All | B C D G M O P S T X There are currently 24 names in this directoryBad Breath/HalitosisNo one wants to experience the awful fear of bad breath, or halitosis, especially in social situations. Although a few medical conditions may cause bad breath, the most common causes are related your teeth, gums, and/or your dental hygiene. A buildup of plaque and tartar (calculus) may lead to gingivitis and gum disease, a common cause of bad breath. In addition, broken or badly decayed teeth may collect debris and, in time, bacteria forms and causes a bad taste and smell. Our tongue can also host a myriad of bacteria. Other causes of bad breath include certain foods, tobacco use, and dry mouth. Improving bad breath starts with an evaluation of your teeth and gums. Removing the bacteria responsible for the malodor is the critical first step in the fight against bad breath. If the source is the gums, treatment can range from a routine cleaning to the deep cleaning (also called scaling and root planning). When the bad odor comes from the teeth, the solution is often a combination of fillings, crowns, or extractions, depending on the severity of the problem. When decay is removed, the odor goes with it. It also is important to brush your tongue to remove plaque and bacteria in the deep grooves of the tongue’s surface that can lead to bad breath. Preventing bad breath entails keeping your teeth, gums, and tongue extremely cleanBitten Lip or TongueMost people accidentally bite their tongues or lips while chewing. At the time, it may be very painful and may cause bleeding. When your lip or tongue is bitten, you must be careful when you are eating for the next day or so. Your lip or tongue will tend to swell slightly making it easier to bite it again. For this minor injury, the best treatment is to rinse your mouth with warm salt water or to apply ice to the bitten area. Sometimes this biting of the lips, cheeks, and tongue is related to an incorrect interaction between the top and bottom teeth. Our top teeth are supposed to be positioned in a way that they protect the lips, cheeks, and tongue from harm. When this relationship is incorrect, and the top and bottom teeth come together without proper overlapping, our lips, cheeks, and tongue can get pinched. Without intervention from your prosthodontist, you will likely continue to bite yourself. Treatment would entail trying to recreate the missing overlap. Often this can be done through adjusting the teeth or prosthesis to change the way they interact. Sometimes it requires replacement of broken, worn, or poorly designed prostheses. Once the proper overlap is restored, the biting often goes away immediately.Bleeding GumsSome serious medical conditions may cause bleeding gums, but the most frequent cause of bleeding gums is poor oral hygiene, which leads to gingivitis. Gingivitis means that the gums are inflamed, red, and bleed easily when touched as a result of plaque building up on the teeth. Proper cleaning of the teeth prevents gingivitis and the subsequent symptom of bleeding gums. Sometimes the problem progresses beyond the superficial inflammation of gingivitis. The bacteria is deeper down between the teeth and the gums. When this is the case, the bacteria are more difficult to reach. This makes it harder for patients to clean out the bacteria alone. These bacteria can cause inflammation that leads to breakdown of the connection of the gums to your teeth and in severe cases, bone loss around the teeth. Your prosthodontist can teach you how to properly clean your teeth using a manual or electric toothbrush and by using tools such as dental floss to clean between your teeth. When the bacteria is deeper, these tools are less effective. At this point, it is important to have your hygienist work with you to eliminate the bacteria and follow up with you on the response of your gums. Bleeding gums are a sign of poor oral care and can easily be resolved by improving your dental hygiene habits.Broken/Chipped ToothA broken tooth may occur as a result of chewing hard foods, trauma, or by grinding your teeth, also known as bruxism. Sometimes the broken teeth are already full strength and at risk of breaking. This risk is higher when the tooth already has extensive restorations (large filling or crown). Teeth with notable cracks in them are also at a higher risk of breaking. When the break in the tooth is minor, the treatment is as simple as a direct restoration, or filling. This is indicated when the broken portion does not involve the cusp of the tooth. When the cusp is broken on a tooth, the ideal solution more often involves an onlay or crown. Sometimes the break in the tooth is so extensive, that the tooth is not able to be repaired. In these cases, the tooth is likely extracted and efforts are focused on replacing the missing tooth. When a tooth breaks, discuss options with your prosthodontist. They will help assess the extent of the break and recommend the ideal treatment for your specific tooth.Bruxism/Teeth GrindingBruxism, or teeth grinding, usually happens at night while you sleep. Most people with bruxism are not aware that they are grinding their teeth in their sleep – unless a partner is awakened by the noise. This habit of bruxism is extremely destructive and in time may wear away your teeth, strain your temporomandibular joint (TMJ), or tire the muscles used in chewing. Studies have shown that bruxism tends to be related to stress, and people generate much greater forces when grinding their teeth than they do during normal jaw function. The movements of the jaw during bruxism are more exaggerated than the more limited movement of someone’s normal jaw function. Although no cure for bruxism is available, your prosthodontist can produce a device that will protect the teeth, support your TMJ and provide relief from muscle fatigue. This device has many names, but generally is referred to as a splint. A splint helps with bruxism through careful control of the interaction of your teeth and through providing something else to damage rather than your teeth. Splints can easily be adjusted or replaced, making them a better recipient of these destructive forces.Cleft Lip/PalateA cleft lip and/or palate are birth defects affecting the roof of the mouth, alveolar process, and/or upper lip. In clefts, the hard and/or soft tissues do not completely develop and close during the first three months of pregnancy. A cleft may be just one side of the palate (unilateral) or both sides (bilateral), and may be part of a syndrome. A cleft may be caused by your mother’s drug or alcohol use, environmental factors, maternal age, or family history. Babies with cleft palates have problems with speech, feeding, development of teeth, ear infections, and hearing. The cleft palate is typically surgically repaired between the ages of 12-18 months. Cleft palates may occur in 1 out of every 2,500 births, and may be seen in an ultrasound before birth. After birth, a physical examination of the baby’s mouth will show the extent of the cleft palate. Because clefting leads to so many complications, people with clefts are often seen by a team of health care providers. The team may include a plastic surgeon, prosthodontist, speech pathologist, oral surgeon, pediatric dentist, and orthodontist. The prosthodontist’s role on this type of a team ranges from the early intervention with nasoalveolar molding. This is where an appliance is used in infants to help guide the growth of each side of the alveolar clefts. This can also be used to mold the baby’s nose to make the initial surgery more successful. The prosthodontist may also work with mature patients to replace any teeth that perhaps did not form due to the cleft. Sometimes oral appliances are required throughout the process to aid in speech, function, and esthetics.Congenital DefectsCongenital defects are disorders that occur while a baby is developing in the mother’s body, often during the first three months of pregnancy. Often called birth defects, most congenital defects are due to inherited or spontaneous genetic mutations. However, some congenital defects are caused by environmental factors such as drug or alcohol use, infections, nutritional deficiencies, or medical conditions. Congenital defects can involve any part of the body, and can be mild or serious, leading to death. One in every 33 babies is born with a defect and congenital defects may cause 1 in 5 infant deaths. Some congenital defects can be detected before the baby is born and treated. Other conditions can be treated with surgery or medication after birth. There are many parts of the body at risk of developmental defects and the teeth are no exception. Sometimes this is an absence of teeth, poorly developed tooth structures, or clefts. When there are congenital problems with teeth, a consultation with a prosthodontist can help guide you to the options that are right for you.Cracked Tooth/TeethA cracked tooth may occur when you chew on hard foods, may be caused by an accident or may be caused by grinding your teeth, also known as bruxism. Cracks are often shallow and don’t cause any problems. You may not even realize that you have a cracked tooth. On some occasions, a cracked tooth may cause pain or sensitivity if biting causes pressure on the cracked portion of the tooth. Treatment may vary depending on the size and location of the cracked tooth. Because these cracks are sometimes not visible, it can be challenging to diagnose the problem. Discomfort from biting pressures could mean the tooth is cracked, but could also be the result of other things. If you feel pain when you bite down on things, it is recommended you see your dental provider. They will be able to run tests to help determine the source of the pain. When teeth are cracked and symptomatic, it is often recommended to place a crown on the tooth. A crown works to hold the tooth together, preventing the separation of the segments on either side of the crack.Dental AnxietyMany people experience dental anxiety during their dental treatment. This dental anxiety may stem from past experiences or just a perception that the dental procedures will be painful. Many methods are available to help reduce or remove dental anxiety. Some people can relieve their dental anxiety simply by discussing their fears with their prosthodontist and learning more about the planned procedure. Using nitrous oxide, also known as laughing gas, during a dental procedure will reduce dental anxiety for a number of people, but very anxious patients may require a prescription medication to reduce their dental anxiety. Any prescription anti-anxiety treatment, including IV sedation, will require the individual to be in good general health and to have a driver to take him or her home after the dental procedure. Be open with your provider of your anxiety and have a discussion on the treatment that is right for you.Dry Mouth/XerostomiaChronic dry mouth, also known as xerostomia, is caused by lack of saliva for a long period of time. Multiple causes for dry mouth exist, including medications, chronic diseases, and certain medical treatments. Chronic dry mouth is not only uncomfortable, but it increases your risk for dental caries and makes it difficult for dentures to fit properly. When a person with this unusually high risk for dental caries is unaware of the risk, it often leads to widespread and significant problems that often require extensive repair or may need extraction. The treatment for people with dry mouths often focuses more on the prevention of dental caries. We often have little control over the dryness, and so we treat the symptoms. Fluoride application, diet counseling, and oral hygiene instruction are common ways to lessen the effects of this level of dryness. To help relieve symptoms of dry mouth you may want to drink fluids that do not contain sugar or acids, with water being the best. You also may want to use sugar-free hard candy or gum to stimulate saliva flow. Many people have also found some relief using over the counter saliva substitutes. If you suffer from dry mouth, you should visit your prosthodontist more frequently than every six months to address your increased risk of tooth decay.GingivitisGingivitis is an inflammation of the gums, also called gingiva. As plaque accumulates on and around the gums, bacteria produce harmful byproducts that can be detrimental to your gums. They can become red and bleed easily when touched. Gingivitis can progress to a more serious condition known as periodontitis or gum disease, which may lead to a chronic infection of the gums, surrounding bone, and supporting structures of the teeth causing the teeth to become loose. Proper cleaning of the teeth prevents gingivitis and the subsequent symptom of bleeding gums. Your dental hygienist or prosthodontist can teach you how to properly clean your teeth using a manual or electric toothbrush, dental floss, and mouth rinses. This is a very manageable disease process if proper care is maintained.Gum Disease/PeriodontitisGum disease is a term that refers to both gingivitis and the more serious condition of periodontitis. Most often gum disease refers to the chronic infection of periodontitis that can destroy the soft tissue in your mouth and the bone that supports the teeth. If left untreated, gum disease, or periodontitis, may result in tooth loss and in some cases it is associated with coronary artery disease. The most obvious cause of gum disease is poor oral hygiene, but several risk factors may increase your chances of developing gum disease. These risk factors include: smoking and tobacco use, family history, diabetes, stress, and in women, hormone changes associated with pregnancy and/or menopause. Proper cleaning of the teeth prevents gum disease and the subsequent symptom of bleeding gums. When the problem has progressed to periodontitis, you will likely need a deeper cleaning to eliminate the bacteria deep within your gums. After treatment and proper follow-up, your provider will be able to assess your progress.Misshapen Tooth/TeethGenetic and environmental factors can affect the development of teeth including the size and shape. Misshapen teeth may be isolated to one tooth or may occur as part of a widespread condition throughout the mouth. Common misshapen teeth include wisdom teeth, second premolars, and upper lateral incisors. Misshapen lateral incisors result from a developmental flaw that causes the tooth to be small and pointed, looking like a peg. Because upper lateral incisors play such an important role in the appearance of your smile, this misshapen tooth receives a great deal of attention. A prosthodontist can determine the best treatment for any misshapen teeth and is uniquely qualified to restore a misshapen tooth, such as a peg lateral, giving you an esthetically pleasing smile. One of the most common genetic defects affecting teeth is called ectodermal dysplasia. Individuals affected by this syndrome often have abnormally small, misshapen teeth or missing teeth. A patient with this inherited disorder should have the dental problems evaluated early in life, and a prosthodontist’s training allows a comprehensive approach to the misshapen and missing teeth. Treatments for these misshapen teeth include restorative options such as crowns, veneers, and composite resins.Missing Tooth/TeethTooth decay, gum disease and injury are common causes of missing teeth. Some people are born without certain teeth, and this condition is called congenitally missing teeth. Genetic factors cause congenitally missing teeth and this condition is often seen in generations of a family. The most common missing teeth are wisdom teeth, upper lateral incisors, and second premolars/bicuspids. Certain systemic conditions, usually inherited disorders, also result in multiple missing teeth. One of the most common genetic defects affecting teeth is called ectodermal dysplasia. Individuals affected by this syndrome often have missing teeth. A patient with congenitally missing teeth associated with ectodermal dysplasia should have the dental problems evaluated early in life, and a prosthodontist’s training allows a comprehensive approach to the missing teeth. It is important to replace missing teeth for proper chewing of food, jaw support, stability of the remaining teeth, and an attractive smile. Missing teeth disrupts proper function and the teeth next to and above the missing tooth/teeth will shift, move, and tip into the space in time. It is much easier to restore a missing tooth soon after it is lost than waiting a number of years after teeth have shifted significantly. A prosthodontist can determine the best method to replace your missing tooth or teeth. Missing teeth are replaced through removable partial dentures, fixed dental prostheses (“bridges”), or dental implants. A discussion with your dental provider would help in determining which option is right for you.Oral CancerAbout two-thirds of oral cancer in the mouth or oral cavity occurs in the floor of the mouth and tongue, but can occur in the upper or lower jaw, lips, gums, and cheek lining. Just behind the mouth is an area known as the orophyarnx. Oropharyngeal cancer (one-third of cases) occurs in the back of the tongue, tonsils, and throat tissue. Oral cancer kills one American every hour of every day, according to the National Cancer Institute. Early detection offers the best chance of survival, yet only one-third of oral cancer is found in the earliest stages when treatment is most effectiveOsteonecrosis of the JawOsteonecrosis of the jaw is a severe bone disease that occurs when there is a loss of blood to the bone. The primary symptom of osteonecrosis of the jaw (ONJ) is exposure of the bone through the gums that doesn’t heal for several weeks. This exposure may occur spontaneously or more likely following an invasive dental procedure such as extraction in patients with certain risk factors. Patients at risk for developing osteonecrosis of the jaw include: Patients receiving radiation therapy to the head and neck to treat cancer. Patients on long-term steroid therapy. Certain cancer patients with metastasis to the bone who use IV Bisphosphonates to decrease pain and the risk of bone fracture. Although these patients have the highest risk to develop osteonecrosis of the jaw, other risk factors are advanced age, diabetes, gum disease, and smoking. The long-term risk of developing osteonecrosis of the jaw for those patients using oral bisphosphonates in treating osteoporosis is unknown at this time, but it certainly seems less than those patients on IV therapy. Various treatment options for osteonecrosis of the jaw have been explored; however, severe cases of ONJ still require surgical removal of the affected bone. A thorough history and evaluation of pre-existing problems and possible sites of dental infection are required to help prevent the condition.Peg Lateral IncisorsPeg lateral incisors describes a condition where the second tooth on either side of the upper front teeth does not develop correctly and is small, often pointed, and looks like a cone. Sometimes, the permanent adult teeth do not develop at all, leaving only the baby teeth or primary teeth in place. While some people refer to these teeth as peg laterals, a true peg lateral incisor is a term reserved for the under-developed adult permanent tooth that erupts after the baby tooth has been lost. Because upper lateral incisors play such an important role in the appearance of your smile, peg lateral incisors receive a great deal of attention. A prosthodontist can determine the best treatment for any misshapen teeth and is uniquely qualified to restore a peg lateral incisor to give you an esthetically pleasing smile. Commonly, these can be treated using composite resins, porcelain veneers, or crowns.Sleep ApneaSleep apnea is when, because of a temporary pause in breathing while sleeping, your lungs are unable to get the oxygen your body needs. The pause may last a few seconds to a several minutes. Often, sleep apnea occurs when an individual’s airway is blocked, which interrupts the airflow and snoring may occur. Typically an individual with sleep apnea is unaware that he or she is having difficulty breathing during the night. Symptoms of sleep apnea include snoring, restless sleep, or tiredness during the day. Different treatments for sleep apnea are available. The gold standard for treatment of sleep apnea is a CPAP (continuous positive airflow pressure) machine. This requires the user to wear a mask over the nose and/or mouth. A constant flow of air inflates the airway and delivers oxygen to the lungs. Sometimes people cannot tolerate this treatment or their apnea is so mild that they could investigate other options. A great alternative to a CPAP is an oral appliance. These work by repositioning the lower jaw or tongue forward to help improve the airflow during sleeping. Research supports the use of an oral appliance in the treatment of sleep apnea in cases of mild to moderate sleep apnea. If you have sleep apnea and cannot tolerate other treatment options, consider talking with a prosthodontist about this option.Spots on Mouth/TongueSpots on your mouth or tongue can result from infection, causing swelling, redness, and ulcers (i.e. cold sore/herpes, gingivitis, thrush, chicken pox). Allergic reactions to food or other substances can cause red and white spots on your mouth or tongue. Other causes of red and white spots are trauma, vitamin deficiencies (i.e. B12), antibiotics, smoking, canker sores, geographic tongue, and cancer. A complete examination of the mouth by your prosthodontist is necessary to determine the cause of the spots on your mouth or tongue. Treatment may include removal of the cause of trauma, antibiotics, anti-viral medication, anti-fungal medications, creams, rinses, and tongue scraping.Teeth GrindingBruxism, or teeth grinding, usually happens at night while you sleep. Most people with bruxism are not aware that they are grinding their teeth in their sleep – unless a partner is awakened by the noise. This habit of bruxism is extremely destructive and in time may wear away your teeth, strain your temporomandibular joint (TMJ), or tire the muscles used in chewing. Studies have shown that bruxism tends to be related to stress, and people generate much greater forces when grinding their teeth than they do during normal jaw function. The movements of the jaw during bruxism are more exaggerated than the more limited movement of someone’s normal jaw function. Although no cure for bruxism is available, your prosthodontist can produce a device that will protect the teeth, support your TMJ and provide relief from muscle fatigue. This device has many names, but generally is referred to as a splint. A splint helps with bruxism through careful control of the interaction of your teeth and through providing something else to damage rather than your teeth. Splints can easily be adjusted or replaced, making them a better recipient of these destructive forces.Temporomandibular Joint Disorder & Facial/Jaw PainThe temporomandibular joint (TMJ), when not functioning properly, can cause a tremendous amount of pain. The tissues behind the joint (retrodiscal tissues) have many nerves that run through them. Once they become inflamed, any slight pressure will cause pain and perpetuate the problem. Treatment involves unloading these tissues to allow them to recover and try to avoid allowing the problem to recur. Depending on your history and symptoms, your prosthodontist may recommend a stabilization splint (bite guard) to treat your pain. This custom-made plastic device fits over the upper or lower teeth and is used to control the interaction between the top and bottom teeth and maintains the joint in a healthy position. Stabilization splints are the most common treatments for TMJ disorders, including facial pain. Facial or jaw pain in the chewing muscles or jaw joint is a common symptom of temporomandibular joint disorders. Facial pain may also be caused by dislocation or injuries which are internal changes to the joint involving a displaced disc, a dislocated jaw, or injury to the muscle. Arthritis and degenerative or inflammatory joint disorders also may lead to facial pain. Facial pain may be relieved by eating soft foods, applying ice packs when pain occurs, and avoiding extreme jaw movements (including wide yawning, loud singing, and gum chewing). Since facial pain is often associated with stress and/or cramps in the chewing muscles, techniques to reduce stress and practicing gentle jaw stretching and relaxing exercises to increase jaw movement may be helpful. Short-term use of common pain medicines may provide temporary relief from jaw discomfort and facial pain.Tooth/Teeth Discoloration or StainsTooth discoloration may be caused by problems with the formation of the tooth enamel, problems within the tooth, or by simple stains from food, beverages, or habits. Certain medications or chemicals taken by a pregnant woman or by a very young child can disrupt the development of tooth enamel and result in the tooth becoming discolored, mottled, or pitted. Tooth discoloration also may be caused by a tooth that is chronically infected or necrotic with the tooth taking on a uniform grayish hue. In this situation, the infection must be treated first and then the color can be corrected by bleaching or a restoration. The simplest form of tooth discoloration is the stains caused by external factors such as food/beverages or tobacco use. Tooth discoloration may be managed by a professional cleaning, tooth whitening procedure, and/or the placement of porcelain veneers. These procedures may remove the discoloration and restore the teeth to their original brightness and whiteness.Tooth/Teeth Sensitivity or PainIdeally, our teeth will function without any discomfort throughout our life, but unfortunately, most of us will experience at least one of the many conditions that can cause tooth pain. There are many causes of tooth pain, including: dental decay, fractured or cracked teeth, damaged or leaking fillings, gum disease or grinding. The type of tooth pain varies based on the condition, but may range from a fleeting sensitivity to a persistent dull ache. Only a dental professional can determine the exact cause of your pain and the appropriate treatment. If you are experiencing pain from a tooth, it is recommended you see your dental provider to have the area assessed. Sometimes the problem is larger than you might believe and you are weeks, days, or hours away from increased pain.XerostomiaChronic dry mouth, also known as xerostomia, is caused by lack of saliva for a long period of time. Multiple causes for dry mouth exist, including medications, chronic diseases, and certain medical treatments. Chronic dry mouth is not only uncomfortable, but it increases your risk for dental caries and makes it difficult for dentures to fit properly. When a person with this unusually high risk for dental caries is unaware of the risk, it often leads to widespread and significant problems that often require extensive repair or may need extraction. The treatment for people with dry mouths often focuses more on the prevention of dental caries. We often have little control over the dryness, and so we treat the symptoms. Fluoride application, diet counseling, and oral hygiene instruction are common ways to lessen the effects of this level of dryness. To help relieve symptoms of dry mouth you may want to drink fluids that do not contain sugar or acids, with water being the best. You also may want to use sugar-free hard candy or gum to stimulate saliva flow. Many people have also found some relief using over the counter saliva substitutes. If you suffer from dry mouth, you should visit your prosthodontist more frequently than every six months to address your increased risk of tooth decay.