Hidden Cavity Revealed in Between Two Teeth

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Dentist is like a detective.  Sometimes the cavity can be inconspicuous.  It might look innocent on the surface but it may be more extensive after dentist worked on the tooth and then the cavity becomes apparent.  For example, for this patient, small cavity is detected on the biting surface of the tooth.  Small black dots in the pits and fissures.

 

Tooth Decay Hidden

 

However, upon closer examination, on the edge or the side of the tooth near the next adjacent tooth, there is a greyish shadow under the tooth structure.  There is a small defect on the edge.  This leads to suspicion of cavity in between the two teeth.  So after patient agrees to work on the tooth, I remove the top surface layer of the enamel.  Then I can see clearly that there is a cavity shown by the brownish black area in close contact with the adjacent tooth.

 

Tooth Decay Exposed

 

Thus, not all cavity is all apparent.  Cavity can develop anywhere on a tooth.  Often cavity will develop in between the two teeth.  With regular dental checkup, dentist can help find those cavities and render treatment before it gets much worse.  The consequence of not treating small cavity is that it will become larger and with enough time, the cavity can progress into the nerve pulp of a tooth and cause toothache.

 

Written by Daniel Tee, DDS, MS

Dental Office in Tempe AZ

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

Pain Is Not The Only Reason to Fix A Tooth

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I would like to point that many people have misconceptions that a tooth only needs to be fixed, i.e. getting a dental filling, if there is pain.  If a tooth is already becoming painful or starting to becoming more sensitive, the nerve within the tooth might be affected and the tooth might require some additional treatment like the root canal therapy to alleviate the pain.  A filling is not enough to fix the tooth.  That’s because there might be some underlying dental problems such as dental cavities and infection that is so severe that it affects the nerve within the tooth.  Nerve chamber of the tooth is located at the most inner part of the tooth and only a deep cavity can affect the nerve to elicit painful response.

Another misconception is that some people will wait out the pain.  They might have some pain initially but they would not see the dentist because they hope that the pain will go away.  Sometimes the pain will go away.  Sometimes the pain goes away for the wrong reasons.  If there is an infection to the nerve within the tooth, the bacteria will continue to damage the nerve until the nerve dies.  The deaden nerve will not sense pain but it will continue to rot.  A tooth would sense pain only if there is dental problems.  It is best to see the dentist before the infection gets worse.

There are many other good reasons to see the dentist.  Dental cavity, ulcers, bad breathe, gum recessions, clenching and grinding habits can affect your teeth.  It is best to fix a small cavity before it gets too big.  If you can feel the pain, the cavity may already be too big.  A big cavity takes more effort and costs more to fix.  I as the dentist would recommend people to get routine dental checkup and cleanings at least two times a year.

 

Written by Daniel Tee, DDS, MS

Dental Office in Tempe AZ

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

Hard Reline for Complete Denture

<<  Topic in Denture Dentist Dentistry Dental Office in Tempe AZ >>

 

One of the common complaint for people wearing the complete denture is that the denture is loose.  The most probably cause of this problem is that the “gum” is receded.  The bony ridge inside the patient’s moth is what supporting the denture and these ridges might become shrunken as time goes on.  It is a normal biological process of bone formation and resorption.  With the denture in the patient’s mouth, the denture would be pressing on these ridges.  The side where it experiences the pressure would cause bone resorption.  The process of bone resorption is slow but it is not uncommon to see people who had been wearing the denture for more than 10 years to have shallow ridges.  That’s because the ridges have been shrunken.

Another situation in which the patient might feel the the denture become loose is when the patient just had immediate denture placed in the mouth after the extraction of teeth.  Immediate denture is usually fabricated for patient who have to have unrestorable teeth extracted and needs the immediate teeth replacement for the purpose of eating and esthetics reasons.  At first the immediate denture might be fitted well.  However, with the healing of the ridge following the extraction of teeth, the ridge would heal and the contour of the ridge might change.  Also, the rate of bone resorption within the ridge is the greatest within the first 4 months following the extraction.  Thus, the immediate denture might become loose as result of these natural processes.

In order to compensate for the changes of the bony ridge, a procedure called the hard reline can be done.  The dentist would use the existing denture and apply the impression material onto the base of the denture.  Then denture with the impression material would be seated together onto the ridge and new impression of the contour of the ridge would be formed.  The dentist can resurface the base of the denture according to the new impression of the ridge.  The new denture base should have more intimate relation with the ridge.  This resolves the ridge resorption problem.

 

Written by Daniel Tee, DDS, MS

Denture Dental Office in Tempe AZ — Partial Dentures, Complete Dentures, Removable Dentures, Flippers

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

 

Inlays and Onlays: Better Alternatives to Dental Fillings

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Dental filling is not the only way to fix a cavity.  There is a better alternative to the traditional filling materials and they are inlays and onlays.  They are more durable than the filling materials.

Inlays and onlays are custom-made porcelain jackets used to fill in the cavity after the dentist has excavated all decay from the tooth.  Inlays and onlays are similar to each other.  They are made of the same materials and fabricated with the same process.  Inlays are smaller porcelain jackets covering the innard of the tooth structures.  Onlays are bigger porcelain jackets covering a bigger area and usually they would extend to cover the sharp pointy cusp of the tooth.  These porcelain jackets are made of special type of porcelain that is more durable than the traditional filling materials such as the composite or the amalgam.  They are custom-made in the lab.

The dental process of inlays and onlays are almost like the filling procedures.  After numbing the patient, a dentist would remove all decay in the tooth.  Then depending on the depth of the cavity, dentist might add a base layer for additional insulation to the tooth.  Then the dentist would take impression of the tooth capturing the exact shape of the cavity.  Then, based on the impression model, the lab can make the inlay or onlay.   In the final visit, the inlay or onlay can be cemented.

 

 

Written by Daniel Tee, DDS, MS

Cosmetic Dental Office in Tempe AZ — White Tooth-Colored Fillings, Porcelain Crowns, Veneers, Inlays, Onlays

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

 

Abrasion Defect

Abrasion Defect is caused by mechanical trauma to the tooth around the gumline due to abrasive action of toothbrush.  Usually there is also recession of the gingiva (or gum).  The gingiva receded because there might be underlying periodontal disease or due to repeated mechanical trauma of the toothbrush.  Once the gingiva is receded, the root surface area will be exposed.  The root surface area is more prone to mechanical abrasion because biologically there is no enamel to protect the root area.  Overtime, with repeated tootbbrush abrasion, the neck of the tooth will be abraded and a notch will form.

Abrasion Defect

Abrasion Defect at the neck of a tooth.

There are multiple ways to resolve the problem.  One way to undergo tissue grafting of the gingiva to repair the receded gingiva tissue.  This way will help to cover up the root surface area.  Another way is to put a bonded filling to repair the tooth.  Utlimately, the source of the problme needs to be correct which is to minimize the abrasion of the toothbrushing.  Patient can use a toothbrush with a soft bristle.  Also, method of toothbrushing can be modified.  Patient can use the toothbrushing method called the roll method which is more gentle on the gingiva.  By repairing the tooth, it not only restores the cosmestic aspect of the tooth but also protects the tooth from further damage in that area.

 

Written by Daniel Tee, DDS, MS

Cosmetic Dental Office in Tempe AZ — White Tooth-Colored Fillings, Porcelain Crowns, Veneers, Inlays, Onlays

Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona. Practicing General Dentist

 

Biopsy Provides Early Detection of Oral Cancer

Oral cancer can happen within the soft and hard tissue around the oral cavity.  It is benefitial to detect oral cancer in its early stage because early detection allows for early treatment and it can save lives.  Dental professional is one of the front line in mankind’s combat against oral cancer because dental professional works around the oral cavity and can help see if there are any changes to the patient’s oral health.  This does not only include detection of cavity and restoring missing teeth.  But in addition, dental professional can perform intraoral and extraoral examination to detect any abnormality in the soft tissue and the bony ridge through visual, tactile and also clinical xray imaging methods.

Some ulcers in the mouth may heal over time.  However, if there is a lesion that does not heal itself and persist or may even enlarge over time, biopsy can be done to verify the type of lesion.  Usually, this procedure only requires local anesthetics.  The dentist would use a scalpel to incise a tissue sample, and then put it into a jaw containing formalin.  The dentist would send this tissue sample to the pathology lab for evaluation.  A report will show whether the suspect lesion is cancerous or not.  If it is cancerous, a followup referral to specialist is given to patient.

Oral Lesion

Oral Lesion on the Cheek Mucosa.

An early detected cancerous lesion can be treated with excisional biopsy because the affected area is often self-contained and can be readily cut out from the surrounding healthy tissue.