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Posts for category: Dental Procedures

By David Mayer, DDS
July 13, 2019
Category: Dental Procedures
BobbyBonesDancesHisWaytoDentalDamage

The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.

Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”

Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?

It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.

If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.

For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.

It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.

If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”

NotSoFastReplacingThatTooth-ConsiderSavingitFirst

Dental implants have soared in popularity thanks to their life-likeness, functionality and durability. But these prized qualities have also created an ironic downside—people are much more likely to replace a tooth with an implant rather than go through the time and effort to preserve it.

We say downside because even though an implant is as close to a real tooth as we can now achieve in dentistry, it still can't rival the real thing. It's usually in your long-term health interest to save a tooth if reasonably possible. And, there are effective ways to do so.

Most dental problems arise from two common oral diseases. One is tooth decay, caused by contact with acid produced by bacteria living in dental plaque. We can often minimize the damage by treating the early cavities decay can create. But if we don't treat it in time, the decay can advance into the tooth's pulp chamber, putting the tooth in danger of loss.

We can intervene, though, using root canal therapy, in which we drill into the tooth to access its interior. We clean out the decayed tooth structure, remove the diseased pulp tissue and fill the empty chamber and root canals to seal the tooth and later crown it to further protect it from re-infection.

Periodontal (gum) disease also begins with bacteria, but in this case the infection is in the gum tissues. Over time the ensuing inflammation locks into battle with the plaque-fueled infection. This stalemate ultimately weakens gum attachment, the roots and supporting bone that can also increases risk for tooth loss.

We can stop a gum infection through a variety of techniques, all following a similar principle—completely removing any accumulated plaque and tartar from the teeth and gums. This stops the infection and starts the process of gum and bone healing.

You should be under no illusions that either of these approaches will be easy. Advanced tooth decay can be complex and often require the skills of an endodontist (a specialist in root canals). Likewise, gum disease may require surgical intervention. But even with these difficulties, it's usually worth it to your dental health to consider saving your tooth first before you replace it with an implant.

If you would like more information on how best to treat a problem tooth, 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 “Save a Tooth or Get an Implant?

By David Mayer, DDS
June 13, 2019
Category: Dental Procedures
Tags: teeth whitening  
3TipsforSuccessfulSafeHomeTeethWhitening

Teeth whitening or bleaching is one of the most affordable and least invasive ways of improving your smile. Although the effect fades with time, whitening can make dull and dingy teeth more attractive in short order.

Teeth whitening is also unique among cosmetic dental procedures in that you can do it yourself at home. While professional bleaching solutions are stronger and capable of greater brightness and longevity, you can still achieve good results with a DIY kit.

If you decide to whiten at home, though, there are a few things to keep mind for a desirable and safe outcome. Here are 3 tips for successful DIY teeth whitening.

Follow the directions. It's not a good idea, both for a successful and safe outcome, to stray away from a kit manufacturer's recommended directions. FDA-approved home kits usually contain 10% or less of carbamide peroxide (one of the more common bleaching agents). That may not seem very strong but it's adequate within the recommended time it remains on your teeth to achieve an effective whitening effect. Exceeding those directions could permanently damage your tooth enamel.

Make sure a home kit will work on your staining. Home whitening kits only affect outer staining on tooth enamel. But dental discoloration can also arise from inside a tooth, often because of trauma, tetracycline use, or as a side effect of a root canal treatment. This kind of internal staining requires a special procedure usually performed by an endodontist to reduce it. So, see your dentist first to make sure your teeth are healthy enough for whitening and that a home kit will work for you.

Get your dentist's advice on home kits. There are a number of whitening applications on the market you can choose, so ask your dentist for recommendations. They can also give you some helpful tips on the whitening process to ensure you'll be safe and successful in your efforts.

Here's a couple of other things to remember to enhance your teeth whitening experience: whether you whiten your teeth at home or with the dentist, be sure you continue to care for your teeth with daily brushing and flossing. And, if you limit your consumption of foods and beverages known to stain teeth, you'll help extend the duration of your brighter smile.

If you would like more information on teeth whitening procedures, 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 Whitening Safety Tips.”

By David Mayer, DDS
May 14, 2019
Category: Dental Procedures
Tags: loose tooth  
SeeYourDentistASAPtoSaveYourLooseTooth

A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.

Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.

While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.

Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.

There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).

If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.

Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.

If you would like more information on treating loose 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 “Treatment for Loose Teeth.”

ConsideranEffectiveandAffordableRPDforTeethReplacement

If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.

RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.

The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.

Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.

RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.

A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.

If you would like more information on teeth replacement options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”