How and When to Use Sealants to Treat Uncomplicated Crown Fractures

Total Page:16

File Type:pdf, Size:1020Kb

How and When to Use Sealants to Treat Uncomplicated Crown Fractures DENTINAL SEALANTS: HOW AND WHEN TO USE SEALANTS TO TREAT UNCOMPLICATED CROWN FRACTURES Glenn Brigden, DVM, DAVDC Jennifer Tjepkema, DVM 511 Saxony Place, Ste 100, Encinitas, CA 92024 (760) 230-1818 t • (760) 452-7770 f • www.PCVetDentistry.com • [email protected] Page 2 of 3 DENTINAL SEALANTS: HOW AND WHEN TO USE SEALANTS TO TREAT UNCOMPLICATED CROWN FRACTURES In order to understand how and when to use dentin- ment of the odontoblastic processes and stimula- al sealants to treat uncomplicated crown fractures, tion of the A-Delta fibers within the pulp, resulting an understanding of the important relationship den- in PAIN. tin has with the pulp and enamel must be achieved. Dentinal tubules are greater in number and larger Dentin is a porous, hard organic (30%) and inorganic in diameter the closer they are located to the pulp. (70%) substance that is covered by enamel (crown) Clinically, this means that the deeper the fracture, and cementum (root). Unlike enamel, dentin is the more dentinal tubules are exposed to the oral continually made through out the life of the tooth. cavity/bacteria. The more dentinal tubules exposed, Although it appears grossly as a solid structure, mi- there is a greater potential for pain and increased croscopically dentin is made of three structures: risk for pulp necrosis. Dentinal tubules provide a dentinal tubules that extend to the pulp, intertubu- conduit for oral bacteria to have direct access to the lar dentin that makes the bulk of dentin and peri- pulp, which could cause irreversible pulpitis and tubular dentin that has a higher crystalline content pulp necrosis. than the intertubular dentin. The dentinal tubules contain odontoblastic processes from odontoblasts Uncomplicated crown fractures need to be treated located within the pulp. Nerve fibers, specifically A- because they could cause pain and/or infection re- Delta fibers, are wrapped around odontoblasts. sulting in tooth death. The treatment protocol will depend on which tooth is fractured, how the tooth is Odontoblasts are cells that form new dentin. There fractured, the depth, and the location. are three types of dentin: primary dentin, which is the dentin that is present when the tooth For example, superficial slab fractures on erupts, secondary dentin, which is the new the buccal aspect of the fourth premolar dentin laid down as the tooth ages and tertia- are good candidates for sealant alone (as ry dentin, which is reparative dentin. Tertiary long as the tooth is vital) but deeper frac- dentin is less organized than secondary or pri- tures at this location might require a true mary dentin and appears brown and shiny. This “restoration” with composite. The most com- dentin is laid down when there is injury to the tooth mon fractures that are treated with a sealant are: such as from chronic wear (ball chewing) or after an uncomplicated fractures involving the cusps of the uncomplicated crown fracture. premolars or mandibular first molars, teeth treat- ed with odontoplasty and in cases of hypoplastic Dentin is composed of tubules that connect the enamel treatments (enamel hypocalcification/hy- pulp to the enamel. The dentinal tubules contain poplasia). fluid, nerves and odontoblastic processes. This means that dentin and the pulp have an integrated Examples of when to not use sealants are: non- relationship; therefore, damage to the dentin affects vital teeth, teeth with resorptive lesions affecting the pulp and damage to the pulp affects the dentin. the crown, teeth with complicated crown fractures This is why the pulp canal is wider in non-vital teeth or caries lesions. Sealants are also not permanent compared to the other dentition and the reason why and might need to be replaced in the future. The fre- uncomplicated crown fractures can result in pulp quency of re-application depends on the chewing necrosis. habits of the patient and if reparative dentin is pres- ent (typically do not seal if tertiary dentin is present). There are three afferent nerves that are responsible Treated teeth need to be radiographically moni- for odontogenic (tooth) pain: A-Beta, A-Delta and C- tored to ensure that the tooth has not died. This can fibers. A-Delta fibers are stimulated when dentin is results due to an inadequate seal, pulpitis present exposed to changes such as temperature, osmolal- prior to procedure or secondary to the initial insult ity (sweet or salty foods) or external stimuli touching (contusion resulting in tooth death). dentin (eating/ chewing toys). This results in fluid movement within the dentinal tubules and move- 511 Saxony Place, Ste 100, Encinitas, CA 92024 (760) 230-1818 t • (760) 452-7770 f • www.PCVetDentistry.com • [email protected] Page 3 of 3 DENTINAL SEALANTS: HOW AND WHEN TO USE SEALANTS TO TREAT UNCOMPLICATED CROWN FRACTURES Odontoplasty is defined as an adjustment of the to remove the solvent and thin the layer of the seal- tooth contour. This procedure needs to be per- ant. This can be performed with a 3-way air-water formed prior to sealing fractures but sometimes this syringe. To prevent oil from being blown onto the procedure is performed as a primary treatment. For tooth from the syringe, it is recommended to “push” example after extraction of the maxillary fourth pre- the air button on the syringe away from the tooth, molar in dogs and cats the cusps of the mandibular and then without letting go of the button, to move first molar are “flattened” and ”rounded” in a man- the syringe over to the tooth. The oil from the syringe ner that would prevent the cusps from traumatizing will be expelled prior to drying the tooth. After evap- the opposing hard palate when the tooth contacts oration of the solvent, the area should be light cured the tissue. The tooth contacting the hard palate for 15-30 seconds (please refer to manufacturer’s is a result of the extraction of the opposing fourth recommendations). premolar. The “contouring” of this tooth is referred to as an odontoplasty. Whenever this procedure is There are 7 dentinal sealant/adhesive generations performed enamel is removed potentially exposing present on the market. The most commonly used dentin thus requiring to be sealed. for this procedure are 5th generation. These den- tinal sealants contain the primer and adhesive in To prepare a fracture site or hypoplastic enamel for one bottle. Our favorite at Pacific Coast Veterinary dentinal sealant the recipient site should have all of Dentistry is 3M ESPE Adaper Single Bond; it is a more the unsupported enamel/dentin removed and then expensive product but has proven in our hands to contoured (odontoplasty) to prevent future frac- work superior to other generic/cheaper brands. tures, plaque retention and allow better reten- tion of the sealant. Typically diamond burs, It is very important to treat uncomplicated fine or medium course tapered diamond burs crown fractures because if left untreated, are recommended. A favorite is a “football” it could lead to the death of that affected shaped diamond bur, which allows excellent tooth and/or dental pain. It is also essen- contouring. After the odontoplasty the tooth tial to recognize which teeth are and are not should be cleaned, smear layer removed and good candidates for this treatment. dentinal tubules “opened”, which can be achieved with acid etchants. References: The most common acid etchant used in dentistry is phosphoric acid at a 37-38% concentration. This 1) Hargreaves K, Cohen S., Cohen’s Pathways of the acid is typically not irritating to soft tissue, but protec- Pulp 10th ed. St. Louis 2011 tion of the gingiva is recommended (gauze wrapped around the tooth works well). The etchant should 2) Wiggs B, Lobprise H. Oral anatomy and physiolo- gy. In: Veterinary Dentistry Principles & Practice. Phila- sit on the tooth between 15-30 seconds (please ad- delphia 1997:62:64 here to manufacturer’s recommendation) and then rinsed (wiping the etchant off the tooth with water 3) Kimberlin L, Brown. Comparison of Shear Bond- soaked gauze works very well). The area should look ing Strength for Two Different Etching Systems in Ca- “chalky”. If it does not, then this step should be re- nine and Human Dentin. J Vet Dent 28 (4); 242-249, peated. Etchant should only be applied to the re- 2011. cipient site, and unaffected enamel should not be etched because it will cause it to demineralize. 4) Robb L, Marx J, Steenkamp G, Heerden WF, Preto- rius E, Boy SC. Scanning Electon Microscopic Study After the etchant has been removed, the tooth of the Dentinal Tubules in Dog Canine Teeth. J Vet should be blotted dry with a cotton pellet or gauze. Dent 24 (2); 86-89, 2007. Once the tooth is dried, 2-3 consecutive coats of 5) Hernandex SZ, Negro VB, Paulero RH, Toriggia PG, the sealant should be applied for 15 seconds with Saccomanno DM. Sacnning Electron Microscopy of gentle agitation while using a fully saturated brush Pulp Cavity Dentin in Dogs. J Vet Dent 27 (1)7-11, to the prepared site. Gently air dry for 15 seconds 2010 511 Saxony Place, Ste 100, Encinitas, CA 92024 (760) 230-1818 t • (760) 452-7770 f • www.PCVetDentistry.com • [email protected].
Recommended publications
  • Material Selection and Shade Matching for a Single Central Incisor
    CLINICAL SCIENCE KAHNG Material Selection and Shade Matching for a Single Central Incisor INTRODUCTION With regard to esthetics, the single central incisor poses the greatest re- by storative challenge for the clinician; not surprisingly, it can also be the most Luke S. Kahng, C.D.T. difficult tooth for the dental technician to match. Selecting the shade of the restoration depends in part on the material used for the understructure, and Mr. Kahng is the founder and owner of there is a wide assortment available from which to choose. The following are Capital Dental Technology Laboratory, among the most common: Inc., in Naperville, Illinois. The labora- tory specializes in all fixed restorations and its LSK 121 division provides per- An experienced technician can mask the underlying dark tooth color using sonalized custom cosmetic work. A porcelains with detailed color-masking techniques. strong proponent of collaborative den- tistry, Mr. Kahng stresses education, communication, and a team approach to patient care. A member of the AACD, UNDERSTRUCTURE MATERIAL his training has included extensive study with Russell DeVreugd, C.D.T., Dr. • Zirconia (e.g., Procera® [Nobel Biocare; Yorba Linda, CA], Lava™ [3M Frank Spear, Dr. Peter Dawson, and ESPE, St. Paul, MN], Cercon® [Dentsply Int., York, PA], Everest™ [KaVo others. America Corp.; Lake Zurich, IL], In-Ceram® [Vident; Brea, CA]) Mr. Kahng is the official clinician for --Flexural strength: approximately 1,200 MPa GC America, Bisco, and Captek. He is --Translucency: very low a frequent lecturer and program facili- tator for dentists and dental technicians, --Opacity: high and has published articles in Practical • Alumina core or glass-infiltrated alumina (e.g., Procera, In-Ceram) Procedures and Aesthetic Dentistry --Flexural strength: 450 to 700 MPa and Dental Dialogue.
    [Show full text]
  • Maxillary Lateral Incisor Agenesis and Its Relationship to Overall Tooth Size Jane Wright, DDS, MS,A Jose A
    RESEARCH AND EDUCATION Maxillary lateral incisor agenesis and its relationship to overall tooth size Jane Wright, DDS, MS,a Jose A. Bosio, BDS, MS,b Jang-Ching Chou, DDS, MS,c and Shuying S. Jiang, MSd Prosthodontists, orthodontists, ABSTRACT and general dentists frequently fi Statement of problem. Agenesis of the maxillary lateral incisor has been linked to differences in encounter dif culties when the size of the remaining teeth. Thus, the mesiodistal space required for definitive esthetic resto- attempting to restore the oc- ration in patients with missing maxillary lateral incisors may be reduced. clusion if unilateral or bilateral Purpose. The purpose of this study was to determine whether a tooth size discrepancy exists in maxillary lateral incisors are orthodontic patients with agenesis of one or both maxillary lateral incisors. congenitally missing. Restora- tion of the missing lateral Material and methods. Forty sets of dental casts from orthodontic patients (19 men and 21 women; mean 15.9 years of age; all of European origin) were collected. All casts had agenesis of one incisor using an implant- or both maxillary lateral incisors. Teeth were measured with a digital caliper at their greatest supported crown, a partial mesiodistal width and then compared with those of a control group matched for ethnicity, age, and fi xed dental prosthesis, or sex. Four-factor ANOVA with repeated measures of 2 factors was used for statistical analysis (a=.05). mesial movement of the Results. Orthodontic patients with agenesis of one or both maxillary lateral incisors exhibited canine are treatment options. smaller than normal tooth size compared with the control group.
    [Show full text]
  • Tooth Size Proportions Useful in Early Diagnosis
    #63 Ortho-Tain, Inc. 1-800-541-6612 Tooth Size Proportions Useful In Early Diagnosis As the permanent incisors begin to erupt starting with the lower central, it becomes helpful to predict the sizes of the other upper and lower adult incisors to determine the required space necessary for straightness. Although there are variations in the mesio-distal widths of the teeth in any individual when proportions are used, the sizes of the unerupted permanent teeth can at least be fairly accurately pre-determined from the mesio-distal measurements obtained from the measurements of already erupted permanent teeth. As the mandibular permanent central breaks tissue, a mesio-distal measurement of the tooth is taken. The size of the lower adult lateral is obtained by adding 0.5 mm.. to the lower central size (see a). (a) Width of lower lateral = m-d width of lower central + 0.5 mm. The sizes of the upper incisors then become important as well. The upper permanent central is 3.25 mm.. wider than the lower central (see b). (b) Size of upper central = m-d width of lower central + 3.25 mm. The size of the upper lateral is 2.0 mm. smaller mesio-distally than the maxillary central (see c), and 1.25 mm. larger than the lower central (see d). (c) Size of upper lateral = m-d width of upper central - 2.0 mm. (d) Size of upper lateral = m-d width of lower central + 1.25 mm. The combined mesio-distal widths of the lower four adult incisors are four times the width of the mandibular central plus 1.0 mm.
    [Show full text]
  • Dental Anatomy Lecture (8) د
    Dental Anatomy Lecture (8) د. حسين احمد Permanent Maxillary Premolars The maxillary premolars are four in number: two in the right and two in the left. They are posterior to the canines and anterior to the molars. The maxillary premolars have shorter crowns and shorter roots than those of the maxillary canines. The maxillary first premolar is larger than the maxillary second premolar. Premolars are named so because they are anterior to molars in permanent dentition. They succeed the deciduous molars (there are no premolars in deciduous dentition). They are also called “bicuspid -having two cusps-“, but this name is not widely used because the mandibular first premolar has one functional cusp. The premolars are intermediate between molars and canines in: Form: The labial aspect of the canine and the buccal aspect of premolar are similar. Function: The canine is used to tear food while the premolars and molars are used to grind it. Position: The premolars are in the center of the dental arch. [Type a quote from the document or the summary of [Type a quote from the document or the summary of an interesting point. You can position the text box an interesting point. You can anywhere in the document. position the text box Use the Text Box Tools tab to anywhere in the document. change the formatting of the Use the Text Box Tools tab to Some characteristic features to all posterior teeth: 1. Greater relative facio-lingual measurement as compared with the mesio-distal measurement. 2. Broader contact areas. 3. Contact areas nearly at the same level.
    [Show full text]
  • TOOTH SUPPORTED CROWN a Tooth Supported Crown Is a Dental Restoration That Covers up Or Caps a Tooth
    TOOTH SUPPORTED CROWN A tooth supported crown is a dental restoration that covers up or caps a tooth. It is cemented into place and cannot be taken out. Frequently Asked Questions 1. What materials are in a Tooth Supported Crown? Crowns are made of three types of materials: • Porcelain - most like a natural tooth in color • Gold Alloy - strongest and most conservative in its preparation • Porcelain fused to an inner core of gold alloy (Porcelain Fused to Metal or “PFM”) - combines strength and aesthetics 2. What are the benefits of having a Tooth Supported Crown? Crowns restore a tooth to its natural size, shape and—if using porce lain—color. They improve the strength, function and appearance of a broken down tooth that may otherwise be lost. They may also be designed to decrease the risk of root decay. 3. What are the risks of having a Tooth Supported Crown? In having a crown, some inherent risks exist both to the tooth and to the crown Porcelain crowns build back smile itself. The risks to the tooth are: • Preparation for a crown weakens tooth structure and permanently alters the tooth underneath the crown • Preparing for and placing a crown can irritate the tooth and cause “post- operative” sensitivity, which may last up to 3 months • The tooth underneath the crown may need a root canal treatment about 6% of the time during the lifetime of the tooth • If the cement seal at the edge of the crown is lost, decay may form at the juncture of the crown and tooth The risks to the crown are: • Porcelain may chip and metal may wear over time • If the tooth needs a root canal treatment after the crown is permanently cemented, the procedure may fracture the crown and the crown may need to be replaced.
    [Show full text]
  • Crown Removal
    INFORMATIONAL INFORMED CONSENT REMOVAL OF CROWNS AND BRIDGES PURPOSE: There are three primary reasons to remove an individual crown or bridge that has been previously cemented to place: 1. Attempt to preserve and reclaim crowns and/or bridges that have fractured while in the mouth; 2. To render some type of necessary treatment to a tooth that is difficult or impossible to perform render treatment without removing the existing crown or bridge; 3. Confirm the presence of dental decay or other pathology that may be difficult to detect or may be obscured while the crown/bridgework is in place. I UNDERSTAND that REMOVAL OF CROWNS AND BRIDGES includes possible inherent risks such as, but not limited to the following; and also understand that no promises or guarantees have been made or implied that the results of such treatment will be successful. 1. Fracture or breakage: Many crowns and bridges are fabricated either entirely in porcelain or with porcelain fused to an underlying metal structure. In the attempt to remove these types of crowns there is a distinct possibility that they may fracture (break) even through the attempt to remove them is done as carefully as possible. 2. Fracture or breakage of tooth from which crown is removed: Because of the leverage of torque pressures necessary in removing a crown from a tooth, there is a possibility of the fracturing or chipping of the tooth. At times these fractures are extensive enough to necessitate extracting the tooth. 3. Trauma to the tooth: Because of the pressure and/or torque necessary in some cases to remove a crown, these pressures or torque may result in the tooth being traumatized and the nerve (pulp) injured which may necessitate a root canal treatment in order to preserve the tooth.
    [Show full text]
  • Maxillary Premolars
    Maxillary Premolars Dr Preeti Sharma Reader Oral & Maxillofacial Pathology SDC Dr. Preeti Sharma, Subharti Dental College, SVSU Premolars are so named because they are anterior to molars in permanent dentition. They succeed the deciduous molars. Also called bicuspid teeth. They develop from the same number of lobes as anteriors i.e., four. The primary difference is the well-formed lingual cusp developed from the lingual lobe. The lingual lobe is represented by cingulum in anterior teeth. Dr. Preeti Sharma, Subharti Dental College, SVSU The buccal cusp of maxillary first premolar is long and sharp assisting the canine as a prehensile or tearing teeth. The second premolars have cusps less sharp and function as grinding teeth like molars. The crown and root of maxillary premolar are shorter than those of maxillary canines. The crowns are little longer and roots equal to those of molars. Dr. Preeti Sharma, Subharti Dental College, SVSU As the cusps develop buccally and lingually, the marginal ridges are a little part of the occlusal surface of the crown. Dr. Preeti Sharma, Subharti Dental College, SVSU Maxillary second premolar Dr. Preeti Sharma, Subharti Dental College, SVSU Maxillary First Premolar Dr Preeti Sharma Reader Oral Pathology SDC Dr. Preeti Sharma, Subharti Dental College, SVSU The maxillary first premolar has two cusps, buccal and lingual. The buccal cusp is about 1mm longer than the lingual cusp. The crown is angular and buccal line angles are more prominent. The crown is shorter than the canine by 1.5 to 2mm on an average. The premolar resembles a canine from buccal aspect.
    [Show full text]
  • Study of Root Canal Anatomy in Human Permanent Teeth
    Brazilian Dental Journal (2015) 26(5): 530-536 ISSN 0103-6440 http://dx.doi.org/10.1590/0103-6440201302448 1Department of Stomatologic Study of Root Canal Anatomy in Human Sciences, UFG - Federal University of Goiás, Goiânia, GO, Brazil Permanent Teeth in A Subpopulation 2Department of Radiology, School of Dentistry, UNIC - University of Brazil’s Center Region Using Cone- of Cuiabá, Cuiabá, MT, Brazil 3Department of Restorative Dentistry, School of Dentistry of Ribeirão Beam Computed Tomography - Part 1 Preto, USP - University of São Paulo, Ribeirão Preto, SP, Brazil Carlos Estrela1, Mike R. Bueno2, Gabriela S. Couto1, Luiz Eduardo G Rabelo1, Correspondence: Prof. Dr. Carlos 1 3 3 Estrela, Praça Universitária s/n, Setor Ana Helena G. Alencar , Ricardo Gariba Silva ,Jesus Djalma Pécora ,Manoel Universitário, 74605-220 Goiânia, 3 Damião Sousa-Neto GO, Brasil. Tel.: +55-62-3209-6254. e-mail: [email protected] The aim of this study was to evaluate the frequency of roots, root canals and apical foramina in human permanent teeth using cone beam computed tomography (CBCT). CBCT images of 1,400 teeth from database previously evaluated were used to determine the frequency of number of roots, root canals and apical foramina. All teeth were evaluated by preview of the planes sagittal, axial, and coronal. Navigation in axial slices of 0.1 mm/0.1 mm followed the coronal to apical direction, as well as the apical to coronal direction. Two examiners assessed all CBCT images. Statistical data were analyzed including frequency distribution and cross-tabulation. The highest frequency of four root canals and four apical foramina was found in maxillary first molars (76%, 33%, respectively), followed by maxillary second molars (41%, 25%, respectively).
    [Show full text]
  • Third Molar (Wisdom) Teeth
    Third molar (wisdom) teeth This information leaflet is for patients who may need to have their third molar (wisdom) teeth removed. It explains why they may need to be removed, what is involved and any risks or complications that there may be. Please take the opportunity to read this leaflet before seeing the surgeon for consultation. The surgeon will explain what treatment is required for you and how these issues may affect you. They will also answer any of your questions. What are wisdom teeth? Third molar (wisdom) teeth are the last teeth to erupt into the mouth. People will normally develop four wisdom teeth: two on each side of the mouth, one on the bottom jaw and one on the top jaw. These would normally erupt between the ages of 18-24 years. Some people can develop less than four wisdom teeth and, occasionally, others can develop more than four. A wisdom tooth can fail to erupt properly into the mouth and can become stuck, either under the gum, or as it pushes through the gum – this is referred to as an impacted wisdom tooth. Sometimes the wisdom tooth will not become impacted and will erupt and function normally. Both impacted and non-impacted wisdom teeth can cause problems for people. Some of these problems can cause symptoms such as pain & swelling, however other wisdom teeth may have no symptoms at all but will still cause problems in the mouth. People often develop problems soon after their wisdom teeth erupt but others may not cause problems until later on in life.
    [Show full text]
  • Unusual Anatomy of a Second Maxillary Molar - a Rare Four- Root Configuration Case Report
    ARC Journal of Dental Science Volume 1, Issue 2, 2016, PP 13-15 ISSN No. (Online): 2456-0030 http://dx.doi.org/10.20431/2456-0030.0102003 www.arcjournals.org Unusual Anatomy of a Second Maxillary Molar - a Rare four- Root Configuration Case Report Dr. Thiago de Almeida Prado Naves Carneiro,DDS, MSc PhD student, Department of Occlusion, Fixed Prostheses, and Dental Materials, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais Brazil. [email protected] Abstract: Although it is a very rare situation, four-rooted maxillary second molars can occur. The existence of two palatal roots is extremely rare and ranges about only 0.4%. The aim of this study is to present and document a very rare anatomic configuration of a four-rooted maxillary second molar. Anatomic variation in the number of roots and root canals can occur in any tooth, although some cases can be extremely rare as the one presented here.Clinicians should be aware of this possibility before considering any kind of treatment. Keywords: Molar, Dental Anatomy, Anatomical Variation 1. INTRODUCTION Usually the maxillary second molars are described in the literature as a teeth that have 3 roots with 3 or 4 root canals. Understanding of the presence of additional roots and unusual root canals is essential and determines the success of endodontic treatment1. The existence of maxillary second molars with 4 roots (2 buccal and 2 palatal) is extremely rare and ranges about only 0.4%.This information comes from a study that showed, after the examination of two different horizontally angled radiographs of 1,000 maxillary second molars, just four with four roots2.
    [Show full text]
  • Two Sets of Teeth in a Lifetime
    Two sets of teeth in a lifetime Two sets of teeth in a lifetime Deciduous teeth: They are the first set of teeth we have and there are altogether 20 of them. They usually start to erupt from around the age of six months until 3 years of age. Permanent teeth: At the age of 6, they sequentially erupt to replace the deciduous teeth which become loose and shed. Deciduous teeth: Space retainer for permanent teeth Normally, underneath the root of each deciduous tooth, there is a developing permanent successor tooth. When it is time for the permanent successor tooth to erupt, the root of the deciduous tooth will resorb and the deciduous tooth will become loose. The place is then taken up by its permanent successor tooth. Deciduous tooth retains the space for its permanent successor tooth. No tooth is dispensable If the deciduous tooth, especially the second deciduous molar, is lost early due to tooth decay, the consequences can be serious: Poor alignment of the teeth The second deciduous molar is already lost The first permanent molar Since the first permanent molar erupts behind the second deciduous molar at the age of 6, the space of the lost second deciduous molar will gradually close up as the first permanent molar moves forward. The permanent tooth is crowded out of the arch when it erupts Later, when the second permanent premolar erupts to replace the second deciduous molar, the permanent tooth will either be crowded out of the dental arch or be impacted and is unable to erupt, leading to poor alignment of the teeth.
    [Show full text]
  • Sensitive Teeth Sensitive Teeth Can Be Treated
    FOR THE DENTAL PATIENT ... TREATMENT Sensitive teeth Sensitive teeth can be treated. Depending on the cause, your dentist may suggest that you try Causes and treatment desensitizing toothpaste, which contains com- pounds that help block sensation traveling from the tooth surface to the nerve. Desensitizing f a taste of ice cream or a sip of coffee is toothpaste usually requires several applications sometimes painful or if brushing or flossing before the sensitivity is reduced. When choosing makes you wince occasionally, you may toothpaste or any other dental care products, look have a common problem called “sensitive for those that display the American Dental Asso- teeth.” Some of the causes include tooth ciation’s Seal of Acceptance—your assurance that Idecay, a cracked tooth, worn tooth enamel, worn products have met ADA criteria for safety and fillings and tooth roots that are exposed as a effectiveness. result of aggressive tooth brushing, gum recession If the desensitizing toothpaste does not ease and periodontal (gum) disease. your discomfort, your dentist may suggest in- office treatments. A fluoride gel or special desen- SYMPTOMS OF SENSITIVE TEETH sitizing agents may be applied to the sensitive A layer of enamel, the strongest substance in the areas of the affected teeth. When these measures body, protects the crowns of healthy teeth. A layer do not correct the problem, your dentist may rec- called cementum protects the tooth root under the ommend other treatments, such as a filling, a gum line. Underneath the enamel and the crown, an inlay or bonding to correct a flaw or cementum is dentin, a part of the tooth that is decay that results in sensitivity.
    [Show full text]