When planning for your new smile, we look at more than the condition of individual teeth. We also step back for the bigger “bite” picture: how do the teeth look and interact with each other?
If we have a normal bite, our teeth are aligned symmetrically with each other. This not only looks aesthetically pleasing with the rest of the face, it also contributes to good function when we chew food. A bad bite (malocclusion) disrupts this mouth-to-face symmetry, impairs chewing and makes hygiene and disease prevention much more difficult.
That's where orthodontics, the dental specialty for moving teeth, can work wonders. With today's advanced techniques, we can correct even the most complex malocclusions — and at any age. Even if your teen years are well behind you, repairing a bad bite can improve both your smile and your dental health.
The most common approach, of course, is braces. They consist of metal or plastic brackets bonded to the outside face of the teeth with a thin metal wire laced through them. The wire attaches to an anchorage point, the back teeth or one created with other appliances, and placed under tension or pressure. The gradual increasing of tension or pressure on the teeth will move them over time.
Â Braces are versatile and quite effective, but they can be restrictive and highly noticeable. Many people, especially older adults, feel embarrassed to wear them. There is an alternative: clear aligners. These are a series of clear, plastic trays that you wear in sequence, a couple of weeks for each tray. When you change to the next tray in the series, it will be slightly different than its predecessor. As the trays change shape guided by computer-enhanced modeling, the teeth gradually move.
If you're interested in having a poor bite corrected, the first step is a comprehensive orthodontic examination. This looks closely at not only teeth position, but also jaw function and overall oral and general health.
With that we can help you decide if orthodontics is right for you. If so, we'll formulate a treatment plan that can transform your smile and boost your dental health.
If you would like more information on the cosmetic and health benefits of orthodontics, 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 “The Magic of Orthodontics.”
While the imagination is one of our most powerful mental abilities, many people still find it difficult to “see” in their minds a future dramatically different from the present. That could be the case with a “smile makeover”—it’s not easy to imagine how proposed changes to your teeth and gums can affect your entire look.
Computer imaging software has helped in this regard. Starting with a photo of your current smile, we can manipulate it with imaging software to show you what any proposed dental work might look like after completion. But imaging technology has its limits: you’re viewing a static, two-dimensional image that can’t really show you how your new smile looks as your mouth and face move in a three-dimensional space.
There is another way, and although it may add to your treatment costs it can give you an even more realistic view of your future appearance. Known simply as a “trial smile,” it’s a procedure in which we temporarily place life-like bonding material called composite resin on your current teeth. We shape, cure and sculpt the resin to produce a three-dimensional model of what your future smile will look like.
A trial smile gives you a chance to experience in real time how this future smile looks and feels as you smile or talk. And although we’ll have to remove it before you leave, we can photograph your new look for you to show to family and friends later for their reaction.
There are a couple of important reasons to have a trial smile. First, it gives us both a chance to review how the proposed changes may enhance your appearance, and whether we need to alter those plans in any way. It’s a kind of dress rehearsal where we can improve the “script” before the actual performance.
Just as important, a trial smile can help reassure you about what to expect from the outcome. You’ll have a fairly accurate idea of how you’ll look, which will help reduce any apprehensions you might have.
If you’d like to include a trial smile in your treatment plan, please feel free to discuss it with us. It can be money well spent to ensure you’ll be satisfied and delighted with your new smile.
If you would like more information on ways to restore 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.”
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.”
Nothing grabs your attention like a sharp tooth pain, seemingly hitting you out of nowhere while you’re eating or drinking. But there is a reason for your sudden agony and the sooner you find it out, the better the outcome for your oral health.
To understand tooth sensitivity, we need to first look at the three layers of tooth anatomy. In the center is the pulp filled with blood vessels and nerve bundles: it’s completely covered by the next layer dentin, a soft tissue filled with microscopic tubules that transmit sensations like pressure or temperature to the pulp nerves.
The third layer is enamel, which completely covers the crown, the visible part of a tooth. Enamel protects the two innermost tooth layers from disease and also helps muffle sensations so the tooth’s nerves aren’t overwhelmed. The enamel stops at about the gum line; below it the gums provide similar protection and sensation shielding to the dentin of the tooth roots.
Problems occur, though, when the dentin below the gums becomes exposed, most commonly because of periodontal (gum) disease. This bacterial infection caused by dental plaque triggers inflammation, which over time can weaken gum tissues and cause them to detach and shrink back (or recede) from the teeth. This can leave the root area vulnerable to disease and the full brunt of environmental sensations that then travel to the nerves in the pulp.
Tooth decay can also create conditions that cause sensitivity. Decay begins when certain oral bacteria multiply and produce higher than normal levels of acid. The acid in turn dissolves the enamel’s mineral content to create holes (cavities) that expose the dentin. Not treated, the infection can eventually invade the pulp, putting the tooth in danger of being lost unless a root canal treatment is performed to remove the infection and seal the tooth from further infection.
So, if you begin experiencing a jolt of pain while eating or drinking hot or cold foods or beverages, see your dentist as soon as possible to diagnose and treat the underlying cause. And protect your teeth from dental disease by practicing daily brushing and flossing, as well as seeing your dentist for regular dental cleanings and checkups. Don’t ignore those sharp pains—your teeth may be trying to tell you something.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
Gastroesophageal reflux disease (GERD) is a digestive disorder that can lead to a number of serious health problems. One of them, tooth erosion, could ruin your dental health.
Your stomach uses strong acids to break down food during digestion. A ring of muscle just above the stomach called the esophageal sphincter works as a one-way valve to allow food contents into the stomach but prevent acid from traveling back up through the esophagus.
GERD occurs when the esophageal sphincter weakens and starts allowing acid into the esophagus and potentially the mouth. The acid wash can eventually damage the esophageal lining, causing pain, heartburn, ulcers or even pre-cancerous cells.
Acid coming up in the mouth can cause the mouth’s normally neutral pH to slide into the acidic range. Eventually, these high acid levels soften and erode tooth enamel, increasing the risk of decay and tooth loss.
Accelerated erosion is often a sign of GERD—in fact, dentists may sound the first warning that a patient has a gastrointestinal problem. Unfortunately, a lot of damage could have already occurred, so it’s important to take steps to protect your teeth.
If you’ve been diagnosed with GERD, be sure to maintain good oral hygiene practices like brushing or flossing, especially using fluoride toothpaste to strengthen enamel. But try not to brush right after you eat or during a GERD episode: your teeth can be in a softened condition and you may actually brush away tiny particles of mineral. Instead, wait about an hour after eating or after symptoms die down.
In the meantime, try to stimulate saliva production for better acid neutralization by chewing xylitol gum or using a saliva booster. You can also lower mouth acid by rinsing with a cup of water with a half teaspoon of baking soda dissolved in or chewing on an antacid tablet.
You can also minimize GERD symptoms with medication, as well as avoiding alcohol, caffeine or spicy and acidic foods. Try eating smaller meals, finishing at least three hours before bedtime, and avoid lying down immediately after eating. Quitting smoking and losing weight may also minimize GERD symptoms.
GERD definitely has the potential to harm your teeth. But keeping the condition under control will minimize that threat and benefit your health overall.
If you would like more information on the effects of GERD on dental health, 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 “GERD and Oral Health.”
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