Posts for category: Dental Procedures
Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.
Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.
Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.
Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.
While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.
That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.
Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.
With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.
The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.
If you would like more information about tooth straightening, please contact us or schedule a consultation.
We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.
Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.
That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.
Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.
Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:
- Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
- Reinsert the root end into the empty socket with firm pressure;
- Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
- Seek dental or emergency medical care immediately;
- If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.
You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.
If you would like more information on what to do in a dental emergency, 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 a Tooth is Knocked Out.”
If you're one of the more than 26 million people in the U.S. with diabetes, you know first hand how the disease impacts your life. That includes your dental health — and whether or not implants are a good tooth replacement option for you.
Diabetes is actually the name for a group of diseases affecting how your body processes glucose, a simple sugar that provides energy for the body's cells. The level of glucose in the blood is regulated by insulin, a hormone produced in the pancreas. Diabetes causes the pancreas to either stop producing insulin (Type 1) or not produce enough (Type 2). Also in Type 2, the body can become unresponsive to the insulin produced.
The implications for either type are serious and can be life-threatening. If glucose levels are chronically too low or high the patient could eventually go blind, suffer nerve damage, or develop kidney disease. Diabetes also interferes with wound healing and creates a greater susceptibility for gangrene: diabetics thus have a higher risk for losing fingers, toes and limbs, and can even succumb to coma or death.
Type 2 is the most common form of diabetes. Fortunately, most people with this type can effectively manage it through diet, exercise and regular glucose monitoring; if need be, prescription medication can help regulate their levels. Even so, diabetics with their disease under control must still be alert to slower wound healing and a higher risk of infection.
Because implant placement is a minor surgical procedure, the aspects of diabetes related to healing, infection and inflammation could have an adverse impact on the ultimate success of the placement. Implant surgery creates a wound in the surrounding gum tissues and bone that will need to heal; the body's immune response in a diabetic can interfere with that process. And if infection sets in, the risks of implant failure increase.
But research has shown that diabetics with good glucose management have as high a success rate (over 95% after ten years) as non-diabetic patients. That means the implant option is a viable one for you as a diabetic — but only if you have your disease under control.
You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.
The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.
But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.
Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.
His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.
One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.
In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.
Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.
If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”
We always look forward to seeing our patients, but not all of you look forward to seeing us! If you’re one of them, don’t worry — we don’t take it personally. Dental anxiety prevents many people from seeking the care they require to restore or maintain a healthy smile.
But if dental problems are allowed to progress, they can affect not only the beauty of your smile and health of your mouth, but your overall wellness, too. Infection can travel from the mouth to other areas of the body, and dental disease exacerbates chronic health conditions like heart disease or diabetes.
Fear should never be an obstacle (in the immortal words of President Franklin Roosevelt, “…the only thing we have to fear is fear itself…”). And fortunately there are some safe options for those of us who can’t get past our anxiety when it comes to dental care:
Oral Sedation. A sedative medication can be prescribed that you take by mouth approximately an hour before your dental visit to minimize anxiety and promote relaxation.
Intravenous (IV; “intra” – inside, “venous” – vein) Sedation. If oral sedation isn’t entirely effective in facilitating treatment, then a medication combining a sedative for relaxation and a pain-blocking anesthetic can be delivered through or small needle or catheter that is gently inserted into a vein. This is referred to as “conscious sedation” because you are in a semi-awake state during which you are able to respond to verbal direction. It takes effect quickly, and you can come out of it quickly. However, you may not remember much about your procedure. It is very different from general anesthesia during which you are completely unconscious.
Dentists who offer IV sedation receive extensive training after which we must pass an exam and apply for a special permit that we maintain through continuing education. We carefully screen patients for eligibility and monitor you throughout so you can rest easy before, during, and after your procedure.
If you would like more information about sedation in dental care, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “Oral Sedation Dentistry.”