Posts for category: Dental Procedures
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
Applying braces or clear aligners to move misaligned teeth is only part of an orthodontist's overall mission to eliminate poor bites (malocclusions). Sometimes a malocclusion isn't caused by the teeth at all—the size of the jaw is the problem!
One type in particular, a cross-bite, often happens because the upper jaw has developed too narrowly. As a result, many of the upper teeth fit inside the lower, the opposite of normal. But a tool called a palatal expander can alleviate the problem if it's applied at an early enough age.
The device works because the upper jawbone initially forms as two halves that fit together along a center line in the roof of the mouth (the palate) running from the back of the mouth to the front. These two bone halves remain separate during childhood to facilitate jaw growth, but eventually fuse around puberty.
Consisting of two sets of wire arms joined together by a hinge mechanism in the middle, the expander device is positioned up against the palate. The orthodontist extends each arm to press against the inside of the back teeth, then adds more outward pressure by turning the mechanism in the middle with a small key. During wear, the patient or caregiver will turn the mechanism in the same way to keep up the pressure on the two sides of the jaw.
This continual pressure keeps the two bones moving away from each other and maintaining a center gap between them. In response, more bone forms on the two halves to fill the gap. In time, the newly formed bone should widen the jaw enough to correct any developing malocclusion.
Timing is everything with a palatal expander—if not used before the jaw bones fuse, the patient will need a surgical procedure to separate the bones to pursue treatment. To catch the problem early enough, children should have an orthodontic evaluation on or before they turn six. An orthodontist may be able to identify this or other emerging bite problems and intervene before it becomes worse. Taking this approach can help save you and your child more expensive orthodontic treatment down the road.
If you would like more information on correcting poor bites, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”
Teenagers and adults alike can improve their smile appearance with dental solutions like teeth whitening or orthodontics. But there are a few cosmetic solutions like porcelain veneers that are better suited for more mature teeth.
Veneers are composed of thin layers of dental porcelain that are bonded to the outside of teeth. They're kind of a tooth "mask" that hides blemishes like chips, discoloration or mild bite problems. They're often less involved and expensive than other types of dental restoration.
Even so, we usually need to remove some of the natural tooth's enamel before applying them. Veneers placed directly on unprepared teeth can appear bulky, so we remove some of the enamel to create a more natural look. And although usually only a slight amount, the alteration is permanent and will require the tooth to have some form of restoration from then on.
This usually doesn't pose a major issue for adults, but it could for a teenager's younger teeth. The nerve-filled dentin in a teenager's still developing tooth is thinner and closer to the pulp (nerve tissue) than in more mature teeth.
There's at least one situation, though, where veneers might be applied safely to a teenager's teeth without this concern. If the teen has abnormally small teeth and are receiving veneers to improve their appearance, they might not need alteration. Because the teeth are already thinner than normal, the "no-prep" veneers may not look bulky when directly bonded to them without preparation.
With most cases, though, it might be best to pursue other options that at the very least can make a cosmetic difference until their teeth are mature enough for veneers. For example, we might be able to repair chipped areas with composite resin material that we form and bond to the tooth to achieve a life-like appearance.
We can discuss these and other options for safely improving your teenager's smile. The important thing is to achieve a more confident appearance without endangering their future health.
If you would like more information on cosmetic treatments for teenagers, 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 “Veneers for Teenagers.”
A beautiful smile is a balanced smile, especially in regard to your gums. A normal smile usually shows 4 mm or less of gum tissue along with about 10 mm of tooth length. But if your gums show more than that, your smile may seem too gummy. In terms of perceived balance, this could detract from your smile's attractiveness.
Fortunately, you don't have to live with a gummy smile—there are various ways to correct or minimize its effect. First, though, we'll need to determine the underlying cause before deciding on the best treatment. And, there are several possible causes, the obvious being too much gum tissue present. Teeth that appear shorter due to wear or incomplete eruption could also make the gums appear larger.
We may be able to correct these size problems by surgically removing and reshaping excess gum tissues and possibly the underlying bone to reveal more of the teeth. We can also bond composite resins or porcelain veneers to shorter teeth to make them appear larger.
But not all gummy smile problems pertain directly to the teeth and gums; instead, it could be your upper lip moves too far up as you smile (hypermobility). Or, your upper jaw may be too long for your face, which can also cause too much of the gums to show during smiling.
With upper lip hypermobility, we may be able to inhibit the lip muscles' movement temporarily with Botox injections that partially paralyze the muscles (the effect eventually wears off, so this treatment will need to be repeated). A periodontist, an oral surgeon, or a plastic surgeon could also permanently alter the upper lip movement through a surgical procedure. Surgery may also be necessary for an abnormally long upper jaw: orthognathic surgery re-positions the jaw to the skull, which can lessen the amount of gums showing.
If your smile is too gummy, we can transform it. But first, let's find out what the real cause is with a comprehensive dental examination. Once we know, we can better advise you on the best way to bring beautiful balance to your smile.
If you would like more information on improving a gummy 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 “Gummy Smiles.”
While children are less likely than adults to experience periodontal (gum) disease, the same can't be said for tooth decay. One aggressive form of decay called early childhood caries (ECC) can have a profound effect on a child's dental development and future health.
That's why dentists who treat young children often use a variety of preventive measures to reduce the risk of ECC and other dental diseases. One popular method is dental sealants, dental material coatings applied to the biting surfaces of teeth that fill in the naturally occurring pits and crevices. These areas are highly susceptible to plaque formation, a bacterial biofilm of food particles that tends to accumulate on teeth. It's the bacteria that live in plaque that are most responsible for the formation of tooth decay.
Roughly one third of children between the ages of 6 and 11 have received some form of dental sealant. It's a quick and painless procedure applied during a routine office visit. The dentist brushes the sealant in liquid form on the teeth, and then hardens it with a special curing light. It's common for children to begin obtaining sealant protection as their molars begin to come in.
With their increased popularity among dentists, researchers have conducted a number of studies to see whether dental sealants have a measurable effect reducing tooth decay. After reviewing the cases of thousands of children over several years, many of these studies seemed to show that children who didn't receive sealants were more than twice as likely to get cavities as children who did.
As evidence continues to mount for dental sealants' effectiveness protecting young children from decay, both the American Dental Association and the American Academy of Pediatric Dentistry now recommend it for all children. Not only can sealants help preserve children's teeth now, but they can reduce future costs for dental treatment that results from tooth decay.