Dental Procedures

Veneers: Not Just for Woodworking

May 6, 2012 by DentalCMO

You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.

Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.

In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.

Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.

Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.

Contact us today to schedule an appointment to discuss your questions about porcelain veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

Is It Wise To Have Your Wisdom Teeth Removed?

March 3, 2012 by DentalCMO

The third molars, called “wisdom teeth” because they usually become visible when a person is 17 to 25 — supposedly the time we achieve wisdom, may have adverse effects on adjacent teeth. Most adults have four wisdom teeth, although some people have more; and some, none at all. The wisest thing to do about wisdom teeth may be to have them removed if they are poorly positioned.

What is an impacted wisdom tooth?

If a wisdom tooth is pushing against gums, other soft tissues, or adjacent teeth at an awkward angle, it is referred to as “impacted.” Usually this occurs when there is not have enough room in the jaws for these last molars to fit next to their adjacent teeth. They can disrupt the gum tissue attachment of their neighboring teeth and the surrounding bone leading to periodontal disease and, ultimately, their loss.

In many cases, impacted teeth are painless, and those who have them have no warning of the problem. Thus it is important to have routine dental exams during the time when the third molars are coming in.

When should wisdom teeth be removed?

It is better to remove wisdom teeth early rather than waiting until periodontal (gum) disease has set in. As individuals age, keeping their wisdom teeth may lead to more serious problems. Periodontal defects tend to get worse in the presence of retained third molars. Furthermore, there is a higher incidence of postoperative symptoms in people over 25.

What are the pros and cons?

Removing impacted third molars can have a negative influence on the periodontal tissues of adjacent second molars. A number of techniques, such as scaling, root planing, and bacterial plaque control, can be used to minimize periodontal problems and promote healthy healing.

Surgical removal of wisdom teeth will involve some mild to moderate post-operative discomfort. Use of aspirin or ibuprofen for a few days after surgery will provide pain relief and control most swelling and symptoms. Antibiotics may be prescribed to ensure infection-free healing. It is important to keep the socket area clean by washing and rinsing with saline or antibacterial rinses. Careful surgery will promote good healing with minimal periodontal consequences to adjacent second molar teeth.

To decide whether your wisdom teeth should be removed, you will need an evaluation to assess the clinical health of the wisdom teeth, the neighboring teeth, and other vital structures. X-ray and digital imaging techniques play an important role in determining the exact position of the wisdom teeth in the jaw. A full assessment and consultation will include all the risks, benefits, likely consequences, and alternative treatment options. This will provide you with the wisdom you need to determine what is best for your wisdom teeth.

To learn more about wisdom teeth, read “To Be or Not to Be: What are the consequences of an impacted wisdom tooth?” Or contact us today to discuss your questions or to schedule an appointment.

Getting the Best Possible Results with Full Dentures

December 25, 2011 by DentalCMO

Even with all the medical know-how we possess at the dawn of the 21st century, complete tooth loss is still a big problem. In this country, more than a quarter of all adults between ages 65 and 74 have lost all of their teeth. For these individuals, removable full dentures are often still used as an affordable and effective way to replace missing teeth.

Success with dentures originates from a collaboration among dentist, laboratory technician, and, of course, the denture-wearer. Creating false teeth that look natural is as much an art as it is a science. We take a number of steps to make sure you will get the best results. These include:

Positioning the teeth. Using facial landmarks and photographs of how you used to look before your teeth were lost helps us determine where to place each tooth and how the upper and lower teeth should line up in relation to each other. For example, we will consider what size the teeth should be; how close to the lip they should be; and how much space should exist between the upper and lower teeth when they are at rest.
Simulating natural gums. If you are someone with a “high lip dynamic” (a lot of gum shows when you smile), it is particularly important to simulate real gum tissue in a set of full dentures. Fortunately, there are many colors and textures available to create a realistic effect. Again, photographs can be helpful in achieving this.
Balancing the bite. We must make sure that your upper and lower dentures come together in a way that facilitates normal biting, chewing, and speech.

As a denture wearer, you will need to visit our office regularly to make sure the gum tissue and bone upon which your dentures rest stay healthy. It’s common to see a gradual loss of bone in people who wear dentures at a rate that varies from person to person. This bone loss can affect the fit of your dentures and lead to other health problems, which we can address if we are monitoring you on an ongoing basis.

If you have any questions about dentures, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “Removable Full Dentures.”

Replacing Missing Back Teeth Is Important – Just Ask Christie Brinkley!

December 11, 2011 by DentalCMO

Supermodel Christie Brinkley has a one-in-a-million smile, but she is just one of millions who have benefited from today’s preferred tooth-replacement technique: the dental implant. In a wide-ranging interview, Brinkley told Dear Doctor magazine about a helicopter accident she suffered while back-country skiing.

“I fractured two molars in the back of my mouth and I had to get two dental implants,” Brinkley told the magazine. “I am grateful for the dental implant technology that feels and looks so natural.”

You might think it serves little purpose to replace a missing back tooth that was barely visible in your smile to begin with — especially if you don’t spend a lot of time posing for magazine covers. But this is actually not the case. Your molars are extremely important for chewing and even for maintaining a more youthful appearance.

Dentists generally agree that losing posterior (back) teeth can have many consequences for the remaining teeth and their surrounding structures, i.e., bone and gums. If back teeth are missing, the front teeth end up bearing more stress than they were built for. And there are certain things that happen when any tooth is lost, whether front or back, that can affect function and appearance.

For one thing, when a tooth is lost the adjacent teeth tend to drift into the empty space or tip towards it. This can adversely affect your bite. Too much shifting can render a tooth basically useless and also leave it more vulnerable to gum disease.

Another complication is the loss of tooth-supporting bone that inevitably occurs when teeth are lost. When a tooth comes out, the bone under it actually begins to melt away. Since back teeth support the vertical dimension of the face, their loss can cause what’s known as “bite collapse” — a reduction in facial height that becomes increasingly noticeable over time and can make you look older.

A dental implant can prevent all of these things, while providing you with a replacement that looks and feels just like the tooth you lost.

If you are interested in learning more about implants, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor’s entire interview with Christie Brinkley, please see “The Secret Behind Christie Brinkley’s Supermodel Smile.” Dear Doctor magazine also has more on “Replacing Back Teeth.”

How to Get What You Want in Your Smile Makeover

November 13, 2011 by DentalCMO

When you begin a smile makeover in our office, you are embarking on an exciting partnership with my laboratory technician and me. You should be full of excitement and anticipation — if you have been dissatisfied with your current smile, and you have great expectations for the results of this project. You will really like what you see in your mirror.

Being completely satisfied with your new look depends upon successful communication — between you and me and also between my dental lab technician and me. As you might expect, your perceptions of how your teeth appear are different from a dentist’s perceptions. My education leads me to think of factors that untrained individuals probably won’t consider, such as crown (tooth) length, midlines (how the teeth line up with other facial features) and the distance from gum to lip.

It is helpful to be able to describe what you like and don’t like about your current smile, and what changes you would like to see. Using visual aids is a good idea. Bring photos and magazine illustrations to show what you have in mind. (Remember that we cannot make you look exactly like a celebrity or anyone else. The pictures are guidelines.)

Things to think about:

The color, size, shape, alignment and spacing of your teeth.
How much of your teeth and gum tissues show when your lips are relaxed and when you smile.
Tooth color: bright “Hollywood” white or more natural looking off-white.

Your makeover is more likely to meet your expectations if you get an advanced view of the results. Computer imaging is one way to do this. Another is for us to make a mock-up of the proposed dental work in tooth-colored wax on models of your mouth.

Finally, a “Provisional Restoration” can be used as a test to make sure that what I envision is also what you, the patient, want to see. A provisional restoration, made from temporary materials, gives you a chance to test out the changes and make sure they work for you — that they not only look good, but they are also functional in terms of biting, chewing, speech, and gum health.

If the provisional restoration works, it is used as a blueprint to make durable and long lasting porcelains in the same design. We will take impressions of the provisional restoration and communicate the relevant information to a dental laboratory technician, who will make the final porcelain tooth replicas for your new smile.

Competent communication and a provisional restoration will put you on track to meet your expectations and obtain the most aesthetic and functional result in your Smile Makeover.

Contact us today to schedule an appointment to discuss your questions about Smile Makeovers. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

Dental Crown FAQs

November 6, 2011 by DentalCMO

Dental crowns are excellent tools that we use to restore functionality, color and/or beauty to teeth and your smile. And while many people may have heard of them, often times there are many questions surrounding the process, costs and their maintenance. This is why we have put together this list of some of the questions we are commonly asked on this subject. Our goal is to provide you with straightforward answers so that you have a clearer understanding of the treatment and are comfortable making the decision to go forward with these excellent tooth restorations should they ever be required.

What Is A Crown?

A dental crown is a tooth-shaped “cap” or cover that a dentist places over a tooth that is badly damaged from trauma or decay in order to restore its color, strength, size and functionality. They are also used for cosmetic reasons to improve discolored or misshapen teeth.

Why Can The Cost Of Crowns Vary?

The reason the cost of a crown can vary greatly, even from dentist to dentist is quite simple. The most beautiful crowns require the artistry and years of experience of a team of dental professionals; your dentist and the laboratory technicians that handcraft crowns. To meet higher expectations of some individuals requires more experience, artistry and skill. And great art just tends to cost more. A customized temporary crown may even be used as a preview to see what a final crown will look like. Another critical factor is the choice of materials used. For example, while all porcelain crowns are made from high-quality ceramic (glass) material, they are not equal. It is therefore more expensive in terms of time, skill and expertise to produce the most natural looking results.

How Long Will A Crown Last?

Most dentists expect a crown to last at least 7-10 years with normal wear and proper maintenance. However, depending on the materials used and location of the tooth, they can last upwards of 50 years or more. For example, a gold crown has the longest lifespan because gold is such a durable material that has little to no negative impact on surrounding teeth. On the other hand, porcelain produces a completely natural look but can cause wear to adjacent teeth.

What Materials Are Most Often Used For Crowns?

The three most common materials used to make crowns are as follows:

Gold
Porcelain-Fused-to Metal (PFM)
All porcelain

To learn more on this topic, read the Dear Doctor article, “contact us to discuss your questions or to schedule a consultation.

Dental Procedures

What is an impacted wisdom tooth?

When should wisdom teeth be removed?

What are the pros and cons?

What Is A Crown?

Why Can The Cost Of Crowns Vary?

How Long Will A Crown Last?

What Materials Are Most Often Used For Crowns?

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