Posts for: March, 2020

TheRightTreatmentforYourChildsInjuredToothIncreasesitsSurvival

Children have a lot of energy that's often channeled through physical activities and sports. Unfortunately, this also increases their risk of injuries, particularly to their teeth.

Injuries to the mouth can endanger permanent teeth's survival. For an older tooth, a root canal treatment might be in order. Not so, though, for a pre-adolescent tooth, even if it is permanent.

A young permanent tooth is still developing dentin, the large layer just below the enamel. This growth depends on the connective tissue, blood vessels and nerves within the pulp in the center of the tooth. Because a root canal treatment removes all of this tissue, it could stunt dentin and root growth and endanger the tooth's future.

Instead, we may need to treat it with one of a number of modified versions of a root canal, depending on what we find. If the tooth's pulp is unexposed, for example, we may need only to remove the damaged dentin, while still leaving a barrier of dentin to protect the pulp. We then apply an antibacterial agent to minimize infection and fill in the area where we've removed tooth structure.

If some of the pulp is exposed, we may perform a pulpotomy to remove just the affected pulp and any overgrown tissue. We then place a substance that encourages dentin growth and seal it in with a filling. If we go deeper toward the root end, we might also perform procedures that encourage the remaining pulp to form into a root end to stabilize the tooth.

If the entire pulp has been damaged beyond salvage, we may then turn to a procedure called an apexification. In this case we clean out the pulp chamber; at the root end we place mineral trioxide aggregate (MTA), a growth stimulator that encourages surrounding bone to heal and grow. We then fill in the root canals and chamber with a special filling called gutta percha to seal the tooth.

The deeper we must penetrate into the pulp, the higher the chances the young tooth's dentin and roots won't form properly, leading to later problems and possible loss. But by employing the appropriate one of these methods, we can minimize the risk and give your child's damaged tooth a fighting chance.

If you would like more information on children and dental injuries, 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 “Saving New Permanent Teeth after Injury.”


By Michael C Scheske, DDS, PC
March 14, 2020
Category: Dental Procedures
Tags: cosmetic dentistry  
4WaysYouCanTakeYearsoffYourSmile

There are ways you can look younger, including eating a better diet and getting physically fit. Cosmetic enhancements can also take years off your appearance.

But while looking for a more youthful appearance be sure you include a "smile update." Your teeth and gums age like the rest of the body—even more so if you've contended with dental disease. Here are 4 ways you might be able to take years off your smile.

Teeth whitening. Teeth naturally yellow as we age, so it's not uncommon for older teeth to look dull. But your dentist can brighten your smile with teeth whitening, the application of a controlled bleaching solution to lighten them. It only works with enamel discoloration and it does fade over time. But it can temporarily change the dynamic of your smile for the better.

Dental enhancements. You can "put a new face" on unattractive older teeth with a number of life-like materials and techniques. Dentists can apply and sculpt composite resin material to fix small chips in teeth. Dental veneers, thin wafers of porcelain bonded to the front of teeth, can mask chips, heavy staining or slight gaps, and can make worn teeth look longer. And life-like crowns can completely cover teeth with major disfigurement.

Dental work updates. Many people have dental work—fillings, crowns, bridges and the like—from earlier in life. It might be time to "revisit" those with a fresh update. For example, a dark grey metal amalgam filling could be replaced with a newer tooth-colored restoration made of composite material or porcelain.

Gum treatments. Your teeth might not be the only elements of your smile needing attention. Gums that have shrunk back or receded from the teeth can ruin your smile. In some cases, treating any underlying gum disease could help them heal and regain their tooth attachment. For major recession, though, you may need grafting surgery to regenerate lost gum tissue, improving both your oral health and your smile.

These and other techniques can turn back the clock on your smile. The best way to maintain a youthful smile, though, is to take care of your teeth and gums through daily brushing and flossing and regular dental visits. Healthy teeth and gums make beautiful smiles.

If you would like more information on rejuvenating your smile, 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 “How Your Dentist Can Help You Look Younger.”


By Michael C Scheske, DDS, PC
March 04, 2020
Category: Dental Procedures
RemovingOneorMoreTeethCouldImproveOrthodonticOutcomes

Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.

One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.

Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.

Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.

Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.

Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.

Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.

Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.

If you would like more information on orthodontic options, 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 “Removing Teeth for Orthodontic Treatment.”












Union, MO
Family Dentist
301 US Hwy 50 W
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Union, MO 63084
(636) 583-8100

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