Posts for: November, 2013
Fans of the classic bumbling-buddies comic film “Dumb and Dumber” will surely remember the chipped front tooth that Jim Carrey sported as simpleminded former limo driver Lloyd Christmas. Carrey reportedly came up with the idea for this look when considering ways to make his character appear more “deranged.” He didn't need help from the make-up department, however… He simply had his dentist remove the dental bonding material on his left front tooth to reveal the chip he sustained in grade school!
Creating a Bond
A dental cosmetic bonding involves application of a composite filling material that our office can color and shape to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed. This is the quickest and lowest-cost option to repair a chip.
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.
A veneer can be used to hide smaller areas of missing tooth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface also may be necessary to fit a veneer.
A chipped tooth makes an impression, but generally not a flattering one. Nearly 20 years after “Dumb and Dumber” hit the theaters, the only thing Jim Carrey had to do recently to hint at a sequel for his nitwitted character was tweet a photo of that goofy grin!
If you would like more information about repairing a chipped 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 “Artistic Repair of Front Teeth With Composite Resin.”
It’s indisputable that fluoride has revolutionized dental care. Decades of research have overwhelming shown this natural, enamel-strengthening chemical has decreased tooth decay.
Too much fluoride, though, can cause enamel fluorosis, a permanent staining of tooth enamel. In its mildest form, the teeth develop faint whitish streaks; in more severe cases, the staining is noticeably darker and the teeth appear pitted. The teeth themselves aren’t damaged, but the unsightly staining could require cosmetic treatment. Children under age 9 (when permanent teeth enamel matures) are especially at risk of fluorosis due to over-fluoridation.
Because of fluoride’s prevalence in hygiene products and many drinking water supplies, it’s not always easy to know if your child is receiving too much. There are two areas, though, that bear watching.
First, you should limit the serving quantity of fluoride hygiene products, particularly toothpaste. Children tend to swallow rather than spit out toothpaste after brushing, so they ingest more fluoride. We recommend a small “smear” of toothpaste on the brush for children under two, and a pea-sized amount for children two to four.
The other concern is your drinking water. Three-quarters of America’s water systems add fluoride, usually to a recommended level of 0.70 PPM (parts per million). To know if your water supply adds fluoride and at what levels, you can contact your local water utility or health department, or check the Center for Disease Control’s website for their “My Water’s Fluoride” program (http://apps.nccd.cdc.gov/MWF/Index.asp). This site will have information if your water system participates in the program.
If your area exceeds recommended levels or is at high risk for fluorosis, we recommend reducing the use of tap water in infant formula. Besides breast-feeding (human breast milk is low in fluoride), you can use either ready-to-feed formula, or mix powdered formula with water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”
One thing you should not do is eliminate your use of products containing fluoride — this may increase your child’s risk of tooth decay. The consequences of decay can be serious and have a life-long effect — and far outweigh the risks of fluorosis staining.
If you would like more information on fluoride and your infant, 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 “Tooth Development and Infant Formula.”
Many people view a tooth extraction (removal) as a major ordeal; but from a dentist’s standpoint it’s a routine procedure. That’s not to say, though, that all extractions are alike — there are varying levels of complexity depending on the type, size and location of the tooth.
Teeth are held in place to the jawbone by a tissue known as the periodontal ligament, whose collagen fibers attach the tooth to the bone of the jaws. By gently manipulating the tooth, we can release the hold that these fibers have on the tooth. This takes not only skill but also a kind of “feel” that comes with experience.
From that point, removing the tooth will depend on its root structure and how it’s positioned in the jaw. Upper front teeth have a single, straight root usually shaped like a cone; their path of removal is relatively straight and uncomplicated. Many teeth in the back, however, have more than one root, and not as straight in shape as an upper front tooth, that complicates the path of removal. Depending on the level of complication, the extraction may require an oral surgeon, a dental specialist.
After the tooth is extracted, it may be necessary to fill the socket (the area of the bone once occupied by the tooth) with some form of grafting material that will encourage bone growth. This new growth will aid with any future plans for dental implants.
After the procedure, we will give you instructions for cleaning and caring for the extraction site as you recover over the next few days. We may also prescribe medications to help you cope with discomfort and swelling, as well as antibiotics and antibacterial mouth rinses.
Before undertaking any extraction, we would first conduct a thorough examination and provide you with your options and our recommendations for treatment. We would also discuss your options for replacing the teeth after theyâ??ve been extracted.
The thought of having an extraction may fill you with anxiety. But in the hands of an experienced professional, removing a tooth is a routine and safe procedure.
If you would like more information on tooth extractions, 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 “Simple Tooth Extraction?”
Today's cosmetic dentist can bring amazing transformations to their patient's smiles. That's because we now have a versatile array of materials and processes that precisely replicate the appearance of natural teeth.
Two of the most useful are porcelain veneers and crowns. Although different in structure and function, veneers and crowns both utilize a material known as dental porcelain, a ceramic material that can be shaped to resemble an individual patient's natural tooth shape, with the same color, hue saturation and translucence as the original or surrounding teeth.
As the name implies, veneers are a thin layer of dental porcelain that adheres to the outer surface of a tooth, essentially as a replacement for enamel. They solve a number of esthetic issues patients have with their teeth, especially those in front: poor color, shape and contours; broken teeth; poor tooth position; and staining that can't be removed with conventional bleaching. They most often require minimal tooth preparation, as only 1 mm or less of tooth enamel needs to be removed. Occasionally, no tooth reduction is required.
However, they are not a good solution where there is not an adequate amount of tooth structure to work with. In this case, a crown may be the best choice. A crown (or cap) covers the remaining tooth structure completely, reinforcing the remaining tooth structure 360°. This is an excellent choice for patients who have lost a large amount of tooth structure due to decay, trauma or grinding habits that have eroded the enamel.
To determine if you are a true candidate for either of these applications you should undergo a smile analysis in our office. During this process it's even possible to create a diagnostic mock-up — a “trial smile,” if you will — with temporary tooth-colored materials applied to your teeth and then photographed for your review.
The smile analysis helps us recommend the best solution for you and in turn will help you make an informed choice on the right application for you. Although either option may not be feasible in all situations, they may just be the right choice to change your smile for the better.
If you would like more information on how porcelain veneers and crowns can help transform your smile, 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 “Porcelain Crowns and Veneers.”