Excessive Wear

When two surfaces are rubbed against each other, the surfaces will eventually wear away. How fast this occurs and how much surface area is lost depends on the hardness of the surface (resistance to abrasion) and how long the force (abrasive action) continues.

How Abrasion Occurs

Enamel is an extremely hard substance.  Because of the hardness, enamel can resist wear and last throughout a lifetime of chewing food. It protects and covers the underlying and much softer inner tooth substance, dentin, and nerve tissue.

While enamel is very resistant to abrasion, it does occur. Here’s how: The most common abrasion we see is when bottom front teeth rub against top front teeth. The enamel on the biting surfaces of these teeth is moderately thick, up to approximately 2 mm. Over the course of a person’s life, these teeth will come in contact and enamel will slowly be lost. Normally, this happens quite slowly. This type of wear is not of concern. The problem with excessive wear begins when a patient grinds or clenches, putting more force on the teeth or working them together for long periods of time. Although the enamel is very hard, if it is “abused” long enough, it, too, will wear away. Wear occurs more quickly when a natural tooth opposes a porcelain crown. Porcelain is much harder than enamel and may actually wear the enamel away even under normal use. In this case it is critical that the bite be properly adjusted to reduce this possibility.

Consequence of Abrasion

Why is the accelerated wear of enamel a problem? Although the wear continues on all teeth, it is most visible on the lower front teeth. Lower front teeth may be the most important teeth in your mouth, since they control the bite relationships of your top and bottom jaws.

Once the enamel is worn away, two undesirable things can happen. First, the exposed dentin can become sensitive to air or temperature changes. Secondly, when not supported by resilient dentin, the enamel can break off and the tooth will become smaller. As this happens, the natural movement of the tooth pushes the tooth further out of its socket. The now shorter tooth stops only when it meets its opposing tooth. Additionally, the dentin tends to stain more readily than enamel, so there will be a distinct and disagreeable cosmetic appearance that will become excessive as time goes on.

Treatment of Abrasion

The treatment of excessive wear depends on how much tooth is missing. If only the enamel is affected, a protective mouthguard is recommended. If a small to moderate amount of dentin is exposed, it can easily be covered with a bonded, tooth-colored resin. The resin, although not as resistant as the original enamel, is still much harder than the dentin. If you still continue to grind or clench your teeth, the resin will be the only tooth structure now affected. In extreme cases of excessive wear, porcelain veneers or full crowns may be the only means of restoration.

Excessive wear is difficult to diagnose in the early stages. It may take months and years for it to become evident.   When noted, it is best treated early when there is the least amount of tooth loss and the highest chance for a long-lasting, conservative solution.

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

-Omni Dental Group

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