CRACKED TOOTH SYNDROME

You may have a very commonly occurring problem in one of your teeth.

Teeth may crack when subjected to stress of chewing hard foods or ice, or by biting on an unexpected hard object. Teeth with or without restorations may exhibit this problem, but teeth restored with typical silver alloy restorations are most susceptible.

SYMPTOMS AND SIGNS ARE SOME OR ALL OF THE FOLLOWING:

1. Pain on chewing
2. Pain on cold air application
3. Unsolicited pain(usually leakage of sugar into tooth crack)
4. No radiographic evidence of problem
5. No dental decay present
6. Easy verification of crack when tooth is prepared for restoration

TREATMENT FOR CRACKED TEETH:

1. SIMPLE CRACK: The majority of cracked teeth (about nine out of ten) can be treated by placement of a simple crown (cap) on the tooth. When the tooth is prepared for the crown, and a temporary restoration is placed, the pain usually leaves immediately. IF THIS IS THE CASE WITH YOUR TOOTH, WE WILL PLACE THE FINAL CROWN WITHOUT A PROBLEM ON YOUR NEXT APPOINTMENT AND THE CONDITION SHOULD BE SOLVED.

1. COMPLEX CRACK: Occasionally (about one in ten) the tooth cracks into the pulp (nerve) of the tooth. IF THE PAIN PERSISTS AFTER PLACEMENT OF THE TEMPORARY CROWN, YOU MAY HAVE A CRACK INTO THE PULP OF THE AFFECTED TOOTH. PLEASE CALL US. THIS TOOTH MAY REQUIRE ENDODONTICS (ROOT CANAL THERAPY) BEFORE THE CROWN IS PLACED. This requires about two additional appointments before crown is placed.

One of the trends in today’s dentistry is the shift toward microdentistry-the practice of removing the least amount of tooth structure necessary to eliminate decay and then replacing it as conservatively,comfortably and esthetically as possible. The key to minimally invasive microdentistry is prevention and early accurate cavity diagnosis followed by microinvasive treatment and palcement of biominetic restorations(restorations using materials that most closely mimic natural tooth structure).

In our office, accurate diagnosis is achieved using loupes with magnification and illumination. We also use laser decay diagnosis(the Diagnodent).

Once the decay is discovered, we use a Waterlase laser to remove the decay. Using hydrokinetic energy, the Waterlase safely and easily eliminates the cavity. In most cases no anesthesia(shot) is necessary.

Call our dental office in Burke, Virginia, for an exam and consultation. We are always accepting New Patients.

It was reported recently in the dental literature that 92% of discolored pits and fissures on molars are decayed and that 90% of old sealants fail. We have laser technology in our dental office(Diagnodent) that allows us to detect this decay at an early stage. The Diagnodent is a low-level diode wavelength laser that flouresces and identifies the bacteria that cause the decay. We then use our Waterlase Laser to remove the decay and place conservative, tooth colored fillings. Come to the dental office of Lawrence T. Fox DDs, in the Fairfax County, Virginia,and experience laser dentistry for yourself.

Dr. Fox’s Son, Erik Fox, was recently accepted to Virginia Commonwealth University, School of Dentistry. Erik will graduate in June of 2013 and will join the dental practice of Lawrence T. Fox DDS in Burke ,Virginia at that time. Erik has special interest in Laser Dentistry and in Oral Surgery.

Our office wishes to provide you with the following information to aid in your decision regarding your proposed implant treatment. Many patients are not aware of the consequences of losing their teeth or the effects which long term denture or partial denture wearing have on the jaws and bone. When teeth are lost the surrounding bone immediately begins to shrink and atrophy.

• You may not be aware that wearing dentures accelerates bone loss and those old dentures are loose because of bone loss. We wish to inform you of this rather than watching and waiting for bone to disappear to a point where treatment success of ANY kind is in doubt.
• At the end of five years, only 40% are still wearing the partial denture made for them. What, therefore, is its real value and utility? Those patients still wearing partial dentures are all losing bone.
• Of those patients who wear partials, 50% chew better without it.
• One study showed that after 8 years, 40% of the teeth which hook to the partial were lost through decay or fracture.
• Patients with natural teeth can bite with about 200 lbs. of force. Denture wearers can bite with only about 50 lbs. of force. Those wearing dentures for 15 years or more can only bite with about 6 lbs. of force and their diet and eating habits have had to be modified accordingly.
• The average lower denture shifts from side to side approximately ½ inch during chewing and is one of the problems which make getting used to it most difficult.
• Denture wearers have decreased nutritional intake, a ten year shorter life span and 30% can only eat soft foods.
• A single tooth implant success rate is above 98% and unlike a bridge; the teeth adjacent to the implant are no more at risk than if no teeth were missing.
• For the maintenance of bone, the health of adjacent teeth, the longevity of the treatment and comfort of the patient an implant(s) is the treatment of choice.

Even in suburban areas like Burke, Virginia and Northern Virginia there are many denture wearers who could benefit from dental implants. 30 million people in the U.S. have no teeth in one or both arches but are mostly unaware of what dentistry can do to improve their health. Implants can restore your chewing function to the equivalent of someone with natural teeth. If you have any further questions, please call our office to discuss them.

Source: Richard Erickson DDS; Dental Update Newsletter

A NEW PARADIGM FOR ORAL CANCER DETECTION
A New Website Teaches People How To Do An Oral Cancer Self Examination

We have joined a new groundbreaking website, www.oralcancerselfexam.com which is dedicated to fighting oral cancer and reducing the mortality rate associated with it. This website shows people how to do a self examination for oral cancer so that when they see something suspicious, they can immediately come see us for a thorough examination.
Did you know:

• Oral cancer kills one American every hour of every day.
• Oral cancer claims more lives than melanoma (skin cancer), strikes three times as many victims as cervical cancer and
is as common as leukemia.
• Two-thirds of oral cancer cases are detected in the late stages of which the 5 year survival rate is only 22%.
• Studies have linked oral cancer to exposure to the sexually transmitted human papilloma virus which means that sexually active patients at an early age are at risk.
• The mortality rate of oral cancer has not decreased in 40 years unlike other cancers where patients have gotten involved in cancer self examinations.

“Cancer self examinations have been well proven to help patients live longer and have a better chance for a more favorable outcome if a cancer is found early. This website can easily teach people how to do self-examination for oral cancer that is simple for people to do at home. This is a welcome addition in the fight against oral cancer.” said Dr. Fox.

Now people can help their dentist identify suspicious areas in their mouth. The pictorial guide on www.oralcancerselfexam.com
demonstrates to people how to do a simple one minute self examination for oral cancer which should be done once a month.

Adds Dr. Fox, “Educating people to do this routine oral cancer self examination will be so helpful to dental professionals and will directly result in saving lives. We can all work together to finally help reduce the effects of this devastating disease

For more information, please contact our office at (703) 978-5253

One of our patients recently asked this question. The most common occurrence is when an old silver amalgam filling begins to corrode. All amalgams eventually break down since they are a metal filling in a wet environment. They break down by separating away from the tooth at the junction of the enamel and the metal. When this happens there becomes a microscopic leak that allows bacteria to enter into the space between the tooth and the filling. Once there, they grow protected and quickly undermine the filling as they eat away at the tooth under the filling.

This particular situation leads to a lost filling, a toothache and possibly an abscessed tooth. It can take a few months to a few years for this to occur. It’s always best to replace a filling when it appears that this process is beginning to happen.

I want to make our patients aware of an occasional problem we see in teeth with large, old silver fillings. When the fillings start to corrode and leak, it’s time to put a crown on them. Sometimes, at a later date, the tooth may abscess. The patient may not understand why and ask,” Why did it abscess? Wasn’t the crown supposed to fix the tooth? I don’t understand!’’

The answer is as follows. In the middle of the tooth there is a chamber that houses the nerve and blood vessels (known as the pulp) when a tooth gets its first cavity (possibly as early as 6-10 years old) this is a traumatic experience to the pulp. The dentist removes the decay and fills the tooth. Here is another trauma, but the nerve recuperates and heals.

Years later, that filling starts leaking and needs to be replaced. Again, trauma. Replace the filling, more injury. But the nerve recovers again. Later, this large filling gets old and the tooth needs to be crowned. Another assault on the nerve.

The pulp, with its vast powers of healing usually returns to health. But sometimes with this fifth or sixth traumatic experience, the pulp finally dies and abscesses, fortunately, this only occurs occasionally but the number of times is still significant. All dentists hate to see this happen, but it does occur. If a tooth is going to abscess, it will, crown or no crown.

The good news is, however, with a root canal we can still save that tooth and you can keep it for the rest of your life.

AMERICAN HEART ASSOCIATION SIMPLIFIES PROPHYLACTIC USE WITH NEW GUIDELINES

On April 19, 2007, the American Heart Association (AMA) updated its online guidelines regarding infectious endocarditis related to patients who should or should not take antibiotics (pre-med) before dental/oral procedures. Major changes have been made and now there are only a few situations in which prophylactic antibiotics are suggested. The guidelines were developed by a group appointed by the AHA that included experts in infectious disease and cardiology members representing the American Dental Association (ADA).

Antibiotics are still recommended in a few situations but the evidence shows that patients have been over treated with the prophylactic antibiotics for several decades. Over prescribing of antibiotics can lead to resistance of the antibiotic in the immune system.

According to the AHA and the ADA, preventive antibiotics are no longer indicated for dental patients with:
• Mitral valve prolapse
• Rheumatic heart disease
• Bicuspid valve disease
• Calcified aortic stenosis
• Most congenital heart conditions

Prophylactic antibiotics are still recommended for:

*Artificial heart valves
*A history of infective endocarditis
*Certain specific serious congenital heart conditions
*A cardiac transplant that develops a problem in a heart valve

For more information on the guidelines or to read the report, go to www.ada.org.

                   Periodontal Disease is a chronic infection of the gums and the bones holding your teeth in place, and it affects an estimated 50 million people within the United States.  Symptoms of periodontal disease include swollen gums, bleeding gums, separation of the gum tissue from the tooth (periodontal pocketing), and bone loss.  If left untreated, the gums and bones surrounding the teeth will continue to deteriorate, leading to possible tooth loss. 

Scaling and root planning are the procedures used to remove the plaque build-up and bacteria from the infected areas around the teeth.  In conjunction with these techniques the hygienist will place the antibiotic, Arestin^TM, in the infected gums to promote healing and further treat the disease. Arestin is a small carpal of powder that is administered quickly, easily, and gently.  Our office has witnessed amazing results with this treatment, which include a shrinking of periodontal pocketing by 1-2mm, a reduction of bleeding, and an overall improvement of oral health.

Recent studies clearly illustrate the inherent correlation between systemic and oral health.  In fact, periodontal disease has been linked to multiple health complications including diabetes and heart disease.  Therefore, if you exhibit any one of the aforementioned symptoms please ask your hygienist about periodontal disease and its eradication through scaling, root planning, and Arestin^TM application.