October 19, 2010
This 21 year old came to see me today complaining of pain and receeding gums. The tissue is very thin and fragile on some people and the gum can receed from brushing too hard, or leaving bacteria on the gumline from brushing too soft.
We cleaned the hard calculus and build up off the teeth and prescribed a toothpaste for sensitive teeth. Rubbing with salt and gentle brushing with a soft brush will help maintain the area – an electric toothbrush can be of benefit here.
Unfortunately the gum won’t repair (it may do slightly as the patient is very young). What we want to do is be very diligent and stop it getting worse. If it gets into the soft part of the lip it can speed up and long term the tooth could then be at risk of getting loose and falling out! Sometimes a specialist can do a graft to cover the sensitive root. If it is well maintained then receeding gums can be stabalised with regular check-ups.
October 14, 2010
This patient is likely to have further complex problems with his front teeth due to the extent of the decay. Decayed teeth if untreated eventually get damage to the nerve inside and end up needing root canal treatment to save, and also the tooth can be so weakened that it can break off. Fortunately, we have been able to repair these teeth with filling for now. These teeth are still at great risk, but the fillings will stabalise the problem and should be serviceable for a few years. The advantage is that all this could be fixed in one day for a few hundred dollars with a very cosmetic result.
The front tooth without any decay is a root treated and crowned tooth treated many years ago.
October 8, 2010
Here is a root canal treatment case that just came in today. The patient had pain in the tooth to bite on and tap on, and there was no reaction to hot or cold.
The tooth has been heavily filled and patched over the years. The top left and bottom right corners are actually tooth coloured filling patched onto the original metal amalgam. As there was no decay obvious we diagnosed that the tooth had cracked and bacteria had entered into the chamber within the tooth where the nerve lies. This causes the nerve tissue to swell from the infection, causing pain, and then the pressure strangles the blood supply to the tooth, leaving a dead infected space within the tooth. This was confirmed when we removed the filling.
We then opened into the root chamber and found the root canal spaces. You can see that the crack extende almost the whole way across the tooth.
I have marked the crack with a yellow arrow. Unfortunately, this crack may continue to leak bacteria back into the centre of the tooth no matter what we do, and the tooth will have to be removed. We are going to try and save the tooth with a root canal treatment and crown for now and hope for the best.
October 7, 2010
Wisdom teeth are so varied in how they present. Here is a patient I just saw and you can see the wisdom tooth on one side is fully impacted (impacted is when there is tooth or bone in the way stopping the tooth from erupting properly). The other side shows a partialy impacted wisdom tooth.
Unfortunately, the partial impacted tooth was visible in the mouth, so it had decayed. The tooth next to it had also decayed because food trapped between the teeth. We removed this partial impacted tooth today without incident.
See my other posts on wisdom teeth from February 2008 link.