Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.
Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.
Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.
Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.
Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.
It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.
If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.
If you would like more information on gaining relief from angular cheilitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Cracked Corners of the Mouth.”
The red, scaly rash suddenly appearing on your face doesn’t cause you much physical discomfort, but it’s still embarrassing. And to make matters worse treating it as you would other skin ailments seems to make it worse.
Your ailment might be a particular skin condition known as peri-oral dermatitis. Although its overall occurrence is fairly low (1% or less of the population worldwide) it seems to be more prevalent in industrialized countries like the United States, predominantly among women ages 20-45.
Peri-oral dermatitis can appear on the skin as a rash of small red bumps, pimples or blisters. You usually don’t feel anything but some patients can have occasional stinging, itching or burning sensations. It’s often misidentified as other types of skin rashes, which can be an issue when it comes to treatment.
Steroid-based ointments that work well with other skin ailments could have the opposite effect with peri-oral dermatitis. If you’re using that kind of cream out of your medicine cabinet, your rash may look better initially because the steroid constricts the tiny blood vessels in the skin. But the reduction in redness won’t last as the steroid tends to suppress the skin’s natural healing capacity with continued use.
The best treatment for peri-oral dermatitis is to first stop using any topical steroid ointments, including other-the-counter hydrocortisone, and any other medications, lotions or creams on it. Instead, wash your skin with a mild soap. Although the rash may flare up initially, it should begin to subside after a few days.
A physician can further treat it with antibiotic lotions typically containing Clindamycin or Metronidazole, or a non-prescription, anti-itch lotion for a less severe case. For many this clears up the condition long-term, but there’s always the possibility of relapse. A repeat of this treatment is usually effective.
Tell your dentist if you have recurring bouts of a rash that match these descriptions. More than likely you’ll be referred to a dermatologist for treatment. With the right attention—and avoiding the wrong treatment ointment—you’ll be able to say goodbye to this annoying and embarrassing rash.
From the moment your child's first tooth appears, usually between six and nine months, you need to be concerned about Early Childhood Caries (ECC). This particular form of tooth decay can have a devastating effect on primary (baby) teeth and lead to their premature demise. Losing one before its time could adversely affect how the future permanent tooth comes in.
You can help prevent ECC with daily brushing and cleaning, regular dental visits (beginning around their first birthday) and limiting the sugar they eat. Here are 3 more things to consider for boosting your prevention efforts.
Breastfeeding. Pediatricians generally recommend breastfeeding if possible for a baby's overall health, including dental development. And although breast milk contains fermentable carbohydrates that boost bacterial growth, it no more promotes tooth decay than similar foods and beverages. That said, though, once the child begins to eat and drink other foods and beverages, the combination of sugars in them and breast milk could increase the bacteria that causes ECC. This is another good reason to wean the child from breast milk as they begin to eat more solid foods.
Bottles and pacifiers. It's quite common for parents and caregivers to soothe a fussing or crying baby with a bottle filled with formula, milk or juice for sipping, or even a pacifier dipped in jam, sugar or some form of sweetener. But these practices can create an environment that promotes high acid production from bacteria feeding on the sugars. Instead, avoid giving them a “prop-up” bottle filled with liquids containing sugar and try to limit bottle use to mealtimes. And provide them pacifiers without sugary additives if you use them.
Medicines. Children with chronic illnesses or other needs often take medication containing sugar or with antihistamines that reduce the flow of acid-neutralizing saliva. If the medications can't be altered, then it's extra important for you to practice diligent, daily hygiene to reduce the effect of higher mouth acid.
If you would like more information on dental disease prevention in babies and young children, 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 “Age One Dental Visit: Why it's Important for Your Baby.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
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