Lansing's Dental Discussion
By Holly Scott-Hetchler DDS
May 22, 2018
Category: Oral Health
Tags: tooth pain  
BeforeweExtractThatProblemToothLetsConsiderSavingit

Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.

We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.

While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.

Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.

Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.

But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.

These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.

If you would like more information on the best treatment choices for your dental health, 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 “Save a Tooth or Get an Implant?

By Holly Scott-Hetchler DDS
May 12, 2018
Category: Oral Health
Tags: pregnancy   dental care  
4ThingsYouShouldFocusonDuringPregnancyforOptimalDentalHealth

Pregnancy creates enormous changes in your physical body. These changes, especially on the hormonal level, can impact many aspects of your health including teeth and gums.

While it’s easy to let dental care take a back seat to other health concerns, you should actually pay close attention to it while you’re expecting. Here are 4 things to focus on during pregnancy to avoid problems with your dental health.

Don’t avoid dental work unless otherwise advised. You may be concerned about undergoing dental procedures during pregnancy, especially those that involve anesthesia. But both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) encourage pregnant women to continue regular dental visits for cleanings and checkups. And unless your obstetrician advises otherwise, it’s usually safe to undergo dental work that can’t wait.

Be on the lookout for pregnancy gingivitis (gum disease). Because of the hormonal changes that occur during pregnancy, your gums could be more susceptible to gum disease caused by plaque buildup. That’s why you should be on alert for signs of a gum infection like swollen, reddened or bleeding gums. And be sure to practice diligent, daily brushing and flossing to remove disease-causing plaque, as well as regularly visiting your dentist for professional cleanings.

Make sure your diet is “tooth” friendly. Because of the changes in your body, you may experience food cravings that alter your normal dietary habits. So as much as possible, try to keep your food choices in line with what’s best for your teeth and gums: minimize your sugar intake (a prime food source for disease-causing bacteria); and focus on nutritiously balanced meals and snacks.

Keep your entire healthcare team informed. When you make your next dental appointment, tell your dentist you’re pregnant and how far along, any medications and supplements you’re taking, or any complications you may be experiencing. This information could have a bearing on how your dentist approaches any treatment. Likewise, let your obstetrician know about any issues with your teeth and gums, as well as any suggested dental work you may need.

If you would like more information on dental care during pregnancy, 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 “Dental Care during Pregnancy.”

By Holly Scott-Hetchler DDS
May 02, 2018
Category: Dental Procedures
Tags: dental implants  
ReplaceTeethforBetterSpeech

The month of May has been designated “Better Speech & Hearing Month” by the American Speech-Language-Hearing Association. Why would this be of interest to dental professionals? Because teeth are vital for good speech, and missing teeth can make it very hard to speak properly.

Speech is all about sounds, and forming sounds correctly requires proper positioning of oral structures such as the lips, tongue and teeth. For example, there are some words that are almost impossible to pronounce correctly without touching your tongue to your teeth. In fact, one of the hardest words to say without teeth…is teeth!

Missing teeth can affect speech indirectly as well, by reducing self-confidence. People who are missing front teeth often develop the habit of talking behind their hand or mumbling to avoid revealing the gap in their smile. Not being able to speak clearly and confidently can affect not only your appearance, but also your job prospects and social life. So what can you do about missing teeth?

Dental implants are today’s preferred tooth-replacement method. Implants are small titanium posts that are inserted in the jaw bone beneath your gums. They serve as “roots” to hold realistic-looking prosthetic (artificial) teeth in place. Implants can be used to replace one tooth, a group of teeth, or an entire row of teeth (upper or lower). Sometimes a dental implant can be placed the same day a failing tooth is removed so that you won’t need a second surgical procedure.

The healthy natural teeth on either side of the gap can also be used to support one or more replacement teeth. This method, called bridgework, can be used to replace a single tooth or several teeth in a row. Another option is removable dentures, which do not stay in the mouth all the time.

Each of these options has its benefits and risks. We’d be happy to discuss all of them in detail and help you decide which would be best in your own situation. To learn more about tooth replacement, please contact us or schedule a consultation. You can also read the Dear Doctor magazine articles “Dental Implant Surgery” and “New Teeth in One Day.”

SteelyDanFoundersDeathHighlightsImportanceofEarlyCancerDetection

Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”

By Holly Scott-Hetchler DDS
April 12, 2018
Category: Oral Health
Tags: teeth grinding  
AddressYourTeethGrindingHabitEarlytoAvoidPotentialToothLoss

Teeth grinding and other biting habits are more than a nuisance — they can generate twenty to thirty times the forces of normal biting. Over the long term, this can cause significant damage to teeth and supporting gums and bone.

This particular kind of damage is known as occlusal trauma (meaning injury from the bite). In its primary form, the habit itself over time can injure and inflame the jaw joints leading to soreness, swelling and dysfunction. The teeth themselves can wear down at a much faster rate than what normally occurs with aging. And although less common but even more serious, the periodontal ligaments holding teeth in place to the bone can stretch and weaken, causing the teeth to become loose and increasing the potential for tooth loss.

There are a number of techniques and approaches for treating excessive biting habits, but they all have a common aim — to reduce the amount of force generated by the habit and the associated problems that result. A custom occlusal guard, often worn while sleeping, helps lessen the force by keeping the teeth from making solid contact with each other. Tissue soreness and swelling can be relieved with anti-inflammatory drugs like aspirin or ibuprofen, muscle relaxants or physical therapy. In cases where stress is a main driver, behavioral therapy and counseling may also be helpful.

Biting forces are also an issue for patients with periodontal (gum) disease. In this case even biting forces within normal ranges can cause damage because the diseased gums and bone have already been weakened. If gum disease is a factor, the first priority is to treat the disease by removing built up plaque. Plaque is the thin film of bacteria and food remnant that’s both the cause and continuing growth of the infection, as well as tartar (calculus) from all tooth and gum surfaces.

A thorough dental exam will reveal whether a tooth grinding habit is playing a role in your teeth and gum problems or if it’s magnifying the damage of gum disease. In either case, there are appropriate steps to stop the damage before it leads to tooth loss.

If you would like more information on teeth grinding or other biting habits, 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 Holly Scott-Hetchler DDS
March 28, 2018
Category: Oral Health
KeepanEyeonYourTeethandGumHealthDuringCancerTreatment

If you’re facing cancer treatment, we wish you the best outcome possible. Treating this disease has advanced tremendously in recent decades, but the available options are still often challenging to endure. It will be your primary focus for the foreseeable future.

As a dental provider we also want you to be aware how the two main treatments, chemotherapy and radiation, could adversely affect your teeth and gums, especially if you’re receiving radiation therapy near the head and neck. The aim of cancer treatment is to attack and destroy cancer cells to prevent their growth. Unfortunately, it can also destroy neighboring healthy cells and lead to harmful consequences in different parts of the body, including the mouth.

Salivary glands, for example, are especially vulnerable to damage during cancer treatment. This could create a situation where the mouth no longer produces adequate saliva flow, leading to a condition called xerostomia or dry mouth. Besides a lot of discomfort, restricted saliva flow can also increase your risk of tooth decay and other dental diseases. This is because saliva is the body’s acid neutralizer (acid can erode tooth enamel) and its first line of defense against microbial infection.

To guard against this, it’s important to support salivary flow as much as possible if you experience dry mouth symptoms during treatment (as well as beyond—it’s possible the damage to these glands could be permanent). Since some medications also contribute to dry mouth, you should speak with your physician about the prescriptions you’re taking: if any have dry mouth side effects ask if there’s an alternative drug without these side effects. You should also drink more water during the day and especially when taking medications. And consider substances like xylitol gum that can help boost saliva flow.

Unfortunately, it may not be possible to fully avoid the effects of these treatments on your teeth and gums. So, be sure you keep up daily brushing and flossing and see your dentist regularly for cleanings and checkups. If necessary, there are a number of restoration options to restore your smile after you’ve completed your treatment.

If you would like more information on dental care during cancer treatment, please contact us or schedule an appointment for a consultation.

By Holly Scott-Hetchler DDS
March 13, 2018
Category: Dental Procedures
Tags: dental implants   Dentures  
Implant-SupportedDentures-aBetterFitwithExcessiveBoneLoss

Some patients who wear dentures face a kind of Catch-22: their denture fit may have loosened and become uncomfortable over time due to continued bone loss, yet the same bone loss prevents them from obtaining dental implants, a superior tooth replacement system to dentures.

But there may be a solution to this dilemma that combines the stability of implants with a removable denture. A set of smaller diameter implants — “mini-implants” — can support a removable denture with less bone than required by a conventional implant.

Like all living tissue, bone has a life cycle: after a period of growth, the older bone dissolves and is absorbed by the body, a process known as resorption. The forces generated when we bite or chew are transmitted by the teeth to the jawbones, which stimulates new bone formation to replace the resorbed bone. When the teeth are lost, however, the stimulation is lost too; without it, resorption will eventually outpace bone growth and repair, causing the bone mass to shrink.

Removable dentures also can’t supply the missing stimulation — bone loss continues as if the dentures weren’t there; and due to the compressive forces of a denture, bone loss accelerates. As the jawbone structure used to originally form the denture’s fit eventually shrinks, the denture becomes loose and difficult to wear. It’s possible to adjust to the new jaw contours by relining the dentures with new material or creating a new set of dentures that match the current bone mass. Without adequate bone, fixed crowns or bridges anchored by conventional implants may also be out of the picture.

On the other hand, mini-implants with their smaller diameter need less bone than the traditional implant. A few strategically placed within the jaw are strong and stable enough to support a removable denture. One other advantage: these mini-implants can be installed in one visit with local anesthesia and usually without the need for incisions or stitches.

If you would like more information on dentures supported by mini-implants, 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 “The ‘Great’ Mini-Implant.”

By Holly Scott-Hetchler DDS
February 26, 2018
Category: Dental Procedures
ChrissyTeigensTeeth-GrindingTroubles

It might seem that supermodels have a fairly easy life — except for the fact that they are expected to look perfect whenever they’re in front of a camera. Sometimes that’s easy — but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.

As she recounted in an interview, “I was… like, ‘Oh my god, is my tooth going to fall out on camera?’ This is going to be horrible.” Yet despite the mishap, Teigen managed to finish the scene — and to keep looking flawless. What caused her dental dilemma? “I had chipped my front tooth so I had temporaries in,” she explained. “I’m a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand.”

Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you’re trying to cope with a stressful situation. Other times, it can occur at night — even while you’re asleep, so you retain no memory of it in the morning. Either way, it’s a behavior that can seriously damage your teeth.

When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down — even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.

You may not be aware of your own teeth-grinding behavior — but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you’re a “bruxer.” So what can you do about teeth clenching and grinding?

We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that’s needed to start controlling the habit. Finding healthy ways to relieve stress — meditation, relaxation, a warm bath and a soothing environment — may also help. If nighttime grinding keeps occurring, an “occlusal guard” (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.

Teeth grinding at night can damage your smile — but you don’t have to take it lying down! If you have questions about bruxism, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”

By Holly Scott-Hetchler DDS
February 18, 2018
Category: Dental Procedures
Tags: dental implants  
DentalImplantsCouldbeYourBestOptiontoReplaceLostTeeth

An estimated 35 million people in the United States are missing all of their teeth on at least one jaw. Your situation may not be as serious — perhaps you've only lost one tooth. But even one missing tooth could eventually impact the health of underlying bone or other teeth — and it can certainly mar an otherwise attractive smile.

Depending on other health factors, you could be an ideal candidate for a dental implant to replace that missing tooth. Since their introduction in the 1980s, implants have rapidly become the popular choice for tooth replacement. They've gained this popularity for several reasons: they're a life-like replacement that also functions like a tooth; they're adaptable to a variety of situations; and they enjoy a 95%-plus success rate.

The key to their success lies in their unique construction: they replace the tooth root, not just the crown. They accomplish this through a metal titanium post imbedded directly into the bone. The titanium attracts bone cells, which eventually grow and adhere to the post to anchor the implant securely in the jaw. This growth also deters bone loss that occurs after tooth loss and continues after acquiring other forms of removable restorations like full or partial dentures.

If implants have one drawback, though, it's their cost, especially if you have multiple lost teeth. The good news if you're missing several teeth is that each tooth does not need an implant due to their inherent strength. As few as two implants could replace three to four missing teeth or play a role as supports for other restorations like removable dentures. Some of the implants' other benefits will also carry over, including enhanced bone health.

To determine if dental implants are a good choice for your missing teeth, you'll need to undergo an evaluation of your individual dental condition (including bone health). From there we can advise you on whether implants could change your dental health and your smile.

If you would like more information on dental implants, 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 “Dental Implants 101.”





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