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Posts for category: Dental Procedures

3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing teeth, 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 “When Permanent Teeth Don't Grow.”

LikeJohnnyManzielYouMayNeedanOralSurgeonforaMajorDentalProblem

QB sensation Johnny Manziel has had a varied career in professional football. After playing two seasons for the NFL Cleveland Browns, he quarterbacked for a number of teams in the Canadian Football League. More recently, he joined the Zappers in the new Fan Controlled Football league (FCF). But then with only a few games under his belt, he was waylaid by an emergency dental situation.

It's unclear what the situation was, but it was serious enough to involve oral surgery. As a result, he was forced to miss the Zappers' final regular-season game. His experience is a reminder that some dental problems can't wait—you have to attend to them immediately or risk severe long-term consequences.

Manziel's recent dental problem also highlights a very important specialty of dentistry—oral surgery. Oral surgeons are uniquely trained and qualified to treat and correct a number of oral problems.

Tooth extraction. Although some teeth can be removed by a general dentist, some have complications like multiple roots or impaction that make regular extractions problematic. An oral surgeon may be needed to surgically remove these kinds of problem teeth.

Disease. Oral surgeons often intervene with diseases attacking areas involving the jaws or face. This includes serious infections that could become life-threatening if they're not promptly treated by surgical means.

Bite improvement. Some poor bites (malocclusions) arise from a mismatch in the sizes of the jaws.  An oral surgeon may be able to correct this through orthognathic surgery to reposition the jaw to the skull. This may compensate for the difference in jaw sizes and reduce the bite problem.

Implants. Dental implants are one of the best ways to replace teeth, either as a standalone tooth or as support for a fixed dental bridge or a removable denture.  In some cases, it may be better for an oral surgeon to place the implants into a patient's jawbone.

Reconstruction. Injuries or birth defects like a cleft lip or palate can alter the appearance and function of the face, jaws or mouth. An oral surgeon may be able to perform procedures that repair the damage and correct oral or facial deformities.

Sleep apnea. Obstructive sleep apnea is usually caused by the tongue relaxing against the back of the throat during sleep and blocking the airway. But other anatomical structures like tonsils or adenoids can do the same thing. An oral surgeon could address this situation by surgically altering obstructing tissues.

It's likely most of your dental care won't require the services of an oral surgeon. But when you do need surgical treatment, like Johnny Manziel, these dental specialists can make a big difference in your oral health.

If you would like more information about oral surgery, please contact us or schedule a consultation.

AreImplantsaNo-GoforYouConsiderTheseOtherRestorationOptions

Our primary aim as dentists is to preserve teeth. There are times, however, when preserving a tooth is no longer worth the effort and we must recommend removing it. Fortunately, extracted teeth can be replaced with a functional and attractive restoration.

Today's top tooth-replacement option is the dental implant. Composed of a titanium metal post imbedded into the jawbone, a single dental implant can replace an individual tooth or a series of implants can support other restorations for multiple teeth. Besides being incredibly life-like, dental implants are highly durable and can last for decades.

But dental implants aren't an optimal choice for everyone. Their cost often matches their status as the premier tooth replacement method. And because they require a minimum amount of bone for proper implantation, they're not always feasible for patients with extensive bone loss.

But even if dental implants aren't right for you, and you want a fixed restoration rather than dentures, you still have options. What's more, they've been around for decades!

One is a bonded crown, which works particularly well for a tooth excessively damaged by decay, excessive wear or fractures. After removing all of the damaged portions and shaping the remaining tooth, we cement a life-like crown, custom created for that particular tooth, over the remaining structure.

Besides improving appearance, a crown also protects the tooth and restores its function. One thing to remember, though, is although the crown itself is impervious to disease, the remainder of the natural tooth isn't. It's important then to brush and floss around crowned teeth like any other tooth and see a dentist regularly for cleanings.

Dental bridges are a fixed solution for extracted teeth. It's composed of prosthetic teeth to replace those missing bonded together with supporting crowns on both ends. These crowned teeth are known as abutments, and, depending on how many teeth are being replaced, we may need to increase the number of abutments to support the bridge.

Although durable, crowns or bridges typically don't match the longevity of an implant. And, implants don't require the permanent alteration of support teeth as is necessary with a bridge. But when the choice of implants isn't on the table, these traditional restorations can be an effective dental solution.

If you would like more information on crown or bridge 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 “Crowns & Bridgework.”

UnlikeBradPittYouDidntMeanToChipYourToothWeCanStillFixIt

It's not unusual for serious actors to go above and beyond for their roles. They gain weight (or lose it, like Matthew McConaughey for True Detective). They grow hair—or they shave it off. But perhaps nothing tops what Brad Pitt did to assume the character of Tyler Durden in the movie Fight Club—he had his dentist chip his teeth.

While a testament to his dedication to the acting craft, Pitt's move definitely falls into the category of "Kids, don't do this at home." Fortunately, people deliberately chipping their teeth isn't a big problem. On the other hand, accidentally chipping a tooth is.

Chipping a tooth can happen in various ways, like a hard blow to the jaw or biting down on something too hard. Chipping won't necessarily endanger a tooth, but the missing dental structure can put a damper on your smile.

But here's the good news: you don't have to live with a chipped tooth. We have ways to cosmetically repair the damage and upgrade your smile.

One way is to fit a chipped or otherwise flawed tooth with a dental veneer, a thin wafer of dental porcelain bonded to the front of a tooth to mask chips, discolorations, gaps or other defects. They're custom-made by a dental lab to closely match an individual tooth's shape and color.

Gaining a new smile via dental veneers can take a few weeks, as well as two or more dental visits. But if you only have slight to moderate chipping, there's another way that might only take one session in the dentist's chair. Known as composite bonding, it utilizes plastic-based materials known as composite resins that are intermixed with a form of glass.

The initial mixture, color-matched for your tooth, has a putty-like consistency that can be easily applied to the tooth surface. We apply the composite resin to the tooth layer by layer, allowing a bonding agent in the mixture to cure each layer before beginning the next one. After sculpting the composite layers into a life-like appearance, the end result is a "perfect" tooth without visible flaws.

Unlike Brad Pitt, it's pretty unlikely you'll ever find yourself in a situation requiring you to purposely damage your teeth. But chips do happen—and if it happens to you, we have more than one way to make your teeth as good as new.

If you would like more information about repairing dental flaws with veneers or composite bonding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”

By Edwin Yee
October 11, 2021
Category: Dental Procedures
Tags: crowns  
WhatYouNeedToKnowToChoosetheRightDentalCrown

In the realm of dental restorations, not all crowns are alike. And, one type isn't necessarily superior to the others. One type of crown may work better for a particular tooth, while a different crown is better suited to another.

Therefore, knowing your options can help you make a more informed choice with your dentist regarding the best crown for your needs. Here, then, is a quick primer on the main types of dental crowns used today.

Metal crowns. Early in the last century, crowns made of gold, silver or other metals were the go-to dental restoration. Because of their strength and durability, metal crowns are still used today, mainly in back teeth that encounter heavy biting forces. Their drawback: They're decidedly not the color of natural teeth and so can stand out if they're placed in the visible "smile zone."

PFM crowns. The first crowns made with dental porcelain solved the appearance problem, but couldn't adequately handle biting forces as well as metal. Out of this came the porcelain fused to metal (PFM) crown, which contains an inner core of metal overlaid with tooth-colored porcelain. Providing both strength and life-likeness, PFM crowns were immensely popular until the mid-2000s.

All-Ceramic crowns. The development of porcelains more durable than earlier versions eventually dethroned the PFM (although the latter is still used today). Sixty percent of the crowns installed in recent years are all-ceramic, many reinforced with a strength material known as Lucite. Many all-ceramic crowns reaching the 15-year mark are still in place and functioning.

All of these crowns continue to be viable options for dental patients. The biggest factor in choosing one particular crown over another is the type of tooth involved and its location. As mentioned before, metal or PFM crowns are usually better for back teeth where durability is a higher priority than aesthetics. All-ceramics work well in high-visibility front teeth that normally encounter lighter biting forces than back teeth.

Regardless of which kind eventually caps your tooth, any of today's modern crowns will function as intended. But the best crown for you will be the one that both protects your tooth and enhances your smile.

If you would like more information on dental crown 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 “Porcelain Dental Crowns.”