My Blog
By Benjamin T. Watson, DDS, MAGD
February 21, 2020
Category: Oral Health
Tags: loose tooth  
ALooseToothisaSignofDeeperDentalTrouble

A loose primary (“baby”) tooth is often a cause for celebration. A loose permanent tooth, however, is a cause for concern. A permanent tooth shouldn't even wiggle.

If you have a loose tooth, it's likely you have a deeper dental problem. Here are the top underlying causes for loose teeth.

Gum disease. Teeth are held in place by an elastic tissue called the periodontal ligament. But advanced periodontal (gum) disease, a bacterial infection usually caused by film buildup on teeth called dental plaque, can damage the ligament and cause it to detach. If it's not treated, it could lead to tooth loss.

Bite-related trauma. A normal bite helps balance out the forces generated when we chew so they don't damage the teeth. But if a misaligned tooth protrudes higher from the jaw, the opposing tooth will likely create more downward pressure on it while chewing. This can stress the tooth's supporting ligament to the point of looseness.

Self-inflicted trauma. While they may be trendy, tongue jewelry can cause dental damage. A wearer who clicks the “barbell” of a tongue stud against their teeth could be creating conditions conducive for gum damage and bone loss, which can cause tooth looseness. Similarly, taking orthodontics into your own hands could also damage your teeth, especially if you have undiagnosed gum disease.

Genetics. Although you can't prevent it, the type of resistance or susceptibility you inherited from your parents (as well as your dental anatomy) can cause you dental problems. Thinner gum tissues, especially around the roots, can make you more susceptible to gum disease or dental trauma, which in turn could contribute to tooth looseness.

There are things you can do to lessen your chance of loose teeth. Brush and floss every day to remove disease-causing bacterial plaque and see a dentist regularly for cleanings to reduce your risk of gum disease. If you have any misaligned teeth, consult with an orthodontist about possible treatment. And avoid oral jewelry and DIY orthodontics.

If you do notice a loose tooth, see us as soon as possible. We'll need to diagnose the underlying cause and create a treatment plan for it. We may also need to splint the tooth to its neighbors to stabilize it and reduce your risk of losing it permanently.

If you would like more information on tooth mobility, 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 “When Permanent Teeth Become Loose.”

By Benjamin T. Watson, DDS, MAGD
February 11, 2020
Category: Dental Procedures
Tags: clear aligners  
ClearAlignersProvideaLessEmbarrassingOrthodonticChoiceforTeens

For decades, traditional braces were the only orthodontic choice for moving misaligned teeth. Although they’re quite effective, they can cause discomfort and, for teens especially, embarrassment due to their noticeable metallic appearance.

In recent years, though, technology has produced an alternative to braces that’s proven effective for many types of patients. Besides being less cumbersome and disruptive to everyday life than braces, clear aligners have another advantage that appeals to teens — they’re much less visible.

Introduced in the late 1990s, clear aligners are a system of individual trays made of nearly invisible polyurethane plastic worn over the upper teeth. The trays are computer-generated based on the patient’s individual mouth structure captured in photographs and x-rays. Each tray in the sequence is incrementally smaller in size; the patient begins wearing the first aligner in the series for about two weeks, 20 to 22 hours a day. They then switch to the next tray in the series for about the same amount of time, and continue in this fashion until they’ve worn each aligner in the series.

Besides their improvement in appearance, aligners also have another advantage: unlike traditional braces, aligners can be removed from the mouth for eating or on a limited basis for rare important social occasions. Brushing and flossing are also much easier with aligners, which don’t pose the same access problems as traditional braces.

Clear aligners were once only effective with select types of orthodontic patients, which didn’t always include teens. Over the last decade, however, significant changes to design and additional implements have widened their application to more patients, especially teens. For example, we can now add tiny “power ridges” to the aligner design that give greater precision over desired tooth movement to create a more controlled and efficient force on the teeth. More recent aligners are also being produced with a thinner, more comfortable material.

A thorough orthodontic exam will tell whether your teen is a good candidate for clear aligners. If so, they’ll benefit from a more comfortable and less embarrassing experience while gaining a new smile for life.

If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”

By Benjamin T. Watson, DDS, MAGD
February 01, 2020
Category: Dental Procedures
DakotaJohnsonandHerMissingToothGapSparksOnlineDebate

Celebrities’ controversial actions and opinions frequently spark fiery debates on social media. But actress Dakota Johnson lit a match to online platforms in a seemingly innocent way—through orthodontics.

This summer she appeared at the premier of her film The Peanut Butter Falcon missing the trademark gap between her front teeth. Interestingly, it happened a little differently than you might think: Her orthodontist removed a permanent retainer attached to the back of her teeth, and the gap closed on its own.

Tooth gaps are otherwise routinely closed with braces or other forms of orthodontics. But, as the back and forth that ensued over Johnson’s new look shows, a number of people don’t think that’s a good idea: It’s not just a gap—it’s your gap, a part of your own uniqueness.

Someone who might be sympathetic to that viewpoint is Michael Strahan, a host on Good Morning America. Right after the former football star began his NFL career, he strongly considered closing the noticeable gap between his two front teeth. In the end, though, he opted to keep it, deciding it was a defining part of his appearance.

But consider another point of view: If it truly is your gap (or whatever other quirky smile “defect” you may have), you can do whatever you want with it—it really is your choice. And, on that score, you have options.

You can have a significant gap closed with orthodontics or, if it’s only a slight gap or other defect, you can improve your appearance with the help of porcelain veneers or crowns. You can also preserve a perceived flaw even while undergoing cosmetic enhancements or restorations. Implant-supported replacement teeth, for example, can be fashioned to retain unique features of your former smile like a tooth gap.

If you’re considering a “smile makeover,” we’ll blend your expectations and desires into the design plans for your future smile. In the case of something unique like a tooth gap, we’ll work closely with dental technicians to create restorations that either include or exclude the gap or other characteristics as you wish.

Regardless of the debate raging on social media, the final arbiter of what a smile should look like is the person wearing it. Our goal is to make sure your new smile reflects the real you.

If you would like more information about cosmetically enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Space Between Front Teeth” and “The Impact of a Smile Makeover.”

By Benjamin T. Watson, DDS, MAGD
January 22, 2020
Category: Oral Health
Tags: oral health  
ThereAreaLotofBacteriainYourMouthbutOnlyaFewMeanYouHarm

Say “bacteria,” especially in the same sentence with “disease” or “infection,” and you may trigger an immediate stampede for the hand sanitizer. The last thing most people want is to come in contact with these “menacing” microorganisms.

If that describes you, however, you’re too late. If you’re of adult age, there are already 100 trillion of these single-celled organisms in and on your body, outnumbering your own cells 10 to 1. But don’t panic: Of these 10,000-plus species only a handful can cause you harm—most are either harmless or beneficial, including in your mouth.

Thanks to recent research, we know quite a bit about the different kinds of bacteria in the mouth and what they’re doing. We’ve also learned that the mouth’s microbiome (the interactive environment of microscopic organisms in a particular location) develops over time, especially during our formative years. New mothers, for example, pass on hundreds of beneficial species of bacteria to their babies via their breast milk.

As our exposure to different bacteria grows, our immune system is also developing—not only fighting bacteria that pose a threat, but also learning to recognize benevolent species. All these factors over time result in a sophisticated, interrelated bacterial environment unique to every individual.

Of course, it isn’t all sweetness and light in this microscopic world. The few harmful oral bacteria, especially those that trigger tooth decay or periodontal (gum) disease, can cause enormous, irreparable damage to the teeth and gums. It’s our goal as dentists to treat these diseases and, when necessary, fight against harmful microorganisms with antibacterial agents and antibiotics.

But our growing knowledge of this “secret world” of bacteria is now influencing how we approach dental treatment. A generalized application of antibiotics, for example, could harm beneficial bacteria as well as harmful ones. In trying to do good we may run the risk of disrupting the mouth’s microbiome balance—with adverse results on a patient’s long-term oral health.

The treatment strategies of the future will take this into account. While stopping dental disease will remain the top priority, the treatments of the future will seek to do it without harming the delicate balance of the mouth’s microbiome.

If you would like more information on the role of bacteria in oral health, 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 “New Research Show Bacteria Essential to Health.”

By Benjamin T. Watson, DDS, MAGD
January 12, 2020
Category: Dental Procedures
Tags: veneers  
VeneersMayNotBetheBestOptionforYourTeenagersTeeth

Just like adults, teenagers experience chipped, stained or disfigured teeth. And during a life stage where issues with appearance can be acutely painful, these defects call out for a solution.

And, there is one: porcelain veneers. These thin wafers of custom-made porcelain are bonded to the front of teeth to cover dental flaws. They’re one of the least invasive—and most affordable—methods for smile enhancement.

There is one caveat, though: The affected teeth will most likely need alteration. Veneers can look bulky when bonded directly to teeth, so we compensate for this by removing some of the surface enamel. This changes the tooth permanently, to the point that it will always require a veneer or some other form of restoration.

But although this may be a minor issue for an adult, it could pose a problem for a teenager. That’s because the pulp, the innermost layer of a tooth containing nerves and blood vessels, is larger in a younger adolescent tooth than in an older adult tooth. Because of its size, it’s closer to the tooth’s surface. During enamel reduction for veneers on a young tooth, this could lead to inadvertent nerve damage. If that happens, the tooth may need a root canal treatment to preserve it.

If the adolescent tooth needing a “facelift” has already been root canaled or sustained significant structural damage, then altering it for veneers may not be too concerning. Likewise, if the teeth are smaller than normal, the bulkiness of a veneer may actually improve appearance and not require alteration. We’ll need to examine a young patient first before making any recommendations.

There are also alternatives to veneers for improving smile appearance. Enamel staining could be enhanced temporarily with teeth whitening. Small chips can be repaired with bonded dental material, or in skilled hands be used to “build” a veneer one layer at a time with no enamel reduction. Although not as durable as regular veneers, these bonding techniques could buy time until the tooth is more mature for veneers.

Whichever path we take, there are effective ways to transform a teenager’s flawed tooth. And that can make for an even better smile.

If you would like more information on dental restorations for teenagers, 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 “Veneers for Teenagers.”





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