Posts for category: Dental Procedures

By Douglas M. Hope, DMD, MAGD
May 20, 2020
Category: Dental Procedures
Tags: tooth pain  
ToothPainHereAreSomePossibleCauses

“My tooth hurts…or maybe more than one. Or, it might be my gums.”

If you're having trouble describing the pain in your mouth, don't feel bad. Although our body's pain mechanism is great for alerting us to a problem, it can't always tell us the true cause and location of that problem.

That's especially true of tooth pain. It could be a sign, for instance, of decay within a tooth's inner pulp. When under attack, the nerves in the pulp often send out pain signals that could be sharp, dull, continuous, intermittent, seeming to come from one tooth or several.

If this is the case, depending on how deep the decay is, you could need a filling to resolve the problem or, if it's more extensive, possibly a root canal treatment to save the affected tooth. If you need a root canal, after removing the pulp's diseased tissue, the procedure calls for filling the empty pulp chamber and root canals to prevent future infection.

Another possibility for the pain is gum disease that has also infected the tooth. Gum disease usually begins with the bacteria in dental plaque, a thin biofilm that builds up on tooth surfaces, which infect the gums. If not treated promptly, the infection can advance below the gum line to the tooth roots and supporting bone. From there, it could invade the tooth and travel through the root canals to the interior pulp.

In this scenario, we'll need to treat the gum disease by removing plaque and tartar (hardened plaque) deposits from all tooth and gum surfaces. This is usually done manually with hand instruments or ultrasonic equipment, but it may also require surgical access to infected areas around the roots. If the tooth's nerve has become involved, we may also need to perform a root canal treatment as described above.

There are three key points to take from these two tooth pain scenarios. First, the only way to determine the true cause of your pain (and what treatment you'll need) is with a dental exam. Second, the sooner your pain is diagnosed and you begin treatment, the better your outcome—so see your dentist at the first sign of pain or other symptoms like swollen or bleeding gums.

And finally, you may be able to prevent these and other dental problems by removing disease-causing plaque through daily brushing and flossing and professional teeth cleaning every six months. Prevention through effective oral hygiene may help you avoid a future bout of mysterious tooth pain.

If you would like more information on treating tooth pain, 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 “Confusing Tooth Pain.”

By Douglas M. Hope, DMD, MAGD
May 10, 2020
Category: Dental Procedures
Tags: apicoectomy  
IfaRootCanalWontWorkThisProcedureMightSaveYourTooth

Root canal treatments are the go-to procedures dentists use to treat a tooth with advanced internal decay that has resulted in the pulp (nerve) dying. And for good reason: root canals are responsible for saving millions of teeth that would otherwise be lost.

In the basic root canal procedure, dentists make access into a tooth's interior with a small hole drilled into the crown. They then remove all diseased tissue within the pulp chamber and root canals. These now empty spaces are then filled, and the tooth is sealed and crowned to prevent further infection.

This is usually a straightforward affair, although it can be complicated by an intricate root canal network. In those cases, the skills and microscopic equipment of an endodontist, a specialist in root canals, may be needed to successfully perform the procedure.

But there are also occasional cases where it may be inadvisable to use a conventional root canal procedure to treat an endodontic infection. For example, it may be difficult to retreat a root canal on a restored tooth with a crown and supporting post in place. To do conventional root canal therapy, it would be necessary to take the restoration apart for clear access, which could further weaken or damage the remaining tooth's structure.

In this and similar situations, a dentist might use a different type of procedure called an apicoectomy. Rather than access the source of infection through the tooth's crown, an endodontist approaches the infection through the gums. This is a minor surgical procedure that can be performed with local anesthesia.

Making an incision through the gums at the level of the affected root, the endodontist can then remove any infected tissue around the root, along with a small portion of the root tip. They then place a small filling and, if necessary, grafting material to encourage bone growth around the area. The gums are then sutured in place and the area allowed to heal.

An apicoectomy is another way to attempt saving a tooth that's well on its way to demise. Without it or an attempt at a conventional root canal treatment, you might lose your tooth.

If you would like more information on treating advanced tooth decay, 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”

By Douglas M. Hope, DMD, MAGD
April 30, 2020
Category: Dental Procedures
DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

By Douglas M. Hope, DMD, MAGD
April 10, 2020
Category: Dental Procedures
RemovingOneorMoreTeethCouldImproveOrthodonticOutcomes

Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.

One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.

Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.

Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.

Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.

Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.

Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.

Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.

If you would like more information on orthodontic options, 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 “Removing Teeth for Orthodontic Treatment.”

By Douglas M. Hope, DMD, MAGD
February 10, 2020
Category: Dental Procedures
HowShawnMendesandMileyCyrusGotTheirStellarSmiles

The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.

"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")

Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)

Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).

Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.

Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.

What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”



Contact Us

Douglas M. Hope, DMD, MAGD

(860) 651-4915
8 Plank Hill Rd. Simsbury, CT 06070