2650 Lake Sahara Dr. Suite 160,
Las Vegas, NV 89117 | 702 734 0776
Many looking for a new smile are concerned about having crowns placed because there is an assumption that crowns are not cosmetic but veneers are. This video reviews the pros and cons..
Have questions or comments? Check out our Facebook Fan Page or on Twitter @sandquistdds
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Recently, we did an email interview with Dr. Scott Biggs, an Endodontist(a dental specialist that treats the pulp or nerve of teeth). You can visit his website at http://www.lvendo.com/
1. Why are toothaches so painful?
A toothache can many times be one of the most painful experiences one will experience in their lifetime. The source of such pain can be very complex. Inside the tooth (the pulp), where nerves and blood vessels reside, is a closed and non-expandable area. When the pulp is inflamed due to cavities, bacteria, etc., the tissue becomes engorged yet has nowhere to go. Thus, the nerves are in essence crushed causing constant stimulation of the nerve causing the pain of a toothache.
2. What is the cause of the usual toothache pain?
Toothache pain can be caused by a variety of factors. The most common cause would be a cavity. The bacteria from the cavity causes inflammation of the pulp inside the tooth causing the pain. Cracks or fractures of a tooth can also introduce bacteria into the pulp causing the same problems. Many times after routine fillings or other dental work, teeth can become sensitive to temperature changes for a period of time. This is usually temporary. Other causes of tooth pain or perceived tooth pain, are high fillings, exposed root surfaces, gum disease, temporomandibular joint disorders, cardiac problems (angina), sinus problems, earaches and other atypical facial pain.
3. Why does a toothache wake you up at night?
When the pulp of the tooth is inflamed and is not treated, a pulp can become irreversibly damaged and degenerate. The most common symptoms associated with this degeneration, are sharp lingering pain to cold or hot and spontaneous pain. Normally a nerve sends a signal to the brain when it has been stimulated telling the brain it feels pain. When a nerve degenerates it will sometimes send signals to the brain without being stimulated. This unstimulated signal causes the spontaneous pain that will wake you up at night.
4. Why does the pain hurt like the dickens for days then just goes away?
When a pulp has completely degenerated to a point where there is no longer vitality in the tooth, the tooth is called necrotic. Many times at this point the severe pain that was experienced previously will go away. Unfortunately this is usually short lived. The pain will almost always return eventually, but this time as a dull aching, throbbing type of pain.
Thank you to Dr. Biggs for this very informative article.
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Dental Implants are a great way to replace missing teeth. Dental implants are comprised of 3 components.
The Implant
An Abutment
New Teeth
Think of the actual implant as a root to replace your root that was lost, it will support the new teeth. It is placed in the bone below the gums.
The abutment connects to the implant and supports the new teeth. This piece emerges through the gums.
A crown is a common way a tooth is restored on a dental implant. The crown is cemented on the abutment. Crowns are not the only way that teeth are added to implants, if there are several implants used it is possible to fabricate a fixed bridge framework to connect the implants together. It is also possible to attach a denture or a removable partial denture to the implant providing greater stability and comfort.
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1. Dental Implant
Dental Implants are replacements for your tooth roots. A Titanium post is placed in the bone and a crown is attached to the new root to replace the missing teeth.
For more information, read a Simple Explanation of Dental Implants
2. A Bridge
A fixed bridge uses the adjacent teeth around the space to support a false tooth to replace the missing teeth.
3. Removable partial denture-metal framework
This is an appliance that is removable, has a metal framework with plastic teeth added to the framework and this uses the other teeth and gums for support.
4. Removable partial denture-plastic framework
This appliance is removable also, but the whole appliance is made of plastic and primarily uses the gums for support.
5. Dentures
This is replacement of all the teeth on either the top or bottom, or both.
6. Live without it or them.
It’s not the best choice but millions of people live with missing teeth.
It’s always best to try to hang onto a tooth as long as possible, but sometimes it’s not possible, thankfully you have options to replace the missing teeth.
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In a previous post Are Your Teeth Sensitive to Cold, we discussed what causes cold sensitivity in teeth and discussed 7 things that cause it. The first approach to dealing with teeth that are cold sensitivity is to try and figure out what’s causing it.
Do you frequently drink regular and/or diet soda?
If so, choose a non carbonated drink or water
Energy drinks?
Reduce the number of drinks daily and drink them with food.
Do you clench or grind your teeth?
Maybe a night guard is needed to protect the teeth during nighttime grinding.
Use Tartar Control or Whitening Toothpastes?
Choose a regular toothpaste instead without the tartar control or whitening agents.
Do you use a hard Toothbrush?
Everybody should be using soft bristled toothbrushes today, but there are some that still feel their teeth won’t get clean unless they use a hard brush. Hard bristled brushes work very well at removing tooth structure as well as plaque.
Usually by removing the cause of the sensitivity, the sensitivity will subside over time, but in some cases it is necessary to intervene. The treatment options for sensitivity are all based around filling up the microscopic tubes in the tooth root that communicate with the nerve of the tooth. Fortunately there are quite a few options. It’s always a good idea to discuss any long term sensitivity with your dentist or dental hygienist. If at any time you experience sensitivity to cold that doesn’t go away immediately when the cold is gone this could be the starting of a tooth ache, which could lead to a root canal. Please call 702 734 0776 or send a quick note to info@sandquistdds.com with questions or to schedule an appintment. You can always reach us on Twitter: @sandquistdds
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Recently, we conducted an email interview with Dr. David Trylovich, a Periodontist in Las Vegas,NV(His Website: http://www.lvperio.com) on the topic of Gummy Smiles. Most people have never heard of what a Gummy Smile is so we decided to interview the expert!
What is a Gummy Smile?
A gummy smile is when you smile and gum tissue is visible above the teeth. The more gum tissue you show the gummier your smile. It is normal to show about 1-2 mm of gum tissue above the teeth. There are several things that can result in a gummy smile, they include: a long upper jaw, hyperactive lip muscles, short upper lip, or excess gum tissue covering the teeth. We will only be discussing the excess gum tissue covering the teeth. Your dentist or periodontist can tell you what is the cause of your gummy smile.
How do I know I have a Gummy Smile?
If you show more than 2-3 mm of gum tissue above the teeth then you have a gummy smile. However, the most important thing to evaluate is the shape and length of your teeth. The average front tooth length is 10 millimeters or just less than 1/2 inch. If you have a gummy smile due to excess gum tissue covering your teeth then you likely have front teeth that are short and square shaped. If so, you are an excellent candidate for a gum lift procedure which will correct your gummy smile and improve the appearance of your teeth.
Are Gummy Smiles Common?
Yes, 14% of people have a gummy smile.
What can be done for a Gummy Smile?
If you have excess gum tissue as the cause of your gummy smile then a quick fix is all you need. You can eliminate your gummy smile and improve your smile in one simple appointment. A minor surgical procedure can give you a beautiful smile. Most people require no additional treatment to their teeth other than the simple removal of excess gum tissue. However, some may require cosmetic bonding, veneers, or crowns to give them the ideal smile.
Won’t bleaching or Veneers fix my smile all by themselves?
Bleaching or veneers will improve the appearance of your teeth but will you will still have short teeth and show excess gum tissue when you smile. Your periodontist will discuss with your dentist what is necessary to give you the best looking smile.
Is a Gummy Smile bad?
No, usually a gummy smile is just a cosmetic concern. If you have a gummy smile, you probably think you were just born with short teeth. Actually, you likely just have excess gum tissue covering the white part (enamel) of your teeth.
What is involved in treating a gummy smile?
A simple two hour surgical procedure will usually eliminate your gummy smile. You will have some minor soreness for a few days after the procedure and will be on a pasta or fish consistency diet for the first week. Most clients return to work on the day following their surgery.
Where can I see before and after photos of gummy smiles?
You can check out the Before and After Gallery at http://www.lvperio.com.
How much does it cost to be evaluated for a gummy smile?
We do complimentary examinations for gummy smiles so it cost you nothing to find out if you have a gummy smile and if so what can be done to fix it.
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A question came through Twitter asking What Causes Teeth Grinding or Gnashing of Teeth?
This is a commonly asked question in most dental offices, but the answer is often challenging. While there’s been lots of research done on the subject of tooth grinding and tooth clenching, so far we really don’t know why it occurs but let’s explore what we do know.
Tooth Clenching is the squeezing of the teeth together straight up and down with various amounts of pressure.
Tooth Bruxism is grinding of the teeth from side to side along with up and down pressure.
Bruxism or Clenching commonly occurs during sleep and is commonly referred to as “Sleep Bruxism” and occurs even virtually every human. The difference between people that suffer from Bruxism and those that don’t is the quantity of the bruxism bursts. In most studies the control group(those that don’t suffer from Bruxism) exhibit roughly 2 bruxism episodes per hour, while those with Bruxism exhibit 6 or more bruxism episodes per hour. We don’t know why non-bruxers, “Grind” their teeth during sleep patterns. We also don’t know why a true bruxers grind their teeth more.
Tooth Grinding can also occur during the day, this can occur during a stressful part of the day, i.e. driving in traffic or a tough day at work. Problems with the way your teeth come together can also lead to tooth grinding. If there is an area that comes together before the others, this can lead to tooth grinding, as a response to the high spot.
In subsequent articles we’ll discuss the effects and possible treatment options for tooth grinding. Tooth Grinding can be devastating to the teeth, leading to destruction of the hardest substance in the body, your tooth enamel.
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A brief video tour of our office and who we are…
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A question came through Twitter over the weekend. What determines the color of peoples teeth?
There are 3 components of teeth, Enamel, Dentin, and the Nerve.
Enamel is the hardest substance in our bodies and when well mineralized as it usually is, it is fairly white. But can also have varying levels of translucency which display the underlying dentin.
Dentin is much softer and contains both organic and inorganic materials. It is typically yellowish in color, but can vary from brown to grey also.
The Nerve contains nerve tissue and vascular tissue that provides nourishment and sensation to the teeth.
Genetics play an important roll in the color of your teeth. Skin color, gingiva color, mineral content of the enamel, and color of the dentin. Medications have been known to alter the color of the dentin, specifically Tetrycycline used during development of the adult teeth will turn the dentin various shades of grey and brown, which darken the teeth. Illness has also shown to alter the appearance the dentin. Both medication and illness usually affect the color during the development of the teeth.
As teeth age they tend to turn yellow. Years of wear and tear can cause the enamel to turn more translucent and the dentin to darken. Kids teeth can often appear yellow in color, typically baby teeth only have 1mm of enamel covering the dentin. If for some reason a portion of the enamel has eroded away as we discussed in Acid Erosion in Children’s Teeth, the enamel will then be thinner and will display more of the yellow dentin.
There are a few other reasons that teeth will darken and those include vitality of the nerve, some teeth will turn dark when the nerve dies. Another reason is a old restorations silver-mercury fillings will turn teeth black and composite restorations tend to yellow over time.
The image above shows a few teeth of various colors in the same dentition. Tooth roots are made up of dentin, and will provide clues to what the color of the dentin is. You will notice that the front left tooth on the screen is darker then the front right one. This is because the dentin of the tooth is darker, probably because of loss of vitality of the nerve. If we were to cut off the enamel of both these teeth and evaluate it, we would notice that it is the same color. The color difference shown here is because of the dentin color change. The surface stains shown on the lower teeth can easily be removed during a hygiene visit.
The primary roll of vital tooth bleaching is to whiten the dentin, there is evidence that the current peroxide based whitening agents will whiten the dentin. 2-4 weeks is usually sufficient for most people but some teeth like the dark tooth shown above may require months of whitening. At home whitening systems provided by your dentist, provide the best results while providing the ability to control the results. In-Office whitening systems are also effective, but often require multiple visits over a period of 3-6 weeks and provide no superior results over the at home systems. Over the counter systems are effective just less effective then the other systems.
Keep your questions coming, on twitter use @sandquistdds and we’ll try to answer them.
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A recent web article titled: Acid Erosion In Children’s Teeth Growing Concern Among Dentists discusses some reasons for acid erosion in children’s teeth, but doesn’t discuss all the issues. The article primarily discusses the child’s diet, specifically avoiding acidic foods and to use Sensodyne’s ProEnamel toothpaste that is designed to reinforce the enamel with a topical fluoride and acid neutralizers.
While this product is helpful along side diet modification, another issue to consider is Gastric Reflux(GERD) which is a very common condition during infancy and often occurs in older children as well. It is common to see “Islands of Wear"(example photos are seen below) on the tops of the molar teeth. While there really isn’t a definitive answer to the cause of these eroded areas, it has been hypothesized that GERD is responsible for these holes in the enamel. These holes in the enamel occur because the acid is allowed to pool on the surfaces of the teeth eroding the enamel, which is why it normally occurs on the top of the lower teeth and the inside of the upper teeth. The location and shape of the eroded areas is often indicative of it’s etiology. A physician reviewed article Reflux in Children discusses symptoms, diagnosis and treatment of GERD in children. Many times GERD in children is a transient condition that comes and goes and sometimes occurs once and never returns. It is often diagnosed because of the evidence of tooth wear.
Yes, Sensodyne ProEnamel is a great product to help prevent the destruction of tooth enamel, but the bigger picture might be treating the actual cause of the acid in the first place.
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Creating Smiles
for You!
