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

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Posts for: March, 2016

By Craig S. Karriker, DMD, PA
March 30, 2016
Category: Oral Health
Tags: oral hygiene   toothpaste  
BeyondTheirMarketingClaimsMostToothpastesareSurprisinglySimilar

In your search for the right toothpaste, you’re inundated with dozens of choices, each promising whiter teeth, fresher breath or fewer cavities. Cutting through the various marketing claims, though, you’ll find most toothpaste brands are surprisingly alike, each containing the same basic ingredients. Taken together, these ingredients help toothpaste perform its primary task — removing daily bacterial plaque from tooth surfaces.

Here, then, are some of the ingredients you’ll find — or want to find — in toothpaste.

Abrasives. A mild abrasive increases your brushing effectiveness removing sticky food remnants from teeth. And unlike the burnt, crushed eggshells of the ancient Egyptians or the brick dust used by 18th Century Brits, today’s toothpaste abrasives — hydrated silica (from sand), calcium carbonate or dicalcium phosphates — are much milder and friendlier to teeth.

Detergents. Some substances in plaque aren’t soluble, meaning they won’t break down in contact with water. Such substances require a detergent, also known as a surfactant. It performs a similar action as dishwashing or laundry soaps breaking down grease and stains — but the detergents used in toothpaste are much milder so as not to damage teeth or irritate gum tissues. The most common detergent, sodium lauryl sulfate, is gentle but effective for most people. If it does cause you irritation, however, you may want to look for a paste that doesn’t contain it.

Fluoride. This proven enamel strengthener has been routinely added to toothpaste since the 1950s, and is regarded as one of the most important defenses against tooth decay. If you’re checking ingredients labels, you’ll usually find it listed as sodium fluoride, stannous fluoride or sodium monofluorosphosphate (MFP). And since it inhibits bacterial growth, fluoride toothpastes don’t require preservative additives.

Humectants, binders and flavoring. Humectants help toothpaste retain moisture, while binders prevent blended ingredients from separating; without them your toothpaste would dry out quickly and require stirring before each use. And, without that sweet (though without added sugar) and normally mint flavoring, you wouldn’t find the average toothpaste very tasty.

The ADA Seal of Approval. Although not an ingredient, it’s still sound advice to look for it on toothpaste packaging. The seal indicates the product’s health claims and benefits are supported by the research standards set by the American Dental Society; and all ADA approved toothpastes will contain fluoride.

If you would like more information on toothpaste and other oral hygiene products, 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 “Toothpaste: What’s in it?


By Craig S. Karriker, DMD, PA
March 22, 2016
Category: Dental Procedures
SurgicallyAccessingSinusescanHelpGrowNewBoneforImplants

Dental implants are by far the best way to replace missing teeth. But they do more than improve your smile: they can restore your ability to eat, chew and talk properly, especially if the teeth replaced are in the back of your mouth. What’s more, they can improve the entire look of your face by restoring facial height and cheek support lost because of the missing teeth.

There is, however, one obstacle to overcome before receiving dental implants — a lack of sufficient bone at the implant site. Bone loss usually occurs when teeth have been missing for some time. This is because when we chew the forces generated by the teeth stimulate continual bone growth to make up for older bone that has dissolved (resorbed). This stimulation doesn’t occur after teeth are lost, which slows the rate of bone growth. Over time the amount of healthy bone diminishes.

Without enough bone for support, implants can’t be placed properly. Fortunately, some of the bone can be regenerated through techniques that place bone grafting material at the site to stimulate and serve as a scaffold for new bone.  The new bone will eventually replace the graft.

For missing upper back teeth with bone loss, we can take advantage of facial anatomy to grow the bone needed for implants. This area of the face is where the maxillary sinuses, air spaces lined with a tissue membrane, are located on either side just above the upper jaw. After determining their exact size and location through detailed x-ray imaging, we can surgically access the area inside the mouth just above the missing teeth.

The sinus cavity is an area where bone growth can occur by placing a bone graft between the floor of the sinus and the sinus membrane. Sometimes bone growth enhancers are used to stimulate and speed up regeneration. The procedure can usually be performed with local anesthesia (much like a routine tooth filling), with only mild discomfort afterward for a few days managed by an anti-inflammatory drug like ibuprofen and a decongestant for sinus swelling.

After six to seven months, we re-evaluate the area to see if sufficient bone has returned for implant surgery. If so, you will be well on your way to achieving a new look and better function through dental implants.

If you would like more information on building new bone through sinus surgery, 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 “Sinus Surgery.”


By Craig S. Karriker, DMD, PA
March 14, 2016
Category: Oral Health
Tags: thumb sucking  
ThumbSuckingOneofManyFactorstoConsiderWhenTreatingaPoorBite

It’s true — thumb sucking beyond age 4 can cause bite problems for permanent teeth. But prolonged thumb sucking is just one of a number of possible contributing factors for a bad bite (malocclusion). A dentist must identify all the factors involved when a bad bite is present — their involvement is essential for a successful treatment outcome.

A fairly benign habit for infants and toddlers, thumb sucking is related to an “infantile swallowing pattern” young children use by thrusting their tongues forward between the upper and lower teeth when they swallow. Around age 4, though, they usually transition to an adult swallowing pattern in which the tongue rests on the roof of the mouth just behind the front teeth. Thumb sucking stops for most children around the same time.

Thumb sucking beyond this age, though, can put increased pressure on incoming permanent teeth pushing them forward. This could lead to an “open bite” in which the upper and lower teeth don’t meet when the jaws are closed. The tongue may also continue to thrust forward when swallowing to seal the resulting gap, which further reinforces the open bite.

Before treating the bite with braces, we must first address the thumb sucking and improper tongue placement when swallowing — if either isn’t corrected the teeth could gradually revert to their previous positions after the braces come off. Besides behavioral incentives, we can also employ a thin metal appliance called a “tongue crib” placed behind the upper and lower incisors. A tongue crib discourages thumb sucking and makes it more difficult for the tongue to rest within the open bite gap when swallowing, which helps retrain it to a more normal position.

An open bite can also occur if the jaws develop with too much vertical growth. Like thumb sucking and improper tongue placement, abnormal jaw growth could ultimately cause orthodontic treatment to fail. In this case, though, surgery may be necessary to correct the jaw structure.

With all these possible variables, our first step needs to be a thorough orthodontic exam that identifies all the cause factors for your child’s specific malocclusion. Knowing if and how thumb sucking may have contributed to the poor bite will help us design a treatment strategy that’s successful.

If you would like more information on the causes of poor tooth position, 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 “How Thumb Sucking Affects the Bite.”


By Craig S. Karriker, DMD, PA
March 13, 2016
Category: Dental Procedures
Tags: tooth staining  
FindoutWhatKindofToothStainingyouHaveBeforeSeekingaSolution

Stained teeth can be embarrassing — so much so you may even hesitate to smile. Before you seek out a whitening solution, though, there are a few things you need to know about tooth staining.

Tooth staining is more complex than you might think. There are actually two types: extrinsic, staining from foods and other substances of the outer surface of the enamel; and intrinsic, discoloration deep within a tooth that affects their outward appearance. The latter staining has a number of causes, including the type of dental materials used to fill a tooth, a history of trauma or the use of the antibiotic tetracycline during early tooth development.

There are some noticeable differences between the two types, although an examination is usually necessary to determine which you have. Extrinsic staining tends to be brown, black, or gray, or occasionally green, orange or yellow. Intrinsic staining can be red, pink or, if caused by tetracycline and fluoresced under ultraviolet light, yellow. If only one tooth is discolored it’s most likely intrinsic due to decay in the tooth pulp.

What can be done also depends on which type. Extrinsic staining can be modified through whitening, with either an office application or a home kit (there are differences, so you should consult with us before you decide). It may also be essential to modify your diet by restricting foods and beverages (coffee, wine or tea) known to cause staining and by eliminating tobacco use. You should also practice daily hygiene, including brushing with a toothpaste designed to diminish staining, and regular office cleaning and polishing.

Intrinsic staining can’t be addressed by these methods. Instead, you may need to undergo a procedure where we enter the interior of the tooth and insert a bleaching agent. If this isn’t an option, you can also choose a cosmetic restoration such as a porcelain veneer or crown that will cover the tooth to better match the color of your other teeth.

Dealing with stained teeth begins with a visit to our office to determine what type of discoloration you have and to learn your options. But regardless of what type you have, there is a way to a brighter smile.

If you would like more information on the causes and treatments of tooth staining, 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 “Tooth Staining.”


By Craig S. Karriker, DMD, PA
March 05, 2016
Category: Dental Procedures
Tags: composite resins  
4AdvantagestoUsingCompositeResinsforRestoringTeeth

Restoring chipped, stained or decayed teeth with dental porcelain is a tried and true method that’s been used for decades. In recent years, though, restorations made with composite resin have become a popular alternative.

Made of a plastic-based matrix with added glass filler, composite resin can be molded and bonded to teeth to replace missing structure with color to match. While they can’t be used for every problem situation, they’re an efficient and economical way to transform your smile.

Here are 4 advantages for using composite resin to restore moderately defective teeth.

They require very little tooth preparation. Crowns, veneers and other porcelain restorations require removing some healthy tooth structure to accommodate them. With the development of stronger bonding materials, composite resins can restore even many large defects in teeth caused by decay or trauma with little structural removal and still remain durable.

Most composite resin restorations are “single-visit” procedures. Unlike porcelain restorations, applying composite resin doesn’t require a dental lab, a process that can take multiple visits. In most cases, a skilled dentist can apply them during a single visit.

They have excellent color matching capabilities. We usually think of teeth as one single shade of white — actually, a single tooth can have varying gradations of color from the root to the tip. As mentioned before, composite resins can be prepared to match those color shades precisely, so your restored teeth look natural and blend well with your other teeth.

Composite resins can be an effective temporary fix for young injured teeth. Because children’s teeth are still developing, permanent restorations for traumatized teeth aren’t usually advisable until they’ve fully matured. Composite resin can be used to restore a young tooth’s form and function until it’s ready for a permanent solution.

If you would like more information on restoring teeth with composite resin, 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 “Artistic Repair of Front Teeth with Composite Resin.”