My Blog

Posts for: August, 2017

By Scott R. Smith, DDS, PC
August 29, 2017
Category: Oral Health
Tags: gum disease  
ConsiderSavingaToothBeforeyouDecidetoReplaceit

Dental implants are the ideal tooth replacement with their life-like appearance, high success rate and durability. If you have significant dental issues, they may seem like the perfect answer. But before you choose to replace a problem tooth with an implant, it might be to your benefit — financially and health-wise — to consider saving the tooth first.

Tooth decay can be a formidable enemy, destroying both tooth structure and the tooth’s connectivity to the jaw. But there are treatment options even for heavily decayed teeth, including cavity filling with composite resins or porcelain that look and function like natural teeth. For decay deep within a tooth’s interior, root canal therapy can rid the pulp chamber and root canals of decay and seal them from future occurrences. The treatment’s success rate is comparable to and less expensive than implants.

While decay damage can be significant, adult teeth are more at risk from periodontal (gum) disease, a gum infection caused by bacterial plaque on tooth surfaces. This disease can weaken gum tissues until they eventually detach from the teeth and lead to loss. Gum disease, though, can often be brought under control by techniques called scaling and root planing that deep clean tooth and root surfaces of plaque and calculus (hardened plaque deposits).

Scaling may require multiple sessions and will require a greater effort from the patient in performing daily oral hygiene and visiting the dentist regularly to closely monitor gum health. And more advanced cases may require surgery to access deep pockets of infection or repair damaged tissues. But even with this effort, treating gum disease rather than replacing a tooth could be much less costly — and you’ll be able to preserve your own teeth.

On the other hand, the disease process may have gone on too long and caused too much damage for the tooth to be saved. In these cases, the best option is to remove it and install a restoration like an implant. By first completing a complete dental examination, we’ll be better able to advise you whether your best course is a “tooth rescue” or a replacement.

If you would like more information on dental repair or replacement options, please contact us or schedule an appointment for a consultation.


By Scott R. Smith, DDS, PC
August 14, 2017
Category: Dental Procedures
NeilPatrickHarrisWhattheOscarsHostTreasuresMost

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


By Scott R. Smith, DDS, PC
August 06, 2017
Category: Dental Procedures
Tags: oral hygiene   orthodontics   braces  
DontForgetYourOralHygieneWhileWearingBraces

There are a few things you need to do — and not do — while wearing braces: avoid hard or sticky foods, for example, or wear protection during sports to avoid injury. There's one important thing, though, that should be at the top of your list — extra attention to daily brushing and flossing.

The fact is your risk for developing tooth decay or periodontal (gum) disease increases during orthodontic treatment. This is because the braces make it more difficult to reach a number of locations around teeth with a toothbrush or floss. Bacterial plaque, the source for these dental diseases, can subsequently build up in these areas.

Teen-aged orthodontic patients are even more susceptible to dental disease than adults. Because their permanent teeth are relatively young they have less resistance to decay than adults with more mature teeth. Hormonal changes during puberty also contribute to greater gum disease vulnerability.

There are some things you can do while wearing braces to avoid these problems. Be sure you're eating a nutritious diet and avoid sugary snacks or acidic foods and beverages (especially sports or energy drinks).  This will deprive bacteria of one of their favorite food sources, and the minerals in healthy food will contribute to strong enamel.

More importantly, take your time and thoroughly brush and floss all tooth surfaces (above and below the braces wire). To help you do this more efficiently, consider using a specialized toothbrush designed to maneuver around the braces. You might also try a floss threader or a water irrigator to remove plaque between teeth. The latter device uses a pressurized water spray rather than floss to loosen and wash away plaque between teeth.

Even with these efforts, there's still a chance of infection. So, if you notice swollen, red or bleeding gums, or any other problems with your teeth, visit us as soon as possible for an examination. The sooner we detect and treat dental disease while you're wearing braces, the less the impact on your future smile.

If you would like more information on taking care of teeth while wearing braces, 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 “Caring for Teeth During Orthodontic Treatment.”