Posts for category: Dental Procedures
Along with periodontal (gum) disease, tooth decay poses one of the two greatest threats to your teeth. Cavities are just the start: if decay invades the pulp, the tooth’s innermost layer, the infection created can continue to advance through the root canals to the supporting bone. This worst case scenario could cost you your tooth.
But we can stop this advanced decay in its tracks with a procedure called a root canal treatment. A root canal essentially removes all the infected tissue within the tooth and then seals it from further infection. And contrary to its undeserved reputation for being painful, a root canal can actually stop the severe tooth pain that decay can cause.
At the beginning of the procedure, we deaden the affected tooth and surrounding tissues with local anesthesia—you’ll be awake and alert, but without pain. We then isolate the tooth with a dental dam of thin rubber or vinyl to create a sterile environment around it to minimize contamination from bacteria found in saliva and the rest of the mouth.
We then drill a small hole through the enamel and dentin to access the interior of the tooth. With special instruments, we remove and clean out all the diseased or dead tissue in the pulp chamber and root canals. After disinfecting the empty spaces with an antibacterial solution, we’ll shape the root canals to make it easier to perform the next step of placing the filling.
To fill all the root canals and pulp chamber, we typically use a rubber-like material called gutta-percha. Because it’s thermoplastic (“thermo”—heat; “plastic”—to shape), we can compress it into and against the walls of the root canals in a heated state to fully seal them. This is crucial for preventing the empty tooth interior from becoming re-infected. Afterward, we’ll seal the access hole with its own filling; later, we’ll bond a permanent crown to the tooth for additional protection and cosmetic enhancement.
After the procedure you may have some temporary minor discomfort usually manageable with aspirin or ibuprofen, but your nagging toothache will be gone. More importantly, your tooth will have a second chance—and your dental health and smile will be the better for it.
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 “A Step-By-Step Guide to Root Canal Treatment.”
Every year dentists place over 5 million dental implants for lost teeth, often removing the problem tooth and installing the implant at the same time. But getting a “tooth in a day” depends on a number of health factors, especially whether or not there’s adequate bone available for the implant. Otherwise, the implant’s placement accuracy and success could be compromised.
Bone loss can be a similar problem when a tooth has been missing for a long period of time. If this describes your situation, you may have already lost substantial bone in your jaw. To understand why, we need to know a little about bone’s growth cycle.
When bone cells reach the end of their useful life, they’re absorbed into the body by a process called resorption. New cells then form to take the older cells’ place in a continuous cycle that keeps the bone healthy and strong. Forces generated when we chew travel through the teeth to the bone and help stimulate this growth. But when a tooth is missing, the bone doesn’t receive this stimulus. As a result, the bone may not replace itself at a healthy rate and diminish over time.
In extreme cases, we may need to consider some other dental restoration other than an implant. But if the bone loss isn’t too severe, we may be able to help increase it through bone grafting. We insert safe bone grafting material prepared in a lab directly into the jaw through a minor surgical procedure. The graft then acts like a scaffold for bone cells to form and grow upon. In a few months enough new bone may have formed to support an implant.
Bone grafting can also be used if you’re having a tooth removed to preserve the bone even if you’re not yet ready to obtain an implant. By placing a bone graft immediately after extraction, it’s possible to retain the bone for up to ten years—enough time to decide on your options for permanent restoration.
Whatever your situation, it’s important that you visit us as soon as possible for a complete examination. Afterward we can assess your options and hopefully come up with a treatment strategy that will eventually include smile-transforming dental implants.
You've reached a decision—that old, unattractive smile has to go. You're ready for a complete makeover—and the field of cosmetic dentistry has the materials, techniques and equipment to make it happen.
But it could be a major undertaking requiring a fair amount of time and money. And once all the procedures are complete, what if you're not happy with the results?
Fortunately, you don't have to wait with nervous apprehension until the end of the dental work to see what your smile will look like. We can give you a realistic preview of your new smile before we even begin—and not on a computer monitor. We can actually create a trial smile applied directly to your actual teeth so you can see your new look up close and personal, and in all three spatial dimensions.
That's not to put down enhanced computer presentations. State-of-the-art imaging software can display an accurate representation of your future smile transposed onto an image of your face. But it's still a two-dimensional image, like any other photograph. It can't present the full range, movement or feel of the real thing.
A trial smile can. We shape and sculpt composite resin to resemble the finished dental work and temporarily bond it to your teeth. Once applied, you'll then be able to see what your appearance will look like from different angles and movements. Although we'll have to remove the trial smile before you leave, we can photograph it so you can show it to family and friends for their reaction.
While it's an added expense, a trial smile has two great benefits. First, it helps both of us "test drive" your new look and see how it performs in different ways: as you speak, when you're relaxed and, of course, when you smile. This allows us, if necessary, to fine-tune your planned dental work. Perhaps the biggest benefit, though, is that it can reassure you you've made the right decision to remake your smile.
With a trail smile, there are no surprises—you'll know what the end result will look like before any work is done. And that can be a great motivator toward obtaining the smile you've dreamed of having.
If you would like more information on restoring your smile, 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 “Testing Your Smile Makeover: The Reassurance of a Trial Smile.”
Root canal treatment can be an effective life preserver for a heavily decayed tooth. The question a lot of people ask, though, is how long might the tooth survive after treatment.
That’s an important concern since the treated tooth was in dire straits beforehand as decay had infected its inner most layer, the pulp. The infection, which had caused the living bundles of nerves, blood vessels and connective tissue within to become inflamed and diseased, was poised to invade even deeper through the root canals. During the root canal treatment, the infected pulp tissue is removed and the empty chamber and root canals are filled with a special filling to seal the tooth from further infection.
The protection, though, isn’t an absolute certainty: how long a treated tooth survives depends on a number of factors. For one, the earlier a diseased tooth can be initially diagnosed — especially if the infection hasn’t spread into the jawbone — the better the procedural outcome. Likewise, the chances of longevity are also better if the initial root canal treatment was thorough in identifying and filling all the root canals as well as capping the tooth with a life-like crown in a timely manner after treatment.
The type and location of the tooth can also affect its long-term health. Front teeth, with their single roots and canals are easier to access and treat. Back teeth, by contrast, can have two or more roots and a more intricate canal network. These kinds of complications could require the use of special microscopic equipment and the expertise of an endodontist, a specialist in root canals.
Even if a re-infection occurs, the tooth isn’t necessarily lost. A repeat root canal treatment that addresses these and other issues, could give the tooth a “third” chance. In any case, if a tooth is worth saving attempting a root canal treatment is generally preferable to losing the tooth and replacing it with a prosthetic tooth — it’s well worth the try.
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: How Long Will it Last.”
With exciting innovations in cosmetic dentistry over the last few decades, we can now transform nearly any unattractive smile. One of the best and most cost-effective of these is the porcelain veneer. These thin layers of dental porcelain are bonded over the front of chipped, slightly misaligned or stained teeth to create an entirely new look.
Veneers have evolved over time, especially with the materials they contain that give them their beauty and life-likeness. The first veneers were made mainly of feldspathic porcelain, a mineral composition known for its similarity in color and translucence to natural teeth.
But because this early porcelain had a high amount of silica (in essence, glass), and because they were created through overlaying several thin layers that weren’t as strong as a single piece, they were prone to shattering. This made them problematic for teeth subject to heavy biting forces or patients with clenching or grinding habits.
The situation changed dramatically in the 1990s, when dental labs began adding Leucite, a sturdier glass-like mineral that didn’t diminish the porcelain’s translucence. Not only did Leucite make veneers more shatter-resistant, it also enabled dental technicians to fashion most of the veneer in one piece to further strengthen it.
More recent veneers may now incorporate an even stronger material called lithium disilicate. Because lithium disilicate has twice the strength of Leucite, veneers made with it can be as thin as 0.3 millimeters. Not only does this blend together the most desirable qualities expected of a veneer—strength, aesthetic appeal and easy fabrication—it allows for a broader range of situations and uses.
Both of these materials can be pressed or milled to assume the exact shape necessary to fit a particular tooth. The manufacturing process also allows for creating smaller veneers that can then be overlaid with porcelain for the most life-like appearance possible.
Thanks to these stronger materials enhancing the natural beauty of porcelain, we now have a wider creative palate for transforming your smile.
If you would like more information on porcelain 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: Your Smile—Better Than Ever.”