My Blog

Posts for: November, 2013

By Mark Lukin
November 25, 2013
Category: Oral Health
Tags: missing teeth  
ReplacingMissingBackTeethDeservesaHighPriority

For most people, replacing missing front teeth takes a higher priority over missing back teeth. The reason is obvious: others can see those missing in front, but not necessarily those in the back.

From a functional view, however, you should still consider replacing missing back teeth. Not only will it improve your chewing ability, it may also prevent a chain reaction of negative effects to your remaining teeth.

Teeth are held in place in the jawbone by a membrane called the periodontal ligament. The ligament is a living tissue that allows teeth to move to keep contact with adjacent and opposing teeth as natural wear occurs. When a space is created by a missing tooth, this natural movement accelerates and the teeth may shift beyond normal ranges.

As a result you can encounter excessive mobility of teeth from bite irregularities, uneven tooth wear, bone loss, potential painful problems with the temporo-mandibular joints (connecting the lower jaw to the skull), and a loss in facial height.

There are three basic options for this kind of tooth replacement. The best option is dental implants: these free-standing replacements don't normally affect surrounding teeth, they're easier to clean, and they help support the bite. On the downside, there must be enough remaining bone to support the implant.

The next best option is a fixed bridge. This option only works, however, if there are teeth on either side of the missing tooth space capable of supporting the bridge, and they must be reduced in size by removing the enamel with the dental drill. They also have a tendency to retain plaque, the main cause of gum disease.

That leaves the last, and least favorable, option, a removable partial denture. They may also trap food and be difficult to wear. They can move in the mouth, stressing — and possibly loosening — the remaining teeth that hold them in place. With all its drawbacks, though, if a partial denture is the only solution to missing back teeth, it's a better alternative than doing nothing and risking long-term problems.

If you would like more information on replacement options for back 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 “Replacing Back Teeth.”


FindingtheRootCauseofBadBreathistheKeytoSuccessfulTreatment

Halitosis (bad breath) is a major personal and social concern — so much so that Americans spend nearly $3 billion annually on rinses, mints and gum to freshen breath. While helpful in alleviating occasional bad breath caused by oral dryness (brought on by stress, eating certain foods, prescription medications, smoking or consuming alcohol), those with chronic halitosis require a much different treatment approach.

That's because there are a number of possible causes for chronic halitosis, among them: xerostomia (chronic dry mouth), caused by mouth breathing; periodontal (gum) disease; or candidiasis, a yeast infection caused by some antibiotics. It may also arise as a secondary symptom of systemic diseases like liver disease, diabetes or cancer.

The most common cause, though, is bacteria. Many types of oral bacteria can produce terrible odors, most notably volatile sulphur compounds (VSCs) with their “rotten egg” smell. Because of its relative dryness and difficulty in cleaning, the back of the tongue is a wonderful environment for bacteria to multiply and thrive.

If you suffer from chronic halitosis, our primary objective then is to try to uncover its specific cause, which will determine what course of treatment we would recommend. First, what is your experience with halitosis — have others noticed it or just you? Next, we would consider your medical history — have you had any health issues with your ears, nose or throat, or experienced any gastrointestinal disorders or lung problems? What kind of medications do you take, and are your kidneys and liver functioning properly? We would also perform a thorough dental exam for any signs of tooth decay, gum disease or a dry, coated tongue as well as look at your diet and lifestyle choices, like smoking or alcohol use.

Having a better idea of what may be causing your bad breath, we can then tailor a treatment plan that might involve, among other things, treatment for tooth decay, a periodontal cleaning (scaling), instruction on better oral hygiene and tongue cleaning with a scraper or brush, or the removal of third molars where debris may be accumulating in the gum flaps.

Finding the cause of bad breath can take time, but is well worth the effort. The end result is a treatment plan that works.

If you would like more information on understanding and treating chronic halitosis, 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 “Bad Breath: More than just embarrassing.”