Posts for category: Dental Procedures
All crowns are designed to restore functionality to a damaged tooth. But crowns can differ from one another in their appearance, in the material they’re made from, and how they blend with other teeth.
A crown is a metal or porcelain artifice that’s bonded permanently over a decayed or damaged tooth. Every crown process begins with preparation of the tooth so the crown will fit over it. Afterward, we make an impression of the prepared tooth digitally or with an elastic material that most often is sent to a dental laboratory to create the new crown.
It’s at this point where crown composition and design can diverge. Most of the first known crowns were made of metal (usually gold or silver), which is still a component in some crowns today. A few decades ago dental porcelain, a form of ceramic that could provide a tooth-like appearance, began to emerge as a crown material. The first types of porcelain could match a real tooth’s color or texture, but were brittle and didn’t hold up well to biting forces. Dentists developed a crown with a metal interior for strength and a fused outside layer of porcelain for appearance.
This hybrid became the crown design of choice up until the last decade. It is being overtaken, though, by all-ceramic crowns made with new forms of more durable porcelain, some strengthened with a material known as Lucite. Today, only about 40% of crowns installed annually are the metal-porcelain hybrid, while all-porcelain crowns are growing in popularity.
Of course, these newer porcelain crowns and the attention to the artistic detail they require are often more expensive than more traditional crowns. If you depend on dental insurance to help with your dental care costs, you may find your policy maximum benefit for these newer type crowns won’t cover the costs.
If you want the most affordable price and are satisfied primarily with restored function, a basic crown is still a viable choice. If, however, you would like a crown that does the most for your smile, you may want to consider one with newer, stronger porcelain and made with greater artistic detail by the dental technician. In either case, the crown you receive will restore lost function and provide some degree of improvement to the appearance of a damaged tooth.
Roughly 75% of American adults are missing at least one tooth, mostly from disease, trauma or extraction for other dental reasons. A few missing teeth, though, never erupted in the first place.
It’s a rare occurrence, but sometimes people are born without certain teeth, usually back molars or premolars that may not be as visible. Occasionally, though, it’s the more visible upper lateral incisors positioned on either side of the central incisors (the two front teeth on either side of the midline of the face).
Missing incisors can lead to poor bites and create difficulties for speech development and nutrition. But these highly visible (or in this case, “invisible”) teeth can also detract from an otherwise attractive smile.
There are ways, however to correct a smile with missing lateral incisors. Here are 3 of those ways.
Canine substitution. We can fill the vacancy created by the missing incisors by orthodontically moving the canines (the “eyeteeth,” normally next to them) into the space. Braces can close the gap in a conservative way, while possibly correcting any existing bite problems. Because canines are larger than incisors, its often necessary to re-contour them and restore them with a crown, veneer or bonding material to look more natural.
Fixed bridge. A second way to fill the space is with a dental bridge. A bridge consists of a series of crowns fused together in a row. The middle crowns replace the missing teeth; the end crowns cap the natural teeth on either end of the gap, which establishes support for the bridge. Another variation is a cantilever bridge in which only one natural tooth is capped for support. With either type, though, the capped teeth will be permanently reduced in size to accommodate the crowns.
Dental implants. This popular restoration is also a favorite for correcting missing incisors. Implants provide a life-like and durable replacement for missing teeth, while not requiring any alterations to existing teeth as with a bridge. But they are more expensive than the other options, and they require adequate space between the adjacent teeth for insertion, as well as healthy bone for proper placement and anchorage. This is also an option that must wait until the jaw has fully matured in early adulthood.
If you would like more information on treating congenitally missing 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 “When Permanent Teeth Don't Grow: Treatment Options for Congenitally Missing Lateral Incisors.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
The term “root canal” is a part of our social lexicon, and not always with a positive meaning. But contrary to its negative reputation, a root canal treatment can make all the difference in your dental health.
Here are 3 things you may not know about this important procedure.
A root canal treatment is a “tooth” saver. Decay deep inside the tooth pulp puts the entire tooth at risk. The infection not only destroys nerves and tissue in the pulp, it has a direct path to the root through tiny passageways known as root canals. By cleaning out this infected tissue, then filling the empty pulp chamber and the root canals with a special filling, the procedure stops the disease from further harm and seals the tooth from future infection. Without it, it’s highly likely the tooth will be lost and other teeth threatened by the infection.
A root canal doesn’t cause pain — it relieves it. The biggest misconception about root canal treatments is their supposed painfulness. That’s just not true, thanks to anesthetic techniques that numb the teeth and gums — and any discomfort afterward is quite manageable with mild anti-inflammatory drugs like ibuprofen. The procedure actually stops the real pain, caused by the infection damaging and finally killing the tooth’s nerves, when it stops the infection.
Root canal treatments are even more effective thanks to recent advancements. Not all infected tooth situations are the same: some teeth have smaller offset passageways called accessory canals that grow off a larger root canal that can be quite difficult to detect and access. Missing them can leave the door open for re-infection. In recent years, though, endodontists, specialists in root canal disorders, have improved the way we address these complications using advanced technologies like specialized microscopic equipment and new filling techniques. The result: a lower risk of re-infection and a higher chance of long-term success.
Hopefully, you’ll continue to enjoy good dental health and won’t need a root canal treatment. But if you do, rest assured it won’t be the unpleasant experience you might have thought — and will be a welcomed solution to pain and threatening tooth loss.
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 “A Step-By-Step Guide to Root Canal Treatment.”
You’re satisfied with your smile appearance except for one thing — your teeth aren’t as white and bright as you wish they could be. So, you’ve decided to do something about their dull yellow color.
You’re also thinking about buying a whitening product you can use yourself rather than a professional application. But you still want the answers to two questions: are home whitening kits safe? And, are they effective?
By and large the answer to the first question is yes — if you use it as directed. The whitening agents in FDA-approved products are in safe proportions to other ingredients and won’t cause any major health issues. That said, if you go beyond the instructed dosage you could damage your teeth, especially your enamel, and cause long-term problems with your dental care.
In addition, if you (or a family member) are still in your early teens, you may want to wait until you’re older. Although most permanent teeth have come in by puberty, their enamel still needs to mature. The chemicals in a whitening kit could be too strong for their under-developed enamel. It’s best to get our advice on whether your teeth are mature enough for whitening.
As to their effectiveness, home whitening kits should perform as their labeling indicates. But there are some differences in effects between a home kit and a professional application.
Although a home kit usually uses the same whitening agents (like carbamide peroxide), its strength is much lower than a professional treatment — about 10% of volume compared to around 30% in clinical solutions. This means it will take much longer to achieve the desired whitening effect that a professional application can in fewer sessions, and with less precision. In addition, home kits are only effective on surface staining of the enamel — discoloration within a tooth requires treatment by a dentist.
You can get satisfactory results from a home whitening kit. But before you make a purchase, consult with us first — we can advise you on what to look for in your purchase, as well as determine if your teeth can benefit from whitening at home.
If you would like more information on teeth whitening, 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 “Tooth Whitening Safety Tips.”