Eruption Patterns of Teeth: Part 2 (Adult Teeth)

Permanent Teeth

The enamel of the permanent teeth actually begins forming at 3 to 4 months of age. If your water is not fluoridated, make sure your baby receives the necessary fluoride supplements. Permanent teeth come in under the baby teeth. Pressure from the upward movement of the permanent tooth causes a resorption of the root of the baby tooth. When the root disappears, the tooth gets loose and eventually falls out. If the permanent tooth does not come in directly under the baby tooth, the baby tooth root will not resorb and not loosen. The second tooth will come in either in front of or behind the baby tooth. This is common. When it happens, see the dentist to determine whether the baby tooth should be removed to permit the proper positioning of the permanent tooth.

lower central incisors                           6-7 years

lower first molar                                   6-7 years

upper first molar                                  6-7 years

upper central incisors                          7-8 years

lower lateral incisors                            7-8 years

upper lateral incisors                           8-9 years

lower canines                                        9-10 years

upper first premolars                           10-11 years

lower first premolars                           10-12 years

upper canines                                       11-12 years

lower second premolars                      11-12 years

lower second molar                             11-13 years

upper second molar                            12-13 years

wisdom teeth                                        17-22 years

Be sure to remember the sealants for the molars and premolars!

If you have any questions about the formation of teeth, please feel free to ask us at (512)250-5012.

 –Omni Dental Group

Eruption Patterns of Primary (Baby) Teeth

Teeth begin forming in children very early in life, as early as the first month of the second trimester of pregnancy. That is why it is so important for pregnant women to follow a proper diet. It is not only to have a healthy baby, but to ensure the proper formation of the teeth. When the hard tissue (the future enamel) of the tooth is forming, minerals and nutrients are taken up by the teeth and incorporated into the structure of the enamel. Good nutrition makes the teeth stronger. Poor nutrition can interfere with proper enamel formation. Eat wisely. Consult your physician about needed vitamin supplements and before taking any medications.

This reference will help you know when baby teeth, also called deciduous teeth, are due to come in and eventually fall out, as the permanent teeth come in. Girls' teeth usually come in before boys' teeth. There is a 6 to 8 month leeway that is considered a normal variation on either side of the age the teeth come into the mouth. Some children might get teeth even earlier or later than that. It depends on their growth patterns. We hope to see teeth come in later, rather than earlier. If the teeth come in later, there is a good chance the mouth will be bigger so the teeth have the necessary room to come in straight. The older a child is when he gets a tooth, the more hand skill he will have for brushing and flossing the tooth to keep it clean and disease-free.

The normal child dentition will have 20 baby teeth. Adults typically have 32 teeth, although there is evidence that many adults do not have tooth buds for the 4 wisdom teeth.

Primary Teeth

Primary teeth start forming at 4 to 6 months in utero, the second trimester of pregnancy. After the baby is born, the teeth continue to grow and erupt into the mouth.

lower central incisors                           6 months

lower lateral incisors                            7 months

upper central incisors                          7.5 months

upper lateral incisors                           9 months

lower canines and eyeteeth               16 months

lower second molars                           20 months

upper second molars                           24 months

If you have any questions about the formation of teeth, please feel free to ask us at (512)250-5012.

 –Omni Dental Group

Electrosurgery

Dental electrosurgery is a surgical procedure for the removal of periodontal or soft tissue. You may be more familiar with the scalpel and suture surgical procedure. Electrosurgery accomplishes the same thing, but in a different fashion. The choice is determined by your particular conditions and needs.

 

Electrosurgery is most often used to remove or recontour small amounts of gingival (gum) tissue, stop minor soft tissue bleeding (prior to impressions for crowns or placement of restorations), and/or expose sound tooth structure when:

· Insufficient clinical tooth structure remains to allow the proper retention of a crown.

· The sound tooth structure is beneath the gingival tissue. 

· The gingival tissue is in poor position or contour.

Conventional surgery is needed when more extensive tissue removal, repositioning, or modification is required.

Electrosurgery is used in dentistry on a regular basis. A local anesthetic is given before the procedure is begun. A calibrated electric current is delivered to the site by a special handpiece and a selection of differently shaped tips. The different shapes are used to accomplish different things. The tip of the electrosurgery handpiece “draws” a line on the soft tissue and the soft tissue “falls off.” There is usually very little postoperative bleeding associated with electrosurgical procedures.

There is generally very little postoperative pain associated with the electrosurgical procedure.  Most patients say it feels like a mild burn from eating hot food.  Any nonprescription pain reliever is usually adequate for pain relief. Postoperative discomfort from conventional surgical crown lengthening is also usually minimal and the healing time is fast.

As with all soft tissue alterations in crown and bridge procedures, there may be an unavoidable delay before the final impression can be made. This is especially true when the crowns being prepared are easily visible when you speak or smile. While the soft tissue looks as if it is healed in a week or so, the tissue will continue to slowly change position and heal more fully for up to 8 weeks. At that time, the tooth may need to be slightly reshaped to compensate for the change before the impression is made. This is especially critical for upper front teeth. Obviously, the more tissue that is removed, the longer the healing time will be and the more likely final impression procedures will need to be postponed. If the procedure is done in a not critically cosmetic area, the impression will usually be made on the same day.

Sometimes the periodontal soft tissue changes that are needed are so extensive that they cannot be adequately accomplished by electrosurgery or a small conventional surgical procedure. If this is the case for you, you will be referred to a periodontist for the procedure. There will be an unavoidable delay in the final restoration while the tissue heals and matures. A wait of 4 to 12 weeks or longer is not unusual.

If you have any questions about electrosurgery, please feel free to ask us at (512)250-5012.

-Omni Dental Group.

Toothy Tips For Thanksgiving Treats

Thanksgiving is just days away, and let's face it: we are all planning on eating a lot of really good food.  Some of this food is, of course, full of sugars, acids, and staining properties that can be detrimental to our dental health.  So, are we supposed to sit back and watch the family eat the pumpkin pie while we eat celery all day if we want to prevent cavities? Obviously not.  Thanksgiving is a time to enjoy family, friends, and good food.  In this blog, I am going to try to provide some suggestions about how to handle the holiday menu without putting your teeth at risk.

Grazing
Before the big evening meal, it is customary to hang around the kitchen or watch football and graze on snacks to stave off the hunger and excitement for the real meal.  This typically involves sugary treats and high-carbohydrate snacks.  We suggest doing something different.  Between the bread, potatoes, pies, and everything else on the dinner table, you really don't need more sugar or carbs.  A tray of fruits and vegetables could do your hunger and your teeth a lot of good.  Crisp produce like carrots, apples, celery, and pickles are full of fiber and they naturally clean your teeth.  Cheese cubes are also a great addition to a grazing tray because they protect teeth from staining and are high in protein and calcium.

Sweets
Cranberries are a holiday favorite and they are extremely good for your teeth and health.  But, they are typically paired with an abundance of sugar to sweeten them.  We suggest cutting that sugar in half and maybe adding some honey, which has more sweetness and is much better for you.  In preparing the deserts and even the sweet potato casserole we recommend cutting down on the use of sugar and experimenting with using honey, especially local honey.  Your treats will still be sweet and delicious and the honey will provide health benefits, while protecting your body and teeth from the damages caused by an excess of processed sugar.

Putting the PRO in Protein
Believe it or not, the protein in turkey and ham can be really good for your teeth.  Eating proteins produces saliva which will wash away stickiness caused from sugars away from your teeth.  Turkey is also high in calcium, which is great for your teeth.  To make a long story short, turkey and ham can do a lot to counteract the negative effects of all of the sweets that we eat on Thanksgiving.

Stains
Red wine, cranberries, the dye in pie fillings, and coffee are all culprits of staining our pearly whites during the holiday season.  So, do we avoid them altogether?  You can, but it is likely that you won't.  There are, however, things you can do to prevent staining.  First and foremost, rinse your mouth well throughout the day with warm water, especially before brushing.  This will help wash away stains as well as acids that can harm enamel.  Second, drink water throughout the day, especially if you are nursing a cup of coffee, tea, or a glass of wine all day.  Third, eat cheese while you drink your wine.  Of course, the combination of wine and cheese is a no-brainer, because it is delicious.  It is also really a good way to protect your teeth.  Cheese puts a natural waxy coat on your teeth that act as a shield from the staining properties of wine.  Don't allow Thanksgiving to be the reason that your teeth are stained.

Brush and Floss
Simply maintaining your habits of rinsing, brushing, and flossing can go a long way to protect your teeth this Thanksgiving.  Bringing some floss in your pocket to the dinner party and rinsing well in the bathroom with warm water is a great way to clean and protect your teeth before you can get home to brush them.  We know you probably don't want to be the guy or gal that shows up with a toothbrush sticking out of your pocket, but a travel-size floss is very inconspicuous and is highly advised.

Enjoy
At the end of the day, we know that the foods we indulge on in the holiday season are not the best for our dental health, but there are ways that we can enjoy these treats and still be responsible stewards of our teeth and gums.  So, after reading this tips we hope you will put them to use, but even more we hope you have a fantastic Thanksgiving and holiday season!  At Omni Dental Group, we are thankful for our awesome clients and all that read our blogs.  Have a great Thanksgiving!

-Omni Dental Group (512)250-5012

Pericoronitis

Pericoronitis is an inflammation (infection) of the soft gum tissue that surrounds the coronal portion (enamel-covered part) of a tooth. It can be associated with the eruption of a tooth, but most often is related to the mandibular (lower) wisdom teeth. The pericoronitis around the lower wisdom teeth is the subject of this short explanation.

Over thousands of years, the diet humans eat has been getting softer and requires less chewing. Our decreasing jaw size and lessened need for wisdom teeth reflects this trend. Unfortunately, our jaws are shrinking faster than our wisdom teeth are disappearing. As a result, particularly in the lower jaw, the wisdom teeth do not have enough room to fully grow (erupt) into the mouth. Although some do find their way into proper position and cause no trouble, all too often the wisdom teeth appear partially covered with gum tissue. This causes a situation in which it is difficult, if not impossible, for the wisdom tooth and surrounding gum to be effectively cleaned on a daily basis. There is a high potential for recurring gum infections. If the tooth and gum cannot be cleaned daily, debris builds up under the gum tissue that partially covers the wisdom tooth. The debris and by-products deteriorate and cause an inflammatory response in the surrounding gum. The gum becomes infected and swollen. If it swells enough, you may even unavoidably bite down on it each time you try to chew food or even swallow.

These infections can be mild, moderate, or severe in nature. They can happen just once or be a continuing problem. There may be little pain or so much pain that you cannot even open your mouth. You may run a fever, have a sore throat, or have swollen glands down the side of your neck.

There are several possible solutions to this problem. You can have the wisdom tooth extracted, and the problem will never occur again. Depending on the position of the teeth, it might be done in this office or you might be referred to a specialist. If you decide to not have the tooth extracted, we can irrigate the area around and under the gum with a medicated solution and clean out the debris with special instruments. Then we will prescribe a specific mouthrinse for you to use postoperatively for several days. If the infection is not too severe, this will often resolve the immediate situation. However, it can recur! In some people, recurrence is frequent; in others, it never happens again. It is very difficult to predict. The better able you are to effectively clean the area, the less likely you are to have the infection again.

After an evaluation of your problem, we will suggest the appropriate option to you. Please remember that the better you can follow our specific recommendations on daily brushing and flossing of your teeth and keeping the time intervals between your periodic hygiene recare appointments, the less likely you will be to have any pericoronitis problems.

Today the following procedures were performed:

If you have any questions about pericoronitis, please feel free to ask us at (512)250-5012.

-Omni Dental Group

Metal Filling-Induced Cracks in Enamel

While tooth enamel is normally hard and brittle, over time very small microcracks will appear in the enamel. This is thought to be due to the thermocycling of the enamel from items you eat and drink that are hotter or colder than room temperature. Again, over time, the expansion and contraction of the enamel causes the cracks to appear. This is not considered a dental problem and is not usually treated. However, teeth that are restored with metal fillings are a different story. Silver amalgam (metal) fillings are composed of not only silver, but also other metals, too. One of the metals is mercury. Most filling materials are at least 30% and some are as high as 50% mercury. Besides being classified as a heavy metal, mercury is a liquid at room temperature (although it is not a liquid in the filling material) and rapidly expands and contracts when its temperature is raised and lowered.

How Cracks Occur

Metal fillings can cause cracks in tooth enamel.

Your mouth is at a temperature of about 98.6 degrees. When you drink hot coffee, followed by eating cold ice cream, the temperature of your mouth will rapidly cycle up 20 or 30 degrees, then down 60 or 70 degrees, then back up to 98.6 degrees. This happens every time you eat or drink something that is not the same temperature as your mouth. Because of the expansion of the mercury component and other metals of the filling material, this expansion and contraction of the filling will cause an outward pressure on the enamel and dentin. The larger the filling is in the beginning and the thinner the enamel is, the more prone the tooth will be to developing cracks. Cracks also provide an avenue for the ingress of fluids and bacteria, a pathway for a cavity to start deep in the tooth. If this were not bad enough, the metal will absorb some of the moisture present in your mouth, and as time passes, will increase in volume. As it expands, it will put outward pressure on the walls of the original filling preparation. This also promotes development of cracks in the tooth.

There are two different paths by which the metal filling can break teeth. You can see for yourself that the fillings are changing. The once smooth and shiny metal becomes black, dull, pitted, and rough. There is metal fatigue. The older the filling, the more likely this has happened. You may also have some tooth sensitivity from fluids or sweets. This is an additional indication that the filling may be leaking and failing. If the filled tooth hurts when you bite down, the tooth may be split and nerve damage may have occurred, or it may be a different, more serious problem altogether. Directly placed metal fillings are an antiquated technique with a material that has been essentially unchanged for almost 180 years.

Treatment Options

You have a choice. You can wait until the cracks become serious and painful and then do even more extensive restorative work, or you can begin, right away, to replace the metal fillings where the cracks are evident. Sometimes, cracks do not get bigger or cause problems; however, many cracks do. During the years, the metal fatigues more and more, and the crack enlarges. In most cases a tooth-colored, bonded direct resin can be used to replace the metal. It seals better to your tooth and has not shown that it cracks the teeth as the metal fillings do. If the existing crack or filling is moderate to large, a gold, resin, or ceramic inlay/onlay will be recommended for the replacement material.

 

If you have any questions about metal filling-induced cracks in enamel, please feel free to ask us at (512)250-5012. – Omni Dental Group

Treating the Adult Patient

Age Affects Needs

Dental treatment needs change as you age. From our years of dental experience, we have found that dental needs of adult patients fall into two distinct categories: those who have not had a history of many restorations (fillings) and those who have had their teeth drilled and filled repeatedly over the years.

The first group is fortunate. While new decay can begin at any time, the older you get, the less likely you are to get new cavities. When those adults who have had few fillings brush and floss their teeth properly to prevent periodontal disease, they will probably develop few new dental problems. Old restorations need infrequent replacement (especially if the fillings are only small fillings). The need for crowns (caps), bridges, implants, or endodontic treatment (root canal therapy) is also minimal.

Multiple Restorations

Those who have had numerous fillings over the years will probably experience more dental treatment needs than the first group. Large, existing restorations have a tendency to break more often than small fillings. When a tooth contains a large filling, there is correspondingly less natural tooth left, which can lead to fractures. Silver fillings are held in place by the surrounding tooth. When there is insufficient tooth left, the silver fillings will not last a long time. The second group can expect to have heavily filled teeth break over and over until a cast restoration (crown or inlay) is needed to restore the tooth.

Cast Restorations

Cast, laboratory-processed restorations will last longer than direct placed materials (silver fillings). In fact, it would be wise to consider placing the cast restorations (when indicated) sooner rather than later. This can eliminate further drilling and aggravation to the patient.

Endodontic Therapy

The adult patient who has had a history of moderate to severe decay and large restorations may also require more endodontic treatment (root canals) than an adult who has few fillings. Larger restorations are likely to have been placed very near to the nerve of the tooth. Over time, a tooth nerve can die when a restoration is placed very near the nerve oroccasionally becomes apparent when the tooth is prepared for a crown or cast restoration. The only alternative to endodontic treatment is to extract the tooth¾not a solution we recommend.

Tooth Fracture

Any tooth that has been drilled and filled could also be subject to fracture. The older and larger the filling, the more likely it is to fracture. If the gum has receded due to improper brushing habits or periodontal disease, sensitive roots or root surface decay may become evident. Root surface decay can damage a tooth much faster than enamel decay.

Prevention Remains a Key Element for Sound Oral Health

Prevent the problem from starting: brush and floss. Once you notice symptoms, get the problem diagnosed and treat the area of concern when it is small. See us at the recommended intervals. Fix the problem so that it stays fixed for the longest time and does not cause more problems. Less drilling is better than more. The longest-lasting restoration may be the restoration of choice.

If you have any questions about dental treatment for the adult patient, please feel free to ask us at (512)250-5012. – Omni Dental Group.

Blast From the Past: Dental Health Beyond Teeth

Good oral health goes beyond brushing and flossing. Find out more about the inside of your mouth and the role its various structures play in speech and digestion.

Your mouth is made up of more than just teeth, so good oral health goes beyond simply brushing and flossing. In addition to your teeth, your mouth is made up of gums, oral mucosa, the upper and lower jaw, the tongue, salivary glands, the uvula, and the frenulum. All of these structures play an important role when it comes to good dental health and are routinely examined when you receive dental care.

The Oral Mucosa

When you open your mouth and look in the mirror, everything that isn’t a tooth is covered by a protective lining called the oral mucosa, which is a mucous membrane similar to the mucous membranes that line your nostrils and inner ears.

The oral mucosa plays an essential role in maintaining your oral health, as well as your overall health, by defending your body from germs and other irritants that enter your mouth. A tough substance called keratin, also found in your fingernails and hair, helps make the oral mucosa resistant to injury.

The Gums

Your gums are the pinkish tissue that surrounds and supports your teeth. Also covered by oral mucosa, gums play a critical role in your oral health. Healthy gums are firm, cover the entire root of the tooth, and do not bleed when brushed, poked, or prodded. Gum disease can ultimately lead to tooth loss, so taking care of your gums by flossing daily is just as essential to dental care as brushing your teeth.

The Upper and Lower Jaw

Your jaws give your face its shape and your mouth the structure it needs for chewing and speech. Human jaws are made up of several bones: The upper jaw contains two bones that are fused to each other and to the rest of your skull, while the lower jawbone is separate from the rest of the skull, enabling it to move up and down when you speak and chew.

The Tongue

The tongue is a powerful muscle covered in specialized mucosal tissue that includes your taste buds. The tongue is not just important to your oral health — it's also considered an integral part of the body's digestive system — it's responsible for moving food to your teeth, and when chewed food is ready to be swallowed, the tongue moves it to the back of the throat so it can proceed into the esophagus. In babies, the tongue and the jaw work together to enable the infant to breastfeed.Additionally, the tongue plays an essential role in the ability to speak by shaping the sounds that come out of your mouth.

The Salivary Glands

You have three sets of salivary glands in your mouth and neck: the parotid, submandibular, and sublingual glands. These glands produce saliva, which contains special enzymes that help break down food, making it easier for you to swallow. Saliva is critical to good oral health, because it protects your teeth and gums by rinsing away food particles and bacteria and by helping to counteract acidic foods that can wear down the protective enamel on your teeth.

The Uvula

The uvula is the small flap of tissue which hangs down at the back of your throat. The uvula is composed of muscle fibers as well as connective and glandular tissues. Like other soft tissue structures in the mouth, the uvula is covered by oral mucosa. The uvula has long been a source of curiosity for scientists as all of its functions are not yet fully understood. However, it seems to play some role in speech and in keeping the mouth and throat moist.

The Frenulum Linguae

The frenulum is a flap of oral mucosa that connects the tongue to the floor of the mouth. This tissue allows the tongue to move about as it does its job. If an infant is born with a frenulum that is too short, or not elastic enough, he or she can have trouble breastfeeding. A short frenulum can also affect speech.

The next time you’re brushing your teeth, spend a minute looking at the parts of the mouth that lie farther inside the oral cavity. Knowing what these structures do and what they look like can help you to maintain optimal oral health.

Call Omni Dental today at (512) 250-5012 to speak with one of our specialists about the latest ways of enhancing your smile and dental health. You can also go to our website: omnidentalgroup.com for more information.

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 Article by: Connie Brichford from everydayhealth.com

Diastemas: Closing the Spaces Between Teeth

The Cause

A diastema is space between teeth, that is, adjacent teeth that do not touch. There are a number of reasons why spaces may exist between teeth. The two most common are an arch length discrepancy (teeth are too narrow for the arch that supports them), or because there are congenitally missing teeth. The remaining teeth then either shift or merely don’t touch the next available tooth. The spaces between the teeth can be just a fraction of a millimeter wide or so wide that a straw can easily fit between the teeth.

The missing teeth can and often do cause a cosmetic problem. In the present culture of the Western world, spaces or gaps between teeth are not regarded as being desirable or attractive.

Treatment Options

There are several options available to treat a diastema. Most of these options work well whether the spaces are large or small or whether there are several spaces or just one space between two teeth.

Orthodontics can be used to move the teeth into a more pleasing alignment. This could be done with a retainer or fixed bands and wires.  Clear Invisalign orthodontic aligners are often used to close these spaces. The advantage is that complex restorations are usually unnecessary and you have no worry about the restoration chipping or breaking after years of service. The disadvantage of orthodontics to close a diastema is the time needed to move the teeth, which can range from a few months to 18 months.

The other option is to have the teeth restored with bonding. The bonding can be done with either resin or with porcelain. The resin will be less expensive and work well to close small diastemas. The porcelain takes an additional visit, is more expensive, and is more appropriate for larger cases in which a more significant appearance modification is needed. This would include changing the color of the teeth, the length of several teeth, or the alignment of several teeth. As a rule of thumb for small spaces, a bonded resin will work well; for larger spaces, orthodontics and porcelain must be considered. Porcelain and resin both can be made to exactly match your existing tooth.

Each situation must be individually examined and evaluated before treatment. Often, we will require study model impressions to be made so we can make measurements of the tooth length, width, and amount of separation between teeth. Using this method, we can show you how you can look through the use of a diagnostic “wax up” showing the new shape of the teeth.

An important point to remember is that if you also want a whiter appearing smile, we should complete the whitening process before the bonding process. Teeth can be whitened, but dental materials such as porcelains and resins cannot be whitened. The restorations are placed to match your tooth color at the time they are placed, so whitening has to come first.

Afterwards

After the teeth are moved or reshaped with porcelain or resin, your appearance will change! Not only that, but your teeth will feel different to you. Your lips will be supported differently. Air will be deflected from your teeth in a different fashion. Depending on the amount of change, you may even need to make slight adjustments to your speech. The good news is that all the adjustments take only several hours to a few days to make. Very quickly, additions and changes become natural for you and you don’t even notice that they were done, except that people will compliment you on how lucky you are to have been born with such beautiful teeth!

 

If you have any questions about diastema closures, please feel free to ask us at (512)250-5012.

–Omni Dental Group.

Blast From the Past: How to Properly Use Dental Floss

You’re flossing. Great. But in order for dental floss to effectively remove plaque from your teeth, you need to be sure you’re using the correct technique.

Because you’ll be putting your fingers into your mouth, be sure to wash your hands before you reach for the floss. Then just follow these steps:

                                                              

• Use enough floss. Break off a piece about 18 inches long. That sounds like a lot, but you want enough to keep a clean segment in place as you move from tooth to tooth. 
• Wrap most of the floss around either the middle finger or the index finger of one hand, whichever you prefer, and a small amount onto the middle or index finger of the other hand. (Using the middle finger leaves your index finger free to maniuplate the floss.)
• Slide between teeth. Gently slide the floss between the teeth in a zigzag motion and be careful not to let the floss snap or “pop” between teeth.
• Form a “C”. Make a C shape with the floss as you wrap it around the tooth. Then carefully pull the floss upward from the gum line to the top of the tooth.
• Roll along. As you move from one tooth to the next, unroll a fresh section of floss from the finger of one hand while rolling the used floss onto the finger of the other hand. Use your thumb as a guide.
• Reach both sides. Don’t forget to floss the back side of each tooth.

As long as you use the correct technique, the type of floss you use is a matter of personal preference. There are many types to choose from, and you can even choose a variety of types to meet your needs and those of your family members. Either way, using the correct technique will help you remove the excess food particles and plaque buildup between your teeth and help improve your oral health.

Call Omni Dental today at (512) 250-5012 to speak with one of our specialists about the latest ways of enhancing your smile and dental health. You can also go to our website: omnidentalgroup.com for more information. 

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 Article from: Oral-B Health

Impressions

There are two types of impressions that we routinely take in this office. The first type is for the fabrication of study models and diagnostic casts. The second is for the construction of laboratory-processed crowns, bridges, and removable partial dentures.

Study Model or Preliminary Impressions

Study model impressions are the most common impressions made in a dental office. A sterilized metal tray or a disposable plastic tray is used for this procedure. The tray is fitted approximately to the dimensions of your upper or lower jaws and will cover your teeth and gum tissue. Once fitted, the tray is partially filled with a soft, viscous impression material. This material has the consistency of thick cookie dough batter. The filled impression tray is placed over your teeth and gently pressed into place. The material will take from 1 to 2 minutes to set.  The impressions are absolutely painless and require no medication or special preparation. The material has a moderately pleasant taste.

From this impression, stone models will be made that are a very close duplicate of your teeth. These models allow us to analyze your teeth and properly design your dental treatment. We investigate the possibilities of orthodontics (braces), custom trays for whitening teeth, and replacement of missing or severely damaged teeth. We make custom trays for final impressions, guides for temporary crowns, mouthguards, splints, etc.

Final Impressions

This type of impression is for fabrication of crowns, bridges, or partial dentures. The impressions are made with a different material, one that is much more accurate in demonstrating the smallest details of the prepared area. Because of the increased need for precision, the impression is different. A custom-fabricated tray is often made from the model made in the preliminary impression. This material will be in place for 3 to 6 minutes. Often, a local anesthetic has been used to prepare the tooth so there should be no discomfort. It is not uncommon that a second or third impression might be taken to ensure the accurate fit of the finished restoration.  If the impression is not right, the final restoration will be compromised.

Occlusal Registration

With both types of impressions, it is standard practice to take an occlusal (bite) registration during the appointment. This gives us the ability to relate the upper and lower jaw models. The impression may be placed on a tray or directly onto the biting surface of your teeth; you will then be instructed to bite down and hold your bite in place until the material sets. The bite registration impression sets very quickly.

If you have any questions about impressions, please feel free to ask us at (512)250-5012. –Omni Dental Group

Preventing Toothbrush Abrasion

The Cause

Brushing improperly (especially with a hard-bristled toothbrush) can cause erosion/abrasion of your tooth or teeth. This is a very common problem. It begins as a small V- or U-shaped area of wear near the gingival (gum) tissue right next to the tooth, usually where the tooth and gum meet. Improper brushing causes the gum tissue to recede; and the tooth may become sensitive to heat, cold, or air stimulation. With time, more enamel wears away and a small horizontal notch is seen on the tooth at the gumline. This is not an area of decay, but a mechanical “cavity” cut in the tooth. Eventually the enamel is worn completely through and the dentin becomes exposed. When that occurs, some people experience severe tooth sensitivity. It may so severe that it is painful to drink cold beverages, breathe in air, or brush your teeth. Not everyone, however, experiences tooth sensitivity.  

Once enough of the gum is brushed away, the root of the tooth becomes exposed. The root surface is not covered with enamel and is much softer than the enamel. It can also be unsightly to have the tissue recede. Since the root surface is not protected by hard enamel, if the improper brushing continues, the root cementum will be worn through and a notch will be made in the dentin. This notch will increase in size, weaken the tooth, and sometimes make the area more prone to decay.

An Example of Tooth Abrasion

Tooth Sensitivity

Some patients with very little loss of tooth structure experience extreme sensitivity. This problem can usually be corrected with the application of a dentin-bonding material or other desensitizing chemicals. The sensitivity problem is often completely cured. The treatment can last (depending on your brushing habits) for 6 months or longer. If necessary, the tooth can be re-treated if the sensitivity returns.

Some patients with a tremendous loss of tooth structure notice very little tooth sensitivity. Whether or not the teeth become sensitive, it is advisable to correct the brushing problem to slow down or eliminate the wear process. It is also recommended that the notches be restored with a tooth-colored filling material. This will restore the appearance of the tooth and protect the previously exposed dentin. In this way, even if you continue to brush improperly, the tooth will be protected.

In cases of minor sensitivity, we might recommend the use of desensitizing toothpaste as a low-cost alternative to the placement of bonded materials. Some cases might also be managed through the use of topical fluoride applications.

Preventing Abrasion

The problems of improper toothbrushing are easily and inexpensively corrected when they are diagnosed in the early stages of development. If allowed to progress, the tooth damage will increase, as will the cost to repair it. The best solution is prevention!    

Use a soft brush and proper technique to prevent abrasion. (See this blog.)

Brush your teeth thoroughly but not abusively. Do not scrub them or cross brush them (an exaggerated horizontal brushing motion). We will select a method of toothbrushing that will best meet your needs and teach you to care for your mouth. Use a soft toothbrush. Change to a new brush every 3 months. But if it happens that you are creating the problem of toothbrush abrasion, get it corrected as soon as it is diagnosed.

If you have any questions about toothbrush erosion or abrasion, please feel free to ask us at (512)250-5012. -Omni Dental Group

How To Get Children to Brush Their Teeth

It is not news that it is important for a child's health to have a clean mouth.  Preventing cavities and periodontal disease is important to the overall health of a person, and children are no different.  It it true, however, that many children rebel against the endless chores of hygiene, especially brushing their teeth.  Why? The answer is probably very simple: children don't like to brush their teeth because they would rather be doing fun "kid stuff."  Not to mention the fact that most kids associate brushing teeth with two things they typically don't like: waking up and bed-time.  So, how do we instill in our children the discipline of brushing their teeth regularly without it being a constant struggle?  Here are some ideas:

1.  Brushing Teeth Can Be Fun! Children learn to think about things as fun or boring based largely in part to their parents and older siblings reactions.  If mom and dad love to brush their teeth, it is likely that kids will, too.  Show your kids how much you enjoy keeping your teeth clean.

2.  Make Teeth-Cleaning a Family Event!  Rather than telling your child to go to the bathroom alone to do a chore, go to the biggest sink in the house and have the whole family brush teeth together.  This can involve a song that determines the amount of time tooth-brushing should take or a competition for best breath or cleanest teeth.  Kids are far more prone to want in on a family ritual than a lonely chore.

3.  Don't Make it About Bedtime!  It is a universal truth that kids want to stay up late like an adult and will resist bedtime.  Part of bedtime in most houses involves putting on pajamas, washing faces, and yes, brushing teeth.  This gives clean teeth a rough group of friends to be associated with in a kid's mind.  Good breath means going to bed, so brush teeth after the last meal or snack of the day.  After dinner or a post-dinner snack, rally the family together for some tooth-brushing bonding.  This separates the time between brushing teeth and bedtime in a way that will be helpful to the reputation the activity gets in the mind of your child.

4.  Fun Accessories!  Although many kids don't care what kind of toothbrush they have, having a cool, colorful brush might get your child more excited about using it.  An awesome action-figure toothbrush or an electric tooth-brushing machine to go with a fun tube of kid's toothpaste could be a real difference-maker in the daily ritual.

In all of these tips, one thing remains central: Kids follow your lead, parents.  You are more than capable of inspiring your kids to develop a respect for oral hygiene habits and with these tips you are even more equipped.  We are always in your corner and desire to see your kids have healthy mouths and habits.

Please don't hesitate to call us if you have any questions about getting your children to brush their teeth.  We are available at (512)250-5012.  -Omni Dental Group.

Re-Treatment of Root Canals

Endodontic treatment is one of the most successful forms of dental therapy that is available today.  But approximately 10% of the teeth that are treated will never heal completely or will develop problems later on. You have a situation that falls into that 10%.

There are several possible indications that there is a problem. You may experience pain or sensitivity on the treated tooth when you bite or put pressure on it. There may be either slight or severe swelling in the treated area.  A fistula (drainage tract) may develop or never fully close. This drainage site will have pus that can be expressed through it. Or you may feel nothing at all. The problem may be something that was discovered through a postoperative radiograph. The bone around the tooth may not have grown back, or there may be more bone destruction seen.

These problems occur for a variety of reasons. The pre-existing infection, the reason for the root canal in the first place, may have left residual effects that never disappeared entirely and have begun to act up again. It is also possible that the original root canal filling was not clinically ideal. This happens due to any of several factors such as severely twisted or curved roots; small, extra canals; separated root canal instruments; cement washout; and others. Sometimes, no clear reason can be seen for the root canal failure. It just happened.

Even if the problem has not been noticed by you, it is not wise to leave an active infection in your body. A nonsurgical retreatment procedure will remove the root canal filling materials, clean and refile the root canal, then refill the canals. The re-treatment is usually more difficult and time consuming than the first root canal.  It is harder to remove condensed, cemented root canal material, cemented posts, and bonded resins or cements in order to re-treat the canals.  Attempts to remove these materials may cause the tooth to fracture and become hopeless. It may not be possible to re-instrument the tooth, based on what is in it. This may not be known until the treatment is begun. It is also possible that re-treatment will not work at all.

Despite these possible problems, re-treatment is the most conservative approach and usually the least expensive approach. When the situation arises, it is the method of choice. It is performed on a tooth that you need to keep. If the re-treatment cannot be done, the problem must be addressed surgically or the tooth will have to be extracted.  A surgical endodontics procedure, called an apicoectomy, may be required if the re-treatment does not work.

We'll do whatever it takes for you to have a healthy smile.

If you have any questions about re-treatment of root canals, please feel free to ask us at (512)250-5012. -Omni Dental Group