Posts for: January, 2016
Restoring missing or unattractive teeth can often be a lengthy process. Months may elapse between initial teeth preparation and final placement to allow time for tissue healing and permanent crown manufacturing. During that period you will likely wear temporary (provisional) crowns to protect the teeth while improving function and appearance.
In the past, provisional crowns were fairly uniform. Today, though, there are provisional crowns available that conform exactly to a patient’s individual mouth. These crowns not only enhance function and appearance, they’re an excellent way to “try out” your new smile before the permanent restoration.
Customized provisional crowns are part of a concept known as “smile analysis.” A new smile involves more than restoring affected teeth: we also consider the overall health of your mouth, the shape of your face, and your own desires and expectations. Your final smile design is a joint collaboration between you, our office and the dental laboratory that will fashion the final restoration.
There are a number of techniques for creating customized provisional crowns. Some techniques involve bonding tooth-colored materials like composite resin directly to the teeth. Others use impression models of your teeth to create an outline or shell that’s filled with an acrylic material and then affixed to your teeth. The aim with any of these techniques is to produce a provisional crown that accurately reflects the final crown’s appearance.
With these types of provisional crowns, we can see how the new teeth will look (their color, shading, shapes and proportions) against the gums, and if they appear to be in balance and harmony with the entire face, including your lips, jaws and facial contour. We can also evaluate how well the new teeth function as you chew, speak or smile.
It takes some extra effort to prepare customized provisional crowns rather than the more uniform version. But this effort is well worth it: by helping us anticipate more accurately how your new restorations will appear and function, customized crowns help ensure your new smile is an attractive and satisfying one.
If you would like more information on temporary restorations, 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 “Concepts of Temporary Restorations.”
Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.
“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.
Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.
“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.
Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?
Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.
Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a thirdÂ to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.
Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”
Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.
If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”
Hopefully, you’ve developed a long-term care relationship with your family dentist. Better known as a general dentist, these professionals are the central players in maintaining your oral health, and your first stop when you have a problem with your teeth or gums.
But there are times when a particular dental situation calls for a specialist, a dentist with additional training (as much as three years or more in their area of specialty) and the equipment and advanced techniques for your particular need. Here, then, are some of the other kinds of dental professionals your general dentist may refer you to if you need specialized care.
Periodontist — From the Latin peri (“around”) and dont (“tooth”), this dentist cares for the supporting structures of the teeth, particularly the gums and bone. Besides treating advanced cases of periodontal (gum) disease, they’re also adept at reconstructive and cosmetic gum procedures or the placement of dental implants.
Orthodontist — Although known commonly as the “braces” doctor, orthodontists have a much wider concern: the interaction and alignment of teeth and jaws. With a keen understanding of growth and development, orthodontists can employ a number of treatments, including braces, to bring teeth into better positions that will improve function and appearance.
Endodontist — Teeth damaged from disease or injury may need treatments that involve the interior of the tooth — the pulp and root canals. While your general dentist can perform basic root canal treatments, an endodontist has the added knowledge and equipment to treat more difficult cases.
Prosthodontist — As with a prosthetic limb that replaces a lost arm or leg, prosthodontists specialize in replacing lost teeth (prostho means “artificial”). Prosthodontists can skillfully create functional, life-like dentures, as well as natural tooth and implant crowns to replace portions of visible teeth.
Oral Surgeon — These dentists are skilled in the diagnosis and surgical treatment of conditions involving the head and neck (the “maxillo-facial” region). They often work in consultation with general dentists and other specialties for treating complex mouth conditions. Besides tooth extraction and other dental procedures, oral surgeons can also surgically correct jaw alignment or treat trauma to the face and neck area. They also place grafts to stimulate bone growth for future implants.
If you would like more information on how dental specialties can benefit your health, 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 “The Dental Universe.”
Whether performed in a dental office or using a home kit, teeth whitening applications are quite effective for bleaching exterior (extrinsic) stains on enamel surfaces. But what if your discoloration comes from inside the tooth? In this case, extrinsic teeth whitening won’t work — you’ll need to undergo an “internal bleaching” method, which can only be performed in a dentist's office.
There are a number of causes for “intrinsic” staining, including too much fluoride exposure or tetracycline use during childhood. One of the more common causes, though, occurs from root canal treatments used to remove the remnants of the pulp tissue inside a tooth’s pulp chamber and root canals. Certain cements used during the procedure to help seal in the filling material and leftover blood pigments can cause the tooth to darken over time.
To alleviate this discoloration, we use a bleaching agent, usually sodium perborate mixed with a diluted solution of hydrogen peroxide to achieve a safe, accelerated color change. After determining that the root canal filling is still intact and the bone is healthy, we create a small cavity in the back of the tooth to access the pulp chamber. The chamber is cleaned of any debris or stained material and then thoroughly irrigated. The original root canal filling is then sealed off to prevent leakage from the bleaching agent.
We then place the bleaching agent in the cleaned-out space with a cotton pellet and seal it in with a temporary adhesive. This step is repeated for several days until we achieve the desired shade of white. Once that occurs we then seal the dentin with a more permanent filling and then restore the cavity we created with a composite resin bonded to the enamel and dentin.
If we’re successful in achieving the desired color, intrinsic whitening could help you avoid more costly options like veneers or crowns for an otherwise healthy and attractive tooth. The end result would be the same — a beautiful smile without those unsightly stains.
If you would like more information on treating internal tooth stains, 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 “Whitening Traumatized Teeth.”