By Michael Wolfgram, DDS
May 15, 2018
Category: Dental Procedures
Tags: root canal  
RootCanalAwarenessWeekATimetoLearnHowTeethAreSaved

What’s the first thing that comes to mind when you think of the month of May? Balmy breezes? Sweet-smelling flowers? How about root canal treatment?

The last item might seem out of place…but for the last ten years, Root Canal Awareness week has been celebrated in May. So let’s take a closer look at this important—and often misunderstood—dental procedure.

What we commonly call a “root canal” is a special treatment that can save diseased teeth which might otherwise be lost. But the root canal itself is actually a set of hollow, branching passages deep inside the hard outer tissue of the tooth. The tiny “canals” contain the tooth’s soft pulp, including nerves, blood vessels and connective tissue. These tissues help teeth grow during childhood but aren’t necessary in healthy adult teeth—and, what’s worse, they can become infected via deep cavity or a crack in the tooth’s outer layers.

When bacteria infect the pulp tissue, the inflammation often causes intense discomfort. In time, the harmful microorganisms can also pass through the tooth’s root and into the tissue of the jaw, resulting in a painful abscess. Eventually, if it isn’t treated, the tooth will likely be lost.

Root canal treatment is designed to remove the infection, relieve the pain…and save the tooth. It is usually performed under anesthesia for your comfort. To begin the procedure, a small hole is made in the tooth’s enamel to give access to the pulp; then, tiny instruments are used to remove the diseased tissue and disinfect the tooth. Finally, it is sealed up against re-infection. Following treatment, a cap (or crown) is often needed to restore the tooth’s full function and appearance.

Despite some rumors you may have heard, root canal treatment is neither very painful nor likely to cause other health problems. So if you come across these discredited ideas, remember that dentists and dental specialists called endodontists perform some 25 million root canal procedures every year—and this treatment method  has been validated for decades.

Of course, like any medical procedure, root canal treatment is not 100% successful. While the procedure has a very high success rate, it’s possible that additional treatments will be needed in some cases. However, the alternative—extracting the tooth—has similar potential downsides; plus a replacement tooth will be needed to avoid the health and lifestyle troubles caused by missing teeth. But one thing is certain: Ignoring disease in the tooth’s soft tissues isn’t a good move, because the infection won’t go away on its own—and down the road it will only get worse.

So this May, while you’re taking time to smell the flowers, spare a thought for the often-misunderstood root canal. If you’d like more information on root canal treatment, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”

By Michael Wolfgram, DDS
May 05, 2018
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

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.”

By Michael Wolfgram, DDS
April 25, 2018
Category: Oral Health
Tags: oral health   nutrition  
DontLetSportsorEnergyDrinksRobyouofYourTeethsEnamel

In the sports world, athletes are always looking for an edge. And it’s not just college or professional sports—even Little Leaguers are focused on enhancing their performance.

That’s why sports and energy drinks have rocketed in popularity. With marketing pitches promising to increase stamina or replace lost nutrients from strenuous workouts, it’s not unusual to find these beverages in sports bags or the team water cooler.

But there’s a downside to them regarding your dental health—they’re often high in sugar and acidity. Both drink types could increase your risk of tooth decay or periodontal (gum) disease over time.

Sugar is a primary food source for the bacteria that can trigger a gum infection. They also produce acid, which at high levels can erode tooth enamel and lead to tooth decay. The risk for enamel erosion also increases with the drink’s acidity.

You can lessen your risk of these unpleasant outcomes by restricting your consumption of these beverages. In fact, unless your sports activity is highly strenuous for long periods, your best hydration choice is usually water.

But if you do drink a sports or energy drink for an extra lift, be sure to take these precautions for the sake of your teeth:

Try to drink them only at mealtimes. Continually sipping on these drinks between meals never gives your saliva a chance to neutralize mouth acid. Reserving acidic foods and beverages for mealtimes will allow saliva to catch up until the next meal.

Rinse with water after your drink. Water usually has a neutral pH. This can help dilute mouth acid and reduce the mouth’s overall acidity.

Don’t brush right after drinking or eating. Increased acid that can occur right after drinking or eating can immediately soften tooth enamel, but saliva can neutralize and help restore minerals to tooth enamel within an hour. Brushing during this period could remove tiny bits of the enamel’s minerals.

Taking these precautions will help keep sports or energy drinks from eroding your tooth enamel. Once it’s gone, you won’t be able to get it back.

If you would like more information on protecting your tooth enamel, 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 “Think Before You Drink: Sports and Energy Beverages Bathe Teeth in Erosive Acids.”

By Michael Wolfgram, DDS
April 15, 2018
Category: Dental Procedures
Tags: dental care  
KeepYourSmileBeautifulinAprilandBeyond

There are well-known holidays on the calendar this month, but here’s one that might have escaped your notice: “Keep America Beautiful Month,” which is observed throughout April! At this time, people from coast to coast are encouraged to clean and beautify their communities. So why not think of it as an occasion to spiff up your smile? Here are five ways to do exactly that:

Have your teeth professionally cleaned. A routine dental visit, which includes a professional cleaning and exam, is one of the best preventive healthcare values there is. It’s a chance to catch dental problems (including potentially serious ones like oral cancer) before they become more difficult to treat. A dental professional can remove built-up deposits of tartar from your teeth using specialized instruments—something you can’t do at home. Plus, you’ll leave the office with a freshly polished smile that looks and feels great.

Get a professional teeth whitening. Having whiter teeth often makes people look more youthful. And one of the best ways to brighten dull teeth is with professional teeth whitening. You can achieve the fastest, most dramatic results with an in-office treatment—up to ten shades in just one visit! We can also make you a custom take-home kit to achieve similar results over time.

Repair chipped teeth. If you feel self-conscious about a chipped tooth, consider cosmetic bonding. In this relatively inexpensive procedure, which often takes just one office visit, tooth-colored resin material is applied to the chipped area and hardened under a special light. The translucent resin is built up layer by layer, bringing teeth with minor flaws back to a great, natural-looking appearance.

Replace old dental work. Sometimes old dental work can stand out more than we’d like it to. This is especially true of amalgam (silver) fillings—but even white fillings can absorb stain after many years. If you feel old dental work is detracting from your smile, it may be time to replace it with up-to-date dental materials.

Straighten your smile. Did you know that there is no maximum age for successful orthodontic treatment? It’s true: Healthy teeth can be moved at any age. And if you think metal braces wouldn’t fit in with your look or lifestyle, consider one of the less-visible alternatives to traditional orthodontic hardware—such as ceramic braces and clear aligners.

Having the smile you want can make you feel more confident in any month of the year. If you’d like more information on cosmetic dentistry, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “How Your Dentist Can Help You Look Younger” and “Orthodontics for the Older Adult.”

By Michael Wolfgram, DDS
March 31, 2018
Category: Oral Health
Tags: tooth decay  
AlthoughaChallengeChronicallyIllChildrenNeedToothDecayPrevention

Families of children with chronic conditions face many challenges. One that often takes a back seat to other pressing needs is the prevention of tooth decay. But although difficult, it still deserves caregivers’ attention because of the dental disease’s potential long-term impact on oral health.

Chronically ill children are often at higher risk for tooth decay, most commonly due to challenges in practicing effective oral hygiene. Some conditions create severe physical, mental or behavioral impairments in children’s ability to brush and floss: for example, they may have a heightened gag reflex to toothpaste in their mouth or they may not be able to physically perform these tasks on their own.

Some children may be taking medications that inhibit salivary flow as a side effect. Saliva is critical for disease prevention because it both neutralizes mouth acid (which can erode tooth enamel) and is a first line of defense against disease-causing bacteria. And a child’s diet, while designed to support treatment of their chronic condition, may conversely not be the best for supporting their dental health.

It’s best if caregivers and their dentists develop a strategy for decay prevention, which should include the following:

  • Regular dental visits beginning at Age One. Besides monitoring dental health, dental visits also provide cleanings and other preventive measures like topical fluoride or sealants;
  • Brushing and flossing support. Depending on a child’s physical and mental capacities, caregivers (or an older sibling) may need to model brushing and flossing, or perform the tasks for the child;
  • Medication and diet changes. If medications are causing dry mouth, caregivers can speak to their physicians about possible alternatives; likewise, they should see if modifications can be made to their diet to better support dental health.
  • Boosting salivary flow. It’s especially important with children who have dry mouth to drink more water or use aids (like xylitol gum or candies) to boost salivary flow.

Although it requires extra effort and time to give attention to a chronically ill child’s dental health, it’s well worth it. By working to prevent tooth decay early in life, these children will be more likely to enjoy good dental health in the future.

If you would like more information on dental care for children with special needs, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Managing Tooth Decay in Children with Chronic Diseases.”





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