Posts for: December, 2015

TreatingaBabyToothwithInnerDecaycanbeComplicated-butStillNecessary

Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.

If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.

If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.

If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.

A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.

These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.

If you would like more information on treating decay in primary teeth, 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 for Children’s Teeth.”


By Hyannis Dental Associates
December 14, 2015
Category: Oral Health
LamarOdomReboundsFromDentalAnxiety

Professional basketball player Lamar Odom is sometimes known as “the candyman” because of his notorious fondness for sweets. But when his sweet tooth finally caught up with him — in the form of a mouthful of decayed teeth — the six-foot-ten-inch, 230-pound hoops star admitted that he had been avoiding treatment… because he was afraid of going to the dentist!

It took two Kardashians (Khloe and Kim) and a painful toothache to finally persuade Odom to sit in the chair. Once he did, it was found that he needed a root canal, a wisdom tooth extraction, and several fillings. Yet the fretful forward sailed through the whole set of procedures in a single visit, and walked out with a big smile afterward. How did his dentists make that happen?

Put it down to the “magic” of sedation dentistry. With anxiety-relieving medications that can be delivered orally (in pill form or by gas) or intravenously (into the bloodstream), the techniques of sedation dentistry can help even the most fearful patients get the dental care they need. That’s good news for about 50 percent of the population, who admit they’re at least somewhat afraid of the dentist — and even better for the 15 percent who avoid dental care completely due to their fear.

Dentists have a number of ways to ease apprehensive patients through a dental visit. An oral anti-anxiety drug can be given in pill form about an hour beforehand. Nitrous oxide (sometimes called “laughing gas”), which is administered by a mask placed over the mouth or nose, may also be used to relieve anxiety. The calming effects of these medications help make any nervousness melt away — and in many circumstances, mild sedation is all that’s needed to ease the fear.

For lengthier or more complex procedures, intravenous (IV) sedation may be recommended. Unlike deeper (unconscious) sedation, IV sedation doesn’t cause “sleep.” Instead, it puts you in a comfortable semi-awake state, where you can still breathe on your own and respond to stimuli… but without feeling any anxiety. And when the procedure is over, you probably won’t have any memory of it at all.

IV sedation can be administered by dentists who are specially trained and equipped with the proper safety equipment. While sedation is being provided, you will be monitored at all times by a dedicated staff member; when it’s over, you will rest for a while as the medication quickly wears off. Then (as is the case with oral sedation), you’ll need another person to give you a ride home.

Does sedation dentistry really work? Lamar Odom thinks so. “I feel so much better,” he said when his 7-hour procedure was over. “I feel like I accomplished something.”

If you would like more information about sedation dentistry, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine article “Oral Sedation Dentistry.”


Implant-BasedRemovableDenturesaGoodChoiceforPatientswithExtensiveBoneLoss

People who’ve lost all their teeth (a condition known as edentulism) face a decision on how to restore their lost function and appearance. And there are a number of options to consider.

A fixed bridge supported by dental implants, for example, is a good choice for patients who still have sufficient bone structure in their jaw. It’s not a good choice, however, for those with the opposite situation — who’ve experienced significant bone loss which has also affected their facial structure. For them, there’s a better alternative that also uses implants for support — the overdenture.

An overdenture is similar to a traditional denture, in that it’s made of life-like crowns permanently set in denture plastic, and may either partially or fully cover the roof of the mouth. The main difference, though, is that unlike traditional dentures which rest for support on the gum ridges, an overdenture is supported by strategically placed implants that the denture fits over and connects to — hence the name “overdenture.”

There are a number of advantages for an overdenture, especially for patients with bone loss. A removable, implant-supported denture can be designed to replace lost tissues that have altered facial appearance — to “fill in” the face and restore aesthetic harmony. Patients who’ve previously worn dentures will also often find their speech better improved than with fixed bridgework.

Because it’s removable, an overdenture and the underlying gums are easier to clean, which helps inhibit disease and lessen further bone loss. It also allows you to properly care for the denture, which can extend its longevity and reduce future potential maintenance and replacement costs.

If you would like to consider removable overdentures as an option, you should begin first with a thorough oral exam that includes evaluating the status of your bone, jaw and facial structure. From there we can advise you if overdentures are the best choice for you.

If you would like more information on overdentures and other restoration options, 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 “Fixed vs. Removable.”




Hyannis, MA Dental Office
Hyannis Dental Associates
750 Attucks Lane
Hyannis, MA 02601-2902
(508) 778-4488

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