My Blog
By Charles Anthony Schultz, DMD, PA
June 07, 2020
Category: Dental Procedures
Tags: gum disease   loose tooth  
HaveaLooseToothYoullNeedThisTwo-PhaseTreatmenttoSaveIt

Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.

One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.

Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.

Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.

The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.

Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.

The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.

Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.

If you would like more information on loose teeth and 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 “Treatment for Loose Teeth.”

By Charles Anthony Schultz, DMD, PA
May 28, 2020
Category: Oral Health
Tags: tooth decay  
PreventingDentalDiseaseStartswithAssessingYourUniqueRisk

Over the last century dentistry has acquired the knowledge, techniques and treatments to prevent or minimize tooth decay. With this enhanced knowledge we’ve amassed a wealth of data about what increases dental disease development and what prevents it.

This has produced a balanced approach to identifying and treating disease-causing factors and incorporating factors that inhibit tooth decay. Known as Caries Management By Risk Assessment (CAMBRA), this approach first identifies each patient’s individual set of risk factors for dental disease and then develops a customized prevention and treatment plan to minimize their risk.

Rather than simply reacting to occurrences of tooth decay — “drill and fill” — CAMBRA anticipates and targets your susceptibility to decay. The primary factors can be represented by the acronym BAD: Bad bacteria, particular strains that produce acid, which at high levels erode enamel and expose the teeth to infection; Absence of saliva, or “dry mouth,” an insufficient flow of saliva that can’t effectively neutralize acid and restore mineral content to enamel; and Dietary habits too heavy in sugar or acid, which can result in bacterial growth and enamel erosion.

With an accurate picture of your particular risk level we can then apply countering factors from the other side of the balance — those that protect teeth from decay. In this case, we use the acronym SAFE: stimulating Saliva flow when needed or applying Sealants on chewing surfaces most susceptible to decay; Antimicrobials that reduce unhealthy bacteria levels and give healthy bacteria an opportunity to thrive; incorporating Fluoride, a chemical known to strengthen enamel, through hygiene products or direct application to the teeth; and an Effective diet, low in sugar and acid and high in fresh fruits, vegetables and whole grains.

There are a number of preventive and treatment measures that fall into each of the four preventive factors. Using the CAMBRA approach we can develop a treatment and prevention plan that incorporates measures that uniquely fit your dental health situation. With such a plan we can greatly reduce your risk of disease development and impact and better ensure a long and healthy life for your teeth and gums.

If you would like more information on managing dental disease prevention, 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 “Tooth Decay: How to Assess Your Risk.”

YouDontNeedtoPassaFootballLikePatrickMahomestoRemoveaLooseBabyTooth

Kids get pretty inventive pulling a loose primary (baby) tooth. After all, there's a profit motive involved (aka the Tooth Fairy). But a young Kansas City Chiefs fan may have topped his peers with his method, revealed in a recent Twitter video that went viral.

Inspired by all-star KC quarterback Patrick Mahomes (and sporting his #15 jersey), 7-year-old Jensen Palmer tied his loose tooth to a football with a line of string. Then, announcing “This is how an MVP gets their tooth out,” the next-gen QB sent the ball flying, with the tooth tailing close behind.

It appears young Palmer was no worse for wear with his tooth removal technique. But if you're thinking there might be a less risky, and less dramatic, way to remove a loose tooth, you're right. The first thing you should know, though: Primary teeth come out when they're good and ready, and that's important. Primary teeth play an important role in a child's current dental and speech function and their future dental development. For the latter, they serve as placeholders for permanent teeth developing within the gums. If one is lost prematurely, the corresponding permanent tooth might erupt out of position and cause bite problems.

In normal development, though, a primary tooth coming out coincides closely with the linked permanent tooth coming in. When it's time, the primary tooth lets you know by becoming quite loose in the socket.

If you think one of your children's primary teeth is ready, clean your hands first with soap and water. Then using a clean tissue, you should be able to easily wiggle the tooth with little tension. Grasp the tooth with the tissue and give it a little horizontal twist to pop it out. If that doesn't work, wait a day or two before trying again. If it does come out, be sure you have some clean gauze handy in case of bleeding from the empty socket.

Normally, nature takes its course from this point. But be on the lookout for abnormal signs like fragments of the tooth left behind in the socket (not to be mistaken for the top of the permanent tooth coming in). You should also look for redness, swelling or complaints of pain the following day—signs of possible infection. If you see anything like this, make a prompt appointment so we can take a look. Losing a primary tooth is a signpost pointing the way from childhood to adulthood (not to mention a windfall for kids under their pillows). You can help make it a smooth transition—no forward pass required.

If you would like more information about caring for primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Importance of Baby Teeth” and “Losing a Baby Tooth.”

By Charles Anthony Schultz, DMD, PA
May 08, 2020
Category: Oral Health
Tags: oral health  
3ThingsYouShouldDotoProtectYourTeethLaterinLife

Entering your “sunset” years doesn't mean you're washed up—you still have a lot to offer the world. That's why the theme for this May's Older Americans Month (sponsored by the Administration for Community Living) is “Make Your Mark.” And to really make that difference, you'll have to maintain your health—including protecting your teeth from loss.

Once upon a time, it was considered the norm for older adults to experience tooth loss and the resulting consequences on their overall well-being. Today, though, not only can advanced restorations lessen the impact of lost teeth, it's also more likely that you can keep your teeth intact for the rest of your life.

To give your teeth their best chance for survival in your later years, here are 3 things you can do to promote their continuing health.

Brush and floss every day. Ridding your teeth of disease-causing plaque on a daily basis is important at any age, but perhaps even more so as you get older. However, hand weakness caused by arthritis or another health condition can make it more difficult to brush and floss. It may help to use a larger-handled toothbrush or an electric toothbrush, and a threading device may help with flossing. If manual flossing is still too difficult, you can try a water flosser that emits a water stream to loosen and flush plaque away.

Relieve chronic dry mouth. Older adults are more prone to chronic dry mouth because of increased use of medications, many of which interfere with saliva flow. It's more than an unpleasant feeling: Deprived of the protective properties of saliva, your mouth is at increased risk of dental disease. If dry mouth is a problem for you, speak with your doctor about alternatives to any saliva-inhibiting medications you're taking. Also, drink more water and use saliva boosters to promote better saliva flow.

Keep up dental visits. Regular dental visits become even more important as you age. Dental cleanings are especially necessary, particularly if you have dental work that can interfere with plaque removal during brushing and flossing. Disease monitoring and screening are more in-depth for older adults who are more prone to tooth decay, gum disease and oral cancer. And if you wear dentures, you should have them checked regularly for fit and overall condition.

If you've already enjoyed decades of dedicated dental care, you need only stay the course. But even if you haven't, adopting new dental care habits now can boost your teeth's health and longevity. To get started, make an appointment with us: We'll assess your current dental health and offer a care strategy for keeping your teeth healthy through the next exciting season of your life.

If you would like more information about dental care for older adults, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Understanding Aging Makes Beauty Timeless.”

By Charles Anthony Schultz, DMD, PA
April 28, 2020
Category: Oral Health
Tags: nerve pain  
FacialNervePainCanbeControlled

Every year 150,000 people, mostly women over age 50, find out they have a painful condition called trigeminal neuralgia. For many it begins as an occasional twinge along the face that steadily worsens until the simple act of chewing or speaking, or even a light touch, sets off excruciating pain.

The source of the pain is the pair of trigeminal nerves that course along each side of the face. Each nerve has three separate branches that provide sensation to the upper, middle and lower areas of the face and jaw.

The problem arises when areas of the myelin sheath, a fatty, insulating covering on nerves, becomes damaged, often because of an artery or vein pressing against it. As a result, the nerve can become hypersensitive to stimuli and transmit pain at even the slightest trigger. It may also fail to stop transmitting even after the stimulation that caused it is over.

Although the condition may not always be curable, there are various ways to effectively manage it. The most conservative way is with medications that block the nerve from transmitting pain signals to the brain, coupled with drugs that help stabilize the nerve and decrease abnormal firing.

If medication isn't enough to relieve symptoms, there may be some benefit from more invasive treatments. One technique is to insert a thin needle into the nerve to selectively damage nerve fibers to prevent them from firing. Another microsurgical procedure attempts to relocate the nerve away from a blood vessel that may be compressing it.

The latter procedure has some higher risks such as facial numbness or decreased hearing, and is often better suited for younger patients. Older patients may benefit more from the needle insertion procedure previously mentioned or a directed beam of high-dose radiation to alter the nerve.

To learn the best options for you, you should first undergo a neurological exam to verify you have trigeminal neuralgia and to rule out other causes. From there, you and your doctor can decide the best course of treatment for your age and individual condition.

Trigeminal neuralgia can be an unpleasant experience. But there are tried and true ways to minimize its effect on your life.

If you would like more information on trigeminal neuralgia, 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 “Trigeminal Neuralgia.”





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