultation. We can decide what you’re looking to do with your smile and if this is the best option for you.

Happy Gums, Happy Heart!

July 14th, 2021

Medical doctors and dental health professionals, like Dr. Robert Farber, Dr. Corey Farber, Dr. Harry Morris, Dr. Henry Bryan, and Dr. Mark Isler, have debated over the connection (or lack thereof) between gum disease and heart disease. While there still is no unanimous consensus on whether there is a link – or the extent to any link there may be – several studies offer some interesting insight into possible correlations that may prove that there are some common factors that point to a likely correlation between the two.

Could there be a link between gum disease and heart disease?

Dr. Simone Ricketts reported on the findings of an Australian study of 80 patients in Profile Magazine. That study showed that 70% of the patients who participated in the study and needed heart transplants also had gum disease. She noted that other studies show a similar pattern, indicating that patients who needed heart transplants or other cardiac surgery procedures, were more likely to have dental problems.

Not Just Heart Disease Linked to Gum Disease

It isn’t just heart disease that experts are linking to periodontal disease, however. More and more evidence is showing that many chronic inflammatory diseases such as diabetes can be linked to periodontal disease. Poor oral hygiene resulting in gum disease was evident in blood tests that showed positive markers for inflammation.

Experts looked at a combination of over 120 medical studies focusing on a link between dental health and heart health. The findings of that research were published in the Journal of Periodontology and the American Journal of Cardiology. While there was no agreement on a definitive link, the research showed some promising results, and offer information that may be helpful to both dental health professionals and their patients.

On its own, gum disease increases the risk of developing coronary artery disease. Data from the National Health and Nutrition Examination Survey (NHANES) showed that gum disease increases the risk factor for blood vessel and artery diseases when those arteries supply blood to the brain.

This is especially important for strokes because they are a common cause of inadequate blood flow to the brain. Data from another study of 50,000+ people found a higher risk of stroke among people with gum disease and tooth loss.

The study did, however, show two very important connections between gum and heart disease:

  • Both the gums of people with gum disease and the blood vessels of people who had atherosclerosis tested positive for similar types of bacteria.
  • Both patients with atherosclerosis and those with gum disease showed the presence of inflammation in their bodies.

Patients need to understand the importance of taking care of their mouths and doing whatever is necessary to ensure or support heart health – even if there is no guarantee that doing so will prevent either disease.

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