Posts for category: Dental Procedures
Those unattractive teeth you see in the mirror are what are standing between you and a truly beautiful smile. If only you could make them go away.
In a way, you can do just that—with dental veneers. For the past three decades dentists have been covering the imperfections of problem teeth with these thin layers of porcelain. What's more, they're usually less involved and expensive than other restorations.
Veneers work best on teeth with moderate flaws like chipping, heavy staining or wearing, or slight misalignments like crookedness or gaps. The dental porcelain used is a ceramic material that so closely mimics the color and translucence of natural teeth it often takes a trained eye to notice any difference.
The first step to getting veneers is to plan your new look with a full examination and a diagnostic mock-up, a temporary application of tooth-colored filling materials applied directly to the teeth. This gives you and your dentist a better visual idea of how veneers will look on your teeth, and to make any adjustments ahead of time. A dental lab will use these findings to create your custom veneers.
In the meantime we'll prepare your teeth to accommodate your veneers. Although they're usually only 0.3 to 0.7 millimeters thick, veneers can still appear bulky when placed straight on the teeth. To adjust for their width we usually must remove some of the teeth's surface enamel so the veneers look more natural. Because enamel can't be replaced, the removal permanently alters the teeth and will require some form of restoration from then on.
When the veneers are ready we'll attach them with special cement so they'll form an almost seamless bond with the teeth. You'll then be able to use them just as before—but with a little caution. Although quite durable, veneers can break under too much force, so avoid biting on hard objects like ice, hard candy or nuts. And be sure you practice good dental care on your veneered teeth with daily brushing and regular dental cleanings and checkups.
The end result, though, is well worth the upkeep. Porcelain veneers can rejuvenate your smile and provide you a new level of confidence for years to come.
If you would like more information on porcelain veneers, 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 Veneers: Your Smile—Better than Ever.”
Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.
“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”
That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.
Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!
The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.
If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”
For chipped, stained, or slightly crooked teeth, dental veneers might be the ideal solution. These thin layers of porcelain bonded directly over the teeth with the perfect blend of color, sizes and shapes, can transform a person’s smile for a relatively modest cost.
But if the teeth belong to a teenager, veneers might not be appropriate. This is because in most cases, we’ll need to remove some of the tooth enamel so that the applied veneers won’t look unnaturally bulky. This alteration is permanent, so the teeth will require some form of restoration from then on.
While not usually a major issue with fully matured adult teeth, it could be with the developing teeth of pre-teens and teens. During childhood and adolescence the tooth’s inner pulp plays an important role in dentin production, and so the pulp chamber is relatively large compared to an adult tooth. This larger size places the pulp closer to the enamel surface than with an adult tooth.
Because of its proximity to the enamel, there’s a greater chance veneer alterations could damage a teenager’s tooth pulp and its nerve bundles. If that happens, we may need to perform a root canal treatment to save the tooth—also not an optimal situation for a developing tooth.
That’s why we need to take into consideration a patient’s age and stage of dental development first, including x-raying the affected teeth to measure the depth of the tooth pulp. If we deem it too risky at the moment, there are other ways to improve dental appearance at least temporarily. This includes whitening externally stained teeth with a bleaching agent, or applying tooth-colored composite resin material to chipped areas. We can also apply a composite material veneer that, although not as durable as traditional porcelain, doesn’t require much if any tooth alteration.
To know your options, have your teenager undergo a thorough dental examination. Your dentist will then be able to discuss with you whether veneers can be safely attempted. And be sure the dentist who may perform the work has experience performing cosmetic procedures on teenagers.
If you would like more information on restoration choices 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.”
As permanent teeth gradually replace primary (“baby”) teeth, most will come in by early adolescence. But the back third molars—the wisdom teeth—are often the last to the party, usually erupting between ages 18 and 24, and the source of possible problems.
This is because the wisdom teeth often erupt on an already crowded jaw populated by other teeth. As a result, they can be impacted, meaning they may erupt partially or not at all and remain largely below the gum surface.
An impacted tooth can impinge on its neighboring teeth and damage their roots or disrupt their protective gum attachment, all of which makes them more susceptible to tooth decay or periodontal (gum) disease. Impacted teeth can also foster the formation of infected cysts that create areas of bone loss or painful infections in the gums of other teeth.
Even when symptoms like these aren’t present, many dentists recommend removing the wisdom teeth as a preemptive measure against future problems or disease. This often requires a surgical extraction: in fact, wisdom teeth removal is the most common oral surgical procedure.
But now there’s a growing consensus among dentists that removing or not removing wisdom teeth should depend on an individual’s unique circumstances. Patients who are having adverse oral health effects from impacted wisdom teeth should consider removing them, especially if they’ve already encountered dental disease. But the extraction decision isn’t as easy for patients with no current signs of either impaction or disease. That doesn’t mean their situation won’t change in the future.
One way to manage all these potentialities is a strategy called active surveillance. With this approach, patient and dentist keep a close eye on wisdom teeth development and possible signs of impaction or disease. Most dentists recommend carefully examining the wisdom teeth (including diagnostic x-rays and other imaging) every 24 months.
Following this strategy doesn’t mean the patient won’t eventually have their wisdom teeth removed, but not until there are clearer signs of trouble. But whatever the outcome might be, dealing properly with wisdom teeth is a high priority for preventing future oral health problems.
If you would like more information on wisdom teeth and their potential impact on dental health, 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 “Wisdom Teeth: Coming of Age May Come with a Dilemma.”
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”