Posts for: February, 2014
Gold is more than a financial commodity or a symbol of wealth — it’s one of the best materials for restoring damaged tooth crowns, the visible portion above the gum line. It’s extremely durable and can last for several decades if properly maintained. It also causes minimal wear to adjacent teeth.
But as new, more life-like materials have come into prominence, gold restorations have diminished in popularity. Dental porcelain in particular, a type of fired ceramic glass that mimics the look and color of teeth, has increased in popularity for use in highly visible areas.
But unlike gold, all porcelain crowns lack strength, tend to be more brittle and can abrade other teeth during biting and chewing. If they break, they can shatter beyond repair. All porcelain crowns are improving dramatically as newer space age materials become available. Historically, though, they are thought of as more unpredictable when used for back teeth; the greater biting forces make them more susceptible to failure than with front teeth.
A Porcelain-Fused-To-Metal (PFM) crown is a hybrid of these two materials that seeks to impart the strengths of both — the aesthetic appeal of porcelain and the durability of gold or platinum. But a PFM crown also has drawbacks: the porcelain surface may still abrade opposing teeth; they can lose their aesthetic appeal if the metal collar becomes visible if gum tissues recede; and they can fail if the porcelain fractures or separates from the metal.
To address some of porcelain’s weaknesses, some PFM variations reduce the amount of porcelain by placing it only on the visible side of a cast gold crown. In addition, other porcelain materials are now coming into use that may be more durable yet just as life-like.
Choosing which material to use for a crown depends on many factors: cost, the location of the crown, and, of course, the patient’s desires for the resulting smile appearance. It all begins with a comprehensive exam: from there, we can advise you on your options and help you make a choice — gold, porcelain or something in between — that’s durable and pleasing to the eye.
If you would like more information on your options regarding dental 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 article “Gold or Porcelain Crowns?”
When your baby’s first teeth erupt in the mouth, it’s a big step in their development. Unfortunately, you may not have much opportunity to celebrate — you’re too busy tending to your infant whose experience is anything but pleasant.
Commonly known as teething, the eruption process usually begins between six and nine months of age, although some children may begin as early as three months or as late as twelve. Not all teeth come in at the same time: it usually begins with the two lower front teeth, then the two upper front teeth, followed by the molars and then the canines (eye teeth). By age three, most children have all twenty of their primary teeth.
Each child’s teething experience is different and may vary in length of time and intensity. The usual signs are heightened irritability, biting and gnawing accompanied by gum swelling, ear rubbing, drooling and sometimes facial rashes. Babies also may have disturbed sleeping patterns and a decreased appetite. Occasionally, this discomfort can be intense.
There are some things you can do to ease this discomfort. Provide your baby a clean, chilled (not frozen) rubber teething ring, chilled pacifier or wet washcloth to gnaw on. Cold foods, like popsicles for older children can also be soothing, though you should limit sugary foods to lower the risk of tooth decay. You can also finger massage swollen gums to counteract the pressure coming from the erupting tooth, or administer pain relievers like baby acetaminophen or ibuprofen. You can use products with Benzocaine®, a numbing agent, for children two years or older — but you should never use alcohol for children of any age for inflamed gums.
Be sure to also set up a Year One dental examination around their first birthday. This is an important first step in your child’s long-term dental care, and a good opportunity to check their teething progress. And, by all means, if you have concerns about your child’s experience with teething, don’t hesitate to call our office.
Teething is a normal part of your child’s development. There’s much you can do to help make it as comfortable and pain-free as possible.
If you would like more information on teething, 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 “Teething Troubles.”
Losing all of your teeth can be both physically and emotionally traumatic. Patients in this condition may need a period of transition from this loss to their permanent restoration. That’s the purpose of “immediate” dentures.
An immediate denture is a tooth appliance available for placement immediately after the final extraction so the patient’s ability to eat and speak isn’t unduly hampered (it also helps preserve their facial appearance). An immediate denture is a temporary measure until a more permanent replacement is achieved; hence, they’re not intended for long-term use.
Over time an immediate denture’s fit will deteriorate. This is because as the gums heal after extraction, and without the natural teeth present, the underlying bone and gum tissues will shrink significantly. The denture fit becomes looser, which leads to movement of the denture within the mouth. This can cause a good deal of discomfort emotionally and physically, and make it more difficult to eat and speak. It’s possible, however, to reline the immediate denture to fit the gum shrinkage and gain more service from it.
At some point, though, it’s necessary to transition from the immediate denture to the permanent restoration. If the permanent solution is a removable denture, we will need to wait until the gums have completely healed. At that time we will make a new and accurate impression of your mouth that reflects any changes since extraction. Even with this high level of accuracy, though, the final fit will depend on the amount of remaining bone and gum tissue needed to support the denture.
There are other options besides a removable denture. We can install a pair of implants in conjunction with a removable denture that can stabilize and retain it in the mouth; implants can also support a fixed bridge. You should weigh all the advantages and disadvantages to these options (including cost), to determine which one is the best solution for you.
In the meantime, the immediate denture will enable you to function in a normal manner, as well as aid with your appearance. Remember, though, it’s only meant for a short period of time — at some point you will need to transition from “immediate” to a more permanent and satisfying replacement.
If you would like more information on dentures, 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 “Immediate Dentures.”
When you think of saliva, the word “amazing” probably doesn’t come to mind. But your life and health would be vastly different without this “wonder” fluid at work in your mouth.
Saliva originates from a number of glands located throughout the mouth. The largest are a pair known as the parotids, located just under the ears on either side of the lower jaw, which produce a thin and watery liquid. The sublingual glands under the tongue produce thicker saliva with a mucous secretion; the saliva from the submandibular glands located under the lower jaw has a consistency somewhere between that of the parotids and the sublingual glands. All these different consistencies of saliva combine to produce a fluid rich in proteins, enzymes, minerals and antibodies.
Saliva performs at least five basic functions in the mouth. First, it washes away food particles after eating and reduces the amount of sugar available for decay-causing bacteria to consume. It protects and disinfects the mouth with antibodies, proteins and enzymes that fight against and help prevent the growth of bacteria. Saliva neutralizes high acidity levels in the mouth, necessary to prevent enamel erosion from acid; and when enamel has softened due to acidity (de-mineralization), the calcium and other minerals in saliva help restore some of the enamel’s lost minerals (re-mineralization). Saliva also aids in digestion by lubricating the mouth and helping the body break down starches in food with its enzymes.
In recent years, scientists have also gained insight into another property of saliva that promises better disease diagnosis in the future. Like blood and urine, saliva contains biological markers for disease. As more diagnostic machines calibrated to these specific markers are developed and used, it could signal a more effective way to identify conditions from saliva samples that are easier to collect than other bodily fluids.
Its less than glamorous image aside, your mouth would be quite a different (and unhealthy) place without saliva. And, developments in diagnostics could make this unsung fluid even more valuable in maintaining your health.
If you would like more information on the importance of saliva to oral 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 “Secrets of Saliva.”