Posts for category: Dental Procedures
There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.
But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.
But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.
After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.
As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.
This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.
If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”
Wearing orthodontic braces brings challenges to daily life. During treatment a patient will need to avoid certain foods and habits, take more time to brush and floss properly, and may endure occasional discomfort. But the effect of metal braces on appearance can be especially difficult, especially for peer-conscious teens.
Clear aligners, though, offer an alternative to braces that could make some of these challenges easier, particularly with your appearance. Aligners are clear plastic trays that fit over the teeth to move them. They can be removed by the wearer for easier brushing and flossing or for special occasions. Best of all, they're much less noticeable than metal braces.
Clear aligners were developed thanks to advances in digital technology. An orthodontist uses a computer application incorporating the data from photographs, x-rays or CT scans of a patient's teeth and jaws to produce a series of clear plastic trays. The patient then wears each tray for about two weeks before changing to the next tray in the sequence.
The trays apply pressure much like metal braces to gradually move teeth to the desired position on the jaw. Each tray is slightly smaller in size than the previous tray in the sequence, so that the progression of tooth movement continues with each succeeding tray. The treatment time is about the same as with conventional braces.
This new orthodontic tool works well for many common bite problems, but until recently they've been limited in scope. But new designs in trays and attachments called buttons added to teeth to provide more leverage have greatly increased their use for more complex bite issues.
Clear aligners also have one other disadvantage, ironically due to one of their principal benefits, removability. Although they can be taken out, they must be worn consistently to achieve results. Some younger patients may not have the maturity level and discipline to responsibly wear their aligners as they should.
That's one issue you'll need to discuss with your orthodontist if you're considering clear aligners for your teen. But if they can maintain wearing consistency, and they have a bite problem that can be corrected with aligners, both you and your teen may find this choice more agreeable and attractive than braces.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
A root canal treatment is a common procedure performed by dentists and endodontists (specialists for inner tooth problems). If you're about to undergo this tooth-saving procedure, here's what you need to know.
The goal of a root canal treatment is to stop tooth decay within a tooth's interior and minimize any damage to the tooth and underlying bone. This is done by accessing the tooth's pulp and root canals (tiny passageways traveling through the tooth roots to the bone) by drilling into the biting surface of a back tooth or the "tongue" side of a front tooth.
First, though, we numb the tooth and surrounding area with local anesthesia so you won't feel any pain during the procedure. We'll also place a small sheet of vinyl or rubber called a dental dam that isolates the affected tooth from other teeth to minimize the spread of infection.
After gaining access inside the tooth we use special instruments to remove all of the diseased tissue, often with the help of a dental microscope to view the interior of tiny root canals. Once the pulp and root canals have been cleared, we'll flush the empty spaces with an antibacterial solution.
After any required reshaping, we'll fill the pulp chamber and root canals with a special filling called gutta-percha. This rubberlike, biocompatible substance conforms easily to the shape of these inner tooth structures. The filling preserves the tooth from future infection, with the added protection of adhesive cement to seal it in.
Afterward, you may have a few days of soreness that's often manageable with mild pain relievers. You'll return for a follow-up visit and possibly a more permanent filling for the access hole. It's also likely you'll receive a permanent crown for the tooth to restore it and further protect it from future fracture.
Without this vital treatment, you could very well lose your tooth to the ravages of decay. The time and any minor discomfort you may experience are well worth the outcome.
If you would like more information on treating tooth decay, 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: What You Need to Know.”
People have depended on dentures for generations—and they still do. That's because they work, both in restoring dental function and a smile marred by missing teeth.
But they have one major drawback related to bone health. That's because living bone has a life cycle: as older cells die, new ones form to take their place. The pressure generated when we chew stimulates this growth. But when this stimulus goes missing along with the teeth, the cell replacement rate slows and bone volume and density gradually diminishes.
Traditional dentures can't transmit this chewing pressure stimulus. And because they rest directly on the gum ridges, they can adversely affect the underlying bone and actually accelerate bone loss.
But implant technology potentially solves this bone loss problem with dentures by using implants rather than the gums to support them. It's a two-fold benefit: first, the implants relieve much of the irritation to the gums and bone caused by traditional dentures. Primarily, though, the implants themselves can slow or even stop continuing bone loss.
Most implants are made of titanium, not only because it's compatible with the body, but also because it has an affinity with bone. Over time bone cells grow on the titanium post imbedded in the jawbone. This process not only creates stability and durability, it can improve bone health.
In recent years dentists have incorporated implants with dentures to create two exciting treatment options. With one option, the dentist installs two or more implants in the jaw, to which a specially fitted removable denture can be attached. You would still have the ease of removing the denture for cleaning, while gaining greater stability and a reduced risk of bone loss.
The other option is a fixed denture (or bridge) attached permanently to implants. For this option, a patient's jawbone must be adequate and healthy enough to support at least four to six implants. A fixed denture is also often costlier and more complex than a removable denture, but it can feel more like real teeth. It also promotes better bone health too.
Although both options are more expensive than traditional dentures, they can pay dividends for long-term dental health. Implants could help you enjoy your new dentures and resulting smile for a long time to come.
If you would like more information on dental implant-supported 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 “Overdentures & Fixed Dentures.”
For chipped, stained, or slightly crooked teeth, dental veneers might be the ideal solution. These thin layers of porcelain bonded directly over the teeth with the perfect blend of color, sizes and shapes, can transform a person’s smile for a relatively modest cost.
But if the teeth belong to a teenager, veneers might not be appropriate. This is because in most cases, we’ll need to remove some of the tooth enamel so that the applied veneers won’t look unnaturally bulky. This alteration is permanent, so the teeth will require some form of restoration from then on.
While not usually a major issue with fully matured adult teeth, it could be with the developing teeth of pre-teens and teens. During childhood and adolescence the tooth’s inner pulp plays an important role in dentin production, and so the pulp chamber is relatively large compared to an adult tooth. This larger size places the pulp closer to the enamel surface than with an adult tooth.
Because of its proximity to the enamel, there’s a greater chance veneer alterations could damage a teenager’s tooth pulp and its nerve bundles. If that happens, we may need to perform a root canal treatment to save the tooth—also not an optimal situation for a developing tooth.
That’s why we need to take into consideration a patient’s age and stage of dental development first, including x-raying the affected teeth to measure the depth of the tooth pulp. If we deem it too risky at the moment, there are other ways to improve dental appearance at least temporarily. This includes whitening externally stained teeth with a bleaching agent, or applying tooth-colored composite resin material to chipped areas. We can also apply a composite material veneer that, although not as durable as traditional porcelain, doesn’t require much if any tooth alteration.
To know your options, have your teenager undergo a thorough dental examination. Your dentist will then be able to discuss with you whether veneers can be safely attempted. And be sure the dentist who may perform the work has experience performing cosmetic procedures on teenagers.
If you would like more information on restoration choices for teenagers, 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 “Veneers for Teenagers.”