Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
For years preparing teeth for fillings or other restorations has required the use of a drill. Although quite effective in removing decayed structure and preparing the tooth for bonding, it usually requires a local anesthetic. That and the noise it generates can be unsettling for many patients.
In recent years, a different type of technique known as “air abrasion” has increased in popularity among dentists. Known also as “particle abrasion,” the technique uses a stream of fine particles to remove decayed tooth structure and is less invasive than the traditional drill. Although the technology has been around since the mid-20th Century, recent developments in suction pumps that remove much of the dust created have made it more practical. It also works well with new natural-looking bonding materials used for tooth structure replacement.
The fine particles — usually an abrasive substance like aluminum oxide — are rapidly discharged through a hand-held instrument using pressurized air aimed at affected tooth areas. Decayed teeth structure is softer than healthier tissue, which allows air abrasion to precisely remove decay while not damaging the other.
Besides removing decay or abrading the tooth for bonding, air abrasion can also be used to minimize stained areas on surface enamel and to clean blood, saliva or temporary cements from tooth surfaces during dental procedures. It’s also useful for smoothing out small defects in enamel or aiding in sealant applications.
It does, however, have a few limitations. It’s not as efficient as the traditional drill with larger cavities or for re-treating sites with metal (amalgam) fillings. Because of the fine texture of the abrasive particles, affected teeth need to be isolated within the mouth using a rubber dam or a silicone sheet. High-volume suction must be continually applied to capture the fine particles before the patient swallows them or it fills the procedure room with a fine cloud of material.
Still, while air abrasion technology is relatively new, it has clear advantages over the traditional drill in many procedures. As advances in the technology continue, air abrasion promises to offer a more comfortable and less invasive experience in dental treatment.
You’ve been embarrassed for a while now by your yellowed, dull teeth. You’re ready for a change.
There’s a simple and cost-effective way to make that change: you can temporarily brighten your smile with teeth whitening, possibly at home. But before you try it, you should first have a dental examination to find out if whitening is the right choice for you.
First off, healthy teeth with outer enamel staining are the best candidates for whitening. Teeth and gums with tooth decay or periodontal (gum) disease should be treated first before undergoing whitening. A dental exam will uncover any health issues you may have with your mouth.
In the same vein, you’ll want to consider whitening carefully if you have dental work like veneers, crowns or implants. Unlike natural teeth, these non-biological materials won’t be affected by the bleaching agent. We can discuss any potential for color mismatch between your whitened natural teeth and your dental work during your examination.
A dental exam can also uncover one other crucial fact — what kind of tooth staining you have. There are two basic types: extrinsic, staining on the outside enamel as we’ve mentioned earlier; and intrinsic, staining that originates from inside a tooth. The whitening kits you purchase from a store and even some of the whitening techniques we use in the office only diminish extrinsic, not intrinsic staining. To address an intrinsically-stained tooth requires a much more involved, invasive clinical technique only performed by dental professionals.
Finally, a dental examination is a good discussion forum for helping you decide between a home kit and a clinical procedure. While DIY kits are effective for the most part, you won’t be able to precisely control the degree of brightness like we can. This could be important if you want a specific shade of whiteness, from a more subtle and natural shade to dazzling “Hollywood” bright. Shade control could also help minimize color mismatch with dental work.
In the end, we want to help you make the best choice for teeth whitening. Even if you decide to pursue whitening at home, we can offer you valuable advice on what to look for when you buy a kit and how to use it. That alone could help ensure you get the new, bright smile you desire!
If you would like more information on teeth whitening, 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 “Important Teeth Whitening Questions…Answered!”
Stained teeth can be embarrassing — so much so you may even hesitate to smile. Before you seek out a whitening solution, though, there are a few things you need to know about tooth staining.
Tooth staining is more complex than you might think. There are actually two types: extrinsic, staining from foods and other substances of the outer surface of the enamel; and intrinsic, discoloration deep within a tooth that affects their outward appearance. The latter staining has a number of causes, including the type of dental materials used to fill a tooth, a history of trauma or the use of the antibiotic tetracycline during early tooth development.
There are some noticeable differences between the two types, although an examination is usually necessary to determine which you have. Extrinsic staining tends to be brown, black, or gray, or occasionally green, orange or yellow. Intrinsic staining can be red, pink or, if caused by tetracycline and fluoresced under ultraviolet light, yellow. If only one tooth is discolored it’s most likely intrinsic due to decay in the tooth pulp.
What can be done also depends on which type. Extrinsic staining can be modified through whitening, with either an office application or a home kit (there are differences, so you should consult with us before you decide). It may also be essential to modify your diet by restricting foods and beverages (coffee, wine or tea) known to cause staining and by eliminating tobacco use. You should also practice daily hygiene, including brushing with a toothpaste designed to diminish staining, and regular office cleaning and polishing.
Intrinsic staining can’t be addressed by these methods. Instead, you may need to undergo a procedure where we enter the interior of the tooth and insert a bleaching agent. If this isn’t an option, you can also choose a cosmetic restoration such as a porcelain veneer or crown that will cover the tooth to better match the color of your other teeth.
Dealing with stained teeth begins with a visit to our office to determine what type of discoloration you have and to learn your options. But regardless of what type you have, there is a way to a brighter smile.
If you would like more information on the causes and treatments of tooth staining, 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 Staining.”
Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:
"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"
And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:
“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”
Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.
For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.
While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.
Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.
Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.
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