Posts for: March, 2017
Since the discovery a century ago of its beneficial effect on tooth enamel, fluoride has become an important part of tooth decay prevention. It's routinely added to toothpaste and other hygiene products, and many water utilities add minute amounts of it to their drinking water supplies. Although there have been questions about its safety, multiple studies over the last few decades have eased those concerns.
Children especially benefit from fluoride during their teeth's developing years. Some children are at high risk for decay, especially an aggressive form known as Early Childhood Caries (ECC). ECC can destroy primary (baby) teeth and cause children to lose them prematurely. This can have an adverse effect on incoming permanent teeth, causing them to erupt in the wrong positions creating a bad bite (malocclusion).
For children at high risk for decay, dentists often recommend applying topical fluoride directly to the teeth as added protection against disease. These concentrations of fluoride are much higher than in toothpaste and remain on the teeth for much longer. Topical applications have been shown not only to reduce the risk of new cavities, but to also stop and reverse early decay.
Children usually receive these applications during an office visit after their regular dental cleaning. There are three different ways to apply it: gel, foam or varnish. To prevent swallowing some of the solution (which could induce vomiting, headache or stomach pain) the dentist will often insert a tray similar to a mouth guard to catch any excess solution. Varnishes and a few gels are actually painted on the teeth.
The American Dental Association has intensely studied the use of topical fluoride and found its application can result in substantial decreases in cavities and lost teeth. They've concluded this benefit far outweighs the side effects from ingesting the solution in children six years and older. With proper precautions and waiting to eat for thirty minutes after an application, the possibility of ingestion can be reduced even further.
While topical fluoride can be effective, it's only one part of a good dental care strategy for your child. Consistent daily brushing and flossing, a nutritious diet low in added sugar, and regular dental visits still remain the backbone of preventive care.
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”