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If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.
Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.
Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.
Advantages of prepless veneers include:
- Tooth preparation or reduction is not needed, leaving the original tooth whole.
- They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
- They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
- They can be used to “lengthen” teeth that have been worn down by grinding.
- Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.
Disadvantages include:
- There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
- Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
- Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
- They do not usually work for lower teeth because of space restrictions.
- They cannot replace lost or damaged enamel.
Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.
Contact us today to schedule an appointment to discuss your questions about prepless veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”
If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.
When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.
If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.
If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.
When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.
Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.
Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”
Most people think of bone as rock-solid, but it's actually a living tissue that's constantly changing. This has significant implications for your oral health, general health, and appearance — if you are one of the 70% of Americans missing at least one tooth.
Throughout the day, your top and bottom teeth make hundreds of fleeting contacts with each other. These small stresses are transmitted though the periodontal ligament (“peri” – around; “odont” – tooth) that supports each tooth in its socket like a hammock. Think of it as a gentle push on the hammock, which causes the tooth to gently bump the underlying bone. The bone then builds up in the spot that's receiving stress to counteract it. This constant remodeling of bone is what allows bone to stay healthy and strong.
When a tooth is lost, the bone does not receive that gentle stress. It reacts by literally melting away. Sometimes this happens fairly quickly — in a matter of months. After the tooth-supporting bone is lost, the jawbone itself begins the same process of deterioration. This could eventually change the shape of the face, as the distance from nose to chin can decrease — even if only a few back teeth are missing. The results aren't pretty. But the good news is, there's a way to prevent all this.
Dental implants, which function as substitute tooth roots, actually save underlying bone when teeth are lost. They do this because they are made of titanium, which fuses to the bone in which it's set, stabilizing it. The implant is topped by a realistic-looking crown, which replaces the part of the missing tooth that was visible in the mouth. Together, they look and function just as your natural tooth did.
If you are missing a lot of teeth, implants can also be used to anchor bridges or even removable dentures while providing that same bone-saving benefit. And when you consider that they are so durable they should never need replacement, implants are a great investment.
If you have any questions about dental implants, please contact us, or schedule an appointment for an implant consultation.
You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”
Your car comes with a maintenance manual that tells you when to get an oil change, rotate the tires, and perform other necessary tasks. By following the manual's directions you can keep your car running in good condition for many years. Too bad a manual doesn't come with your teeth and gums!
Such a manual would concentrate on a few basic tasks we call oral hygiene and teeth cleanings. Both tasks are mainly dedicated to removing dental plaque or biofilm from the surfaces of your teeth and the surrounding gums. Plaque is now referred to as a biofilm, a film composed of bacteria, that naturally forms in your mouth. Studies have shown that dental plaque causes periodontal disease (gum disease) and dental caries (tooth decay).
Tips for Daily Removal of Dental Plaque
The way you hold your toothbrush is crucial to your ability to remove plaque effectively. We recommend that you hold it in your fingertips as you would a pen or pencil. Use small motions and pressure. Brushing too hard can damage gum tissues. Use a soft bristled brush, hold it at about a 45 degree angle to the gum line and then use a gentle scrubbing motion. Studies have shown some electric toothbrushes to be more efficient at plaque removal than hand-held brushes; but in general how you use the brush is more important than what kind of brush it is.
To remove plaque deposits from the hard-to-reach areas between your teeth, floss at least once a day. Wrap the floss around each tooth surface and gently move it up and down for a few strokes, cleaning the sides of your teeth where they face each other.
You can use an antibacterial mouthrinse to get help reduce the bacterial plaque or biofilm that you missed in brushing and flossing.
The best way to make sure you are brushing correctly is to have a dental professional demonstrate for you. We would be happy to demonstrate the correct techniques in your own mouth so that you can see how it feels, and you can copy the methods we use.
Professional Maintenance Schedule
Your car needs to go into the shop from time to time for professional maintenance. Your teeth also need a regular schedule of maintenance from a professional dentist or hygienist. Over time, plaque that you do not manage to clean off your teeth accumulates and forms hard deposits called calculus or tartar. If left on your teeth these deposits cause inflammation of your gum tissues and can lead to infection, abscesses, and even tooth loss. During a professional cleaning a technique called scaling removes these substances. For more advanced forms of gum disease, root planing is used to remove deposits of calculus below the gum line.
Contact us today to schedule an appointment to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”
When it comes to tooth pain, it is important to identify two things: what is causing your pain and what can be done about it. In some instances you can handle it yourself at home; however, for others, you should contact us so that we can diagnose and treat the problem. See how much you really know about tooth pain by taking our true/false test.
- It is perfectly normal to experience tooth sensitivity to hot and cold foods for a few days after dental treatment.
True or False - If you experience sharp pain when biting down on foods, you should hold off on contacting us to see if the pain gets better on it own.
True or False - Tooth pain is caused by a reaction of nerves inside the tooth's enamel with the severity of the pain dependant upon the type and degree of the stimulus.
True or False - Generally speaking, pain is a protective response that ranges from minor to severe as a way of informing the body that something is wrong.
True or False - If a tooth's root surface is sensitive, you should use a firm toothbrush to ensure that you are keeping the area clean by thoroughly removing dental bacterial plaque.
True or False - Lingering pain after eating hot or cold foods and liquids probably means that the pulp within your tooth is probably damaged or inflamed as a result of deep tooth decay or injury from a physical trauma.
True or False - Regarding tooth sensitivity, you should only contact us if the pain persists for several months because this is not likely to be anything serious.
True or False - If a tooth's pulp becomes damaged or dies, you will need a root canal.
True or False - With tooth pain, knowing how long to wait before you contact us can save physical, financial and emotional stress.
True or False - People often confuse tooth and sinus pain because they both can feel the same — a dull ache with pressure in the upper teeth and sinus area on one or both sides of the face.
True or False
Answers: 1) True. 2) False. You should contact us asap for an examination before the pain worsens. 3) False. The nerves are located in the tooth's pulp chamber. 4) True. 5) False. Use a soft bristled toothbrush not a firm one. 6) True. 7) False. While tooth sensitivity generally does not signal a serious issue, if it persist for days or worsens, contact us. 8) True. 9) False. Early interception is best. 10) True.
To learn more, continue reading the Dear Doctor magazine article “Tooth Pain? Don't Wait!” Or contact us today to schedule an appointment to discuss your questions.
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