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TreatingDecayedBabyTeethProtectsFuturePermanentTeeth

Primary ("baby") teeth may look cute and adorable, but they're a big player in your child's dental health. A primary tooth lost prematurely could eventually lead to a major bite problem.

Primary teeth fulfill a number of functions, most notably enabling young children to eat solid foods, speak and relate to people with a normal smile. But they also serve as placeholders and guides for future permanent teeth developing within the gums.

Problems arise, though, when a child loses a primary tooth early due to disease or trauma, leaving an open space on the jaw. Nearby teeth tend to drift in to fill the space intended for the permanent tooth, leaving little to no room for it when it's time to erupt. This can cause it to erupt out of position, which in turn could force other teeth out of alignment. The end result is a poor bite.

You can, however, avoid this costly outcome by either treating and preserving a decayed baby tooth, or preventing other teeth from drifting into a vacancy left by a lost primary tooth until the permanent tooth comes in.

Depending on the level of decay, treating a diseased primary tooth can include fillings, crowns or modified root canal therapy. For children at high risk for decay, a dentist may also apply sealant to the teeth to inhibit plaque buildup. Although some of these procedures can be extensive, they're often worth the time and effort to prevent a poor bite.

If, on the other hand, we eventually lose the tooth, we can still intervene by installing a space maintainer. This is essentially a loop of wire securely attached to a tooth on one side of a gap, while the other end of the loop butts up against the tooth on the other side. This prevents either tooth from migrating into the space until the permanent tooth is ready to come in.

Primary teeth may not seem all that important, but in the greater picture, they truly are. By taking care of them, you'll be doing your child's soon arriving permanent teeth a favor.

If you would like more information on pediatric dental care, 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 “Importance of Baby Teeth.”

LoveandHipHopHostsNo-GapSmileandHowYouCanHaveOneToo

Nina Parker, the host of Love & Hip Hop for six seasons, is now busy with the new game show Blockbusters and her own talk show The Nina Parker Show. But even with a full plate, she took time recently for some personal care—getting a new smile.

Parker's fans are familiar with her noticeable tooth gap. But a video on TikTok in February changed all that: In the video, she teasingly pulls away a mask she's wearing to reveal her smile—without the gap.

Parker and other celebrities like Madonna, Michael Strahan and David Letterman are not alone. Teeth gaps are a common smile feature, dating back millennia (even in fiction: Chaucer described the Wife of Bath as being "gap-toothed" in The Canterbury Tales).

So, what causes a tooth gap? Actually, a lot of possibilities. The muscle between the teeth (the frenum) may be overly large and pushing the teeth apart. There may be too much room on the jaw, so the teeth spread apart as they develop. It might also have resulted from tongue thrusting or late thumb sucking as a child, influencing the front teeth to develop forward and outward.

A tooth gap can be embarrassing because they're often front and center for all the world to see, but they can also cause oral health problems like complicating oral hygiene and increasing your risk for tooth decay. They can also contribute to misalignment of other teeth.

Fortunately, there are ways to alleviate a gap. One way is to move the teeth closer together with either braces or removable clear aligners. This may be the best approach if the gap is wide and it's contributing to misalignment of other teeth. You may also need surgery to alter the frenum.

You can also reduce less-pronounced gaps cosmetically with dental bonding or porcelain veneers. Bonding involves applying a type of resin material to the teeth on either side of the gap. After some sculpting to make it appear life-like, we harden the material with a curing light. The result is a durable, tooth-like appearance that closes the gap.

A veneer is a thin wafer of porcelain, custom-made to fit an individual patient's tooth. Bonded to the front of teeth, veneers mask various dental flaws like chips, deformed teeth, heavy staining and, yes, mild to moderate tooth gaps. They do require removing a small amount of enamel on the teeth they cover, but the results can be stunning—completely transformed teeth without the gap.

Getting rid of a tooth gap can be a wise move, both for your smile and your health. You may or may not take to social media to show it off like Nina Parker, but you can feel confident to show the world your new, perfect smile.

If you would like more information about treating teeth gaps and other dental flaws, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Space Between Front Teeth.”

WithMoreCrownChoicesPatientsCanSaveaToothandTheirSmile

Porcelain crowns are most commonly used to protect and support teeth damaged by disease or trauma. Today's highly advanced crowns are more effective than ever—and more life-like and attractive.

For instance, dentists often install a crown for a tooth that's endured long-term decay. It's often necessary for a dentist to remove significant portions of affected dentin of a decayed tooth over time, which weakens its overall structure. By crowning the tooth, a dentist can both protect it from further decay and provide it structural support. For similar reasons, dentists routinely place crowns after root canal treatments.

To fulfill their role in preserving and strengthening teeth, crowns must be made of durable materials. For this reason, earlier generations of dentists often turned to crowns composed of precious metals like gold or silver, which could withstand daily chewing forces. But these metal crowns did have one downside: Other than shape, they little resembled real teeth.

Crowns later became more life-like around the middle of the 20th Century with the advent of a type of crown composed of a metal shell encased with a tooth-colored porcelain layer. Marrying functionality with aesthetics, these porcelain-fused-to-metal (PFM) crowns became quite popular and reigned supreme until the early 2000s.

At that time, advances in dental porcelain led to the emergence of the all-ceramic crown. The effort had started a full decade before when dental labs began adding a material called Lucite to porcelain to give it strength. With further improvements, these new porcelain materials, which no longer required metal for durability, soon displaced PFMs as the most commonly installed crown.

Today's dental patient now has more crown choices than patients in previous generations. Especially useful for visible teeth (those in the "Smile Zone"), an all-ceramic crown now enhances rather than detracts from a tooth's appearance. Metal and PFM crowns haven't gone away either—they're often used with teeth that encounter heavy biting forces like molars, and which are not as noticeable.

With more choices, patients no longer need sacrifice their appearance to protect their teeth. You can now preserve a troubled tooth—and still maintain an attractive smile.

If you would like more information on restorative dentistry, 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.”

Same-DayImplantsOfferanAttractiveSmileThroughouttheProcess

With traditional implant methods, it could take months before you can enjoy your new replacement tooth. That's usually not a big deal for a back tooth that's mostly out of sight. It's a different story, however, for a highly visible front tooth—the extended time without a tooth can be embarrassingly uncomfortable for some.

There is, however, another option, one you may already have seen advertised: same-day tooth replacement. In effect, you receive the implant and a life-like temporary crown in a single dental visit.

During the conventional process, the dentist surgically installs the titanium implant post into a prepared channel in the jawbone. Once it's properly positioned, the dentist then sutures the gum tissue over the implant. This protects the implant while bone cells grow and attach themselves to the post to give it a strong and durable hold within the bone.

But now dentists have developed another method to help address the appearance problem posed by teeth that are more visible. With this method, the dentist affixes a temporary crown onto the implant post immediately after installing it. The patient thus walks out the same day without a missing tooth gap and a full smile.

This is a welcome alternative for people desiring to maintain an attractive smile throughout the implant process. But it does have one major qualification—the patient's underlying jawbone must be relatively healthy and supportive of the implant. If not, the implant may require a longer period of bone growth before and after surgery to fully secure it. In those cases, it may be better to use the conventional method.

As we've already noted, a "same-day" crown isn't the permanent one, especially with single tooth implants. That's because the implant still requires bone integration over several weeks to achieve full durability. For that reason, this initial crown is made slightly shorter than the surrounding teeth to limit its encounter with biting forces generated by daily chewing, from which those forces would likely damage the implant at this stage.

After completion of the bone integration stage, the patient returns to swap out the temporary crown for the fully functional permanent crown. The "same-day" crown has served its purpose—providing the patient a seamless full smile throughout the implant process.

If you would like more information on "same-day" 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 “Same-Day Tooth Replacement With Dental Implants.”

By Edwin Yee
April 09, 2022
Category: Oral Health
Tags: oral health  
UnderstandingDentalInsuranceThe3TypesofPlans

Health insurance is an important part of life, helping to even out the high costs of medical treatment. Without it, many of us would find it extremely difficult to financially weather physical illness or injury.

But many also view health insurance as frustratingly complicated, including policies that cover dental care. Regarding the latter, people often view it as medical insurance's identical twin—which it's not. While insurance for clinical services and hospitalization manages cost in a comprehensive manner, the majority of dental plans function more like a discount coupon.

The great majority of dental policies today are paid for by employers as a salary benefit to their employees. There can still be differences in policies and it's important to know what kind of plan your workplace has provided you. Here's a rundown of the three basic types of dental insurance plans.

Fee-for-Service. This is the most common dental plan in which the employee is able to choose their dentist and the insurance company pays the dentist for services rendered. Each individual policy outlines the treatments covered, as well as the percentage of payment.

Direct reimbursement. With this approach, the employer pays employees' dental bills directly out of company funds. Even so, an insurance company is often still involved, but as a paid administrator for the employer, reimbursing the dental provider on behalf of the company.

Managed care. An insurance company may also create a network of dental providers that all agree to a set schedule of fees for services rendered. These dental health maintenance organizations (DHMOs) or preferred provider organizations (PPOs) can reduce patients' out-of-pocket expenses. But covered patients can only use dentists within the DHMO or PPO network to receive benefits.

You can, of course, purchase dental insurance as an individual rather than receive it as an employee benefit. If so, you'll need to weigh what you pay out for the policy and what you receive in benefits with what you would pay out-of-pocket without it to see if you're truly realizing any savings.

Either way, understanding a dental insurance plan can be a challenge for the average person. Fortunately, most dental offices are well experienced with these plans. Your dentist's staff can be a valuable resource for helping you get the most out of your insurance benefits.

If you would like more information on the financial side of dental care, please contact our office. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Insurance 101.”





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