Posts for category: Dental Procedures
As December brings the old year to a close, it’s a great time to set goals for the year to come. This might include a major life change, such as a new job—or even a new romance! If one of these items is on your list for 2019, a smile makeover may be just the thing to help you get there.
Having a great smile can give your self-confidence a real boost. It can also affect how you are perceived by others. According to a survey by the American Academy of Cosmetic Dentistry, 99.7% of adults believe a smile is an important social asset and 96% believe an attractive smile makes a person more appealing to members of the opposite sex. At the same time, three quarters of adults feel that an unattractive smile can hurt a person’s chances for career success.
If you aren’t pleased with your smile and want a new look, we can help you figure out which cosmetic dental treatments could be right for you. The answer might be something simple—like an overall brightening of the smile with professional teeth whitening, or fixing a small crack or chip in a single tooth with cosmetic tooth bonding. If you’re unhappy with worn-down or crooked teeth, dental veneers or orthodontic treatment might be the way to go. In fact, many adults find that orthodontic treatment with clear aligners is a great way to get a beautiful, straight smile without drawing attention to the fact that a makeover is in progress.
Of course, it’s not only important for your smile to look good but also for your whole mouth to stay healthy. So if you are experiencing any tooth pain, unusual mouth sores or gum problems, it’s time for you to come in for an exam. And if it’s been a while since you’ve had a dental checkup and professional teeth cleaning, why not make an appointment for early in the year? Don’t start the new year with last year’s dental problems!
If you would like more information about cosmetic dental treatments or preventive dentistry, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “How Your Dentist Can Help You Look Younger” and “Dental Hygiene Visit.”
Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.
One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.
It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.
We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).
Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.
Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.
The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.
At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.
Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.
Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.
At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.
If you would like more information on the effects and treatment of impacted 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 “Exposing Impacted Canines.”
Stained teeth can be embarrassing — so much so you may even hesitate to smile. Before you seek out a whitening solution, though, there are a few things you need to know about tooth staining.
Tooth staining is more complex than you might think. There are actually two types: extrinsic, staining from foods and other substances of the outer surface of the enamel; and intrinsic, discoloration deep within a tooth that affects their outward appearance. The latter staining has a number of causes, including the type of dental materials used to fill a tooth, a history of trauma or the use of the antibiotic tetracycline during early tooth development.
There are some noticeable differences between the two types, although an examination is usually necessary to determine which you have. Extrinsic staining tends to be brown, black, or gray, or occasionally green, orange or yellow. Intrinsic staining can be red, pink or, if caused by tetracycline and fluoresced under ultraviolet light, yellow. If only one tooth is discolored it’s most likely intrinsic due to decay in the tooth pulp.
What can be done also depends on which type. Extrinsic staining can be modified through whitening, with either an office application or a home kit (there are differences, so you should consult with us before you decide). It may also be essential to modify your diet by restricting foods and beverages (coffee, wine or tea) known to cause staining and by eliminating tobacco use. You should also practice daily hygiene, including brushing with a toothpaste designed to diminish staining, and regular office cleaning and polishing.
Intrinsic staining can’t be addressed by these methods. Instead, you may need to undergo a procedure where we enter the interior of the tooth and insert a bleaching agent. If this isn’t an option, you can also choose a cosmetic restoration such as a porcelain veneer or crown that will cover the tooth to better match the color of your other teeth.
Dealing with stained teeth begins with a visit to our office to determine what type of discoloration you have and to learn your options. But regardless of what type you have, there is a way to a brighter smile.
If you would like more information on the causes and treatments of tooth staining, 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 “Tooth Staining.”
Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.
To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.
Â While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.
The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter.Â It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.
Â Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.
Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.
If you would like more information on your treatment options 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”