Posts for category: Dental Procedures
As permanent teeth gradually replace primary (“baby”) teeth, most will come in by early adolescence. But the back third molars—the wisdom teeth—are often the last to the party, usually erupting between ages 18 and 24, and the source of possible problems.
This is because the wisdom teeth often erupt on an already crowded jaw populated by other teeth. As a result, they can be impacted, meaning they may erupt partially or not at all and remain largely below the gum surface.
An impacted tooth can impinge on its neighboring teeth and damage their roots or disrupt their protective gum attachment, all of which makes them more susceptible to tooth decay or periodontal (gum) disease. Impacted teeth can also foster the formation of infected cysts that create areas of bone loss or painful infections in the gums of other teeth.
Even when symptoms like these aren’t present, many dentists recommend removing the wisdom teeth as a preemptive measure against future problems or disease. This often requires a surgical extraction: in fact, wisdom teeth removal is the most common oral surgical procedure.
But now there’s a growing consensus among dentists that removing or not removing wisdom teeth should depend on an individual’s unique circumstances. Patients who are having adverse oral health effects from impacted wisdom teeth should consider removing them, especially if they’ve already encountered dental disease. But the extraction decision isn’t as easy for patients with no current signs of either impaction or disease. That doesn’t mean their situation won’t change in the future.
One way to manage all these potentialities is a strategy called active surveillance. With this approach, patient and dentist keep a close eye on wisdom teeth development and possible signs of impaction or disease. Most dentists recommend carefully examining the wisdom teeth (including diagnostic x-rays and other imaging) every 24 months.
Following this strategy doesn’t mean the patient won’t eventually have their wisdom teeth removed, but not until there are clearer signs of trouble. But whatever the outcome might be, dealing properly with wisdom teeth is a high priority for preventing future oral health problems.
If you would like more information on wisdom teeth and their potential impact on dental health, 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 “Wisdom Teeth: Coming of Age May Come with a Dilemma.”
What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.
"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."
But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.
"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."
What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.
Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.
To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.
Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?
"I love my veneers!" she declared, noting that they have held up well for over a decade.
A tooth with deep decay is in real peril. If the disease isn’t stopped, it can eventually infect the bone and greatly increase the risk of losing the tooth. But tooth decay removal and a root canal treatment can stop advancing decay and resulting infection in its tracks.
During this common procedure we first drill into the tooth to access the inner pulp. After removing the infected pulp tissue, we disinfect and fill the empty chamber and root canals with gutta percha. We then seal the tooth and crown it to protect against re-infection.
But while most root canals are successful and long-lasting, sometimes the tooth becomes re-infected. Here are 3 factors that could affect the long-term success of a root canal treatment.
Early treatment. Like many health problems, the sooner we detect decay and treat it, the better the outcome. A tooth in which the infection has already advanced beyond the pulp is at greater risk for re-infection than one in which the infection is localized in the pulp. Keeping up your regular dental visits as well as seeing the dentist at the first sign of abnormality—spots on the teeth or pain—can increase your chances of early diagnosis.
Tooth complications. Front teeth with their single roots and canals are much easier to access and treat than a back molar with an intricate root canal network. Root canals can also be extremely narrow making them easy to miss during treatment. In cases like this the expertise and advanced equipment of an endodontist (a specialist in root canal treatment) could help increase the odds of success in complex situations.
The aging process. Teeth do wear over time and become more brittle, making them increasingly susceptible to fracture. A previous root canal treatment on an aging tooth might also increase the fracture risk. To avoid this, it’s important for the tooth to receive a crown after the procedure to protect the tooth not only from re-infection but undue stress during chewing. In some situations, we may also need to place a post with a bonded composite buildup within the tooth to give it extra support.
Even if a tooth has these or similar complications, a root canal treatment may still be advisable. The benefits for preserving a decayed tooth often far outweigh the risks of re-infection.
If you would like more information on root canal treatments, 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 Canal Treatment.”
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.