Posts for category: Dental Procedures
Upgrades can be exciting—moving on to a larger house, the latest smartphone, or maybe a new car. And, the same can apply with tooth replacements: Maybe you're ready now to upgrade your existing restoration to a dental implant, the most advanced tooth replacement method now available.
But you might encounter a speed bump in your plans: whether or not you have enough bone available for an implant. Here's why your bone may not be adequate.
Like any other cellular tissue, bone has a life cycle: older cells die and newer cells form to take their place. This process stays on track because of the forces generated when we chew, which stimulates new growth.
But that stimulus disappears when a tooth goes missing. This slows the bone growth cycle to the point that bone volume can gradually dwindle. You could in fact lose up to a quarter of bone width in just the first year after losing a tooth.
And, you'll need adequate bone to provide your implants with sufficient strength and stability, as well as the best possible appearance alongside your other teeth. If you don't have enough bone, we must either enhance its current volume or opt for a different restoration.
Fortunately, we may be able to do the former through bone augmentation or grafting. With this method, we place a graft of bone tissue in the area we wish to regenerate. The graft becomes a scaffold upon which new bone cells build upon. It's possible for grafting to produce up to 5 mm in additional width and 3 mm in height to supporting bone.
We can also use this method to prevent bone loss by placing a graft immediately following a tooth extraction. Some studies show the graft can help preserve bone up to 10 years, giving patients time to consider or prepare for a dental implant.
There are circumstances, though, where bone loss has been too extensive to make up enough ground to place an implant. If so, there are other effective and life-like restorations to replace missing teeth. But there's still a good chance augmentation can restore the bone you need for a new smile with dental implants.
If you would like more information on dental implant 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 “Dental Implants After Previous Tooth Loss.”
Modern dental restorations are not only more life-like than past generations, but also more durable. Today's fillings, crowns and bridges can last for years or even decades.
But that doesn't mean you can set them and forget them—they all require some level of maintenance and care. Here are 3 common restorations and what you need to do to make them last.
Fillings. Whether traditional dental amalgam ("silver") or tooth-colored composites, fillings today are incredibly strong and durable. But they do have one point of vulnerability, especially larger ones—the seam where the filling material meets the natural tooth. Bacteria tend to build up along this seam, which could lead to decay and the formation of a new cavity that weakens the filling. To avoid this, be sure you're brushing and flossing everyday and seeing your dentist at least twice a year.
Veneers. Dentists bond these thin shells of tooth-colored porcelain over the visible surface of teeth to hide chips, stains or other blemishes. But although the bonding agents we use create an incredibly strong hold, the bond between the veneer and tooth could weaken when subjected to higher than normal biting forces produced by nail-biting, ice-chewing or a tooth grinding habit. If you have such a habit, see your dentist about ways to minimize it and protect your veneers.
Bridges. Traditional bridges consist of an array of artificial crowns with those in the middle substituting for the missing teeth, while those on the end attach to the natural teeth on either side of the gap to support the bridge. Bridges can also be supported by dental implants. In either case, tooth decay or gum disease could undermine the natural teeth or bone supporting a bridge. To avoid a bridge failure, keep the areas around supporting teeth or implants clean and regularly checked by a dentist.
Above all, the danger dental disease poses to natural tissues also threatens the restorations that depend on them. Keeping your mouth free of disease is your best strategy for ensuring your dental work enjoys a long, functional life.
If you would like more information on protecting your dental work, 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 “Extending the Life of Your Dental Work.”
Advanced decay doesn't necessarily mean it's curtains for an infected tooth. Millions of teeth in that condition have been saved by a tried and true procedure called root canal therapy.
Although they may vary according to the complexity of a case, all root canal procedures share some similarities. After numbing the tooth and gum areas with local anesthesia, the procedure begins with a small hole drilled into the tooth to access the infected pulp and root canals, tiny passageways inside the root.
The dentist then uses special instruments to clear out infected tissue from the pulp and canals, followed by thoroughly sanitizing the resulting empty spaces. This is followed with filling the pulp chamber and root canals with a rubber-like substance (gutta percha) to seal the interior of the tooth from further infection. Later, the dentist typically crowns the tooth for further protection and support.
Root canals have become the standard treatment for teeth with advanced decay. There are, however, some circumstances where performing a root canal isn't a good idea. For example, a previously root-canaled tooth with a crown and supporting post. A dentist would need to fully disassemble the restoration to gain access into the tooth, which could significantly weaken it.
But there may be another option if a standard root canal is out of the picture: a surgical procedure performed by an endodontist (a specialist in interior tooth treatment) called an apicoectomy. Instead of drilling through the tooth crown, the endodontist accesses the tooth root through the adjacent gum tissue.
Like a traditional root canal, the procedure begins by anesthetizing the tooth and surrounding gums. The endodontist then makes a small incision through the gums to expose the diseased tissues at the tooth's root. After removing the infected tissue and a few millimeters of the root tip, they place a small filling to seal the end of the root canal against infection and suture the gum incision.
This is a specialized procedure that requires the state-of-the-art equipment and advanced techniques of an endodontist. But it does provide another possible option for saving a diseased tooth that might otherwise be lost.
If you would like more information on treatments for tooth decay, 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 “Apicoectomy: A surgical Option When Root Canal Treatment Fails.”
Between the final game of the World Series in late October and spring training in February, major league baseball players work on their skills preparing for the new season. Reporters on a Zoom call to the New York Yankees' training camp wanted to know what star outfielder Aaron Judge had been doing along those lines. But when he smiled, their interest turned elsewhere: What had Aaron Judge done to his teeth?
Already with 120 homers after only five seasons, Judge is a top player with the Yankees. His smile, however, has been less than spectacular. Besides a noticeable gap between his top front teeth (which were also more prominent than the rest of his teeth), Judge also had a chipped tooth injury on a batting helmet in 2017 during a home plate celebration for a fellow player's walk-off home run.
But now Judge's teeth look even, with no chip and no gap. So, what did the Yankee slugger have done?
He hasn't quite said, but it looks as though he received a “smile makeover” with porcelain veneers, one of the best ways to turn dental “ugly ducklings” into “beautiful swans.” And what's even better is that veneers aren't limited to superstar athletes or performers—if you have teeth with a few moderate dental flaws, veneers could also change your smile.
As the name implies, veneers are thin shells of porcelain bonded to the front of teeth to mask chips, cracks, discolorations or slight gaps between teeth. They may even help even out disproportionately sized teeth. Veneers are custom-made by dental technicians based on a patient's particular tooth dimensions and color.
Like other cosmetic techniques, veneers are a blend of technology and artistry. They're made of a durable form of dental porcelain that can withstand biting forces (within reason, though—you'd want to avoid biting down on ice or a hard piece of food with veneered teeth). They're also carefully colored so that they blend seamlessly with your other teeth. With the right artistic touch, we can make them look as natural as possible.
Although porcelain veneers can accommodate a wide range of dental defects, they may not be suitable for more severe flaws. After examining your teeth, we'll let you know if you're a good candidate for veneers or if you should consider another restoration. Chances are, though, veneers could be your way to achieve what Aaron Judge did—a home run smile.
If you would like more information about porcelain veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers: Strength & Beauty As Never Before.”
Advances in technology often lead to greater choices for things like automobiles or smartphones. In recent decades, advances in orthodontics have given families another choice besides braces for straightening teeth: clear aligners.
Clear aligners are a series of computer-generated mouth trays of clear plastic that are custom made for an individual patient's teeth. Like braces, these trays worn in the mouth put pressure on the teeth to move in a desired direction. Patients wear an individual tray for about two weeks and then change it out for the next tray in the series. Each subsequent tray is designed to pick up where the former tray left off in the progress of tooth movement.
Although treatment takes about as along as braces, clear aligners have some distinct advantages. First and foremost, their clear plastic construction makes them nearly invisible to outside observers. This makes them ideal for appearance-conscious teens (or adults) who may be embarrassed by the look of metallic braces.
And unlike their fixed counterpart, clear aligners can be removed by the wearer for meals, hygiene and the rare special occasion. As a result, patients with aligners aren't as restricted with food items and have an easier time keeping their teeth clean and avoiding dental disease than braces wearers.
But although definitely a benefit, removability can be potentially problematic depending on the maturity level of the patient. To be effective, an aligner tray must remain in the mouth for the majority of the time—too much time out negates the effect. Patients, then, must be responsible with wearing aligners as directed.
Clear aligners may also not work for treating difficult bites, especially those that require targeted movement (or non-movement) of select teeth. In those cases, braces may be the necessary treatment. But this situation has changed in recent years with the development of new devices and techniques that increase the range of bite problems clear aligners can treat.
Depending then on the bite problem and a patient's level of personal responsibility, clear aligners can be a viable orthodontic choice. And just like braces, they too can improve both dental function and appearance.
If you would like more information on orthodontic options for teens, 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 “Clear Aligners for Teens.”