Posts for: June, 2020
Your child could hit a speed bump on their road to dental maturity—tooth decay. In fact, children are susceptible to an aggressive form of decay known as Early Childhood Caries (ECC) that can lead to tooth loss and possible bite issues for other teeth.
But dentists have a few weapons in their arsenal for helping children avoid tooth decay. One of these used for many years now is the application of sealants to the biting surfaces of both primary and permanent teeth. Now, two major research studies have produced evidence that sealant applications help reduce children's tooth decay.
Applying sealant is a quick and painless procedure that doesn't require drilling or anesthesia. A dentist brushes the sealant in liquid form to the nooks and crannies of a tooth's biting surfaces, which tend to accumulate decay-causing bacterial plaque. They then use a curing light to harden the sealant.
The studies previously mentioned that involved thousands of patients over a number of years, found that pediatric patients without dental sealants were more than three times likely to get cavities compared to those who had sealants applied to their teeth. The studies also found the beneficial effect of a sealant could last four years or more after its application.
The American Dental Association and the American Academy of Pediatric Dentistry recommend sealants for children, especially those at high risk for decay. It's common practice now for children to first get sealants when their first permanent molars erupt (teeth that are highly susceptible to decay), usually between the ages of 5 and 7, and then later as additional molars come in.
There is a modest cost for sealant applications, but far less than the potential costs for decay treatment and later bite issues. Having your child undergo sealant treatment is a worthwhile investment: It could prevent decay and tooth loss in the near-term, and also help your child avoid more extensive dental problems in the future.
Looking in the mirror, you probably focus on your teeth and gums—i.e., your smile. Your dentist, though, will take the time to look deeper into your mouth, searching for anything out of the ordinary. That could be a type of mouth sore known as lichen planus.
Lichen planus are lesions that can appear on skin or mucus membranes, including inside the mouth. The name comes from their resemblance to lichens, a fungus found on trees or rocks (although the sore itself isn't fungi). As such, they often have a lacy pattern of lines emanating from purplish bumps.
Again, the first indication you have such a condition may come from your dentist. Sometimes, though, you may notice greater sensitivity to spicy or acidic foods and, if the gums are affected, irritation when you eat or brush.
If you find out you have lichen planus, don't be alarmed—it usually doesn't pose harm to your health and it's not contagious. Its appearance, though, could be mimicked by more harmful medical conditions, so your dentist will want to confirm the lesion observed is truly lichen planus.
It's routine, then, for your dentist to excise a small sample of the sore's tissue and send it to a pathology lab for biopsy. Although results will more than likely confirm lichen planus or some other benign lesion, it's better to err on the side of caution and ensure you're not dealing with something more serious.
If you are diagnosed with lichen planus, you may need to take steps to manage symptoms. In most people, the sore will go away on its own, although there's no guarantee it won't reappear sometime later. In the event it lingers, your dentist may prescribe a topical steroid to help ease any discomfort.
You can also minimize a future outbreak by practicing effective daily oral hygiene to reduce the bacterial populations that may contribute to the condition. And when you're symptomatic, try avoiding spicy or acidic foods like citrus, peppers or caffeinated beverages.
Lichen planus is more bothersome than harmful. Taking the above steps can help you avoid it or deal with it more effectively when it occurs.
If you would like more information on lichen planus, 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 “Lichen Planus: Mouth Lesions That are Usually benign.”
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.