Posts for category: Dental Procedures
A dental implant as a permanent replacement for a missing tooth can match or even look better than your original tooth. How this happens takes knowledge, skill, experience, and even some art.
Here are some of the factors involved:
- Bone quantity and quality: To look and function like an original tooth, an implant must be supported by an adequate base of (jaw) bone and gum tissue. Bone has a tendency to melt away or resorb after a tooth is lost. Using new bone grafting techniques can help minimize the bone loss that occurs during healing at the extraction site. Bone grafting can also be used to rebuild lost bone at the implant site.
- Adequate bone supporting neighboring teeth: If you lose bone that supports teeth on either side of an implant, the papillae (the little pink triangles of gum tissue between the teeth) may not regenerate after the implant is placed.
- Your inborn tissue type: If your gum tissues are thin and delicate rather than thick and robust, they will be more difficult to work with. To ensure that there is sufficient gum tissue support, (gum) grafting may be necessary.
- Using the temporary crown as a template: A dental implant actually replaces a tooth root. Most dental implants are made of commercially pure titanium, which fuses with the bone in your jaw, making it very stable. The crown, the part of the tooth that is visible above the gum line, is attached to the implant; a customized temporary crown can be fitted to the implant. The temporary crown is a trial for the final crown. It can be used to assess color, shape, the appearance of your smile, and the implantâ??s function in your bite and speech. It gives you the opportunity to decide about design adjustments before the final, permanent crown is placed.
- The skill, experience, and collaboration of your dental team: Each situation is different. The final success of your implant depends on your pre-surgical assessment and diagnosis, as well as how the surgical and restorative phases of treatment are performed. The use of an outstanding dental laboratory is vital to a successful result.
Contact us today to schedule an appointment for an assessment or to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”
If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.
Q: What is a root canal?
A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.
Q: Why do I need to get a root canal?
A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.
Q: What happens if I don't get a root canal?
A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.
Q: Will it be painful?
A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.
Q: What happens after that?
A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.
Q: Is there an alternative?
A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.
If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”
Without a doubt, an effective root canal treatment can extend the life of a tooth for many years. But sometimes even a well-maintained tooth can fall prey to disease months or even years after a root canal treatment. While there are a number of reasons to account for this failure, a common one is so tiny it could have easily been missed during the first treatment.
A root canal is an open space within the tooth that contains the pulp. The pulp is a connective tissue with a network of nerve fibers connected to the root that alert the brain to environmental changes involving the tooth. It is most important during the tooth’s early development, but becomes less important as we age. The pulp is susceptible to infection from tooth decay or periodontal (gum) disease, which if left untreated can threaten the tooth’s survival. During a root canal treatment, we enter these spaces, clear out the diseased pulp and fill the canal with a bio-compatible filling; we then seal it off to deter further decay.
The treatment could ultimately fail, though, because of accessory or lateral canals missed during the procedure. Like a tree with smaller branches growing out of its larger limbs, accessory canals are smaller access ways that branch off of the main root canals. These accessory canals, which can occur anywhere along a main canal, can be quite small and not easily detected during an initial root canal treatment. They are especially susceptible to infection due to gum disease if they open into the periodontal membrane, the main attachment point between teeth and bone.
If we suspect the presence of accessory canals (either initially or after ensuing problems following a root canal treatment), this could require the skills of an endodontist, a dentist who specializes in the treatment of a tooth’s interior. Accessory canals are treated in much the same way as larger canals, but may require an endodontist’s specialized microscopic equipment and filling techniques. Effective treatment of these smaller accessory canals will certainly improve the chances of a successful, long-term outcome for the tooth.
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 “Accessory Canals.”
Your otherwise beautiful smile has one noticeable flaw — one or more of your teeth are deeply discolored or stained. More than likely this staining is deep within the teeth, what we refer to as intrinsic staining. There are a number of reasons this can occur — from fillings or use of antibiotics, for example — and our first approach should be to attempt a whitening technique.
However, if that doesn't produce the desired result, porcelain laminate veneers are another option you might consider. Veneers are made of dental porcelain, a bio-compatible material that can be shaped and colored to closely match neighboring teeth. After a minimal amount of tooth reduction (removal of some of the enamel from the tooth surface) to prepare for the laminate, the veneers are then permanently bonded to the tooth surface and cover the discolored natural tooth. Besides changing the appearance of discolored or stained teeth, veneers can also be used to correct other imperfections such as chipped or misshapen teeth.
Patients, however, have a common question: how long will the veneers last? With proper care, veneers can last anywhere from seven years to more than twenty years. It's possible, though, to damage them — for example, you can break them if you bite down on something that goes beyond the porcelain's tolerance range, such as cracking nut shells with your teeth (not a good idea even for natural teeth!). You should also keep in mind that veneers are composed of inert, non-living material and are attached and surrounded by living gum tissue that can change over time. This process may eventually alter your appearance to the point that the veneer may need to be removed and reapplied to improve the look of your smile.
If a veneer is damaged, all is not necessarily lost. It may be possible to re-bond a loosened veneer or repair a chipped area. The worst case is replacement of the veneer altogether. Chances are, though, this will only happen after the veneer has already served you — and your smile — for many years.
If you would like more information on porcelain laminate 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.”
Our smiles are our “calling cards” for first impressions. When our front teeth are missing, chipped or otherwise damaged, it will certainly make an impression — and not a positive one.
The good news is many aesthetic problems with front teeth can be remedied with the use of composite resins. This cost-effective treatment choice not only minimizes a negative appearance, but can actually create a positive smile transformation.
Composite resins are tooth-colored materials made up of two or more polymer substances. We call materials like these biomimetic, meaning something non-living that’s fashioned to appear or “mimic” something living. Composite resins are made of substances that aren’t teeth, but fashioned to look and function like teeth.
Composite resin restorations are bonded to the outside of the tooth with dental adhesive, with little to no preparation of the enamel surface of the tooth. They’re best suited for teeth with minor to moderate damage from decay or trauma, but where the majority of the structure is still viable and intact.
These restorations require skill and an artistic eye to achieve the most life-like result. One of the most important considerations is tooth color. The natural color of your teeth is actually a combination of color from the inner core of the tooth, the dentin, and the outer enamel layer. Much of the color comes from the dentin as it shows through the translucence of the enamel. The intensity and hue also changes along the length of the tooth — there are subtle zones of color that run vertically along the length of the crown (the visible portion of the tooth). Our aim is to replicate this variety of color in the restoration and affix it in such a way that it blends with the natural color of surrounding teeth.
Composite resins aren’t the best option for all situations; depending on the tooth’s condition and location, a porcelain veneer may be the better choice. After a thorough dental examination, we can make the best recommendation for your situation. If conditions are right, a composite resin restoration could transform your smile and your life.
If you would like more information on front teeth repair options, 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 “Artistic Repair of Front Teeth With Composite Resin.”