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Posts for category: Dental Procedures

VeneersMayNotBeaGoodOptionforaTeenager

People love dental veneers—those thin, porcelain shells bonded to teeth to mask stains and blemishes. For a relatively modest price, they can vastly improve a smile.

But what if it's your teenager who needs a smile upgrade? Teens also experience dental flaws like adults—which, at their age especially, disrupt their self-image and social confidence.

So, can veneers work for teens? Technically, yes, but there's a possible snag, depending on the maturity level of their teeth.

The potential problem relates to the tooth preparation that precedes the bonding of the veneers. One option is no-prep veneers and they are a nice solution depending on the size and shape of the existing teeth. If the teeth are slight in size, no preparation is necessary. If the teeth are large, even though veneers are thin, they can still look unnaturally bulky when bonded to unprepared teeth. A dentist may need to remove some of the tooth's surface enamel before applying the veneers.

Although this alteration has little effect on an adult tooth (other than requiring a veneer or restoration from that time on), it could damage a less mature tooth and stunt its development. A younger tooth can have a larger pulp—the central tooth chamber containing blood vessels and nerves—that's closer to the enamel surface than an adult tooth.

Because of the pulp's proximity to the surface of an immature tooth, there's a risk of damaging it during the tooth preparation phase for veneers. If that happens, the tooth may need additional treatment to save it.

We don't depend on a teen's calendar age to determine whether or not it's safe to install veneers. Instead, we examine the teeth and measure how close the pulp may be to the surface, as well as the thickness of the middle layer of dentin. Veneers could be acceptable if it appears the teeth have reached a healthy level of maturity.

If not, though, we may need to consider less invasive ways to improve a teen's smile. For stains or other outer discolorations, whitening with a bleaching solution significantly brightens teeth. We can repair chips by bonding and sculpting color-matching dental material to the teeth. And, these or similar cosmetic measures won't endanger an immature tooth like a veneer application.

Once a young patient's teeth have matured, we can revisit the subject of veneers. That may take time, but the more attractive smile that results will be worth the wait.

If you would like more information on dental care for adolescents, 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.”

ProperDentalWorkCareWillExtendTheirLongevity

Modern dental restorations are not only more life-like than past generations, but also more durable. Today's fillings, crowns and bridges can last for years or even decades.

But that doesn't mean you can set them and forget them—they all require some level of maintenance and care. Here are 3 common restorations and what you need to do to make them last.

Fillings. Whether traditional dental amalgam ("silver") or tooth-colored composites, fillings today are incredibly strong and durable. But they do have one point of vulnerability, especially larger ones—the seam where the filling material meets the natural tooth. Bacteria tend to build up along this seam, which could lead to decay and the formation of a new cavity that weakens the filling. To avoid this, be sure you're brushing and flossing everyday and seeing your dentist at least twice a year.

Veneers. Dentists bond these thin shells of tooth-colored porcelain over the visible surface of teeth to hide chips, stains or other blemishes. But although the bonding agents we use create an incredibly strong hold, the bond between the veneer and tooth could weaken when subjected to higher than normal biting forces produced by nail-biting, ice-chewing or a tooth grinding habit. If you have such a habit, see your dentist about ways to minimize it and protect your veneers.

Bridges. Traditional bridges consist of an array of artificial crowns with those in the middle substituting for the missing teeth, while those on the end attach to the natural teeth on either side of the gap to support the bridge. Bridges can also be supported by dental implants. In either case, tooth decay or gum disease could undermine the natural teeth or bone supporting a bridge. To avoid a bridge failure, keep the areas around supporting teeth or implants clean and regularly checked by a dentist.

Above all, the danger dental disease poses to natural tissues also threatens the restorations that depend on them. Keeping your mouth free of disease is your best strategy for ensuring your dental work enjoys a long, functional life.

If you would like more information on protecting your dental work, 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 “Extending the Life of Your Dental Work.”

WereImprovingOurEffectivenessinTreatingToothDecay

For several decades, dentists have been saving teeth from tooth decay following a few basic guidelines: 1) Identify decay as soon as possible; 2) Thoroughly remove decayed tooth structure; and 3) Fill any cavities. With millions of diseased teeth rescued, observing these simple steps have proven a rousing success.

But as with most things, even this successful protocol isn't perfect. For one, some healthy tissue gets removed along with the diseased portions. The average percentage of "collateral damage" has dropped over the years, but it still happens—and a reduction in healthy tissue can make a tooth less structurally sound.

Another drawback, at least from the patient's perspective, is the dental drill used for removing decay and preparing cavities for filling. Many people find drilling unpleasant, whether from its vibrations in the mouth or its high-pitched whine. The drill's burr head design also contributes to greater healthy tissue loss.

But those weaknesses have lessened over the last few years, thanks to innovations on a number of fronts.

Better risk management. Tooth decay doesn't occur out of thin air—it arises out of risk factors unique to an individual patient like personal hygiene, bacterial load, saliva production or even genetics. Taking the time to identify a patient's "tooth decay risk score" can lead to customized treatments and practices that can minimize the occurrence of decay.

Earlier detection. Like other aspects of dental health, the sooner we detect decay, the less damage it causes and the more successful our treatment. X-rays remain the workhorse for detecting decay, but now with improvements like digital film and better equipment. We're also using newer technologies like laser fluorescence and infrared technology that can "see" decay that might otherwise go undetected.

Less invasive treatment. The dental drill is now being used less with the advent of air abrasion technology. Air abrasion utilizes a concentrated spray of particles to remove diseased tooth structure more precisely than drilling. That means less healthy tissue loss—and a more pleasant (and quieter!) experience for the patient.

In effect, "less is more" could describe these improvements to traditional decay treatment. They and other methods promise healthier teeth and happier patients.

If you would like more information on current treatments for tooth decay, 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 “Minimally Invasive Dentistry: When Less Care is More.”

WhichImplantCrownAttachmentMethodisBestforYou

If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.

As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.

Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.

But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.

Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.

So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.

In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.

If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”

TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. ¬†And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”



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