Posts for: October, 2013
Although traditional porcelain laminate veneers are much less invasive than other cosmetic dental applications, they still often require the removal of some of the surface tooth enamel, a process known as tooth reduction. Now, an alternative veneer treatment known as “no-prep” veneers eliminates this initial step of tooth reduction for some patients.
Although most reductions take very little of the tooth enamel, they do permanently alter the tooth. No-prep veneers are growing in popularity because the tooth is not permanently altered, allowing for two benefits: if desired, the veneer application can be reversed and the tooth returned to its original state; and there's more flexibility for patients to “test-drive” their new look with prototype veneers worn while the permanent veneers are manufactured, with changes made easily during this tryout period.
Dentists have long regarded at least a minimum of tooth reduction as absolutely necessary for the proper adhesion of veneers, and to avoid a bulky or over-contoured smile. And, while advances in no-prep veneers have largely addressed these concerns, it is true this option isn't for every patient considering a veneer application.
For example, patients with large or forward-positioned teeth are not good candidates for no-prep veneers. Patients who choose a veneer treatment over orthodontic treatment for certain conditions will likely need some tooth preparation to achieve an acceptable aesthetic result. For patients generally, no-prep veneers have a limited application range on the bottom jaw due to space limitations.
Simply put, traditional veneers are a more versatile option for most patients. On the other hand, no-prep veneers can be a good choice for patients with genetically small or misshapen teeth, teeth reduced by erosion or grinding, or those with narrow or diminished smiles.
If you're considering this option, our first step is to conduct a complete examination of your teeth and mouth. We'll carefully evaluate every aspect of your mouth structure and overall dental condition. If you fit the criteria, you may be able to avoid tooth reduction and still gain the smile you desire.
If you would like more information on no-prep veneers, 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 “Porcelain Veneers Without the Drill.”
Caring for a young child can be overwhelming at times. Sometimes, it may feel like you can't read enough books to learn the correct way to do everything from potty training to feeding. It's also important to teach your child healthcare habits during these crucial years, so that they continue these habits for a lifetime!
Here are a few simple ways you can help your child to institute lifetime oral care habits.
- DO: Encourage your Child to Brush Every Day with Fluoride Toothpaste. Fluoride will help make your child's teeth more resistant to tooth decay. You should use a thin smear of fluoride toothpaste for children under age two and a pea-sized amount for older children. At age two, you can also begin empowering your child to brush, but make sure that you supervise and finish the job. Your child will probably need your help until around the age of six.
- DON'T: Share your Germs. Did you know that children are not born with the bacteria that cause tooth decay? In fact, the bacteria are transmitted to them from adults! You should never share a cup or spoon with your child. Also, next time you kiss your child, kiss him or her on the cheeks instead of the lips. Believe it or not, you can transmit harmful bacteria through this quick little kiss.
- DO: Limit your Child's Sugar Intake. When your child consumes sugar, the bacteria use the sugar to produce acids that dissolve tooth enamel, eventually leading to tooth decay. Saliva can neutralize those acids, but it needs enough time, 30 to 60 minutes, to work its magic. That is why it is important to limit sugar intake between meals.
- DON'T: Give Your Child a Bottle at Night. Juice, milk and even breast milk contain sugars that promote tooth decay, in particular during sleep, when less saliva is being produced. So, though it may be tempting, do not let your child go to bed with a bottle.
- DO: Take your Child to the Dentist Early. The American Academy of Pediatric Dentistry recommends that all children have their first dental visit by the age of one. Your toddler will benefit from regular dental visits, because we will monitor tooth decay, correct brushing techniques and also, most importantly, ensure that he or she is comfortable in the dental chair.
- DON'T: Allow your Child to Suck His or Her Thumb Past Age Three. Thumb sucking for comfort is a very normal behavior for babies and toddlers. However, if your child constantly sucks his or her thumb past the age of three, it can affect teeth alignment and jaw development.
If you would like more information about oral care for your child, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Dentistry and Oral Health for Children.”
Metal braces for correcting teeth alignment have long been a fixture of adolescence. But although they're effective, they tend to put a crimp on a teenager's life with changes in diet and irritation and discomfort from the devices and regular adjustments. For many teens, though, these are minor compared to the change in their appearance that comes with traditional braces, and the embarrassment they may feel.
In recent years, there's been a growing use of another orthodontic device that reduces many of these inconveniences, especially regarding appearance. Known as the clear aligner, this transparent, “almost invisible” device can be taken out for eating, cleaning or important social events.
Clear aligners are a sequential set of clear trays made of polyurethane plastic that are generated for an individual patient using information derived from x-rays, photographs or models. Each tray in the sequence is slightly different from the previous one to account for the tooth movement achieved wearing the previous tray. The patient will wear a tray for about two weeks and then, if all looks well, move to the next tray. This process continues until the teeth arrive at the proper alignment, a period of about six to twenty-four months depending on the patient's initial condition and their progress.
Up until recently, aligners were a viable option for a limited category of patients, mainly adults. Recent advances have changed that. Aligners now include tiny “power ridges” that enable them to move teeth in more than one plane, something previous versions were unable to do. “Eruption tabs” can also be incorporated into aligner sets to hold the space for permanent teeth that haven't erupted yet — a must for many younger patients. We can also temporarily bond attachments to the teeth known as buttons (made with a composite that blends in with the natural tooth color) that give more leverage and stability to the aligner.
With these changes, clear aligners are now an effective choice for a wider group of patients, including many teens. Aligners are comfortable to wear, easy to care for, and for teens acutely conscious of their appearance, less obtrusive than traditional metal braces.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
You have a beautiful smile, but you hesitate to show it because of your stained teeth. Fortunately, whitening techniques could take away that embarrassment.
There are two basic types of tooth staining or discoloration: extrinsic, in which the stain is on the surface of the teeth and mostly caused by substances like coffee, wine or tobacco; and intrinsic, which occurs deep within the tooth, caused by such factors as aging, previous dental treatments and fillings, the use of antibiotics (tetracycline, predominantly), or over-exposure to fluoride.
Whitening or bleaching is an effective and relatively affordable solution for many instances of both intrinsic and extrinsic staining. Bleaching solutions are available in over-the-counter (OTC) home kits or as a professional application in the dental office.
Most bleaching solutions use carbamide peroxide, a chemical compound that is effective in removing most stains. OTC home applications contain carbamide peroxide (or an equivalent) in concentrations of about 10% as opposed to 15-35% found in professional solutions. Though less costly than a professional application, OTC products take longer (usually up to three weeks) to achieve desired results. With its stronger solution, a professional application in our office can achieve the same level of brightness in only one or two visits. We may also use special lighting to accelerate the chemical process, as well as rubber dams or gels to protect gums and soft tissues from solution irritation during the procedure.
Although effective, whitening isn't a permanent solution — over time the effect will fade, usually six months to a year depending on how you care for your teeth. Matching tooth color can also be difficult in some cases, especially if you have a mix of natural teeth and artificial crowns or bridges. And, whitening may not be adequate for some types of staining.
Regardless of which application you wish to use — OTC or professional — it's a good idea to visit us first for a professional consultation. We can recommend whether whitening is a good choice for your particular type and level of staining, or if some other option like porcelain veneers might be the better choice. Regardless, there are solutions to the problem of staining, and a way to gain a brighter smile.
If you would like more information on bleaching, 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 “Teeth Whitening.”
You've probably heard about dental implants — today's best option for replacing missing teeth; maybe you even have one or more already. A dental implant is a tiny screw-shaped metal post that sits in your jawbone and supports a lifelike dental crown. Natural teeth and implant-supported teeth have differences and similarities.
The main difference between implants and natural teeth — besides the fact that you were born with one and not the other — is the way they attach to your bone. Implants actually fuse to the bone, becoming part of it. This is a unique property of titanium, the metal from which implants are made. Maintaining that attachment is extremely important; we will discuss how best to ensure that in a moment.
Natural teeth do not ever become part of the bone that surrounds them. Instead, they attach to it via the periodontal ligament (“peri” – around; “odont” – tooth), which is made up of tiny fibers that go into the tooth on one side and the bone on the other. These fibers form a sort of hammock for each tooth.
Another difference is that natural teeth can decay while implant-supported teeth can't. But that doesn't mean you don't have to worry about dental hygiene — far from it! And here's where we get to the main similarity: oral hygiene is extremely important to maintain both teeth and implants. Lax oral hygiene for either can result in bacterial infections that may lead to gum disease, and even bone loss.
The main enemy of a properly fused implant is a bacterial infection known as “peri-implantitis” (“peri” – around; implant “itis” – inflammation), which starts when bacterial biofilm (plaque) is allowed to build up on implant-supported crowns. Peri-implantitis can lead to a well-like or dish-shaped loss of bone around the implant, which in turn can cause the implant to lose its attachment to the bone. If this happens, the implant can no longer function. Fortunately, this infection is preventable with good brushing and flossing techniques at home, and regular professional cleanings here at the dental office.
So another similarity, then, is that natural teeth and implants can last a lifetime with proper care. And that's the result we're aiming for!