Dental Health in Children @eine kleine dental

Overview

Tooth decay (dental caries) affects children in Japan more than any other chronic infectious disease. Untreated tooth decay causes pain and infections that may lead to problems; such as eating, speaking, playing, and learning.

The good news is that tooth decay and other oral diseases that can affect children are preventable. The combination of dental sealants and fluoride has the potential to nearly eliminate tooth decay in school-age children.

What Parents and Caregivers Can Do

Here are some things you can do to ensure good oral health for your child:

• Encourage your children to eat regular nutritious meals and avoid frequent between-meal snacking.
• Protect your child’s teeth with fluoride.
• Use a fluoride toothpaste. If your child is less than 7 years old, put only a pea-sized amount on their toothbrush.
• If your drinking water is not fluoridated, talk to a dentist or physician about the best way to protect your child’s teeth.
• Talk to dentist about dental sealants. They protect teeth from decay.
• If you are pregnant, get prenatal care and eat a healthy diet. The diet should include folic acid to prevent birth defects of the brain and spinal cord and possibly cleft lip/palate.

Bridges, Partials and Dentures @eine kleine dental

With dentures and partials, you can replace missing teeth to benefit your eating and speaking ability and enhance your appearance.

There are two ways to replace teeth as long as other teeth remain in the same arch.

The most stable replacement is the (1) fixed partial denture, or bridge.

• A bridge uses crowns as the anchors on the remaining stable teeth on either side of the space, with the replacement tooth attached to these anchors.
• When properly executed a bridge feels very similar to natural teeth.
• Bridges are generally made of porcelain-fused-to-metal crowns or are all gold or gold alloy.

The second option for tooth replacement when some teeth are remaining is the (2) removeable partial denture.  This type of prosthesis uses some of the remaining natural teeth as anchors but is removeable. The removeable partial denture will restore chewing function and stability but not to the degree of a fixed partial denture, or bridge.

• Sometimes the removable partial denture is the only alternative if the there are not enough stable teeth to support a bridge.
• Removable partial dentures must be evaluated periodically. Over time, the residual jawbone may continue to resorb, changing the underlying support for the partial denture. Subsequently, more foce may be placed on the anchor teeth, loosening them.
• Anchor teeth for partials are also more difficult to keep clean, this makes them more susceptible to dental decay or periodontal disease.

The final step in the replacement of teeth occurs when a patient is completely edentulous (toothless) in either of one or both arches. The removeable complete denture is the basic option in either case.

• The replacement teeth are embedded in a pink acrylic denture which is placed against the residual jaw ridge. The stability of the denture is dependent on the amount of ridge remaining, the proper contours of the denture and hydrostatic pressure created.
• A maxillary (upper arch) denture is relatively stable. The mandibular (lower arch) can be much less stable due to the shape of the mandible (jawbone) and the decrease in surface area on which the denture rests.
• Bottom line. If given a choice, it is important to do anything you can to save at least some of your mandibular (lower arch) teeth.

Crowns@eine kleine dental

Crowns can be used to attach a bridge or protect a weak tooth from breaking. Crowns are created from a wide range of materials, which impacts the wearability and longevity of the restoration.

Crowns are used if the decay is so large that an amalgam or composite filling will not suffice.

Crowns cover the cusps of the tooth and hold the remaining tooth surfaces together

A dental crown covers the entire tooth with the crown margins close to under the gingival margin.

Crowns are made by grinding and shaping the tooth. Once the tooth is properly shaped an impression is made. The crown is then constructed in the lab.

It is then fitted, adjusted and cemented into place.

A crown should always feel like it belongs to you. At Eine Kleine dental we aim to get the occlusion right so that it feels comfortable and normal.

Crowns can be (a) made entirely of porcelain – the new generation of porcelain materials have more strength than their predecessors and superb aesthetic properties or (b) are constructed of a substructure of gold or non-precious metal with porcelain baked onto the surface of the metal. The metal provides strength while the porcelain matches the shade and contour for the teeth.

Crowns are often called “permanent” restorations. Permanent does not mean eternal. They are subject to extremes of temperature and chewing forces. Over time materials may wear down or fail and restoration may need to be replaced. The tooth-to-restoration margin is also subject to decay if plaque is allowed to accumulate

Restorative Dentistry @eine kleine dental

- Repair, improve and enhance your teeth and oral health.

Root Canals

In cases where decay has progressed to the point where it is close to reaches the pulp in the center of the tooth – this encroachment may present as a toothache.

If the decay is removed and pulp has not been physically entered with the dentist’s drill, the tooth may be fixed with a conventional restoration (filling). If the decay extends into the pulp, or if there is evidence that the pulp is damaged or dead, endodontic (root canal) therapy is needed to preserve the tooth.

Root canal (endodontic) treatment treats the soft inside tissue of the tooth known as pulp.

During root canal treatment, an opening is made in the top of the tooth and the inflamed or infected pulp is carefully removed. The inside of the root canal is cleaned and shaped and then filled with a bio-compatible material and sealed.

The general rule is that there is one canal for each tooth root – although accessory canals may sometimes exist and also need to be treated.

Over time endodontically treated can become brittle. The standard treatment for an endodontically treated tooth is to have the missing parts of the tooth rebuilt.

Sometimes a post is placed in the canal to aid in retention of the build-up. Often a temporary filling is placed until the dentist can place a full coverage crown on the tooth to prevent breakage and to restore it to full function.

Teeth which have been endodontically treated are not “dead” only pulpless. The periodontal ligament which holds the tooth to the jawbone is still quite alive. While the pulpless tooth will not have pain of pulpal origin, there is possibility that pain from the periodontal ligament. This pain is usually associated with abnormal force on the tooth, or occurs if the root of the tooth fractures

Periodontal Disease – Gum Disease @eine kleine dental

What is it?

Periodontal disease (commonly referred to as gum disease) is the leading cause of tooth loss in adults. It is a chronic bacterial infection that causes the gums to become inflamed. Periodontal therapy, such as root scaling and planning, treats the disease process by removing bacterial plaque, calculus and toxins

Periodontal disease is comprised of two main categories: gingivitis and periodontitis.

Gingivitis is inflammation of the gingiva (gums). It is indicated by swelling, redness and bleeding of the gums when they are brushed or probed. Most people – probably 90% or more have had gingivitis at some time during their lives.

Periodontitis is often the silent destroyer. Gum inflammation spreads so that the bone which supports the teeth deteriorates. In its early stages this deterioration is unknown to the patient. There is no pain and the surface signs are similar to gingivitis. Over time there is deepening of the pockets around the teeth with gum recession, and eventual loosening of the teeth when enough bones is lost.

What happens

Both gingivitis and periodontitis are caused by bacterial plaque. It is important to remove the harmful plaque on a daily basis through effective flossing, brushing and maintenance of good dental hygiene. Other factors can contribute to the progression of periodontal disease. Smoking has been shown to have an adverse effect on periodontal health. In women, changes in hormone levels can increase gingival inflammation. Some women experience pregnancy gingivitis – severe inflammation of the gums – due to the overgrowth of certain bacteria which feed on hormones secreted in the fluid from the gingival.

Periodontal disease is an inflammatory reaction to the plaque which collects on your teeth and under your guns. As the plaque collects on your teeth, the mass absorbs the minerals in the saliva. Over time, the soft plaque hardens into dental calculus, or tartar. Calculus provides an environment which enables plaque to thrive. When allowed to grow unimpeded, it will eventually become an irritant to the gum tissues and triggers an inflammatory response. As the inflammatory response continues the destruction spreads from the soft tissue of the gums to the alveolar bone which supports the teeth. As this bone is destroyed the teeth may become loose and change position. When this occurs the periodontitis has progressed to an advanced stage.

You may be able to detect some of the signs of periodontal disease yourself –  these are;

• Bleeding gums
• Redness of the gums – which should normally be pink
• Bad breath
• Mobile teeth

The most common being the “pink toothbrush syndrome”. This indicates gums which bleed when you brush your teeth. Many people assume that a little bleeding is natural, usually because their gums have always bled when they cleaned their teeth. Bleeding is a sign of inflammation but it does not signify the extent of the problem. Gum redness and bad breath are also not a measure of the severity but they are significant warning signs. When your teeth start to drift around – you can be certain that the problem is at the severe stage.

Treatments

If you think you have periodontal disease a visit to your dentist is in order. A thorough examination will include measuring periodontal pockets with a probe. Gingivitis is marked by bleeding with gentle probing. Periodontitis is marked by probing depths of 4 millimeters or more.

First and foremost, the plaque must be thoroughly removed on a daily basis for inflammation to be controlled. Good brushing and flossing technique are important. Scaling and root planning – “Deep cleaning” – scraping your teeth and scraping under the gums – constitutes the basic therapeutic approach to treating periodontal disease. This can be done with a hand tools and an ultrasonic cleaner. Scaling and root planning may require anesthesia due to the potential discomfort. Once the scaling is complete the teeth are polished to remove any stains and loose plaque. Polishing with a rotating rubber cap and a mild abrasive or “Basic cleaning” can be effective in treating mild gingivitis but is not effective in treating periodontitis.

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