Posts for: September, 2014
Although traditional porcelain laminate veneers are much less invasive than other cosmetic dental applications, they still often require the removal of some of the surface tooth enamel, a process known as tooth reduction. Now, an alternative veneer treatment known as “no-prep” veneers eliminates this initial step of tooth reduction for some patients.
Although most reductions take very little of the tooth enamel, they do permanently alter the tooth. No-prep veneers are growing in popularity because the tooth is not permanently altered, allowing for two benefits: if desired, the veneer application can be reversed and the tooth returned to its original state; and there's more flexibility for patients to “test-drive” their new look with prototype veneers worn while the permanent veneers are manufactured, with changes made easily during this tryout period.
Dentists have long regarded at least a minimum of tooth reduction as absolutely necessary for the proper adhesion of veneers, and to avoid a bulky or over-contoured smile. And, while advances in no-prep veneers have largely addressed these concerns, it is true this option isn't for every patient considering a veneer application.
For example, patients with large or forward-positioned teeth are not good candidates for no-prep veneers. Patients who choose a veneer treatment over orthodontic treatment for certain conditions will likely need some tooth preparation to achieve an acceptable aesthetic result. For patients generally, no-prep veneers have a limited application range on the bottom jaw due to space limitations.
Simply put, traditional veneers are a more versatile option for most patients. On the other hand, no-prep veneers can be a good choice for patients with genetically small or misshapen teeth, teeth reduced by erosion or grinding, or those with narrow or diminished smiles.
If you're considering this option, our first step is to conduct a complete examination of your teeth and mouth. We'll carefully evaluate every aspect of your mouth structure and overall dental condition. If you fit the criteria, you may be able to avoid tooth reduction and still gain the smile you desire.
If you would like more information on no-prep veneers, 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 “Porcelain Veneers Without the Drill.”
Whether you are a serious or “weekend” athlete, you know the importance of protecting yourself against injury. While looking after your joints, ligaments and bones may garner most of your attention, you shouldn't neglect looking after your teeth and mouth as well. In fact, there are more than 600,000 emergency room visits each year for sports-related dental injuries. A knocked out tooth could eventually cost you $10,000 to $20,000 in dental treatment during your lifetime.
The best protection is really quite simple — wear a properly-fitted athletic mouthguard. Researchers estimate that mouthguards may prevent more than 200,000 dental injuries annually. Be aware, though — not all mouthguards are alike or provide the same level of protection.
Mouthguards generally fall into three types. Stock mouthguards are the least expensive of the three, and also the least effective at protection. They come in limited sizes and can't be customized to the wearer. “Bite and Boil” mouthguards are made of thermoplastic that becomes pliable when heated (as when boiled in water). In this state the mouthguard can be pressed into the wearer's teeth, which hardens to that fit once the thermoplastic cools. However, the fit isn't exact and they don't always cover the back teeth. Also during the heat of competition, the mouthguard softens and loses some of its stability and protection.
While more expensive than the other two types, a custom-fitted mouthguard made by a dentist provides the best level of protection. Made of a tear-resistant material, they are more comfortable to wear than the other types and cover more of the interior of the wearer's mouth.
A properly fitted and worn mouthguard protects the mouth and jaw area in a number of ways. It cushions the soft tissue of the lips and gums from cuts and abrasions caused by contact with sharp teeth surfaces after an impact. It absorbs and distributes forces generated in an impact that can cause tooth loss or even jaw fracture, and also cushions the jaw joint (TMJ) to reduce the likelihood of dislocation or other trauma.
A custom-fitted mouthguard can cost hundreds of dollars, but that price is relatively small compared with the physical, emotional and financial price you'll pay for an injury. This investment in your oral health is well worth it.
If you would like more information on the use of athletic mouthguards, contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Athletic Mouthguards.”
A crown is an effective way to save a tooth and restore its form and function. These life-like “caps” that fit over and are permanently attached to teeth have been used for decades with good results.
For this type of restoration to be effective, though, there must be enough of the natural tooth remaining above the gum line for the crown to “grab on to.” This poses a problem if the tooth has broken or decayed too close to the gum tissue.
Fortunately, there is a way to expose more of the remaining tooth for applying a crown. Known as crown lengthening, this surgical procedure is also used for “gummy” smiles, where normal tooth length is obscured by excess gum tissue that makes the teeth appear shorter.
We begin the procedure by first numbing the tooth and gum area with a local anesthetic. We then make tiny incisions inside the gum line on both the tongue and cheek side of the tooth to create a small flap. With this area below the gum line now open to view, we then determine whether we need to remove excess gum tissue or a small amount of bone around the tooth to expose more of the tooth itself. We then position the opened gum tissue against the bone and tooth at the appropriate height to create an aesthetic result.
You shouldn’t experience any discomfort during the procedure, which usually takes about sixty minutes for a single tooth area (which needs to involve at least three teeth for proper blending of the tissues). The pressures and vibrations from equipment, as well as any post-procedure discomfort, are similar to what you would encounter with a tooth filling. After the gum tissue has healed (about six to eight weeks), we are then able to fit and attach a crown onto the extended area.
Crown lengthening a small area may result in an uneven appearance if you’re dealing within the aesthetic zone. One option in this case is to consider undergoing orthodontic treatment first to correct the potential discrepancy that may result from surgery. After orthodontics, we can perform crown lengthening on just the affected tooth and still achieve an even smile.
Crown lengthening is just one of many tools we have to achieve tooth restorations for difficult situations. Using this technique, we can increase your chances of achieving both renewed tooth function and a more beautiful smile.
If you would like more information on crown lengthening, 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 “Saving Broken Teeth.”
If you’re apprehensive about visiting the dentist, you’re not alone. Studies show a majority of us — as high as 75% — have experienced some form of anxiety about dental treatment. Between 10% and 15% of those have a high degree of anxiety that may cause them to avoid visiting the dentist altogether.
If you’ve experienced this level of anxiety, you weren’t born with it. Such fears develop from early experiences with dentistry, or from stories or attitudes relayed to us by others. While this undue emotional stress could adversely affect your general health, the greater threat is to your oral health, if it causes you to avoid dental care altogether.
Fortunately, anxiety from the thought of dentistry can be overcome. The best approach is relatively simple — counteract the bad experiences of the past with new, more positive experiences. Moderate dentistry should be able to completely eliminate any discomfort during treatment. And with each new good experience, your feelings and attitudes will gradually change over time for the better.
The first step is to discuss your anxiety about dental care with us. It’s important to establish trust with your care provider from the outset if you want to successfully overcome your anxiety. We will listen and not discount or diminish the reality of your fears and their emotional and physical effect; instead, we will work with you to include overcoming anxiety as a part of your treatment plan.
The next step is to proceed with treatments and procedures you feel you can easily undergo, so that at the end of each visit you’ll have a more positive view of that particular treatment (and that you could undergo it again). We won’t rush to complete treatments until you’re ready for them. Although this may extend the duration needed to complete a procedure, it’s important for us to proceed at a pace more conducive to creating and reinforcing new positive feelings and attitudes about dental visits.
In the end, we want to do more than treat an immediate or emergency-related dental condition. We want to help you overcome the anxiety that has kept you from seeking long-term dental care — and thus better dental health — a part of your life.
If you would like more information on overcoming dental treatment anxiety, 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 “Overcoming Dental Fear & Anxiety.”
While dental implants are the preferable choice for teeth replacement, your life circumstances may cause you to postpone it or some other permanent restoration. In the meantime, you need a temporary solution for your tooth loss.
Removable partial dentures (RPDs) have met this need for many years. RPDs are traditionally made of rigid, acrylic plastic resin and fasten to existing teeth with metal clasps. While effective as temporary tooth replacements, RPDs do have their drawbacks: they can be uncomfortable, develop a loose fit and are prone to wear and staining.
Recently, though, new RPDs made of a flexible type of nylon are addressing some of these drawbacks. Because the nylon material is thermoplastic (able to change shape under high heat), it can be injected into a cast mold of a patient’s mouth to create the denture base, to which life-like replacement teeth are then attached. And rather than a metal clasp, these RPDs have thin, finger-like nylon extensions that fit snugly around existing teeth at the gum line.
The new RPDs are lightweight, resistant to fracture and offer a more comfortable, snugger fit than the older RPD. And because the nylon material can be made to closely resemble gum tissue, the base can be designed to cover receding gum tissue, which may further improve the appearance of a patient’s smile.
On the downside, these new RPDs are difficult to reline or repair if they’re damaged or the fit becomes loose. And like all RPDs, they must be regularly removed and cleaned thoroughly to prevent any accumulating bacterial biofilm that could increase the risk of gum disease or tooth decay (the attachment extensions are especially susceptible to this accumulation). They should also be removed at night, since the reduction in saliva flow while you sleep can worsen bacterial buildup.
Still, the new flexible RPD is a good choice to bridge the time gap between lost teeth and a permanent restoration. They can restore lost function and improve your smile during the transition to implants or a fixed bridge.