Dental Topics
Below is a listing of many common dental conditions and procedures. If you want more information about a specific topic, just click on the name and you will be taken to a detailed explanation.
If you still have questions, please don't hesitate to Contact Us.
Cosmetic Dentistry
A smile can be the most eye-catching feature of your face. Even a subtle change can make a big difference in the way you look and feel. New techniques like whitening, bonding, enamel shaping, veneers, and white fillings allow us to create a beautiful smile with, at times, only minimal changes to existing teeth.
Teeth Whitening is a very popular procedure in cosmetic dentistry. It is a relatively easy and effective technique for obtaining a dazzling, whiter smile, at home, in a matter of days.
Bonding is a procedure where tooth-colored composite resin material is placed to "fill in the blanks." One of the most frequent uses of the bonding technique is to fill in a gap between front teeth.
Enamel Shaping (Contouring) is the process of shaping natural teeth to improve their appearance. Shaping can be used to correct minor cases of crowded or overlapping teeth, smooth rough edges, or make small adjustments to the shape of a tooth.
Veneers are laboratory fabricated, porcelain facings that are bonded to the front surfaces of teeth to whiten teeth, close spaces, straighten teeth, or repair chipped or worn teeth. The veneers are only about 1 mm thick (the thickness of a fingernail). That same thickness is "shaved" off the natural tooth surface so when the veneer is bonded to the tooth, the tooth doesn't feel or look "thicker".
Caps (Crowns) are rarely used for cosmetic correction any more, since the advent of veneers, but in some cases a crown may be necessary for a particular tooth. A tooth with a bad fracture or a large filling that is breaking down, or has decay around it, may be a candidate for a crown instead of a veneer. This patient has veneers on top, but one of the front teeth had a large filling and had to be crowned.
White fillings replace silver or gold fillings with a more natural looking tooth-colored material. Since teeth are translucent, dark fillings cause the whole tooth to appear darker when viewed from the side. Replacing older dark
topTeeth Whitening
What is Teeth Whitening?
Teeth Whitening is actually a mild bleaching process that restores stained or discolored teeth to a healthy, natural color. Don't be misled by unproven and ineffective over-the-counter whitening solutions. Our office uses an advanced procedure that is only available from your dentist.
What Causes Tooth Discoloration?
Teeth become discolored for different reasons:
- Frequently drinking coffee, tea, or colas.
- Some antibiotics may darken developing teeth in children.
- Aging - The dentin underneath the enamel of a tooth gradually darkens with age.
- Use of tobacco products.
- Accidents - If a tooth has been traumatized, sometimes the nerve will gradually "die," and the tooth becomes dark.
- After Root Canal Therapy, a tooth will generally darken.
Is Whitening Safe?
Whitening is very safe. We use a product that has been proven safe when used under the direction of a dentist.
Is Whitening For Me?
Dr. Surber will evaluate your teeth and smile to determine whether whitening is right for you. In some cases a different cosmetic procedure may better meet your expectations, but whitening is a safe, fast and easy process that is effective for almost everyone!
What Is The At-Home Whitening Process?
First, we will make impressions of your teeth so that our lab can create custom whitening trays to fit your mouth. These trays will guide the whitening agent to the areas of your teeth that need to be whitened. We will record the current color of your teeth to help you monitor your progress.
Next, we will fit your custom trays in your mouth to ensure they feel comfortable. We will instruct you on how to apply the whitening agent to your trays and how to insert them into your mouth. You will take the custom trays and whitening agent home with you. The treatment can be applied any time of day since the clear, custom-fitted trays are barely visible and do not interfere with your ability to speak.
When Will I See Results?
Immediately! Most patients see results after the first treatment. It will typically take from 2 to 6 weeks to restore your teeth to a beautiful white. The time it will take depends on the original color of your teeth, how discolored they were, and how frequently the treatment is applied.
How Long Will The Results Last?
The effects typically last several years. Many patients choose to "touch-up" their teeth every 6 to 12 months by applying the treatment once or twice. "Touch-ups" are especially useful for patients that drink beverages that stain teeth, like coffee, tea, and colas.
Are There Any Side-Effects?
Some patients may experience heightened tooth sensitivity to cold, or mild tooth or gum sensitivity during treatment, but these symptoms are only temporary and disappear within a few days.
topTooth Discoloration
What Causes Tooth Discoloration?
Teeth become discolored for different reasons:
- Drinking coffee, tea, or colas.
- Some antibiotics may darken developing teeth in children.
- Aging - The dentin underneath the enamel of a tooth gradually darkens with age.
- Use of tobacco products.
- Accidents - If a tooth has been traumatized, sometimes the nerve will gradually "die", and the tooth becomes dark.
- After Root Canal Therapy, a tooth will generally darken.
What Can Be Done About Tooth Discoloration?
The four most common remedies for tooth discoloration are:
- Bonding
- Whitening
- Veneers
- Caps (Crowns)
Each patient must be evaluated individually, so Contact Us to set up a consultation. Dr. Surber will discuss the appropriate options with you for your particular case.
topAccidents
Tooth Knocked Out
Do not wipe the tooth clean. Place the tooth in a glass of milk, if possible. If milk is not available, use a wet napkin or cup of water. See a dentist immediately. Sometimes, if the tooth is placed back in its socket soon enough by your dentist, the tooth can be saved. Time is critical in this situation!
Broken and Chipped Tooth
Remove the fractured piece to prevent choking and don't chew on anything hard. Call your dentist immediately. Some teeth can be filled. More severe cases may need to be crowned. If the tooth has broken into the nerve the tooth will need Root Canal Therapy and a Crown, or it will need to be extracted.
Loose Tooth
If you were hit by an object, call your dentist immediately. Depending on the severity of the blow, your dentist may let the tooth "tighten-up" on its own, or your dentist may bond the tooth to the uninjured teeth next to it for support until it heals. The tooth may turn dark and/or abscess after an accident. That may happen immediately, or it could be years later. If the tooth does eventually abscess, it will require Extraction or Root Canal Therapy and a Crown just like any other abscessed tooth.
Lacerated (Cut) Lip or Tongue
Apply pressure to stop or slow the bleeding. If the wound is severe or doesn't stop bleeding, call your dentist or go to the Emergency Room at the hospital immediately. The wound may require stitches to stop the bleeding, prevent infection and to help it properly heal.
topRoot Canal Therapy
When the nerve of a tooth becomes infected or abscessed, Root Canal Therapy is the only way to save the tooth. A tooth can become abscessed as a result of deep decay, a cracked tooth, or trauma to the tooth. The only alternative to Root Canal Therapy is an Extraction.
During Root Canal Therapy, the tooth is "numbed" (just like having a filling). Then the unhealthy nerve is removed and medication is placed in the tooth to treat the bacterial abscess (infection). After the infection is removed and treated, a filling is placed in the roots where the unhealthy nerve was.
A tooth that has undergone Root Canal Therapy is more brittle and must be crowned to give the tooth sufficient strength. The tooth is cared for in the same way as other natural teeth. Brush and floss daily, and visit your dentist for regular preventative dental check-ups.
topSensitivity
Teeth can be sensitive for many reasons.
Pressure
Sensitivity to chewing pressure can be caused by:
- Clenching/Grinding
- Decay
- Abscess
- Cracked tooth
Sweets
Sensitivity to sweet foods is usually caused by decay.
Hot and/or Cold
Sensitivity to hot and/or cold foods usually indicates:
- Decay
- Abscess
- Worn Teeth (Attrition)
- Receded Gums
It is not unusual for recent dental restorations to be sensitive to hot, cold, or pressure. This sensitivity should decrease with time. If sensitivity from a recent dental restoration worsens or persists, contact your dentist.
Whitening
Whitening can also temporarily cause mild sensitivity during treatment that disappears within a few days.
Toothache
Sensitivity due to a dental problem will worsen with time and become a toothache. A toothache is not like a headache. It won't just go away, even if the pain temporarily subsides. The problem that is causing the pain will just get worse, as will the pain, and simple treatment may no longer be possible. (See our pages on cavities, root canals, abscesses, and extractions to see how a cavity progresses from a minor to a major problem). At the first sign of a toothache, contact your dentist.
topBonding
Bonding is simply adding a little tooth-colored composite material to "fill in the blanks." One of the most frequent uses of the bonding technique is to fill in a gap between front teeth.
Before: A noticeable space between the front teeth.
After: Bonding fills the space, but still keeps the teeth looking natural.
topEnamel Shaping
Enamel Shaping (Contouring) is the process of shaping natural teeth to improve their appearance. Shaping can be used to correct minor cases of crowded or overlapping teeth, smooth rough edges, or make small adjustments to the shape of a tooth. No anesthesia is necessary!
Before: This patient has a small notch in three of her four front teeth.
After: Minor contouring (shaping) of the enamel makes her teeth smooth and natural looking!
topVeneers
Veneers are custom, porcelain facings that are bonded to the front surfaces of teeth to whiten teeth, close spaces, straighten teeth, or repair chipped or worn teeth. The veneers are only about 1 mm thick (the thickness of a fingernail). That same thickness is "shaved" off the natural tooth surface so when the veneer is bonded to the tooth, the tooth doesn't feel or look "thicker".
Before: Discoloration on front teeth and teeth are uneven in length.
After: Veneers return the natural, healthy glow! Teeth are now lengthened evenly.
topFillings
After decay is removed from a tooth, something must be placed in that space to give strength back to the tooth.
Fillings: Fillings are the most common restorative procedure.
Inlays and onlays: In addition to fillings, lab fabricated inlays and onlays are sometimes used. Although many patients think of these as fillings as well, they are actually different since they are laboratory fabricated.
White fillings: White fillings are used most of the time in our office. They are an attractive, durable alternative to silver (amalgam) fillings. White fillings are made of a strong composite resin that is matched to the surrounding tooth color. In the past, white fillings were placed only on front teeth, but recently a stronger more durable material has been developed that can withstand the chewing pressure of back teeth.
Silver (amalgam) fillings: Although white composite resin fillings are used most of the time by our office, there may be circumstances that call for a silver (amalgam) filling. Typically, silver fillings are placed on back teeth (molars).
White Porcelain or Resin inlay or onlay: A porcelain or resin inlay or onlay is used when the cavity is too big for a filling, but isn't so big that a crown is required. An inlay is a filling within the cusp tips of the tooth. Onlays (also known as overlays) will overlay one or more cusps in order to protect and strengthen the tooth.
An inlay or onlay may also be made of gold.
topCrowns
A crown fits over the entire top of the tooth above the gum line. Crowns cover, protect, seal and strengthen a tooth. A crown is needed when a filling just will not work. A crown may be made of gold, white porcelain, or porcelain fused to gold. There are many situations that may call for a crown:
If a tooth has decay so deep and large that a filling will not stay, or if the tooth structure is weakened, a crown must be placed on the tooth to save it.
When large old fillings break down, or get decay around them, they usually need to be crowned. It is important to crown a tooth that has been structurally weakened to prevent a cracked or broken tooth. Once a tooth breaks, it may not be possible to save it.
When a tooth is cracked, a filling will not seal the crack. A crown has to be placed over the tooth to hold it and the crack together. If a crown is not placed on the tooth, the tooth will become sensitive to chewing pressure, or will eventually break. It is important to crown a cracked tooth before it breaks, because in some cases a broken tooth cannot be crowned and must be extracted.
Broken / Fractured tooth.
A tooth that has broken is usually too weak to hold a filling. A crown will hold the tooth together and prevent it from breaking again. If the fracture involves the nerve, Root Canal Therapy may be required before the tooth is crowned. In some cases, a broken tooth cannot be saved and must be extracted.
This patient chose not to have the cracked tooth above crowned, and it later fractured. This tooth had to be extracted because it cracked all the way to the root.
Teeth that are very sensitive, either from a lot of "wear", or from receded gums, sometimes require crowns to seal and protect the teeth from hot and cold sensitivity.
A tooth that has undergone Root Canal Therapy will need a crown to properly seal and protect the tooth. A tooth with Root Canal Therapy is more brittle than a tooth with a healthy nerve and blood supply. A crown provides the necessary support to the tooth.
In cosmetic dentistry, crowns (sometimes called "caps") are used less frequently since the advent of veneers, but in some cases a crown may be necessary for a particular tooth. A tooth with a bad fracture or a large filling may be a candidate for a crown instead of a veneer.
Before: This tooth has a large filling as shown. A crown is needed on this tooth, instead of a veneer, because there isn't enough natural tooth left to support a veneer. A crown will cover and protect the tooth, but will look the same as a veneer.
After: The top teeth now have veneers, except the one that had the large filling, which now has a crown.
topBroken / Chipped Tooth
If you have a broken or chipped tooth as a result of a very recent trauma or accident, contact your dentist immediately!
If you have a broken or chipped tooth that is not the result of a recent trauma, Dr. Surber can evaluate the tooth for possible treatment. It is still important to have the tooth evaluated right away, because in some situations a minor procedure now can save you from a more significant procedure in the near future!
A very small chip may be corrected by enamel shaping. If the chip is a little larger, the best options may be bonding or a veneer. If the chip is on a molar, an onlay may be appropriate. Large chips and fractured teeth generally require a crown. If the fracture involves the nerve, Root Canal Therapy may be necessary before the tooth is crowned. It is important to have a broken tooth crowned before it becomes infected or abscessed!
In extreme cases, a broken tooth cannot be saved. In this case, an extraction is needed. The missing tooth can be replaced with a bridge or an implant.
Each case is unique. Only your dentist can properly diagnose the best course of treatment for your tooth.
topLatest Techology
Our office uses modern, state-of-the-art technology to enhance patient comfort and to help you get the smile you deserve!
Computer Digital Radiography (CDR)
Digital x-rays can now be taken using sensors that transmit the image directly into a computer monitor. This larger image helps the patient understand the doctor's explanations more easily and enables the doctor to "zoom in" on a specific area of the tooth. An important advantage to this new technology is that it reduces the amount of radiation by 90%. Digital x-rays are also faster. The digital image only takes a minute or two to appear in the monitor. In addition, this new technology is friendly to the environment since no chemicals are needed for developing the image.
Intraoral Camera
Our intraoral camera uses a tiny fiber-optic wand to easily take vivid photographs of the inside of your mouth. This allows us to let you see what we see.
MicroDentistry
MicroDentistry means finding decay as early as possible so that treatment can be done with minimal removal of natural tooth structure. Restorations (fillings) are the smallest possible, esthetically pleasing, and long-lasting.
Dental Imaging Software
Dental imaging software allows us to simulate cosmetic and other procedures so you can see the effect on your smile before we start! We take digital pictures of your teeth and then use a sophisticated computer simulation program to create the projected "after" images.
Soft Tissue Laser
Modern lasers are used to cosmetically contour gums, lengthen crowns to provide ample structure for restoration, and treat pockets of infection during gum treatment.
Lasers are self-sterilizing, provide the maximum amount of control, and are virtually painless during the procedure and post-operatively.
DIAGNOdent
The DIAGNOdent is a new high tech laser system that aids in early diagnosis of cavities in the complex anatomy of the chewing surfaces of teeth. It utilizes laser light of a defined wavelength to help detect and quantify demineralized tooth substances without x-ray exposure.
Ultrasonic Cleaning
The cavitron is an ultrasonic scaler. Power scalers do a more thorough job in less time. This results in significantly decreased scaling time and healthier, cleaner teeth and gums. Hand scalers require repetitive scrapping movements and are restricted to adaptation of only one or two sides of the instrument. In comparison, all four sides of a power scaler can be adapted, because the device moves in an elliptical motion. This comes in handy when removing stain and deposits from behind and between the teeth. Ultrasonic scalers are more effective in removing stain as well. The ultrasonic vibration helps control oral bacteria by breaking down the cell wall of the bacteria. The water used to cool the cavitron then helps to rinse away bacteria, stain and debris.
Prophy Jet
An advanced air polishing cleaning technology which uses air/water/sodium bicarbonate (baking soda) to gently remove stains and dental plaque while at the same time polishing the teeth.
Power Bleaching
For In-Office bleaching, we utilize the advanced Zoom! light-activated process. Click here to learn more about Zoom!
Virtual Reality Glasses
We have Virtual Reality glasses available for longer procedures so you can watch a movie while you're getting your dental work done!
Multimedia Education
Our treatment rooms are equipped with state-of-the-art patient-education DVD systems. If you are uncertain about a particular procedure, we will be happy to play the DVD video segment for you.
Veneers
New technology in veneer fabrication allows us to perform dazzling transformations with minimal surface preparation.
White fillings
Although white fillings have been around for a long time, the new materials can now be used in a wider range of applications allowing you to keep your smile as white as it can be!
Used in conjunction with a conventional visual examination, the ViziLite™ test improves identification, evaluation and monitoring of abnormalities in those at increased risk for oral cancer. The ViziLite™ Test Kit includes a handheld disposable light and mouth rinse that work together to help detect abnormalities that might not be visible to the unaided eye.
topX-rays
Computer Digital Radiography (CDR)
Dental X-rays can now be taken using sensors that transmit the image directly into a computer monitor. This larger image helps the patient understand the doctor's explanations more easily and enables the doctor to "zoom in" on a specific area of the tooth. An important advantage to this new technology is that it reduces the amount of radiation by 90%. Digital X-rays are also faster. The digital image only takes 20 seconds to appear in the monitor. In addition, this new technology is friendly to the environment since no chemicals are needed for developing the image.
What are Dental X-rays?
What most people call X-rays are actually X-ray photographs (also known as radiographs). An image is made using X-rays, which are similar to sunlight, but of a shorter wavelength, and able to show us what's below the surface of a tooth. Even though we call them X-rays, we are actually referring to the image created by X-rays.
Why are Dental X-rays Necessary?
X-rays are the only way to identify problems that aren't externally visible. X-rays are very essential in doing a complete and thorough dental examination. They are especially important in diagnosing serious conditions early to allow for effective treatment before you experience discomfort. X-rays show bone anatomy and density, decay between the teeth or how extensive the decay is, whether an abscess is present, impacted teeth, or if children have permanent teeth.
No cavities on first visit
Months later, cavities that start between the teeth can't be seen by visual examination, but they can be detected on an X-ray.
This cavity was detected and filled before the patient felt any discomfort, and before the nerve became infected or the tooth became abscessed.
There is another cavity shown in the X-ray on the right. Can you find it? It's difficult for the untrained eye to spot. If you think you know where it is, send an e-mail to webmaster@SurberSmiles.com and we will tell you if you're right! (Hint: It's not the left edge of the top left tooth. That's just the edge of the frame around the X-ray).
How Often Do I Need Dental X-rays?
The number and type of X-rays you will need depends on several factors such as age, current dental health, and external signs that may trigger a cause for concern. We are sensitive, however, to your concerns about exposure to radiation, and we only perform those X-ray procedures that are necessary for your continued dental health.
Still Have Questions or Concerns?
If you have any questions or concerns about dental X-rays, feel free to discuss them with any of our staff. They are highly trained in the prudent and effective use of dental X-rays and share your concerns about exposure levels.
topCavities
Tooth Decay begins when the protein of your saliva combines with the sugars and carbohydrates of food particles left on and between your teeth. This combination creates bacteria-laden plaque, from which acid is produced that eats away at the hard enamel shell around your tooth. Left unchecked, a hole will be created in the enamel and a cavity will rapidly form in the softer dentin which lies under the enamel. If the cavity is caught in time, usually a Filling will correct the problem. Larger cavities may require an Inlay or Onlay, or a Crown. However, if nothing is done and the decay spreads, the sensitive pulp (nerve) may become involved, often causing an Abscess, and Root Canal Therapy or Extraction may be required.
Months later, cavities that start between the teeth can't be seen by visual examination, but they can be detected on an X-ray.
This cavity was detected and filled before the patient felt any discomfort, and before the nerve became infected or the tooth became abscessed.
There is another cavity shown in the X-ray on the right. Can you find it? It's difficult for the untrained eye to spot. If you think you know where it is, send an e-mail to webmaster@SurberSmiles.com and we will tell you if you're right! (Hint: It's not the left edge of the top left tooth. That's just the edge of the frame around the X-ray).
topGum Contouring
Some people have teeth that look too "short" due to the relationship between their teeth and gums. This creates a "gummy" smile. A procedure called "gum contouring" is often used to remove excess gum tissue and expose more of the crown of the tooth. In fact, your gum line can be carefully sculpted to create just the right proportion between gum tissue and tooth surface -- and the result is a better looking smile.
If the gum is uneven around a tooth, gum contouring can smooth and balance the way your tooth and gum look. The procedure produces a consistent, even gum line that is esthetically pleasing.
Crown Lengthening is the same procedure applied for functional instead of (or in addition to) cosmetic reasons.
topCrown Lengthening
In many cases of dental decay, tooth fracture, or even in instances where an individual has "short" teeth, a crown lengthening procedure will allow us to properly construct an esthetic and functional crown, bridge, or restoration.
Crown lengthening is a simple surgical procedure which adjusts the position of the gum around the affected tooth, thereby providing a more solid tooth on which to anchor the restoration of choice. A functional crown lengthening will help you regain a beautiful smile and allow you to eat and speak with comfort and confidence.
A purely esthetic crown lengthening procedure to correct a "gummy" smile is often referred to as Gum Contouring.
This tooth required crown lengthening to provide enough tooth surface for a restoration
topGum Treatment
Gum treatment is the treatment of active gum and jaw bone disease. The treatment can slow or stop the progression of the disease. Since there are different stages of gum disease (from gingivitis to advanced periodontitis), there are different levels of treatment. In some cases, the patient may be referred to a specialist.
Gum treatment consists of one or more of the following procedures, depending on the individual case:
Prophylaxis(Cleaning)
Scaling and Root Planing
Scaling and Root Planing is a common non-surgical treatment for periodontal disease. By using special instruments, we remove bacteria and infection from the unhealthy deep pockets around the teeth below the gum line. This is often referred to as a "deep cleaning".
First the tooth is scaled to remove the plaque and tarter that has accumulated on the tooth.
Then the root is planed or smoothed. This eliminates any rough areas on the root that can easily trap plaque and bacteria.
A smooth clean root provides a healthy environment to allow the gums to heal naturally and reattach to the tooth. This will create a reduced pocket, therefore eliminating areas for bacteria to hide and cause further disease.
Scaling and Root Planing combined with a strict home care routine and more frequent periodontal cleanings and exams will increase your chances of keeping your natural smile.
Sometimes, in order to treat advanced gum disease, surgical procedures are necessary, such as:
- Crown Lengthening
- Pocket Depth Reduction
- Soft Tissue Grafts
- Bone and Tissue Regeneration
- Ridge Augmentation
Peridex® is a prescription mouth rinse that reduces the redness, swelling and bleeding of gums caused by gingivitis. Dr. Surber may prescribe Peridex® for use between visits.
A home care routine specific to the patient's individual needs may be prepared to prevent the patient from relapsing.
topPocket Depth Reduction
Normal, healthy gums have small pockets around each tooth. The bacteria and infection associated with periodontitis causes these pockets to become deeper, trapping more bacteria and causing more infection. When the pockets become too deep for scaling and root planing, a Pocket Depth Reduction procedure is often a solution.
During a Pocket Depth Reduction procedure, Dr. Surber gently folds back the gum and removes the disease-causing bacteria and infection.
Dr. Surber will then smooth the root surfaces and, if necessary, reshape the gum and bone.
This will allow the gums to form smaller, healthier pockets.
topSoft Tissue Grafts
We are concerned foremost with your health. However, some of the procedures we perform are intended not only to control disease, but to provide you with a cosmetic benefit. Some patients may look older than their years because their teeth appear to be too long ("long in the tooth"). Soft tissue grafts and other root coverage procedures are designed to cover exposed roots and make the teeth look much better.
When gum tissue recedes due to periodontal disease, it pulls away from the teeth. Periodontal plastic surgery procedures can restore some coverage and dramatically improve a person's smile.
Soft tissue grafts and other root coverage procedures cover exposed roots and restore healthy gum tissue. This will reduce further bone loss and recession, make the tooth less sensitive, protect the root from root cavities, and look more natural when you smile.
topBone and Tissue Regeneration
When the damage caused by Periodontal Disease is significant, a Bone and Tissue Regeneration procedure may be necessary to save your teeth.
During this treatment, Dr. Surber gently folds back the gum and removes the disease-causing bacteria and infection. He will then place membranes, bone grafts and tissue-stimulating proteins to help your body naturally heal and regenerate bone and tissue.
Regeneration of the bone and tissue, along with a strict home care program and increased professional cleanings, will greatly increase your chances of keeping your natural teeth.
Ridge Augmentation
Sometimes, when a tooth is lost, the gum and bone where the tooth was shrinks and creates an indention in the gum. This happens because the jawbone isn't holding a tooth in place anymore, even though there may be a bridge or partial in place. Dr. Surber can correct this defect with ridge reconstruction, making your smile look natural again.
topAbscessed Tooth
Periapical (root-tip) Abscess
A periapical (root-tip) abscess is a pocket of infection at the base of a tooth's root. The tooth becomes abscessed after the pulp (nerve) of the tooth becomes infected. A periapical abscess is usually caused by deep decay or an accident (trauma to the tooth involving nerve damage). A periapically abscessed tooth will require either Root Canal Therapy or an Extraction. In some cases an antibiotic will also be prescribed.
Lateral Abscess
A lateral abscess is similar to a periapical abscess, but develops along the lateral surface of the tooth's root. In this case, the infection comes from outside the tooth instead of from within. A lateral abscess can either be gingival (located near the gum line) or periodontal (located deeper in the periodontal tissues). Since most cases of lateral abscess are due to periodontitis (gum disease), treatment is part of an overall periodontal (gum) treatment program.
All Abscesses
An abscessed tooth is usually sensitive or painful. The discomfort is what normally alerts the patient to the problem. Occasionally, an abscess may be detected on an x-ray and treated before the patient experiences any discomfort. Left untreated, an abscess may compromise the immune system and in some cases may become life-threatening.
topAllergies
Many people have allergies to dust and pollen. Some people have specific allergies to certain medications or materials. You will be asked about any specific allergies you may have on your new-patient questionnaire. Be sure to let us know prior to treatment if you have allergies to any of the following:
Allergies to Medications
If you have ever had an allergic reaction to any medication, including dental anesthetics, please let us know. If you can't remember the name of the medication, we can contact the health care provider that used or prescribed the medication to get the name. We have alternate anesthetics that can be used in case of allergies. There are also alternate drugs that can be prescribed in case of allergies to oral antibiotics or analgesics (pain relievers).Allergies to Materials
If you are allergic to Latex, please notify us prior to treatment and we will be happy to use Nitrile gloves instead. If you have any other allergies we should be aware of, please let us know so we can provide a comfortable environment for you. topAnesthesia
New advances in dental medications have virtually eliminated the discomfort of dental procedures. There are several elements to creating a comfortable experience for your dental appointment:
Comfort and Relaxation
The first step is to make you relaxed and comfortable. From the comfortable environment in our reception area to the soothing environment we have created around the dental chairs, no detail is too small when your comfort is concerned. Our caring, professional staff are committed to creating a stress-free environment for your comfort.
Some patients need a little help achieving a relaxed state. Nitrous Oxide ("laughing gas") is available when needed to make you more comfortable.
Topical Anesthetic
A topical anesthetic can be used any time the surface of the gum needs to be "numbed", such as easing the discomfort of a painful mouth sore or preparing a site for an injectable local anesthetic.
Local Anesthetic
Modern fast-acting local anesthetics, in conjunction with effective topical anesthesia, have virtually eliminated the discomfort of "getting numb". Local anesthetics are available in several strengths so you don't have to experience the "fat lip" sensation for hours after leaving the dental office.
Post-visit Analgesics
Generally, if there is any discomfort at all after a dental procedure, over-the-counter analgesics such as aspirin or non-asprin pain relievers are all that is needed. In exceptional circumstances a prescription pain reliever will be used.
Any questions?
If you have any questions or concerns about anesthesia, Dr. Surber will be happy to discuss them with you. We want you to be as comfortable as possible.
topAnkylosis
Tooth ankylosis is the fusion of the tooth to the bone, preventing the tooth from erupting. This can happen in both primary ("baby") teeth and permanent teeth, and may occur at any stage during development or eruption. The cause of this condition is still uncertain. Theories include trauma and heredity. An exam and x-ray are the main diagnostic methods for determining ankylosis. Some cases require surgical extractions for orthodontic and functional purposes.
topBaby Bottle Syndrome
Baby Bottle Syndrome or Early Childhood Caries is the rapid decay of baby teeth in an infant or child from frequent exposure, for long periods of time, to liquids containing sugars. The upper front teeth are most commonly affected.
The problem is usually caused by a baby falling asleep while nursing a bottle or while breast feeding. While the child is asleep, the sugary liquid pools around the front teeth. The bacteria living in every baby’s mouth then turns the sugars to acid which causes decay.
Common sources of liquids high in sugars are:
- A bottle containing formula, milk, soda, or juice
- A pacifier dipped in honey
- Breast milk
You can help prevent Baby Bottle Syndrome by:
- Cleaning your child’s teeth daily
- Not allowing your child to fall asleep with a bottle filled with juice, milk, or formula
- Not allowing your child to sip on a bottle filled with juice, milk, or formula for long periods of time as a pacifier
- Giving your child plain water when he or she is thirsty
- Making sure your child gets the fluoride needed to prevent decay
- Making regular dental appointments for your child beginning when their first tooth erupts
Dr. Surber can provide you with more information which can improve the care of your child’s teeth and maximize their oral health.
topBad Breath (Halitosis)
Many times bad breath is caused by the bacteria in the mouth and on the tongue. Sometimes it can be an indication of gum disease. Either way, your first stop to address persistent breath problems should be our office, because if gum disease is present, it must be treated promptly to avoid tooth loss. Gum disease is the leading cause of tooth loss among adults!
Possible causes for halitosis are:
- Tooth Decay
- Periodontal (Gum) Disease
- Inadequate Oral Hygiene (not brushing and flossing)
- Odor-causing foods
- Use of Tobacco Products
- Sinus or Respiratory Infection
- Continued Mouth Dryness (Xerostomia)
- Some Medical Disorders
- Some Medications
Dr. Surber can help you determine the cause, and if the cause is an oral condition, a treatment plan can be developed to combat this common source of embarrassment.
topBleeding Gums
Healthy gums do not bleed.
Bleeding gums are a sign of infection. Healthy gums do not bleed. Brush and floss the area well. If bleeding persists, Contact Us immediately for an appointment.
Infection can lead to Gum Disease and tooth loss. Bleeding gums can often be your first indication of infection. Early stages of Gum Disease are rarely painful, so bleeding gums may be your only indication of Gum Disease! Healthy gums do not bleed.
So what's the moral here? Healthy gums do not bleed!
topBridges
Permanent Fixed Bridge
A Permanent Bridge replaces one or more missing teeth. A Bridge will:
- Keep teeth from drifting into the space created from a missing tooth
- Help preserve normal function and normal bite for the jaw joint
A Permanent Bridge is usually anchored to the teeth on both sides of the space from the missing tooth. This gives the bridge strong support. Brushing a bridge is no different than brushing natural teeth, but special flossing instructions are given to keep the bridge and surrounding tissue healthy.
A Permanent Bridge is permanently bonded in place, unlike a Partial Denture (sometimes called a "Removable Bridge"), which is removable.
topCleaning
Your regularly scheduled check-up is often referred to as a "cleaning", but there is much more to it than that! The technical term is oral prophylaxis, which means prevention of oral disease.
One way to prevent oral disease is to remove harmful plaque and tartar (calculus) both above and below the gum line. You may also be given special instructions on brushing or flossing to keep clean the areas where we found significant buildup. That is the familiar "cleaning" part of your checkup.
It's easy to tell which tooth has been "cleaned" in this photo!
Another way to prevent oral disease is by early detection and treatment. During your checkup you will be screened for many potential threats to your oral health, including:
- Cavities
- Gum Disease
- Oral cancer
In addition, some systemic diseases, such as diabetes, often present themselves first inside the mouth, so early detection extends beyond just oral disease.
Your Dental Hygienist is your first-line of defense against oral disease. Your hygienist is a highly trained professional who can evaluate your teeth and gums, both visually and with the assistance of x-rays and other modern technology, to discover threats to your oral or general health. Your dentist will review the findings of your hygienist and advise you on any threats to your oral or general health.
topCracked Tooth
If you have a cracked tooth as a result of a very recent trauma or accident, contact your dentist immediately!
When a tooth is cracked, a filling may not seal the crack. A crown may have to be placed over the tooth to hold it and the crack together. If the crack is not restored, the tooth will become sensitive to chewing pressure, or will eventually break. It is important to restore a cracked tooth before it breaks, because in some cases a broken tooth cannot be filled or crowned and must be extracted.
topDentures
When most or all your natural teeth have been lost, dentures provide many benefits:
- Restore your self-esteem
- Regain your eating ability
- Aid speaking ability
- Give support back to the lips and cheeks (giving you a natural and younger appearance).
A Complete Denture is placed in the patient's mouth after all the teeth have been extracted and the gum tissue has healed. Healing takes anywhere from a few weeks to a few months, depending upon the patient.
An Overdenture usually requires that at least 2 roots be kept. These roots may be used to hold the denture in place by placing inserts in the roots and in the denture. The denture then attaches to the roots. These roots also give support to the denture and help retain the ridge the denture sits on.
An Implant-Retained Denture is similar to an Overdenture, but uses implants as anchors.
An Immediate Denture is placed the same day the teeth are extracted. The advantage to an Immediate Denture is that the patient does not have to be without teeth during the healing period.
A Partial Denture or "removable bridge" replaces one or more missing teeth, but there must be teeth remaining for the partial to attach to. Unlike a Fixed Bridge, a partial is removable. A partial will prevent other teeth from shifting, preserving your remaining teeth.
Dr. Surber will evaluate your condition and needs to help you determine the option that is best for you.
topDenture Problems
Loose Fit
Dentures rest on a ridge of bone and gum tissue. Over time, that ridge will shrink causing the dentures to no longer fit properly. If there are tooth roots that have been retained to hold the denture (Overdenture), or if implants have been placed to retain the denture (Implant-Retained Denture), or if it is a Partial Denture, the ridge will not shrink as rapidly as with a Complete Denture, but there will still be some change over time. This causes the denture or partial to become loose. Sometimes a denture or partial can be relined to make it fit properly. However, if the denture or partial is worn or brittle, or if the change in the ridge is significant, a new denture or partial may need to be fabricated in order to obtain a proper fit.
Sore Spot
As gums change over time, a sore spot will occasionally develop due to changes in how the denture or partial rests on the gums. If a sore spot develops, contact us for an adjustment or relining of your denture or partial.
Discolored Dentures
Dentures get bacteria build-up on them, just like natural teeth. Soak dentures and/or partials daily in a cleaning solution and brush daily as well. If all of the stain and bacteria can't be removed, bring the dentures and or partials to our office to be professionally cleaned.
Bad Odor
Dentures can absorb bacteria and fluids that cause offensive odors to develop. If your dentures appear to be clean but have an odor, contact us for advice on some simple remedies for removing these odors.
Broken or Chipped Denture
Chips or fractures in your dentures or partials can sometimes be easily repaired. Bring them to our office for evaluation.
topExtractions
Extraction is the complete removal of a primary or a permanent tooth. An Extraction can be surgical or non-surgical. This depends on the difficulty of the extraction and whether or not the tooth is impacted or erupted, and whether it has straight or curved roots.
An Extraction may be done by our office or you may be referred to an Oral Surgeon (someone who specializes in difficult or surgical extractions). No one looks forward to an extraction, but modern anesthesia will help keep you comfortable throughout the procedure.
Reasons for an extraction are:
- Advanced Gum Disease. This is the #1 reason adults loose their teeth!
- An abscessed tooth that cannot be saved.
- A tooth with decay too deep to save the tooth.
- A tooth that has broken at the gum line and cannot be saved.
- Impacted tooth (typically a "Wisdom Tooth")
Nothing is better than a healthy set of teeth, and many advances in dentistry allow us to save teeth that we could not previously, but sometimes an extraction is necessary.
When an extraction is performed, it is important to put something in the place of the missing tooth or teeth. If the space is just left open, your teeth will shift and cause many unnecessary complications. An extracted tooth may be replaced by a temporary or permanent bridge, an implant, or by a partial or complete denture.
topGrinding Teeth
What is Bruxism?
Grinding of teeth, also known as Bruxism, occurs in children as well as adults. Grinding of teeth generally occurs during sleep.
What if my Child is Grinding His or Her Teeth?
Children often grind their teeth when their teeth are erupting. This is not uncommon, nor is it a problem if it is mild. However, in more severe cases the child can develop a malocclusion. Malocclusion may then lead to TMJ problems or to a need for Orthodontics. If you have any concerns about your child's Bruxism, be sure to have Dr. Surber check for signs of excessive wear so that treatment options can be discussed and implemented to prevent serious problems.
What about Bruxism in Adults?
Adults may grind their teeth at night due to:
- Malocclusion
- Stress
The result of bruxism can be:
- Worn spots (attrition) that can lead to:
- o Malocclusion (if the patient doesn't have already)
- o Sensitivity
- o Brittle teeth that require crowns
- TMJ problems
- Noise that sometimes disrupts the partner's sleep
How can Bruxism be Treated?
Sometimes, the damage caused by bruxism must be addressed first. Any malocclusion, sensitivity, brittle teeth, or TMJ problems should be discussed with Dr. Surber first to be sure those problems are resolved and that the subsequent treatment for bruxism prevents a recurrence of those problems. Further damage from bruxism can be prevented with a mouth guard that is worn during sleep. This guard is comfortable and easy for most people to wear. Contact Us for an appointment to stop the damage caused by bruxism and correct any serious problems.
topGum Disease
What is Gum Disease?
According to the American Dental Association, at least 60% of adults in the United States have moderate-to-severe gum disease! No doubt, you've heard some of the terms: Plaque, Tartar, Calculus, Gingivitis, Periodontitis, Pyorrhea, Periodontal Disease, Gum Disease. But what does it all mean? Quite simply, Gum Disease (Periodontal Disease) starts when plaque and tartar (calculus) are allowed to accumulate at the base of your teeth. The bacteria in the plaque leads to an infection in the gums (gingiva) called Gingivitis. Left untreated, the infection spreads to the tissue and bone that holds your teeth in place, a condition called Periodontitis (Pyorrhea). Because of the bacterial infection associated with Periodontitis, tooth abscesses are also common.
This patient has Periodontitis. Notice the bone deterioration and uneven level of bone.
Healthy gums and bone.
What are the Signs of Gum Disease?
Gum Disease is rarely painful, especially in the early stages. Although there may be no visible signs, some of the common indications of Gum Disease are:
- Gums that bleed when you brush or floss (healthy gums will not bleed)
- Gums that are red, swollen, or tender
- Gums that have pulled away from the teeth (receded)
- Pus (infection) between the teeth and gums
- Loose permanent teeth or separating (drifting) teeth
- Changes in the way your teeth fit together when chewing
- Persistent bad breath
What are the Dangers of Gum Disease?
Gum Disease is the leading cause of tooth loss among adults. More importantly, the infection releases toxins into the bloodstream leading to serious health risks:
diagram of Gum Disease dangersSources: National Institute of Dental & Craniofacial Research and American Heart Association
Is There a Cure?
Gum Treatment can effectively be used to treat and control even advanced cases of Periodontitis (Pyorrhea), but the more advanced the disease, the more likely it will lead to tooth loss. Prevention and Early Detection are your best defenses against Gum Disease. It is critical to catch and treat Gum Disease early before destruction of bone and tissue has compromised your oral health.
How Can I Prevent Gum Disease?
The best "brushers" in the world will naturally build up tartar on their teeth. Even patients with "healthy" gums and teeth should see their dentist regularly to remove the build-up of tartar and check for the formation of new cavities. Patients with Gum Disease, or patients that build up large amounts of tartar, may need to have their teeth cleaned frequently to help control the amount of bacteria in the mouth. At your regular recall appointments (Cleanings), we always evaluate the condition of your gums.
A thorough exam, which includes x-rays, visual inspection, and an analysis of hard and soft tissue, helps determine the health of your gums.
If you have any specific questions about Gum Disease that weren't answered here, or if you would like an appointment for a Gum Disease screening, please Contact Us.
topHeadaches / Migraines
Migraine Prevention Breakthrough
The field of migraine prevention therapy has been at somewhat of a standstill. Although numerous drugs are now on the market which are intended to subdue migraine pain after the attack has already begun, preventing migraine has been less than satisfactory.
However, research has found one common factor to all migraine and tension-type headache sufferers: tender and sore temple and scalp muscles caused by intense and prolonged jaw clenching during sleep. Not teeth grinding, but jaw clenching…and there is a world of difference.
Established research has shown:
- Jaw clenching muscles of migraine suffers are 70% larger in volume and generate significantly higher bite forces than control subjects.
- Migraine sufferers who experience headaches soon after or upon waking show significant evidence of nocturnal jaw clenching.
- Tension-type headache patients contract their temporalis muscles (clench their jaw) during sleep, on average, 14 times more intensely that asymptomatic controls.
The FDA has recently approved the first non-drug, no side-effect method for migraine pain prevention, the NTI-tss, a small and comfortable specialized mouthpiece which covers only your upper two front teeth while you sleep.
The NTI-tss must be custom fitted by a dentist. And why just the two front teeth? Because that prevents the back molars and canine teeth from coming into contact. Without those teeth contacting, jaw clenching intensity is reduced by two-thirds!
In clinical trials, 82% of migraine sufferers who used the NTI-tss for eight weeks had a 77% average reduction in migraine attacks, and were continuing to improve (details at the NTI-tss web site). There were no side-effects or adverse results. This is not to say the intense jaw clenching alone is the cause of migraine, but does put research back on track.
So for the best way to prevent migraine, instead of putting a pill in your stomach, you put a device on your teeth!
For a free consultation regarding the NTI-tss, Contact Us.
topHealthy Gums
Healthy gums are the foundation for your teeth, much like the foundation for your house. Healthy gums provide the support needed for your teeth to function as they should. Having unhealthy gums is like having termites in the foundation of your house. To the untrained eye everything seems fine, but progressive and often irreversible damage is being done.
What Are Healthy Gums?
Healthy gums
- Are light pink in color (darker for people with darker complexions)
- Are stippled, much like the surface of an orange
- Are not tender or swollen
- Don't bleed when brushing or flossing
Healthy Gums Don't Bleed
Gum disease (Periodontitis) is the leading cause of tooth loss among adults. It is known as a "silent" disease because it is rarely painful, especially in the early stages. Bleeding Gums is often the first warning sign most people have of Gum Disease.
A Healthy Heart Starts with a Healthy Smile
Gum Disease can kill more than just your smile! Recent research has identified a link between Gum Disease and Heart Disease, and other health problems. The bacteria associated with Gum Disease can enter your bloodstream and threaten your overall health.
Making Your Gums Healthy
Patients with Gum Disease often require specialized Gum Treatment. Visit your dentist to find out what is appropriate for your particular case.
Keeping Your Gums Healthy
Prevention and Early Detection are your best defenses against Gum Disease.
- Brush and floss daily.
- Visit your dentist regularly.
- Follow your dentist's instructions for any special needs you may have.
Impacted Tooth
Impacted teeth are unerupted or partially erupted teeth that cannot fully erupt due to:
- Lack of space (crowding)
- Misalignment (tooth is rotated out of position)
- Conflicting position (another tooth has erupted over that position)
- Ankylosis - when other causes of impaction are not corrected in a timely manner, the roots of the impacted tooth can fuse to the surrounding bone creating a tooth frozen in an unerupted or partially erupted state.
The teeth most likely to become impacted are the third molars, also known as "wisdom teeth." The first molars are also known as the 6-year molars since they generally erupt at around age 6, and the second molars are also known as the 12-year molars since they generally erupt at around age 12. If the third molars erupted normally, they might be called 18-year molars. But there is rarely enough space to fit these last teeth into the small space left behind the second molars, so the third molars often become impacted.
This panoramic x-ray shows the impacted 3rd molars (wisdom teeth). The upper wisdom teeth are crowding the sinus cavity and may erode the roots of the 2nd molars. The lower wisdom teeth are impacted sideways and are likely to cause crowding of the lower teeth, leading to malocclusion.
The most important thing to know about impacted teeth is that they almost always require extraction. The longer the extraction is postponed, the longer the tooth roots grow. When the tooth roots of an impacted tooth are allowed to develop, the risk of complication due to extraction increases significantly because the tooth roots may "wrap around" sensitive facial nerves.
The risks of keeping an impacted tooth extend beyond the impacted tooth itself. Any impacted tooth will exert forces on the arch of your smile that may cause unnecessary crowding of your teeth. An impacted tooth below the gum surface may erode the roots of adjacent teeth. An impacted tooth above the gum line may create a "food trap" that is difficult to brush or floss and is likely to lead to decay.
If you have an impacted tooth and you are not FULLY aware of the risks and alternatives associated with keeping or extracting an impacted tooth, please Contact Us for an appointment.
topv
Dental Implants
What are Dental Implants?
Dental Implants have been used successfully for many years. The implant itself is a post that is surgically placed in the jaw. A prosthesis (artificial tooth or teeth) is then attached to the post. Dental implants involve cooperation between a specialist and our office. The surgical phase of treatment is completed by the specialist, and the restorative phase is completed at our office.
What are Mini-Implants?
Mini-implants can be used in some situations. Visit our mini-implants page to learn more.
What are Dental Implants Used For?
There are two basic uses for Dental Implants: 1. As an artificial root for a single tooth replacement. 2. As anchors for a fixed or removable prosthesis to replace multiple teeth.
What Are the Benefits of Dental Implants?
With the exception of your natural teeth, nothing looks more natural than an implant. One important benefit of implants is that they slow the shrinking of bone and gum tissue from the area of the missing tooth, thus preventing premature aging.
- Of Americans between the ages of 18 and 64, approximately 49% are missing at least one tooth.
- Dental implants are the most advanced tooth replacement system ever devised.
- More than nine out of ten implants last longer than 15 years.
- Dental implants never develop decay.
- Dental implants never require root canals.
- Dental implants preserve the jawbone, which can prevent premature aging.
- No one can be disqualified for implant treatment solely because of their age -- some patients receive implant treatment when they are in their nineties!
How Are Dental Implants Placed?
Step One:
The gum is gently folded back and a space is prepared for the implant to be placed.
Step Two:
The dental implant "anchor" is put into place.
Step Three:
A temporary cap is placed on the implant and the gum tissue is repositioned around the implant. The implant is left alone for several months so the bone can attach to the implant and create a secure anchor.
Restorative Phase:
Step One:
After the implant has had a chance to attach to the bone tissue, the temporary cap is removed from the anchor and a post is attached to the anchor.
Step Two:
The implant is now ready for a prosthesis. An impression is taken of the implant and the appropriate prosthesis (crown, bridge or overdenture) is made.
Step Three:
The prosthesis is then attached to the implant(s).
Considering a Dental Implant?
If you are considering a dental implant, contact us for an evaluation appointment. We will perform an evaluation to determine whether you are a good candidate for a dental implant. If you are a good candidate for an implant, we will provide you with further information to help you decide.
topInfection Control
Dr. Surber shares your concern about the spread of disease and works hard to safeguard her patients, and staff, against infection.
When you visit our office, you will see a clean office carefully maintained by well-trained staff. Our dental team always wear gloves, eye protection and complete protective wear during each procedure. After each patient, they discard those gloves, wash their hands and put on a new pair of gloves.
Your protection starts long before you ever enter the treatment room. Here are a few of the things that you don't see: All surfaces are cleaned and disinfected, staff members sterilize all instruments after their use and dispose of anything that is potentially infectious.
Dr. Surber and her staff want you to know that your protection, care and comfort are our top priorities. That is why we meet, or exceed, the highest infection control standards.
topInternal Bleaching
Internal, or non-vital, bleaching is used to lighten a darkly discolored tooth that has had root canal therapy. A chemical oxidizing agent is placed within the coronal portion of a tooth to remove tooth discoloration. It may be performed in the dental office using a procedure known as "chair side bleach." In this procedure, bleach crystals are placed inside the tooth, left for a period of time, and then removed before leaving the office. This may be done once or several times, depending upon the discoloration of the tooth. Another method is known as "walking bleach". In this procedure, bleach crystals are placed inside the tooth, left for several days and then the patient returns to the dental office to have the bleach crystals removed. Again, this procedure may be performed one or more times, depending upon the discoloration of the tooth.
topJaw Problems
What is TMJ?
TMJ is an acronym for temporomandibular joint, which is a fancy way of saying jaw joint. Clinically, we refer to problems associated with the TMJ (jaw joint) as TMJ Syndrome or TMD (disorder). But many patients just call it "TMJ". Often, TMJ Syndrome presents itself as a popping sound and sensation near the jaw joint.
Who can have TMJ Syndrome?
TMJ problems can afflict people of all ages, although patients under 40 are more susceptible and it occurs more frequently in women.
What are the Symptoms of TMJ Syndrome?
TMJ Syndrome symptoms include:
- Headaches
- Earaches, stuffiness, or ringing in the ears
- Pain or soreness in and around the jaw joints
- Dizziness
- Numbness in fingers and arms
- Difficulty swallowing
- Limited movement or locking of the jaw
- Clicking or grating sounds in the jaw joints
- Pain behind the eyes
- Neck, shoulder, or back pain
- Facial pain
- Unexplained loosening of teeth
Left untreated, the TMJ symptoms increase in number and severity as you get older.
What should I do if I suspect TMJ Syndrome?
In order to determine the best course of treatment, an accurate diagnosis is imperative. Consult with Dr. Surber to determine if you are suffering from TMJ Syndrome. Many times all that's needed is a simple adjustment to your bite (the way your teeth come together), or a small mouthpiece that corrects the way your jaw joint closes.
topLoose Teeth
If you have a loose tooth as a result of a very recent trauma or accident, contact your dentist immediately!
Adults
The most common cause for loose teeth among adults is Gum Disease. If you are not currently receiving treatment for Gum Disease, and you are experiencing loose teeth, contact us for a Gum Disease screening appointment.
Children
The most common cause for loose teeth in children is erupting permanent teeth. As permanent teeth begin to erupt, the roots of the primary teeth (baby teeth) dissolve and the teeth become loose. Primary teeth will generally fall out on their own at the appropriate time, but if a primary tooth doesn't fall out soon after the permanent tooth erupts, contact us so we can prevent complications from a retained primary tooth.
Your child may be tempted to wiggle a loose tooth, and that is fine, but do not apply any significant pressure to a primary tooth to hasten it's removal. The primary teeth play an important role in guiding the permanent teeth into proper position.
topMalocclusion
Mal - occlusion literally means "poor closing" or "bad bite." A bad bite can be caused by several factors:
Dental Malocclusion
A dental malocclusion occurs when the teeth are not lined up properly, even though the jaws may be properly aligned.
Dental malocclusion caused by crowding
Skeletal Malocclusion
A skeletal malocclusion occurs when the upper and lower jaws don't line up correctly.Overbite: Upper jaw protrudes or lower jaw recedes (or both).
Underbite: Lower jaw protrudes.
Bad Habits
Your teeth are not as fixed in place as you might think! Just as a constant breeze can cause a tree to grow at an angle, repetitive forces on your teeth can cause them to become "out of alignment."
- Thumbsucking can lead to an Open Bite.
- Tongue thrusting (pushing your tongue against your teeth) can slowly, but surely, move your teeth out of alignment.
- Fingernail biting, or habitually biting or chewing on most objects, can cause worn teeth.
- Mouth breathing: Breathing primarily through your mouth instead of your nose can dry out the tissues of your mouth leading to swollen and irritated gums. Also, the unnatural jaw alignment of mouth breathing creates and imbalance that can lead to a malocclusion. If mouth breathing is caused by blocked nasal passages, the obstruction must be corrected as well to prevent a relapse.
Grinding Teeth (Bruxism)
Severe cases of grinding teeth (bruxism) can also change the occlusion. Most people who grind their teeth do so in their sleep and therefore may be unaware of the problem.
Missing Teeth
Primary (baby) teeth that are prematurely lost due to decay or injury sometimes necessitate the use of a spacer to keep the surrounding teeth growing straight until the permanent tooth erupts to replace the missing tooth. If missing permanent teeth are not replaced with implants, a bridge, or a partial denture, the adjacent teeth can "tip" into the empty space and the opposing teeth can "super-erupt" meaning they grow longer than is natural.
Correcting a malocclusion
Of course, more than one of the above factors may be involved, so it is important to obtain a professional evaluation. Left untreated, a malocclusion not only affects the patient's appearance, it can also lead to TMJ problems and an increased risk of decay and gum disease.
Dr. Surber evaluates each individual case to determine the best course of action to prevent or cure the malocclusion.
topNight Guard
Since most of the damage typically caused by bruxism is during sleep, a night guard can usually be made to stop further damage. A night guard is custom made to fit over the upper or lower teeth. With the night guard in place, the patient can't grind their teeth together and cause further damage.
topWorn Teeth
When the enamel of a tooth is worn away, the tooth often becomes sensitive and is more susceptible to decay. Advanced cases often require crowns to save the teeth.
Tooth enamel may be worn away in several ways. One or more of the following factors may cause premature wear:
topAttrition
Attrition is the gradual loss of enamel through "wear". A small amount of attrition may be caused by normal speaking and eating, but this typically doesn't produce excessive wear. More extreme cases of attrition are typically caused by Bruxism, the grinding of teeth against teeth. Bruxism typically occurs at night while the patient sleeps, so often the patient is unaware of the grinding or enamel loss.
Abrasion
Abrasion is the wearing away of tooth enamel by a foreign object. Common causes of abrasion are:
- Brushing too hard or too long
- Fingernail biting, chewing on pens or pencils, holding needles or pins between the teeth, etc.
- Oral jewelry - Patients with pierced lips and/or tongue often wear away the enamel on adjacent teeth
Erosion
Erosion is the chemical wear of tooth enamel. Typically this kind of wear is caused by an acid. Citric acid is one of the most common agents. Citrus fruit (lemons, limes, oranges, grapefruit) contain citric acid, as do most soft drinks and citrus juices (like lemonade). Some candies also contain citric acid. Many soft drinks contain additional harmful acids. Coffee and tea also contain corrosive acids. Bulimic individuals (people who intentionally and repeatedly induce vomiting) also expose their teeth to very strong stomach acids.
Occasional exposure to most dietary acids is rarely a problem, but repeated exposure to high levels of these acids can cause premature wear. Some common habits to avoid are:
- Regularly sucking on lemons or limes
- Regularly eating or sucking on candies, especially "sour" candies as they often contain sugar and citric acid!
- Drinking several soft drinks daily, even "diet" soft drinks
- Drinking several glasses of lemonade daily
- Drinking several cups of coffee or glasses of tea daily
Even if you only occasionally eat or drink highly acidic foods, it's a good idea to at least rinse your mouth with fresh water when you are finished in order to reduce the amount of time the acids have to work on your teeth.
If you would like us to examine your teeth to determine whether or not there is premature wear of enamel, please contact us for an evaluation. It is possible that a mouth guard can be fabricated to control or prevent the enamel loss.
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