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By Janis Dental
September 19, 2021
Category: Oral Health
Tags: loose tooth  
YouNeedtoActFasttoSaveaLooseTooth

Some things in life are almost guaranteed to make you go, "Uh, oh"—your car won't start, your a/c goes out, or, worse yet, you get an unexpected letter from the IRS.

Here's another: One of your teeth is loose. And, if you don't act quickly, that loose tooth may soon become a lost tooth.

But first, we need to find out why it's loose. It's usually due to one of two types of injury related to your bite. One type is called primary occlusal trauma. This results from your teeth encountering higher than normal biting forces. This often happens if you habitually gnash or grind your teeth together outside of normal functions like eating or speaking.

The other type is secondary occlusal trauma. In this case, the supporting gum tissues and bone have been weakened or lost by disease, with the gum tissues possibly becoming detached. Without this support, even normal biting forces could loosen a tooth.

Our treatment approach for a loose tooth may differ depending on which of these is the cause. For primary occlusal trauma, we want to reduce the biting forces that have contributed to loosening the tooth. One way to do this is to create a mouthguard that when worn prevents teeth from making solid contact during grinding episodes.

For secondary trauma, we want to first focus on treating any gum disease responsible for weakening the gum tissues. Once we have it under control, the gums and bone tissues can heal and possibly regain and strengthen their attachment with the tooth.

At the same time, we may also need to stabilize a loose tooth to prevent its loss. This usually involves splinting, whereby we use neighboring healthy teeth to support the loose tooth. One way to do this is to attach a metal strip across the backs of the loose tooth and its more stable neighbors, or by way of a channel cut through the top biting surfaces of the teeth.

If a loose tooth regains its attachment with the gums and bone, it may stabilize and any splinting can be removed. If not, splinting may become a permanent solution. Either way, prompt treatment can help us save your loose tooth.

If you would like more information on treating loose teeth, 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 “Loose Teeth: Biting Forces Can Loosen Teeth.”

LoveandHipHopHostsNo-GapSmileandHowYouCanHaveOneToo

Nina Parker, the host of Love & Hip Hop for six seasons, is now busy with the new game show Blockbusters and her own talk show The Nina Parker Show. But even with a full plate, she took time recently for some personal care—getting a new smile.

Parker's fans are familiar with her noticeable tooth gap. But a video on TikTok in February changed all that: In the video, she teasingly pulls away a mask she's wearing to reveal her smile—without the gap.

Parker and other celebrities like Madonna, Michael Strahan and David Letterman are not alone. Teeth gaps are a common smile feature, dating back millennia (even in fiction: Chaucer described the Wife of Bath as being "gap-toothed" in The Canterbury Tales).

So, what causes a tooth gap? Actually, a lot of possibilities. The muscle between the teeth (the frenum) may be overly large and pushing the teeth apart. There may be too much room on the jaw, so the teeth spread apart as they develop. It might also have resulted from tongue thrusting or late thumb sucking as a child, influencing the front teeth to develop forward and outward.

A tooth gap can be embarrassing because they're often front and center for all the world to see, but they can also cause oral health problems like complicating oral hygiene and increasing your risk for tooth decay. They can also contribute to misalignment of other teeth.

Fortunately, there are ways to alleviate a gap. One way is to move the teeth closer together with either braces or removable clear aligners. This may be the best approach if the gap is wide and it's contributing to misalignment of other teeth. You may also need surgery to alter the frenum.

You can also reduce less-pronounced gaps cosmetically with dental bonding or porcelain veneers. Bonding involves applying a type of resin material to the teeth on either side of the gap. After some sculpting to make it appear life-like, we harden the material with a curing light. The result is a durable, tooth-like appearance that closes the gap.

A veneer is a thin wafer of porcelain, custom-made to fit an individual patient's tooth. Bonded to the front of teeth, veneers mask various dental flaws like chips, deformed teeth, heavy staining and, yes, mild to moderate tooth gaps. They do require removing a small amount of enamel on the teeth they cover, but the results can be stunning—completely transformed teeth without the gap.

Getting rid of a tooth gap can be a wise move, both for your smile and your health. You may or may not take to social media to show it off like Nina Parker, but you can feel confident to show the world your new, perfect smile.

If you would like more information about treating teeth gaps and other dental flaws, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Space Between Front Teeth.”

By Janis Dental
August 30, 2021
Category: Oral Health
Tags: oral health  
CrackedMouthCornersHowtoResolveThisIrritatingProblem

In addition to the usual tooth and gum problems, dentists also see patients with soft tissue infections in and around the mouth. One of the more common of these is the irritation or "cracking" of the corners of the mouth.

Formally known as angular cheilitis (or perleche, a French word, meaning "to lick"), cracked mouth corners are localized irritations made worse by saliva accumulation or an accompanying yeast infection. They're prominent among children and young adults who drool during sleep or while wearing orthodontic braces.

Older adults can also develop cracked mouth corners because of deep wrinkle lines around the mouth ("marionette lines") or tissue irritation from wearing dentures. Teeth loss, especially in the back of the jaws, can weaken facial support leading to collapse of the bite, which can contribute to angular cheilitis.

The condition can cause anything from minor discomfort at the mouth corners to a yeast infection that spreads throughout the mouth and throat. Whatever the symptoms, treatment usually begins with antifungal medication in the form of a mouthrinse or a topical ointment. The dentist may also prescribe a steroid ointment like zinc oxide paste to control inflammation and serve as a barrier against infection.

If the infection has spread beyond the mouth corners, patients may also need to use an antibacterial mouthrinse (usually chlorhexidine) to clear up the infection and help prevent a relapse. Besides cleaning their appliances with chlorhexidine, denture wearers with angular cheilitis should also take their dentures out at night to reduce the chances of a reoccurrence.

Along the same vein, patients who contend with frequent cracked mouth corners and who have missing teeth should have those teeth replaced by some form of restoration. If that involves dentures, it's important to maintain a good fit with them to reduce the chances of tissue irritation. And patients with deep wrinkle lines around their mouth may be able to lessen them through dermatological treatment.

Even though cracked mouth corners rarely pose a major health problem, the discomfort they cause can be a drag on your daily life and activities. Remember that you don't have to suffer—a visit to your dentist could start you on your journey toward relief from this irritating problem.

If you would like more information on angular cheilitis and similar mouth conditions, 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 “Cracked Corners of the Mouth.”

By Janis Dental
August 20, 2021
Category: Dental Procedures
Tags: root canal  
DontFeartheRootCanal-ItCouldJustSaveYourTooth

Root canals often get a bum rap. Although the procedure saves millions of teeth every year, it's often erroneously portrayed as an unpleasant experience. And if that wasn't enough, a long-discredited medical theory has found new life on the internet asserting root canals are a health danger.

First off, root canals play an immensely important role in treating teeth with advanced decay. If not promptly treated, a cavity can turn into a major infection of the interior tooth pulp and root canals, and ultimately the supporting bone. Teeth with this level of decay are not long for this world.

A root canal treatment stops this disease process in its tracks. After numbing the tooth and surrounding gums, we drill a small hole into the tooth's interior and then remove all of the infected tissue within the pulp and root canals. After disinfecting these areas, we fill them with a rubber-like substance called gutta percha.

After sealing off the access hole—and later capping the tooth with a life-like crown—the tooth is secure from further decay. And, by the way, the procedure doesn't hurt, thanks to local anesthesia. If anything, any pain caused by the decay attacking the tooth's nerves has now been alleviated.

So, what about the idea floating on the Web that root canals are dangerous? The "root" for this conjecture is a theory by Weston Price, an early 20th Century dentist, that leaving a "dead" body part in the body leads to various health problems (including cancer). That would include a root-canaled tooth, which has had the living tissue in the pulp removed.

There's just one problem—Weston's theory was fully investigated in the 1950s and overwhelmingly discredited. The supposed cancer threat was also reviewed in a 2013 study, which found no link between root canals and increased cancer risk. In fact, dental patients who had undergone several root canals had a diminished risk.

Like all other health procedures, root canals have some risks of complication. But those complications are far from life-threatening—it's tooth-saving benefits are often worth the risk. So, fear not if your dentist says you need a root canal. It won't hurt and it won't endanger your health—and it could save your tooth.

If you would like more information on root canal therapy, 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 Canal Safety.”

PlaqueRemovalistheTopPriorityforPreventingorTreatingGumDisease

Tooth loss is often the unfortunate conclusion to a case of untreated periodontal (gum) disease—incentive enough to try either to prevent it or aggressively treat an infection should it occur. In either case, the objective is the same: to remove all plaque from dental surfaces.

Dental plaque (and its hardened form, tartar) is a thin buildup of bacteria and food particles on tooth surfaces. It's a ready food source for sustaining the bacteria that cause gum disease. Removing it can prevent an infection or “starve” one that has already begun.

Your first line of prevention is brushing and flossing your teeth daily to remove any accumulated plaque. Next in line are dental cleanings at least twice a year: This removes plaque and tartar that may have survived your daily hygiene.

Plaque removal is also necessary to stop an infection should it occur. Think of it as a more intense dental cleaning: We use many of the same tools and techniques, including scalers (or curettes) or ultrasonic devices to loosen plaque that is then flushed away. But we must often go deeper, to find and remove plaque deposits below the gums and around tooth roots.

This can be challenging, especially if the infection has already caused damage to these areas. For example, the junctures where tooth roots separate from the main body of the tooth, called furcations, are especially vulnerable to disease.

The results of infection around furcations (known as furcation involvements or furcation invasions) can weaken the tooth's stability. These involvements can begin as a slight groove and ultimately progress to an actual hole that passes from one end to the other (“through and through”).

To stop or attempt to reverse this damage, we must access the roots, sometimes surgically. Once we reach the area, we must remove any plaque deposits and try to stimulate regrowth of gum tissue and attachments around the tooth, as well as new bone to fill in the damage caused by the furcation involvement.

Extensive and aggressive treatment when a furcation involvement occurs—and the earlier, the better—can help save an affected tooth. But the best strategy is preventing gum disease altogether with dedicated oral hygiene and regular dental visits.

If you would like more information on preventing and treating gum disease, 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 “What are Furcations?





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