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Posts for category: Dental Procedures

By H. David Allick, DDS, PA
September 06, 2020
Category: Dental Procedures
ThisOrthodonticDeviceCouldReducetheNeedforFutureBraces

Each year, millions of children and teenagers wear braces or clear aligners to straighten a crooked smile. But there may be a way to treat some of these bite problems and avoid braces—by intercepting the problem at an earlier age.

This can often be done if the bite problem stems from abnormal jaw development rather than misaligned teeth. An example of this occurs when the upper jaw growth outpaces the lower jaw, causing the upper teeth to protrude beyond the lower teeth. Aside from the effect on appearance, protruding front upper teeth may extend beyond the protection of the lip and be more prone to injury.

A device called a Herbst appliance could prevent this from happening. The top of the device has two hinged metal tubes that connect to elastic bands bonded to the back teeth on both sides of the upper jaw. The bottom also has tubes affixed in the same way to the bottom teeth, except they're slightly smaller and fit within the upper tubes.

The lower tubes sliding within the upper tubes produces slight pressure against the lower jaw to ease it forward. This gradually influences the lower jaw to grow at a pace equal with the upper jaw to decrease the chances of poor bite development. Unlike other corrective methods, the Herbst appliance fixed in place and out of the way won't interfere with sports or other physical activities.

An installed Herbst appliance may change a patient's sensations during swallowing, eating or speaking, but most children adapt to the changes within a few days. And, because the device can create challenges for keeping the back teeth clean, many dentists recommend adding a fluoride rinse to daily brushing and flossing as an added boost against tooth decay.

The Herbst appliance is most effective during the period of most rapid physical growth between the ages of 11 and 14, but if the teeth are already beginning to protrude it can be undertaken as early as 8 or 9. Either way, this important orthodontic tool could help address a complicated bite problem and reduce the need for more costly orthodontic treatment later on.

If you would like more information on early interventions for poor bites, 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 “The Herbst Appliance.”

By H. David Allick, DDS, PA
August 27, 2020
Category: Dental Procedures
Tags: oral health   pregnancy  
EliminatinganInfantsLiporTongueTieCanMakeBreastfeedingEasier

Most babies come into the world ready and able to nourish at their mother's breast—no training required! About one in ten children, though, may have a structural abnormality with their tongue or lip that makes it difficult for them to breastfeed.

The abnormality involves a small strip of tissue called a frenum or frenulum, which is found in the mouth connecting soft tissue to more rigid structures. You'll find a frenum attaching the upper lip to the gums, while another connects the underside of the tongue to the floor of the mouth.

Frenums are a normal part of oral anatomy and usually don't pose a problem. But if the frenum tissue is too short, thick or tight, it could restrict lip or tongue movement. If so, a baby may not be able to achieve a good seal on their mother's nipple, causing them to ineffectively chew rather than suck to access the mother's milk. Such a situation guarantees an unpleasant experience for both mother and baby.

The problem can be addressed with a minor surgical procedure performed in a dentist's office. During the procedure, the dentist first numbs the area with an anesthetic gel. The frenum is then snipped with scissors or a laser.

With very little if any post-procedure care, the baby can immediately begin nursing. But although the physical impediment may be removed, the child may need to “relearn” how to nurse. It may take time for the baby to readjust, and could require help from a professional.

Nursing isn't the only reason for dealing with an abnormally shortened frenum. Abnormal frenums can interfere with speech development and may even widen gaps between the front teeth, contributing to poor bite development. It's often worthwhile to clip a frenum early before it creates other problems.

It isn't absolutely necessary to deal with a “tongue” or “lip tie” in this manner—a baby can be nourished by bottle. But to gain the physical and emotional benefits of breastfeeding, taking care of this particular problem early may be a good option.

If you would like more information on the problem of tongue or lip ties in infants, 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 “Tongue Ties, Lip Ties and Breastfeeding.”

By H. David Allick, DDS, PA
August 07, 2020
Category: Dental Procedures
Tags: Dental Implant  
3BenefitsofDentalImplantstoReplaceMissingTeeth

Here's the bad news on the overall state of dental health in the United States: Over 120 million people have one or more missing teeth—roughly one American in three. But there's also good news: We can replace missing teeth with a number of effective restorative methods. At the top of the list are dental implants, highly regarded by dentists and patients alike as the most lifelike and functional tooth replacement system available.

Dental implants have been growing in popularity since their introduction in the 1980s. Their structural design and construction have continued to improve, giving patients even more options for implant-based tooth replacement.

To bring greater attention to the benefits of this popular restoration, the American Academy of Implant Dentistry (AAID) designated August as Dental Implant Month in 2016. In recognition, here are 3 of those benefits you might gain from choosing dental implants to replace your missing teeth.

Durability. Unlike other restorations such as conventional dentures or bridges, implants replace the entire root structure of the tooth. To be more precise, implants are a tooth root replacement in the form of a post imbedded securely in the jawbone. As the bone grows around and attaches to the implant, it develops a durable and highly functional hold that can last for decades.

Adaptability. Many people assume dental implants are used only to replace individual teeth, but implants can also support multi-tooth restorations. A few strategically placed implants can securely attach a partial or total bridge to the jaw, or provide added support for a removable denture.

Affordability. At first glance, an implant's initial cost places it at the high end of the scale for tooth replacement options. But because of their long-term durability and high success rate (greater than 95% still in place after ten years), implants may cost less in the long run than lower-priced restorations that may require repair or replacement sooner.

Although they have a wide range of applications, implants aren't suited for some dental situations. Because implants require a minimum amount of bone present in the jaw, for example, extensive bone loss might nullify them as a current option. Even in this case, though, grafting therapy to rebuild the bone could make it possible to place dental implants at some point in the future.

If you've recently lost a tooth or you have an older restoration you'd like to replace, dental implants might be a great option for you. Your first step is an initial exam and consultation to find out if this premier dental restoration is right for you.

If you would like more information about dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants: Your Third Set of Teeth.”

By H. David Allick, DDS, PA
July 28, 2020
Category: Dental Procedures
HerestheScooponYourUpcomingRootCanal

You might be a bit apprehensive if your dentist recommends a root canal treatment, especially if it's your first. That's understandable: Popular culture has portrayed the root canal as an unpleasant experience.

But as a routine dental procedure, root canal treatments have been responsible for saving millions of decayed teeth. And, with local anesthesia, the procedure is painless. In fact, a root canal treatment stops pain that often results from advanced tooth decay.

So, let's take the mystery out of the root canal. Here's the 411 on this vital but often misunderstood dental procedure.

Why the name “root canal”? The terms for the procedure—root canal therapy, root canal treatment or simply “root canal”—arise from one of the principal parts of the tooth involved, root canals. These are tiny passageways that lead from the tooth's innermost layer, the pulp, to the tooth roots. While treatment often focuses on decay or diseased tissue within the pulp, the root canals can be infected too and must be included in the later filling process.

Who can perform a root canal? All general dentists are trained in basic root canal procedures. Depending on your tooth's condition, your family dentist may be able to perform it. But if your tooth has an intricate root canal network or some other complication, you may need an endodontist, a specialist in interior tooth and root treatments. Endodontists can perform advanced root canal techniques and have the specialized equipment to handle intricate cases.

What happens during a root canal? Although details may vary depending on the type of tooth and extent of decay, there's a basic process for all root canal procedures. After numbing the tooth and surrounding tissues, the dentist drills into the tooth to access the inner pulp chamber and root canals, then removes the diseased tissue and disinfects the empty chamber and canals. After preparing the canals, the dentist then fills the empty spaces. This, and subsequent sealing and crowning, protects the tooth from future decay.

After the procedure you may have some minor soreness for a few days, which is usually manageable with mild pain relievers like ibuprofen or acetaminophen. This discomfort will diminish with time, and your tooth will have a new lease on life.

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 Treatment.”

By H. David Allick, DDS, PA
June 28, 2020
Category: Dental Procedures
WhatReallyHappensDuringaRootCanalTreatment

Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.

You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.

But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?

First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.

Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.

Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.

Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.

You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.

If you would like more information on root canal therapy, 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 “A Step-By-Step Guide to Root Canal Treatment.”