Posts for: February, 2017
Tooth decay can wreak more havoc than just producing cavities. It can work its way into the innermost parts of the tooth — the pulp and tiny passageways called root canals that lead to the tooth's connection with the bone.
If that happens, you'll need more than “drilling and filling.” Without intervention, your tooth could be lost. That intervention is a root canal treatment, a procedure that removes the infection from within the tooth and preserves it from re-infection.
You've probably heard the old belief that root canal treatments are painful. With modern anesthetic techniques to deaden pain, that's not true. In fact, root canal treatments stop the pain caused by infected nerves within the pulp and root canals. More importantly, it saves your tooth.
Root canals can be performed by a general dentist. More extensive decay or complex root canal networks may require the services of an endodontist, a dentist who specializes in root canal anatomy and treatments. Endodontists have advanced techniques and equipment to handle even the most difficult case.
Regardless of who performs it, the basic procedure is the same, as is the goal: to completely remove all diseased tissue within the tooth and seal it with a special filling to prevent re-infection. To access the diseased pulp, we first drill an access hole, usually in the biting surface of a back tooth or the back of a front tooth. We then use specialized instruments to remove the infected tissue and flush out the space with antibacterial solutions.
We then insert a filling called gutta percha into the empty pulp chamber and root canals, seal off the filling with adhesive cement, and close the access hole with filling. These fillings and sealants prevent bacteria from reentering the tooth. For added protection against infection and fracturing, we also recommend placing a full-coverage dental crown. This also enhances the appearance of the tooth, which must be modified during the root canal procedure.
The end result: your once endangered tooth has been preserved for hopefully many years to come. So if we recommend you undergo a root canal treatment, don't wait — the tooth you save may be your own.
Porcelain veneers have become a popular way to transform a smile. They're ideal for stained, chipped or slightly misaligned teeth. But although they don't need as much tooth preparation as crowns or other bridgework, the traditional veneer still requires some permanent tooth alteration.
Now, there's an alternative: no-prep veneers. With this option we can avoid any tooth structure removal or keep it to a minimum. And it may not even require local anesthesia while applying them.
Veneers are as their name implies: a wafer-thin layer of tooth-colored porcelain that's bonded to the outside of a tooth, much like siding on a house. Although the traditional veneer is usually no more than a millimeter in width, they can still add an unnatural bulky look and feel to a tooth. To compensate, we remove portions of the enamel. A tooth permanently altered this way will henceforth require some form of restoration.
No-prep veneers are much thinner; they also don't extend under the gum line like traditional veneers. At the most the new veneers may only require us to perform some minor reshaping of the enamel, but not to the extent of traditional veneers. And because your tooth isn't permanently altered, we could presumably remove the veneer and return the tooth to its natural state and appearance (although removing the bonding might not be that easy).
There are some situations where some tooth alteration may still be necessary, like oversized or forward-jutting teeth. A bad bite (malocclusion) may require orthodontic treatment first — which in some cases could be an alternative treatment to veneers altogether.
To find out if you're a candidate for no-prep veneers, visit us for a complete examination. From there we can discuss your options and whether we can transform your smile with little change to your teeth.
We can easily take for granted the comfort we now experience when we undergo dental work. For much of human history that hasn't been the case.
Local anesthesia has been a major factor in the evolution of pain-free dentistry. The term refers to the numbing of nerve sensation in the tissues involved in a procedure. This type of anesthesia is usually applied in two ways: topical and injectable.
We apply topical anesthetic agents to the top layers of tissue using a cotton swab, adhesive patch or a spray. Topical agents are useful for increasing comfort during cleanings for patients with sensitive teeth or similar superficial procedures. Topical anesthesia is also used in conjunction with injections as a way to prevent feeling the minor prick of the needle. In essence, you shouldn't feel any pain or discomfort from beginning to end of your procedure.
Injectable anesthesia deadens pain at deeper levels of tissue. This makes it possible for us to perform more invasive procedures like tooth extraction or gum surgery without using general anesthesia. The latter form is a more intense undertaking: it renders you unconscious and may require assistance for lung and heart function.
Most important of all, subtracting pain sensation from the procedure helps relieve stress: first for you and ultimately for us. If we know you're comfortable, we can relax and concentrate on the work at hand. The procedure goes much more smoothly and efficiently.
Many people, though, have concerns about how long the numbness will linger after the procedure. This has been viewed in the past as an annoying inconvenience. But in recent years, dentists have become more adept at fine-tuning the agents they use as a way to reduce post-procedure numbness. There's also promising research on chemical agents that can quickly reverse the numbing effect after a procedure.
All in all, though, using local anesthesia broadens the range of dental work we can perform without putting you to sleep. More importantly, you'll be able to relax as we perform procedures that could improve your dental health for years to come.
You want to look your best for that once-in-a-lifetime moment — like your wedding day. It can also take time and effort: many people spend months losing weight or trimming up at the gym. But while you’re getting the rest of your body ready for the big event, don’t forget your smile.
The best approach is to make a plan that addresses your smile’s shortcomings — a “smile makeover,” if you will. And the best place to begin is with us, your family dentist. We’re already familiar with your dental health status, so we can advise you on what’s possible and best for you.
We can also provide many of the services that enhance smile appearance. If your teeth are relatively healthy and attractive, a thorough dental cleaning or a whitening application can revive your smile’s brightness just in time for the big day. And for minor defects like a chipped tooth or discolored old fillings, we can bond the latest tooth-colored materials to those unsightly areas. And any of these procedures can be performed in one visit.
Installing porcelain veneers is an effective way to restore more moderate tooth defects. These thin outer coverings with life-like color, shape and texture can effectively hide mild to moderate chipping, discoloration or slight gaps between teeth. Teeth with more extensive damage can be completely covered with a crown made of similar life-like materials. Either of these solutions could match the shape and color of nearby teeth.
By planning well enough ahead, you may also benefit from more extensive cosmetic changes. Missing teeth always pose a challenge, but there are a number of viable options: fixed bridges using adjacent teeth; various denture solutions, including implant-supported removable overdentures; and the dental implant, the rising star for dental restorations that replaces both the root and crown with a durable, life-like tooth. There are also orthodontic solutions for misaligned teeth (at any age!) and surgical procedures for gums that help restore lost tissue or correct a “gummy” smile showing too much of the gums.
Whatever your needs, there’s a way to make your smile more attractive. It’ll be all the more reason to display it confidently on your special day.
If you would like more information on smile transformations, 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 “Planning Your Wedding Day Smile.”
Discovering a loose tooth can be exciting — if you're six, that is, and anticipating a windfall from the tooth fairy. If you're an adult, a loose tooth is a different story. You're in real danger of it becoming a lost tooth, and there won't be another one coming in to replace it.
Fortunately, that result isn't inevitable, but we have to take quick action if we're going to save your tooth. The first step is to find out why it's loose.
Tooth looseness occurs primarily because the gum and bone structures that hold teeth in place have been damaged in some way. Otherwise healthy teeth and gums can be injured in an accident or with dental habits like teeth grinding or clenching that increase the biting forces against teeth. The latter could require some intervention like a night guard to prevent teeth from grinding to reduce the abnormal biting force.
But disease is often the root cause for tooth looseness. Periodontal (gum) disease, a bacterial infection triggered by bacterial plaque, can inflame and weaken gum tissues, eventually causing bone loss followed by the gum tissue detaching from the teeth. In this weakened condition even normal biting forces could loosen a tooth.
If gum disease is the primary culprit, our treatment starts there. By aggressively removing plaque and calculus (tartar) from the tooth surfaces, including deep below the gum line around the root, the gum tissues become less inflamed and begin to heal. This in turn can strengthen their attachment to a loose tooth. In more advanced cases, we may need to surgically graft lost bone and gum tissue to rebuild the attachment.
We may also need to stabilize a loose tooth while we're performing these other treatments. The most common way is to join or splint a loose tooth to nearby stable teeth. There are varieties of splints: one type involves rigid dental material bonded across the enamel of the loose tooth and its neighbors. In another, we cut a small channel in the involved teeth, and then insert a metal splint, bonding it within the channel.
Whatever needs to be done, we need to do it promptly — if you notice a loose tooth, contact us as soon as possible. The earlier we begin treatment the more likely we'll save your loose tooth.
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.”