If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.

When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.

If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.

If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.

When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.

Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.

Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”

Most people think of bone as rock-solid, but it's actually a living tissue that's constantly changing. This has significant implications for your oral health, general health, and appearance — if you are one of the 70% of Americans missing at least one tooth.

Throughout the day, your top and bottom teeth make hundreds of fleeting contacts with each other. These small stresses are transmitted though the periodontal ligament (“peri” – around; “odont” – tooth) that supports each tooth in its socket like a hammock. Think of it as a gentle push on the hammock, which causes the tooth to gently bump the underlying bone. The bone then builds up in the spot that's receiving stress to counteract it. This constant remodeling of bone is what allows bone to stay healthy and strong.

When a tooth is lost, the bone does not receive that gentle stress. It reacts by literally melting away. Sometimes this happens fairly quickly — in a matter of months. After the tooth-supporting bone is lost, the jawbone itself begins the same process of deterioration. This could eventually change the shape of the face, as the distance from nose to chin can decrease — even if only a few back teeth are missing. The results aren't pretty. But the good news is, there's a way to prevent all this.

Dental implants, which function as substitute tooth roots, actually save underlying bone when teeth are lost. They do this because they are made of titanium, which fuses to the bone in which it's set, stabilizing it. The implant is topped by a realistic-looking crown, which replaces the part of the missing tooth that was visible in the mouth. Together, they look and function just as your natural tooth did.

If you are missing a lot of teeth, implants can also be used to anchor bridges or even removable dentures while providing that same bone-saving benefit. And when you consider that they are so durable they should never need replacement, implants are a great investment.

If you have any questions about dental implants, please contact us, or schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

What is composite resin bonding?
This term refers to a kind of tooth-colored material that is a mixture of a plastic resin and a glass filler. The glass gives the mixture, or composite, strength and translucency that is similar to a natural tooth. The composite is bonded to the tooth by slightly abrading or roughening the tooth so that the resin fills in small cuts in the tooth surface and bonds with it. The end result functions and looks like part of the original tooth.

What is bonding used for?
This technique is a good way to restore chipped or stained teeth or to change a tooth's shape or color. It can also be used to restore parts of a tooth near the gum line where the gums have receded and left the root partially exposed.

What are the advantages of bonding?
Composite resin tooth restorations have several advantages.

• They take only a single dental visit because they are done right in the dental chair rather than having to be sent to a dental lab for preparation.
• They are less expensive than many other dental restorations.
• They leave most of the original tooth intact since little tooth preparation or drilling has to be done in order to make the composite material bond to the tooth.
• They can be made in a wide range of colors and can be matched well with the teeth around them.
• Because little of the original tooth has to be removed, they are a good choice for teens, whose dental arches (upper and lower jaws) are still developing.

What are the disadvantages of bonding?
The composite resin material is not as strong as the original tooth material, so the bonded restorations may not last over a long time. If it does last, the material may also stain as it ages.

When should you choose bonding?
Composite resin bonding is a good choice for a quick and attractive tooth restoration that may be replaced later by something more permanent, such as porcelain veneers.

Contact us today to schedule an appointment to discuss your questions about bonding. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”

When dentists talk to patients, they often use specialized vocabulary referring to various dental conditions. Do you understand what they mean when they use these words — or are you wondering what they are talking about?

Here's your chance to test your knowledge of ten words that have a particular meaning in the context of dentistry. If you already know them, congratulations! If you don't, here's your chance to learn what these words mean in the dental world.

Enamel
In dentistry, enamel is the hard outer coating of your teeth. It is the hardest substance produced by living animals. It is a non-living, mineralized, and composed of a crystalline form of calcium and phosphate.

Dentin
The dentin is the layer of a tooth that is just beneath the enamel. It is living tissue similar to bone tissue.

Pulp
When dentists speak of pulp, we mean the tissues in the central chamber of a tooth (the root canal) that nourish the dentin layer and contain the nerves of the tooth.

Bruxism
Many people exert excess pressure on their teeth by clenching or grinding them. This is called bruxism, a habit that can be very damaging to teeth.

Occlusion
By this we mean how the upper and lower teeth are aligned, and how they fit together. This can also be referred to as your bite.

Dental caries
This term refers to tooth decay. Dental caries and periodontal disease (see below) are two of the most common diseases known to man. Today, these diseases are not only treatable, but they are also largely preventable.

Periodontal disease
A term for gum disease, this term comes from “peri,” meaning around and “odont,” meaning tooth. It is used to describe a process of inflammation and infection leading to the progressive loss of attachment between the fibers that connect the bone and gum tissues to the teeth. This can lead to loss of teeth and of the bone itself.

Erosion
When you consume acidic foods or drinks, the acids in your mouth react directly with minerals in the outer enamel of your teeth, causing chemical erosion. This is not the same as tooth decay, which is caused by acids released by bacterial film that forms on your teeth (see below).

Dental implant
A dental implant is a permanent replacement for a missing tooth. It replaces the root portion of the tooth and is most often composed of a titanium alloy. The titanium root fuses with the jaw bone, making the implant very stable. A crown is attached to the implant and can be crafted to match your natural teeth.

Plaque
Dental plaque is the whitish film of bacteria (a biofilm) that collects on your teeth. Your goal in daily brushing and flossing is to remove plaque.

Contact us today to schedule an appointment to discuss any questions you may have about your teeth and gums. You can also learn more by reading Dear Doctor magazine article “How and Why Teeth Wear.”

When it comes to replacing missing teeth, we have numerous options. However, two of the most common treatment options include bridgework and dental implants. See how much you really know about dental implants and bridgework by taking our quick and easy true/false self test.

1. When it comes to costs, dental implants may initially cost more than bridgework but are less expensive than bridgework over a lifetime.
   True or False
2. Both bridgework and dental implants can last a lifetime when properly maintained.
   True or False
3. Prior to placing a three-unit fixed bridge, if the surrounding teeth have crowns, they must be redone so that the bridge fits and wears properly.
   True or False
4. Replacing a single tooth with a three-unit bridge, requires removing the enamel on the adjacent teeth even if these teeth are disease-free.
   True or False
5. In addition to being permanent tooth replacements, another advantage of dental implants is that they don't decay like teeth supporting bridgework.
   True or False
6. It is not uncommon for root canal treatment to be required to save teeth that support bridgework if they have been subjected to severe decay and their nerves become infected.
   True or False
7. Placing a dental implant requires more time when compared to placing a three-unit bridge.
   True or False
8. Both bridgework and dental implants require minor surgery to replace a missing tooth.
   True or False
9. Dental implants are more desirable than bridgework because placing them does not affect the adjacent teeth.
   True or False
10. Studies indicate that bridges are only 67% successful at 15 years whereas dental implants have success rates into the 90s.
    True or False

Answers: 1) True. This fact shocks many people. 2) False. This is more commonly true for dental implants. 3) True. 4) True. This is one of the disadvantages of bridgework. 5) True. This is just one of the advantages of a dental implant. 6) True. 7) True. 8) False. Dental implants require surgery to be placed. 9) True. This fact is a significant advantage for dental implants. 10) True. Your results may vary; however, this statistic represents what you might expect.

To learn more, continue reading the Dear Doctor magazine article “Implants vs. Bridgework.” Or, you can contact us today to schedule an appointment or to discuss your questions.