Craig S. Karriker, DMD, P.A.- 400 South Granard Street, Gaffney, SC 29341, (864) 487-0710

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Posts for: September, 2014

By Craig S. Karriker, DMD, PA
September 29, 2014
Category: Oral Health
SavingaBabyToothistheBestOptionforPermanentToothDevelopment

Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.

Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.

Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.

There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.

If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.

In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.

If you would like more information on the importance of baby teeth, please contact us or schedule an appointment for a consultation.


By Craig S. Karriker, DMD, PA
September 26, 2014
Category: Oral Health
Tags: tooth decay   dry mouth  
DryMouth-CausesRisksandCures

A consistently dry mouth is not only uncomfortable and unpleasant but also probably more serious than you think. Dry mouth, medically known as xerostomia (“xero” – dry; “stomia” – mouth) affects millions of people, but few understand why it happens or why it is important.

What Causes Dry Mouth?

It is normal to awaken with a dry mouth because saliva flow decreases at night. But if your mouth is persistently dry throughout the day, it may be a result of habits such as smoking, alcohol or too much coffee drinking or even dehydration. It is also a common side effect of some medications. Xerostomia is not a disease in itself, but it could be a symptom of salivary gland or other systemic (general body) disease.

Why is Saliva Important?

A persistently dry mouth can be a problem. Not only does it feel unpleasant and lead to bad breath, it can also significantly increase your risk for tooth decay. Saliva lubricates your mouth for chewing, eating, digestion and even speaking. Saliva also has important antibacterial activities. Most importantly normal healthy salivary flow neutralizes and buffers acids in the mouth to protect the teeth from the acids produced by bacteria on the teeth that cause decay, and by acids in sodas, sports drinks and juices that can erode tooth enamel.

Not only does saliva neutralize acids but with its high mineral content it can actually reverse de-mineralization — the process by which acids attack enamel and remove calcium from the enamel surface. Healthy saliva actually re-mineralizes the outer layers of tooth enamel, but the process can take 30-60 minutes. That's why it's important not to snack on sugars or drink sodas between meals — one an hour and your mouth is acidic all the time.

Individuals without enough saliva are especially at risk for root decay and fungal infections, and they are also more likely to lose tooth substance through abrasion and erosion.

What Can We Do for a Dry Mouth?

If your mouth is usually dry, make an appointment with us to assess the causes of the problem. However it may be more serious with medical implications. The solution may be as simple as drinking more water and using good daily oral hygiene, or it may necessitate prescription medication to promote more saliva flow.

Contact us today to schedule an appointment to discuss your dry mouth and what we can do to help. For more information read the article in Dear Doctor magazine “Tooth Decay – How To Assess Your Risk.”


By Craig S. Karriker, DMD, PA
September 18, 2014
Category: Oral Health
Tags: gum disease  
BleedingGumsareaPossibleSignofPeriodontalGumDisease

If you notice your gums bleeding when you brush your teeth, you’re not alone — it’s estimated that as many as 90% of the population have at some time had the same experience. That doesn’t mean it’s normal, though; in fact, unless you’re pregnant, have a systemic condition like diabetes or take blood-thinning medication, it’s more likely a sign that an infection has caused your gums to become inflamed and tender. The infection arises from a bacterial biofilm that’s been allowed to accumulate on tooth surfaces due to inadequate brushing and flossing.

If not treated, the early form of this infection known as gingivitis can develop into a more serious form of gum disease in which the various tissues that help attach teeth to the jaw become infected and eventually detach. As it progresses, detachment forms voids known as periodontal pocketing between the teeth and gum tissues. The end result is receding gum tissue, bone loss and eventually tooth loss.

If you begin to notice your gums bleeding when you brush, you should make an appointment with us for an examination — and the sooner the better. During the exam we’ll physically probe the spaces between your teeth and gum tissues with a periodontal probe, a thin instrument with a blunt end marked in millimeters. As we probe we’ll determine the quality of the gum tissue — whether the probe inserts easily (a sign the tissues are inflamed) or gives resistance (a sign of healthy tissue). We’ll also determine the degree of detachment by measuring the depth of the insertion with the millimeter scale on the probe.

The presence of bleeding during this examination is a strong indication of periodontal disease. Taking this with other signs we encounter during the exam (including the degree of pus formation in any discovered pockets) we can then more accurately determine the existence and level of advancement of the disease.

While gum disease is highly treatable, the best results occur when the condition is discovered early, before the infection severely damages tissues around the teeth. Being on the lookout for bleeding and gum tenderness and responding to it quickly can significantly simplify the necessary periodontal treatment.

If you would like more information on bleeding gums and other symptoms of gum disease, 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 “Understanding Gum (Periodontal) Disease.”


By Craig S. Karriker, DMD, PA
September 10, 2014
Category: Oral Health
Tags: gum disease   loose teeth  
DeterminingtheCauseofToothLoosenessKeytoEffectiveTreatment

A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.

Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.

Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.

Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.

In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.

If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.

If you would like more information on loose 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 “Loose Teeth.”


By Craig S. Karriker, DMD, PA
September 02, 2014
Category: Dental Procedures
Tags: dentures  
SuccessfulOutcomesWithDenturesDependsonAttentiontoDetail

While dental implants are considered the gold standard for tooth replacement, removable dentures are still a viable choice, especially for patients with edentulism (complete tooth loss). Removable dentures have also undergone considerable advancement to improve their function, appearance and longevity.

But even with these advancements, dentures still require a fair amount of skill, experience and — of utmost importance — a sense of art. If you’re considering this option, long-term success depends on a careful process of construction, fit adjustment and regular checkups to maintain that fit.

Our first step is to determine exact tooth placement on each denture. Using facial features (or photos before tooth loss) we establish placement landmarks so that corresponding upper and lower teeth align properly. We also consider tooth size, their orientation in relation to the lip, and the needed space to leave between the upper and lower teeth when they are at rest. We make these determinations based on accepted standards of beauty, but also taking into account your particular comfort level with any features that might alter your appearance.

The denture’s gums must also look realistic when you smile, especially if your upper lip rises above the teeth to expose more gum tissue. We also want to match the color and texture of your natural gums, as well as incorporate palatal rugae, the little ridges behind the upper front teeth that aid with speech and chewing food.

When we first place the new dentures in your mouth, we may need to adjust them for balance between the upper and lower sets when they come together. An imbalanced fit could have an adverse effect on your ability to bite, chew and speak normally.

Your dentures should have a good, comfortable fit. Over time, however, you will encounter some degree of bone loss because you no longer have your natural teeth to stimulate bone growth and absorb the forces created during function when your teeth contact. This and other factors may cause your dentures to become loose and uncomfortable to wear. For that reason, it's important for you to visit us regularly to maintain that good fit and check the health of underlying tissues and bone.

Careful planning and denture construction help ensure your new dentures successfully restore form and function to your mouth. Regular monitoring will also ensure they continue to serve you well for as long as possible.

If you would like more information on removable dentures, 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 “Removable Full Dentures.”