What is Microdontia?
Microdontia is literally “small teeth.” When
this condition is present, one or more teeth have shortened
roots and are smaller than normal, or they are cone-shaped
or malformed in some other way. It commonly affects a
single tooth or a pair of teeth, especially the
maxillary laterals or the third molars. Very rarely, microdontia
may affect all teeth (called generalized microdontia);
this is sometimes
seen in cases of pituitary dwarfism.
Another, similar condition is relative generalized
microdontia, in which the teeth may be only slightly smaller
than normal but the jaw
structure is somewhat larger than normal. This can give
the impression of true generalized microdontia, and typically
occurs in children who inherit their tooth size from one
parent and the jaw size from the other parent.
When only one or a few teeth are involved,
it's important to consider the possibility that adjacent
teeth may shift in response to the wide space caused by
the smaller teeth. This can lead to a malocclusion, or
an abnormal bite, possibly requiring orthodontic treatment.
Also, if the roots are abnormally small or short, this
can limit treatment possibilities, as such teeth may not
be strong enough for normal-sized crowns. Teeth with small
roots also can't be used as supports for a bridge, commonly
used to replace missing teeth.
Treatment Options
• If the roots are adequate, we can place temporary
crowns (caps) on the teeth as they grow in, to help them
maintain their position and normal spacing.
• Permanent crowns can be placed once teeth are fully
grown in and developed.
• If roots are not adequate on primary teeth, we
may place space maintainers to act as placeholders until
the permanent teeth grow in.
• If the abnormal teeth are lost prematurely, we
can create a removable appliance with artificial replacement
teeth which will maintain
normal space and appearance.
• In adults, dental implants can be placed with normal-sized
crowns to replace the microdont (the small tooth).
What is Migratory Glossitis?
The top surface of a normal tongue is typically smooth,
with a slight groove down the center (called the midline).
However, if you were to look at your tongue under a strong
magnifying glass or microscope, you would see that the
top surface is actually covered by tiny raised structures.
The most numerous of these are small, slender, coneshaped
structures called filiform papillae.
Migratory glossitis, or geographic tongue, is a chronic
inflammation characterized by random shedding of patches
of the filiform papillae.
This results in irregular, well-defined red lesions on
the tongue's surface where the loss of papillae has occurred.
They are bordered by a white line or band of necrotic
(dead) filiform papillae which will ultimately slough
off. If you have migratory glossitis, your tongue will
likely have a map-like (geographic) appearance as a result
of the prominently-bordered lesions described above.
Migratory glossitis doesn't usually present any symptoms
other than an occasional burning sensation or increased
sensitivity on the
tongue. These symptoms may persist for several weeks,
spontaneously disappear, then return again at unpredictable
intervals.
The lesions usually reappear in different locations on
the tongue upon each outbreak.
Migratory glossitis can occur in anyone over two years
of age, and is twice as common in females as in males.
The condition is often
associated with food allergies or with a fissured tongue.
Increased stress may also trigger an outbreak.
Treatment Options
Usually, migratory glossitis requires no treatment. If
your case is severe, or if you are suffering from burning
or other discomfort as a
result of the condition, we may recommend that you apply
topical vitamin A (also called retinoic acid) for relief.
What is Nicotine Stomatitis?
Nicotine stomatitis is a lesion that develops on the hard
or soft palate of some smokers. It appears as white with
raised red dots; the red areas represent inflamed ducts
of the minor mucous glands. The surface usually has a
rough texture, which makes the palate appear cooked. The
appearance of the lesions may become more prominent as
the condition persists.
The lesions are persistent, continuing as long as smoking
persists. There are usually no symptoms associated with
this condition, even
when it is long-standing. If smoking is lessened significantly
or discontinued, the lesions may disappear completely,
depending on the
extent of the tissue changes.
Nicotine stomatitis is most common in men over 40 years
of age. Pipe and cigar smokers develop nicotine stomatitis
condition most frequently, but it also occurs in cigarette
smokers. Nicotine stomatitis is often associated with
the habit of holding the smoke in the mouth for extended
periods of time as opposed to quickly exhaling it. Although
tobacco usage is unquestionably associated with cancer
in some patients, there is no sound evidence of nicotine
stomatitis being a pre-cancerous condition. However, for
optimum oral as well as overall health, tobacco use of
any kind should be avoided.
Treatment Options
The lesions associated with nicotine stomatitis may disappear
when tobacco use is discontinued. Treatments for this
condition include
medications and techniques aimed at smoking cessation.
What is a Papilloma?
Papillomas are slow-growing, soft lesions that are sometimes
caused by a virus. They can also spread through direct
contact with the
mouth's lining (the mucosa). Papillomas can occur at any
age, and can be found anywhere on the skin but typically
exist on the tongue, lips, gums, corners of the mouth,
the inside of the lips or cheeks, and roof of the mouth,
including the soft palate and throat. They originate from
the epithelium, which is the outer layer of tissue that
lines the inside of the mouth. Papillomas are knob-like
or elongated finger-like growths that usually appear to
be attached by a stalk of tissue; however, larger growths
can be broad and flattened. Frequently, papillomas consist
of multiple frond-like growths that we can easily examine
with a dental explorer or an air syringe. They are pink
or white, and are usually under one centimeter in diameter.
Clusters of papillomas may merge to form large lesions.
Treatment Options
Papillomas are benign (non-cancerous) growths, but we
will remove them surgically because of the potential for
increased growth and the likelihood of injury to the tissue
such as ulceration, soreness, pain, and infection. Papillomas
very rarely heal or disappear on their own.
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What is Periapical Abscess?
A periapical abscess is an infection at the base or root
end of the tooth (called the apex), and usually encompasses
the bottom 1/3 of
the tooth root. The abscess is a collection of pus that
develops in response to a bacterial infection within the
center of the tooth (the
pulp). The source of this original infection can be either
an untreated cavity, or a broken or fractured tooth. Both
create an opening in the enamel, which allows bacteria
into the tooth's pulp. This opening may occur either on
the crown portion of the tooth or along the root's surface.
It's through this opening that bacteria enter the tooth's
pulp, causing the infection. Acute abscesses may also
form as a result of other conditions in the root tip area,
such as a dental granuloma or a radicular cyst. The original
source of these problems is again an infection in the
dental pulp.
In addition to pus formation, an abscess can also cause
a great deal of pain, especially when you chew or otherwise
apply pressure to the infected tooth. A fever and swollen
lymph nodes in the neck may also develop as your body
attempts to fight off the infection. Periapical abscesses
often drain on their own through openings called fistulous
tracts (or gum boils).
