Posts for category: Dental Procedures
You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.
The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.
But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.
Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.
His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.
One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.
In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.
Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.
If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”
“To gain something, sometimes you have to give up something else.”
No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.
In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.
Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).
Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.
We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.
As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.
The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.
If you would like more information on correcting a poor bite, 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 “Tooth Removal for Orthodontic Reasons.”
The internet has transformed how we get information. Where you once needed to find an encyclopedia, telephone directory or library, you can now turn to your handy smartphone or tablet for the same information.
But this convenience has a dark side: A lot of material online hasn’t undergone the rigorous proofreading and editing published references of yesteryear once required. It’s much easier now to encounter misinformation—and accepting some of it as true could harm your health. To paraphrase the old warning to buyers: “Viewer beware.”
You may already have encountered one such example of online misinformation: the notion that undergoing a root canal treatment causes cancer. While it may sound like the figment of some prankster’s imagination, the idea actually has a historical basis.
In the early 20th Century, a dentist named Weston Price theorized that leaving a dead anatomical part in the body led to disease or major health problems. In Price’s view, this included a tooth that had undergone a root canal treatment: With the vital pulp removed, the tooth was, in his view, “dead.”
Price amassed enough of a following that the American Dental Association rigorously investigated his claims in the 1950s and found them thoroughly wanting. For good measure, a Journal of the American Medical Association (JAMA Otolaryngology—Head & Neck Surgery) published a study in 2013 finding that not only did canal treatments not increase cancer, but they might even be responsible for decreasing the risk by as much as forty-five percent.
Here’s one sure fact about root canal treatments—they can save a tooth that might otherwise be lost. Once decay has infiltrated the inner pulp of a tooth, it’s only a matter of time before it spreads through the root canals to the bone. Removing the infected pulp tissue and filling the resulting empty space and root canals gives the tooth a new lease on life.
So, be careful with health advice promoted on the internet. Instead, talk to a real authority on dental care, your dentist. If they propose a root canal treatment for you, they have your best health interest—dental and general—at heart.
If you would like more information on root canal treatment, 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 Safety: The Truth About Endodontic Treatment and Your Health.”
Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.
Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.
Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).
But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.
Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.
But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.
Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.
If you would like more information on treating complex bite problems, 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 “Exposing Impacted Canines.”
People improve their smiles for a lot of reasons: to better their career prospects, to put some juice in their social lives or just to do something special for themselves. But you may have an even stronger reason: a once-in-a-lifetime event—maybe your wedding day—is coming up soon.
You have several options for transforming your smile for the big day—and some are even quite economical. Here are 4 affordable ways to make your smile beautiful for that forever moment.
Cleanings. While dental cleanings should already be part of your regular dental care, scheduling one right before a big event can do wonders for your smile. Not only can your hygienist remove any lingering dull and dingy plaque and tartar, but they can polish your teeth for a brighter shine. Remember, though: dental cleanings support your own hygiene efforts, they don't replace them. Your own daily practice of brushing and flossing will also help you maintain a beautiful smile.
Teeth Whitening. You can also get an extra boost of brightness with a tooth whitening procedure. Using a professional bleaching solution and other techniques, your dentist can lighten your smile to your tastes, from a more natural hue to dazzling white. The whitening effect, though, is temporary, so plan to see your dentist no more than a few weeks before your big day.
Bonding. Perhaps a tiny chip is all that stands between you and a knockout smile. Your dentist may be able to repair that and other minor defects by bonding tooth-colored materials to the chip site. These composite resin materials have the shine of enamel and can be color-blended to match your tooth's natural shade. Composite resins are also fairly rugged, although you should avoid biting down on hard foods or objects.
Veneers. Although more expensive than the previous options mentioned, veneers are still affordable compared to crowns or bridgework. Usually made of thin layers of dental porcelain, dentists bond veneers to the front of teeth to mask mild to moderate problems like heavy staining, disfiguration and minor gaps. But because veneers are custom-fabricated by a dental lab, you'll need to plan them with your dentist at least six months before your event. The resulting change to your smile, though, may well be worth the wait.
If you would like more information on transforming your smile for a special event, 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 “Planning Your Wedding Day Smile.”