Why Are My Teeth Getting More Crowded?
The natural position that your teeth want to move towards is a result of the complex interaction between your tongue, cheeks, muscles, ligaments around your teeth, and forces from other teeth. Light, constant forces on your teeth will tend to cause them to move toward the position where all the forces are equal. Many people have braces when they are younger and think that once the teeth are all straight, they’ll just stay that way. If only it was so! Those same forces that caused the teeth to end up where they were in the first place, usually are still there and will tend to want to push the teeth back into those same positions. This is why your orthodontist or dentist recommends wearing a retainer for the rest of your life.
Teeth also have a tendency to want to drift forwards / towards the middle. The dental term for this is called “mesial drift”. The most common places you’ll see this are on back molars that are missing a tooth in front of them as well as your front, bottom teeth. Back molars will fall forwards into any space that is there. They never fall backwards. Your front bottom teeth tend to get crowded before anything else. Most orthodontists will bond a small wire around the back of those front bottom teeth to keep them from getting crowded again. This is called a lingual bar retainer.
So what can you do to keep your teeth from getting more crowded?
- If your teeth are significantly crowded, you’ll need braces or Invisalign to straighten them.
- Some mild cases of crowding can be resolved with something easier like a retainer with activated springs. This is only something that can be done by your dentist or orthodontist.
- If you’ve got a retainer, wear it consistently. Most people should wear it every night. After you’ve been wearing it for several years
- If you don’t have a retainer, consider getting your dentist, orthodontist, or an online dental lab to make one for you.
- Some people have a very active tongue that pushes forward on the front teeth and causes a space to open up between them. This is called a tongue thrust. Certain types of exercises can help you reduce this or sometimes you’ll need help from an orthodontist or speech pathologist.
- Avoid any types of habits that are putting force on your teeth. This can include consistent sucking on fingers or anything else. Some people like to hold objects in between their teeth which can damage or move them.
Am I Too Old To Straighten My Teeth?
A common question I get asked by adult patients is whether they’re too old for braces or Invisalign. There is an idea out there that your bone changes as you get older and moving your teeth no longer becomes possible. Good news, this isn’t true!
I still remember when I was younger, my grandfather turned 65 and decided that after all those years he wanted to straighten his teeth. He ended up doing Invisalign with his dentist and got the straight teeth he wanted with no complications.
There are a couple of things that tend to be more common in older age that can complicate orthodontic treatment. First, if you’ve got significant bone loss around your teeth due to gum disease, orthodontic treatment may not be a good idea for you. If you had gum disease in the past that is now under control and you’ve still got decent bone support around your teeth, orthodontic treatment can still a good option for you. When in doubt, ask your dentist or orthodontist if you’re a candidate.
Secondly, a lot of my older patients have many bridges, implants, or missing teeth. These things can complicate orthodontic treatment. Bridges and implants can’t move with braces while missing teeth can make it harder to move certain teeth. Again, have your dentist or orthodontist take a look to see if any these things will cause a problem for you.
If you are older, don’t let it keep you away from straightening your teeth if it is something you really want to do!
Six Month Smiles Review
Have you seen your dentist advertising something called “Six Month Braces”, Six Month Smiles”, or something similar? Sounds too good to be true right? Let’s take a look at what you can expect with this type of treatment.
Six Month Smiles and similar systems are a set of orthodontic treatment systems designed specifically for use by general dentists. The goal with these types of systems are to align your front teeth to give you a better smile without changing anything with the back teeth. This is what allows the treatment time to be so short (usually 6 to 9 months on average). The procedure involves your dentist placing clear brackets on your teeth and primarily using white coated nickel-titanium wires to level and align your teeth.
Most orthodontists aren’t terribly happy with general dentists doing more orthodontics. To understand why this is you’ve got to understand how dentists and orthodontists are trained. When I was in dental school, almost no time was spent on orthodontics. The basic speech we got was that if a patient needs braces, you should send them to an orthodontist and not try to do it yourself. Orthodontists on the other hand are taught to treat almost every single case to perfection, no matter how long that process takes. There are very specific guidelines on what is considered a “perfect” case and that is what they shoot for. Orthodontists without fail are some of the smartest people who graduated from dental school. The top 4 people in my class all went on to become orthodontists. Unfortunately, a lot of what comes with that can be a rigid and perfectionist mindset, which is great for certain things and not so great for others.
Here’s my thought on it. Most adult patients don’t want absolute perfection of all teeth, front and back. They want crowded teeth to not be crowded and they want spaces closed. They want a nice smile. They don’t want to wear braces forever. They don’t want to have to mortgage their house to pay for it. There are some exceptions to this. Some adults have back teeth that don’t come together well, teeth that are tipped over, or really crowded or spaced out teeth. These cases should absolutely be treated by an orthodontist.
Six Month Smiles and Six Month Braces work great for their intended purpose. They do a great job at getting a good cosmetic result in a short time frame. The downside with these systems is that the general dentists who use them usually don’t have nearly as much orthodontic experience as what you’d get with an orthodontist. If something goes wrong the case ends up being more complicated, the dentist doesn’t have the same tool bag to fix it that an orthodontist does.
So to recap here are the major pros and cons of doing Six Month Smiles…
Pros of Six Month Smiles
- Short treatment time
- Less costly (on average)
- Good cosmetic result
Cons of Six Month Smiles
- Usually not as good of a result as you could get with an orthodontist
- Can’t be used to treat all types of cases
- Problems that occur aren’t always able to be dealt with by the dentist
If you’re considering doing Six Month Smiles, figure out what your goals are for straightening your teeth before you make a final decision. There isn’t just one right answer. Figure out what works best for you based on the all the pros and cons.
Crowns In A Day
Many dentists now advertise that they can do your crown in a single visit. They’ve probably got a poster or banner that looks like this one. CEREC is the brand name of the first system that allowed dentists to do this. CEREC is still the leader in the industry but there are a lot more options that dentists may use nowadays. Let’s take a look at the pros and cons of doing things this way.
First, we’ve got to understand the traditional way a crown is done. Before digital impression technology came about this is how crowns were always made. The dentist prepares your tooth for the crown, takes an impression of the prepared tooth, and makes a temporary crown to go on your tooth for about two weeks while the dental lab makes your permanent crown. At the second visit several weeks later, they take off the temporary crown, try on the permanent crown, and then cement it on if everything fits well. Many dentists still use this exact method. Some dentists will use this same method but instead of using those impressions with the goop, they’ll take a digital impression of your tooth and send that off to the dental lab instead. Either way, it’s still a two visit process.
With single visit crowns, the dentist prepares the tooth normally and then takes a digital impression of your tooth with a special camera. Computer software is used to design a crown for your tooth right there and the crown is then cut out of a block of porcelain on a special milling machine. The dentist then glazes it or polishes it and then cements it on your tooth the same day.
Pros to Single Visit Crowns
- It’s only a single visit. That means only getting numb once. Only going to the dentist once. I think everyone would agree this is a major positive.
- Because they always use digital impressions, the fit of the crown is usually excellent.
- You don’t have to wear a temporary crown. Temporary crowns tend to come off pretty easily and can be a pain in those couple of weeks.
Cons to Single Visit Crowns
- The appointment is quite a bit longer. Instead of an hour and half you’re probably looking at 2 1/2 hours. This can vary quite a bit based on the dentist.
- The crowns on average don’t look as natural as a dental lab fabricated one. Really talented dentists can make beautiful crowns with these systems but on average, they’re not nearly as talented as a dental lab that does it all day.
- Some of the materials used in these types of crowns tend to be a bit more untested than their lab created brethren. There have been a couple of misfires in the last several years with materials that were supposed to be good but then started having problems a couple of years out.
- If the dentist only has one type of material on hand, oftentimes that’s what they’ll use every time instead of using the most appropriate material for the case at hand. The first dentist I ever worked with had an early version of one of these systems and he tended to use a subpar material for a lot of teeth which caused a lot of complications.
So at the end of the day, there isn’t a simple yes or no answer to whether one visit crowns are a good idea. It really is a big “it depends” depending on your specific situation and the dentist who is doing your crown.
Personally, I’d have no problem getting a crown done on one of these systems, as long as the dentist was using the best material for the situation. If you do go to a dentist who offers this, make sure you ask some basic questions about why they’re picking whatever material they’re using. If a crown created by a lab is a better option, it’s definitely worth it to wear a temporary crown for a couple of weeks in order to have a better long term result.
Tooth Killers
Want your teeth to last your entire life? Then avoid these foods, drinks, and bad habits that kill your teeth!
Habits:
If you remember one single thing from all of this, it’s that teeth are for eating and nothing else. Don’t use them as a tool to accomplish other tasks.
Chewing ice – Your teeth are extremely tough but aren’t meant to stand up to constant wear and tear from crunching into hard things. Over time you’ll develop cracks in your enamel that will progress to broken teeth. I saw an 18 year old patient the other day who had cracked a back molar (no previous fillings) just from her ice chewing habit.
Chewing your nails – This causes wear especially on your front teeth. It can also lead to jaw pain due to constantly pushing your front jaw forward to chew on your nails.
Opening bottlecaps – I’ve seen a ton of injuries from people opening bottles with their teeth. The most common injury from this one is chipping off a corner of one of your front teeth.
Brushing too hard – Brushing too hard can wear away both your gum tissue as well as your teeth. Use a soft bristled toothbrush and brush gently.
Resting a pencil or any other object (like hairpins, etc) in between your teeth. – This will either move your teeth or wear them down. Either way is bad.
Aggressive toothpick use – Toothpicks can be really damaging to health of your gums around your teeth. When the gums recede, the bones recede as well.
Tongue piercings – These are super damaging to your teeth.
Sucking on cough drops, mints, or lozenges that have been sweetened with sugar – This is a recipe for getting cavities. I’ve had plenty of patients who tell me they have a great diet, but find out they have a ton of cavities just from this.
Smoking – OK so this is more of a long term one, but it’ll still kill your teeth. Smoking increases your risk of gum disease, the #1 reason why people lose teeth.
Foods and Drinks:
Soda of any kind – The sugar and acid combo in sodas cause cavities to develop rapidly. Avoid drinking them on any regular basis. I believe soda is the single biggest reason I have a job as a dentist.
Sports beverages – You may think these are healthier or better for you but for the most part, they’re really not. Drink water instead.
Sucking on lemons or other citrus fruits – Just like with soda, the acid and sugar is a tooth killer.
Popcorn kernels – Popcorn is great right up until that moment you crunch down on a kernel and break your tooth.
Hard nuts – Some of the softer nuts aren’t a problem, but consistently eating hard nuts can certainly do damage to your teeth especially if you’ve had large fillings on your teeth in the past.
Frozen vegetables or fruits – Just as bad as chewing ice. Blend them up in a smoothie instead.
Why Do Dental Crowns Come Off?
So you had a bunch of dental work done 15 years ago and everything has been going great. Then one day you’re eating a nice soft slice of bread and “pop”, you feel something loose in your mouth and when you take a closer look it is your dental crown that has come off. First of all, get into your dentist ASAP to get it evaluated. Things can shift around if the crown is off too long. If you can’t get in right away, check out our guide on temporarily recementing a crown that has come off.
Now, let’s take at the many different reasons why a dental crown might come off.
- The cement holding it in place has dissolved out from under the crown. – There are very few materials that are able to withstand the harsh environment of the mouth. Over time, certain types of cement can be dissolved and when has dissolved, the crown will loosen up and come off.
- The cement didn’t bond very well to the tooth or the crown. – Certain types of dental cements are tolerant of some amounts of water. Other types of cements require absolute isolation from any saliva in your mouth. If any of the oil from the dental drill or saliva from your mouth gets on the tooth it can make it so that the bond of the cement to the tooth doesn’t set up correctly. Over time this will cause the crown to loosen and eventually come off.
- There is decay underneath the crown – This is the most common reason crowns come off. Cavities can start to develop at the interface between your tooth and the crown. This decay eventually spreads underneath the crown until a large portion of the tooth underneath is soft. As you can imagine, a crown can’t hold on terribly well to a tooth with a soft or broken down surface so it comes off. In these situations you need a new crown, or if it really bad a root canal or extraction.
- Your bite loosened it up – If you have a very strong bite or especially if you grind your teeth, this constant force in all directions can slowly break the bond of the cement. Once your dentist has recemented it back on, your best option is to wear a nightguard to reduce those forces on your tooth and crown.
- The tooth or filling underneath broke – Sometimes the tooth underneath will break all the way off. Instead of seeing a hollow crown, you’ll see a crown part of your tooth still inside the crown. This tends to happen more so with front or premolar teeth as they are much smaller and can’t handle significant lateral pressure once weakened by decay or a crown. Usually the teeth can’t be saved when this happens.
- The tooth was already short to begin with. The longer and more parallel the tooth surface when it is prepared for a dental crown, the better it will stay on. Dentists try to maximize this as much as possible but certain teeth, especially your last molars in the back, tend to be very short no matter what the dentist does. These teeth tend to have crowns come off at a much higher rate than any other teeth.
When you see your dentist, ask them why they think the crown came off. Oftentimes they’ll have at least a good guess as to why. In some situations there are things you can do (like the things I mentioned above) to keep the crown from coming off again.
Can Pacifiers Cause Permanent Damage?
Ever seen a four or five year old child still using a pacifier? Unfortunately, I have and not just one or two children either! It seems like pacifier use is becoming extremely common these days, which for the most part is fine. I’ve got four kids of my own, and I definitely understand why! Those early years with your kids are challenging enough and anything you can do to help keep your little one happier seems worth it. Pacifiers help soothe young children and also reduce the risk of SIDS. One of the greatest things about pacifiers is that you can take them away when it is time to do so. The problem is that most parents either don’t know when they should stop them or are afraid to upset their child by doing so.
No matter how hard it is, you need to have your child stop using a pacifier by age 2. The long term use of a pacifier beyond age 2 can cause permanent damage with the proper position and alignment of the jaw, roof of the mouth, and teeth. Any changes in these areas prior to age two will resolve all on their own as long pacifier use is stopped. The typical pattern I see with children who have used pacifiers too long is a high narrow roof the mouth, narrow top arch of teeth, and front teeth that no longer come together when biting down. The only solution for this is an early, extended, and expensive course of orthodontic treatment. From start to finish you might be looking at nearly $10,000 in orthodontic costs to fix everything.
Another non-dental complication of pacifier use is an increased rate of ear infections. The constant suction produced by pacifier use increases the size of a tube that leads to the middle ear. This allows more bacteria, etc to travel up the tube and cause infections.
So how do you get the child to stop using it? Parents have tried all sorts of different methods including dipping the pacifier in something distasteful like vinegar, cutting parts of it off, putting a hole in it, and ultimately just taking it away. No matter how you do it, the couple of days to a week where you make the change are going to be difficult. As long as you stick with the process, it will be over quickly and your child will re-adjust to life without it sooner than you think. One of the worst things you can do is take it away and give it back several times over. Once you commit to the process just go for it!
Chew Gum For A Healthy Mouth!
I get asked quite often whether gum chewing is good for your mouth. Real simple answer… Yes and Yes! Chewing gum has been proven over and over to have many benefits for your oral health. Here are 6 of the major ways that gum helps keep your mouth healthy!
#1 Chewing gum increases your saliva flow. The biggest benefit to come of this is an increased buffering capacity of your mouth. What this means is that your mouth can bring it’s pH back to a normal level much more quickly after eating or drinking something acidic. This is especially important if you drink soda, fruit juice, or sports drinks on a regular basis as all of these tend to be quite acidic.
#2 Chewing gum reduces cavities. Most of this is a result of the increased saliva flow and buffering capacity that we talked about before. There are huge decreases in cavity development with consistent chewing of gum, especially after meals.
#3 Chewing gum reduces plaque on your teeth. This is a result of the increased saliva flow as well as the mechanical action of the gum on your teeth. It’s estimated that people only clean 35-40% of the plaque off their teeth when brushing. Gum can definitely help improve this for you. Reduced plaque will help keep your gums healthy.
#4 Chewing gum reduces bad breath. This effect comes from the increased saliva flow as well as the flavorings in the chewing gum. This effect tends to be temporary as researchers found that the odor returned to regular levels within three hours of stopping chewing the gum.
#5 Chewing gum with baking soda as an ingredient can reduce stains. Arm and Hammer makes a couple of gum products containing this. The effect can be seen after about 4 weeks of chewing with it.
#6 Chewing gum helps with dry mouth. As long as your salivary glands haven’t been destroyed by radiation or other rare medical conditions, chewing gum with increase your saliva flow helping your mouth feel dry. People with dry mouth tend to develop cavities much more quickly so chewing gum can be an easy solution to significantly reduce that risk.
So obviously you should chew gum right? Now which one to pick?
Your best option is a xylitol based gum. In addition to all the benefits listed above, xylitol also has an anti-cavity effect. This effect of xylitol has been shown to last up to several weeks after chewing a xylitol based gum!
The next best option is a sorbitol based gum. Researchers have done several studies on the effects of sorbitol based gums. One study followed participants for three years. One group of people chewed gum after each meal and the other group didn’t. At the end of the three years, the gum chewing group developed significantly less cavities than the control group.
I’d avoid using a sugar based gum on a routine basis. While the act of chewing the gum seems to cancel out the sugar content, you don’t get the same benefits as you get with xylitol or sorbitol based gums.
Common Toothpaste Ingredients
There are so many different types of toothpaste out there, all with different ingredients. Which ones are important? Which ones sometimes cause allergic reactions? Can any cause harm? Let’s find out!
- Toothpaste has a pretty wide range of components. The standard formula includes the following categories in these amounts…
- Abrasives to aid in removing plaque (20-40%)
- Water (20-40%)
- Moisturizing components (20-40%)
- Foaming agents (1-2%)
- Binding agents (2%)
- Flavoring agents (2%)
- Sweetening Agents (2%)
- Therapeutic agents (up to 5%)
- Coloring or preservatives (1%)
Cavity Protection
Fluoride – Using a fluoride toothpaste is one of the single biggest things you can do to help prevent cavities. While, I’m on the fence about fluoride in the water supply, I’m am strongly for using fluoride toothpaste every day. The benefits of this are huge and you don’t get the full body exposure that you get with fluoride in in your drinking water. Most toothpastes come with 0.22% sodium fluoride (1100 parts per million / ppm) or 0.76% sodium monofluorophosphate (1000 ppm). There are some extra strength toothpastes that contain 1500 ppm, which has been shown in studies to be more effective in controlling cavities. Some Crest brand toothpastes (such as Crest Pro Health) contain a slightly different form of fluoride known as stannous fluoride. This type of fluoride helps protect against cavities as well as gingivitis but it does tend to cause significant staining in some people. 1500 ppm is the upper limit for over the counter toothpastes. A 5000 ppm toothpaste is available by prescription from your dentist or physician.
Xylitol – Xylitol is an alternative sweetener that has shown to have some benefits in preventing cavities. It isn’t nearly as effective as fluoride but can be a good adjunct or for young children who can’t use fluoride toothpaste yet.
Plaque and Gingivitis Control
Triclosan – Colgate is the only brand of toothpaste that uses triclosan as they have a patent on this formulation. Triclosan works as an antibacterial agent and reduces the total bacteria load in your mouth. Studies have shown that it helps reduce plaque and tartar build-up more so than other toothpastes that don’t contain it. There have been some concerns about triclosan as a hormone disruptor. To date, no studies have shown any problems arising from it.
Tartar Control
Tetrasodium pyrophosphate – Some people tend to build up tartar at a much higher rate than others and these people are the ones who benefit most from a tartar control toothpaste. Tartar build-up on your teeth is mostly a result of excess calcium and magnesium in your saliva. Tetrasodium pyrophosphate binds to these minerals and makes it so that they can’t be deposited on your teeth.
Abrasiveness and Whitening
Whitening in a toothpaste isn’t so much about specific ingredients, but more about how abrasive the toothpaste is. The more abrasive the toothpaste, the better you’re able to to remove heavy stains on the outside of the tooth (sometimes at the expense of some of your tooth enamel). Common abrasive ingredients in toothpaste are chalk (calcium carbonate) or baking soda. A lot of toothpastes also have silicon or aluminum oxides today. I’ve put together a chart with the estimated abrasiveness ratings of many of the toothpastes currently out there. Higher values mean that the toothpaste is more abrasive. All things else being the same, you’d like a toothpaste that is less abrasive.
Low abrasive toothpastes are usually considered 75 or below.
Medium abrasiveness is 75-100.
Highly abrasive is 100-150.
Extremely abrasive (as in don’t use) is 150+.
The FDA recommends that you never brush with product with an abrasiveness level over 200. I personally think you should use a toothpaste with less than 100.
| Toothpaste | RDA Value |
| Brush w. plain water | 4 |
| Plain Baking Soda | 7 |
| Biotene Drymouth Toothpaste | 23 |
| Arm and Hammer Dental Care | 35 |
| Sensodyne Pronamel | 35 |
| Arm and Hammer Advance Whitening/Peroxide | 42 |
| Oxyfresh Original | 45 |
| Arm and Hammer Dental Care Sensitive | 48 |
| Tom’s of Maine Sensitive | 49 |
| Arm and Hammer Peroxicare Regular | 52 |
| Rembrandt Original | 53 |
| Arm and Hammer Dental Care PM Bold Mint | 54 |
| Tom’s of Maine Children’s | 57 |
| Clinpro 5000 Fluoride Toothpaste | 62 |
| Rembrandt Mint | 63 |
| Colgate Regular | 68 |
| Arm and Hammer Advance White Sensitive | 70 |
| Colgate Cavity Protection | 70 |
| Colgate Total | 70 |
| Colgate Total Mint Gel | 72 |
| Biotene Original | 78 |
| Sensodyne Original | 79 |
| Colgate Sensitive Maximum Strength | 83 |
| Biotene Sensitive | 85 |
| Aquafresh Sensitive | 91 |
| Rembrandt Plus | 94 |
| Kid’s Crest | 95 |
| Crest Regular | 99 |
| Sensodyne Extra Whitening | 104 |
| Arm & Hammer Advance White Paste | 106 |
| Crest Sensitivity Protection | 107 |
| Colgate Optic White Platinum | 110 |
| Prevident 5000 | 112 |
| Aquafresh Whitening | 113 |
| Arm & Hammer Advance White Gel | 117 |
| Colgate Whitening | 124 |
| Colgate Sensitive Pro-relief | 127 |
| Crest Extra Whitening with Scope | 130 |
| Crest Pro-Health with Scope | 130 |
| Crest Extra Whitening | 130 |
| Ultra Brite Original | 133 |
| Colgate Enamel Health Sensitivity Relief | 135 |
| Colgate Enamel Health Whitening | 135 |
| Colgate Sensitive Max Strength | 140 |
| Crest MultiCare Whitening | 144 |
| Ultra Brite Advanced Whitening | 145 |
| Colgate Tartar Control | 180 |
| Crest Pro-Health | 189 |
| Colgate 2-in-1 Tartar Control/Whitening | 200 |
Combating Sensitivity
Potassium nitrate – Your teeth have millions and millions of tiny tubes running through them. When your teeth become very sensitive, one method to decreasing the sensitivity is to start plugging up those tubes in your teeth. This is what potassium nitrate does if you use it consistently. One thing most people don’t know is that you have to use a sensitivity toothpaste containing potassium nitrate for about two weeks before you get the effects. Some common toothpastes that contain potassium nitrate are Sensodyne, Crest Sensi-relief, or Colgate Sensitive.
Sodium citrate – This works in a similar manner
High fluoride toothpastes – These toothpastes are only available by prescription. The most common brand is known as Prevident 5000 but there are many other generic versions as well. The 5000 stands for 5000 ppm of fluoride in the toothpaste. Standard toothpastes that you can purchase at the store only have 1000-1500 ppm. The higher levels of fluoride help strengthen your enamel and also help plug up the tubes in the teeth in a similar way to potassium nitrate.
Detergents / Foaming Agents
Sodium lauryl sulfate (SLS) – Ever wonder why your toothpaste foams when you brush with it? This ingredient is the reason why. SLS is a surfactant that is used in many products including toothpastes, shampoos, bodywashes, soaps, and detergents. There have been some concerns about SLS and cancer. To date, studies have found no link whatsoever between them. The one problem that SLS products do cause in some people are gum or skin irritation. I have quite a few patients in my dental practice who are mildly allergic to SLS and it causes them to develop mouth sores if they use a toothpaste that contains it. If you’re one of these people, look for a SLS free toothpaste. They can be more difficult to find but they are out there. Tom’s of Maine is my favorite SLS free toothpaste.
Flavorings and Other Miscellaneous Ingredients
Sweeteners – Obviously, sugar in toothpaste is a bad idea, although early formulations of toothpaste did contain honey and sugar products! The most common sweeteners currently in toothpaste include saccharin, sorbitol, and mannitol, and xylitol.
Polyethylene plastic beads – Some toothpastes have used colored plastic beads just to make the toothpaste more cosmetically appealing. These beads have a tendency to get stuck under the gumline causing a little bit of discoloration and occasionally irritation. I see them on a somewhat regular basis in patients in my dental practice. Most companies are phasing these out now due to several negative articles that have come out about them.
Cinnamon flavorings – These types of flavorings also have a tendency to cause some gum irritation in a small percentage of people. If you’re consistently getting mouth ulcers and you use anything cinnamon flavored, try using something else to see if it helps.
Putting Off Dental Treatment
I saw a patient today who I’d recommended a crown on about 6 months ago. She came in to the office and said, “OK, I’m ready to get it done!”. When I took a look at the tooth, the tooth had a crack that went all the way through it. There was no way to save the tooth and it had to be pulled. Unfortunately this is an all too common situation. I’ll see someone, recommend treatment, and they’ll disappear for 6 months to a year. Sometimes they don’t get treatment done because they can’t afford it. In other situations they don’t do it because they’re too busy or just don’t make it a priority. When they come back that small cavity has turned large, that medium sized cavity has turned into a root canal, or that tooth that needed a crown has turned into an extraction. In just about every situation, it ends up costing a whole lot more money to fix the new problem. So when can you safely put off dental treatment and when should you get it done as soon as possible?
Cavities:
Small cavities usually can be put off for some time. In the early stages they tend to spread slowly. If you maintain a good diet and brush and floss well, sometimes they won’t spread at all.
Medium to large cavities should not be put off for any long amount of time. These cavities tend to spread rapidly and the tooth often ends up needing a crown, root canal, or extraction the longer you wait. Crowns, root canals and dental implants are far more expensive than a filling.
Root Canals:
Teeth that need root canals shouldn’t be put off. They can either get so bad that they need to be extracted or they can get infected, causing you swelling, pain, and in rare cases infections that spread to the rest of the body.
Crowns:
Teeth that need crowns largely depend on the specific situation. If it needs a crown because of a cavity, you should get it done as soon as possible. If it needs a crown because it has already had a root canal, you should get it done as soon as possible. If you need a crown because the tooth is already broken, you can usually put it off for longer than most other cases as long as it isn’t causing you pain.
Orthodontics:
When orthodontic treatment is recommended for younger children (age 7-12) you should do it soon. Certain types of orthodontic treatment are only possible while a child is growing. Once the growth plates fuse, correcting some types of problems can become very difficult or impossible.
Orthodontic treatment in the late teenage years or as an adult is not urgent. Nothing will likely change to make things more difficult.
Implants:
Implants should be done soon after having a tooth removed. Your bone shrinks very quickly after having a tooth extracted and in some cases an implant becomes impossible later on unless you have significant bone grafting done.
Gum / Periodontal Disease:
Mild to moderate gum disease can be put off longer than most other types of dental treatment. Severe gum disease should be treated as soon as possible. Gum disease usually doesn’t progress quickly but over time can cause some very significant tooth problems as well as overall health issues.
When in doubt, ask your dentist their honest opinion about how long they would expect before it would become a problem. An honest dentist will usually tell you straight up what problems are urgent and which ones can be put off for some time.