Posts for: August, 2014
A crown is an effective way to save a tooth and restore its form and function. These life-like “caps” that fit over and are permanently attached to teeth have been used for decades with good results.
For this type of restoration to be effective, though, there must be enough of the natural tooth remaining above the gum line for the crown to “grab on to.” This poses a problem if the tooth has broken or decayed too close to the gum tissue.
Fortunately, there is a way to expose more of the remaining tooth for applying a crown. Known as crown lengthening, this surgical procedure is also used for “gummy” smiles, where normal tooth length is obscured by excess gum tissue that makes the teeth appear shorter.
We begin the procedure by first numbing the tooth and gum area with a local anesthetic. We then make tiny incisions inside the gum line on both the tongue and cheek side of the tooth to create a small flap. With this area below the gum line now open to view, we then determine whether we need to remove excess gum tissue or a small amount of bone around the tooth to expose more of the tooth itself. We then position the opened gum tissue against the bone and tooth at the appropriate height to create an aesthetic result.
You shouldn’t experience any discomfort during the procedure, which usually takes about sixty minutes for a single tooth area (which needs to involve at least three teeth for proper blending of the tissues). The pressures and vibrations from equipment, as well as any post-procedure discomfort, are similar to what you would encounter with a tooth filling. After the gum tissue has healed (about six to eight weeks), we are then able to fit and attach a crown onto the extended area.
Crown lengthening a small area may result in an uneven appearance if you’re dealing within the aesthetic zone. One option in this case is to consider undergoing orthodontic treatment first to correct the potential discrepancy that may result from surgery. After orthodontics, we can perform crown lengthening on just the affected tooth and still achieve an even smile.
Crown lengthening is just one of many tools we have to achieve tooth restorations for difficult situations. Using this technique, we can increase your chances of achieving both renewed tooth function and a more beautiful smile.
If you would like more information on crown lengthening, 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 “Saving Broken Teeth.”
No matter how damaged or decayed your teeth may have become, there’s a restorative solution for it. From porcelain veneers that cover unattractive teeth to dental implants that permanently replace missing teeth, we have the means to give you back a beautiful, life-like smile.
But what if the problems with your teeth are relatively mild — a chipped tooth or a cavity in a highly visible place? Porcelain veneers and bridgework involve extensive tooth preparation that permanently alters the tooth. Is there a less intrusive option that still results in a life-like restoration?
The answer is yes. Composite resins are tooth-colored materials that are bonded directly to tooth surfaces. Made of a plastic-based material matrix with inorganic glass-like filler, composite resins require very little tooth preparation and are often applied in a single visit.
They’re an excellent way to address imperfections or defects with an otherwise healthy tooth, while still preserving the majority of its remaining structure. In the hands of a skilled dentist, composite resins can be used to fill, repair and reshape teeth. They’re also an ideal choice for younger patients whose dental arches are still in development — restorations that require extensive tooth preparation might compromise the tooth’s long-term health. A composite resin treatment could serve as a transitional bridge until a more extensive restoration can be performed after the patient’s mouth structure has fully matured.
Composite resins do have some disadvantages. Because the resin material isn’t as strong as the tooth structure it replaces (although there have been great improvements in the last few years in resin strength), it may not stand up to biting pressures over time if there isn’t enough remaining tooth structure available to support it. They material can also dull and stain with use.
Still, for moderate imperfections or as an interim solution until another restoration can be undertaken, composite resins are a good choice.
If you would like more information on restorations with composite resin, 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.”
Keeping up your dental hygiene with daily brushing and flossing is essential to preventing disease and maintaining good oral health. But that doesn’t mean it’s all on your shoulders — the fact is, you have a strong partner in your dental hygienist. This valuable member of our staff provides a number of different functions that add a boost to your hygiene habits.
Perhaps the most important of those functions is semi-annual teeth cleanings. While daily brushing and flossing removes most of the bacterial plaque that causes dental disease and decay, harder deposits (tartar) will still form over time, especially in places your brush or floss can’t reach. To remove it requires advanced skills and specially designed hand instruments or ultrasonic equipment. In the case of advancing gum disease, your hygienist may also assist with a procedure known as root planing to reach plaque and tartar adhering to tooth root surfaces below the gum line.
Dental hygienists are also on the lookout for abnormalities that may be a sign of disease. During teeth-cleaning sessions, your hygienist looks for gum inflammation or bleeding that may indicate the presence of periodontal gum disease, a progressive condition that, left untreated, could lead to tooth loss. We will be able to assess the extent of the disease by gently probing and measuring any detachment of the gum tissue that has formed voids known as pockets. They also look for signs of oral cancer — bumps, sores or areas of swelling or tenderness.
There’s one other function your hygienist provides to enhance your oral health — educating and training you on dental care. They can provide you helpful information on risk factors for tooth decay or other dental diseases, along with helpful ways to reduce that risk. They can also help you improve your brushing and flossing techniques by demonstrating proper form.
Cleaning, monitoring and educating — these different “hats” your hygienist wears form a beneficial part of your overall dental care. Working together, you’ll be able to keep your teeth and gums in good form and function.
If you would like more information on the benefits of a dental hygienist, 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 Hygiene Visit.”
When you’re trying to maintain a good oral hygiene routine, your toothbrush is bound to see a lot of action. Day in and day out, it gets used about twice a day, every day — morning and night, whether you’re feeling great or under the weather, in a hurry or not. And it's stored in the bathroom: a moist environment with the potential for exposure to plenty of bacteria (and not just the ones that live in your mouth). So after all of that service, does your toothbrush itself need any particular care or cleaning — and do you need to worry about getting sick from brushing?
Let’s answer the last question first. It’s very unlikely that you can re-infect yourself with an illness (a cold, for example) from using your own toothbrush. That’s because once you’ve been infected, the antibodies that are built up in response to the invading germs will generally prevent you from getting the same disease for some time afterward. Using someone else’s toothbrush, however, is a never a good idea — especially if they are sick (whether they show any symptoms or not), and doubly so if the bristles are still wet. It’s very possible to transfer all kinds of bacteria — even the bacteria that cause tooth decay — from person to person this way.
Can bacteria really survive for any length of time on your toothbrush? The short answer is yes, as they can (and do) live almost everywhere. But for people in a normal state of health, there’s no real reason to worry: Through long exposure, your body is generally quite capable of defending itself from these microorganisms. The American Dental Association states, “[T]here is insufficient clinical evidence to support that bacterial growth on toothbrushes will lead to specific adverse oral or systemic health effects.”
However, if you or a family member have a compromised immune system (due to radiation treatment, chemotherapy or disease, for example), it might make sense to take some precautions. Using an antibacterial mouthrinse before you brush can reduce the amount of bacteria in your mouth — and on your toothbrush. Washing the brush afterward with an antimicrobial cleaner or sanitizer can also decrease the level of bacteria that remains on the toothbrush.
For everyone else, it’s best to follow a few common-sense steps for toothbrush care: Rinse your brush with tap water after you use it, to remove any remaining toothpaste and debris; store it upright, where it can air-dry before it’s used again (not in a closed container, where bacteria can thrive); and get a new brush every three months. Your toothbrush is a major weapon in the fight against tooth decay — keeping it in good shape will help you maintain a healthy mouth and a healthy body.
If you have questions about toothbrushing or oral hygiene care, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine article “Oral Hygiene Behavior.”
The main strategy in fighting dental disease is to try to prevent it in the first place. The success of this strategy depends largely on effective oral hygiene with three essential elements: daily brushing, daily flossing, and semi-annual checkups with professional cleaning.
Many people have little trouble incorporating brushing into their daily routine; flossing, though, is a different matter for some. They may feel it’s too time-consuming or too hard to perform. Patients with orthodontic appliances especially may encounter difficulty navigating the floss around the appliance hardware.
Flossing, though, is extremely important for removing bacterial plaque, the primary aim of oral hygiene. This thin film of food remnant that builds up and sticks to the teeth is the breeding ground for bacteria that cause both tooth decay and periodontal (gum) disease. It’s important that as much plaque as possible is removed from the teeth and gum surfaces every day. While brushing removes plaque from the open surfaces of the teeth, flossing removes plaque clinging between teeth and around the gums that can’t be accessed with a toothbrush.
If traditional flossing is too difficult, there’s a viable alternative using an oral irrigator. Also known as a water flosser, an oral irrigator directs a stream of pressurized, pulsating water inside the mouth to blast away plaque in these hard to reach places. The hand applicator comes with a variety of tips that can be used for a number of dental situations, such as cleaning around braces or implants. In home use since the early 1960s, the latest versions of oral irrigators have proven to be very effective, especially for orthodontic patients — research shows an oral irrigator used in conjunction with brushing can remove up to five times more plaque than just brushing alone.
That being said, traditional flossing is also effective at plaque removal when performed properly. Sometimes, resistance to flossing can be remedied with a little training during dental checkups. We can work with you on techniques to improve your flossing activity, as well as train you to use an oral irrigator.
Whichever method you choose, it’s important for you to incorporate flossing (or irrigation) into your daily routine. Removing plaque, especially in those hard to reach places, is essential for reducing your risk of developing destructive dental disease.
If you would like more information on flossing or oral irrigation, 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 “Cleaning Between Your Teeth.”