Diastema (Gap Between Teeth)

Reviewed by the Faculty of

Columbia University College of Dental Medicine

What Is It?
A diastema is a space or gap between two teeth. It appears most often between the two upper front teeth. However, gaps can occur between any two teeth.

A mismatch between the size of the jaw bones and the size of the teeth can cause either extra space between teeth or crowding of teeth. If the teeth are too small for the jaw bone, spaces between the teeth will occur. If the teeth are too big for the jaw, teeth will be crowded.

Spaces develop for a few other reasons as well.

Sometimes some teeth are missing or undersized. This happens most often with the upper lateral incisors (the teeth next to the two upper front teeth). That can cause the upper central incisors to develop a space.

A diastema also can be caused by an oversized labial frenum. The labial frenum is the piece of tissue that normally extends from the inside of your upper lip to the gum just above your two upper front teeth. In some situations, the labial frenum continues to grow and passes between the two front teeth. If this happens, it blocks the natural closing of the space between these teeth.

Habits can also lead to gaps between the teeth. Thumb sucking tends to pull the front teeth forward, creating gaps.

Spaces can develop from an incorrect swallowing reflex. For most people, the tongue presses against the roof of the mouth (palate) during swallowing. Some people develop a different reflex known as a tongue thrust. When they swallow, the tongue presses against the front teeth. Over time the pressure will push the front teeth forward. This can cause spaces to develop.

Periodontal (gum) disease results in the loss of the bone that supports the teeth. In people who have lost a lot of bone, the teeth can become loose. This movement can result in gaps between the front teeth.

Children may have temporary gaps as their baby teeth fall out. Most of these spaces close as the permanent teeth reach their final positions.

Symptoms
A diastema that occurs because of a mismatch between the teeth and the jaw does not have symptoms. However, spaces caused by a tongue thrust habit or periodontal disease will tend to expand or grow with time. The teeth may become loose, and discomfort or pain may occur, particularly during biting or chewing.

Diagnosis
You may notice a space when brushing or flossing. Your dentist can see spaces during an examination.

Expected Duration
If the gap was caused by a mismatch between the permanent teeth and the jaw size, the spaces can be expected to remain throughout life.

Gaps caused by a tongue thrust habit or periodontal disease can get larger with time.

Prevention
Not all spaces can be prevented. For example, if the reason for a space is a missing tooth or a mismatch between the teeth and the jaw size, the spaces cannot be prevented without treatment.

Maintaining your gum health is essential to good oral health. Regular flossing and brushing will help to prevent periodontal disease and its related bone loss.

People with a tongue thrust habit can re-learn to swallow by pushing their tongue up against their palate. Breaking this habit can prevent widening of the spaces between teeth.

Treatment
Sometimes, a diastema is part of a set of problems that require orthodontic treatment. In other cases, a diastema is the only problem. However, some people may seek treatment for reasons of appearance.

Some people get braces, which move the teeth together. Often, no matter where the diastema is, you must wear a full set of braces — on both your upper and lower teeth. That's because moving any teeth affects your entire mouth.

If your lateral incisors are too small, your dentist may suggest widening them using crowns, veneers or bonding.

If you have a space because you are missing teeth, you might need more extensive dental repair. This might include dental implants, a bridge or a partial denture.

If a large labial frenum is causing the gap, the frenum can be reduced through surgery called a frenectomy.

If a frenectomy is done in a younger child, the space may close on its own. If it is done in an older child or an adult, the space may need to be closed with braces.

If the gap is caused by periodontal disease, then periodontal treatment by a dentist or gum specialist (periodontist) is necessary. When gum health is restored, in many cases braces can be used to move the teeth into place. A splint can be used to attach teeth to other teeth and prevent them from moving again. In some cases, a bridge will be required to close the spaces.

When To Call a Professional
If you have a space between your teeth or see one in your child's mouth, talk with your dentist. He or she will determine the reason for the space and may refer you to an orthodontist, a specialist in treatment with braces. The American Association of Orthodontists recommends that children be evaluated by an orthodontist by age 7. Treatment (if needed) may not begin right away. You and the orthodontist will discuss the overall treatment plan.

If your space is the result of periodontal disease, your dentist may refer you to a periodontist.

Prognosis
If a diastema is closed through orthodontics or dental repair, the space will tend to stay closed. However, to help prevent the space from coming back, wear your retainers as directed by your orthodontist. Your orthodontist may also splint (attach) the backs of the teeth to other teeth with composite (plastic) and a wire to prevent them from moving. Learn more about tooth whitening here.

The above article is from colgate.com

San Diego Smiles
Kurt Christensen, DDS - Steven Krause, DDS, MAGD
337 West Madison Avenue
El Cajon, CA 92020
Phone: (619) 442-8841
Website: www.SDSmileStudio.com

Dental Emergency

Accidents happen, and knowing what to do when one occurs can mean the difference between saving and losing a tooth.

Here are some tips for common dental emergencies: 

• For a knocked-out permanent or adult tooth, keep it moist at all times. If you can, try placing the tooth back in the socket without touching the root. If that’s not possible, place it in between your cheek and gums, in milk, or use a tooth preservation product that has the ADA Seal of Acceptance. Then, get to your dentist’s office right away. 
• For a cracked tooth, immediately rinse the mouth with warm water to clean the area. Put cold compresses on the face to keep any swelling down. 
• If you bite your tongue or lip, clean the area gently with water and apply a cold compress. 
• For toothaches, rinse the mouth with warm water to clean it out. Gently use dental floss to remove any food caught between the teeth. Do not put aspirin on the aching tooth or gum tissues. 
• For objects stuck in the mouth, try to gently remove with floss but do not try to remove it with sharp or pointed instruments. 

When you have a dental emergency, it’s important to visit your dentist or an emergency room as soon as possible.

Here are some simple precautions you can take to avoid accident and injury to the teeth:   

• Wear a mouthguard when participating in sports or recreational activities. 
• Avoid chewing ice, popcorn kernels and hard candy, all of which can crack a tooth. 
• Use scissors, NEVER your teeth, to cut things. 

Most dentists reserve time in their daily schedules for emergency patients. Call your dentist and provide as much detail as possible about your condition.

The above article is from mouthhealthy.org

San Diego Smiles
Kurt Christensen, DDS - Steven Krause, DDS, MAGD
337 West Madison Avenue
El Cajon, CA 92020
Phone: (619) 442-8841
Website: www.SDSmileStudio.com

What to Do About Chipped Baby Teeth?

Children are naturally rambunctious with all their high-energy antics such as running, jumping, diving, or just biting down too hard on something. It goes without saying that a chipped baby tooth is a common experience during these early stages, especially a chipped front tooth.

If your child chips his or her tooth, don’t panic. Unless your child is in pain, a chipped baby tooth is usually nothing serious. Nevertheless, when a chipped tooth does occur, it’s wise to call the dentist and schedule an appointment. Because the sooner you deal with the problem, the better. After all, sometimes your child may not even realize what just happened, and there may be damage that you can’t see.

Chipped Baby Tooth Repair
There are many ways to deal with a chipped tooth and it’s worth reiterating that you should always see a dentist as soon as possible after the event, no matter how severe. A chipped tooth can cause pain and discomfort when chewing or when exposed to very hot or cold temperatures. Below is a list of methods on how best to deal with a chipped tooth.

• Stay calm: Chipping a tooth is a common thing among children. When such an event happens, there’s no need for alarm. Also remember not to make your child feel self-conscious about their chipped tooth, even if it’s noticeable.
• Check your child: You’ll want to check and see if your child is in pain or crying. Also check for blood.
• Call the dentist: Remaining calm, explain what happened and follow any instructions your dentist may give you before scheduling an appointment.
• Rinse / cold compress: Aside from calling the dentist, you’ll want to rinse your child’s mouth with cold water and apply a cold compress to reduce any potential swelling. You’ll also want to collect any teeth fragments from the scene of the accident and bring them to your dentist. In a case where you cannot find any teeth fragments and your child is having difficulty breathing, immediately take them to an emergency room to make sure they didn’t inhale any teeth fragments.
• Pain relief: If your child continues to feel pain after the event, an advised amount of children’s ibuprofen is appropriate. If you are not sure, ask your dentist or doctor what the correct dosage before administering any medication.
• Keep an eye on it: In some cases, the damage from the lost tooth will become visible later, such as a chipped baby tooth turning grey. Also make sure their gums do not become infected.

While it’s never fun when your child gets a chipped tooth, sometimes these things happen, and having a plan is essential in such an event.

The above article is from crest.com

San Diego Smiles
Kurt Christensen, DDS - Steven Krause, DDS, MAGD
337 West Madison Avenue
El Cajon, CA 92020
Phone: (619) 442-8841
Website: www.SDSmileStudio.com

Tooth Pain and Sensitivity Before or After Filling Cavities

If you have cavity symptoms, you may have pain in your teeth or in your gums. Cavity pain relief depends on the extent of your tooth decay. Regardless if your cavity symptoms are mild or severe, you should visit your dentist as you may need a filling.

Tooth Fillings for Cavity Pain Relief
Dental fillings are among the most common ways to relieve cavity pain. Here’s a basic overview of cavity pain relief with a dental filling:

• Numbness: The first thing the dentist will do is numb the area of the cavity.
• Cleaning: Once the area is numb, the dentist removes the decayed part of the tooth.
• Filling: The final step in cavity pain relief—the dentist places a filling made from the material of your choice.

Causes of Tooth Pain After Fillings
Fillings are used to replace the decayed area of a tooth, reducing the pain associated with the cavity itself. But tooth pain after filling a tooth is not unusual. Some common reasons for tooth pain after a filling include:

• Tooth sensitivity: A tooth that has just had a filling placed will be more sensitive to hot foods and cold foods, air temperature, and the pressure of biting. This type of tooth pain after filling a cavity should resolve within a few weeks. If not, contact your dentist.
• Cracked or loose tooth fillings: Tooth pain after filling a cavity can occur if the filling is not fitting properly to the tooth, or if it develops cracks. If you suspect that your tooth pain is caused by a cracked or ill-fitting filling, contact your dentist.
• Allergic reaction to tooth fillings: Some people have allergic reactions to the material used for their fillings, such as silver. To help avoid tooth pain after filling a cavity, be sure to tell your dentist about any allergies when discussing your filling choices.

Tooth Filling Pain Relief
You can reduce your risk of tooth pain after filling a cavity by avoiding common sensitive teeth triggers, including very hot or cold foods. In addition, toothpaste designed for sensitive teeth can help minimize the possible sensitivity and tooth pain after filling a cavity. Crest Gum and Sensitivity oral care products are formulated to help relieve the pain associated with sensitivity fast while offering additional protection against food and drinks that cause sensitivity.

If you have cavity symptoms, you may have pain in your teeth or in your gums. Cavity pain relief depends on the extent of your tooth decay. Regardless if your cavity symptoms are mild or severe, you should visit your dentist as you may need a filling.

When you have a dental procedure, you may experience sore teeth afterward. Sore teeth are common after many dental procedures, whether it is something as simple as a cavity filling or as complicated as gum surgery.

Sore Teeth After Filling
Whether you suffer from short-term sore teeth after receiving a filling or long-term sensitive teeth, it is important to follow a complete oral care routine. The Crest Pro-Health Sensitive Shield collection of products can help keep sore teeth clean and healthy, with a toothpaste designed to protect your sensitive teeth.

• Gentle Brushing: The Oral-B Sensi-Soft Manual Toothbrush is easy on sore teeth.
• Soft Flossing: Oral-B Glide Pro-Health Comfort Plus Mint Floss is shred-resistant and extra soft.
• Sensitivity Protection: Crest Gum and Sensitivity Toothpaste starts treating sensitivity immediately at the source while helping to fight plaque, gingivitis, and cavities.

The above article is from crest.com 

San Diego Smiles
Kurt Christensen, DDS - Steven Krause, DDS, MAGD
337 West Madison Avenue
El Cajon, CA 92020
Phone: (619) 442-8841
Website: www.SDSmileStudio.com

Dentures

Dentures are removable appliances that can replace missing teeth and help restore your smile. If you’ve lost all of your natural teeth, whether from gum disease, tooth decay or injury, replacing missing teeth will benefit your appearance and your health. That’s because dentures make it easier to eat and speak better than you could without teeth—things that people often take for granted.

When you lose all of your teeth, facial muscles can sag, making you look older. Dentures can help fill out the appearance of your face and profile. They can be made to closely resemble your natural teeth so that your appearance does not change much. Dentures may even improve the look of your smile.

Types of dentures:

• Conventional. This full removable denture is made and placed in your mouth after the remaining teeth are removed and tissues have healed, which may take several months. 
• Immediate. This removable denture is inserted on the same day that the remaining teeth are removed. Your dentist will take measurements and make models of your jaw during a preliminary visit. You don’t have to be without teeth during the healing period, but may need to have the denture relined or remade after your jaw has healed. 
• Overdenture. Sometimes some of your teeth can be saved to preserve your jawbone and provide stability and support for the denture. An overdenture fits over a small number of remaining natural teeth after they have been prepared by your dentist. Implants can serve the same function, too. 

New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place. It is not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases. As your mouth becomes accustomed to the dentures, these problems should go away. Follow-up appointments with the dentist are generally needed after a denture is inserted so the fit can be checked and adjusted. If any problem persists, particularly irritation or soreness, be sure to consult your dentist.

Even if you wear full dentures, you still have to practice good dental hygiene. Brush your gums, tongue and roof of your mouth every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

Like your teeth, your dentures should be brushed daily to remove food particles and plaque. Brushing also can help keep the teeth from staining. 

• Rinse your dentures before brushing to remove any loose food or debris. 
• Use a soft bristle toothbrush and a non-abrasive cleanser to gently brush all the surfaces of the dentures so they don't get scratched.
• When brushing, clean your mouth thoroughly—including your gums, cheeks, roof of your mouth and tongue to remove any plaque. This can help reduce the risk of oral irritation and bad breath. 
• When you’re not wearing your dentures, put them in a safe place covered in water to keep them from warping. 
• Occasionally, denture wearers may use adhesives. Adhesives come in many forms: creams, powders, pads/wafers, strips or liquids. If you use one of these products, read the instructions, and use them exactly as directed. Your dentist can recommend appropriate cleansers and adhesives; look for products with the ADA Seal of Acceptance. Products with the ADA Seal have been evaluated for safety and effectiveness.

If you have any questions about your dentures, or if they stop fitting well or become damaged, contact your dentist. Be sure to schedule regular dental checkups, too. The dentist will examine your mouth to see if your dentures continue to fit properly.

The above article is from mouthhealthy.org

San Diego Smiles
Kurt Christensen, DDS - Steven Krause, DDS, MAGD
337 West Madison Avenue
El Cajon, CA 92020
Phone: (619) 442-8841
Website: www.SDSmileStudio.com

Is Composite Resin Bonding Right For You?

Composite resin bonding can be a fast, minimally invasive and inexpensive option for the beautiful smile you're looking for. But knowing what makes you a good candidate can help you determine if it's the right investment for you.

What Is Composite Bonding?

Composite bonding is a cosmetic technique wherein a type of dental material – in this case, composite resin – is shaped and molded on your teeth to give the appearance of straighter, whiter smile. It can be used as a cosmetic solution to chipped teeth, gapped teeth and staining in both teeth and fillings. Unlike porcelain veneer placement, which can take more than two visits, composite resin bonding can be completed in one appointment.

According to Everyday Health, the cost for bonding can range from about $300 to $600 per tooth for a simpler procedure, like a cavity filling. Although many dental insurance plans do not cover cosmetic bonding, it's good practice to ask whether they will cover a portion – especially if it's part of a medically necessary procedure, which some insurers acknowledge.

Whom Is Composite Bonding Right For?

Composite resin bonding isn't for everyone. If your smile is crooked as the result of an over- or underbite, this treatment won't serve to correct it. Instead, speak with your dentist to determine if more in-depth work is needed like adjusting your bite or any complex chips or gaps in your teeth. Bonding is primarily for those who seek a cosmetic solution for teeth that are otherwise healthy.

What Can You Expect During Your Visit?

Composite bonding is a safe and effective technique that was developed more than 50 years ago, and has been widely available for over three decades, according to the American Dental Association (ADA). The fillings and processes today are very efficient, making it easier for both you and your dentist.

The treatment itself often starts with the removal of some surface enamel, allowing the dentist to best shape the composite resin to your tooth, followed by the application of the bonding agent. Your dentist will then add the composite resin, cure it with a special light and finish by polishing your teeth. Because the process involves a high level of technique for a natural mold and shape, it's best to work with a dentist who has experience and specialty in this area.

What Aftercare Is Needed?

With normal care, today's composite material is durable enough to last without regular attention; you won't need to seek out your dentist for special visits and upkeep. Nonetheless, make sure to keep your regular dental checkup and daily oral care a priority. Mouthwashes like Colgate Total® Gum Health, for instance, can improve gum strength by 45 percent for those who find their gumline tougher to maintain after bonding treatment. You should also avoid biting down on particularly hard foods, or ice, to prevent cracking.

If you're interested in achieving a brighter smile, composite resin bonding is a great option. Be sure to take care of your other oral necessities, first, to ensure your natural smile is healthy inside and out.

The above article is from colgate.com

San Diego Smiles
Kurt Christensen, DDS - Steven Krause, DDS, MAGD
337 West Madison Avenue
El Cajon, CA 92020
Phone: (619) 442-8841
Website: www.SDSmileStudio.com

What Is Dental Public Health? A Look At How It Can Help

Below is an excerpt from an article found on colgate.com

Many oral diseases can be prevented with routine care and regular dental checkups. Unfortunately, not everyone is able to access adequate oral care. Dental public health programs work to rectify that. They provide assistance and programs so people can avoid the pain and discomfort poor oral health causes.

Recognized by the American Dental Association as a dental specialty since 1950, public dental programs focus on oral health issues within populations and communities rather than individuals. The goal is to assure optimal oral health among Americans through disease prevention and dental health promotion. Here are just a few examples of such programs that aim to improve the oral health of all Americans.

Dental Care for Students

Dental problems in kids can also affect a child's health and even his or her performance at school. In a study of 1,500 elementary to high school children from disadvantaged backgrounds in Los Angeles, California, 73 percent were found to have dental caries, says a study from the Herman Ostrow School of Dentistry at the University of Southern California. The study found a correlation between these dental issues, lower grades and increased missed school days.

Dental sealants can reduce child tooth decay by more than 70 percent, estimates the Centers for Disease Control and Prevention (CDC). This is why several states have implemented school-based programs to provide sealants to children from low-income families who are at risk for cavities. Such programs identify a target market within a school district to meet the needs of children who are less likely to receive private dental care.

Dental Care for Seniors

Cost keeps many people away from the dentist, especially older adults. The problem: Avoiding preventive dental care will only lead to more extensive and expensive procedures later on. Furthermore, the severity of gum disease increases with age. As many as 23 percent of adults between the ages of 65 and 74 have severe gum disease, while people of all ages at the lowest socioeconomic level have the most severe gum disease, putting low-income seniors at risk, according to the CDC.

Medicare doesn't cover routine dental procedures and fewer than half of the states offer comprehensive dental benefits through Medicaid, leaving many seniors without necessary dental insurance. Some dental public health solutions include community outreach programs, like the Division of Geriatric Dentistry at Tufts University, which teaches the elderly about denture care and provides oral health and cancer screenings.

Dental Care for Expectant Moms

Dental care is especially important during pregnancy, but many women are unaware that oral health problems during this time can put both Mom and baby at risk. In a questionnaire provided to all maternity hospitals in the state of Iowa, 44 percent of women claimed they didn't visit a dentist during their pregnancy, reports the Iowa Department of Public Health. To help expectant moms stay informed and in charge of their overall health, the National Center for Infants, Toddlers, and Families launched an app called Text4Baby, which educates mothers on their baby's development and baby care through their child's first year. It can also be used to set reminders for prenatal doctor and dentist visits, so that women can get the care they and their child need. Agencies on the federal, state and local level have partnered with this app to provide resources and information to expectant moms in their communities.

Preventive dental care, from using a quality toothbrush with extra soft bristles especially for sensitive gums like Colgate 360 Enamel Health Sensitive, to regular checkups, is vital for maintaining a healthy mouth and overall well-being. Dental public health programs can improve the lives of those who otherwise wouldn't have access to dental care, while increasing awareness of quality oral care for all.

To read the entire article visit colgate.com

San Diego Smiles
Kurt Christensen, DDS - Steven Krause, DDS, MAGD
337 West Madison Avenue
El Cajon, CA 92020
Phone: (619) 442-8841
Website: www.SDSmileStudio.com