Posts for: February, 2014
In modern times, metals have played an important role in tooth preservation and restoration. From the dental amalgam used for a century and a half to fill cavities to the titanium alloy of dental implants, your dental care would not be as comprehensive as it is today without them. But could these metals, so important in providing oral health, cause an allergic reaction in some people?
An allergy is an exaggerated response of the body’s immune system to any substance (living or non-living) it identifies as a threat. The response could be as minor as a rash or as life-threatening as a systemic shut-down of the body’s internal organs. An allergy can develop with anything, including metals, at any time.
A low percentage of the population has an allergy to one or more metals: some surveys indicate 17% of women and 3% of men are allergic to nickel, while even fewer are allergic to cobalt and chromium. Dermatitis patients seem to have a higher reaction rate, some allergic even to metals in jewelry or clothing that contact the skin.
Dental amalgam, an alloy made of various metals including mercury, has been used effectively since the mid-19th Century to fill cavities; even with today’s tooth-colored resin materials, amalgam is still used for many back teeth fillings. Over its history there have been only rare reports of allergic reactions, mainly localized rashes or moderate inflammation.
The most recent metal to come under scrutiny is titanium used in dental implants. Not only is it highly biocompatible with the human body, but titanium’s bone-loving (osteophilic) quality encourages bone growth around the implant’s titanium post inserted into the jawbone, strengthening it over time. But does titanium pose an allergic threat for some people? One study reviewed the cases of 1,500 implant patients for any evidence of a titanium allergy. The study found a very low occurrence (0.6%) of reactions.
The conclusion, then, is that the use of metals, especially for dental implants, carries only a minimal risk for allergic reactions and none are life-threatening. The vast majority of dental patients can benefit from the use of these metals to improve their oral health without adverse reaction.
If you would like more information on metal allergies with dental materials, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Metal Allergies to Dental Implants.”
Losing all of your teeth can be both physically and emotionally traumatic. Patients in this condition may need a period of transition from this loss to their permanent restoration. That’s the purpose of “immediate” dentures.
An immediate denture is a tooth appliance available for placement immediately after the final extraction so the patient’s ability to eat and speak isn’t unduly hampered (it also helps preserve their facial appearance). An immediate denture is a temporary measure until a more permanent replacement is achieved; hence, they’re not intended for long-term use.
Over time an immediate denture’s fit will deteriorate. This is because as the gums heal after extraction, and without the natural teeth present, the underlying bone and gum tissues will shrink significantly. The denture fit becomes looser, which leads to movement of the denture within the mouth. This can cause a good deal of discomfort emotionally and physically, and make it more difficult to eat and speak. It’s possible, however, to reline the immediate denture to fit the gum shrinkage and gain more service from it.
At some point, though, it’s necessary to transition from the immediate denture to the permanent restoration. If the permanent solution is a removable denture, we will need to wait until the gums have completely healed. At that time we will make a new and accurate impression of your mouth that reflects any changes since extraction. Even with this high level of accuracy, though, the final fit will depend on the amount of remaining bone and gum tissue needed to support the denture.
There are other options besides a removable denture. We can install a pair of implants in conjunction with a removable denture that can stabilize and retain it in the mouth; implants can also support a fixed bridge. You should weigh all the advantages and disadvantages to these options (including cost), to determine which one is the best solution for you.
In the meantime, the immediate denture will enable you to function in a normal manner, as well as aid with your appearance. Remember, though, it’s only meant for a short period of time — at some point you will need to transition from “immediate” to a more permanent and satisfying replacement.
If you would like more information on dentures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Immediate Dentures.”
Everyone's heard the jokes about root canals. Now, let's go beyond the myths and get to the “root” of the matter. Here are a few things everyone should know about this relatively painless and beneficial procedure.
1) If you experience discomfort after eating hot or cold foods, sharp pain when biting down, swelling of the gum tissue, or acute tooth pain, you may need root canal treatment.
All of the above are symptoms of disease in the pulp tissue, which lies deep within the roots of teeth, inside tiny canals that go from one end of the root to the other. Pulp tissue can become infected or inflamed for a variety of reasons, such as trauma or deep tooth decay, causing pain and leading to further complications.
2) Diseased pulp tissue in the root canal must be removed to prevent more problems.
The acute pain may go away — but without treatment, the infection in the pulp tissue won't. It will eventually travel through the ends of the tooth's roots and into surrounding areas. This can lead to dental abscesses, and may even cause systemic problems and diseases in other parts of the body.
3) Root canal treatment is effective.
Removing the diseased pulp tissue removes the infection. Pulp tissue itself is a remnant of tooth development which the tooth no longer needs. After the tissue is removed, the root canal is filled with a biocompatible material, and then it is sealed. A crown or other restoration is usually done after root canal treatment to restore the tooth to its full function.
4) Root canal treatment is generally pain-free.
Just like having an ordinary filling, the process begins with an anesthetic administered to numb the tooth and the nearby area. A tiny hole in the tooth's biting surface provides access to the canal, and minute instruments are used for the procedure. Afterwards, over-the-counter pain relievers are typically all that's needed to relieve the sensitivity that may persist for a day or two following the treatment.
5) A properly done root canal preserves your natural teeth.
A tooth that has had appropriate root canal treatment and restoration can last just as long as a natural tooth. That's important, because the other option — removal of the tooth — can lead to issues like unwanted tooth movement and bite problems. Saving your natural teeth should be the first priority in proper dental care.
If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”
If your gums bleed when you brush your teeth, it’s unlikely the cause is brushing too hard. The more common reason (especially if you’re experiencing little to no pain) is periodontal (gum) disease caused by the accumulation of bacterial deposits known as dental plaque and calculus where your teeth and gums meet.
This bacterial dental plaque results in an infection in the soft tissues of the gum; the body responds to this infection with antibodies, which in turn cause the gums to become swollen, or inflamed. As this biological “war” rages on, both the infection and inflammation become chronic. The tissues are weakened from this disease process and bleed easily.
Bleeding gums, then, is an important warning sign of possible gum disease. As the infection progresses the normal attachment between the teeth and gums begins to break down and form pockets in the void. The infection will continue within these pockets, eventually spreading deeper into the gums and bone. The gum tissue may begin to recede, resulting in bone loss and, if untreated, to tooth loss.
In the early stages of the disease, bleeding gums could be the only symptom you notice. It’s possible the bleeding may eventually stop, but this doesn’t mean the disease has, and is more likely advancing. If you’ve encountered bleeding gums, you should visit us as soon as possible for a complete examination.
There’s a two-pronged approach for treating gum disease. The first prong — and top priority — is to remove as much of the offending bacterial plaque and harder deposits (calculus) as possible, along with the possibility of follow-up antibacterial and antibiotic treatment. This may require more than one session, but it’s necessary in stopping the disease. The second prong is instituting proper oral hygiene: daily brushing and flossing (using proper techniques we can teach you) and semi-annual professional cleanings in our office to remove any plaque or calculus not removed with brushing.
Bleeding gums is your body’s way of telling you something isn’t right with your gums. The sooner you seek diagnosis and treatment, the better your chances of halting the damage caused by the disease.
If you would like more information on bleeding gums as a warning sign of gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bleeding Gums.”