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Posts for category: Dental Procedures

By Dear Doctor
December 11, 2017
Category: Dental Procedures
Tags: crowns  
CrownscannowbemadeIn-OfficewiththeCADCAMSystem

The traditional way to restore a tooth with an artificial crown takes several weeks and multiple office visits: from tooth preparation and impression molding to crown production by a dental laboratory, followed by adjustments and cementing. Now, there’s an alternative that reduces this process to a fraction of the time, and all from your dentist’s office.

Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) is a digital system that enables dentists to create dental restorations with laboratory-grade materials in minutes rather than weeks. As it continues to innovate, you’ll see more and more dentists investing in the new technology for their patients.

A crown restoration with CAD/CAM begins like any other with decay removal and preparation of the tooth. It diverges, though, from the traditional in how an impression of your teeth and gums is obtained: instead of rubber-like molding materials to create a physical impression, we lightly dust the mouth interior with a reflective powder. Using a scanning wand, the reflective powder allows us to capture multiple, detailed images of your mouth that the CAD/CAM computer transforms into an accurate three-dimensional model.

We use the model to first assess if the tooth has been effectively prepared for a restoration. If so, the design feature of the system will provide us with thousands of tooth forms to choose from to match with your natural teeth. You’ll be able to view the proposed size and shape of the new crown via computer simulation before signing off on the design.

Next is the actual manufacture of the crown that takes place right in the dentist’s office. A pre-formed block of ceramic material is inserted in the milling equipment where, following the pre-determined computer design, the milling heads carve the ceramic block. After milling, we fine-tune the crown surface and apply stains or glazes fired to create a life-like color and texture that matches your natural teeth. We can then adjust the crown in your mouth and permanently affix it to the tooth.

While much of the CAD/CAM system is automated, ultimate success still depends on the dentist’s expertise and artistry. CAD/CAM enhances those skills with greater precision and in much less time than traditional crowns. It’s certainly a growing option for many people to restore the form and function of decayed teeth.

If you would like more information on computer-aided dental restorations, 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 “Creating In-Office Dental Restorations with Computers.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Dear Doctor
November 03, 2017
Category: Dental Procedures
Tags: loose dentures  
BoneLossCouldbetheReasonforYourLooseDentures

When you first received your removable dentures the fit was firm and comfortable. Lately, though, they’ve become loose, making it difficult to eat or speak without slippage.

The problem may not be with your denture, but with bone loss. Human bone goes through a natural cycle of dissolving (known as resorption) and new growth to take the lost bone’s place. The jawbone receives further stimulation to grow from the forces generated by natural teeth when we bite or chew.

When natural teeth are missing, however, the jawbone lacks this stimulation, which over time results in bone loss and gum tissue shrinkage. Traditional dentures can’t transmit this stimulating force to the jawbone either, so the bone and gum structure under a denture will also shrink. This results in a looser fit for the denture.

The simplest option to correct a loose-fitting denture (especially if it’s the first occurrence) is to reline the dentures with additional material to re-form the fit to the new conditions in the mouth. A permanent relining will require sending your dentures to a dental laboratory to apply the new material based on a mold of your current anatomy beneath the denture.

If, however, your dentures have already undergone a few relinings, or after examining your gums we determine a relining won’t provide the fit and stability needed, then it may be time for a new denture. Although this is more costly than a relining, a new appliance could provide a more accurate fit to the current contours in your mouth.

The latter option may also give you a chance to benefit from advancements in denture technology or materials since you received your current denture. One such advancement is a removable denture that’s supported by implants. It’s possible to achieve this new supporting foundation for the denture with as few as two strategically-placed implants in the lower jaw.

If you’ve begun to notice denture looseness, be sure to make an appointment for an examination. From there, we can advise you on what will work best in your particular case.

If you would like more information on your options regarding removable dentures, 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 “Loose Dentures.”

SevereDentalInjuriesMayRequireEndodonticTreatment

If you regularly participate in sports or other physical activity, you’re at a higher risk for dental injuries. While chipped teeth are the most common result of these injuries, a few may result in more serious trauma — dislodged, cracked or knocked out teeth. In these cases, the core of the tooth — the pulp — and the root may have been damaged. Saving the tooth may require endodontic treatment and possibly the expertise of a specialist in the field, an endodontist.

Endodontics, from the Greek words for “within” and “tooth,” is a specialty of dentistry that treats disease or damage affecting the inner parts of a tooth, particularly the pulp chamber, the root canals, and the root. While all dentists are trained in endodontic procedures, an endodontist has advanced training, experience and specialized equipment to address complex cases.

The type of endodontic treatment needed for an injured tooth will depend on the extent of damage. A mature, permanent tooth with pulp damage, for example, may require a root canal treatment. In this procedure the pulp chamber and root canals are thoroughly cleaned out, and then are filled with a special filling to prevent any future infection. Later the tooth should be crowned to permanently seal it. Although a general dentist may perform a root canal, more complex cases, such as a tooth with an extensive root canal network, may need to be performed by an endodontist using microscopic equipment.

A tooth that has undergone severe trauma, especially a knocked out tooth, will need extensive follow-up care by a general dentist and possibly an endodontist to improve its chances of long-term survival. Because of the severity, the tooth may lose viability and the body ultimately may begin to reject it. For this reason, the tooth should be monitored on a regular basis and may need further treatment from time to time, even up to five years after the injury.

One final word: if you participate in sports or exercise activity, you can significantly reduce your risk of dental injury with a mouthguard. There are various types, but the best protection is one custom designed to fit the specific contours of your mouth. We’ll be glad to advise you further on how to protect your teeth from injury.

If you would like more information on dental injury prevention and 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 “Trauma & Nerve Damage to Teeth.”

WhatsCausingYourToothacheTheAnswerDeterminesYourTreatment

Pain has a purpose: it tells us when something's wrong with our bodies. Sometimes it's obvious, like a cut or bruise. Sometimes, though, it takes a bit of sleuthing to find out what's wrong.

That can be the case with a toothache. One possible cause is perhaps the most obvious: something's wrong with the tooth. More specifically, decay has invaded the tooth's inner pulp, which is filled with an intricate network of nerves that react to infection by emitting pain. The pain can feel dull or sharp, constant or intermittent.

But decay isn't the only cause for tooth pain: periodontal (gum) disease can trigger similar reactions. Bacteria living in dental plaque, a thin film of food particles on tooth surfaces, infect the gums. This weakens the tissues and can cause them to shrink back (recede) from the teeth and expose the roots. As a result, the teeth can become painfully sensitive to hot or cold foods or when biting down.

Finding the true pain source determines how we treat it. If decay has invaded the pulp you'll need a root canal treatment to clean out the infection and fill the resulting void with a special filling; this not only saves the tooth, it ends the pain. If the gums are infected, we'll need to aggressively remove all plaque and calculus (hardened plaque deposits) to restore the gums to health.

To further complicate matters, an infection from tooth decay could eventually affect the gums and supporting bone, just as a gum infection could enter the tooth by way of the roots. Once the infection crosses from tooth to gums (or gums to tooth), the tooth's long-term outlook grows dim.

So, if you're noticing any kind of tooth pain, or you have swollen, reddened or bleeding gums, you should call us for an appointment as soon as possible. The sooner we can diagnose the problem and begin appropriate treatment the better your chances of a good outcome — and an end to the pain.

If you would like more information on diagnosing and treating tooth pain, 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 “Confusing Tooth Pain: Combined Root Canal and Gum Problems.”