By Peter Brusco DMD
September 19, 2020
Category: Oral Health
Tags: loose tooth  
CalltheDentistImmediatelyIfYouHaveaLooseTooth

Do you remember when one of your baby teeth began to wiggle? You knew it wouldn't be long before it came out, followed by a little something from the “tooth fairy” under your pillow.

Those were the days! But a loose permanent tooth is something else entirely: Often a sign of advanced periodontal (gum) disease, you may be on the verge of losing the tooth forever.

This sad affair begins with dental plaque, a thin biofilm found on tooth surfaces and the ideal haven for oral bacteria that can trigger a gum infection. You might not notice such an infection in its early stages, other than a few initial signs like gum redness, swelling, or bleeding. If these occur, it's imperative you seek treatment promptly.

Without treatment, the infection can spread below the gum line, weakening gum attachments to teeth (which actually hold teeth in place) and eventually doing the same to underlying bone. All of this damage can lead to a tooth becoming loose and eventually falling out.

But it's not inevitable a loose tooth will eventually be lost, though it may require long-term efforts to save it. We may first need to do a bite adjustment, which will often allow a tooth to decrease its mobility. If the mobility has not been reduced enough, we may recommend stabilizing the teeth through splinting: These are techniques used to join the loose tooth to more stable teeth, usually with a thin strip of metal or other dental material.

We'll also need to treat the underlying cause, which in the case of gum disease requires aggressive plaque removal. Our goal is to manually remove all plaque and tartar (calcified plaque) deposits, particularly below the gum line. It may also require surgery to fully access deep pockets of infection. But once we remove the offending plaque, the gums can begin to heal.

The best strategy, though, is to avoid gum disease altogether. You can substantially lower your infection risk by brushing and flossing daily and getting a dental cleaning every six months. Dental visits also allow us to check your gums for any signs of infection that might require prompt action.

A loose tooth for a kid is a cause for celebration. It's the exact opposite for an adult loose tooth. Taking care of your gums with daily hygiene and receiving prompt treatment for any emerging infection could help you avoid it.

If you would like more information on treating gum disease, 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 “When Permanent Teeth Become Loose.”

DirectVeneersOfferaQuickandAffordableAlternativetoTraditionalVeneers

Orthodontics, veneers and other cosmetic dental techniques can turn a less than perfect smile into a beautiful one—but not always very quickly. For example, porcelain veneers can take weeks from planning to installation, including the meticulous work of an outside dental lab to produce veneers that look natural as well as beautiful.

But you may be able to take advantage of another approach, one that often takes no more than a couple of dental visits. Called direct veneers, it's actually a process of bonding and sculpting life-like composite materials to teeth that are heavily stained, chipped or that contain tiny crevices called “craze lines.”

Unlike the similarly-named traditional method, direct veneers don't involve the creation of layered porcelain veneers fashioned by a dental lab. But this newer process is similar to the older one in that some of the enamel must be removed from the teeth in question to provide a suitable surface for the composite material to adhere. This alteration will be permanent, requiring a restorative covering on the treated teeth from then on.

Right before this preparation, though, a dentist typically makes an impression of the patient's mouth. This will be the basis for creating the procedural plan for the dental work, particularly a “trial smile” from similar composite material that can be applied to the patient's teeth before actual restoration work begins. This temporary application gives both patient and dentist an opportunity to visualize the final look, and make needed adjustments in color and shaping.

Once the work plan is finalized, the patient then returns for the actual restoration procedure. The dentist begins by applying and bonding the composite material to the prepared teeth. Then, using a drill and manual instruments, the dentist shapes and smooths the material into a tooth-like appearance that blends with other teeth. The procedure can take a few hours, but it can usually be completed during a single visit.

Although direct veneers may not last as long as porcelain veneers, the process is less costly and requires less time to complete. Direct veneers could be an economical solution for achieving a more attractive smile.

If you would like more information on direct veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic with a firsthand patient account by reading the Dear Doctor magazine article “A New Smile With Direct Veneers.”

By Peter Brusco DMD
August 30, 2020
Category: Oral Health
HowtoCareforYourChildsValuablePrimaryTeeth

Infancy is perhaps the only time in a person's life where a smile with just a few tiny teeth is still endearing. More will come—and then each will gradually depart, succeeded by permanent replacements.

That short lifespan, though, doesn't diminish their importance. Primary teeth not only provide children the ability to eat solid food and develop speech, but they set the stage for future dental health.

The latter arises from primary teeth's role as placeholders for incoming permanent teeth. Because permanent teeth eruption occurs in stages, primary teeth prevent earlier erupted teeth from drifting into the space intended for a later tooth. If they're lost prematurely and other teeth crowd into the space, the intended tooth may not have enough room to erupt properly, cascading from there into a poor bite (malocclusion).

The most common reason for premature loss is an aggressive form of tooth decay in children under 6 called early childhood caries (ECC). About one in four U.S. children encounter ECC, with those in poverty at higher risk. Infection in one tooth can spread to others, including newly erupted permanent teeth.

The goal then is to prevent ECC as much as possible, and initiate prompt treatment should it still occur. A good prevention strategy has two prongs: the actions and habits of parents or caregivers; and the prevention and treatment measures taken by dental providers.

At home, it's important that you wipe your newborn's gums with a clean, damp cloth after each feeding to reduce bacterial growth. As teeth erupt, switch then to gentle brushing with a rice grain-sized amount of baby toothpaste. You should also limit their sugar consumption, including not allowing them to sleep with a bedtime bottle of any liquid other than water.

It's also important that you start your child's regular dental visits around their first birthday. This allows us to detect any developing cavities, as well as apply sealants and topical fluoride to help prevent decay. And should a cavity develop, regular visits help ensure prompt treatment to preserve the tooth.

Your child's set of primary teeth only last a few short years, but their contribution echoes for a lifetime. Taking these measures to protect them from tooth decay ensures they'll fully make that contribution.

If you would like more information on dental care for children, 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 “Do Babies Get Tooth Decay?

YouDontNeedtoPassaFootballLikePatrickMahomestoRemoveaLooseBabyTooth

Kids get pretty inventive pulling a loose primary (baby) tooth. After all, there's a profit motive involved (aka the Tooth Fairy). But a young Kansas City Chiefs fan may have topped his peers with his method, revealed in a recent Twitter video that went viral.

Inspired by all-star KC quarterback Patrick Mahomes (and sporting his #15 jersey), 7-year-old Jensen Palmer tied his loose tooth to a football with a line of string. Then, announcing “This is how an MVP gets their tooth out,” the next-gen QB sent the ball flying, with the tooth tailing close behind.

It appears young Palmer was no worse for wear with his tooth removal technique. But if you're thinking there might be a less risky, and less dramatic, way to remove a loose tooth, you're right. The first thing you should know, though: Primary teeth come out when they're good and ready, and that's important. Primary teeth play an important role in a child's current dental and speech function and their future dental development. For the latter, they serve as placeholders for permanent teeth developing within the gums. If one is lost prematurely, the corresponding permanent tooth might erupt out of position and cause bite problems.

In normal development, though, a primary tooth coming out coincides closely with the linked permanent tooth coming in. When it's time, the primary tooth lets you know by becoming quite loose in the socket.

If you think one of your children's primary teeth is ready, clean your hands first with soap and water. Then using a clean tissue, you should be able to easily wiggle the tooth with little tension. Grasp the tooth with the tissue and give it a little horizontal twist to pop it out. If that doesn't work, wait a day or two before trying again. If it does come out, be sure you have some clean gauze handy in case of bleeding from the empty socket.

Normally, nature takes its course from this point. But be on the lookout for abnormal signs like fragments of the tooth left behind in the socket (not to be mistaken for the top of the permanent tooth coming in). You should also look for redness, swelling or complaints of pain the following day—signs of possible infection. If you see anything like this, make a prompt appointment so we can take a look. Losing a primary tooth is a signpost pointing the way from childhood to adulthood (not to mention a windfall for kids under their pillows). You can help make it a smooth transition—no forward pass required.

If you would like more information about caring for primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Importance of Baby Teeth” and “Losing a Baby Tooth.”

By Peter Brusco DMD
August 10, 2020
Category: Oral Health
Tags: oral health   oral hygiene  
KeepTheseTopFactorsinMindWhenBuyingYourNextToothbrush

Search online for “right tool for the job” and you'll get over a billion results related to everything from baking cakes to repairing cars. It's also just as applicable to oral hygiene.

One of those “right” tools is the humble toothbrush. Most of us use the manual variety whose basic components—a long narrow handle and a bristled head—haven't changed much in a couple of centuries. That hasn't stopped competing manufacturers, however, from striving to produce the latest and greatest toothbrush. It's a wonderful testament to the free market, but it might leave you dizzy with indecision about which product is right for you.

You can avoid this paralysis if you remember why you're using a toothbrush in the first place—to remove the daily buildup of dental plaque, a thin bacterial film that causes tooth decay and gum disease. With that in mind, here are the top things to consider when picking out your next toothbrush.

Bristle texture. Although you might think a stiff-bristled brush would be better at removing plaque, most dental professionals recommend soft bristles. Stiffer bristles can damage your gums and lead to recession; on the other hand, coupled with the mild abrasives and detergents in toothpaste, soft bristled-brushes are just as effective in removing plaque.

Comfortable size and shape. Toothbrushes come in various lengths and handle widths, so choose one that's comfortable in your hand. If you have issues with manual dexterity, consider one with a wider and thicker handle that's easier to hold. You'll be acquainted for at least six months (that's how often you should change out your current brush for a new one), so get a toothbrush that feels right to you.

The ADA Seal of Acceptance. Like toothpaste, the American Dental Association also tests toothbrushes. Those that meet the ADA's high dental product standards can include the ADA Seal of Acceptance on their packaging. When you see it, it's a good indication that particular toothbrush will perform well. You can also get advice from your dentist or hygienist on what type of brush you should use.

Every time you brush, you're potentially improving your dental health and avoiding disease. Make sure it counts with a toothbrush that's right for you.

If you would like more information on toothbrushes, 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 “Sizing Up Toothbrushes.”





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Kinnelon, NJ Dentist
Peter Brusco DMD
170 Kinnelon Rd # 29A
Kinnelon, NJ 07405
(973) 838-5862
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