My Blog

By Christopher Couri, DDS, MS
January 10, 2022
Category: Dental Procedures
Tags: loose tooth  
CallYourDentistASAPifYouHaveaLooseTooth

If you notice a loose tooth, don't wait! Call your dentist ASAP. That loose tooth may be in danger of being lost or damaged permanently—and you won't know if that's true without having the tooth examined.

To understand why, let's first consider how your teeth are normally held in place—and contrary to popular belief, it's not primarily through the bone. The actual mechanism is a form of gum tissue called the periodontal ligament attaching the tooth to the bone. This ligament secures teeth in place through tiny collagen fibers that attach to both the tooth and bone.

The periodontal ligament can effectively secure a tooth while still allowing for some movement. However, these ligaments can come under attack from periodontal (gum) disease, a bacterial infection primarily caused by dental plaque. Without aggressive treatment, the infection can destroy these tissues, causing them to eventually detach from the teeth.

This can result in loose teeth, which is, in fact, a late sign of advanced gum disease. As such, it's a definite alarm bell that you're in imminent danger of losing the teeth in question.

Treating a gum infection with accompanying loose teeth often has two components. First, we want to stop the infection and begin the healing process by removing any and all plaque and tartar (hardened plaque) on tooth surfaces. This includes deposits below the gum line or around the roots of the tooth, which may require surgery to access them.

Second, we want to help stabilize any loose teeth while we're treating the infection, which can take time.  We do this by using various methods from doing a bite adjustment of individual teeth tat are getting hit harder when you put your teeth together to splinting loose teeth to healthier neighboring teeth. We may also employ splinting when the tooth is loose for other reasons like trauma. This provides a loose tooth with needed stability while the gums and bone continue to heal and reattach.

Securing a loose tooth and treating the underlying cause isn't something you should put off. The sooner we address it, the more likely you won't lose your tooth.

If you would like more information on permanent teeth that become loose, 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 “When Permanent Teeth Become Loose.”

By Christopher Couri, DDS, MS
December 31, 2021
Category: Oral Health
Tags: dry mouth  
TakeStepstoStopChronicDryMouthandAvoidDentalDisease

We all experience that unpleasant "cotton-mouth" feeling now and again. But what if it happens all the time? Chronic dry mouth is more than unpleasant—it could be a medical condition that threatens your oral health.

Chronic dry mouth is a sign you don't have enough saliva present. That's a problem because we need saliva to keep our teeth and gums healthy by neutralizing the oral acid that erodes tooth enamel. Saliva also supplies antibodies to fight infection.

A saliva deficiency could be the result of lifestyle habits like drinking alcohol or smoking, metabolic diseases or treatments like chemotherapy or radiation. More commonly, though, it's a side effect from a medication you're taking.

Given the heightened risk it causes to your teeth and gums, what can you do to alleviate chronic dry mouth?

Review your medications. If you're taking prescribed medications, talk with your pharmacist or doctor about possible oral side effects associated with any of them. If so, it may be possible to switch to an alternative medication without the dry mouth side effect.

Don't use tobacco. Regardless of whether you smoke, dip or chew, tobacco use can interfere with saliva production. Kicking the habit not only improves saliva flow, it may further reduce your risk for oral diseases, especially oral cancer.

Drink more water. Saliva is mainly composed of water—so, be sure your body has plenty of it to facilitate saliva production. It's a good idea to sip extra water throughout the day, and especially before and after you take medication.

Practice oral hygiene. As a general rule, brushing and flossing every day is pivotal in preventing dental disease—but it's especially important with dry mouth. Be sure, then, to brush twice and floss once every day. You should also see your dentist at least every six months for dental cleanings and checkups.

Chronic dry mouth could be setting you up for future dental disease. But taking steps to alleviate it while practicing daily dental care could help you avoid that unhappy outcome.

If you would like more information on alleviating chronic dry mouth, 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 “10 Tips for Dealing With Dry Mouth.”

By Christopher Couri, DDS, MS
December 21, 2021
Category: Dental Procedures
Tags: wisdom teeth  
DecidingtheFateofWisdomTeethMoreNuancedThaninthePast

If you're of a certain age, there's a good chance you've had your third molars—wisdom teeth—removed. At one time, extracting these particular teeth was a common practice, even if they hadn't shown any signs or symptoms of disease or dysfunction. But now, if you have a son or daughter coming of age, your dentist may recommend leaving theirs right where they are.

So, what's changed?

Wisdom teeth have longed been viewed as problematic. As the last of the permanent teeth, they often erupt on a jaw already crowded with other teeth. This can cause them to come in out of position—or not at all, remaining partially or totally submerged (impacted) beneath the gums.

Misaligned teeth are more difficult to keep clean of bacterial plaque, which in turn raises the risk of tooth decay or gum disease. Impacted teeth can put pressure on the roots of neighboring teeth, which further increases the risk for disease or bite problems.

To avoid these common problems associated with wisdom teeth, dentists often remove them as a preemptive measure. Given their size and possible root complexity, this is no small matter: Removing them usually requires oral surgery, making wisdom teeth extraction one of the top oral surgical procedures performed each year.

Today, however, many dentists are taking a more nuanced approach to wisdom teeth. While they still recommend removal for those displaying signs of disease or other problems, they may advise leaving them in place if the teeth are healthy, not interfering with their neighbors, and not affecting bite development.

That's not necessarily a final decision, especially with younger patients. The dentist will continue to monitor the wisdom teeth for any emerging disease or problems, and may put extraction back on the table if the situation merits it.

The key is to consider each patient and their dental needs regarding wisdom teeth on an individual basis. If warranted, removing the wisdom teeth may still be warranted if will help prevent disease, keep bite development on track and optimize oral health overall.

If you would like more information on wisdom teeth, 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 “Wisdom Teeth: Coming of Age May Come With a Dilemma.”

By Christopher Couri, DDS, MS
December 11, 2021
Category: Dental Procedures
Tags: celebrity smiles   crown  
WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

By Christopher Couri, DDS, MS
December 01, 2021
Category: Dental Procedures
Tags: root canal  
GotQuestionsAboutRootCanalsWeHaveAnswers

You might have a few questions should you find out you need a root canal for a tooth infected with advanced decay. Most will be about what you should expect before, during and after a procedure.

But first, let's deal with a couple of your obvious concerns right upfront:

  1. No, contrary to your Uncle Bill, it won't be painful (if the infected tooth is throbbing, though, the procedure will relieve your pain);
  2. Yes, based on outcomes for millions of treated teeth over several decades, the odds are high the procedure will save your tooth.

As to other questions you might have, here's a basic 411 concerning your upcoming root canal procedure.

The "Why." Many consider tooth decay to be mainly a cavity forming in the outer enamel and dentin layers of a tooth. But tooth decay can destroy tooth structure as it advances through to the pulp, the heart of a tooth. The resulting infection will also spread into the root canals to eventually infect the roots and supporting bone. A root canal treatment removes the decay and stops the advancing infection in its tracks.

The "How." There are a number of variations on the procedure, but they all follow this basic process: After thoroughly numbing the tooth and surrounding tissues, we drill a hole into the tooth to access the pulp chamber and the root canals. We then remove all infected tissue through this access and disinfect the tooth's interior spaces. We then fill these spaces with a rubber-like filling to prevent future infection.

The "After." Once we've completed filling, we seal the access hole. Sometime later, we'll crown the tooth to provide further protection against infection and add support to the tooth. In the meantime, you may have a few days of discomfort, which is usually manageable with mild pain-killers like ibuprofen or acetaminophen.

A lot of root canals can be performed by a general dentist, but more complicated cases may require an endodontist. In either scenario, a root canal could give your infected tooth another chance at life that it wouldn't otherwise have.

If you would like more information on root canal therapy, 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.”





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