You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.
While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.
When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.
If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.
Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.
Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.
If you would like more information on your dental restoration options, 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 “Straightening a Smile before Replacing Lost Teeth.”
While many people still consider dental implants the "new kids on the block" in dental restoration, they're now in their fourth decade of use. And since their inception implant technology has continued to improve and revolutionize how we replace missing teeth.
Implants are a different "species" compared to other restoration methods. To be precise, an implant is a tooth root replacement—usually a titanium metal post imbedded directly into the jaw bone. Titanium is not only a biocompatible metal, but bone cells naturally grow on its surface to create a strong and durable hold. It's this secure hold that's most responsible for implants' high long-term success rate.
But we should also credit some of this success to the steady stream of advances over the years in implant construction and supporting technologies. For one thing, we're now more accurate and precise with implant placement thanks to advances in computer tomography (CT) and cone beam CT (CBCT) scanning.
These digital processes merge a series of images taken by a special camera to form a three-dimensional model of the jaw. We can manipulate this model on a computer monitor to view it from different vantage points. It can help us locate and avoid anatomical structures like nerves and sinuses when determining where to place a future implant. CT and CBCT are especially useful when there's a concern about adequate available bone, a necessity for stable implants.
Technology has also improved how we create surgical guides, often used during implant surgery to obtain the most accurate results. Surgical guides are custom-made devices that fit over the teeth with the drilling locations for the implants marked on them. Recent advances in 3-D printing have made these guides even more accurate so that they fit more securely in the mouth. This greater stability increases their accuracy during the drilling sequence during surgery.
These and other advances are helping ensure every implant is a success story. The end result is both a functional restoration and a beautiful smile.
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 Technology Aids Dental Implant Therapy.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
’Tis the season for holiday joy with sweet treats at every turn. Don’t let it be the season for dental woes as well. You've heard that sugar causes cavities. That’s because bacteria in your mouth feed on sugar and release acid as a by-product. The acid eats away at tooth enamel, resulting in tooth decay if not checked. To protect your smile during the December onslaught of cookies, candies and other goodies, follow these tips:
Seek balance. Foods that stick to your teeth like candy canes, chewy candies or potato chips provide more opportunity for cavities to develop. To help keep your smile sparkling for the New Year, mix it up with healthy options. Chances are you will come across tooth-healthy offerings like raw vegetables, a cheese plate or mixed nuts. Vegetables scrub your teeth while you chew and stimulate the production of saliva, which helps neutralize acid and rebuild tooth enamel. Cheese also neutralizes acid in the mouth and has minerals that strengthen teeth, while nuts stimulate saliva production and provide vitamins and minerals that keep teeth strong and healthy.
Consider your timing. There’s a higher risk of developing tooth decay when sweets are consumed as standalone snacks, so when you do eat sugary treats, try to have them at mealtime. Repeated snacking between meals exposes teeth to food particles throughout the day, and the acids produced can continue to act on your teeth for 20 minutes after a treat is consumed. During meals, however, other foods present help balance out the sugar and stimulate saliva production, which helps neutralize acid and wash away food particles, sugar and acid from your teeth.
Watch what you drink. Sipping sweet drinks over time can have ill effects on your teeth because of prolonged contact with sugar. If you consume sugary beverages, try to do so in moderation and preferably along with a meal. Sipping your drink through a straw can help keep the beverage away from direct contact with your teeth. Consider opting for water—there are plenty of other opportunities for extra sugar and calories! Besides, water washes away food bits and dilutes acidity. After eating the sweet stuff, it’s a good idea to drink water or at the very least swish a little water around in your mouth.
Keep up good oral hygiene. With all the holiday busyness—shopping, gatherings with friends and family, school functions—you may find yourself exhausted at the end of the day. Still, this is an especially important time to keep up your oral hygiene routine. Brushing your teeth with fluoride toothpaste morning and night and flossing every day are key to keeping your teeth for the long haul.
Finally, if you are due for a dental checkup or cleaning, give us a call to make sure you start the New Year with a healthy smile. If you have a flexible spending account that will expire with the calendar year, make it a priority to fit in an end-of-year dental appointment. Please contact us or schedule an appointment for a consultation if you would like more information about keeping in the best oral health. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”
A root canal treatment is a highly effective way to save a deeply decayed tooth. Sometimes, though, complications make it difficult or even impossible to perform the traditional procedure. In those cases, we may need to use a different option.
Tooth decay becomes an imminent threat to a tooth's survival if it works its way into the pulp, the innermost layer of a tooth. It's only a short advancement from there into the roots by way of the root canals.
In a typical root canal treatment, we access the pulp by drilling a small hole in the biting surface of a back tooth or the back side of a front tooth. We remove all the tissue within the pulp and fill it and the root canals with a special filling to prevent re-infection. After sealing the access hole, we cap the tooth with a crown to further protect it.
Although root canal treatments have a high success rate, re-infection can still occur. Often, a second root canal will save the tooth from the new infection.
In some cases, though, using the traditional procedure might do more harm than good. It's possible we may find extra canals previously undetected branching out from the primary canal at the root end. Canals can calcify and narrow, making them extremely difficult to fill. Subsequent dental work may also prove troublesome: we would have to take the restoration apart, which could further weaken the tooth.
The alternative is a procedure known as an apicoectomy. Instead of accessing the pulp through the crown, we access the root end through the gum tissue. We then focus on removing infected tissue at the tooth's root end, along with a tiny amount of the root tip. We then place a small filling at the end of the root canal (essentially plugging it up) to prevent further infection. We may also perform grafting to encourage bone growth in any voids left by the procedure.
Endodontists, specialists in root canals, have the advanced training and specialized equipment to perform an apicoectomy. With their expertise, they may be able to save your tooth with this specialized procedure when a root canal treatment won't work.
If you would like more information on options for treating decayed 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
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