What is a cleft lip and palate?

The word "cleft" simply means a crack or divide. A cleft lip is simply the body incorrectly or incompletely closing the facial structures during development. This incomplete closing leaves a cleft, or divide, in the lip and/or palate of the new born. Below is an ultrasound showing a cleft lip

Clefts can be simply the lip (cleft lip).

Or they can be more severe and include the palate (cleft lip and palate).

In the cleft lip and palate the teeth are often involved.

Missing, misaligned, and or misplaced teeth can be common.

Clefts, no matter the severity, are normally very repairable

and the scare can be almost unrecognizable.

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Does your jaw pop or click?

TMJ is the abbreviation for Temporal Mandibular Joint. It is the joint directly in front of your ear that is used by your body to open and close your mouth. It is, like most other joints in your body, made up of cartilage, fluid, bones, and muscles.. And just like any other joint in the body any piece to this puzzle can deteriorate, get misplaced, damaged, or have any other number of problems.

If any sort of damage does occur then pain, clicking, popping may result.

If you have had any of the above symptoms the best thing to do

is to see your dentist right away.

He/she needs to determine what is the cause of your TMJ discomfort and

what, if anything, can be done to solve the problem.

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What is the black line around my crown?

Nothing is wrong.

What you are seeing is simply the metal that your crown is

made out of showing out from underneath.

I know I know, you thought that your crown was white and that

there wasn't any metal in it.

Well, there is. You have what is referred to as a porcelain

fused to metal crown of (PFM).

The crown is made of a metal substructure to give it it's strength and

then porcelain is layered over the top to make it look like a tooth.

The PFM has been used for years and has had remarkable success.

The only draw back to these types of crowns is the metal line showing through

and the fact that the porcelain layers can begin to separate from each other

and cause the pieces of porcelain to fall off the crowns.

Today there are new advances in crown technology that have

eliminated both of these problems.

There is a new material, to the world of dentistry that is, called zirconium.

Zirconium crowns are milled from a solid block and are very very strong.

This milling process means that they are not put together piece by piece.

Therefore there are no pieces to come apart. The crown is one solid unit.

Zirconium is also white so the color is that of most teeth and will never show a

metallic line because there is no metal.

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Implant case from yesterday.

Just finished up a nice implant case.

Patient came in with one of his four front teeth broken off at the gum line.

(Pictured here)

The big problem was that he already had bridges on both sides of the broken tooth.

Since he didn't want to destroy a good bridge he went for the implant.

We extracted the tooth, placed the implant, and placed a temporary on it the same day.

The patient returned in 8 weeks to receive the final crown.

He is very happy with the result.

(Pictured below)

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I cracked my front tooth! What now?

Okay so you, your child, your mom, your brother, etc. etc. just fell face first into something, over something, under something, etc. etc. and broke the corner of your/their front tooth off.

What do you do now?

Well, that depends. Lets break this down into 3 simplified categories.

The nerve of a tooth is in the middle of the tooth.

#1 If you just broke off a small corner of the tooth and it didn't reach the nerve then a simple filling is probably all you would need.

#2 If you broke off a larger corner but still didn't reach the nerve then you more then likely would need a crown.

#3 If you broke your tooth so severely that you got down into the nerve then you will need a root canal AND a crown.

And although all of this may be a traumatic experience don't worry. Your cracked and broken smile can be completely repaired and have you back to being the model you know you were born to be.

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Just take out all my teeth!

Every once in a while we will get someone who asks us to take

all of their teeth out and just give them dentures.

In almost all cases the answer to this is no.

The reason for this is because these people are looking for a fix.

A fix to all of their dental problems.

They figure that if they have no teeth then they can't have anymore mouth problems.

Oh how wrong that is.

Dentures come with their own set of problems.

Do they fit?

Will they stay in?

Can I chew with them?

Etc.

Etc.

Now, for some people a denture is absolutely the right way to go.

But for most there are other options.

And once you go with a denture you can never go back to real teeth.

Its kind of a, the grass is always greener on the other side mentality.

Do dentures work?

Yes.

But they require work, cleaning, and care just like teeth do.

If you aren't willing to work on your teeth then the problems you

had with your teeth will follow you to your dentures.

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Why are new fillings sensitive sometimes?

New fillings that are placed by your dentist should not be sensitive.

If they are they should not remain that way for long.

Some very large fillings may take longer then others, but

eventually every filling should calm down.

So what exactly is going on when a fillings sensitive?

It has to do with expansion and contraction.

As with most things, when a tooth is exposed to hot or cold

temperatures it will expand or contract accordingly.

If a tooth has never had a filling it will all contract and expand at the same time.

If a tooth HAS had a filling however this is where we may get an issue.

If the tooth and the filling have a different point at which they want

to expand or contract then there can be some discomfort.

Over time this discomfort should go away as the tooth gets used to the filling.

If the discomfort does not go away then the filling needs to be re-done.

If it still hurts then there are some different types of filling materials that can be used.

If it still hurts then other treatments may be needed.

Filling sensitivity is a funny thing.

Someone can get 4 fillings in the same day.

Same doctor.

Same filling material.

Same everything.

But only 1 will end up hurting.

It is a real tooth by tooth thing and can drive patients, and dentists, crazy!

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Teething in a 6 year old?

Teething pains. In a six year old.

We all know about the teething that happens in the first year of your child's life.

But not too many people are familiar with the teething that happens when a child in 6.

At the age of 6 years old, or so, your child will get in their first adult molars.

They are called, 6 year molars.

These teeth are the largest teeth that anyone will ever have in their mouths.

These teeth are not the little pointy teeth that little kids get in the front of their mouths.

These teeth are large and flat.

They need to place more force in order to break through the gums then the little ones do.

Therefore, if your child is around the age of 6 years and they complain about pain

way in the back of their mouth they may just be teething all over again.

Its always a good idea to get things checked out by a dental

professional just to insure that they do not have active cavities causing this ache.

But more often then not it will simply be the child's first molars coming in.

The best thing to do is treat this case of tooth eruption just like the others.

A mild over the counter pain killer such as Tylenol or ibuprofen and

then some orajel at the spot the tooth is coming in.

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Veneers with no drilling or shots

Much has been made in the media recently about getting veneers.

Veneers are a great product.

They can fix a multitude of problems such as discoloration,

slight tooth rotations and crowding.

There are two types of veneers however.

The one that I will talk briefly about today is the kind of veneer called no-prep.

These veneers require no shots. No drilling. And disturb non of the natural tooth structure.

The patient simply comes to the dentist, gets a few impressions taken,

and shows up 2 weeks later to get the veneers placed.

The veneers are basically like fake fingernails except they do not need to be replaced

except for the rare case that they were to break off.

The only down side is that these types of veneers may make your teeth look a little bulky.

They are only .3 mm thick. But still your mouth is sensitive enough

to feel a human hair. So even at .3 mm they may take some getting used to.

I would highly recommend that if you have ever thought about veneers

that you take a look at some of these no-prep products.

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It shouldn't be too hard to pull out, should it?

This happens all the time.

People, who neglect their teeth, will wait until they have a tooth that is

broken off at the gums to come to my office to get it extracted.

The laugh a little nervous laugh and say...

"well, not much left so it should be pretty easy yo pull out, huh?"

The answer to that is, NO.

Imagine getting a fence post out of the ground.

Not the easiest thing in the world, right?

Now, take a chain saw and cut the fence post off at the ground.

How easy is that going to be now?!

If you want a tooth out, please, please, please, do not wait until

it is so broken down that there is nothing to grab on to.

It is NOT easier.

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Pointy Canines

Canines are unlike any other teeth in the mouth.

Every other tooth in the mouth is, almost, a copy of a another tooth in the same quadrant.

You have 2 incisors, 2 pre-molars, and 2 molars per quadrant but only 1 canine.

These teeth are also, typically, the longest rooted teeth in the mouth.

One problem that people have with their canines is that sometimes

they feel as if they are a bit too pointed.

They hide them when they smile for fear that they look too much like a vampire.

Well there has never been an easier fix for just about anything.

All you need to do is file those bad boys down just a bit.

You do not need to be numbed up and it will only take a moment to do.

You will have less enamel so the chances that you could get decay in the

future are slightly higher. But, there is hardly anyone ever that gets

cavities on the points of their canines. Just doesn't happen.

Food can't stick there very easily.

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What's wrong with your tongue?!

It's called geographic tongue.

Geographic tongue is a condition where the tissue of the tongue will vary in

appearance from one section of the tongue to another.

The location, size, color and duration of the variations is different from person to person

and can even change within the same person over time.

There is no real threat with geographic tongue. Most people with geographic

tongue don't even know they have it. All they know is that they have always

had this funnysection of their tongue that changes texture and color from time to time.

The only main side effect coincidental with geographic tongue is a heightened

sensitivity to spicy foods form time to time. These episodes will occur as

the spots of the geographic tongue go through their phase of appearing and

then disappearing.

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Tori

Tori.

Ever heard of the word?

A tori is a lump of bone that resides in the mouth.

Most people that have tori think nothing of it because they have always had it.

Well, not everyone does have it.

But even if you do have it it really not that big of a deal.

Its just bone and likely wont ever cause you any problems.

One of the only time that it may cause you problems is if you need a denture.

Dentures are very hard to fabricate over the top of tori.

It is only a minor problem however due to the fact that tori can be removed.

So if you have a hard boney lump that has been in your mouth forever,

it may not hurt to get it checked out, but more often then not its simply just a tori.

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The Cosmetic Dentist Myth.

There is a myth out there in the dental world.

It is the myth of the "Cosmetic Dentist".

There is no such thing. Tune into this video and

I will explain.

(I know the audio is a little off from the video)

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I told you so!!

There is something that I hate to see and hear at my office.

It is to see a parent tell a child "I told you to brush your teeth"

while they are shaking their finger at them.

This phrase is said by parents whose children have cavities

and will need to get their teeth filled.

Now, I am a parent of 5 children myself.

And I am all for natural consequences.

If I tell you to bring a jacket and you don't and you get cold,

well then that is the child's fault and a little cold air won't do any harm.

But the whole scene in the dental office is different.

If we are putting fillings into permanent teeth, then your child

is bound to need fairly extensive work on these teeth later in life.

A tooth that has no filling is MUCH better of long term then

a tooth that has even a small filling that is placed very young.

I know dentistry does not seem like a serious health issue, but it can be.

Its like taking your kids to get immunized.

They cry and say they don't want to.

You then say, "Fine but you'll regret it."

Then 10 years down the road your kids gets some life threatening disease

and you just shake your finger and say "See. Told ya you should

have gotten those immunizations."

You would never do that.

Some things are just too important.

You force your kids to take vitamins.

You make them get their immunizations.

You SHOULD make them brush their teeth.

Either under your supervision or you do it for them when they are young.

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My tooth just tipped over!

Most people think that its no big deal to get a tooth taken out. they will say things like "its just one tooth" and "I've got a ton more". Well, you do have a lot more teeth then just that one but this does NOT mean that getting a tooth out will not create many other problems in the mouth.

Some of the problems that can occur are as follows.

#1 The tooth that chews against the tooth you just took out will move up, or down, into the spot just vacated by the extracted tooth. This top tooth is moving down into the mouth.

#2 The teeth right next to the extracted one will begin to tip into the spot just vacated by the extracted tooth. These next two pictures were taken 5 years apart. The patients tooth tipped completely over and needed to be extracted.

Both of these can cause your bite to be thrown completely off and make chewing uncomfortable.

#3 As you chew hard and crunchy foods, they will pinch up against the gums where the tooth used to be.

Moral to the story is

if you can fix your teeth, then do it.

If you can't, then get the hole filled where the tooth used to be ASAP.

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Just take em out!!

Every once in a while we will get someone who asks us to take

all of their teeth out and just give them dentures.

In almost all cases the answer to this is no.

The reason for this is because these people are looking for a fix.

A fix to all of their dental problems.

They figure that if they have no teeth then they can't have anymore mouth problems.

Oh how wrong that is.

Dentures come with their own set of problems.

Do they fit?

Will they stay in?

Can I chew with them?

Etc.

Etc.

Now, for some people a denture is absolutely the right way to go.

But for most there are other options.

And once you go with a denture you can never go back to real teeth.

Its kind of a, the grass is always greener on the other side mentality.

Do dentures work?

Yes.

But they require work, cleaning, and care just like teeth do.

If you aren't willing to work on your teeth then the problems you

had with your teeth will follow you to your dentures.

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Tongue Piercing = Bad Idea

Tongue Piercing

You see it all the time.

People with barbells sticking out their tongue.

You may even have one yourself.

But is it safe?

In a word...... NO!

Can you feel a stray hair on your arm? Probably not.

Can you feel a stray hair on your leg? Again, probably not.

Can you feel a hair in your mouth? Absolutely.

The reason for this is because the tongue has more nerves contained in it then almost any other part of your entire body. It is very sensitive and very precise. Therefore, ramming a large steel rod through it will certainly damage these nerves. Piercing the tongue can lead to a loss in ability to feel your tongue and ability to taste food.

Besides loss of taste and feel there are also other dangers.

Since the mouth can not be kept sterile, as other parts you may pierce,

the chance of infection is greater. The above picture is a very nicely infected tongue.

Cracking your teeth on a tongue ring is also a very real concern. I have treated many cracked teeth from people biting down on tongue rings.

Want another reason?

How about this one.

If you catch your tongue ring on something. You can actually pull it out of your tongue and cause, this......

Look Fun????

My suggestion, DON'T DO IT!!!

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My Crown Just Fell off!!!

You are eating a meal and all of a sudden you feel something crunchy.

You search for the crunchy item with your tongue and pull the item out.

Its one of your crowns!

You don't know how it happened but it just came off.

First Rule: Do not panic.

Crowns can come off for several reasons.

Some of these reasons are very very easy to fix.

So just because your crown came off does not mean that its the end of the world.

First thing to do is to look into the crown.

If its empty then things are in good shape.

This means that the cement that holds the crown on simply broke loose and you just need to get it re-cemented.

If there is a bunch of stuff in the tooth then you may have a little more of a problem on your hands.

What is in the crown may be fragments of the tooth. If there are a lot of fragments then you may need to have a new crown made due to the fact that that one may not fit any longer.

So until you can get to the dentist to find out exactly which case is yours, what can you do?

Try to stick it back on.

If it fits snuggly then you may just be able to baby it until you get in to the dentist.

If it fits loosely then you can simply put a bit of toothpaste into it and then stick it back on.

The toothpaste will make up the difference in the fit of the crown and help keep it on.

Call your dentist ASAP and get his/her opinion.

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