Porcelain veneers are one of the best ways to transform your teeth’s appearance with only a small amount of tooth preparation. But even that small amount could leave a veneered tooth permanently altered.
As the name implies, veneers are thin layers of custom-designed porcelain bonded to the outside of a tooth to cover defects. They’re usually ideal for minor chipping, staining or even slight tooth misalignments. But although they’re thin—often just a millimeter or so in thickness—they can still make a tooth appear or feel bulky.
To reduce this extra width, we usually need to remove some of the tooth’s surface enamel. Since enamel doesn’t replenish itself, this alteration could mean the tooth will require a restoration from then on.
But now, you may be able to take advantage of new advances in this popular restoration: No-Prep or Minimal Prep veneers that involve little to no tooth alteration. In most cases they’re simply bonded to the teeth with only slight enamel reshaping.
Because of their ultra-thinness, No-Prep veneers (usually between 0.3 to 0.5 mm, as thin as a contact lens) are bonded directly to teeth that are practically untouched beforehand. A Minimal Prep veneer usually requires only enamel reshaping with an abrasive tool before it’s placed. And unlike traditional veneers, they can often be removed if needed to return the teeth to their original form without another restoration.
These new veneers are best for people with small teeth, often from wear due to teeth grinding, narrow smiles (the side teeth aren’t visible while smiling), or slightly misshapen teeth like underdeveloped teeth that can appear peg-shaped. But people with oversized teeth, some malocclusions (bad bites) or similar dental situations may still require enamel removal to avoid bulkiness even with ultra-thin veneers.
If you don’t have those kinds of issues and your teeth are reasonably healthy, we can apply No-Prep or Minimal Prep veneers in as few as two appointments. The result could be life-changing as you gain a new smile you’re more than happy to share.
If you would like more information on no-prep veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “No-Prep Porcelain Veneers.”
“You need a root canal,” isn’t something you want to hear during a dental visit. But whatever your preconceptions about it may be, the fact is root canal treatments don’t cause pain — they alleviate it. What’s more, it may be your best chance to save a tooth that’s at high risk for loss.
First of all, root canal treatments address a serious problem that may be occurring inside a tooth — tooth decay that’s infiltrated the pulp chamber. If it’s not stopped, the decay will continue to advance through the root canals to the bone and weaken the tooth’s attachment. To access the pulp and root canals we first administer a local anesthesia and then create an opening in the tooth, typically in the biting surface.
After accessing the pulp chamber, we then remove all the pulp tissue and clean out any infection. Â We then fill the empty pulp chamber and root canals with a special filling and seal the opening we first created. The procedure is often followed some weeks later with a laboratory made crown that permanently covers the tooth for extra protection against another occurrence of decay and protects the tooth from fracturing years later.
Besides stopping the infection from continuing beyond the roots and saving the tooth from loss, root canal treatments also alleviate the symptoms caused by decay, including tenderness and swelling of surrounding gum tissue and sensitivity to hot and cold foods or pressure when biting down. And, it reduces pain — the dull ache or sometimes acute pain from the tooth that may have brought you to our office in the first place.
General dentists commonly perform root canal treatments; in more complicated cases they’re performed by an endodontist, a specialist in root canal treatments. Afterward, any discomfort is usually managed with non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen or aspirin.
Root canal treatments are a common procedure with a high rate of success. Undergoing one will end the pain and discomfort your infected tooth has caused you; more importantly, your tooth will gain a new lease on life.
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 “Common Concerns about Root Canal Treatment.”
If you’ve had issues with periodontal (gum) disease, no doubt a few things have changed for you. You may be seeing us for dental cleanings and checkups more frequently and you have to be extra diligent about your daily brushing and flossing.
There’s one other thing you may need to do: change your diet. Some of the foods you may be eating could work against you in your fight against gum disease. At the same time, increasing your intake of certain foods could boost your overall oral health.
The biggest culprits in the first category are carbohydrates, which make up almost half the average diet in the Western world, mainly as added sugar. Although carbohydrates help fuel the body, too much can increase inflammation—which also happens to be a primary cause of tissue damage related to gum disease.
Of course, we can’t paint too broad a brush because not all carbohydrates have the same effect on the body. Carbohydrates like sugar or processed items like bakery goods, white rice or mashed potatoes quickly convert to glucose (the actual sugar used by the body for energy) in the bloodstream and increase insulin levels, which can then lead to chronic inflammation. Complex or unprocessed carbohydrates like vegetables, nuts or whole grains take longer to digest and so convert to glucose slowly—a process which can actually hinder inflammation.
Eating less of the higher glycemic (the rate of glucose conversion entering the bloodstream) carbohydrates and more low glycemic foods will help reduce inflammation. And that’s good news for your gums. You should also add foods rich in vitamins C and D (cheese and other dairy products, for instance) and antioxidants to further protect your oral health.
Studies have shown that changing to a low-carbohydrate, anti-inflammatory diet can significantly reduce chronic inflammation in the body and improve gum health. Coupled with your other efforts at prevention, a better diet can go a long way in keeping gum disease at bay.
If you would like more information on the role of diet in 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 “Carbohydrates Linked to Gum Disease.”
Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.
We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.
While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.
Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.
Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.
But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.
These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.
If you would like more information on the best treatment choices for your 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 “Save a Tooth or Get an Implant?”
As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
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