Posts for category: Dental Procedures
Besides reduced biting and chewing function, a missing tooth can cause an embarrassing inhibition to healthy social interaction. This can be especially so for teens who greatly value peer relationships and acceptance.
Be that as it may, we typically discourage a permanent replacement for teens with a missing tooth, particularly dental implants. While we value a patient’s psychological needs, the long-term effect on dental health may be too great to advise otherwise.
The effect we’re concerned with involves jaw growth and development. Although a person’s permanent teeth have usually all erupted by early adolescence, the jaws continue to grow until the late teens or early twenties. Natural teeth can adapt to this growth because the periodontal ligament that holds them in place allows for incremental tooth movement. The teeth move in response to jaw growth and are thus able to maintain their proper relationship and alignment in the jaw as growth occurs.
Dental implants, on the other hand, are imbedded into the jaw bone: they, therefore, can’t move like natural teeth and thus can’t adjust their position with jaw growth, particularly the upper jaw as it grows forward and down. This can result in the implants appearing as though they are left behind or retreat into the jaw. It can also affect the position of the gums and inhibit their growth around the implants.
It’s best then to hold off implants and other permanent restorations until the jaw has finished developing. That, however, isn’t always easy to determine: specialized x-ray diagnostics may help, but it’s not an exact science. Your input as a parent will also be helpful, such as whether you’ve noticed the end of growth spurts (not changing clothes or shoe sizes as often) or your child’s recent similarity in appearance to other adult members of your family. It thus becomes a judgment call, based on examination and experience, as to whether it’s safe to proceed with implants — and may require erring on the side of caution.
In the meantime, there are temporary restorations that can improve appearance while you wait for the appropriate time to undertake a permanent restoration. Two of the most useful are removable partial dentures (RPDs) or a bonded bridge, a less invasive form of the traditional bridge. With a proper assessment we can advise you on which option is your best choice.
If you would like more information on tooth restorations for teenagers, 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 “Teenagers & Dental Implants.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
If your tooth sustains damage that compromises its structure — typically through decay or trauma — you have several options depending on the extent of the damage: One of them is a crown. This method saves the tooth and its root and completely conceals the visible portion of the tooth, or crown, under a natural-looking cap made to mimic as closely as possible the size, shape and color of the original tooth.
Crowns also hide imperfections in the original tooth like discoloration, chipping, fractures, excessive wear (from bruxism, or tooth grinding, for example), or abnormalities in the way the tooth formed. And they’re used following root canal treatments, which treat infected pulp at the center (canal) of a tooth root by removing the pulp and replacing it with an inert, rubber-like material.
Saving the natural tooth has long been the goal of dentistry because normal micromovements of the tooth root, which is suspended in its jawbone socket by elastic ligaments, stimulate the surrounding bone to rejuvenate. Without that stimulation, the bone continues to lose old cells, but no longer replaces them. Crowns are also designed to restore tooth function.
The function and location of the damaged tooth can determine what material the crown will be made of. If the damaged tooth is clearly visible when you smile, porcelain, the most realistic-looking material, is almost always used. If the tooth receives significant bite force, a stronger material is considered — either, a gold/porcelain combination, or a high-strength ceramic. If you are restoring a second molar, an all-gold crown may be considered.
With the advent of dental implants, saving a damaged tooth is no longer the only option for preserving the health of the bone surrounding the tooth root. The implant — a tiny biocompatible, titanium screw-like artificial root — is placed in the jawbone and is then capped with a natural-looking crown of course!
If you would like more information about dental crowns, 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 “Crowns & Bridgework.”
Today’s healthcare patients are asking questions. They want to know the “why” behind the “what” that their care providers are recommending for their health.
There’s a similar trend in dentistry — and it’s one we dentists encourage. We want you to know the “why” behind your treatment options — because you’re as much a participant in your own dental health as we are. The more informed you are, the better equipped you’ll be to make decisions to maintain or improve your health and the appearance of your smile.
As your dental care partner, it’s also essential we help you develop a long-term care plan based on your needs. There are aspects of dental care that are routine: daily brushing and flossing, an oral-friendly diet, and regular dental cleanings and checkups to assess your oral health. But we also need to think strategically, especially if you have risk factors that could impact your future dental health.
To do this we follow a four-step dental care cycle. In Step 1 we identify all the potential risk factors you personally face. These include your potential for dental disease, which could lead to bone and tooth loss, and the state of your bite and jaw structure that could complicate future health. We’ll also take into account any factors that could now or eventually affect your smile appearance.
Once we’ve identified these various factors, we’ll then assess their possible impact on your health in Step 2, not just what may be happening now but what potentially could happen in the future. From there we move to Step 3: treating any current issues and initiating preventive measures to protect your future health.
In Step 4 we’ll monitor and maintain the level of health we’ve been able to reach with the preceding steps. We’ll continue in this stage until we detect an emerging issue, in which we’ll then repeat our cycle of care.
Maintaining this continuum will help reduce the chances of an unpleasant surprise in your dental health. We’ll be in a better position to see issues coming and help reduce their impact now so you can continue to have a healthy mouth and an attractive smile.
If you would like more information on planning your dental treatment, 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 “Successful Dental Treatment: Getting the Best Possible Results.”
What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.
"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."
But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.
"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."
What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.
Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.
To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.
Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?
"I love my veneers!" she declared, noting that they have held up well for over a decade.