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.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
Every day the forces you generate when you bite or chew can exert enormous pressure on your teeth. And day after day your teeth remain stable and secure, thanks to an intricate system of periodontal ligaments, attaching gum tissue and bone. The latter element is especially important — healthy bone makes healthy teeth.
And vice-versa — the same biting forces are transmitted through the tooth root to the bone via the periodontal ligament to stimulate new bone growth to replace older bone that has dissolved (resorbed). If a tooth’s missing, however, the bone doesn’t receive that stimulation, and the resorbed bone isn’t replaced at a healthy rate. In fact, you can lose up to a quarter of bone width in the first year alone after tooth loss.
And this can cause a problem when you’re looking to replace that missing tooth with what’s considered the best restorative option available: dental implants. Known for their life-likeness and durability, implants nonetheless need sufficient bone to anchor properly for the best outcome. Without it, implants simply aren’t practical.
But that doesn’t have to be the end of the story: it’s quite possible to regenerate enough bone to support implants through bone grafting. Bone material from the patient (or another donor, human, animal or synthetic) is placed under the gum at the missing tooth site to serve as a scaffold for new growth. The new bone growth will eventually replace the graft material.
The size of the graft and extent of the procedure depends of course on the amount of bone loss at the site. Loss can be kept to a minimum, though, if the graft is placed immediately after a tooth extraction, a common practice now. After a few months, the bone created through the graft is sufficient for supporting an implant and gives you the best chance for a beautiful outcome.
If you’re considering an implant for a missing tooth, you should schedule a consultation appointment with us as soon as possible. After a thorough dental exam, we’ll be able to tell you if bone grafting to support implants is a good idea for you. It adds a little more time to the overall implant process, but the results — a new, more attractive smile — will be well worth it.
If you would like more information on bone regeneration, 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 “Can Dentists Rebuild Bone?”
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
For decades, dental x-rays have helped us accurately diagnose and treat a wide array of dental diseases and conditions. But even with recent advances in digital imaging, the traditional x-ray does have one drawback: its two-dimensional view doesn’t always provide the “big picture” that a three-dimensional viewpoint can provide.
But a new type of x-ray technology can do just that: known as cone beam computed tomography (CBCT), these machines record hundreds of digital images as a cone-shaped beam of x-ray energy is projected through a device that rotates around a person’s head. A computer then assembles the images into a single three-dimensional image that can be manipulated on screen to view from various angles. Not only does this provide greater context and detail, it does so with no more radiation exposure than a standard 20-film digital full-mouth x-ray series.
While CBCT hasn’t replaced the traditional x-ray, it’s making its mark in a number of specialized areas of dentistry. The following are just a few of the ways CBCT is improving both accuracy and treatment outcomes.
Orthodontics. CBCT can provide a much more detailed view of the entire jaw; this can help us determine the best locations for realigning teeth safely and effectively.
Dental Implants. With a CBCT scan we can precisely locate nerve canals, sinuses and adjacent teeth before implant surgery to locate the best position for the implant.
TMD Treatment. To help develop the best treatment approach for alleviating the pain and dysfunction of temporo-mandibular joint disease (TMD), a CBCT scan can provide us detailed information on how the disease is affecting a patient’s joints, teeth, sinuses and airway.
Impactions. An impacted tooth can exert damaging pressure against the roots of neighboring teeth. A CBCT scan allows us to observe the impacted tooth from various vantage points to determine the best treatment approach for neighboring teeth, nerve canals and sinuses.
If you would like more information on CBCT technology, 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 “Getting the Full Picture With Cone Beam Dental Scans.”