Scott R. Cayouette, DMD, FAGD
B. Thomas Kays, DDS

Dentist - Charleston

1040 Savannah Hwy, Charleston, SC 29407

(843) 556-8030
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By Charleston Restorative & Cosmetic Dentistry, LLC
May 14, 2020
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 Charleston Restorative & Cosmetic Dentistry, LLC
May 04, 2020
Category: Oral Health
Tags: sensitive teeth  
ToothSensitivityCouldBeaSignofDeeperProblems

If you wince in pain while eating or drinking something hot or cold, you’re not alone: tooth sensitivity afflicts one in three Americans. To understand what’s possibly going on, let’s look first at tooth anatomy.

Teeth are mainly composed of three layers: an outer protective enamel that covers the upper crown, a middle layer called dentin and an inner pulp. The dentin is composed of small tubules that transmit outer temperature and pressure sensations to nerves in the pulp.

The enamel serves as a “muffler,” damping sensations to protect the nerves from overload. In the root area, the gums and a thin material called cementum covering the roots also help muffle sensation.

But sometimes teeth can lose this muffling effect and the nerves encounter the full brunt of the sensations. The most common reason is gum recession, usually caused by periodontal (gum) disease. The gums have shrunk back or “receded,” and after a short while the cementum covering will also be lost, exposing the dentin in the root area.

Another problem is enamel erosion caused by mouth acid. Chronic high acidity, often caused by bacterial growth or acidic foods and beverages, can dissolve the enamel’s mineral content, causing decay and exposure as well of the underlying dentin.

To avoid future tooth sensitivity, it pays to prevent these two dental problems. The most important thing you can do is practice daily brushing and flossing to reduce bacterial plaque and see your dentist regularly for dental cleanings and checkups.

But if you’re already experiencing symptoms, you’ll first need an accurate diagnosis of the cause. If it’s related to gum disease, immediate treatment could help stop or even reverse any gum recession. To address enamel erosion, your dentist may be able to protect and strengthen your teeth with sealants and topical fluoride.

There are also things you and your dentist can do to reduce your symptoms. One is for you to use hygiene products with fluoride, which can take the edge off of sensitivity, or potassium, which helps reduce nerve activity. Your dentist can further reduce nerve sensitivity by blocking the tubules with sealants and bonding agents.

Tooth sensitivity is an irritating problem in itself; more importantly, though, it’s often a warning of something else seriously wrong that needs attention. If you’re feeling a little sensitive in the teeth, see your dentist as soon as possible.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”

By Charleston Restorative & Cosmetic Dentistry, LLC
April 24, 2020
Category: Dental Procedures
Tags: porcelain veneers  
Ultra-ThinVeneersMightHelpYouAvoidEnamelRemoval

Dental veneers—thin, life-like layers of porcelain bonded to teeth—can turn a so-so smile into a beautiful one. But most veneers have a distinct drawback: To make them look as natural as possible, the teeth they're bonded with must have some of their surface enamel removed.

Even though they're 1 millimeter or less in thickness, veneers on an unprepared tooth can look bulky. Removing some of the surface enamel remedies this, but doing so permanently alters the tooth. The tooth will need a veneer or some other protective restoration from then on.

Now, though, there's an alternative veneer available for many dental patients. Known as No-Prep or Minimal-Prep, these new veneers are often as thin as a contact lens.

These new types of veneers can often be placed directly on the teeth just above the gum line without any enamel removal and look natural. At the most, the enamel beneath them may need reshaping with an abrasive tool. And, unlike traditional veneers with tooth alteration, these low-prep veneers can often be applied without anesthesia, and in as few as two appointments.

No- or Minimal-Preps are better suited for certain kinds of patients: those with small teeth or teeth that appear small due to larger mouth features; worn teeth from aging or teeth grinding or with small gaps; narrow smiles where the side teeth aren't as visible; and teeth that are slightly misshapen or with minor staining.

On the other hand, patients with oversized teeth or front teeth that jut forward may still encounter problems with an unnatural, bulky appearance even with ultra-thin veneers. The latter situation can often be corrected with orthodontic treatment first to realign the teeth to their proper positions. Once the bite is corrected, no-prep veneers may then become a viable option.

If you'd like to consider these minimal preparation veneers, see your dentist for an examination. The exam results will help determine what type of veneer solution is right for you. And whether you go with traditional or No-Prep veneers, the change in your smile can be amazing.

If you would like more information on porcelain veneers without enamel removal, 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 “No-Prep Porcelain Veneers.”

By Charleston Restorative & Cosmetic Dentistry, LLC
April 14, 2020
Category: Dental Procedures
EvenCelebritiesHaveAccidentsSeeWhatTheyDotoRestoreTheirChippedTeeth

Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.

Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.

Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.

The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.

Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.

Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.

Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.

If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”

By Charleston Restorative & Cosmetic Dentistry, LLC
April 04, 2020
Category: Dental Procedures
Tags: tooth decay  
AreLaserstheFutureforTreatingAdvancedToothDecay

Advanced tooth decay is a serious dental problem that can threaten an affected tooth's survival. But for decades now dentists have reliably used root canal treatment to better a decayed tooth's odds. This routine procedure performed with dental drill and special hand tools removes infected tissue inside a tooth and replaces the voids with a filling to prevent future infection.

But now there's a new way to perform a root canal—with a surgical laser. Lasers, amplified and focused light beams, aren't new to healthcare—they're an integral feature of many routine medical treatments and surgeries. But their use is relatively new to dentistry, and to endodontics (treating the interior of teeth) in particular.

Lasers can be used in root canal treatment to perform a number of tasks. They can remove diseased tissue and other debris from the innermost tooth pulp. They can be used to clean and shape root canal walls in preparation for filling. And they can also be used to soften and mold the filling material to fit more precisely within a tooth's particular root canal network.

Although laser-assisted root canal therapy isn't yet widespread, laser's limited use to date has given us a fair picture of both their advantages and disadvantages. As with other medical laser applications, lasers are very precise in removing diseased tissue without too much disruption of healthy tissue. There's less need for anesthesia than with dental drills, and lasers are a lot less noisy and jarring. Patients by and large experience less bleeding, as well as less discomfort or infection afterward.

But because laser light can only travel in a straight line, they're difficult to use in many tightly curved root canals. In these cases, the traditional methods are better suited, although a laser can be used in conjunction with other tasks. Temperature with lasers must also be carefully managed lest the high heat that's often generated damages natural tissues.

Although lasers won't be replacing traditional treatment methods for decayed teeth in the foreseeable future, there's hope they'll become more commonplace as technology and techniques continue to advance. Lasers can only improve what already is an effective means of saving teeth.

If you would like more information on treatments for advanced 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 “Laser-Assisted Root Canal Treatment.”





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