Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.
After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.
More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.
Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.
Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.
Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.
A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.
Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.
If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?”
If you've suddenly noticed your smile looking more “toothy,” you may have a problem with your gums. They may have lost their normal attachment to your tooth and begun to shrink back — or recede.
Millions of people have some form of gum recession. The most common cause is periodontal (gum) disease, but it's not the only one. You may be more susceptible to gum recession because of heredity — you have thin gum tissues passed down to you from your parents. You may also be brushing too hard and too often and have damaged your gums.
Healthy gums play an important role in dental health. The crown, the tooth's visible part, is covered with a hard, protective shell called enamel. As the enamel ends near where the root begins, the gums take over, forming a tight band around the tooth to protect the roots from bacteria and acid.
Receding gums expose these areas of the tooth meant to be covered. This can lead to another tell-tale sign — tooth sensitivity. You begin to notice pain and discomfort while you consume hot or cold foods. And because it leaves your teeth and gums looking much less attractive, it can affect your confidence to smile.
Fortunately, though, we can help restore receded gums. If you have gum disease, it's imperative we treat it as early as possible. We do this by removing plaque, a thin film of bacteria and food particles that triggers the infection. We use special techniques and hand instruments to remove plaque and calculus (hardened plaque deposits) from all tooth surfaces including along the roots.
Gum disease treatment can help stop and even reverse gum recession. In some cases, though, the recession may have advanced too far. If so, we may need to consider surgically grafting donor tissue to the recessed areas. Depending on the site and extent of recession, this can be a very involved procedure requiring microscopic techniques.
The best approach, though, is to take care of your gums now. Daily brushing and flossing removes harmful plaque; regular dental visits take cleaning a step further and also give us an opportunity to detect disease early. By looking out for your gums now you might be able to avoid gum recession in the future.
After years battling disease, your troubled tooth reached its useful life's end. It's been extracted, and we've replaced it with a life-like dental implant. So now, as far as the implant goes, disease is no longer an issue…right?
Sorry, no—though not to the same degree as a natural tooth, an implant could be endangered by gum disease. Although the implant's materials can't be infected, the supporting gums and bone can.
In fact, there's a particular type of gum disease associated with implants known as peri-implantitis (“peri” around an implant; “itis” inflammation) that first affects the gums surrounding an implant. Although peri-implantitis can arise from an excess of dental cement used to affix the crown to the implant, it most commonly starts like other forms of gum disease with dental plaque.
Dental plaque, and its hardened form calculus (tartar), is a thin, bacterial biofilm that builds up on teeth surfaces. It can quickly accumulate if you don't remove it every day with proper brushing and flossing. The bacteria living in plaque can infect the outer gum tissues and trigger inflammation.
Gum disease around natural teeth can spread quickly, but even more so with implants. That's because the natural attachment of the gums helps supply antibodies that impede infection. Implants, relying solely on their connection with the bone, don't have those gum attachments. As a result, peri-implantitis can move rapidly into the supporting bone, weakening the implant to the point of failure.
The good news, though, is that peri-implantitis can be treated successfully through aggressive plaque removal and antibiotics. But the key to success is to catch it early before it progresses too far—which is why you should see your dentist at the first sign of gum swelling, redness or bleeding.
You can also prevent peri-implantitis by practicing daily brushing and flossing, including around your dental implant. You should also see your dentist twice a year (or more, if they advise) for cleanings and checkups.
Dental implants overall have a greater than 95% success rate, better than any other tooth restoration system. But they still need daily care and regular cleanings to ensure your implants are on the positive side of those statistics.
Your teeth are meant to last a lifetime. Even with wear and tear from years of eating and biting they can continue to function properly and look attractive well into your senior years.
Teeth are resilient thanks in part to enamel, the hardest substance in the human body. But the gums also contribute to this resilience: besides attractively framing the teeth, they protect the dentin and roots below the enamel covering.
Unfortunately, the gums can shrink back or “recede” from their normal place. Not only does this look unattractive, the recession can also expose teeth to disease and cause tooth sensitivity to temperature changes or biting pressure.
There are a number of causes for gum recession, some of which you may have little control over. If, for example, your teeth come in off center from their bony housing, the gum tissues may not develop around them properly. You might also have inherited a thinner type of gum tissue from your parents: thinner tissues are more delicate and susceptible to recession.
But there are other causes for which you have more control. Over-aggressive brushing (too hard for too long), ironically, does more harm than good as it can injure your gums and cause them to recede. More likely, though, your recession is a direct result of neglecting proper hygiene for your teeth and gums.
When teeth aren't properly cleaned through daily brushing and flossing, a thin film of bacteria and food remnant called plaque builds up on tooth surfaces. This can trigger periodontal (gum) disease, which subsequently causes the gum tissues to detach from the teeth and often recede.
To reduce your risk of gum disease, you should gently but thoroughly brush and floss daily, and visit us for cleanings and checkups at least twice a year. If you have a poor bite (malocclusion), consider orthodontic treatment: malocclusions make it easier for plaque to accumulate and harder to remove.
Above all, if you begin to see signs of gum problems — swelling, bleeding or pain — see us promptly for an examination and treatment. Dealing with these issues early is the best way to ensure your gums continue to do their jobs for the long-term.
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
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