Possible Problems with a Dental Crown

Crowns aren't placed on perfect teeth. They're generally only required after a tooth has experienced some type of catastrophic event, such as fracture, tooth decay or a lost filling.
These same events can have a detrimental effect on other aspects of the tooth, like its nerve. It may, however, take time for these problems to develop. And for this reason, a tooth that previously seemed just fine, either before the crowning process was begun or even many years after, may suddenly begin to hurt.

• Discomfort or sensitivity - Patients may experience sensitivity immediately after the procedure as the anesthesia begins to wear off. If the tooth that has been crowned still has a nerve in it, you may experience some hot and cold sensitivity. Your dentist may recommend that you brush your teeth with a tooth paste designed for sensitive teeth. Pain or sensitivity that occurs when you bite down may mean that the crown is too high on the tooth. If this is the case, call your dentist. He or she can adjust the bite on the crown.
• Chipped crown - Dental crowns made of all porcelain can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the crown remaining in your mouth. If the chipping is extensive, the crown may need to be replaced.
• Loose crown - Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If your crown feels loose, contact your dentist.
• Crown falls off - Sometimes crowns fall off. This can due to an improper fit or a lack of cement. If this happens, call your dentist. He or she will give you specific instructions on how to care for your tooth and crown for the day or so until you can be seen for an evaluation. Your dentist may be able to re-cement your crown in place; if not, a new crown will need to be made.
• Allergic reactions - Because the metals used to make crowns are usually a mixture of metals, a rare allergic reaction may occur. Let your dentist know about all allergies or sensitivities.
• Tooth pain - Ache, throbbing, pain when biting.
• “Bite” issues - Irregular bite, tenderness when biting.

When Do I Need a Dental Crown?

A crown is a restoration that covers, or “caps,” a tooth to restore it to its normal shape and size. A crown can also strengthen and improve the appearance of your tooth. Crowns are necessary when a tooth is generally broken down and a filling won’t solve the problem. If your tooth is cracked, a crown holds your tooth together to seal the cracks so the damage doesn’t get worse. Crowns are also used to support a large filling when there isn’t enough of the tooth remaining.

Functions of a crown:

1. Restore the form, function and esthetics of a tooth - Because a dental crown encases the entire visible portion of a tooth, porcelain crowns can be used to enhance or idealize the cosmetic appearance of teeth.
2. Improve the strength of a tooth - Dental crowns are routinely placed on teeth that have broken, have had large portions destroyed by tooth decay or have had root canal treatment. That's because beyond just restoring a tooth's shape, a crown can provide a reinforcing and strengthening effect too.
3. Protect the underlying tooth from any mechanical, chemical, or thermal injury.

Your dentist may also recommend a crown in order to protect weak teeth from fracturing (like after a root canal), restore already fractured teeth, or cover badly shaped or discolored teeth.

Teeth Wearing Away?

Your teeth are built to last. They can even last a lifetime with regular teeth cleanings and dental care. However, the daily grind of chewing, brushing, and grinding, along with accidental injuries, can take a toll.

Reasons for tooth erosion:

• Chipped, fractured or broken teeth - Things such as chewing ice, hard candy, popcorn kernels and opening nuts with your teeth can lead to chipping and breakage of natural teeth and restorations. Teeth that have fillings or root canals are at highest risk, because they aren't as strong as intact teeth. Most frequently, teeth are damaged as a result of an accident or sports-related injury. Although a chipped tooth can be repaired, a fracture is more difficult to fix especially if the crack extends below your gum line.
• Teeth grinding - Unconscious grinding or clenching of teeth, over time, can damage the chewing surfaces. In many cases, people don't realize they have a problem until a dentist notices signs on their tooth surfaces.
• Acid and tooth enamel erosion - Teeth become vulnerable when acid levels in the mouth are too high. Acid erodes enamel, making teeth more susceptible to decay. Acidic foods and drinks, and acid-producing bacteria in the mouth are prime culprits.
• Excessive consumption of alcohol - Alcoholics and binge drinkers can have the same wear on their teeth because of too much alcohol. Not only do teeth become thin and almost transparent in these extremes, but the body also loses needed vitamins and minerals, depriving teeth of some needed nutrients, too.
• Other physical conditions – Conditions such as cancer or even pregnancy show their presence on teeth, and individuals are advised to combine medical care with regular preventative dental care and maintenance.
• Medications - Many medications cause dry mouth. Saliva is necessary for keeping the mouth clean. Keeping a wash of saliva around the teeth keeps decay from forming as rapidly and provides needed moisture for gum tissue. Certain medications suck the saliva out of your mouth. Syrupy medicines also harm teeth by coating them with sticky sugar. Rinsing after taking cough, cold or allergy syrups, or having children rinse after taking them, will help keep residue from building up and attacking enamel.
• Brushing right after meals - If you have the habit of brushing right after dinner, stop doing so. Acids weaken tooth enamel and leave it more prone to erosion during brushing. Wait about 20 to 30 minutes before brushing your teeth.
• Brushing hard - Some people like to brush very hard. They want to keep their teeth very clean so they will scrub very hard, but that will traumatize the gums. Over time, it will cause the gums to recede. Brush gently and spend at least three minutes brushing and flossing your teeth each time. Always use a soft or ultrasoft toothbrush.

Mouth Cancer Causes, Diagnosis And Treatments

A cancerous (malignant) tumor starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. Some people develop mouth cancer for no apparent reason. However, certain risk factors increase the chance that mouth cancer may develop. These include:

• Smoking - Mouth cancer is just one cancer which has a much higher incidence in smokers than in non-smokers.
• Alcohol - Drinking a lot of alcohol can increase your risk of developing mouth cancer.
• Chewing tobacco or the betel leaf.
• Poor dental hygiene.

Symptoms:

The most common symptoms of mouth cancer are a sore or ulcer in the mouth that does not heal and pain in the mouth that does not go away. In many cases, changes are seen in the mouth before the cancer develops. This means that early treatment of these changes may prevent progression. Other symptoms include:

• White patches anywhere in your mouth
• Red patches anywhere in your mouth
• A lump on the lip, tongue or in the mouth or throat
• Unusual bleeding or numbness in the mouth.
• Pain when chewing or swallowing
• A feeling that something is caught in the throat
• A change in your voice, or speech problems.
• A lump in the neck.

Diagnosis:

To confirm diagnosis, a patient needs a biopsy. A small sample of tissue is removed from a part of the patient’s body and is looked under the microscope to look for abnormal cells. If the doctors have confirmed mouth cancer, further tests are done such as, CT scan or MRI scan to see if the cancer has spread to other parts of the body. These tests reveal how much the tumor has grown in mouth and whether cancer has spread to local nymph nodes or to other areas of body.

Treatment:

Treatment options which may be considered include radiotherapy, surgery and chemotherapy. The treatment advised for each case usually depends on various factors such as the exact site and extent of the cancer and your general health. In many cases, treatment aims to cure the cancer. There is a good chance of a cure if it is treated in the early stages. Many cases are diagnosed at an early stage. This is because early mouth cancers are more easily detected than cancers deeper inside the body. In some cases, treatment aims to control the cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly.

The most common treatment is surgery. The type of operation depends on the size of the cancer and its site. The operation may be to remove the cancer and some of the surrounding normal tissue. Radiotherapy is a treatment which uses high-energy beams of radiation which are focused on malignant (cancerous) tissue. This kills cancer cells, or stops cancer cells from multiplying. Chemotherapy is a treatment which uses anti-cancer medicines to kill cancer cells, or to stop them from multiplying.

It is important to have regular dental checkups to screen for oral cancer.

Tooth Discoloration

In today’s self-conscious society, the dull, stained effects of tooth discoloration represent a common dental complaint. Beyond the professionally managed teeth whitening options, people are employing new, everyday products in their ongoing struggle against yellow teeth and other forms of tooth discoloration. From whitening strips and take-home trays to whitening toothpaste and chewing gum, people are going to various lengths to achieve and maintain a white, attractive smile.

Tooth discoloration could be extrinsic or intrinsic. Extrinsic discoloration occurs in the outer layer of the tooth, called the enamel. Enamel stains can range from white streaks to yellow tints or brown spots and pits. Intrinsic discoloration occurs in the inner structure of the tooth, called the dentin, when the dentin darkens or displays a yellow (or gray) tint. Extrinsic staining can be effectively treated using various whitening techniques, intrinsic staining may be more stubborn, potentially requiring alternative cosmetic treatment such as veneers.

Causes:

• Foods/drinks - Coffee, tea, colas, wines and certain foods (e.g., tomatoes, cherries, blueberries etc.) can cause extrinsic tooth stains.     
• Tobacco use - Smoking or chewing tobacco can result in discolored teeth
• Poor dental hygiene - Inadequate brushing and flossing to remove plaque and stain-producing substances can cause tooth stains.
• Disease - Diseases affecting enamel and dentin can lead to tooth discoloration. Certain infections in pregnant mothers can cause tooth discoloration in the baby by affecting enamel development.
• Medications - Antihistamines, antidepressants and high blood pressure drugs can discolor teeth. Maternal use of tetracycline antibiotics during the second half of pregnancy may result in discoloration of the baby's tooth enamel.
• Ageing - As you age, the outer layer of enamel on your teeth wears away, revealing the dentin's natural, yellow color. Additionally, over the years your teeth accumulate more stains and tartars, causing them to darken and discolor.
• Dental work - Procedures requiring certain dental materials, such as silver amalgam restorations, can produce a grayish-black cast to teeth

Treatments: 

• Good hygiene - Practice proper dental hygiene by brushing and flossing daily, and getting professional teeth cleanings every six months or more frequently, depending on your dentist's recommendation 
• Whitening procedures
• In-office tooth whitening - Dentist can easily remove extrinsic and some intrinsic tooth discoloration caused by foods/drinks and other causes by applying a bleaching peroxide gel to the tooth enamel.
• At-home bleaching - Many dentists believe that professionally dispensed take-home whitening kits may produce the best results over time. More suitable for extrinsic tooth discoloration, home whitening usually is done with teeth whitening kits, gels or strips.
• Over-the-counter at home whitening products – These are convenient and low-cost alternative to bleaching discolored teeth without dentist supervision.
• Composite bonding, crowns and veneers - For teeth severely discolored by excessive fluoride, root canal treatment, or consumption of certain drugs, your dentist may recommend covering the tooth's outer surface with a color-matched composite bonding material, porcelain veneers or porcelain crowns instead of bleaching.

Consult with your dentist for the best tooth discoloration treatment options for your individual case.

How to Prevent Enamel Loss

Tooth enamel is the hardest tissue in the human body. It protects your teeth when you chew on crunchy foods and consume acidic beverages. But over time the enamel can chip, scrape, and wear away. And once it is gone, the body can’t replace it, making your teeth vulnerable and putting your oral health at risk. That’s why it’s so important to prevent tooth enamel loss starting at an early age and throughout your whole life.

Here are tips to prevent enamel loss:

• Limit your consumption of highly acidic foods like soda and citrus fruits. When you do consume them, rinse your mouth out with clean water immediately afterward. 
• Don’t swish, swirl or hold acidic drinks in your mouth for too long
• Make use of a straw when you consume acidic drinks. The straw helps the liquids to bypass the teeth and travel directly to your throat.
• Cut down on the amount you snack. No matter what you eat, the acidity level in your mouth is elevated for a few hours after your finish. Only snack when you are truly hungry, and try to brush your teeth or at least rinse your mouth afterward.
• Chew sugar-free gum for a few minutes during the time between meals. Gum increases your saliva production which in turn enhances the teeth with minerals
• Drink more water, and drink water more frequently
• Always use fluoride toothpaste. Fluoride strengthens the teeth but it is not in all toothpastes, so be sure to ready the label carefully.
• Consider using a mouthwash along with a fluoride paste to give you extra protection from the effects of everyday acids.
• Make sure you’re using a soft-bristled brush.

Talk to your dentist to learn other ways to prevent enamel loss. Take care of the strongest substance in your body and your enamel will take care of you!

Tooth Cavities

Dental cavities are holes in teeth caused by tooth decay. Cavities are caused by tooth decay - a process that occurs over time. Here's how tooth decay develops:

• Formation of plaque - Your mouth naturally contains many types of bacteria. Some thrive on food and drinks that contain certain forms of sugar. When these sugars aren't cleaned off your teeth, the bacteria quickly begin feeding on them and producing acids. The bacteria, form bacterial plaque — a sticky film that coats your teeth. If the plaque is not removed while it's soft, it becomes hard and difficult to remove — a good place for bacteria to hide.
• Plaque attacks - The acids in plaque remove minerals in your tooth's hard, outer enamel. This erosion causes tiny openings or holes in the enamel — the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid.
• Destruction - As tooth decay develops, the bacteria and acid continue their march through your teeth, moving next to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. When decay advances to this extent, you may have a severe toothache, sensitivity, pain when biting or other symptoms. Your body also may respond to these bacterial invaders by sending white blood cells to fight the infection. This may result in a tooth abscess — a pocket of pus that's caused by a bacterial infection.

Prevention:
There are two main factors to preventing them: oral hygiene and diet change. Good oral hygiene includes brushing your teeth at least twice a day and flossing at least once, having a professional teeth-cleaning every six months, and having X-rays and a dental exam annually to detect cavity development (depending on your risk factors, your dentist may prescribe X-rays more or less frequently).

Reducing the amount of sugar — especially sugary drinks and juices — can help prevent cavities. You may consider brushing your teeth or rinsing your mouth after eating sticky foods.

Dental sealants may help prevent cavities and are most frequently applied to the teeth of children after their molars come in. Sealants are thin, plastic-like coatings on the surface of the molars that prevent the accumulation of plaque.
Fluoride is another cavity-prevention strategy. It can be consumed in drinking water or as a supplement. Topical fluoride is frequently applied as part of routine dentist visits.

Most importantly, visit your dentist regularly. The dentist can find decay early, when it can be treated.