There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.

But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.

But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.

After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.

As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.

This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.

If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”

Dental implants have soared in popularity thanks to their life-likeness, functionality and durability. But these prized qualities have also created an ironic downside—people are much more likely to replace a tooth with an implant rather than go through the time and effort to preserve it.

We say downside because even though an implant is as close to a real tooth as we can now achieve in dentistry, it still can't rival the real thing. It's usually in your long-term health interest to save a tooth if reasonably possible. And, there are effective ways to do so.

Most dental problems arise from two common oral diseases. One is tooth decay, caused by contact with acid produced by bacteria living in dental plaque. We can often minimize the damage by treating the early cavities decay can create. But if we don't treat it in time, the decay can advance into the tooth's pulp chamber, putting the tooth in danger of loss.

We can intervene, though, using root canal therapy, in which we drill into the tooth to access its interior. We clean out the decayed tooth structure, remove the diseased pulp tissue and fill the empty chamber and root canals to seal the tooth and later crown it to further protect it from re-infection.

Periodontal (gum) disease also begins with bacteria, but in this case the infection is in the gum tissues. Over time the ensuing inflammation locks into battle with the plaque-fueled infection. This stalemate ultimately weakens gum attachment, the roots and supporting bone that can also increases risk for tooth loss.

We can stop a gum infection through a variety of techniques, all following a similar principle—completely removing any accumulated plaque and tartar from the teeth and gums. This stops the infection and starts the process of gum and bone healing.

You should be under no illusions that either of these approaches will be easy. Advanced tooth decay can be complex and often require the skills of an endodontist (a specialist in root canals). Likewise, gum disease may require surgical intervention. But even with these difficulties, it's usually worth it to your dental health to consider saving your tooth first before you replace it with an implant.

If you would like more information on how best to treat a problem tooth, 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?”

Each year, the National Safety Council recognizes June as National Safety Month. It's the perfect time to focus on safety: With summer temperatures heating up, so do sports and outdoor activities—and, unfortunately, the risk of accidents. As the old Boy Scout motto goes, everyone should "be prepared." And while that means watching out for sunburn, poison ivy or traveling hazards, it also means being alert for potential tooth injuries.

Even during casual recreational sports, an unintentional hit to the face or jaw could chip, move or, worse yet, knock a tooth out completely. As with any other aspect of safety, prevention should be at the top of your list when it comes to dental injuries. In that regard, anyone involved in a contact sport or other high-risk activity should wear a mouthguard. This device absorbs much of the force generated during a hard impact to the face or jaw that might otherwise affect the teeth.

Mouthguards fall into two basic categories. The first are retail guards available at sporting goods stores and many pharmacies, most commonly "boil and bite" guards. They're so named because a wearer first softens them with very hot water and then bites down on them to personalize their fit. Once cooled, the mouthguard will maintain its shape. While reducing the severity of impact injuries, these retail mouthguards can be bulky and uncomfortable to wear.

The second category, a custom mouthguard created by a dentist, offers a sleeker, more comfortable fit. These guards are based on a direct impression of the wearer's mouth that we take at the dental office. Although any mouthguard is better than no mouthguard, a 2018 study confirmed that custom-made mouthguards from the dental office perform better than the kind bought in a drug store or sporting goods store.

Summer is prime time for creating cherished family memories. With a little dental injury prevention knowledge, you can help make sure those summer memories are happy ones. If you would like more information about dental injury prevention and treatment, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “Dental Injuries: Field-Side Pocket Guide.”