Posts for category: Dental Procedures
A crown — a life-like “cap” made of dental porcelain that permanently covers an existing tooth — is an effective way to restore a still-viable decayed or broken tooth’s appearance. Properly fitting the crown over the tooth requires some healthy tooth structure above the gum line.
But what if the tooth has broken down to the gum line? In this case, we would need to perform a common procedure known as crown lengthening to expose more of the tooth.
Crown lengthening is a minor surgical procedure performed with local anesthesia to numb the tooth, surrounding gum tissues and supporting bone. We first make tiny incisions inside the gum-line on both the cheek and tongue side of the tooth to expose the bone, and then carefully remove a small amount of bone from either side of the tooth; this will expose or “lengthen” the tooth. Once finished, we suture the gum tissue back into place with self-dissolving sutures against the bone and tooth.
Most procedures take only sixty to ninety minutes, and the mild discomfort afterward is usually managed with pain relievers like ibuprofen. While the gum tissues may appear to be healed after a week, we typically wait six to eight weeks to perform the final crown restoration to give the tissues time to fully mature.
Crown lengthening may not work in all situations, especially with a severely fractured tooth. In these cases, we may need to evaluate the long-term viability of the tooth and consider other restorative options. Depending on your bite, it may also be necessary to treat with orthodontics first: not only will the tooth move into a better position, but the treatment may move both the gum and bone down with the tooth. Subsequent crown lengthening will then only affect the intended tooth and not adjacent ones, resulting in a more even smile.
The first step is for us to decide after a thorough examination if you would benefit from crown lengthening. If so, this minor surgical procedure could pave the way for better mouth function and a more attractive smile.
There's no doubt treating dental problems can improve your health. But because the mouth is among the most sensitive areas of the body, many dental procedures can be potentially uncomfortable after treatment.
We rely on pain medication to alleviate any dental work discomfort, especially during recuperation. Our arsenal of pain-relieving drugs includes strong opioid narcotics like morphine or oxycodone which have effectively relieved dental pain for decades. But although they work wonders, they're also highly addictive.
We've all been confronted in the last few years with startling headlines about the opioid addiction epidemic sweeping across the country. Annual deaths resulting from opioid addiction number in the tens of thousands, ahead of motor vehicle accident fatalities. Although illegal drugs like heroin account for some, the source for most addiction cases—an estimated 2 million in 2015 alone—is opioid prescriptions.
Dentists and other healthcare providers are seeking ways to address this problem. One way is to re-examine the use of opioids for pain management and to find alternative means that might reduce the number of narcotic prescriptions.
This has led to new approaches in dentistry regarding pain relief. In a trend that's been underway for several years, we've found managing post-discomfort for many procedures can be done effectively with non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, acetaminophen or ibuprofen. They don't share the addictive quality of narcotics and are regarded as safer when taken as directed.
There's also been a recent modification with using NSAIDs. Dentists have found that alternating the use of ibuprofen and acetaminophen often amplifies the pain relief found using only one at a time. By doing so, we may further reduce the need for narcotics for more procedures.
The trend now in dentistry is to look first to NSAIDs to manage pain and discomfort after dental work. Narcotics may still be used, but only in a secondary role when absolutely needed. With less narcotic prescriptions thanks to these new pain management protocols, we can reduce the risk of a dangerous addiction.
Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.
That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.
Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.
The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.
It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.
What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.
How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”
As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.
Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb). It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.
It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.
We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.
Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.
At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.
If you would like more information on diagnosing and treating root resorption, 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 Resorption: An Unusual Phenomenon.”
One of the key parts to an effective oral disease prevention plan is practicing daily oral hygiene to remove dental plaque. Both brushing and flossing are necessary for cleaning your teeth of this thin biofilm of bacteria and food particles most responsible for tooth decay and periodontal (gum) disease.
But as important as they are, these two essential hygiene tasks aren’t the end-all-be-all for lowering your disease risk. For the best protection, you should also visit your dentist at least twice a year for thorough dental cleanings. That’s because plaque you might have missed can turn into something much more difficult to remove: calculus.
Also known as tartar, calculus is hardened deposits of plaque. The term comes from the Latin word meaning “small stone,” an apt description of its texture on tooth surfaces. Although not the same as the branch of mathematics that bears the same name, both derive from the same Latin word: Merchants and traders centuries ago used small stones to “calculate” their various transactions.
Over time soft and pliable dental plaque hardens into calculus, in part due to a reaction with saliva. Because of the difficulty of accessing all tooth surfaces, calculus can form even if you have an effective daily hygiene practice.
Once formed, calculus can adhere to teeth so tenaciously, it’s impossible to remove it with brushing and flossing. But dentists and hygienists can remove calculus safely with special tools called scalers.
And it should be removed or it will continue to foster bacterial growth. This in turn increases the chances for infections that attack the teeth, gums or underlying bone. Keeping it under control will therefore diminish your risk for developing dental disease.
Although there are other factors like heredity that can affect your disease risk, keeping your mouth clean is the number one thing you can do to protect your teeth and gums. A daily hygiene practice and regular dental visits will help ensure plaque and its calcified form calculus won’t be a problem.