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By Riverdale Dental Associates
January 20, 2018
Category: Dental Procedures
EarlyActionNeededtoSaveYourToothfromRootResorption

Along with the gums, your teeth’s roots help stabilize them. Without them your teeth couldn’t handle the normal biting forces you encounter every day. That’s why a rare condition called root resorption must be treated promptly: this gradual breakdown and dissolving of root structure could eventually cause you to lose your tooth.

Resorption is normal in primary (“baby”) teeth giving way for permanent teeth or sometimes during orthodontic treatment. But the form of resorption we’re referring to in permanent teeth isn’t normal, and is highly destructive.

The condition begins in most cases outside the tooth and works its way in, usually at the gum line around the cervical or “neck-like” region of the tooth (hence the term external cervical resorption or ECR). ECR produces pink spots on the teeth in its early stages: these are spots of weakened enamel filled with pink-colored cells that cause the actual damage. The cells create cavity-like areas that can continue to enlarge.

We don’t fully understand what causes ECR, but there seems to be links with excessive force during orthodontics, tooth trauma (especially to the gum ligaments), tooth grinding habits or internal bleaching procedures. However, most people with these problems don’t develop ECR, so the exact mechanism remains a bit of a mystery.

The good news, though, is that we can treat ECR effectively, provided we discover it before it inflicts too much damage. That’s why regular dental visits are important, coupled with your own observation of anything out of the ordinary and immediate dental follow-up.

If the affected area is relatively small, we may be able to remove the cells causing the damage and repair the area with a tooth-colored filling. If it appears the pulp (the tooth’s innermost layer) is involved, we may need to perform a root canal treatment to remove infected tissue and fill the empty space with a special filling. You may also need other procedures to reduce the chances of gum recession around the affected tooth.

Proactive dental care is your best insurance against losing a tooth to root resorption. So keep an eye on your teeth and see your dentist regularly to keep your teeth and gums healthy.

If you would like more information on the signs and treatments for root resorption, 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 Resorption: An Unusual Phenomenon.”

By Riverdale Dental Associates
January 05, 2018
Category: Dental Procedures
Tags: celebrity smiles   veneers  
VivicasVeneerstheMakingofaHollywoodSmile

What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.

"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."

But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.

"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."

What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.

Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.

To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.

Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?

"I love my veneers!" she declared, noting that they have held up well for over a decade.

For more information about veneers, please contact us or schedule an appointment for a consultation.

By Riverdale Dental Associates
December 21, 2017
Category: Dental Procedures
Tags: gum disease  
DontDelayTreatmentofGumDisease

Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.

One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.

It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.

We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).

Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.

Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.

If you would like more information on treatments for gum disease, please contact us or schedule an appointment for a consultation.

By Riverdale Dental Associates
December 06, 2017
Category: Oral Health
Tags: toothache  
WhattoDoAboutYourChildsToothacheBeforeSeeingtheDentist

If your child begins complaining of tooth pain without an accompanying fever or facial swelling, it’s likely not an emergency. Still, you should have us check it—and the sooner the better if the pain persists or keeps your child up at night. There are a number of possible causes, any of which if untreated could be detrimental to their dental health.

Before coming in, though, you can do a cursory check of your child’s mouth to see if you notice any abnormalities. The most common cause for a toothache is tooth decay, which you might be able to see evidence of in the form of cavities or brown spots on the tooth’s biting surfaces. If you notice swollen or reddened gums around a tooth, this could be a possible sign of a localized area of infection known as an abscess. You should also ask your child if they fell or were hit in the mouth and look for any signs of an injury.

If you don’t see anything unusual, there may be another cause—stuck food like popcorn or candy lodged and exerting painful pressure on the gum tissue or tooth. You may be able to intervene in this case: gently floss around the affected tooth to try to dislodge any food particles. The pain may ease if you’re able to remove any. Even so, if you see abnormalities in the mouth or the pain doesn’t subside, you should definitely plan to come in for an examination.

In the meantime, you can help ease discomfort with a child-appropriate dose of ibuprofen or acetaminophen. An ice pack against the outside jaw may also help, but be careful not to apply ice directly to the skin. And under no circumstances rub aspirin or other painkiller directly on the gums—like ice, these products can burn the skin. If these efforts don’t help you should try to see us the same day or first thing the next morning for advanced treatment.

The main thing is not to panic. Knowing what to look for and when to see us will help ensure your child’s tooth pain will be cared for promptly.

If you would like more information on handling dental issues with your child, 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 “A Child’s Toothache.”

By Riverdale Dental Associates
November 21, 2017
Category: Dental Procedures
Tags: adult braces   orthodontics  
YourAgeWontNecessarilyDecideAgainstStraighteningYourSmile

It’s something you think about often—especially when you look in a mirror or at a photo of yourself. You wish something could have been done about it a long time ago. But now you think you’re too old to correct your misaligned teeth—your “crooked” smile.

Actually, you can transform your smile through orthodontics, whatever your age. Millions of your peers have done just that—currently, an estimated one in five orthodontic patients is an adult.

If orthodontics isn’t right for you it won’t be because of age, but most likely the condition of your gums and underlying bone or your overall health. That first factor is extremely important: if you’ve lost a significant amount of bone due to periodontal (gum) disease, there may not be enough to support the force of moving the teeth during orthodontics.

Health conditions like severe heart-valve disease, uncontrolled diabetes or drugs to treat arthritis or osteoporosis can also make tooth movement difficult. And, if you have restricted saliva flow (dry mouth), wearing orthodontic devices could be uncomfortable and increase your risk of tooth decay.

If, however, your mouth and body are reasonably healthy (and you don’t have a difficult bite problem to correct), there’s no reason why you can’t undergo orthodontic treatment. The only other thing that might hold you back is concern over your appearance during treatment. Many adults balk at the possible embarrassment of wearing metal braces “at their age.”

If this is a concern, you may have an alternative: clear aligners. These are a series of computer-generated clear plastic trays that conform to the individual contours of your teeth. Each tray is slightly different—you wear one for a short period of time (usually two weeks) before moving on to the next tray to successively and gradually move your teeth. They’re nearly invisible to others and, unlike fixed metal braces, you can take them out for a rare special occasion.

The only way you’ll know whether correcting your misaligned teeth is a viable option is to undergo a full orthodontic evaluation. From there we can help you decide if and how you want to gain a straighter, more attractive smile.

If you would like more information on adult orthodontics, 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 “Orthodontics for the Older Adult.”





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