Posts for category: Dental Procedures

By Douglas M. Hope, DMD, MAGD
March 06, 2021
Category: Dental Procedures
Tags: tooth decay  
FrequentSinusInfectionsTakeaTriptoYourDentist

If you suffer frequent sinus infections, you might want to see a dentist. No, really—your recurring sinusitis might stem from a decayed tooth.

Tooth decay can start as a cavity, but left untreated can advance within the tooth and infect the pulp and root canals. If it reaches the end of the root, it can cause the root tip and surrounding bone to break down.

A severe toothache is often a good indicator that you have advanced tooth decay, which can usually be stopped with a root canal treatment.  But a decayed tooth doesn't always produce pain or other symptoms—you could have a “silent” infection that's less likely to be detected.

A symptomless, and thus untreated, infection in an upper back tooth could eventually impact the maxillary sinus, a hollow air-filled space located just above your back jaw. This is especially true for people whose tooth roots extend close to or even poke through the sinus floor.

That “silent” infection in your tooth, could therefore become a “loud” one in the sinuses causing chronic post-nasal drip, congestion and, of course, pain. Fortunately, a physician or an ear, nose and throat (ENT) specialist might suspect a dental origin for a case of recurring sinusitis, a condition known as maxillary sinusitis of endodontic origin (MSEO).

Antibiotic treatment can clear up sinusitis symptoms short-term. It's unlikely, though, it will do the same for a dental infection, which may continue to trigger subsequent rounds of sinusitis. The best approach is for a dentist, particularly a specialist in interior tooth disease called an endodontist, to investigate and, if a decayed tooth is found, treat the source of the infection.

As mentioned earlier, the solution is usually a root canal treatment. During this procedure, the dentist completely removes all infected tissue within the pulp and root canals, and then fills the empty spaces to prevent future infection. In one study, root canal therapy had a positive effect on alleviating sinusitis in about half of patients who were diagnosed with a decayed tooth.

If your sinusitis keeps coming back, speak with your doctor about the possibility of a dental cause. You may find treating a subsequently diagnosed decayed tooth could alleviate your sinus problem.

If you would like more information on how your dental health could affect the rest of your body, 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 “Sinusitis and Tooth Infections.”

KeepYourNewStraightenedSmileStraightWithanOrthodonticRetainer

You can't correct a poor bite with braces or clear aligners overnight: Even the most cut-and-dried case can still require a few years to move teeth where they should be. It's a welcome relief, then, when you're finally done with braces or aligner trays.

That doesn't mean, however, that you're finished with orthodontic treatment. You now move into the next phase—protecting your new smile that took so much to gain. At least for a couple of more years you'll need to regularly wear an orthodontic retainer.

The name of this custom-made device explains its purpose: to keep or “retain” your teeth in their new, modified positions. This is necessary because the same mechanism that allows us to move teeth in the first place can work in reverse.

That mechanism centers around a tough but elastic tissue called the periodontal ligament. Although it primarily holds teeth in place, the ligament also allows for tiny, gradual tooth movement in response to mouth changes. Braces or aligner trays take advantage of this ability by exerting pressure on the teeth in the direction of intended movement. The periodontal ligament and nature do the rest.

But once we relieve the pressure when we remove the braces or aligners, a kind of “muscle memory” in the ligament can come into play, causing the teeth to move back to where they originally were. If we don't inhibit this reaction, all the time and effort put into orthodontic treatment can be lost.

Retainers, either the removable type or one fixed in place behind the teeth, gently “push” or “pull” against the teeth (depending on which type) just enough to halt any reversing movement. Initially, a patient will need to wear their retainer around the clock. After a while, wear time can be reduced to just a few hours a day, usually during sleep-time.

Most younger patients will only need to wear a retainer for a few years. Adults who undergo teeth-straightening later in life, however, may need to wear a retainer indefinitely. Even so, a few hours of wear every day is a small price to pay to protect your beautiful straightened smile.

If you would like more information on orthodontic retainers, 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 “The Importance of Orthodontic Retainers.”

By Douglas M. Hope, DMD, MAGD
February 04, 2021
Category: Dental Procedures
HowYouTooCouldHaveLindseyVonnsViralVideoSmileMakeover

Instagram, America's humongous digital photo and video album, is chock-full of the silly, mundane, and poignant moments of people's everyday lives. That includes celebrities: Tom Hanks buying a used car; Ryan Reynolds sporting tiny sunglasses; Taylor Swift and Ed Sheeran taking a hike. And then there's former Olympic alpine skier, Lindsey Vonn—posting a video of her recent dental visit.

Winner of several World Cup competitions and the first woman to gain the gold for downhill racing at the 2010 Winter Olympics, Vonn broke her two front teeth during a—you guessed it—skiing competition a few years ago. This past September, she went to the dentist to update her restoration and gave her followers a fascinating firsthand look at dental bonding, a technique for repairing a chipped or broken tooth.

Although dental bonding has been around for decades, it's taken a leap forward in the last few years because of improvements in bonding material. A mixture of plastic and glass components, composite resins can produce a strong and durable result when bonded to teeth. To begin the technique, the tooth's surface is prepared so that the composite resin can better adhere. Along with an adhesive agent, the bonding material is applied as a paste, which makes it easier to shape and sculpt for the most realistic look. This is usually done layer by layer, with each individual layer hardened with a curing light.

The technique allows us not only to achieve the right tooth shape, but also to incorporate your natural tooth color. We can tint the composite resin as we work so that your restored tooth blends seamlessly with the rest of your natural teeth. The result: A “new” tooth that's both beautiful and natural-looking.

What's more, dental bonding is more affordable than veneers or crowns and can often be done in a single visit. You will, however, need to exercise care with your new restoration. Although highly durable, it can be damaged if you bite into something hard. You'll also need to watch foods and beverages like tea or coffee that can stain the dental material.

Even so, we can help you regain the smile you once had before you took your teeth skiing—Lindsey Vonn-style—or whatever you were doing that resulted in a “whoopsie.” All it takes is a call for an appointment to start you on the path to a more attractive smile.

If you would like more information about cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Artistic Repair of Front Teeth With Composite Resin.”

By Douglas M. Hope, DMD, MAGD
January 15, 2021
Category: Dental Procedures
EndodonticTreatmentCouldSaveaToothinCrisis

Dental patients have amazing options for tooth replacement. Dental implants, for example, can replace the entire tooth, root and crown, giving patients a new tooth nearly as good as the old one.

Nearly—but not exact. Even implants can't match the full benefits of a natural tooth, including one in less than perfect shape. Our first goal as dentists, then, is to save a diseased tooth if at all practical before considering replacing it.

That often involves a root canal treatment to address decay threatening a tooth's interior. The procedure requires drilling into the tooth to access its innermost pulp, cleaning out the pulp and root canals, and then filling the empty spaces. Since all dentists are trained in basic root canal treatment, your general dentist may be able to perform it.

But some dental situations call for more advanced endodontics, the dental specialty for treating disease and other problems inside a tooth. So, in what situations would you see an endodontist?

When your dentist refers you. Your dentist wants you to receive the level of treatment necessary to save your tooth. After examination, they may determine your situation would be better served by the advanced training, equipment and techniques (including surgery) of an endodontist.

When your tooth has complications. Patients often need an endodontist when existing factors complicate treatment of advanced tooth decay. A patient may have dental pain that's difficult to pinpoint, requiring the diagnostic resources of an endodontist. It's also common for a tooth's root canal network to be highly intricate, and which respond better to treatment with specialized endodontic tools and techniques.

When root canal treatment fails. Most root canal treatments are successful in protecting the tooth from further infection. That said, it's still possible for a root-canaled tooth to become re-infected or develop more problems. Again, an endodontist and their “tool chest“ re-treating a root-canaled tooth may be the best option for saving it.

You also don't have to wait for a referral—you can see an endodontist if you believe they would be best to treat your decayed tooth. You can find one near you by visiting an online endodontist directory at www.aae.org/find. An endodontist may be the lifesaver your diseased tooth needs.

If you would like more information on saving a tooth through endodontic treatment, please contact us or schedule an appointment for a consultation.

By Douglas M. Hope, DMD, MAGD
December 06, 2020
Category: Dental Procedures
Tags: dental implant   bridgework  
CouldaDentalBridgeBeaBetterChoiceThanImplants

What a difference forty years can make: Dental bridges once occupied the top spot for choices to replace missing teeth until the arrival of dental implants in the 1980s. Today, dental implants are the gold standard for dental restoration.

But although bridgework may have lost “first chair” in the orchestra of restorations, it's still a viable option. In fact, it can be the best option in certain situations.

Bridges consist of a series of porcelain crowns fused together like fence pickets. The center crowns, known as the pontics, “bridge” the gap left by a missing tooth or teeth. The crowns on each end, the abutment teeth, crown the natural teeth on either side of the gap to support the bridge.

Bridges are effective and durable, but with a major downside: To accommodate the abutment crowns, we must reduce the size of the natural teeth to which they'll be attached. This alteration can weaken those teeth's structure and require them from then on to have some form of restoration. They're also at higher risk for tooth decay.

Implants, on the other hand, don't require this alteration, and may also be more durable than bridges. Why then consider a bridge?

Price can be a factor: Implants may be more expensive, especially involving multiple teeth. Keep in mind, though, that this only compares the initial cost: Because implants have a 95% or more ten-year success rate, with further evidence they could potentially last for decades, they may actually cost less in the long-run than bridge restorations that have a higher chance of being replaced sooner.

But the prime reason is that some dental situations aren't suitable for dental implants. For instance, implants require a certain amount of bone for proper placement, so people with extensive bone loss may not be able to acquire them. Health conditions like uncontrolled diabetes or a compromised immune system can also complicate implant installation. A bridge in these cases may represent a better alternative.

With the help of your dentist, you'll need to consider your individual situation, dental and financial, in deciding between an implant or a bridge. And, if a dental bridge is your best option, it will be a solid choice for restoring your missing teeth and your smile.

If you would like more information on various dental restoration methods, 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 “Crowns & Bridgework.”



Contact Us

Douglas M. Hope, DMD, MAGD

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