Of all the of amazing procedures in today's dentistry, surgery that causes new bone to grow — in places where it had previously been lost — is high on the list of the most extraordinary. (When bone is lost or resorbed, it is broken down into its mineral components, which are dissolved into the bloodstream. Resorption of tooth-supporting bone often takes place after teeth are lost.) Dental techniques that cause new bone growth are important because a certain amount of bone is needed to replace lost teeth with dental implants.

Today's dental implants themselves are an amazing innovation. Implants consist of a replacement for the tooth's root, usually made of a metal called titanium. A replacement for the crown, the part of the tooth that is visible above the gums, is attached to the titanium root. Titanium has the remarkable quality of being able to fuse with the bone in which it is anchored. This process, first discovered in the 1950s, is called osseointegration.

In the case of missing upper back teeth, many people who wanted dental implants in the past were told that they did not have enough bone to anchor the implants and that they had to get removable dentures instead.

But now a new surgery called maxillary sinus augmentation can cause your body to regenerate bone where it was lost and is needed to anchor dental implants.

Bone in the upper jaw or maxilla usually supports your upper back teeth. Inside the maxilla, on either side of your upper jaw, are air spaces in the bone, which are lined with a membrane. These spaces, called the maxillary sinuses, are generally shaped like pyramids; but their shape and size is different in each person. The new surgical procedures involve lifting up the sinus membrane in the area where bone is needed and filling the space thus created with a bone grafting material. Your body then creates new bone to fill the space. This usually takes about six months. If you have almost enough bone to stabilize the implants, they can be placed simultaneously with the graft, thus saving time and avoiding a second surgical procedure.

All grafting materials used today are approved by the Food and Drug Administration (FDA) and must be prepared according to their guidelines. They are specially treated to render them completely safe for human use.

After the surgery there is usually no more than mild to moderate swelling and some discomfort, about the same as having a tooth removed.

If you are missing upper back teeth, contact us to schedule an appointment to evaluate your upper jaw. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery.”

For a bride, there is so much to remember when planning the wedding — invitations, a dress, flowers, the site, the caterers, the cake, the photographer — the list goes on and on. In the midst of all these things, don't let a very important piece of the plan be forgotten — your smile!

Your wedding will be celebrated every year on your anniversary and commemorated in beautiful photos at any time. It is a special occasion you, your family, and your friends will always remember. But how will you and your family look in those photos? You have an opportunity to get makeovers that will make your smiles shine radiantly, and not only in your album. Your makeover will improve your appearance, your self-confidence, and your oral health far into the future.

Start with a visit to your dentist to assess your current situation and discuss your goals and dreams. Each person's situation will be different. At a minimum you may need a professional cleaning to make sure that your teeth and gums are healthy. Get started on treating any cavities or gingivitis (gum inflammation). If you haven't already, now is a great time to establish healthy dental hygiene habits including proper daily brushing and flossing.

You may feel that your teeth are discolored and need to be whiter and brighter. Your upper and lower jaws may not meet properly for the most effective biting and chewing. Your teeth may be crowded or misshapen. All these things and more can be modified and repaired with today's dentistry.

Teeth can be whitened by bleaching in the dentist's office or with products that can be used at home under a dentist's supervision.

Orthodontia may be needed to repair your bite. Today orthodontia may be done either with traditional braces, or with clear aligners. Remember that this process works slowly, so start well in advance of your wedding day.

After your teeth are properly aligned, your dental team can work on subtle contouring, overall shape and color changes for individual teeth, using techniques such as porcelain laminate veneers. Temporary veneers can be made so that you can try out your new look before the final installation.

Wedding planning works best when started early. To make sure you, your new spouse, and your family look and feel their best, remember to include smile makeovers in your plan.

Contact us today to schedule an appointment to discuss your questions about wedding smile makeovers. You can also learn more by reading the Dear Doctor magazine article “Wedding Day Smiles.”

What is orthodontics?

Orthodontics is a sub-specialty of dentistry devoted to the study of growth and development of the teeth and jaws and treatment of improper bites (malocclusions).

What causes improper bites?

Malocclusions result from irregularities in the positioning of teeth, disproportionate jaw relationships, or both.

Why have orthodontic treatment?

Orthodontic treatment is carried out primarily to improve the alignment and function of your teeth and bite. It also results in improved oral health, easier maintenance, a better smile, and enhanced self-confidence and esteem.

What is the first step?

Schedule an appointment with our office for an orthodontic evaluation of your teeth and jaws and learn what options are best for you.

What do we need in order to plan your orthodontic treatment?

• Molds (impressions) of your teeth to study your bite (study models).
• “Articulated models” placing your study models in a machine that replicates jaw movement.
• Specialized x-rays showing your teeth and how your jaws align.
• Photographs of your smile and position of your teeth.
• Computer imaging.

What are braces?

Orthodontic appliances, commonly known as braces, are small brackets that are placed on teeth, through which thin flexible wires are threaded. They are the parts that move the teeth.

How do they work?

The wires tend to straighten out to their undistorted forms moving the teeth with them. Since the tissues that attach the bone to the teeth are living, they are constantly changing and remodeling themselves. Harnessing these natural forces allows the movement of teeth. Light controlled forces acting through the wires cause new bone to be formed as the teeth move into new improved positions.

What are current options for orthodontic appliances?

• Fixed appliances, traditionally known as braces, include brackets bonded to the teeth. These may be either metal or clear brackets, which are less visible but more susceptible to breakage.
• Removable appliances, or clear aligners. These consist of a series of computer-generated clear plastic custom fitted trays that progressively move the teeth into better alignment.

Orthodontic treatment is an ingenious scientific discovery that has allowed the dental profession to precisely move teeth for better appearance as well as improved function. It harnesses the body's natural processes by which tissues normally remodel themselves to maintain a steady state, allowing your dental team to move your teeth into improved position for a lifetime of dental health and a great smile.

Contact us today to schedule an appointment or to discuss your questions about orthodontics. You can learn more by reading the Dear Doctor magazine article “The Magic of Orthodontics.”

The goal of restorative dentistry is to return the teeth to full form (shape) and function. For years, a key tool for achieving this goal has been through the use of metal amalgams (silver looking dental fillings). However, this technique does have some disadvantages. One is the fact that they can involve removal of healthy tooth structure to retain them. Too much “undercutting” can undermine and weaken a tooth resulting in less resistance to biting forces possibly leading to fatigue fractures and cracked tooth syndrome. Another approach is call “biomimetic” which literally means mimicking life. This approach to dentistry is made possible through the structured use of tooth-like materials such as composite resins. Scientific studies and clinical experience have validated their use as both safe and predictable.

By mimicking life, we rely upon our delicate balance of artistry, experience and expertise to provide you with properly restored teeth that function and wear normally, while appearing indistinguishable from natural teeth. Dental composite are now the most commonly used materials for tooth-colored adhesive restorations and have properties similar to a natural tooth's enamel and dentin. They consist of resin which are plastic and fillers made of silica (a form of glass). The fillers give the composites wear resistance and translucency (see through properties). However, most of the properties of enamel are also mimicked quite well by dental porcelains. Porcelains are a form of ceramic, that are formed by the action of heat. Dental porcelains come in all colors and shades so we can easily and perfectly match the color of virtually any natural tooth. As for longevity, porcelain is typically your best option because it is the closest option in mimicking a natural tooth.

To learn more on this subject, you can continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” Or contact us today to schedule an appointment to discuss your specific questions.

If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.

When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.

If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.

If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.

When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.

Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.

Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”