Should I Save My Tooth?

Many times patients present in my office with a compromised tooth either due to cavities, fractures or even gum disease and often times it can be very questionable about the best decision to make for saving a tooth. Often times I am asked what information do I use to make the best decision. Here are some simple guidelines I use to help patients make informed decisions?

1. Front or back tooth? This plays a huge variable in re: to esthetics...how much will this affect my smile?

2. Function? How is this tooth used? Do you eat with this tooth or is it just a placeholder? Does it have a history of having problems? Do you grind your teeth?

3. Does this tooth affect other teeth around it? Gum disease can affect adjacent teeth as well as infection. Is there a tooth beside it than can help take some of the stress of that one not being there?

4. How much work is involved to get the tooth healthy again? Will it require multiple procedures? What is the long term prognosis of the tooth if I fix it? What sort of investment is needed to rehabilitate this tooth? What kind of investment is needed to replace the tooth if I have it removed?

5. What does the xray say about the tooth? What kind of symptoms are we having with this tooth? Have we had this problem with other teeth?

The message is simple: there are many things a dentist looks at to help make an educated decision on what is best for the patient. Typically there are different options available but you must consult a dentist to see what is best for you. Keep in mind, we do not make our decisions on what insurance covers, we make our decision on what we do if it was one of our loved ones was in this situation.

Signs of Gum Disease

What are the signs/symptoms of gum disease?

There are many signs of gum disease but the following are commonly associated with gum disease (also known as periodontal disease).

1. Red, swollen gums.
2. Bleeding gums when brushing and flossing.
3. Loose teeth.
4. Bad breath/foul odor from gums
5. Bone loss. Receding gums typically follow this.

While there are many additional symptoms/signs that can be present during gum disease...the above are most common findings. Interesting enough, there are new studies coming out everyday linking a variety of systemic health problems with gum disease. Consulting with a dentist is the best way to assess for gum disease as well as treatment needed.

What is Whitening For Life?

Whitening for Life is a program designed to reward patients who join our office and commit to getting regular checkups and cleanings to promote good oral health.

With our Whitening for Life program, you receive:

• One set of customized upper and lower trays with starter kit at minimal charge to cover cost of
  materials and time needed to fabricate the custom trays
  
• One tube of whitening gel at every recall exam appointment at no charge. Additional tubes are available for purchase.

To be eligible for the program, you must meet the following criteria:

• Be a patient of record or become a new patient of record
  
• Have had a complete dental examination by Dr. Glasmeier with
  recommended x-rays.
  
• Do not have active, untreated disease, gum (periodontal) disease, decay
  (caries), root sensitivity, oral cancer, etc
  
• Agree to and sign Whitening For Life consent form
  
• Stay current in keeping with your recommended cleaning appointments
  (prophylaxis(cleanings), periodontal maintenance)
  
• Must not have any outstanding balances or previous bad debts

Please Remember:

• We are here to help you with your health and have a wonderful smile!
  
• Whitening isn't for everyone
  
• Your oral health conditions may not make whitening a wise choice
  
• Whitening procedures may not be effective on some teeth
  
• Regular cleanings/checkups as well as prescribed home care are the foundation to whiter
  teeth while teeth whitening is a supplement.

Why do I need an Injection for Fillings?

Why is an injection(shot) necessary for fillings?

Sometimes patients do not require injections for fillings. It depends on how large and how deep the cavity(decay) is and where is sits in relation to the nerve. I like to think of a tooth like an M&M peanut. The outer candy shell is the enamel, which has no nerve endings. The inner chocolate layer is the dentin, which does have nerve endings and then there is the peanut, aka the "pulp" or nerve of the tooth.

Cavities that form only in the enamel tend to not cause sensitivity therefore do not need to be numb to be fixed. However when the cavity penetrates into the second layer, the dentin, hot/cold/sensitivity begins. Decay into dentin will require local anesthesia(injections) to put the tooth into a comfortable state so the cavity can be removed. When cavities get into the nerve, thats when we speak of root canals. Once decay(bacteria) have penetrated into the nerve, an onslaught of symptoms begins. Ranging from cold sensitivity to throbbing, sharp pain to biting pain to gum tenderness, the nerve will require removal to eliminate the infection and sensitivity.

So to summarize, the need for being "numb" relies on how far the cavity got into the M&M peanut :)

Sedation options

Who is Sedation For?

People who have . . .

• High fear
• Traumatic dental experiences
• Difficulty getting numb
• A bad gag reflex
• Very sensitive teeth
• Complex dental problems
• Limited time to complete dental care

People who . . .

• Hate needles and shots!
• Hate the noises, smells and tastes associated with dental care
• Are afraid or embarrassed by their teeth

What is Sedation Dentistry?

Sedation dentistry allows you to be sedated just enough to be pain free and unaware of the treatment, as if you were relaxing. That is why it is normally referred to as conscious sedation dentistry. So if you have sensitive teeth, a fear of dentists, have a bad gag reflex, hate needles, or have limited time to spend on dental care at the dentist, Sedation during dentistry procedures can help you.

Whatever the case may be sedation by your dentists can help you be more anxiety free during your dentistry treatment. Your dentist's ultimate goal is to make your visit to the dentist a relaxing and enjoyable one. Since you are completely comfortable, relaxed, and pain free your sedation dentist can do years of dental treatments in one or two dental visits.

With sedation your dentist can restore sore gums to good dental health, fix a chipped tooth, replace crowns or dentures, whiten yellow or stained teeth, and more. All pain free.

Does everyone fear going to the dentist?

What percent of patients do you see have anxiety or fear going to the dentist?

I would say 70-80% of my patients have had or do have some fear of the dentist. It usually stems from a bad experience or not understanding what is going on. By simply educating the patient, much fear is eliminated when the patient knows exactly what the problem is, how to fix it, and what it takes to fix it. I take pride in most of the services I offer but the one I take the most pride in is the one you don't see listed--helping you CONQUER your fear of dentistry. I am confident I can help you not only conquer your anxiety but help you establish a routine of regular dental care that prevents you from needing frequent amounts of dental work and be proud of your oral health and smile!

Why fillings on baby teeth?

I don't understand..if my child has a cavity on a baby teeth and they are going to get a permanent replacement anyways, why fix the baby tooth?

I get this question a lot as one would think if there is replacement what is the big deal? The big deal is that the baby teeth need to be thought of as “space holders” for the permanent teeth. If a baby tooth is lost prematurely, a permanent tooth can come in a different position which can further alter the development of the rest of the adult teeth. An adult teeth can also be affected if an infected baby tooth left untreated can cause disturbances of a permanent tooth's growth and development. In some cases I have seen an abscessed baby tooth that caused an adult tooth to become infected before it had a chance to even erupt! Once again, an ounce of prevention can prevent a ton of problems…it is much more conservative(and cheaper) to have a cavity fixed on a baby tooth rather than “letting it go” only to find out then that the child could lose a permanent tooth or have major crowding issues with the permanent teeth(much more expensive!!). Having said this, if the baby teeth has a cavity but is within 3-6 months of coming out anyways, then a filling may not be necessary. Please consult the dentist before you try to make that determination as we are knowledgeable when a child will lose a particular baby tooth.