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Posts for: June, 2020

TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”


By Barbara Preussner, DMD
June 19, 2020
Category: Dental Procedures
HerestheScooponYourUpcomingRootCanal

You might be a bit apprehensive if your dentist recommends a root canal treatment, especially if it's your first. That's understandable: Popular culture has portrayed the root canal as an unpleasant experience.

But as a routine dental procedure, root canal treatments have been responsible for saving millions of decayed teeth. And, with local anesthesia, the procedure is painless. In fact, a root canal treatment stops pain that often results from advanced tooth decay.

So, let's take the mystery out of the root canal. Here's the 411 on this vital but often misunderstood dental procedure.

Why the name “root canal”? The terms for the procedure—root canal therapy, root canal treatment or simply “root canal”—arise from one of the principal parts of the tooth involved, root canals. These are tiny passageways that lead from the tooth's innermost layer, the pulp, to the tooth roots. While treatment often focuses on decay or diseased tissue within the pulp, the root canals can be infected too and must be included in the later filling process.

Who can perform a root canal? All general dentists are trained in basic root canal procedures. Depending on your tooth's condition, your family dentist may be able to perform it. But if your tooth has an intricate root canal network or some other complication, you may need an endodontist, a specialist in interior tooth and root treatments. Endodontists can perform advanced root canal techniques and have the specialized equipment to handle intricate cases.

What happens during a root canal? Although details may vary depending on the type of tooth and extent of decay, there's a basic process for all root canal procedures. After numbing the tooth and surrounding tissues, the dentist drills into the tooth to access the inner pulp chamber and root canals, then removes the diseased tissue and disinfects the empty chamber and canals. After preparing the canals, the dentist then fills the empty spaces. This, and subsequent sealing and crowning, protects the tooth from future decay.

After the procedure you may have some minor soreness for a few days, which is usually manageable with mild pain relievers like ibuprofen or acetaminophen. This discomfort will diminish with time, and your tooth will have a new lease on life.

If you would like more information on root canal treatment, 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 “Root Canal Treatment.”


EvenAll-NaturalFruitJuicesCouldRaiseYourChildsRiskforToothDecay

The amount of sugar your child consumes has a huge bearing on their tooth decay risk: The more they take in, the higher it is for this destructive disease. That's why you should moderate their intake of the usual suspects: sodas, candies and other sugar-laden foods. But you should also put the brakes on something considered wholesome and nutritious: fruit juices. And that includes all natural juice with no sugar added.

Sugar in any form is a prime food source for decay-causing bacteria. As bacteria consume leftover sugar in the mouth, they produce acid as a byproduct. With an ample source of sugar, they also multiply—and this in turn increases their acid production. Acid at these high levels can soften and erode tooth enamel, which leads to tooth decay and cavities.

Limiting or even excluding sugar-added foods and snacks can help minimize your children's risk for tooth decay. For designated snack times, substitute items like carrot sticks or even popcorn with a dash of spice rather than sweet snacks and candies. If you do allow occasional sweet foods, limit those to mealtimes when saliva, which neutralizes acid, is most active in the mouth.

As you manage sugary items your children may eat or drink, the American Academy of Pediatrics also advises you to moderate their consumption of fruit juices, including all-natural brands with no added sugar. Their recommended limits on daily juice drinking depend on a child's age and overall health:

  • Infants (less than one year) or any children with abnormal weight gain: no juice at all;
  • Toddlers (ages 1-3): 4 ounces or less per day;
  • Younger children (4-6): 6 ounces or less per day; and
  • Older children (7-18): 8 ounces (1 cup) or less per day.

As for the rest of your children's daily hydration needs, the most dental-friendly liquid for any of us is plain water. For older school-age children, low- or non-fat milk is also a sound choice.

Preventing tooth decay in your children is a continuous task that requires all of us, parents and dental providers, to do our part. Besides daily hygiene (brushing and flossing) and regular dental visits, keeping sugar at bay—including with juices—is an important part of that effort.

If you would like more information on best dental health practices for children, please contact us or schedule an appointment for a consultation.