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Posts for: October, 2016

AnInfectedorInjuredPrimaryToothCanBeSaved-butitsComplicated

Primary (baby) teeth don't last long. But despite their short life span, they do a number of important things, like enabling a child to eat solid food. But perhaps their most important long-term function is “paving” the way for their permanent replacements.

If one is lost prematurely, though, the permanent tooth might not come in properly aligned. That's why if a primary tooth is in danger of loss due to decay or injury, we'll do our best to save it.

But that could get a little tricky if the infected or damaged part of the tooth is the innermost pulp. If it were an adult tooth, the best course might be a root canal treatment: access the pulp, clear out the diseased tissue, and then fill the space with a special filling. But with a primary tooth (or a young permanent tooth for that matter) that may not be advisable.

That's because the pulp plays a more important role in a child's tooth than an adult's. Its nerves and other tissues stimulate dentin growth; a full root canal could disrupt that growth and weaken the tooth in the long run.

With a child's tooth, we proceed carefully depending on how infected or damaged the pulp might be. If it's only slightly exposed or not at all, we try then to remove as much decayed tooth material outside the pulp as necessary, then apply antibacterial agents or dentin growth stimulators.

If we do have pulp exposure, we'll try to remove only as much of the affected pulp as necessary through a procedure called a pulpotomy. This technique will only be used if the remaining pulp looks healthy or restorable to health.

If not, we may need to perform a pulpectomy to remove the entire pulp. Most like a typical root canal, it's a last resort: without the pulp, dentin growth could be stunted and the tooth won't develop as healthy as it should.

Of course, the best approach is to prevent teeth from developing such problems in the first place. So, be sure to practice effective daily hygiene with your child and keep up regular dental visits beginning at age one.

If you would like more information on treating decayed 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.”


By Paul A. Neumann, DDS
October 10, 2016
Category: Dental Procedures
NeilPatrickHarrisWhattheOscarsHostTreasuresMost

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


By Paul A. Neumann, DDS
October 02, 2016
Category: Oral Health
Tags: snoring   sleep apnea  
CustomOralAppliancesCouldHelpStopSleepApnea

For millions of Americans, sleep apnea is a serious health condition. Not only can it impair your day-to-day living, you might be more susceptible to high blood pressure, heart disease or stroke.

Sleep apnea occurs when you stop breathing for short periods while asleep. When blood oxygen drops too low, your body automatically wakes you to take a breath. This can disrupt your sleep several times a night. Chronic symptoms like drowsiness, irritability or headaches during the day, or indications you're a loud snorer, are all possible signs of sleep apnea.

Fortunately, we can treat sleep apnea. One way is continuous airway pressure therapy (CPAP), a pump device that supplies pressurized air through a mask to keep the airway open during sleep. Although CPAP is effective, some people find it uncomfortable to use.

There's a more comfortable option for sleep apnea caused by mouth structures like the tongue or tonsils obstructing the airway. It involves a custom-fitted oral appliance worn while you sleep that moves these structures out of the way.

Such appliances come in two basic types. One type fits over the upper and lower teeth and uses tiny metal hinges to move the lower jaw and tongue forward away from the airway. The other fits around and presses the tongue down like a tongue depressor to move it forward.

Before starting treatment, we need to first find out if you actually have sleep apnea and what's causing it (some cases may be more acute and require advanced treatments like jaw surgery). We'll need to perform medical and oral exams and take a history, and we'll likely refer you to a sleep medicine specialist for further testing.

If you have obstructive sleep apnea, a custom-fitted appliance could be a good solution. We'll create and adjust it according to your particular mouth and jaw contours for maximum comfort. Besides the appliance, you might also lose excess weight, adjust your sleep position, seek treatment for allergies, and quit smoking. All these could help reduce sleep apnea.

In any event, your first step is to find out if you have sleep apnea. From there we'll help you find the right treatment to improve your overall health and well being.

If you would like more information on treatments for sleep apnea, 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 “Sleep Disorders & Dentistry.”




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