By Steven D. Dunning DDS
April 11, 2018
Category: Dental Procedures
KeeponCourseduringthe3PhasesofaSmileMakeover

Are you ready for a new smile? You’ve endured the embarrassment and drain on your of self-confidence long enough. The good news is that modern cosmetic dentistry has an awesome array of materials and methods ready and able to help you make that transformation.

But before you proceed with your “smile makeover” it’s good to remember one thing: it’s a process. And depending on how in-depth your makeover might be, it could be a long one.

To help you navigate, here’s an overview of the three main phases of your smile makeover journey. Each one will be crucial to a successful outcome.

The “Dream” Phase. The path to your new smile actually begins with you and a couple questions: what don’t you like now about your smile? And if you could change anything, what would it be? Right from the start you’ll need to get in touch with your individual hopes and expectations for a better look. With your dentist’s help, take the time during this first phase to “dream” about what’s possible—it’s the first step toward achieving it.

The Planning Phase. With that said, though, your dreams must eventually meet the “facts on the ground” to become a reality. In this phase your dentist works with you to develop a focused, reasonable and doable plan. To do this, they’ll need to be frankly honest with you about your mouth’s health state, which might dictate what procedures are actually practical or possible. You’ll also have to weigh potential treatment costs against your financial ability. These and other factors may require you to modify your expectations to finalize your treatment plan.

The Procedure Phase. Once you’ve “planned the work,” it’s time to “work the plan.” It could be a single procedure like whitening, bonding or obtaining a veneer. But it might also involve multiple procedures and other specialties like orthodontics. Whatever your plan calls for, you’ll need to be prepared for possibly many months or even years of treatment.

Undergoing a smile makeover can take time and money, and often requires a lot of determination and patience. But if you’ve dreamed big and planned well, the outcome can be well worth it.

If you would like more information on ways to transform your smile, 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 “Beautiful Smiles by Design.”

By Steven D. Dunning DDS
April 03, 2018
Category: Oral Health
ProtectYourSmile-NationalFacialProtectionMonth

Dental injuries result in thousands of visits to the emergency room every year, and many of these injuries occur while engaging in sports and recreational activities. Whether playing on an organized team or joining a spontaneous game with friends, athletes are much more likely to suffer a dental injury when not wearing a mouthguard. Five national dental organizations have joined together for National Facial Protection Month to urge athletes to use a mouthguard during both practice and games.

The American Dental Association and the Academy for Sports Dentistry recommend using mouthguards for over 30 sporting activities. While it comes as no surprise that mouthguards are recommended for football, hockey and basketball, the list also includes many activities that may not immediately come to mind—among them, surfing, ultimate frisbee, skateboarding, volleyball, skiing and bicycle riding.

In short, it’s wise to protect your smile while participating in any activity where your teeth may make contact with a hard surface. A properly fitted mouthguard can prevent injuries to the teeth, mouth and jaw, and may even help protect against head and neck injuries. Even those who participate in casual recreational activities should consider a mouthguard as an insurance policy against future pain and expense.

There are three types of mouthguards: a stock mouthguard that is bought ready to use from your neighborhood store, the “boil-and-bite” type that is formed to the mouth after being softened in hot water, and a custom-made mouthguard that is available from the dental office. Although any mouthguard is better than no protection at all, the best protection and most comfortable fit comes from a mouthguard that is custom-made by your dentist.

If you have questions about preventing dental injuries, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards”¬†and “The Field-Side Guide to Dental Injuries.”

PeriodontalSurgerymaybeNeededtoHaltGumDiseaseandEncourageHealing

There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.

As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.

Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.

There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.

Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.

If you would like more information on surgical procedures for gum disease, 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 “Periodontal Surgery: Where Art Meets Science.”

PromptTreatmentforGumDiseaseCouldUltimatelySaveYourTeeth

Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.

Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.

Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.

As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.

But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.

While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.

And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.

If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Periodontal Plastic Surgery.”

ProvisionalRestorationsletyouTryoutYourNewSmileFirst

Transforming your smile with veneers, crowns or other restorations could be a life-changing decision. To help make that change a successful one, it’s possible to fit you with a kind of temporary restoration that allows you to “try out” your new look and even make modifications before you receive the permanent one.

Referred to as a prototype or provisional restoration, it’s different from other temporary, “one-size-fits-all” restorations that serve mainly a functional purpose until the permanent restoration is ready. By contrast, a provisional restoration is a customized “blueprint” of the final restoration so you can better communicate with your dentist to get what you want.

Provisional restorations are test runs — they help both patient and dentist evaluate three key areas critical to ultimate success:

Your ¬†Smile — with provisional restorations you can get input from others (and from what you see in the mirror) regarding tooth coloring and how it blends with other teeth, the attractiveness of the crown shapes, and whether the teeth appear proportional and balanced with the gums.

Your Facial Appearance — changing the look of teeth may also alter overall facial appearance. Do the new teeth fit well with the lips and other facial features? Do they change the smile line, and does it appear harmonious with the rest of the face?

Your Mouth Function — There’s more to teeth, of course, than how they look. Teeth are essential for biting, chewing and speaking. So, can you perform these tasks comfortably with the provisional restoration?

While you’re wearing the provisional restoration, we’ll discuss these and other areas, what might look or work better, or if you feel we’ve hit the mark just right. We can then modify or verify our specifications with the dental lab creating the final restoration.

Of course, a provisional restoration will allow you to function normally like other temporary options. But their custom detail serves a higher purpose — to help us improve your future smile.

If you would like more information on customized temporary restorations, 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 “Concepts in Temporary Restorations.”





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