By Wang and Cortes Dental
May 17, 2017
Category: Dental Procedures

Primary (baby) teeth might not last long, but their impact can last a lifetime. Their first set of teeth not only allows young children to eat solid foods, but also guide permanent teeth to form and erupt in the proper position.

Unfortunately, primary teeth aren't immune to tooth decay. If the decay is extensive, the tooth may not last as long as it should. Its absence will increase the chances the permanent teeth won't come in correctly, which could create a poor bite (malocclusion) that's costly to correct.

If a primary tooth is already missing, we can try to prevent a malocclusion by installing a “space appliance.” This keeps nearby teeth from drifting into the empty space intended for the permanent tooth. The best approach, though, is to try to save a primary tooth from premature loss.

We can often do this in much the same way as we would with a permanent tooth — by removing decayed material and filling the prepared space. We can also perform preventive applications like topical fluoride or sealants that strengthen or protect the tooth.

It becomes more complicated, though, if the pulp, the interior of the tooth, becomes decayed. The preferred treatment for this in a permanent adult tooth is a root canal treatment. But with a primary tooth we must also consider the permanent tooth forming below it in the jaw and its proximity to the primary tooth. We need to adapt our treatment for the least likely damage to the permanent tooth.

For example, it may be best to remove as much decayed structure as possible without entering the pulp and then apply an antibacterial agent to the area, a procedure known as an indirect pulp treatment. We might also remove only parts of the pulp, if we determine the rest of the pulp tissue appears healthy. We would then dress the wound and seal the tooth from further infection.

Whatever procedure we use will depend on the extent of decay. As we said before, our number one concern is the permanent tooth beneath the primary. By focusing on the health of both we can help make sure the permanent one comes in the right way.

If you would like more information on caring for children's primary teeth, 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 “Root Canal Treatment for Children's Teeth.”

May 03, 2017
Category: Uncategorized
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I have children, so I know that bumps, bruises, and accidents are part and parcel with childhood. In many cases, the bumps and bruises can be mended with a bandage and a kiss; what happens, though, when the bump results in a pediatric dental emergency? In this two-part series, I will review the basic procedures that will help you protect your child’s teeth in the event of a more significant childhood accident.

What To Do If a Baby Tooth is Knocked Out

  1. Contact my office as soon as possible. While baby teeth aren’t replanted as permanent teeth are, I can still help make your child more comfortable and prevent infection.
  2. Rinse your child’s mouth with cold water and apply a cold compress to help dull the pain and reduce inflammation.
  3. Spend your time comforting your child and let them know they will be okay.

What To Do If a Permanent Tooth is Knocked Out
Contact my office as soon as possible. Fast action can help save the tooth. If the tooth is knocked out after office hours, call the emergency number.

  1. Find the tooth and gently rinse it with cold water. Leave the deep cleaning and sterilization to me.
  2. If possible, place the tooth back in the socket and hold it in place with a washcloth.
  3. If you cannot access the socket, then place the tooth in a container of cold milk or your child’s saliva - NOT water.

With luck on our side, I won’t have to see your child for the pediatric emergencies above. If I do, however, you are armed with the knowledge to help your child maintain their healthy, natural teeth. If you know another parent who might benefit from this information, feel free to pass it along. Be sure to read next month’s email for part 2 of our pediatric dental emergency series.

By Wang and Cortes Dental
May 02, 2017
Category: Oral Health

Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:

"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"

And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:

“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”

Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.

For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.

While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.

Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.

Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.

May 02, 2017
Category: Uncategorized
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If you still have your wisdom teeth, chances are that you and I have discussed having them removed. Even if they don’t seem to be causing you a problem now, leaving them in place could lead to major problems later. If you feel that having your wisdom teeth removed is something you can put off, think again. I’ve seen a host of dental health issues caused by wisdom teeth that have become impacted or that have led to more extensive structural damage to the teeth and jaw structure. Before you decide to put it off for another year or so, consider the potential problems that are waiting to happen.

Impacted Wisdom Teeth
With X-rays, I can detect a potential problem well before it causes you pain. If you put off having your wisdom teeth extracted, you can expect to experience some or all of the following symptoms:

  1. A throbbing pain towards the back of your mouth (exactly where your wisdom teeth are)
  2. Swollen, painful, and bleeding gums
  3. A swollen jawline and/or swollen glands in the neck and shoulder area
  4. Headaches

While the discomforts described above might be concerning enough, what you really need to worry about is the complications associated with impacted wisdom teeth.

If you wisdom teeth become impacted, the you might also experience the following complications:

  1. Damaged or misaligned teeth caused by wisdom teeth that are trying to find some room
  2. Gum disease that results from ineffective cleaning of the wisdom teeth
  3. Cysts that can cause intense pain and misalign your other teeth

Before you have to suffer through any of the above symptoms or complications, call our office today to schedule an appointment for a wisdom tooth extraction. Taking care of your teeth now will prevent you from needing more extensive treatments in the future.

By Wang and Cortes Dental
April 17, 2017
Category: Oral Health

If you suspect you have periodontal (gum) disease, it's important to get a correct diagnosis and begin treatment as soon as possible. The sooner you begin treatment the better the long-term outcome.

Gum disease is a bacterial infection that's most often triggered by plaque, a thin film of food particles on tooth surfaces. Plaque buildup most often occurs when a person doesn't practice effective oral hygiene: daily brushing and flossing and professional cleanings at least twice a year.

The most common type of gum disease, gingivitis, can begin within days of not brushing and flossing. It won't always show itself, but you can have symptoms like swollen, red or bleeding gums, as well as bad taste and breath. You could also develop painful abscesses, which are localized pockets of infection within the gums.

If we don't stop the disease it will eventually weaken the gum attachment to the teeth, bone loss will occur and form deep pockets of infection between the teeth and bone. There's only one way to stop it: remove the offending plaque from all tooth surfaces, particularly below the gum line.

We usually remove plaque and calculus (hardened plaque deposits) manually with special hand instruments called scalers. If the plaque and calculus have extended deeper, we may need to perform another procedure called root planing in which we shave or “plane” the plaque and calculus (tartar) from the root surfaces.

In many cases of early gum disease, your family dentist can perform plaque removal. If, however, your gum disease is more extensive, they may refer you to a periodontist, a specialist in the treatment and care of gums. Periodontists are trained and experienced in treating a full range of gum infections with advanced techniques, including gum surgery.

You can also see a periodontist on your own for treatment or for a second opinion — you don't necessarily need a referral order. If you have a systemic disease like diabetes it's highly advisable you see a periodontist first if you suspect gum disease.

If you think you might have gum disease, don't wait: the longer you do the more advanced and destructive the disease can become. Getting an early start on treatment is the best way to keep the treatment simple and keep gum disease from causing major harm to your teeth and gums.

If you would like more information on the diagnosis and treatment of 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 “When to See a Periodontist.”

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