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Posts for category: Dental Procedures

YourTeenagersTeethMayNotBeMatureEnoughforVeneers

Teenagers and adults alike can improve their smile appearance with dental solutions like teeth whitening or orthodontics. But there are a few cosmetic solutions like porcelain veneers that are better suited for more mature teeth.

Veneers are composed of thin layers of dental porcelain that are bonded to the outside of teeth. They're kind of a tooth "mask" that hides blemishes like chips, discoloration or mild bite problems. They're often less involved and expensive than other types of dental restoration.

Even so, we usually need to remove some of the natural tooth's enamel before applying them. Veneers placed directly on unprepared teeth can appear bulky, so we remove some of the enamel to create a more natural look. And although usually only a slight amount, the alteration is permanent and will require the tooth to have some form of restoration from then on.

This usually doesn't pose a major issue for adults, but it could for a teenager's younger teeth. The nerve-filled dentin in a teenager's still developing tooth is thinner and closer to the pulp (nerve tissue) than in more mature teeth.

There's at least one situation, though, where veneers might be applied safely to a teenager's teeth without this concern. If the teen has abnormally small teeth and are receiving veneers to improve their appearance, they might not need alteration. Because the teeth are already thinner than normal, the "no-prep" veneers may not look bulky when directly bonded to them without preparation.

With most cases, though, it might be best to pursue other options that at the very least can make a cosmetic difference until their teeth are mature enough for veneers. For example, we might be able to repair chipped areas with composite resin material that we form and bond to the tooth to achieve a life-like appearance.

We can discuss these and other options for safely improving your teenager's smile. The important thing is to achieve a more confident appearance without endangering their future health.

If you would like more information on cosmetic treatments 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 “Veneers for Teenagers.”

By Nancy Duggan, DDS
April 18, 2019
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

PeriodontalSurgeryAllowsustoAccessDeepSurfacesforPlaqueRemoval

All treatments for periodontal (gum) disease focus on one goal — to remove any bacterial plaque and calculus (hardened plaque deposits) that are at the heart of the infection. Plaque is a thin surface film of food particles and bacteria that cause gum disease.

Plaque builds up on tooth surfaces due to inadequate oral hygiene. And as the disease progresses brushing and flossing won’t be enough — you’ll need our services and specialized equipment to fully remove the plaque and calculus. The basic technique is called scaling in which we remove plaque and calculus manually from tooth surfaces above and just a few millimeters below the gum line.

As the disease develops, though, the slight natural gap between teeth and gums may begin to increase to form voids known as periodontal pockets. Filled with infection, these pockets can extend below the gum line onto the roots of the tooth. If the pocket extends more than 4 millimeters, basic scaling may not be able to remove all of the plaque and calculus.

Periodontists (dentists who specialize in the treatment and care of gum tissues) can perform a surgical method to access these deeper areas. Known as flap surgery, this procedure aims not only to reach and disinfect periodontal pockets and root surfaces, but also repair damaged gum tissue and create a better environment for future hygiene and treatment.

As the name implies, we create an opening in the gum tissue with one side remaining attached to the gum structure — much like the flap of a paper envelope. Through this opening we’re able to reach areas to remove plaque and calculus, as well as install both bone grafts to regenerate lost bone and growth factors to stimulate tissue growth. Once finished, we stitch the flap back into place with sutures and, in many cases, place a moldable dressing to protect and hold the flap secure while the incision heals.

This relatively minor procedure can be performed with local anesthesia and requires only a few days of recuperation. The results, though, can provide long-term benefits — reduced infection, better bone and gum health, and a more conducive environment for future maintenance of health — that could save your teeth and your smile for many years to come.

If you would like more information on treatments for gum 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 “Periodontal Flap Surgery.”

CompositeResinCouldAmpupYourTeethsAttractivenessinJustOneVisit

It might not rise to the level of a miracle, but cosmetic dentistry can achieve some amazing outcomes with unattractive teeth. A skilled and experienced dentist can turn "ugly ducklings" into beautiful "swans." And that achievement might not be as in-depth or expensive as you might think, thanks to the increased use of dental materials called composite resins.

Composite resins are pliable, tooth-colored materials we apply directly to tooth surfaces. They're most often used with broken, chipped or misshapen front teeth—the composite material replaces the missing tooth structure.

Composite resins have been around for decades, but haven't been widely used because they didn't have the strength of dental porcelain. In recent years, though, dentists have perfected techniques for bonding and shaping composites to teeth that have increased their durability. With just the right skill and artistry, composites can look like natural teeth.

We can correct many tooth flaws using composite resins right in our office. After roughening up the outer enamel surface of the tooth and performing other steps to aid bonding, we begin applying liquid resins to form a base layer that we then harden with a special light source. We continue to add layers to increase the color depth and shape of the restoration, before finally polishing it to resemble natural teeth.

Composite restorations are ideal for moderate tooth structure loss, but may not be appropriate for heavily worn, previously root canal-treated or fractured teeth. These and other kinds of flaws may require a different solution such as a dental porcelain restoration with veneers or crowns. Where composites can be used, though, they provide an affordable option that doesn't require an outside dental lab for fabrication—we can often perform it in one visit.

If you'd like to consider a composite resin restoration for a less than perfect tooth, see us for a complete examination and consultation. If your situation appears to be compatible for using this particular technique, composite resins could change your smile for the better in just a few minutes.

If you would like more information on how we can improve 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 “Artistic Repair of Front Teeth with Composite Resin.”

By Nancy Duggan, DDS
March 09, 2019
Category: Dental Procedures
JohnnysTeethArentRottenAnyMore

Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.

In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.

For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.

Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.

It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.

That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”

We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?