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Crowns for Baby Teeth

Stainless Steel Crowns

My Dentists wants to put crowns on my child’s teeth. This seems like an extreme measure since they will eventually fall out anyways!

Usually, dentists repair decayed teeth with filling material. However, when teeth are badly broken down by the cavity (decay) process, have had nerve treatment or are weakened by a developmental condition, replacing almost the entire crown portion of a tooth with traditional filling material is not always a practical nor secure solution.

 ss-crown

A remedy must be found that allows the tooth to withstand the forces of biting and chewing  long enough for the incoming adult tooth to replace it – which could be many years.

Replacing the diseased crown of a tooth with a durable stainless steel crown (silver caps) is the most economical and durable solution until the tooth falls out and is replaced with the permanent (adult) tooth. These caps are not made in a lab like permanent adult crowns are. They come ready made in a variety of shapes and sizes, no impressions need to be taken, and there is no additional lab fees associated with their costs.  Additionally, they are categorized under  “routine restorative” so most insurance policies cover them as basic treatment. They are just another way to restore baby teeth so that they can function.

Why not just pull the tooth?

11-16-2016-7-58-51-pmThis is a common question, and sometimes, the teeth are not repairable and must be removed. However, taking out teeth before their natural time is a “last resort” solution. Baby teeth are vital to the dentition as natural space holders for the permanent teeth. Their premature removal will interfere with the eruption of the adult teeth.

Removing a baby tooth before its time is not the end of the problem. The space where the baby tooth was removed must still be replaced with a spacer maintaining appliance so that the adjacent teeth will not start to move into and invade this important place.

The chart below shows the normal eruption pattern of primary and permanent teeth. You will notice that there are many years between the emergence of the baby teeth and the age at which the adult teeth will eventually arrive in the mouth to replace them.

 

Permanent (Adult) Teeth

During a child’s teenage years, The adult teeth continue to develop there is significant growth and development of the dentition and jaws. This needs to be taken into consideration when restoring a badly broken down adult tooth in a child.

If you refer back to the eruption chart, you will notice that the first permanent teeth begin to erupt around 6 years of age.

BGC

From the illustration above, you can see that if a baby tooth becomes badly broken down by decay or a developmental condition when the child is still young, a suitable interim solution needs to be found until the permanent adult teeth are ready to emerge into position. Stainless steel crowns become an effective, affordable and practical semi-temporary measure until then.

Stainless steel crowns have been around for over 75 years and are safe and effective. They are easy to keep clean and rarely allow decay to reoccur. Although, some parents may not like the metallic appearance of the steel crowns,  since baby molars are in the back of the mouth, they are less noticeable.

All of this makes them an affordable and effective treatment solution for an otherwise serious problem.

We hope you have found this article informative. Please visit and subscribe to our blog to learn more about Your Smile Dental Care.

 

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

 

 

 

 


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Cracked Tooth Syndrome

My Dentist said that my tooth is cracked and needs to be taken out. Can it not just be filled in?

Although enamel is the hardest substance in our body (way more harder than bone) and can withstand a great deal of wear and tear, certain stresses can still put our beautiful smiles at risk for fracturing.

There are many types of cracked teeth and your treatment options will depend on the location, type and severity of the fracture. Even a perfectly healthy tooth can develop a crack severe enough to end the life of that tooth.

Understand that a cracked tooth is different than a chipped tooth. Unlike bone, enamel cannot repair a crack by filling it in with more enamel. Most teeth that chip or fracture a cusp is repaired using filling material or the placement of a full coverage crown when the break occurs in the crown portion of the tooth. Even teeth that break off at the gum line can still be built back up again.

However, there are some breaks to the tooth that actually cause a fracture line to occur down into the root or split the tooth partially or entirely. Once the crack reaches below the gum line and into the root surface, the condition is untreatable and the tooth must be removed.

Signs & Symptoms of a Cracked Tooth:

– pain while biting or chewing
– sensitivity to hot or cold
– portion of the crown is mobile (loose)
– infected pulp
– a toothache that comes and goes
– no signs or symptoms

 

“Cracked tooth syndrome describes a tooth with an incomplete fracture but no part of the tooth has broken off yet.”

 

Although early detection and treatment is essential to minimize the risks associated with a compromised tooth, sometimes, a cracked tooth is hard to detect when the signs and symptoms are not always obvious and dental imaging does not show the fracture. Other times, it is evident to us, but the patient is completely unaware that they have a fractured tooth.

If your dentist has advised that your tooth needs to be removed, it is likely that the break is severe and deep enough that the tooth cannot be saved and must be removed and replaced. This is why regular dental checkups and exams are so important.

Hope as a Strategy…

We have patients who ask us how long they can wait until they have the time or finances to repair a cracked tooth. One can only hope that the situation will not worsen, but hope can be a poor strategy when dealing with a fracture line. Without the assistance of a crystal ball, we cannot determine with certainty how long someone can wait to delay treatment. Experience tells us that, in order to the disappointing loss of a tooth, fractures should be at least be examined to determine what type of crack you’re dealing with.

A simple cracked or chip in the enamel can be smoothed off until it can be repaired properly. However, deeper fractures that reach into the dentinal or nerve chamber must be treated quickly so that the problem does not worsen and cause an infection, crack the root or split the tooth.

Prevention: The Better Strategy

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As the saying goes, “Do something now that your future self will thank you for.” Taking some preventative steps now can reduce the likelihood of tooth fractures in the future.

1.  An unbelievable amount of force is exerted your teeth is you clench and grind at night. Your dentist can make you a custom-fitted night guard to protect your teeth while you sleep.

2. Wear a protective mouth guard and/or mask during high risk activities such as sports.

3. If you chew on hard objects like pencils and ice or use your teeth to open/hold objects ~Stop! Be extra careful also when eating food with bones, kernels or seeds/pits.

4. Follow the recommendation of your dentist when they advise you to have a crown placed on teeth that are most vulnerable to fracturing such as those with large fillings or have been root canal treatment.

Your teeth can serve you well for a lifetime if they are not treated as an afterthought. Following these prevention tips, having regular dental check-ups and attending to any necessary restorative care when they are small issues does not rob you of your choice and focus as emergency situations often do.

And, if you experiencing any of the aforementioned signs and symptoms, see your dentist immediately!

Yours in Better Dental Health,

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

 

 

 


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Gummy Smile

Treating the Gummy Smile…

gummy-smile-correctionDo you think you show too much gum when you smile?

When you smile, usually the lip sits just above the teeth and only a very small amount of gum tissue is visible. In some cases, however, a disproportionate amount of gum tissue is exposed when smiling, and, while this is not unattractive nor an issue for many people, others look to have this corrected.

The scale we use is:

Mild:  1-25%

Moderate: 25-50%

Advance: 50-100%

Severe: more than 100%

Rest assured, there are many solutions for correcting a gummy smile and your treatment options will depend on the nature of your particular condition which could involve the jaw, gums, teeth or a combination of these structures. Your dentist will discuss the diagnostic findings with you and an appropriate treatment recommendation will advised.

“A gummy smile can be mild to advanced and identifying the cause is the first step.”

 

Non Surgical

Botox – Botox injections is a simple and temporary correction that is non-invasive and allows you to see results before trying surgery. The injections will weaken/paralyze the muscles of the upper lip to control the amount of lip retraction so that more of your gums are covered when you speak and smile. The amount of injections depends on how strong the muscle is and sometimes, the muscle is just too strong or the gummy condition too extensive for any effective results. This treatment option is only temporary and must be repeated every 3-9 months to maintain your new smile.

 

Surgical

Some surgeries to correct gummy smiles are more invasive than others and treatment recommendations will depend on the severity and type of gummy smile. It is also common to combine treatments to help achieve the best result.

gummy-smile-before-and-after

Lip repositioning – This involves making a small incision along the gum tissue to separate the inside of the upper lip from where it meets the gum line and repositioning it. This will limit the retracting movement of the lip and allow it to assume a lower position over the gums and keep closer to the teeth when you smile. This is a permanent procedure with a quick healing time and minimal after-surgery discomfort.

Short lip length – If the length of your upper lip is too short then it may not adequately cover your gums. This is often successfully corrected with lip repositioning surgery.

11-7-2016-3-25-15-pmJaw Orientation – The position of your upper jaw and the amount of vertical length can be excessive and interfere with the lip’s coverage of your upper gums. Orthognathic surgery may be needed in order to reposition the entire upper jaw so that it is more proportionate for an aesthetically pleasing smile.

20161116_171230Frenulum Attachment– If you lift up your upper lip you will notice that there is an extension of tissue that attaches the inside of your upper lip to the gums. This is called a frenulum and a surgical procedure can be done using local anaesthetic to cut and release or elongate this tissue so that your upper lip can then cover your gums more.

Short teeth – Gum tissue is removed to reveal more tooth crown or to achieve a more proportionately amount of visible gum line. Using a laser or electro-surgical cauterizing tool, the gums are re-contoured to achieve a more aesthetically pleasing shape, symmetry, length of the gum line. This is often done when teeth are short due to insufficient eruption and sometimes, the underlying bone may also need to be re-shaped.

Strong levator muscles – If the lifting (levator) muscles in the upper lip are causing the lip to pull back too far when smiling, they can be surgically cut and weakened to reduce this pulling action. The incision is made on the inside of the lip so that the scar will not show.

Medical conditions/Medications – Some medical conditions and/or their therapies can cause an abnormal overgrowth of gum tissue which covers the crown portion of the tooth. The gum tissue can be trimmed back to reveal more tooth structure.

noelia

Looking at this image. You can see the upper lip is in a lower
position now that the levator muscles have been relaxed. This “mild”
gummy smile was easily corrected.

 

Not every person with a gummy smile considers it a hindrance nor an impact to their enjoyment of life, comfort, and well-being. However, if you are reluctant to smile and are looking for a solution, speak to your dentist and they will assess your smile. If, in their opinion, the correction should be evaluated by a dental specialist, they will make the appropriate referral for you.

Your Smile is a wonderful expression and we hope you have many reasons to use it!

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