Posts for: March, 2014
Our smiles are our “calling cards” for first impressions. When our front teeth are missing, chipped or otherwise damaged, it will certainly make an impression — and not a positive one.
The good news is many aesthetic problems with front teeth can be remedied with the use of composite resins. This cost-effective treatment choice not only minimizes a negative appearance, but can actually create a positive smile transformation.
Composite resins are tooth-colored materials made up of two or more polymer substances. We call materials like these biomimetic, meaning something non-living that’s fashioned to appear or “mimic” something living. Composite resins are made of substances that aren’t teeth, but fashioned to look and function like teeth.
Composite resin restorations are bonded to the outside of the tooth with dental adhesive, with little to no preparation of the enamel surface of the tooth. They’re best suited for teeth with minor to moderate damage from decay or trauma, but where the majority of the structure is still viable and intact.
These restorations require skill and an artistic eye to achieve the most life-like result. One of the most important considerations is tooth color. The natural color of your teeth is actually a combination of color from the inner core of the tooth, the dentin, and the outer enamel layer. Much of the color comes from the dentin as it shows through the translucence of the enamel. The intensity and hue also changes along the length of the tooth — there are subtle zones of color that run vertically along the length of the crown (the visible portion of the tooth). Our aim is to replicate this variety of color in the restoration and affix it in such a way that it blends with the natural color of surrounding teeth.
Composite resins aren’t the best option for all situations; depending on the tooth’s condition and location, a porcelain veneer may be the better choice. After a thorough dental examination, we can make the best recommendation for your situation. If conditions are right, a composite resin restoration could transform your smile and your life.
If you would like more information on front teeth repair options, 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 “Artistic Repair of Front Teeth With Composite Resin.”
While periodontal disease can take on a variety of forms, most are caused by a thin layer of bacterial plaque called biofilm. This layer of plaque will form every 8-12 hours and sticks like glue to your teeth near the gum line. With time, tartar formation occurs at and below the gum line.
If left unchecked, biofilm can give rise to a very unhealthy progression. It first triggers an infection that leads to painful inflammation, progressive bone loss and the gum tissue losing attachment with a tooth. Void spaces (or pockets) form where the gum and bone tissue once adhered; infectious plaque and tartar moves into these pockets and advances deeper to the root. Overcome by disease, the tooth is in danger of being lost.
It's imperative then to remove as much of this entrenched plaque and tartar as possible. Renewed oral hygiene is not enough — removing plaque and tartar from the root surfaces requires a treatment known as root planing.
Root planing is a meticulous, labor-intensive process. We first clear away larger portions of plaque around the teeth and gums with hand instruments or an ultrasonic device and then flush out the pockets with water. After administering a local anesthetic for pain, we would then turn to a number of small hand instruments known as curettes to probe and scrape away as much remaining plaque below the gum line as we can get to.
Root planing requires experience and a good sense of touch to work in areas that can't be clearly seen. Observing the gum line, though, can give us a good indication of progress as these tissues will actually change color once the biofilm and tartar deposits have been removed.
Being so deeply entrenched, not all the deposits might be removed during one session. However, as plaque and tartar are removed, the gum tissues will begin to heal and become less inflamed. This will make it easier to remove plaque in subsequent sessions.
Root planing takes time, but the effort is well worth it. In the short term you'll notice less inflammation and pain around your teeth and gums. In the long-term, it just may save your teeth.
If you would like more information on root planing and periodontal disease, 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 “Root Planing.”
Dental implants are a popular and effective restoration for lost teeth, if there’s enough bone present to support the implant. That might not be the case, however, because without the stimulation of the lost tooth, the bone may dissolve (resorb) over time. It’s possible, however, that you may need to re-grow bone in the back area of the upper jaw where your upper (maxillary) sinus is located.
Sinuses are air space cavities located throughout the skull. This feature allows your head to be light enough to be supported by your neck muscles. Inside each sinus is a membrane that lines your sinus cavities, nasal passages and other spaces. The maxillary sinus is located on each side of the face just below the eyes. Pyramidal in shape, the floor of the pyramid lies just above the upper back teeth.
A surgeon approaches the sinus through the mouth, with the objective of moving the sinus membrane up from the floor of the sinus. This is accomplished by placing bone-grafting material in the area. Over time the body uses the grafting material as a scaffold to produce new bone that then replaces the grafting material. The resulting new bone becomes the support for the implant.
If enough bone exists to stabilize an implant but not anchor it, then the surgeon can approach the sinus from the same opening that’s used for the intended implant site, insert the grafting material, and install the implant during the same procedure. If not, the surgeon creates a small “window” laterally over the teeth to access the sinus and insert the graft. The implant is installed a few months later after the new bone is created.
The procedure usually requires only a local anesthetic, although some patients may require additional sedation or anti-anxiety medication. After the surgery, you normally experience mild to moderate swelling and discomfort, about the same as having a tooth removed. All these symptoms can be managed with non-steroidal, anti-inflammatory pain medication and a decongestant for minor congestion in the sinus. We might also prescribe an antibiotic to help prevent infection.
Although this procedure adds another step and possibly more waiting time to implantation, it gives you an option you wouldn’t otherwise have — a life-like, effective replacement of your back teeth with dental implants.
If you would like more information on bone regeneration for 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 “Sinus Surgery.”
So you came in to the dental office for an exam, and now you’ve been told you need a root canal. But you’re wondering: Do I really have to do this? I’ve heard all sorts of things about the procedure. What if I wait a while — would that be so bad?
The answer is: It just might! Whenever we dentists recommend a root canal procedure, we have good reasons for doing so. Here are the top five reasons why you shouldn’t delay getting this important treatment.
- The tooth is infected and dying; a root canal stops the infection. While the outer layers of the tooth are hard, the inner pulp is made of soft, living tissue. This tissue sometimes becomes infected (through deep decay, cracks in the tooth surface, etc.), and begins to die. Once that happens, treatment is needed right away — to stop the pain, control the infection, and keep it from spreading.
- Root Canal Treatment Alleviates Pain. That’s right: Root canal treatment doesn’t cause pain — it relieves it. The procedure is relatively painless, despite the old stories you might have heard. In fact, it’s not unlike having a cavity treated, though it may take a little longer. So if you’re experiencing tooth pain (a major symptom in most cases of root canal trouble), remember that the sooner you get it treated, the sooner you’ll be pain-free.
- It won’t get better on its own… If you ignore some things, they will go away. Root canal problems aren’t one of those things. In some cases, if you wait long enough, the pain will go away. But that’s not a good sign, because the problem won’t go away on its own; it simply means that the nerves inside the tooth are all dead. The infection continues to smolder like glowing coals in a fire.
- …But it could get worse. Left untreated, bacteria from the infected tooth pulp can travel through the roots of the tooth and into the tissue of the gums and jaw. That can cause a painful, pus-filled abscess to form, which will require urgent treatment. In extreme cases, It can also result in increasing systemic (whole-body) inflammation, potentially putting you at risk for more serious conditions, like heart disease and stroke.
- Root Canal Treatment Can Save the Tooth. If you neglect treatment of a root canal problem long enough, you’re at serious risk for losing the infected tooth. And tooth loss, once it starts, can bring on a host of other problems — like an increased risk of tooth decay on remaining teeth, as well as gum disease, bite problems… and, as oral health problems escalate, even more tooth loss. Why put yourself at risk?
If you would like more information about root canal treatment, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “A Step-By-Step Guide To Root Canal Treatment” and “Tooth Pain? Don’t Wait!”