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ConsideranEffectiveandAffordableRPDforTeethReplacement

If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.

RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.

The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.

Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.

RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.

A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.

If you would like more information on teeth replacement 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”

By Mark J. Schwartz, DMD
May 08, 2019
Category: Dental Procedures
RootCanalsareaSafeWaytoSaveTeeth

Every year U.S. dentists perform around 25 million root canal treatments and save countless teeth from the ravages of decay. But if you search "root canal" on the Internet, you might encounter an unsettling charge against this tooth-saving treatment—that it causes cancer.

Root canal treatments are routinely used when tooth decay has infected the pulp, the innermost layer of a tooth. During the procedure, we access the pulp and remove all the infected tissue. We then fill the empty pulp and root canals, seal the access hole and later crown the tooth to prevent further infection. Without this intervention, the decay can continue to advance toward the roots and supporting bone, putting the tooth in imminent danger of loss.

So, is there any credibility to this claim that root canal treatments cause cancer? In a word, no: there's no evidence of any connection between root canal treatments and cancer—or any other disease for that matter. On the contrary: root canals stop disease.

As with other types of urban legends and internet hype, the root canal-cancer connection may have arisen from another discredited idea from the early 20th Century. A dentist named Weston Price promoted the notion that leaving a "dead" organ in the body led to health problems. From his perspective, a root canaled tooth with its removed pulp tissue fit this criterion.

In the mid-1950s, dentistry thoroughly examined Dr. Weston's theory pertaining to treatments like root canals. The Journal of the American Dental Association devoted an entire issue to it and found after rigorous scientific inquiry that the theory had no validity in this regard. Another study in 2013 confirmed those findings. In fact, the later study instead found that patients who underwent a root canal treatment had a 45 percent reduction in oral cancer risk.

Given the freewheeling nature of the Internet, it's best to speak with a dental professional about your oral health before trusting a post or article you've found online. Not only are they more informed than an unverified online source, they would certainly not knowingly subject you to a procedure to save a tooth at the expense of your health.

If you would like more information on root canal treatment, 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 Safety.”

WhyemBigBangTheoryemActressMayimBialikCouldntHaveBraces

Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.

“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.

Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.

Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.

Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.

Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.

So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!

For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”

By Mark J. Schwartz, DMD
April 18, 2019
Category: Oral Health
Tags: mouthguards  
AprilIsNationalFacialProtectionMonth

April brings the perfect weather to get outside and play. Fittingly, April is also National Facial Protection Month. Whether you prefer softball or basketball, skateboarding or ultimate frisbee, don't forget your most important piece of equipment: a mouthguard to protect your face and your smile!

In an instant, a blow to the mouth can cause a dental injury that is painful to endure and expensive to treat. In just about any sporting activity, your mouth could come into contact with a piece of equipment, another person or the ground. That's why the American Dental Association and the Academy for Sports Dentistry recommend using a mouthguard when participating in any of over 30 activities, including some that aren't typically considered contact sports, like volleyball and bike riding.

Common sense, observation and scientific research support the use of mouthguards during sporting activities—but are the ones you get from your dentist really any better than the kind you can grab off the shelf at a sporting goods store or drugstore? The answer is yes!

In a 2018 experiment, researchers created a model of the human head to test how direct impact affects the teeth, jaws and skull. They compared the effects of impact when using no mouthguard, when using a custom-made mouthguard available from the dentist, and when using a stock mouthguard. They also tested mouthguards of different thicknesses. The results? The experimenters determined that any mouthguard is better than no mouthguard and that custom mouthguards available from the dental office are more effective than off-the-shelf mouthguards in protecting teeth, jaws and skull from impact. They also found that the thicker the mouthguard, the better the protection.

Although custom mouthguards are more expensive than the kind you can buy at the corner store, the difference in protection, durability, comfort and fit is well worth the investment. We consider your (or your child's) individual needs, take a precise model of your mouth and provide you with a custom-fit mouthguard of the highest quality material.

Don't ruin your game. A mouthguard can go a long way in protecting your teeth and mouth from injury. If you would like more information about a sports mouthguard, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

By Mark J. Schwartz, DMD
April 08, 2019
Category: Dental Procedures
Tags: apicoectomy  
IfaRootCanalCantbeDonethisProcedureMightSaveYourTooth

Untreated tooth decay can destroy your teeth; prompt action as soon as its diagnosed will help prevent that undesirable outcome. And even if decay has advanced into the tooth's pulp and root canals, there's still a good chance we can stop it with a root canal treatment. Using this procedure, we can clean out the infection and refill the tooth's interior space with a special filling to protect it from further infection.

Although root canal treatments have gained an unwarranted reputation for pain, they rarely cause even the mildest discomfort. More importantly, they work, which is why they're the go-to treatment dentists use for advanced decay.

But sometimes a unique dental situation might make performing a root canal extremely difficult—possibly even doing more harm than good. For example, trying to access the interior of a tooth with a crown restoration might require removing the crown, which could further weaken or damage the tooth. In other cases, the root canals might have become calcified due to trauma or aging and become too narrow to access.

Even so, we may still be able to save a tooth through a minor surgical procedure called an apicoectomy. Rather than access the diseased area through the tooth crown as with a root canal treatment, an apicoectomy makes access to the infected tissue at the root end.

An apicoectomy also differs from a root canal treatment in that we'll need to surgically go through the gum tissue. After numbing the area with a local anesthetic, we'll make a small incision through the gums at the level of the infection. After removing any infected tissue, we would then fill the space with a small filling to prevent re-infection. We then close the incised gum tissues with sutures and allow them to heal.

With the help of fiber optic lighting and surgical microscopes, endodontists (specialists in interior tooth problems) can perform an apicoectomy quickly and with very little trauma at the surgical sight. If you undergo an apicoectomy, you should be back to normal activity in a day or two at the most. And like its sister procedure the root canal, an apicoectomy could help preserve your teeth for many years to come.

If you would like more information on this and other treatments for tooth decay, 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”





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