Posts for category: Dental Procedures
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.”
Smiling feels great and makes others feel good as well. But if you are self-conscious about exposing teeth that are showing imperfections or excessive wear, you may not be smiling as broadly as you should be. Fortunately, there are ways to correct the esthetic issues that might be holding you back. One involves covering the natural tooth partly or completely with a natural-looking but flawless “facade.”
Perhaps you've heard about dental veneers and crowns? Both can achieve similar, eye-pleasing results by changing the shape and color of your teeth and even helping to compensate for uneven spacing or alignment. And both are custom-designed for your teeth. So what's the difference and which is right for you?
One distinguishing feature is the amount of tooth each covers. A veneer is a wafer-thin layer of dental porcelain that bonds to the front of your tooth. A crown, also fashioned from dental porcelain, fits over and covers the entire existing tooth, like a hood, right down to the gum. With either approach, to ensure the best, most natural fit, some of the natural tooth structure must be reduced by a minimal amount. In the case of veneers, up to 1 mm of tooth enamel — about the thinness of a fingernail — is removed. Crowns are generally thicker than veneers, so in their case the removal of at least 2 mm of tooth is needed.
Another difference between veneers and crowns is the situations in which one might be more suitable than the other to achieve the desired results. For example, a crown may be necessary when too much tooth structure has been lost to decay or other problems, or for use on back teeth that have to withstand greater impact from biting and chewing. A dental professional can make a recommendation based on your goals, the condition of the tooth or teeth in question, and other factors.
Either way, both veneers and crowns are an excellent solution for a range of esthetic concerns — from poor tooth color/staining, chips and cracks, and excessive wear at the bottom of teeth (from bruxism, a term for teeth grinding) to making small teeth look larger, closing minor gaps between teeth, and making slight corrections in alignment.
If you would like more information about veneers and crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Porcelain Veneers: Strength & Beauty As Never Before.”
For well over a century, removable dentures have been the main treatment option for patients suffering from severe or total edentulism (loss of teeth). In recent years, however, the dental implant has been recognized as the best option because it can provide patients with permanent tooth replacement, and even more so as implant technology continues to advance.
But while permanent tooth replacement using implants offer more comfort and a better fit than dentures, they are more expensive, sometimes out of the financial reach of many patients. There is, however, one alternative for the lower jaw that blends the two options for tooth replacement into one. This alternative is known as an implant overdenture.
The implant overdenture begins just as a fixed dental implant would: we surgically implant two titanium posts into the lower jaw and allow them to fuse with the bone over time (thanks to the unique way that bone interacts with titanium). But rather than next affixing a porcelain crown to the post as we would with a dental implant, we would instead fashion a denture that fits over the two posts (hence the term overdenture). The overdenture has receiver sites that connect securely with the titanium posts to hold the overdenture in place. This ensures a snug fit with no slippage — resulting in better ability for the wearer to chew food and speak — and without the continuous need for dental adhesive. And just as with traditional dentures, you can remove the overdenture for cleaning.
It might also be an optimal solution for patients with severe issues involving bone loss or compromised teeth that make it difficult for them to support either a fixed prosthesis or a traditional removable denture.
This option does have some drawbacks: since it's still a removable denture, it can still move during meals and food can sometimes get underneath it, which can be annoying. Also, overdentures for the upper jaw require more than two implants because the upper bone is less dense; thus because of a greater number of implants, an upper overdenture is more costly than a lower one.
In the end, an implant overdenture to the lower jaw might be an optimal solution for you — financially and practically — to restore function from severe or total edentulism.
If you would like more information on implant overdentures, 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 “Implant Overdentures for the Lower Jaw.”