Posts for: April, 2015
For some time now, you’ve noticed things about your teeth and gums — your overall smile — that you would like to change. But you’re in unfamiliar territory: you don’t know where to begin.
Here, then, are a few basic cosmetic dentistry questions you should ask yourself and us to get you moving in the right direction.
Am I a candidate for cosmetic dentistry? Invariably, the answer is yes — there’s always a way to enhance your appearance, starting with basic hygiene or whitening. But whether you’re a candidate for a particular procedure will depend on a full examination of your mouth — a “smile analysis” — to assess its current condition and needs, and what cosmetic options would best fit those needs.
Are my expectations realistic? That will first depend on what we find with your smile analysis. It will, however, also include studying the bigger picture — how certain changes might affect not only your smile but your overall facial appearance. Your wants and desires are extremely important in this process, but they should also be balanced with a dose of reality — some things may not be in your best interest health-wise to undertake, or are not in keeping with basic aesthetic principles of beauty.
Will I be able to have an idea beforehand how the changes will look? We’ve come a long way in providing patients ways to preview their new smile before undertaking a procedure. It’s often possible to “see” your proposed smile through computer simulation, or in some cases “test drive” it with temporary (provisional) crowns or veneers. For restorations involving porcelain crowns, it may be possible to take your input and fine-tune the shape and color of the permanent crown before it’s completed.
What will it cost? This will depend on the treatment plan we develop. Some treatments like teeth whitening are relatively inexpensive, while procedures like dental implants or orthodontics are major investments. You should also consider the costs to your time — some treatments require only a single visit, while others may take months or even years to complete. Depending on your financial means and comfort level, cost will need to be factored into the final plan, as well as your expectations.
If you would like more information on cosmetic dentistry, 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 “Cosmetic Dentistry: A Time for a Change.”
Tooth whitening procedures and products have become increasingly popular over the last two decades. There are two main sources of application: professional procedures performed in a dentist’s office; and over-the-counter products for performing whitening applications at home. While there are pros and cons to both approaches, neither type poses a significant health risk — that is, if you match the correct product to the type of staining you have, and it’s applied according to the manufacturer’s instructions.
Although whitening treatments may differ in formula and strength, almost all use hydrogen peroxide as the bleaching agent, usually contained in carbamide peroxide which splits into hydrogen peroxide and urea upon activation. After many studies, there’s a strong consensus that hydrogen peroxide used at the levels found in whitening products doesn’t cause any harm to the body, including as a precursor to cancer.
But as the 16th Century Swiss physician Paracelsus once noted, “All substances are poisons… The right dose differentiates a poison from a remedy.” This is true of the chemicals that make up whitening products — they’re safe unless they’re overused. Going beyond their directions for use could lead to tooth enamel damage.
Further caution is also in order for teenagers using whitening products. Although they may have their permanent teeth (although younger teens may still have some primary teeth), the enamel layer is still developing and can be more vulnerable to damage from whitening chemicals than for adults.
The best approach for both a professional or home whitening procedure is to first seek consultation from our office. If nothing else, you should at least undergo a dental examination to identify the true cause of your teeth’s staining or discoloration. If the discoloration originates within the tooth, home applications and many professional treatments will not help if they bleach the outer surface only. We can also advise you on the proper application and dosage for a chosen product.
Using the right whitening product and in an appropriate manner will reduce the risk of injury to your teeth and overall health. And, the end result can be a brighter, more vibrant smile.
If you would like more information on tooth whitening, 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.”
When decay spreads to the tooth’s inner pulp, a root canal treatment may be necessary to save it. It’s a common procedure: after removing all tissue from the pulp, the pulp chamber and root canals are filled with a special filling. The tooth is then sealed and a crown installed to protect the tooth from re-infection and/or fracture, possibly extending the tooth’s life for many years.
Sometimes, however, the tooth doesn’t respond and heal as expected: the number, size and shape of the patient’s root canals may have complicated the procedure; there may have been a delay before installing the final crown or restoration or the restoration didn’t seal the tooth as it should have, both occurrences giving rise to re-infection. It’s also possible for a second, separate occurrence of decay or injury to the tooth or crown to undo the effects of successful treatment.
It may be necessary in these cases to conduct a second root canal treatment, one that may be more complicated or challenging than the first one. For one thing, if the tooth has been covered by a crown or other restorative materials, these will most likely need to be removed beforehand. In cases where the root canal network and anatomy are challenging, it may require the expertise of an endodontist, a dental specialist in root canal treatments. Using advanced techniques with microscopic equipment, an endodontist can locate and fill unusually narrow or blocked root canals.
Because of these and other possible complications, a root canal retreatment may be more costly than a first-time procedure. Additionally, if you have dental insurance, your particular benefit package may or may not cover the full cost or impose limitations on repeated procedures within a certain length of time. The alternative to retreatment, though, is the removal of the tooth and replacement with a dental implant, bridge or partial denture with their own set of costs and considerations.
The complications and costs of a repeated procedure, though, may be well worth it, if it results in a longer life for the tooth. Preserving your natural tooth is in most cases the most desired outcome for maintaining a healthy mouth.
If you would like more information on root canal treatments, 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 “Root Canal Treatment.”
The “wear and tear” nature of gingival (gum) tissue enables it to readily handle the chewing and biting actions of eating and still perform its most important function: protecting the roots of your teeth from decay and environmental exposure. But while they're resilient, they're not invincible: it's quite possible for them to lose their attachment to a tooth and begin to recede, leaving the root surfaces exposed.
Gum recession can occur for a number of reasons: poor oral hygiene; over brushing and flossing; malocclusion (a poor bite); personal habits, like biting down on hard foreign objects; or poorly fitted dentures or other appliances. From a genetic point of view, people with thinner gingival tissues are more prone to gum recession than those with thicker tissues. Whatever the cause, the result is the same — the exposed tooth becomes more sensitive to environmental factors (such as heat, cold, abrasion or erosion). More importantly, it now has a higher susceptibility to decay and disease, leading to its possible demise.
But there may be a solution. Although the original tissue may be lost, periodontal plastic surgery can restore a protective layer of tissue to the tooth, and at the same time give you back the smile you once had.
From the Greek word “plastik” for sculpting or modeling clay, plastic surgery procedures restore both form and function to a bodily structure. While the term “plastic surgery” can apply to other procedures in medicine such as rhinoplasty or face lifts, the periodontal procedure particularly involves grafting similar tissue to an area of recession, and then “shaping” it into a natural, life-like form.
To graft means to remove tissue from a donor site and attach it to a recipient site. In the case of periodontal tissue, the recipient patient can also be the donor with the tissue coming from some other area of the same mouth (the graft can also come from another human or an animal). Using advanced techniques and a touch of artistry, the surgeon positions and sutures the graft in place.
The result: not only a new protective covering for your tooth, but a more pleasing appearance when you smile.
If you would like more information on periodontal plastic surgery, 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 Plastic Surgery.”