Posts for category: Dental Procedures
Modern dental care wouldn’t be the same without x-rays. Since dentists began capturing x-ray images a century ago to detect beginning tooth decay, billions of teeth have been preserved.
“Catching it early” is the key to staying ahead of this aggressive bacterial infection. Once it breaks through the protective defenses of tooth enamel, it can advance toward the center of the tooth, the pulp, damaging dentin as it goes. While we can effectively stop it at this point with a root canal treatment, it’s better for the tooth’s long-term health to detect and treat any decay early on with a less-invasive filling or other treatment method.
X-ray imaging helps make that possible, revealing decay much easier than we can see with the unaided eye. And while we can often detect decay in front teeth by visual examination or by using very bright lighting, that’s not as easy with the less accessible back teeth. For those teeth we use a special x-ray technique known as the bitewing.
The name comes from the small frame used to hold the film. It’s held in place in the mouth by the patient biting down on small tabs or “wings” extending from the frame. The x-ray beam travels through the outer cheek and teeth to the film being held in the frame on the back side of the teeth. When exposed, we’ll be able to view the interior of these back teeth: a set of four bitewings gives us a full view of all the upper and lower molars and pre-molars on each side of the jaws.
Like other forms of radiation energy, too much or too frequent exposures to x-rays can lead to serious health problems. But bitewing x-rays carry little risk to health. That’s because they fit well with the ALARA principle, meaning “As Low As Reasonably Achievable,” which helps guide our use of x-rays. Patients receive a fraction of the radiation exposure from routine bitewing x-rays than they receive annually from the natural environment.
Without bitewing x-rays and other diagnostic methods, the chances are high that tooth decay or other dental problems can go undetected in their early stages. Using this important tool can help us head off major damage before it occurs.
If you would like more information on the role of x-rays in dental care, 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 “Bitewing X-Rays: A Routine Part of Your Dental Exam.”
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
The dental implant is the closest thing in modern dentistry to a natural tooth. This is because an implant replaces more than the visible crown — it also replaces the root, thanks to a metal post imbedded in the bone.
But what if you have a metal allergy — are you out of luck replacing a tooth with an implant? Before answering this question, let's take a closer look at metal allergies.
An allergy is an overreaction of the body's immune system to a particular foreign substance. This response can be as inconsequential as a minor rash or as life-threatening as a shutdown of the body's organ systems. You can be allergic to anything, including metals.
Usually, these allergies are to specific kinds of metals. For example, about 17% of women and 3% of men are allergic to nickel, while smaller percentages are allergic to cobalt or chromium. Most allergic reactions to metal occur from external contact with jewelry or similar metal items that create rashes or other anomalies on the skin. On a more serious note, an allergy to metal in a body replacement part could result in the body rejecting it.
Metals have also played an important role in dental care, particularly dental amalgam used for tooth fillings. Dental amalgam is a mixture of a precious metal like gold or silver with other metals like copper, tin and, in small amounts, mercury. While dental amalgam has been used safely for decades, there have been rare cases of inflammation or rashes.
This brings us to dental implants and the most common metal used in them, titanium. The commercial version of this metal is highly prized in medical and dental applications because it has a special affinity with bone. Bone cells readily grow and adhere to the metal, which strengthens the bond between the implant and the jawbone.
Even if you have a rare allergy to certain metals, it's even rarer that would include titanium. In one particular study of 1,500 implant patients less than 1% reported any reaction at all.
If you're concerned, you can undergo testing to see if you react to titanium. More than likely, though, you'll be able to join the millions of other patients who have successfully restored their smiles with dental implants.
If you would like more information on dental implants as a tooth replacement option, 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 “Metal Allergies to Dental implants.”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
Today’s crowns, the visible part of a tooth replacement system, can effectively mimic the shape and color of natural teeth. But not all crowns are equal — so it’s best to be well-informed before you undergo a restoration on your natural teeth such as a single crown or bridgework — or if you need a crown on a dental implant that replaces a missing tooth.
To give you a starting point, here are 3 things to keep in mind about crowns as you consider a dental restoration.
Material composition. Most crowns in years past were made of a precious metal, most notably gold. What it lacked in appearance, it made up for in performance and durability. In recent years, dental porcelain has become the popular choice because of its ability to mimic the appearance and translucent color of natural teeth. Today’s porcelains are much stronger and are used more frequently for back teeth than in years past. A common recommendation for back teeth is a hybrid crown using metal and porcelain. Metal is incorporated beneath the porcelain in this type of crown to create a strong foundation and is also used along biting surfaces for strength. Porcelain is used in the more visible areas for esthetics.
The dental technician’s level of artistry. Most dentists sub-contract crown fabrication to dental laboratory technicians who may have varying levels of experience and artistic ability. A highly skilled technician can produce a crown that blends seamlessly with the patient’s remaining natural teeth.
Take a “test drive” of your future smile. Although we as dentists adhere to certain aesthetic principles, beauty is ultimately subjective — “in the eye of the beholder.” The final product must meet your expectations and level of comfort. If available, then, consider wearing temporary “trial smile” crowns as a preview of your new smile while your permanent set is under construction. This allows you to “try out” your future smile ahead of time, so you can make recommendations and sign off on the final set before it’s finished.
Undertaking any dental restoration is an important life step, both for your health and appearance. Being well-informed — especially about the crowns that you and others will see — will help you make wise choices that lead to a satisfying outcome.