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Posts for: March, 2014

By Central Florida Cosmetic & Family Dentistry
March 24, 2014
Category: Oral Health
Tags: furcation  
BoneLossAroundRootFurcationsPosesTreatmentandCleaningChallenges

Although they may appear inert, teeth are anything but — they grow and change like other bodily tissues until complete maturation. Teeth roots are especially adaptable; teeth with multiple roots develop much like forks in a road as each root takes a different path toward the jawbone.

This fork where they separate is called a furcation. It’s normal for lower molars and premolars to have two furcations, while upper molars traditionally have three. Furcations pose difficulties for teeth cleaning and maintenance. If bone loss has occurred around them, a condition called a furcation invasion has occurred. This loss is most likely due to periodontal (gum) disease, an inflammation arising from bacterial plaque on the teeth that hasn’t been removed through proper oral hygiene.

We identify furcation invasions through x-ray imaging and tactile probing. They’re classified in three stages of development: Class I describes early onset in which marginal bone loss has occurred, exposing a groove that leads to the beginning of the furcation; Class II is moderate bone loss where a space of two or more millimeters has developed horizontally into the furcation; and, Class III, advanced bone loss whereby the bone loss has extended from one side of the tooth to the other, or “through and through furcation.”

Our first step in treatment is to remove any detectable plaque and calculus on the tooth surface, including the roots (known as scaling and root planing). These areas can be difficult to access, especially near furcations, and requires special instruments known as scalers or curettes. We may also employ ultrasonic scalers that use high-frequency vibrations coupled with water to break up and flush out the plaque and calculus.

We then apply antimicrobial or antibiotic medicines to further disinfect the area and inhibit bacterial growth while the affected tissues heal. As the infection and inflammation subsides, we then turn our attention during subsequent visits to address the bone loss around the furcation. This may involve surgical procedures to aid in re-growing gum tissue and bone and to create better access for cleaning and maintaining the area.

Finally, it’s important to establish good oral hygiene habits and regular checkups and cleanings to prevent further complications or a reoccurrence of the disease. Maintaining these habits will help you avoid tooth loss and other problems with your oral health.

If you would like more information on furcations, 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 “What are Furcations?


By Central Florida Cosmetic & Family Dentistry
March 21, 2014
Category: Oral Health
TreatingThumbSuckingNowCouldReduceOrthodonticTreatmentLater

One of the most common parental concerns is the habit of many children, even late into childhood, to suck their thumbs or fingers. Many parents have asked us, “Could this affect their teeth?”

The answer, unfortunately, is yes — thumb sucking can contribute to a malocclusion (bad bite) that could eventually require orthodontic treatment. Before making any assumptions, however, we need to understand the bigger picture.

To begin with, infants have a different swallowing mechanism than adults and older children. When you as an adult swallow, you'll notice the tip of your tongue positions itself just above the back of the top front teeth. An infant, however, will thrust their tongue between their upper and lower jaw as they swallow (also known as an infantile swallowing pattern or primary tongue thrust). The infant normally begins changing to an adult swallowing pattern when their primary (baby) teeth begin to erupt.

However, if a child's swallowing transition is slower than normal and the tongue rests between the jaws for a longer duration, it can inhibit the full eruption of teeth, believed to be the main cause of an open bite (a gap between the upper and lower teeth when the jaws are shut). The thumb during sucking resting between the teeth can have the same effect.

Thumb sucking may not necessarily lead to a malocclusion — for example, an abnormally developing jawbone could be the culprit. If prolonged thumb sucking does become a concern, however, there are steps we can take to reduce the impact of the habit. We can install a thin metal “tongue crib” behind the upper and lower incisors that will not only discourage thumb sucking, but also help retrain the tongue not to rest between the upper and lower teeth. There are also exercise routines known as orofacial myofunctional therapy (OMT) that can retrain specific muscles in the mouth to encourage more normal chewing and swallowing patterns.

These steps may not prevent future orthodontic treatment, but they could reduce its extent. The key is regular dental checkups and consultation to ensure your child's teeth and bite are developing normally.

If you would like more information on the effects of chronic thumb sucking on the mouth, 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 “How Thumb Sucking Affects the Bite.”


By Central Florida Cosmetic & Family Dentistry
March 12, 2014
Category: Oral Health
Tags: teething  
HelpingYourBabyCopeWiththeDiscomfortofTeething

When your baby’s first teeth erupt in the mouth, it’s a big step in their development. Unfortunately, you may not have much opportunity to celebrate — you’re too busy tending to your infant whose experience is anything but pleasant.

Commonly known as teething, the eruption process usually begins between six and nine months of age, although some children may begin as early as three months or as late as twelve. Not all teeth come in at the same time: it usually begins with the two lower front teeth, then the two upper front teeth, followed by the molars and then the canines (eye teeth). By age three, most children have all twenty of their primary teeth.

Each child’s teething experience is different and may vary in length of time and intensity. The usual signs are heightened irritability, biting and gnawing accompanied by gum swelling, ear rubbing, drooling and sometimes facial rashes. Babies also may have disturbed sleeping patterns and a decreased appetite. Occasionally, this discomfort can be intense.

There are some things you can do to ease this discomfort. Provide your baby a clean, chilled (not frozen) rubber teething ring, chilled pacifier or wet washcloth to gnaw on. Cold foods, like popsicles for older children can also be soothing, though you should limit sugary foods to lower the risk of tooth decay. You can also finger massage swollen gums to counteract the pressure coming from the erupting tooth, or administer pain relievers like baby acetaminophen or ibuprofen. You can use products with Benzocaine®, a numbing agent, for children two years or older — but you should never use alcohol for children of any age for inflamed gums.

Be sure to also set up a Year One dental examination around their first birthday. This is an important first step in your child’s long-term dental care, and a good opportunity to check their teething progress. And, by all means, if you have concerns about your child’s experience with teething, don’t hesitate to call our office.

Teething is a normal part of your child’s development. There’s much you can do to help make it as comfortable and pain-free as possible.

If you would like more information on teething, 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 “Teething Troubles.”


By Central Florida Cosmetic & Family Dentistry
March 04, 2014
Category: Oral Health
Tags: oral health   oral hygiene  
Top5TipsforGoodOralHygiene

It’s a recognized goal of modern dentistry to help you keep your natural teeth clean and disease-free, so you’ll be able to enjoy them for your whole life. But dentists can’t accomplish that goal by ourselves — we need your help! Maintaining good oral hygiene is the best way to ensure that your smile stays as healthy as it should be. Here are a few simple tips that can make a big difference in your dental health.

  1. Use the right brush, and change it as needed. What’s the right brush? Generally speaking, it’s one with soft bristles that’s small enough to fit your mouth comfortably. However, if you have trouble using a manual brush effectively (because of arthritis, for example), consider getting a good-quality electric brush. Change your brush when its bristles begin to stiffen or wear out. Ask us about proper brushing technique if you have any questions — and, of course, make sure to use a toothpaste with fluoride.
  2. Floss — every day. Because no matter how hard you try, you simply can’t reach all the areas in between your teeth with a brush alone — and that’s where many cavities get started. Plus, when it comes to preventing periodontal (gum) disease, flossing may be even more important than brushing, since it can actually remove plaque (a bacterial film) from under the gums. So no more excuses — OK?
  3. Stay away from sugary drinks and between-meal snacks. That includes sodas, cookies, and so-called “energy” drinks, which often pack a damaging one-two punch of sugar and caffeine. If you eat sugary treats at all, do so only after a meal. This will give your mouth plenty of “free time” to neutralize the acids that result when sugar is processed by oral bacteria. It’s these acids that are the primary cause of tooth decay.
  4. Avoid bad oral-health habits. Some you already know: smoking (or using tobacco products of any kind); excessive consumption of alcohol; chewing on pencils, fingernails, or anything else that doesn’t belong in your mouth. But some you may not know: A clenching or grinding habit at night can cause serious tooth damage without you even realizing it. Getting an oral piercing increases your chance of chipping a tooth, and can lead to other problems. And playing sports without a mouthguard is risky business.
  5. See your dentist regularly. You can do plenty on your own to keep up your oral health — but it’s also important to see us regularly. When you come in for an office visit, we will check you for early signs of problems, and take care of any that we find… before they get bigger and harder to treat. We’ll also make sure you leave with a sparkling smile that has been thoroughly and professionally cleaned.

If you would like to learn more about maintaining good oral hygiene, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine articles on “How to Help Your Child Develop the Best Habits for Oral Health” and “Oral Hygiene Behavior.”