Although they may appear inert, teeth are anything but — they grow and change like other bodily tissues until complete maturation. Teeth roots are especially adaptable; teeth with multiple roots develop much like forks in a road as each root takes a different path toward the jawbone.
This fork where they separate is called a furcation. It’s normal for lower molars and premolars to have two furcations, while upper molars traditionally have three. Furcations pose difficulties for teeth cleaning and maintenance. If bone loss has occurred around them, a condition called a furcation invasion has occurred. This loss is most likely due to periodontal (gum) disease, an inflammation arising from bacterial plaque on the teeth that hasn’t been removed through proper oral hygiene.
We identify furcation invasions through x-ray imaging and tactile probing. They’re classified in three stages of development: Class I describes early onset in which marginal bone loss has occurred, exposing a groove that leads to the beginning of the furcation; Class II is moderate bone loss where a space of two or more millimeters has developed horizontally into the furcation; and, Class III, advanced bone loss whereby the bone loss has extended from one side of the tooth to the other, or “through and through furcation.”
Our first step in treatment is to remove any detectable plaque and calculus on the tooth surface, including the roots (known as scaling and root planing). These areas can be difficult to access, especially near furcations, and requires special instruments known as scalers or curettes. We may also employ ultrasonic scalers that use high-frequency vibrations coupled with water to break up and flush out the plaque and calculus.
We then apply antimicrobial or antibiotic medicines to further disinfect the area and inhibit bacterial growth while the affected tissues heal. As the infection and inflammation subsides, we then turn our attention during subsequent visits to address the bone loss around the furcation. This may involve surgical procedures to aid in re-growing gum tissue and bone and to create better access for cleaning and maintaining the area.
Finally, it’s important to establish good oral hygiene habits and regular checkups and cleanings to prevent further complications or a reoccurrence of the disease. Maintaining these habits will help you avoid tooth loss and other problems with your oral health.
If you would like more information on furcations, 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 “What are Furcations?”
She's an international star who's recognized everywhere she goes. As Carol Brady, she was an ambassador for the “blended family” before most of us even knew what to call her bunch. And her TV Land Pop Culture Icon Award is on permanent display in the National Museum of American History. So what item that fits inside a purse can't Florence Henderson do without?
“I will never leave home without dental floss!” she recently told an interviewer with Dear Doctor magazine. “Because I have such a wide smile, I have found spinach or black pepper between my teeth after smiling very broadly and confidently.”
Henderson clearly understands the importance of good oral hygiene — and she's still got her own teeth to back it up! In fact, flossing is the best method for removing plaque from between the teeth, especially in the areas where a brush won't reach. Yet, while most people brush their teeth regularly, far fewer take the time to floss. Is there any way to make flossing easier? Here are a couple of tips:
Many people have a tendency to tighten their cheeks when they're holding the floss, which makes it more difficult to get their fingers into their mouths and working effectively. If you can relax your facial muscles while you're flossing, you'll have an easier time.
To help manipulate the floss more comfortably, try the “ring of floss” method: Securely tie the floss in a circle big enough to easily accommodate the fingers of one hand. To clean the upper teeth, place fingers inside the loop, and let the thumb and index finger guide the floss around each tooth. For the lower teeth, use two index fingers. Keep moving the floss in your hand so you always have a clean edge... and remember, the goal is to get the tooth clean, but it shouldn't hurt — so don't use too much pressure or go too fast.
So take a tip from Mrs. Brady: Don't forget the floss! If you would like more information about flossing and other oral hygiene techniques, please contact us for a consultation. You can learn more in the Dear Doctor magazine article “Flossing: A Different Approach.”
Here are some helpful facts about Invisalign treatment:
- Invisalign is made up of clear aligners. Each aligner is worn for about two weeks, gradually and subtly shifting your teeth into their proper position.
- Most traditional braces are worn for two years; however with Invisalign in Honolulu, the process is a bit faster. The average Invisalign wearer can expect to sport their clear aligners for about 9-15 months.
- They are tailor made to fit you. If you’ve ever had a suit or article of clothing made just for you, you might even say that it fits you like a glove. There’s nothing like it. Well, the same goes for Invisalign in Honolulu, HI. Each aligner is molded to fit the shape and contours of your mouth, giving you custom-made braces that feel great!
- You can remove them during meals and when brushing and flossing. This is a big relief for many of our patients because this means no food restrictions. Enjoy all your favorite foods without worrying about your clear braces in Honolulu. Furthermore, you can brush and floss regularly, which is a big advantage over those who wear traditional braces.
Water is essential to life. It’s relatively abundant and affordable in the United States, with treated water averaging about $2.00 per thousand gallons. It’s also critical to dental health as part of oral hygiene and as a vehicle for added fluoride to protect against tooth decay.
Water is also big business. We Americans drink an estimated 85 million packaged bottles of water every day. As with any profitable business, there’s no small marketing hype by the bottled water industry, including claims of superiority over community tap water.
These claims should be examined more closely. One advocacy group, the Environmental Working Group (EWG), subjected several brands of bottled water to independent analysis with some surprising results. Many of the samples contained disinfection byproducts, wastewater pollutants like caffeine or drug residue, heavy metals and, in some cases, bacteria. While none of the contaminants found exceeded legal limits, companies weren’t forthcoming with consumers on the possible presence of these substances in their product.
If fluoride is one of those unidentified substances in bottled water it could affect the dental health of an infant or small child. While fluoride is a proven cavity fighter, infants and smaller children can ingest too much for their body weight. For this reason, parents often use bottled water to mix with formula, believing it to be fluoride-free, when in fact it may not be.
Because bottled water is regulated by the Food and Drug Administration, it isn’t subject to the more rigorous standards for tap water administered by the Environmental Protection Agency. Manufacturers also aren’t required to identify the source of their water, the methods and degree of purification and testing for contaminants. There are independent organizations that seek those answers on behalf of the public. For example, EWG publishes a Bottled Water Scorecard online (www.ewg.org/research/ewg-bottled-water-scorecard-2011) with ratings and information on different brands of bottled water.
If you have concerns about your tap water, you may want to consider another alternative to bottled water — in-home water filtration. EWG also has a guide on various types of filtration methods at www.ewg.org/tap-water/getawaterfilter.
The purity of your water greatly impacts your family’s health, including your teeth. Distinguishing between fact and hype will help you make better decisions about the water you drink.
If you would like more information on water quality and safety, 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 “Bottled Water: Health Or Hype?”
According to popular culture, a root canal treatment is one of life’s most painful experiences. But popular culture is wrong — this common treatment doesn’t cause pain, it relieves it. Knowing the facts will help alleviate any anxiety you may feel if you’re scheduled to undergo the procedure.
A root canal treatment addresses a serious problem involving the pulp of a tooth that has become infected. The pulp is a system of blood vessels, nerves and connective tissues inside the tooth that helps the tooth maintain its vitality. It also contains a series of minute passageways known as root canals that interconnect with the body’s nervous system.
The pulp may become infected for a number of reasons: tooth decay, gum disease, repetitive dental procedures, or traumatic tooth damage. Once the pulp becomes irreversibly damaged it must be completely removed from the tooth and the root canals filled and sealed in order to save the tooth.
We begin the procedure by numbing the affected tooth and surrounding tissues with local anesthesia and placing a dental dam (a thin sheet of rubber or vinyl) over the area to isolate the tooth and prevent the spread of infection to other oral tissues. We then drill a small hole in the top of the tooth to access the pulp chamber. Using special instruments, we then remove the infected or dead pulp tissue through the access hole and then wash and cleanse the root canals and pulp chamber with antiseptic and antibacterial solutions.
After additional preparation, we fill the root canals and pulp chamber with a filling especially designed for this kind of treatment, usually a rubber-like substance called gutta-percha that easily molds and compresses when heated. We then seal the access hole with a temporary filling (until a permanent crown can be fashioned) to prevent infection from reentering the pulp space. After the procedure, you may experience some minor discomfort easily managed with over-the-counter pain relievers.
You’ll find the root canal treatment alleviates the symptoms prompted by the pulp infection, particularly acute pain. What’s more, a successful root canal will have achieved something even more crucial to your health — it will give your tooth a second chance at survival.
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 “A step-By-Step Guide to Root Canal Treatment.”
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