Posts for category: Dental Procedures
If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.
This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.
Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.
First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.
After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.
If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.
After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.
This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.
If you would like more information on dealing with impacted teeth, 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 “Exposing Impacted Canines.”
Porcelain veneers have been used for several decades to enhance a dental patient's smile. These thin wafers of color-matched dental porcelain are bonded to the visible surface of teeth to mask chips, disfigurements, discoloring or slight misalignments and gaps. Thanks to the artistry of dentists and dental lab technicians, the average observer often can't distinguish a veneered tooth from a natural one.
Veneers are great—but they're even more life-like and versatile thanks to recent technological advances. Here are a few of these high tech means that can help make your veneers as attractive as possible.
Digital photography. There's a lot that goes into making sure an individual's veneers seamlessly blend in with other teeth. Photographs in digital form that can be transferred electronically to dental labs are invaluable, especially for accurate color matching. A high resolution photograph can also relay an enormous amount of information about a patient's existing teeth including shape, size, length and position.
Computer imaging. We want you to be satisfied with your final veneer appearance. The best way to ensure that—and to relax any jitters you may have over the process—is to enable you to “see” your new smile before your veneers are even made. We can do that with computer imaging software that modifies a current photo of your smile to look as it will be with veneers. It's also a great tool for making changes to the veneer plan based on what you see in the model.
Tryout veneers. We can even take it a step further, by letting you see how your proposed veneers will look like on your own teeth. We do this by creating provisional veneers made of composite materials that we temporarily bond to your teeth. You can try them out for a while (and get others' impressions) until your permanent veneers are ready. And as with computer imaging, tryout veneers can guide updates to your veneer schematics before they're made.
Using these and other advanced techniques can help fine-tune the design of your new veneers to make sure they're the best they can be. They're great tools in achieving our ultimate goal with your veneers—a beautiful smile that everyone thinks is natural.
If you would like more information on the smile-transforming power of dental 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.”
You might be a bit apprehensive if your dentist recommends a root canal treatment, especially if it's your first. That's understandable: Popular culture has portrayed the root canal as an unpleasant experience.
But as a routine dental procedure, root canal treatments have been responsible for saving millions of decayed teeth. And, with local anesthesia, the procedure is painless. In fact, a root canal treatment stops pain that often results from advanced tooth decay.
So, let's take the mystery out of the root canal. Here's the 411 on this vital but often misunderstood dental procedure.
Why the name “root canal”? The terms for the procedure—root canal therapy, root canal treatment or simply “root canal”—arise from one of the principal parts of the tooth involved, root canals. These are tiny passageways that lead from the tooth's innermost layer, the pulp, to the tooth roots. While treatment often focuses on decay or diseased tissue within the pulp, the root canals can be infected too and must be included in the later filling process.
Who can perform a root canal? All general dentists are trained in basic root canal procedures. Depending on your tooth's condition, your family dentist may be able to perform it. But if your tooth has an intricate root canal network or some other complication, you may need an endodontist, a specialist in interior tooth and root treatments. Endodontists can perform advanced root canal techniques and have the specialized equipment to handle intricate cases.
What happens during a root canal? Although details may vary depending on the type of tooth and extent of decay, there's a basic process for all root canal procedures. After numbing the tooth and surrounding tissues, the dentist drills into the tooth to access the inner pulp chamber and root canals, then removes the diseased tissue and disinfects the empty chamber and canals. After preparing the canals, the dentist then fills the empty spaces. This, and subsequent sealing and crowning, protects the tooth from future decay.
After the procedure you may have some minor soreness for a few days, which is usually manageable with mild pain relievers like ibuprofen or acetaminophen. This discomfort will diminish with time, and your tooth will have a new lease on life.
If you would like more information on root canal treatment, 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.”
Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.
Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.
The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.
These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.
In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.
Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.
The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.
The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.
If you would like more information on treating jaw disorders, 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 “Botox Treatment for TMJ Pain.”
A lot of cosmetic dental procedures focus on how teeth look: whether they're stained, chipped or otherwise disfigured. But a true smile makeover requires looking beyond individual teeth appearance and asking if they're properly aligned. Your teeth may be beautiful in and of themselves, but they could detract from your smile if they're not straight.
Orthodontics—the dental specialty dedicated to correcting poor bites—can be just as important to your smile appearance as veneers, crowns or other restorations. Cosmetic enhancement, though, isn't an orthodontist's only priority: a poor bite can interfere with dental function and oral hygiene, so repairing it and making sure the teeth "bite" together correctly is just as important to your health.
Your first step is to undergo a comprehensive orthodontic exam. Its purpose is two-fold: to diagnose the nature of your particular bite problem; and to determine if your mouth is healthy enough to undergo the necessary treatment to correct it. From here, your orthodontist will propose a treatment plan to correct your particular bite problem.
Although a number of orthodontic appliances may be used, the most likely tools employed will be either fixed braces or removable clear aligners. Both of these use the mouth's natural ability to move teeth by applying subtle pressure on the teeth and supporting periodontal structures for a period of time.
While braces are effective, if you're an adult or teenager and nothing in your bite situation would preclude their use, you may choose clear aligners. Aligners are a sequence of plastic mouth trays that are computer-generated based on the patient's mouth impression. Patients wear the trays in succession, each slightly smaller than the previous one, until they complete the series.
People often prefer aligners over braces for a couple of reasons. Unlike fixed braces, you can take them out of your mouth for eating, cleaning or special occasions. And because they're clear, they're nearly invisible to others and so less embarrassing than metal braces.
Whichever method, you'll be under the supervision of a trained dentist or orthodontist who will monitor your progress and make treatment adjustments as necessary to keep you on course. It takes a lot of skill to make sure the bite fits together correctly. Remember, the plastic aligner is always between your teeth. Making sure your teeth come together is something a dentist must supervise or else it may not allow your teeth to fit together properly. In the end, you could have an entirely new smile that's healthier and more attractive—let's just make sure the bite is correct as well.
If you would like more information on gaining a straighter, more attractive 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 “The Magic of Orthodontics: The Original Smile Makeover.”