Regardless of culture, the smile is a universal gesture of friendship and openness, and an important communication tool in your social and career relationships. But what if you’re not comfortable with your smile because of misaligned, damaged or missing teeth? That could have a dampening effect on your interactions with people and your own self-confidence.
Cosmetic dentistry can change all that — we have an arsenal of treatments that can rejuvenate your smile. We must first, though, develop a design plan, often involving multiple dental disciplines. It will definitely involve you — your desires, expectations and choices.
It begins with a thought-provoking discussion with our office. Generalities — “I want a beautiful smile” — aren’t enough. Effective planning begins with a clear perspective about your teeth: What do you like or dislike about them? If you could change anything, what would it be? These initial discussions help us specify your expectations.
While the initial discussion envisions the future, the next step focuses on the present — the current condition of your teeth, mouth and entire facial structure. This requires a comprehensive examination to identify any health issues like tooth decay, periodontal gum disease or bone loss. We must also take in the “big picture,” like the shape of your face, out-of-balance features (asymmetries), skin complexion, eye shape and color, or the form and posture of your lips.
Considering all these factors, we then develop a treatment plan with specifics on how to achieve the desired transformation. We will offer our prognosis for what we believe is achievable and maintainable for your specific situation. Here we provide various models, perhaps even including computer simulation, to depict your future smile. In the end, we create a workable plan that meets both reality and your expectations.
With the design plan completed, we can then harness all the techniques and materials available to achieve it. These range from less invasive procedures like whitening, tooth reshaping, cosmetic bonding or porcelain veneers, to more involved restorations like crowns, bridgework or dental implants. In some cases, orthodontics may be necessary to correct bad bites or other malformations of your oral structures.
Smile design ensures we’re employing the right techniques for your particular situation. It all serves the end goal — a new smile that can transform your life.
If you would like more information on smile design, 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 “Beautiful Smiles by Design.”
Did you know that you probably do at least one thing during the course of an average day that puts your healthy smile at risk? These are some of the more common offenders:
Coffee, Soda, and Sports Drink Consumption
If you really can’t give them up, try to consume these beverages with restraint. Their high acidity and/or sugar content can erode protective tooth enamel, making your pearly whites more prone to staining and decay. Even natural fruit juices should be consumed in moderation as they tend to be high in sugar and sometimes acidity (e.g. orange juice). Your best bet? Water, of course. It won’t damage your teeth and thanks to fluoridation may even help remineralize and fortify your enamel.
Brushing Immediately After Eating
If you were told to brush after every meal, forget it. Acids in foods and beverages can soften your enamel, and brushing may actually accelerate erosion. Wait at least an hour to brush, which is the time it generally takes for your oral pH to normalize and your tooth enamel to reharden. However, it is advisable after eating to floss and rinse out your mouth with plain water or a mineralized dental wash to help wash away food particles.
Jaw Clenching, Tooth Grinding, Pencil Chewing
These and similar “parafunctional” behaviors — outside the uses for which teeth are designed — can cause undue tooth wear and exert stresses that can cause chips and fractures. They can affect other parts of the oral system, too, potentially resulting in jaw joint pain and muscle spasms, headaches and other head and neck ailments.
It’s hard to cut out all high-sugar/high-acid foods and beverages, so where complete elimination isn’t possible, focus on moderation and try to consume them only during mealtime. Jaw clenching and other parafunctional behaviors are often subconscious and may be harder to control; in such cases an unobtrusive device like a clear occlusal (bite) guard can alleviate the problem.
If you would like more information about tooth damage and prevention please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Decay” and “Stress & Tooth Habits.”
If you are at all uncomfortable at the thought of getting a dental implant, you might be pleasantly surprised to learn the truth about these marvelous state-of-the-art tooth-replacement systems — and the special role of a relatively new device, the mini-implant. So, first, let's go over some basic facts.
What's a dental implant? Basically, it's just a replacement for the root part of the tooth, the part that lies beneath the gum line. It attaches to a crown, which is a replacement for the visible portion of the tooth. But instead of ceramics or metals, implants are made of titanium, which becomes fused to the surrounding bone. When complete, implants are much stronger and longer-lasting than other methods of tooth replacement, like bridgework and dentures.
Implants are presently regarded as the best way to replace missing teeth, with a success rate of over 95%. They also help prevent bone loss in the jaw, a major goal of modern dentistry. Having one put in is an office procedure that's generally accomplished with local anesthesia, and most patients experience only minor discomfort. Standard dental implants can be used to replace a single tooth, or multiple teeth. The mini-implant, which is just a miniature version of the same technology, is now playing an increasing role in many other phases of dentistry.
Why mini-implants? Because in several situations, this smaller and less expensive alternative offers a solution that's just as good — or better — than any other dental treatment. One area where mini-implants excel is in supporting lower jaw overdentures.
Many people find that lower dentures are far more troublesome than upper dentures. The movement of the tongue muscle, and the smaller area of surface contact (compared to the upper denture, which is supported by the palate) often results in a poor, loose fit, which leads to problems when eating or speaking. These problems can be solved by affixing a lower overdenture (an implant-retained denture) with just two mini-implants.
Not only do mini-implants help prevent bone loss, they also give the denture wearer increased stability, comfort, and confidence. And they do so at a price that's more economical than you might think. In some cases, the mini-implants can be placed in a single one-hour office visit, and your own denture can be modified to fit them — so you can go home and eat a steak that night!
Another area where mini-implants are finding increasing use is in orthodontics. Orthodontic appliances (commonly called braces) move teeth by exerting a light force on them, using a wire which is fixed to a solid anchor point. Traditionally, other teeth are used as anchors — but sometimes these teeth move as well! By using immovable mini-implants as the anchor points, the process is greatly simplified. Strategically placed mini-implants called TADS (temporary anchorage devices) can be used to correct both skeletal (jaw) position and dental (tooth) position problems.
Mini-implants may also be used in upper dentures and temporary bridgework.
If you would like more information about mini-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 articles “Implant Overdentures for the Lower Jaw,” “The Great Mini-Implant,” and “What are TADS?”
Dental implants are one of the best tooth replacement systems available. But while they can rejuvenate patients’ smiles and potentially provide a lifetime of service, they require thorough planning and preparation before the implant is inserted.
The process begins with the assembling of your treatment team. Implants require the training and expertise of a number of professionals who collaborate during the process: a dental specialist, like an oral surgeon, periodontist or a general dentist trained in implant dentistry, who surgically installs the implant; a dental technician who fashions the permanent life-like crown that will attach to your particular implant; and a restorative dentist who begins and ends the process with you — from initial consultation and planning to the permanent crown attachment. You, the patient, are also part of the team — your input and informed choices are essential to a successful outcome.
Your restorative dentist will take the first steps to develop your treatment plan. It begins with both a dental examination and a general health assessment to determine your fitness for any surgery. The dental examination serves to evaluate the site where the proposed implant or implants will be placed, along with x-rays for assessing the quantity and quality of bone at the site. Next, the dentist will create study models of your mouth to assess bite, and possibly take photographs to guide decisions on the implant crown’s color and appearance. The last step may be the development of surgical guides to ensure accurate placement of the implants by the surgeon.
One of the biggest questions to answer at this stage is whether or not you have sufficient bone mass to support the implant. You may have experienced significant bone loss due to disease or from resorption (the dissolving of bone) because of tooth loss. Insufficient bone mass can be remedied with a bone graft placed within the site that stimulates bone growth, which if successful will provide enough bone to support the implant.
While this preparatory phase before implant placement can be very involved, it’s absolutely necessary for ultimate success. The careful planning and prep work performed by your implant team — and your own participation in the process — will ensure that you’ll be happy with your new implants and your new smile.
If you would like more information on dental implant 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 “Dental Implants.”
Normally, teeth erupt and grow in a symmetrical alignment: on the top palate, for example, the two central incisors take center stage; on either side are the lateral incisors, and then beside these the canines (cuspids).
But what happens when teeth don’t grow in? The result can be a smile that just doesn’t quite look right; more importantly, normal function is impaired because the person can’t grasp and chew food correctly.
These missing teeth are the result of a congenital (“from birth”) defect. It’s estimated that almost a quarter of all people are missing one or more wisdom teeth, and more than 5% are missing one or more second premolars or upper lateral incisors.
In a normal arch (the upper or lower set of teeth), each tooth type performs a particular role during eating. A missing tooth causes the remaining teeth to compensate, but beyond their capacity. The remaining teeth also tend to move to fill in any gaps left by the missing teeth, as when the eye teeth move toward the central incisors in the absence of the lateral incisors. This puts them out of position, so they can’t cover (“occlude”) their counterparts on the other arch and grasp food properly.
To improve the smile and restore proper chewing function it’s necessary to first move these “out of position” teeth to their correct position through orthodontics. We would then fill the gaps that result with life-like restorations (preferably dental implants with crowns) that resemble the type of tooth that should be there.
The restoration needs to be timed carefully, especially for young patients whose jaw structure has not fully developed. If implants are installed before the jaw’s full maturity (usually late teens or early twenties), the implant crowns may not appear to be the right length as the jawbone continues to grow. Since bone growth depends on the normal pressures exerted by the teeth, there may also be insufficient bone mass in the gap area to support a dental implant. Growing bone with bone-grafting material may be necessary before installing implants.
The total process could take many months or even years, depending on age and other conditions. In the end, though, the results can be astounding — better function and a vibrant, new smile.
If you would like more information on developmental problems with 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 “When Permanent Teeth Don’t Grow.”
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