Your Smile Dental Care


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Frustrated about Chipped Teeth?

Why are my front teeth chipping?

A few years ago, I began noticing that my front teeth were starting to chip. First the chips were small and my dentist filed them down, but they keep chipping and I’m afraid that one day they might break right off. Help!

It’s not always a simple fix… 

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Of course, it is difficult to give an appropriate answer until a proper exam and bite analysis has been done, but you have a right to be concerned. Although enamel is the hardest substance in the body – twice the hardness of bone – teeth can fracture for any number of reasons. If there was no sudden trauma or injury that occurred causing them to break, then we have to look at other possible causes. 

The front teeth are slender, single rooted teeth. They are designed to bite into food not chew like the larger, multi-rooted molars. When atypical forces are applied to these teeth, they will eventually begin to break down as well as the surrounding jawbone that supports them. 

Let’s look at some of the possible causes for chipped front teeth: 

25-04-2016 10-42-28 AM1. Injury/Trauma – When a front tooth has received a “hit”, parts of the tooth can break. If just the crown portion *fractures, then the extent of repair depends on how severe the break was. A small, simple break can be fixed with matching tooth coloured filling material with or without pins for reinforcement. If the break is more complicated and the nerve centre of the tooth has been damaged, then a root canal will be performed before the broken tooth is repaired. The extent of the trauma will often determine the likelihood of future maintenance for the tooth. Even a filling that is placed on a small, fracture can fall out repeatedly simply because the chemical bond between the tooth and the filling material is weaker than the bonds of natural enamel. Longer term solutions like veneers or full coverage crown may be recommended.

*Fractured root – Because there are many degrees of cracked or chipped teeth, it is important that you see your dentist for a proper clinical and radiographic examination. The treatment and outcome will depend on the type, location and extent of the break. Early intervention is very critical as delaying treatment can result in the loss of your tooth. 

2. Grinding/Clenching – This can be a very destructive force upon teeth causing them to fracture and become loose. Because it is usually a unconscious habit, it is difficult to control without the aid of an bruxism appliance. Nowadays, your dentist may also recommend the use of Botox to relax the facial and jaw muscles involved in the dynamics of bruxism. Until this habit is under control, teeth and their supporting structures will continue to wear and breakdown. 

25-04-2016 10-56-25 AM3. Missing teeth – Losing teeth, either due to trauma or disease, and not replacing them with a suitable, long-term solution causes fewer teeth to do the work of many. The forces in the mouth during chewing and clenching can reach a staggering 150 lbs/square inch. These forces are naturally designed to be distributed throughout the dental arches and the work shared by 28 to 32 teeth. It is when fewer teeth are expected to withstand this tremendous load that we begin to see destruction to the jaws, muscles, teeth, and gums. Ideally, a dentist will perform a comprehensive evaluation of the dental collapse that is occurring in a patient’s mouth. Only then can a proper recommendation be made. 

25-04-2016 11-19-29 AM4. Bite – Sometimes, after orthodontic treatment, tooth repair, tooth loss or injury, a person’s bite can become off-kilter. If your upper and lower teeth are not meeting properly, or teeth have shifted from their original positions, the aforementioned forces can be brought to bear on a few teeth before the rest of the dentition realigns itself in the chewing process. This constant high biting, unequal distribution of forces and readjusting of the jaws can cause havoc to the teeth and muscles. A bite analysis is performed, high bite areas are identified and then readjustments can be made so that the entire bite is equalized. Sometimes, the collapse of the dental arches and teeth over the years requires more comprehensive intervention with a treatment plan that involves a considerable amount of readjusting and opening of the bite.

Ortho 15. Post Ortho – Sometimes. after completing orthodontic treatment to correct crooked or misaligned teeth, other bite issues arise. It is important that you stay in touch with your orthodontist so that they can re-evaluate your bite periodically. Orthodontics is a complex dental specialty and treatment outcomes may vary from person to person. If you have developed TMJ, grinding, or other problems after your braces have been removed, further treatment considerations and adjustments may have to be made. 

Expectations vs Reality

There’s an old Neil Young lyric that comes to mind when we talk about expectations, They give you this, but you pay for that.”

Nobody wants to be sold a false set of goods or have unexpected treatment outcomes, but sometimes, what seems like a simple fix can actually be a problem that is not easily resolved the first appointment.  Your dentist may have initially concluded that filing down your teeth will fix your bite, but continuing to do so will just cause another set of issues without determining what the real source of the problem is.

When the uncertainties of a dental issue are fully explained beforehand and something has to be repaired again or requires additional maintenance and readjusting, then it’s no surprise to the patient nor the dentist. If you are returning time and time again for the same issue then a decision has to be made. Has your dentist recommended a long term solution but you are not ready to commit financially? Are you expecting a quick fix or patchwork dentistry? Perhaps, the dentist cannot determine the source of your problem and needs to refer you to another dentist for further evaluation.

29-12-2014 6-30-52 PMThere are risks and benefits involved with treatments in all healthcare professions. This is why communication is so very important. Disappointment, misunderstanding and frustration can be avoided when a dentist helps a patient understand and manage a situation that may be more complicated or chronic in nature.

When a patient is offered solutions, but for whatever reason, decides not to comply with treatment recommendations, then they need to understand the possible future implications of their decision. However, if a particular problem persists after repeated dental visits and following all of your dentist’s advice, then it is reasonably acceptable to ask your dentist to refer you to a dentist more specialized in your particular dental issue.

There is nothing quite as long lasting and as strong as your natural teeth. Preventing dental disease, breakdown and injury in the first place is your best bet for avoiding the uncertainties of some treatments that may require on-going monitoring, modification or even re-treatment. 

If you are new to the area or just searching for a dental family to call your own, Dr. Sam Axelrod and his team of caring professionals are always here to help. We’re just a phone call away to answer any questions or concerns you may have.

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Your in Better Dental Health,

The Your Smile Dental Care Team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com

 

 

 


3 Comments

Tips for a less Painful Dental Cleaning

Not everyone SMILES when having their teeth cleaned!

04-04-2016 3-25-58 PMNothing costs more in the long run like neglect.  This is why we promote regular dental re-care visits and cleanings so passionately. But for some people, cleanings are not exactly routine – they are painful!

A visit to the hygienist can be a real deal breaker when it comes to professional dental visits with some people avoiding cleanings at all costs. Technique is a learned skill. For some, it comes naturally, while for others it takes time to really hone their craft.

A good hygienist will be both thorough in their technique and gentle, but understand that dental scaling is often a tedious and time consuming process. The more build-up you have, the longer and more involved the procedure.

You can help predict your next cleaning experience by following some, if not all, of the following advice.

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1. The more frequent you have your teeth cleaned professionally, the less buildup there will be and the less tender and sensitive your gums will be.

2. Good home oral hygiene (especially flossing) helps to reduce the tartar accumulation. Oftentimes, using an electric toothbrush will do a more thorough job.

3. Take an anti-inflammatory before and after your appointment to reduce any discomfort during and after the cleaning.

4. Ask if you can have topical numbing spray/gel or have your teeth frozen (anesthetic) during the cleaning.

5. If your teeth are sensitive or you have gum recession, try switching to a toothpaste for sensitive teeth to build up some resistance in the sensitive areas.

6. You can reduce the chance of sensitive gum recession by not wearing them away with harsh toothbrushes, toothpastes or scrubbing action.

7. If you can identify exactly what exactly causes you discomfort during the cleaning (water-sprayer, ultrasonic cleaner etc…), perhaps your hygienist can offer an alternative cleaning method.

8. If you have a lot of tartar buildup, break up the cleaning over 2 or more appointments

9. Sometimes, an earlier appointment in the day will help if you find yourself more fatigued as the day wears on. Worth a try!

10. Ask around. Like any professional skill, it takes time to hone your craft, so to speak. If you feel that you need to switch hygienists, perhaps the office employs more than one or ask your family and friends for a good recommendation.

11. A scolding, judgmental hygienist can also be a painful experience. Advice can be given in a compassionate tone without reducing it to a lecture. Never be intimidated to the point where you let this type of conduct go unanswered. Let the hygienist AND the dentist know how you feel.

12. Do not judge the quality of dental treatment based on the absence of pain afterwards. If it has been a long while since you’ve had your teeth cleaned last, a good, thorough cleaning can leave gums swollen and sore. Your hygienist will tell you what to expect after your cleaning and what you can do to relieve post-cleaning discomfort.

 

There’s a saying – “A toothbrush can’t remove 6 months worth of tartar 30 minutes before your dental appointment.” Our goal is to help you have the best patient experience possible. Being an engaged advocate for yourself and taking responsibility for a healthier you by using the techniques described above will go a long way in improving your future dental cleanings.

Yours in Better Health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com