When you or a family member takes a traumatic hit to the mouth, what should you do? Besides immediate first aid, your next action will depend on the extent of damage to any teeth. What you do and when you do it may even determine whether an injured tooth is eventually saved or lost.
If a tooth has been completely knocked out, you have about five minutes to replace the tooth in the socket to give it the best chance of reattachment and long-term survival. While we can certainly perform this action in our office, getting to us within five minutes may not be possible. Fortunately, any person can perform this action on site (see the article linked below for basic instructions on replantation). If for some that's not possible, you should control bleeding at the tooth site with direct pressure, place the recovered tooth in milk or the patient's saliva, and see us as soon as possible.
If, however, the injured tooth has been obviously knocked out of line but not completely detached from its socket, you have a small cushion of time to seek dental treatment — but not much. For this degree of injury, you should see us within six hours of the incident. We will be able to determine the exact nature of the injury, and treat the condition by moving the teeth back into proper position and splinting them.
You have up to twelve hours for broken or chipped teeth still in their normal position. Try to locate and save any broken-off fragments — it may be possible to re-bond them to the teeth. Although it may not be as urgent as other situations, you should still seek treatment as soon as possible. A broken tooth could leave the inner pulp exposed — a situation that left untreated could lead to eventual tooth loss.
Traumatic injuries to the mouth can have serious consequences for your long-term dental health. With our consultation and treatment efforts, we can help you save an injured tooth.
If you would like more information on caring for dental injuries, 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 Field-Side Guide to Dental Injuries.”
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.”
Diabetes and periodontal (gum) disease are two types of inflammatory conditions that have more in common than was once thought. There is strong evidence to show that each of these diseases is a risk factor for the development and growth of the other. Studies have also found that treating one condition successfully may have a positive impact on the treatment of the other.
From the Greek meaning “to pass through the urine,” diabetes mellitus causes an abnormal rise in blood glucose level that can't be adequately controlled by insulin, the body's primary hormone for that task. Either the pancreas can't produce an adequate supply of insulin (as with Type 1 diabetes) or there is resistance to the hormone's effects (as with Type 2 and gestational/pregnancy diabetes). If you are a diabetic patient, you face many difficult issues with your health: your body develops an altered response to inflammation that may severely inhibit wound healing. You also may become more prone to chronic cardiovascular disease.
Periodontal (gum) disease describes a group of diseases caused by dental plaque, a whitish film that contains infection-causing bacteria. As infection rises within the gum tissues, the auto-immune system of the body responds to this threat and inflammation results. If the person is also a diabetic, this response may be impaired and may have a direct effect on how severe the periodontal disease progresses.
Periodontal disease can also affect your blood glucose level, if you are a diabetic. A number of studies have demonstrated that diabetic patients who have improved control of their periodontal disease through better oral hygiene and dental treatments have shown improvement in their blood sugar levels. There's even some evidence that effective periodontal treatment that reduces inflammation may improve the body's sensitivity to insulin. Likewise, bringing diabetes under control with supplemental insulin or positive lifestyle changes can help lessen the likelihood and severity of periodontal disease.
To sum it up, if you have been diagnosed with some form of diabetes, taking care of your teeth and gum tissues can have a positive impact on your diabetes. Likewise, making healthy changes in your lifestyle to bring your diabetes under control can reduce your risk for periodontal disease.
If you would like more information about periodontal disease and its effect along with diabetes, 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 “Diabetes and Periodontal Disease.”
You're planning for one of the most important days in your life — your wedding — and you want everything to be perfect. You've chosen the outfits, the setting, the flowers... but there's one more thing to think about. Is your smile just as bright as your hopes for the future? Do you wish you could improve its appearance in time for the big date?
Here's good news: You can! Depending on how much advance notice you have — and what level of enhancement you need — your wedding day smile makeover can range from a thorough dental cleaning to a full-scale orthodontic treatment program. Let's look at a few options that can help you look and feel your best on this very special day.
Getting your teeth thoroughly, professionally cleaned can help remove some surface stains and tartar in just one appointment! Depending on the level of discoloration, and how long it's been since your last cleaning, more than one session may be needed. You have this basic and effective treatment done every three to six months anyway — right? So, be sure and schedule one before your wedding!
Sometimes your smile needs more than just routine maintenance. If that's the case, there are many other options to help it look its best. Tooth whitening is a safe, effective and economical way to lighten teeth by several shades. In-office treatments are quicker and more predictable, but dentist-supervised at-home bleaching kits are also an option if you have more time.
Porcelain veneers offer a more striking and more permanent solution for discolored teeth. To get the optimum “wow” effect from this treatment, figure from two to four office visits, and a total treatment time of at least three months.
Cosmetic bonding is a great way to hide those little chips in the front teeth, or discolored old fillings in back. Using the newest high-tech materials and a dose of old-fashioned artistry, we can restore the shiny, translucent look of your natural teeth — only with fewer imperfections. After a thorough evaluation, cosmetic bonding can often be performed as a one-visit procedure.
If your smile needs even more help, don't despair — there are still plenty of ways to improve it.
Teeth that are damaged or missing can be restored by crowns or bridgework. When the roots are intact, a crown replaces the visible part of the tooth above the gum line. If the tooth is missing, a bridge is used to secure a false tooth to two abutments on either side. Properly done, these restorations may last a decade or more, and generally require two or more visits.
Dental implants are a great way to restore missing teeth. They offer a permanent, natural-looking tooth replacement with numerous advantages over other restorative treatments. Achieving these results requires careful planning and takes a bit more time. If you need tooth restoration, be sure to ask us whether dental implants might be right for you.
If you would like more information about a wedding-day smile makeover, don't hesitate to contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.