Posts for: November, 2013
Compared to traditional braces, orthodontic clear aligners seem miraculous in many ways, almost too good to be true. You may be wondering if they really work. The answer is yes — but they are not for everyone.
What are orthodontic aligners and how do they work?
Clear orthodontic aligners are an alternative to traditional braces that are used to move your teeth and transform your smile without much interference to your daily life. They are removable trays made of a clear plastic material that is essentially invisible.
When using aligners, a sequence of slightly different trays is custom-made to fit over your teeth. You must wear each one 20 hours a day for two weeks before changing to the next in the series. The aligners are computer generated, designed by state-of-the-art techniques based on models and images of your own teeth. They work because slight changes in the sequential aligners gradually shift your teeth. If they are worn consistently, the process takes from six months to two or three years.
Advantages over traditional braces are:
- The aligners can be removed for eating, drinking, brushing, flossing and social occasions.
- They have no rough edges or wires, making them more comfortable.
- Changes become visible quickly as your teeth move into their new, better positions.
Clear aligners are a good solution for correcting mild to moderately crowded or incorrectly spaced teeth. They are most effective if your back teeth already fit together properly. Clear aligners are usually effective in correcting simpler or tipping movements of teeth in two dimensions. For more complex movements, traditional braces may be required. Clear aligners are usually recommended for adults whose teeth and jaws are fully developed, and not for children.
When do you need traditional fixed braces?
Traditional braces are fixed brackets attached to the teeth through which narrow, flexible wires are threaded. They may be necessary if your teeth do not meet properly, creating too much overbite or underbite. Closing spaces where teeth are missing, rotating teeth, or other complicated situations probably make you a better candidate for traditional braces.
Each particular situation is unique. To find out if clear aligners are right for you, make an appointment with us for an assessment and diagnosis of your own situation. For more information see the Dear Doctor magazine article “Clear Orthodontic Aligners.”
Getting a new crown for a front tooth is a standard procedure performed in thousands of dental offices around the country. But dental patients are sometimes surprised to find that the price of this routine treatment can vary by a substantial amount. What accounts for the difference? The answer tells us a lot about how crowns are made, and the value of aesthetics in dentistry.
Crowns may be made of several different materials. Gold, the most traditional restoration material, makes for a time-tested, functional and durable crown, lasting as long as 50 years. Gold is a precious (and expensive) metal, but considered over the lifetime of the restoration, it's an economical choice. Yet, even for back teeth, it's losing out in popularity to more aesthetically pleasing alternatives.
Porcelain-fused-to-metal (PFM) crowns and all-porcelain crowns replicate the look of natural teeth more accurately. The kind of porcelain used in restorations must have special strengtheners added, which enable it to stand up to wear and tear in the mouth. There are different porcelain materials used in dental restoration, each with a different look, quality and longevity. There are also new, high-tech ceramic materials. Each one has advantages and drawbacks, and each one's cost is different.
Besides the material, another large part of a crown's cost is the custom-fabrication of every piece. Since it must match the other teeth in form and function — and often in looks as well — every crown must be made to an individual's exact requirements. This includes the tooth's exact size and shape, its spacing, and (often) its particular color.
Making this happen is a multi-step process. First, a dentist carefully prepares a model of the affected tooth and its neighbors. Then, the fabrication work is normally performed by a highly skilled laboratory technician, at the dentist's direction. Finally, the dentist prepares the tooth for the restoration, performs final adjustments, and attaches the finished crown. When it's done, the restored tooth can be difficult to tell apart from any other.
The level of craftsmanship involved at the dental laboratory can vary — and along with it, the price. Dentists may even choose different technicians based on the quality level they're striving for. All of these factors affect the final cost of the crown, and its value to the patient.
It has been said that beauty is in the eye of the beholder, and this is certainly true in the case of dental restorations. The choice of a “best” crown is different for every person — more than one alternative may be available, and each comes with its own price. If you have more questions about your options for a crown restoration, don't hesitate to ask us!
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Value of Quality Care,” “Porcelain Crowns & Veneers,” and “Gold or Porcelain Crowns.”
If you were to look closely at many of your teeth, you would notice deep, natural grooves in the enamel surface. Often referred to as “pits and fissures,” these are some of the most difficult places in the mouth to keep clean. Toothbrush bristles simply can't reach deep enough into them to be effective; what's more, their warm, moist environment is the perfect breeding ground for bacterial growth. Consequently, pits and fissures are the most common location for tooth decay.
Children are especially susceptible — pits and fissures account for 43% of tooth decay in patients between the ages of six and seven. This is because when children's teeth erupt (first become visible in the mouth) the new enamel is more permeable and less resistant to decay than older teeth. Until the enamel matures, the risk for decay remains high.
Fortunately, in recent years there has been a decrease in the occurrence of tooth decay among children. Better hygiene practices, fluoride products and fluoridated drinking water, better nutrition, and regular dental visits are all factors in this improvement. One development in particular provides children an extra layer of protection — the use of sealants on the tooth surfaces.
Sealants are protective coatings applied to tooth surfaces, especially in pits and fissures that act as a barrier between bacteria and the immature enamel. Although the degree and extent of sealant use varies across the profession, many dentists recommend sealant application in children for all permanent molars and many primary molars soon after eruption.
The accessibility of regular dental care also plays a factor — those who have no or limited access (and thus are at high risk for tooth decay) may benefit from sealants on all of their back teeth, while children with regular care access (low risk) may need only a few. In fact, some dentists only recommend sealants in low-risk children when tooth decay is already present and after first removing as much decay as possible.
The goal, of course, is to prevent decay, or reduce its effects, in children. Sealants can help, but only when coupled with other measures — and a good habit of oral hygiene.
If you would like more information on sealants for children's 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 “Sealants for Children.”
Do you have silver dental fillings that you wish you didn't have? Wouldn't it be nice if no one could look in your mouth and see how many cavities you had as a kid? Tooth-colored fillings may offer a solution to the problem of too much metal in your mouth. How much do you really know about non-metallic tooth-colored fillings? Take our quiz and find out.
True or false: Tooth-colored fillings are a radical new technology.
False. A variety of dental porcelains and composite resins have been successfully used in tooth restoration for many years. These materials have been designed to mimic the properties of the two major components of teeth: the hard outer enamel, and the bone-like inner dentin. Our increasing understanding of tooth structure and composition has led to better and more natural-looking filling substances.
True or false: Teeth must remain rigid under the pressure of the bite.
False. At one time, metal amalgam (silver) fillings were preferred because of their extreme hardness. But we now know that the crowns of our teeth actually flex under the forces of the bite. This discovery has spurred the development of new methods and materials to stabilize the restored tooth and reduce the incidence of premature failure.
True or false: It's usually more complicated to put in a tooth-colored filling than a metal one.
False. Regardless of which material is used, the basic process of filling a tooth is the same. The dentist prepares the tooth for treatment, removes decay, and places a filling directly into the tooth. If the filling is moderately deep, a tooth-colored filling may be set in several layers which are successively “cured” or hardened. More extensive restorations may require more than one visit, but the natural-looking results generally justify the extra time.
True or false: Regular metal fillings make the tooth structure stronger.
False. Properly securing an amalgam filling may require the tooth to be “undercut,” meaning that a greater amount of healthy tooth material must be removed. This can weaken the tooth structure, eventually leading it to chip and crack. Non-metallic fillings don't require undercutting, so more tooth structure is left intact. This more conservative treatment can result in a stronger, longer-lasting restoration.
True or false: Non-metallic (tooth-colored) fillings are safer than silver fillings.
False. While each method has advantages and disadvantages, and may not be an appropriate treatment in every situation, both methods have been deemed safe and effective by major U.S. and international science and health organizations. While there have been recent concerns about mercury in amalgam fillings, there is presently no reason to believe that it presents any cause for concern.
If you would like more information about tooth-colored fillings, 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 “The Natural Beauty of Tooth-Colored Fillings.”