Alan J. Kossman, DDS
916 Belvidere Road
Belvidere, IL 61008
815-544-3111

EffectiveHygieneisKeytoPreventingEnamelWhiteSpotsWhileWearingBraces

Finally — your braces are off! A look in the mirror reveals a straighter, more attractive smile. Unfortunately, it may also show something not so attractive — tiny, chalky spots on your teeth.

These “white spot lesions” are created by acid remaining too long in contact with the enamel, causing it to lose minerals at those places. The acid comes from plaque (a thin film of bacteria and food particles) that brushing and flossing fail to remove. Snacking on foods and beverages with added sugar or high acid content may also make it worse.

Besides their unattractiveness, these spots can lead to tooth decay — so it’s important to try to prevent it. Limiting sugar-added snacks and acidic beverages to mealtimes will help, but the main key to preventing lesions is more thorough brushing and flossing.

Because of the braces, this can take longer to do than if you weren’t wearing them. It’s also more difficult maneuvering your toothbrush or floss around the orthodontic hardware. You can improve thoroughness and access by using a powered brush or one specially designed for use with braces. And, a water flosser that removes plaque between teeth with a pulsating spray of water is an effective alternative to string floss.

Even if (despite your best efforts) some lesions form, we can still treat them. Resuming normal hygiene practices after braces may take care of it — if not, we can strengthen the affected areas of the enamel with pastes, gels, or other topical fluoride applications. We can also use a technique called caries infiltration that injects tooth-colored resin (often used for cosmetic dentistry) beneath the white spot to harden it, and leave it more translucent in resemblance of normal enamel. If these fail to produce satisfactory results, we can use cosmetic bonding that permanently covers the tooth with resin or veneers.

It’s best, though, if you can prevent the lesions while you’re wearing braces. Besides daily hygiene, be sure to keep up regular dental visits for teeth cleaning. Your efforts will go a long way toward keeping your newly aligned teeth bright and blemish-free.

If you would like more information on dental care and hygiene while wearing braces, 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 “White Spots on Teeth during Orthodontic Treatment.”

YoumayNeedOrthodonticWorkBeforeGettingaDentalImplant

For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.

But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.

We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.

But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.

Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.

There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.

If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.

If you would like more information on restoring your smile after losing teeth, please contact us or schedule an appointment for a consultation.

By Belvidere Dental
January 21, 2018
Category: Oral Health
Tags: baby teeth  
WhyitsWorththeEfforttoSaveaProblemBabyTooth

There are usually two moments when primary (“baby”) teeth generate excitement in your family: when you first notice them in your child’s mouth, and when they come out (and are headed for a rendezvous with the “tooth fairy”!).

Between these two moments, you might not give them much thought. But you should—although primary teeth don’t last long, they play a pivotal role in the replacing permanent teeth’s long-term health.

This is because a primary tooth is a kind of guide for the permanent one under development in the gums. It serves first as a “space saver,” preventing nearby teeth from drifting into where the permanent tooth would properly erupt; and, it provides a pathway for the permanent tooth to travel during eruption. If it’s lost prematurely (from injury or, more likely, disease) the permanent tooth may erupt out of position because the other teeth have crowded the space.

That’s why we try to make every reasonable effort to save a problem primary tooth. If decay, for example, has advanced deep within the tooth pulp, we may perform a modified root canal treatment to remove the diseased tissue and seal the remaining pulp from further infection. In some circumstances we may cap the tooth with a stainless steel crown (or possibly a white crown alternative) to protect the remaining structure of the tooth.

Of course, even the best efforts can fall short. If the tooth must be removed, we would then consider preserving the empty space with a space maintainer. This orthodontic device usually takes the form of a metal band that’s cemented to a tooth on one side of the empty space with a stiff wire loop soldered to it that crosses the space to rest against the tooth on the other side. The wire loop prevents other teeth from crowding in, effectively “maintaining” the space for the permanent tooth.

Regular dental visits, plus your child’s daily brushing and flossing, are also crucial in preventing primary teeth from an “early departure.” Keeping them for their full lifespan will help prevent problems that could impact your child’s dental health future.

If you would like more information on the right care approach for 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 “Importance of Baby Teeth.”

26MillionFansLikeJustinBiebersChippedTooth

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”

By Belvidere Dental
December 22, 2017
Category: Oral Health
TheImportanceofBabyTeeth

Ah, the baby teeth: those cute little pearl buttons that start to appear in a child’s mouth at around 6 to 9 months of age. Like pacifiers and bedtime stories, they’ll be gone before you know it — the last usually disappear by age 10-13. So if the dentist tells you that your young child needs a root canal, you might wonder why — isn’t that tooth going to be lost anyway?

The answer is yes, it is — but while it’s here, it has some important roles to play in your child’s development. For one thing, baby teeth perform the same functions in kids as they do in adults: Namely, they enable us to chew, bite, and speak properly. The primary teeth also have a valuable social purpose: they allow us to smile properly. If a baby tooth is lost prematurely at age 6, the child may suffer detrimental effects for five years or more — and that’s a long time for someone so young!

Even more important, baby teeth have a critical function in the developing mouth and jaw: Each one holds a space open for the permanent tooth that will eventually replace it — and it doesn’t “let go” until the new tooth is ready to come in. If a primary (baby) tooth is lost too soon, other teeth adjacent to the opening may drift into the empty space. This often means that the permanent teeth may erupt (emerge above the gum line) in the wrong place — or sometimes, not at all.

The condition that occurs when teeth aren’t in their proper positions is called malocclusion (“mal” – bad; “occlusion” – bite). It can cause problems with eating and speaking, and often results in a less-than-perfect-looking smile. It’s the primary reason why kids get orthodontic treatment — which can be expensive and time-consuming. So it makes sense to try and save baby teeth whenever possible.

Procedures like a root canal — or the similar but less-invasive pulpotomy — are often effective at preserving a baby tooth that would otherwise be lost. But if it isn’t possible to save the tooth, an appliance called a space maintainer may help. This is a small metal appliance that is attached to one tooth; its purpose is to keep a space open where the permanent tooth can come in.

If your child is facing the premature loss of a primary tooth, we will be sure to discuss all the options with you. It may turn out that preserving the tooth is the most cost-effective alternative in the long run. If you have questions about your child’s baby teeth, please contact us or schedule an appointment for a consultation.





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