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Posts for category: Dental Procedures

By Kathleen M. Geipe, DDS, PA
April 08, 2019
Category: Dental Procedures
Tags: root resorption  
CatchRootResorptionEarlyforBestChancesofSavingYourTooth

As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.

Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb).  It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.

It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.

We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.

Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.

At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.

If you would like more information on diagnosing and treating root resorption, 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 Resorption: An Unusual Phenomenon.”

GetAheadofaDevelopingCross-BitewithThisEarlyInterventionMeasure

Applying braces or clear aligners to move misaligned teeth is only part of an orthodontist's overall mission to eliminate poor bites (malocclusions). Sometimes a malocclusion isn't caused by the teeth at all—the size of the jaw is the problem!

One type in particular, a cross-bite, often happens because the upper jaw has developed too narrowly. As a result, many of the upper teeth fit inside the lower, the opposite of normal. But a tool called a palatal expander can alleviate the problem if it's applied at an early enough age.

The device works because the upper jawbone initially forms as two halves that fit together along a center line in the roof of the mouth (the palate) running from the back of the mouth to the front. These two bone halves remain separate during childhood to facilitate jaw growth, but eventually fuse around puberty.

Consisting of two sets of wire arms joined together by a hinge mechanism in the middle, the expander device is positioned up against the palate. The orthodontist extends each arm to press against the inside of the back teeth, then adds more outward pressure by turning the mechanism in the middle with a small key. During wear, the patient or caregiver will turn the mechanism in the same way to keep up the pressure on the two sides of the jaw.

This continual pressure keeps the two bones moving away from each other and maintaining a center gap between them. In response, more bone forms on the two halves to fill the gap. In time, the newly formed bone should widen the jaw enough to correct any developing malocclusion.

Timing is everything with a palatal expander—if not used before the jaw bones fuse, the patient will need a surgical procedure to separate the bones to pursue treatment. To catch the problem early enough, children should have an orthodontic evaluation on or before they turn six. An orthodontist may be able to identify this or other emerging bite problems and intervene before it becomes worse. Taking this approach can help save you and your child more expensive orthodontic treatment down the road.

If you would like more information on correcting 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”

By Kathleen M. Geipe, DDS, PA
March 09, 2019
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

By Kathleen M. Geipe, DDS, PA
February 27, 2019
Category: Dental Procedures
HeresWhatyouNeedtoKnowaboutaRootCanalTreatment

A root canal treatment is a common procedure performed by dentists and endodontists (specialists for inner tooth problems). If you're about to undergo this tooth-saving procedure, here's what you need to know.

The goal of a root canal treatment is to stop tooth decay within a tooth's interior and minimize any damage to the tooth and underlying bone. This is done by accessing the tooth's pulp and root canals (tiny passageways traveling through the tooth roots to the bone) by drilling into the biting surface of a back tooth or the "tongue" side of a front tooth.

First, though, we numb the tooth and surrounding area with local anesthesia so you won't feel any pain during the procedure.  We'll also place a small sheet of vinyl or rubber called a dental dam that isolates the affected tooth from other teeth to minimize the spread of infection.

After gaining access inside the tooth we use special instruments to remove all of the diseased tissue, often with the help of a dental microscope to view the interior of tiny root canals. Once the pulp and root canals have been cleared, we'll flush the empty spaces with an antibacterial solution.

After any required reshaping, we'll fill the pulp chamber and root canals with a special filling called gutta-percha. This rubberlike, biocompatible substance conforms easily to the shape of these inner tooth structures. The filling preserves the tooth from future infection, with the added protection of adhesive cement to seal it in.

Afterward, you may have a few days of soreness that's often manageable with mild pain relievers. You'll return for a follow-up visit and possibly a more permanent filling for the access hole. It's also likely you'll receive a permanent crown for the tooth to restore it and further protect it from future fracture.

Without this vital treatment, you could very well lose your tooth to the ravages of decay. The time and any minor discomfort you may experience are well worth the outcome.

If you would like more information on treating tooth decay, 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: What You Need to Know.”

By KATHLEEN M. GEIPE, DDS, PA
February 26, 2019
Category: Dental Procedures
Tags: dental implants  

Are you thinking of getting dental implants?

Dental implants were discovered more than 30 years ago and technology is advanced enough at your Salisbury, MD, doctor's office, to dental implant repair dental restorations.

Want to know more about dental implants?

Dental implants are biocompatible fixtures surgically placed into the jawbone. Dental implants consist of several parts, such as; a titanium post that's inserted into the jawbone, a screw that secures an abutment over the titanium post, and a crown matching the rest of your teeth to complete your smile.

Dental implants in Salisbury, MD:

The procedure is straightforward. The titanium post is surgically inserted into your jaws to replace missing tooth root. It provides stability and strength, and prevents weakening and shrinkage of the jawbone.

After inserting the titanium post, the dentist seals your gums and allows 3 to 6 months for osseointegration (a process of the post fusing to the rest of your jawbone) to occur.

After healing is complete, your Salisbury dentist re-opens the area above the titanium post, inserts a screw, places an abutment above the screw, and secures a crown on top that matches the rest of your teeth.

How do you fix a dental implant crown?

Repairing dental crowns depends on the severity of the dental crown damage.

For minor breaks or cracks, your doctor buffs and reshapes your crown in a single appointment without anesthesia.

For severe fractures or cracks, this means the structure of your dental crown is compromised and you'll need a new crown. Your doctor will take impressions of the tooth, send them to be made at which will then be sent to a lab and new custom crown(s) are made to match the rest of your teeth.

If you need dental implants or need to restore a dental implant crown, then you need to call your Salisbury, MD, dentist, Dr. Kathleen Geipe, by calling (410) 543-0599 today!