Posts and Cores for Dental Crowns

If you have had a dental crown recently placed (particularly on a root canal treated tooth) you may have been surprised to learn that you needed a post or core placed in addition to the crown. These procedures allow us to maximize the strength of the natural enamel and add structure back to broken down teeth. In every instance, they are an integral part of the long term success of a crown. 

When teeth have root canals placed or deep cavities removed, they are left with a large hole in the center of the tooth or a missing wall of enamel. For a crown to be successfully cemented, the tooth has to have a fairly regular "teepee" shape. Any large holes or divots in the tooth prevent the lab from making a successful restoration.  A core is a bulk of material added to the tooth to provide strength and structure prior to finishing the crown. They are made from a variety of material, depending on the specific needs of the tooth and the plan for the final crown. Many times the endodontist will place the buildup themselves once the root canal is finished. 

When a tooth is missing multiple walls of enamel or lacks enough structure above the gumline (as is common with fractured teeth), a post may need to be placed in addition to a core. Posts are solid metal or composite rods that are cemented in the roots of root canal treated teeth. They extend upward and act as an anchor for the core buildup. Without a post, large cores are prone to failure and fracture. This causes huge headaches, particularly after the root canal and crown are completed. An important point to note is that posts can only be placed on root canal treated teeth, as it needs to be placed within the root system. In rare instances, a root canal may be performed on a healthy tooth so that a post can be placed.

We always try our best to notify patients of the potential need for a post and/or core prior to starting crown treatment. These procedures are not optional steps, but rather necessary precautions for the long term stability of the tooth. If you would like to know more about posts, cores, dental crowns or root canals, please give our office a call!

Irritants in Oral Health Products

Have you noticed a burning sensation after switching toothpastes? Dryness? Canker sores? These are very common problems stemming from both inactive and active ingredients in various oral health products. Take a look at what compounds are generally most problematic and how to avoid them!

One of the most common irritants in toothpaste is Sodium Lauryl Sulfate (SLS). This compound is used in some brands as a foaming agent, surfactant and detergent. While it is not an active ingredient, it theoretically helps the toothpaste create better contact with the teeth. Unfortunately, many patients are sensitive to this ingredient and can develop sores or tissue sloughing (outer layer of skin becomes irritated and loose) in response to its use. The most common sign of an SLS sensitivity is cracking/irritation at the corners of the mouth after switching toothpastes. 

Another common and problematic component in toothpastes is cinnamon flavoring. As a whole, cinnamon is a known irritant with a high potential for reacting with the oral mucosa. Applying it twice a day for two minutes (as with normal brushing) can cause burning and tissue sloughing in many patients. This varies greatly from person to person and has to be judged on an individual level. Some patients love cinnamon toothpaste and handle it just fine!

A final ingredient to pay attention to is alcohol in mouth rinses. Many common "Listerine-type" rinses use alcohol as a antimicrobial in controlling periodontal disease. Unfortunately, alcohol can irritate sensitive gums and dry out the teeth. Alcohol based rinses are still a good choice for patients suffering from gingivitis or periodontitis. However, many patients have a higher propensity towards tooth decay and would benefit more from a fluoride rinse like ACT with fluoride. 

If you start to notice burning, dryness or tissue sloughing in your mouth after starting a new product, discontinue it immediately and give our office a call. If you are having problems finding a toothpaste that doesn't irritate your gums, we suggest trying Biotene toothpaste or Tom's Clean and Gentle with Fluoride. Both of these products were created with sensitive tissue types in mind and are free of unnecessary compounds. If you would like to know more about toothpaste choices, brushing, flossing or dental home hygiene, please give our office a call!

Is bleaching safe for your teeth?

Every year, millions of patients worldwide bleach their teeth using various products. Whether prescribed by a dentist or purchased over-the-counter, almost every effective whitening method utilizes some type of peroxide gel. When used correctly, they are all safe and effective ways to lighten the color of your teeth. Read on to catch the full story!

Peroxides (hydrogen peroxide, carbamide peroxide, etc.) whiten teeth by breaking down the pigmented compounds in the tooth's dentin layer (between the enamel and pulp). To reach this space, these products rely on opening up small gaps in the dentin called microtubules. This can cause a temporary sensitivity to air and cold liquids. However, the tubules quickly re-mineralize and close in a matter of hours. For cases of extreme sensitivity, we may recommend extra fluoride applications to dull the ache. 

Research shows that whitening causes no long term negative effects on teeth. However, prescription strength whitening procedures (zoom whitening or custom bleach trays) have the potential to irritate or discolor the gum tissue. This is why it is important to follow the dentist's directions carefully. It is also important to note that over whitening can cause the teeth to have a blue tint that many patients find undesirable. 

When performed correctly, whitening is an easy and convenient way to improve the cosmetics of your smile. If you would like to discuss your tooth whitening options, please give our office a call!

Specialist Spotlight: Camarillo Childrens Dental Group

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight the dental services offered by Camarillo Children's Dental Group.

At our office, we treat patients of all ages and even have a dedicated room just for children. However, kids with extensive dental needs, extreme phobia or developmental disorders are best seen by a pediatric dentist. Doctors Eunha Cho and Steven Parle offer additional expertise in behavioral management, sedation and dental development. Dr. Parle is a licensed orthodontist and offers a whole spectrum of services geared towards straightening teeth and correcting smiles. 

Doctors Cho and Parle operate out of several locations to serve your specific needs. Together, they offer over 40 years of expertise in treating younger patients. If you have any more questions about Camarillo Children's Dental Group or about your referral to their office,please give us a call!

Website: http://www.camarillochildrensdentalgroup.com/

 

Dry Mouth and Tooth Decay

Do you often find yourself with a dry mouth? This sensation, formally known as xerostomia, is reported by over one fifth of all adults nation wide. Understanding why and how this condition works is crucial to managing your overall oral health. Dry mouth conditions are known to be one of the most detrimental factors in the tooth decay process. 

Your saliva contains multiple remineralizing and protective compounds to keep your dental enamel healthy. On top of physically cleaning the tooth surface, saliva can help buffer acids and provides enzymes that inhibit bacterial growth. This is why individuals suffering from dry mouth develop new cavities at a remarkably faster rate than those with normal salivary function. In addition to the amount of decay, those with xerostomia tend to have different types of decay. For them, cavities are commonly found on the roots and smooth surfaces of the teeth. 

The most common cause of dry mouth is as a side effect from unrelated medications. Over 500 medications are known to decrease normal salivary function. Of these, 120 are on the list of top 200 drugs prescribed in the United States. Other causes include radiation treatment, stress, hormonal changes and exercise. 

From a dental perspective, treating dry mouth is as important as managing the symptoms. As a basic measure, we recommend always keeping a water bottle handy fend of the sensation of dryness. Additionally, Biotene products are excellent at keeping the mouth moisturized. They contain the sugar alcohol xylitol, which naturally stimulates salivary flow and helps limit bacterial growth. We also typically recommend fluoride varnish application to give your teeth an extra boost of remineralization. 

If you are worried about your dry mouth or have any questions about managing your symptoms, please give our office a call. We are always happy to help you better understand and care for your entire oral needs!

Do you need to get numb for every filling?

If you've had a dental filling placed recently, chances are you had to get numb before the procedure began. Local anesthetics, like lidocaine and septocaine, make modern dentistry relatively painless and easy for the patient. However, there is a chance you got to skip the shot for your most recent filling. Why didn't you need to get numb? Was there really a cavity there? Read on to find out. 

Inside of every tooth is a nerve chamber that transmits sensations of pain, cold and vibration to the brain. This, coupled with the pressure sensors in the tooth ligament, give you input on the current status (and any potential harm) of the tooth. The sensation of pain is largely dependent on input from cells called odontoblasts relaying information to the dental nerve. Odontoblasts live within the inner dentin layer of the teeth, with long arms that extend to the interface between the dentin and enamel. Enamel, by contrast, is 95% mineral and contains no cells. If your filling is limited to enamel, there is no biological mechanism to transmit pain directly to the tooth nerve. Thus, there is no absolute need to numb the tooth for these procedures. 

We perform fillings on shallow areas of decayed enamel to prevent them from getting deeper. Once the bacteria pass from enamel to dentin, their growth spreads exponentially due to the higher concentration of organic matter. If we can remove and stop the decay while it is limited to enamel, there is no need for anesthesia and a much lower risk of post-operative complications. 

Other reasons for not needing injections during fillings include working on teeth with root canals or dead nerve tissue. Without a living nerve to transmit pain information, the is usually little benefit from providing the anesthesia. If you would like to now more about dental filings, how they are performed and why we place them, please give our office a call!

Specialist Spotlight: Westlake Oral and Plastic Surgery

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight the surgical services offered by Westlake Oral and Plastic Surgery.

At Westlake Oral and Plastic Surgery, Doctors Donald Nikchevich, Michael Newton and Scott Bennion provide our patients with the best in surgical care. They approach every situation with years of experience and the latest in dental technology. We typically refer to Westlake Oral and Plastic Surgery for patients requiring dental extractions or implants. In both situations, technologies like cone beam CT scans and platelet rich plasma (PRP) applications ensure the best outcomes coupled with speedy and predictable recovery. 

With your referral appointment, be sure to check out the Westlake Oral and Plastic Surgery website to register with their office and add your medical history online. This helps streamline your surgical consultation and ensures accuracy of information. If you have any questions on your upcoming dental referrals or would just like to recap your treatment plan/options, feel free to give our office a call!

Website: www.scoms.com

Address: 911 Hampshire Road, Westlake Village, CA, 91361

 

Bacteria on your toothbrush?

In a recent article, the American Dental Association recognized that where and how you store your toothbrush has a significant impact on the types of bacteria it harbors. Toothbrushes left sitting out on bathroom counters to dry harbor many types of bacteria, some associated with the "other" things we do in the bathroom. Fortunately, there is no scientific evidence that these bacteria can harm your mouth.

To keep the general level of bacteria on your toothbrush at its lowest, the ADA recommends rinsing with tap water after brushing and allowing the brush to air dry. Putting the brush in a case or cover can retain moisture and actually cause more bacterial growth between the bristles. The brush (or brush head in electric units) should be changed every three to four months to maximize their cleaning ability. 

Finally, it is important to remember to never share a toothbrush. We now understand that both gum disease and tooth decay are bacterial in nature, and that these bacteria can be transferred from person to person. This is particularly important for children under the age of three who are highly susceptible to cavity-causing bacteria. If you have any other questions on dental hygiene or oral health products, please give our office a call! 

Dental Questions: Is chewing gum good for your teeth?

Many popular gum brands market their sugar-free products as dentist recommended or protective against cavities. The general idea behind this is that chewing gum is a natural saliva stimulant. Your saliva is one of the most important protective factors in fending off tooth decay. It naturally buffers acidic foods and inhibits the ability of bacteria to damage dental enamel. This is why patients with chronic dry mouth are extremely prone to getting new cavities. Chewing gum triggers your saliva glands to create more fluids and thus better protect your mouth between meals. 

An important point in this recommendation is that the gum has to be sugar free. If the product contains fructose, sucrose or any other dietary sugar, any benefit from saliva stimulation is lost. In this circumstance, the constant contact to sugar weakens enamel and fuels the decay-causing bacteria. Look for gums sweetened with a sugar substitute like sorbitol or (ideally) xylitol. When consumed at a high enough concentration, xylitol can actually interfere with bacterial enzymes and stop their ability to produce acid. However, you would need to specifically seek out a xylitol gum (such as Xyloburst, typically available at health food stores) and consume about six sticks a day. While six pieces of gum a day may seem excessive, it is an inexpensive and easy preventative measure for those with the highest risk of developing new cavities. 

We know that picking good products for your oral hygiene can be difficult. If you have any further questions on chewing gums, mints or other supplements, please give our office a call. We are always happy to help you find the best tools for your oral health needs!

Dental Questions: Why does my tooth hurt after a filling/crown?

If you've ever had dental pain after a filling or crown, you know how frustrating this situation can be. Did something go wrong? Is it normal? Rest assured, "post operative sensitivity" is one of the most common complaints after dental work. Depending on the type, timing and severity of pain, it can indicate a few potential problems. Read on to catch a glimpse into how we interpret and treat patients with after-treatment pain!

Any time a dentist uses an instrument to modify the structure of a tooth, there is a chance that this procedure will irritate the dental nerve. Typically, this pain is reversible and is a response of the tooth cells being transiently injured during treatment. It is usually described as weak or dull and resolves on it's own in about two weeks. If we are working near the pulp of the tooth (such as with deep cavities and certain fractures) there is a higher likelihood of causing irreversible irritation of the dental nerve. In this scenario, the tooth becomes hyper-sensitive as the inner tissue becomes necrotic. Patients usually describe this pain as a sharp, prolonged sensitivity to hot/cold foods. Over time, it transitions to a spontaneous pain and sensitivity to taping and chewing. In these instances, the best solution is to perform a root canal to clean out the dead tissue and relieve any infection that may be present. 

Beyond these types of nerve irritation, some fillings become sensitive due to the nature of the materials we use in dentistry. Many types of fillings and crown cements are physically bonded to the tooth. This process involves painting on a resin "glue" and using a light to cure it to the tooth. The chemical change causes a small amount of shrinkage that can put pressure on the microscopic tubes in the tooth's dentin layer. Patients usually feel this pain as sharp and sensitive to biting and chewing. To solve this, we may change the material used to fill your tooth or remove the old filling and place a temporary "sedative" filling and see if the nerve calms down. Interestingly, we usually see this type of pain on smaller fillings, as they tend to have more walls made of natural teeth, and thus more surface area to place tension on. 

A final (and probably most common) source of post-operative pain is the filling/crown simply being too high. We check every single restoration we place with marking paper to make sure it doesn't change the way your teeth together. However, the ligaments in your teeth can feel changes on a microscopic level and can be difficult to account for. This problem is easily detected and fixed- we simply need to remove the area of the filling/crown that is interfering with your opposing teeth. 

Any patient complaint of pain after a procedure is taken very seriously and typically handled the same way. We will have you come in for an emergency appointment where we will take an X-ray (to see where the nerve is) and check the bite (to rule out a "high" restoration). We use this information to perform other tests to narrow down the possibilities to a correct diagnosis. Our ultimate goal at this visit is to get you out of pain and make a plan to protect the tooth long-term. If you would like to know more about the fillings we place and the risks/benefits of these procedures, please give our office a call.