Posts for: October, 2013
Your otherwise beautiful smile has one noticeable flaw — one or more of your teeth are deeply discolored or stained. More than likely this staining is deep within the teeth, what we refer to as intrinsic staining. There are a number of reasons this can occur — from fillings or use of antibiotics, for example — and our first approach should be to attempt a whitening technique.
However, if that doesn't produce the desired result, porcelain laminate veneers are another option you might consider. Veneers are made of dental porcelain, a bio-compatible material that can be shaped and colored to closely match neighboring teeth. After a minimal amount of tooth reduction (removal of some of the enamel from the tooth surface) to prepare for the laminate, the veneers are then permanently bonded to the tooth surface and cover the discolored natural tooth. Besides changing the appearance of discolored or stained teeth, veneers can also be used to correct other imperfections such as chipped or misshapen teeth.
Patients, however, have a common question: how long will the veneers last? With proper care, veneers can last anywhere from seven years to more than twenty years. It's possible, though, to damage them — for example, you can break them if you bite down on something that goes beyond the porcelain's tolerance range, such as cracking nut shells with your teeth (not a good idea even for natural teeth!). You should also keep in mind that veneers are composed of inert, non-living material and are attached and surrounded by living gum tissue that can change over time. This process may eventually alter your appearance to the point that the veneer may need to be removed and reapplied to improve the look of your smile.
If a veneer is damaged, all is not necessarily lost. It may be possible to re-bond a loosened veneer or repair a chipped area. The worst case is replacement of the veneer altogether. Chances are, though, this will only happen after the veneer has already served you — and your smile — for many years.
If you would like more information on porcelain laminate 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.”
Did you know that the American Academy of Pediatric Dentistry recommends that all children have their first dental visit by the age of one? You might be surprised by this recommendation, since most children do not have many teeth at this age. However, it is important to start your child early on the path of good oral health!
Here are a few things you can expect from this first dental visit:
- Developing a Rapport. Much of this visit will be dedicated to helping your child to feel at ease in our office. We'll spend time talking to your child, so that he or she is comfortable sitting in the dental chair and being examined.
- Looking for Signs of Decay. During the comprehensive examination, we'll be looking for any signs of tooth decay and conducting a risk assessment for potential future cavities. Keep in mind that baby teeth serve as guides for your child's permanent teeth, so it is vital that you take proper care of them. You may not know it, but your child's permanent teeth are already forming beneath the gums, and if teeth are lost early, there is a higher risk for orthodontic problems later in life.
- Reviewing Oral Hygiene Techniques. We would like this visit to be instructional and informative for you. Feel free to ask any questions that you have about caring for your child's teeth. In addition, we'll take some time during this visit to review with you the correct way to brush your child's teeth.
- Talking about Oral Health Habits. We'll also spend a portion of this appointment doing a bit of fact gathering to ensure that you're not inadvertently doing anything that promotes decay, such as leaving a baby bottle with a sugary substance in your child's crib at night.
If you would like more information about the age one dental visit, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “The Age One Dental Visit.”
Although traditional porcelain laminate veneers are much less invasive than other cosmetic dental applications, they still often require the removal of some of the surface tooth enamel, a process known as tooth reduction. Now, an alternative veneer treatment known as “no-prep” veneers eliminates this initial step of tooth reduction for some patients.
Although most reductions take very little of the tooth enamel, they do permanently alter the tooth. No-prep veneers are growing in popularity because the tooth is not permanently altered, allowing for two benefits: if desired, the veneer application can be reversed and the tooth returned to its original state; and there's more flexibility for patients to “test-drive” their new look with prototype veneers worn while the permanent veneers are manufactured, with changes made easily during this tryout period.
Dentists have long regarded at least a minimum of tooth reduction as absolutely necessary for the proper adhesion of veneers, and to avoid a bulky or over-contoured smile. And, while advances in no-prep veneers have largely addressed these concerns, it is true this option isn't for every patient considering a veneer application.
For example, patients with large or forward-positioned teeth are not good candidates for no-prep veneers. Patients who choose a veneer treatment over orthodontic treatment for certain conditions will likely need some tooth preparation to achieve an acceptable aesthetic result. For patients generally, no-prep veneers have a limited application range on the bottom jaw due to space limitations.
Simply put, traditional veneers are a more versatile option for most patients. On the other hand, no-prep veneers can be a good choice for patients with genetically small or misshapen teeth, teeth reduced by erosion or grinding, or those with narrow or diminished smiles.
If you're considering this option, our first step is to conduct a complete examination of your teeth and mouth. We'll carefully evaluate every aspect of your mouth structure and overall dental condition. If you fit the criteria, you may be able to avoid tooth reduction and still gain the smile you desire.
If you would like more information on no-prep 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 Without the Drill.”
Loose teeth are an exciting rite of passage in childhood; in adulthood, they're anything but. In fact, a permanent tooth that feels loose is a sign that you need to make an appointment with our office right away. The quicker we act, the better chance we will have of saving the tooth.
What causes loose teeth? In the absence of a traumatic dental injury, the culprit is usually periodontal (gum) disease. This is a bacterial infection of the gum and/or bone tissues that surround and support your teeth. The infection is caused by bacterial plaque that sits on your teeth in the absence of effective oral hygiene. Over time, periodontal disease will cause gum tissue and eventually bone to detach from the teeth. As more of this supporting tissue is lost, the teeth will gradually become loose and (if the disease remains untreated) eventually fall out.
Loose teeth can also be caused by a clenching or grinding habit that generates too much biting force. This force can stretch the periodontal ligaments that join the teeth to the supporting bone, making your teeth looser.
Whether the cause of your tooth looseness is biological (gum disease) or mechanical (too much force), treatments are available here at the dental office. The first step in treating gum disease is a thorough cleaning to remove plaque and harder deposits on the teeth (tartar or calculus); this includes the tooth-root surfaces beneath the gum line. You will also be instructed on effective oral hygiene techniques and products to use at home. This type of therapy will promote healing of the gums that will cause some tightening of the teeth. Additional treatments will probably be necessary to gain the maximum healing response to allow the teeth to be most stable. For example, we may also want to temporarily or permanently splint the loose tooth or teeth to other teeth so that biting forces do not loosen them further.
There are other mechanical approaches we can employ to prevent a loose tooth from receiving too much force. For example, we can reshape the tooth by removing tiny amounts of its surface enamel in order to change the way upper and lower teeth contact each other. We also may suggest a custom-made nightguard to protect your teeth if you have a nighttime grinding habit.
The most important thing to know about loose teeth is that it's crucial to intervene quickly. So if you are experiencing tooth looseness, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Loose Teeth” and “Treatment for Loose Teeth.”
Root canal treatments are an important method for stopping the disease process within an infected tooth and ultimately saving it. However, one of the few side effects could have an aesthetic impact on your smile. Leftover blood pigments or the filling materials themselves can cause a darkening of the tooth — the tooth could eventually stand out in an unsightly way from surrounding teeth.
There is, however, one possible solution: a whitening technique known as internal or non-vital bleaching can lighten a darkened, non-vital tooth. For this procedure, we would insert a bleaching mix (usually sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a short period of time. The chemical reaction of the mix whitens the tooth from within.
Our first step is to make sure by x-rays that the root canal filling in the tooth is still intact and still has a good seal. We then create a small opening in the rear of the tooth just above the root canal filling, irrigate it with water to remove any debris, and then add a special cement at the point where the root canal filling begins to seal it from any leakage of the bleaching solution into the root canal filling.
We then insert the bleaching solution into the empty pulp chamber. This is covered with a cotton pellet, which is then sealed in with a temporary filling. We repeat this application over a number of days until we see a noticeable change in the tooth color (normally after one to four visits). At this point, we would remove any residual solution and apply a permanent filling to seal the tooth.
This procedure can be performed instead of more extensive procedures such as veneers and crowns as a cover for the discolored tooth, or as a way to lighten teeth before applying a veneer or crown to help prevent discoloration from showing through. Either way, non-vital bleaching can help remove unsightly discoloration and restore vibrancy to your smile.
If you would like more information on internal or non-vital bleaching, 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 “Whitening Traumatized Teeth.”