Longevity Of Your Teeth

Three aspects of oral health determines the longevity of teeth. One of them is the structural integrity of enamel, which can be jeopardized with cavities. Another factor is the health of the tissues that keep the teeth in place, like our gums and bone. The habits like clenching and grinding also can damage the teeth, wear them down, and make the teeth shorter.

How are cavities treated?

Cavities can be treated in different ways depending on how deep and wide the cavity is. The solutions can be composite restorations, zirconia crowns, root canal treatment, or an extraction. The causes of tooth decay are usually plaque, sugary drinks or dry mouth, these factors should be minimized to prevent further decay. If tooth decay is caught at an earlier stage a composite restoration can address the problem however like anything natural wear and tear on restored teeth are inevitable.

 It is not unusual to see cracks and decay around decades-old mercury fillings and metal-based caps (crowns) or bridges. People may not always be aware of these problems, but they can lead to irreparable damage. 

Can I wait until something happens?

old mercury restoration broken tooth
Broken tooth due to old Mercury restoration

The visible fracture lines on a tooth are like a crack in the windshield; they can lead to unexpected beyond repair harm. In our practice, when we notice these types of issues, we share them with our patients, utilizing microscopic camera photos and digital radiographs. These tools help our patients make educated decisions about their oral health.

It is the most effective and the least expensive option to restore teeth before they start breaking and hurting! Losing teeth always has an impact on the harmony and the health of the rest of the mouth and the body, so it is best to take preventative measures and address problems early on.

How many years do new crowns last?

Digital technologies combined with today’s biologically friendly, durable and aesthetic dental materials allow us to achieve microscopic precision that do not allow leaks between teeth and restorations, which is the main reason for failing bondings, crowns and bridges. Although we expect them to last 10-20 years or more, the longevity of these crowns does depend on the individual’s use, habits, and food choices.

How do gum health affect the longevity of teeth?

Our gums are like a cover protecting our teeth, they attach to teeth and seal around them. The small space between the gum and tooth enamel is the perfect dark and moist environment for bacterial accumulation. As bacterial colonies form, their toxins prepare an environment that attracts more aggressive bacterial colonies. The pathogenic activity breaks the seal and bacteria make their way into the root surfaces, supporting bone and tissues. The longer the disease left untreated the bigger toll it takes on the jawbones, teeth and the whole body. This is a quiet and non-painful process. Patients initially notice bleeding gums, then they develop bad breath and sometimes pain. At later stages of gum disease teeth start to move and fall out. The whole disease process has devastating consequences not only on the mouth but also on the whole body including diabetes, heart disease, and low birth weight according to the American Academy of Periodontology. You can keep your gums healthy by seeing your hygienist every six months. If it has been a while since you have visited a dentist then your periodontal health will need to be evaluated to determine if you would benefit from any periodontal therapies 

Why do gums recede?

Gumline recession is a problem for many patients. The gum line moves down, elongating the shape of their teeth. This can come with increased sensitivity to cold and to toothbrush bristles. There are various causes of gum recession. Incorrect tooth brushing habits, past orthodontics treatment, and bite-related problems maybe a few of them

Why is gum recession bad?

The root surfaces are made up of a porous substance which is softer and weaker than enamel. Roots of teeth are not meant to be exposed to rough conditions of the oral cavity where acids and bacteria are present. Healthy, tight gums protect these weak surfaces of teeth and ensure their longevity. When gums recede, roots get cavities, and they get scooped in at the gumline. Receded gums aesthetically look displeasing as teeth look disproportionate and longer. 

How can receded gums be corrected?

Gum graft is a common procedure that patients with gum recession are recommended by their dentists. Although technically it is a proven way to help with receding gums, It is a surgery that involves cutting and suturing of both the gums and the palate from where the extra tissue is harvested. If all of the teeth are affected, that would require many surgeries since only 2-3 teeth can be treated at a time. 

Fortunately, a more desirable procedure is available to treat receding gums, which is called Pinhole gum rejuvenation procedure. After twenty years of clinical trial and studies, Dr. Chao from California innovated this technique and started training his colleagues throughout the world. 

What makes Pinhole surgical Technique (PST) different from Gum graft?

The biggest difference is that PST does not require the use of scalpel and stitches. The treatment is performed through ‘pinhole’ sized incisions with the help of specially designed instruments. This technique makes the healing process much more comfortable than a gum graft since the roof of the mouth and gums are not cut open.

What is Dr. Alptekin’s experience with PST?

Dr. Alptekin received his training directly from Dr. Chao in 2017. He is one of the few practitioners in the Metrowest area who is certified to perform PST. He also receives referrals from his colleagues whose patients suffer from receding gums.

Does Pinhole technique work for everyone?

The success of the procedure depends on several factors like the general health of the patient; and the cause, type, and severity of the recession. Once Dr. Alptekin evaluates he discusses the possible outcomes with the patient. 

How does clenching or grinding hurt the teeth?

As a result of clenching and grinding the edges of the teeth first become flat and they continuously get shorter. The top and bottom jaws get closer as the height of the teeth is lost. This causes the loss of a smile line and collapses the face since lips are not adequately supported. Loss of enamel will expose the inner layer of the teeth leading to faster damage.   

How can I stop grinding and clenching habits?

teeth clenching
Gum recession and tooth wear due to traumatic bite

Investigating the root cause of these habits is the first step for the right treatment. Nighttime activities can be related to breathing issues, stress, or neurological activity. The effects of these unconscious habits are minimized by the use of custom fabricated guards that fit around your teeth for night time use.

When patients clench during the day it is usually a conscious effort for them to avoid the habit. Grinding, on the other hand, can be the result of struggling to find a comfortable fit between the top and bottom teeth. 

When the bite is not balanced, the biting forces, which can go up to 160 lbs, are not evenly distributed throughout the jaw. These heavy loads which are concentrated on certain teeth due to high points or premature contact, cause gum line recession. Soreness around mouth, teeth sensitivity, head and neck aches, and distorted posture can be the result of jaw joint disorders.

Why does my bite feel off?

Changes in our mouth, like receiving a tooth restoration or orthodontic treatments lead to changes in relations of top and bottom teeth. In follow-ups to these treatments, the bite should be evaluated to assure they are in ideal closing relation.  Even if teeth look perfectly aligned, if the relationship between upper and lower teeth are ignored, the bite could be compromised. Common results of this disharmony are tooth wear and receding gums, which jeopardizes the longevity of teeth.

Is there a way to make sure my bite fits well?

t-scan
The T-Scan™ uses colors to represent the forcefulness of tooth contacts, from low forces (blue) to high forces (red). Forces are also represented as a percentage of force on individual teeth.

Many patients may remember the time their dentist placed a new restoration in their mouth and had them bite into a paper. The purpose of doing this is to recognize any discrepancies with the new restoration and adjust it. Although being a good idea this technique lacks some very important details; namely, the timing and intensity of the bite. 

If our jaws only opened and closed in one way (like a crocodile) perhaps this may not have been a problem. However, because of sliding hinge motions on our jaws, it's crucial to be able to evaluate the intensity and duration of chewing function. For example, a premature contact of two teeth may be perceived by the central nervous system as a contracting signal and may result in muscle spasm. 

Dr. Alptekin uses T-scan technology to identify any occlusal discrepancies by having patients bite on to a smart digital paper. T- scan technology allows him to detect the timing and intensity of a bite, and he uses this information to equilibrate the bite. Patients report relief immediately.                     

What is TMJ?

TMJ is the jaw joint. The problems with TMJ can be very complicated due to its elaborate composition. TMJ does unique sliding hinge motion and it is connected to its counterpart on either side unlike any other joint in the body. The teeth play a critical role in the function and health of TMJ and other associated structures, like the head, neck muscles, and ligaments.  

Why is my jaw popping and clicking when I eat or talk?

We have seven different groups of muscles attached to our skull and neck that work together to open and close our mouths. If any of these muscles are strained, it can cause an unbalanced function and lead to popping and clicking. The muscle strains can be the result of habits like grinding and clenching, or an uneven bite. While some people do not experience any other symptoms, some suffer from headaches, neck aches, and lockjaw due to jaw joint-related problems. 

What can be done for the TMD symptoms?

laser biotech treatment for TMJMany times painkillers and muscle relaxants are prescribed for patients with TMJ problems. Dr. Alptekin has been searching through the literature for a solution without side effects brought about by medications. The therapeutic lasers are the perfect answer for those people suffering from jaw joint-related soreness, lockjaw, and pain. 15 minutes of treatment gives immediate pain relief and follow up treatments help with healing the tissues and preventing future problems. 

Laser stops pain from TMJ and Trigeminal Neuralgia

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