Dowd Family Dentistry
309 McArthur Road
Fayetteville, NC 28311

Office: (910) 822-5888

Fax: (910) 822-0055

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Posts for: July, 2014

AlternativestoRootCanalTreatmentCanSaveanInjuredImmatureTooth

When a permanent tooth has been injured, our first priority should be to save it. A root canal treatment (where the interior pulp of the tooth is removed and the pulp chamber and root canals are filled and sealed) is usually the best approach for tooth preservation.

An immature permanent tooth, however, presents a different challenge. While the pulp is less essential to a mature tooth’s vitality, it serves a critical purpose in the tooth’s early development before early adulthood. The pulp produces layers of dentin necessary for the tooth’s root system development. Completely removing the pulp at this stage may retard root development and cause the tooth to eventually weaken, and become brittle and darkened.

For younger teeth, we should therefore use alternative techniques that preserve as much healthy pulp as possible. One of these alternatives is Indirect Pulp Therapy, used when the pulp hasn’t been exposed by the trauma. With this technique we remove as much damaged dentin as possible while preserving the harder dentin closer to the pulp. After applying an antibacterial agent to protect against infection, and then filling and sealing the tooth, the pulp can continue to produce dentin in a normal way.

If pulp exposure has occurred, some form of pulpotomy — the partial removal of any damaged or infected pulp — would be in order. Our goal here is to leave as much of the pulp as possible, and then apply substances that stimulate the remaining pulp to create dentin. The most common type of growth substances are calcium hydroxide or mineral trioxide aggregate (MTA).

If the pulp isn’t at all salvageable, we may then turn to a procedure known as apexification. After removing the pulp we insert MTA at the root end of the tooth, then fill and seal the remaining interior as in a regular root canal treatment. The MTA will help the surrounding bone to heal and continue to grow around the root to further support the tooth.

Recent research into pulp stem cells promises further advances in this area. The regenerative qualities of stem cells could eventually help us “engineer” root development. Until then, there are still effective ways to give a young, damaged tooth a fighting chance to survive.

If you would like more information on preserving injured 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 “Saving New Permanent Teeth After Injury.”


By Dowd Family Dentistry
July 02, 2014
Category: Dental Procedures
DemiMooreDoesntMindtheGap

Once upon a time, a well-known Hollywood actress might have hired a private eye to keep unflattering pictures from appearing in the media. Today, that’s no longer the case. Take timeless beauty Demi Moore: In a widely circulated set of photos, her gap-toothed grin showed she was actually missing one of her front teeth!

It turns out the actress released the pictures herself, as she live-tweeted the tooth replacement procedure from her dentist’s office. Moore later explained that the tooth fell out suddenly as she was sitting at her desk.

Celebrities are just like regular folks… except they have more followers on twitter. So we’re happy when they show us that no matter how bad a dental problem may seem, there’s almost always a way to regain a gorgeous-looking smile. We’re not sure exactly how Demi’s dentist chose to restore the damaged tooth — but depending on the individual circumstances, modern dentistry offers a number of ways to close the gap.

A crown (or cap) is a replacement for the entire visible area of the tooth. It may be needed due to accident or trauma, or as a follow-up to root canal therapy. Placing a crown usually requires more than one office visit. First, the tooth is prepared by removing any decay and shaping it, and a precise model is made of the bite. Next, the permanent crown is custom-made in a dental laboratory; this is placed during a subsequent visit. Advances in technology, however, have made it possible in some instances to deliver the permanent crown in a single office visit. If the tooth still has a healthy root structure, a crown is usually a viable option — even when most of the visible part is gone.

What if the entire tooth, including the roots, are missing? Then your replacement options could include bridgework or a dental implant. A fixed bridge is a series of crowns joined together as one unit. The teeth on either side of the gap are prepared just as they would be for crowns, and the bridge (including a replacement for the missing tooth in the middle) is attached. Bridges have been used successfully for many years, but they have a drawback: They require enamel to be removed from the healthy teeth on either side of the gap, which could lead to a greater chance of decay, gum disease, or a root canal in the future.

The optimal solution, however, might be a dental implant. With this remarkable technology, the replacement tooth is solidly anchored into the jaw via a screw-shaped post made of titanium — a metal which actually becomes fused with the living bone tissue. A custom-made, lifelike crown is then securely attached to the metal implant. Dental implants are the most successful tooth-replacement procedure; they help preserve bone quality in the jaw — and with regular care, they can last a lifetime.

So if your smile is making you camera-shy, why not talk to us about your tooth-restoration options? If you would like additional information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Dental Implants.”