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Posts for: February, 2015

HowDesignerNateBerkusGotaHeadStartonaGreatSmile

When it comes to dental health, you might say celebrity interior designer and television host Nate Berkus is lucky: Unlike many TV personalities, he didn't need cosmetic dental work to achieve — or maintain — his superstar smile. How did he manage that? Nate credits the preventive dental treatments he received as a youngster.

“I'm grateful for having been given fluoride treatments and sealants as a child. Healthy habits should start at a young age,” he told an interviewer from Dear Doctor magazine. We couldn't have said it better — but let's take a moment and examine exactly what these treatments do.

Fluoride treatment — that is, the topical (surface) application of a concentrated fluoride gel to a child's teeth — is a procedure that's often recommended by pediatric dentists. Although tooth enamel is among the hardest substances in nature, fluoride has been shown to make it more resistant to tooth decay. And that means fewer cavities! Studies show that even if you brush regularly and live in an area with fluoridated water, your child could still benefit from the powerful protection of fluoride treatments given at the dental office.

Another potent defense against cavities is dental sealants. Despite your child's best efforts with the toothbrush, it's still possible for decay bacteria to remain in the “pits and fissures” of the teeth — those areas of the molars, for example, which have tiny serrated ridges and valleys where it's easy for bacteria to grow. Dental sealants fill in and protect vulnerable areas from bacterial attack, greatly decreasing the risk that future dental treatment will be required.

Why not take a tip from our favorite celebrity interior designer, and ask about cavity-preventing treatments for your children's teeth? If you would like more information about fluoride treatments or dental sealants, please contact us for a consultation. You can learn more in the Dear Doctor magazine articles “Topical Fluoride” and “Sealants for Children.”


AlternativestoRootCanalTreatmentCanSaveanInjuredImmatureTooth

When a permanent tooth has been injured, our first priority should be to save it. A root canal treatment (where the interior pulp of the tooth is removed and the pulp chamber and root canals are filled and sealed) is usually the best approach for tooth preservation.

An immature permanent tooth, however, presents a different challenge. While the pulp is less essential to a mature tooth’s vitality, it serves a critical purpose in the tooth’s early development before early adulthood. The pulp produces layers of dentin necessary for the tooth’s root system development. Completely removing the pulp at this stage may retard root development and cause the tooth to eventually weaken, and become brittle and darkened.

For younger teeth, we should therefore use alternative techniques that preserve as much healthy pulp as possible. One of these alternatives is Indirect Pulp Therapy, used when the pulp hasn’t been exposed by the trauma. With this technique we remove as much damaged dentin as possible while preserving the harder dentin closer to the pulp. After applying an antibacterial agent to protect against infection, and then filling and sealing the tooth, the pulp can continue to produce dentin in a normal way.

If pulp exposure has occurred, some form of pulpotomy — the partial removal of any damaged or infected pulp — would be in order. Our goal here is to leave as much of the pulp as possible, and then apply substances that stimulate the remaining pulp to create dentin. The most common type of growth substances are calcium hydroxide or mineral trioxide aggregate (MTA).

If the pulp isn’t at all salvageable, we may then turn to a procedure known as apexification. After removing the pulp we insert MTA at the root end of the tooth, then fill and seal the remaining interior as in a regular root canal treatment. The MTA will help the surrounding bone to heal and continue to grow around the root to further support the tooth.

Recent research into pulp stem cells promises further advances in this area. The regenerative qualities of stem cells could eventually help us “engineer” root development. Until then, there are still effective ways to give a young, damaged tooth a fighting chance to survive.

If you would like more information on preserving injured 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 “Saving New Permanent Teeth After Injury.”