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Posts for category: Dental Procedures

By George Mui, DDS, Ltd. Gentle Dental Care
October 13, 2020
Category: Dental Procedures
Tags: veneers  
DirectVeneersOfferaQuickandAffordableAlternativetoTraditionalVeneers

Orthodontics, veneers and other cosmetic dental techniques can turn a less than perfect smile into a beautiful one—but not always very quickly. For example, porcelain veneers can take weeks from planning to installation, including the meticulous work of an outside dental lab to produce veneers that look natural as well as beautiful.

But you may be able to take advantage of another approach, one that often takes no more than a couple of dental visits. Called direct veneers, it's actually a process of bonding and sculpting life-like composite materials to teeth that are heavily stained, chipped or that contain tiny crevices called “craze lines.”

Unlike the similarly-named traditional method, direct veneers don't involve the creation of layered porcelain veneers fashioned by a dental lab. But this newer process is similar to the older one in that some of the enamel must be removed from the teeth in question to provide a suitable surface for the composite material to adhere. This alteration will be permanent, requiring a restorative covering on the treated teeth from then on.

Right before this preparation, though, a dentist typically makes an impression of the patient's mouth. This will be the basis for creating the procedural plan for the dental work, particularly a “trial smile” from similar composite material that can be applied to the patient's teeth before actual restoration work begins. This temporary application gives both patient and dentist an opportunity to visualize the final look, and make needed adjustments in color and shaping.

Once the work plan is finalized, the patient then returns for the actual restoration procedure. The dentist begins by applying and bonding the composite material to the prepared teeth. Then, using a drill and manual instruments, the dentist shapes and smooths the material into a tooth-like appearance that blends with other teeth. The procedure can take a few hours, but it can usually be completed during a single visit.

Although direct veneers may not last as long as porcelain veneers, the process is less costly and requires less time to complete. Direct veneers could be an economical solution for achieving a more attractive smile.

If you would like more information on direct veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic with a firsthand patient account by reading the Dear Doctor magazine article “A New Smile With Direct Veneers.”

By George Mui, DDS, Ltd. Gentle Dental Care
October 03, 2020
Category: Dental Procedures
Tags: dental implant  
CouldaMetalAllergyStopYouFromGettingDentalImplants

The subject of allergies covers a wide swath in medicine. Among other things, people have allergic reactions to animal fur, various foods and plant pollen. The effects are equally wide-ranging, anything from a mild rash to anaphylaxis, a life-threatening shutdown of the body's vital systems.

Approximately 5% of people are also allergic to various metals including nickel, cobalt, chromium and gold. Reactions to metal can occur when an allergic person comes in contact with items like jewelry, clothing or even mobile phones. There's even a chance of a metal allergy reaction from certain kinds of dental work.

It's unlikely, though, that you should be concerned if you're considering dental treatment or cosmetic work to upgrade your smile. Although allergic reactions like inflammation or a rash have been known to occur with amalgam “silver” fillings, it's quite rare. It's even less of a concern since “tooth-colored” materials for fillings are now outpacing the use of amalgam fillings, which are used in out-of-sight back teeth.

Of course, metal is used for other dental treatments besides fillings, including the most popular of tooth replacement systems, dental implants. An implant is essentially a metal post, usually made of pure titanium or a titanium alloy, which is imbedded into the jawbone. Even so, there's little chance you'll develop an allergic reaction to them.

For one thing, titanium is highly prized in both medical and dental treatments because of its biocompatibility. This means titanium devices like prosthetic joints and implants won't normally disrupt or cause reactions with human tissue. Titanium is also osteophilic: Bone cells readily grow and adhere to titanium surfaces, a major reason for dental implants' long-term durability.

That's not to say titanium allergies don't exist, but their occurrence is very low. One recent study detected a titanium allergy in only 0.6% of 1,500 implant patients who participated.

At worst, you may need to consider a different type of tooth replacement restoration in the rare chance you have a titanium allergy. More than likely, though, you'll be able obtain implants and enjoy the transformation they can bring to your smile.

If you would like more information on allergic reactions and 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 “Metal Allergies to Dental Implants.”

By George Mui, DDS, Ltd. Gentle Dental Care
September 23, 2020
Category: Dental Procedures
Tags: root canal   tooth pain  
TheremaybemoretothatToothachethatSuddenlyStopsAching

If a pain you’ve been feeling goes away, you might believe the problem that caused it is gone too. But that doesn’t mean it has, especially with a tooth. An excruciating toothache that suddenly stops should still be examined. Here’s why.

Tooth decay often works its way into a tooth’s innermost layer, the pulp, which contains bundles of nerves and other tissue. The infection attacks the nerves, which send pain signals to the brain. As the infection persists, though, the nerves will eventually die and will no longer be capable of sending pain signals — hence the “mysterious” end of your toothache.

Although the pain has stopped, the infection is very much active in the tooth and will continue to work its way through the root canals to the jaw. And ultimately, the pain will return as the infection invades the bone.

But there’s good news: a tooth in this condition can be saved with a procedure known as root canal therapy. We drill a small hole in the tooth to access the pulp, usually through the biting surface of back teeth or in the rear in front teeth. Once inside the pulp chamber, we clean out the infected and dead tissue. We then fill the empty pulp chamber and the root canals with a special filling and seal the access hole. In a few weeks the tooth receives a life-like crown to further protect it from re-infection and fracture years later.

A straightforward root canal treatment can be performed by a general dentist. If there are complications like a complex root canal network, however, then the skills and specialized equipment of an endodontist (a specialist in root canals) may be needed.

A root canal treatment resolves the real cause of a toothache that suddenly stopped, as well as puts an end to future pain and infection related to the tooth. More importantly, it can save your tooth and add many more years to its life.

If you would like more information on 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 “A Severe Toothache.”

By George Mui, DDS, Ltd. Gentle Dental Care
September 18, 2020
Category: Dental Procedures
Tags: partial denture  
APartialDentureCanRestoreaSmileMarredbyaFewMissingTeeth

Dentures in one form or another have been around for centuries. Although dental implants have earned a well-deserved prominence of late, the denture still remains a viable tooth replacement option.

What's more, dentures aren't reserved for total tooth loss only. Even if you've lost just a few of your teeth, we can fit you with a removable partial denture (RPD). Although mainly considered a temporary solution for missing teeth, some people depend on an RPD for many years due to finances or other issues.

The traditional RPD consists of a rigid acrylic plastic base that resembles gum tissue supported by a metal framework, with prosthetic (false) teeth precisely placed to fill the space of the missing teeth. They're held in place with metal clasps that extend from the metal framework to fit over the remaining natural teeth.

Although they're an effective restoration, traditional RPDs have a few drawbacks. Some people find them uncomfortable to wear or have an allergy to the acrylic plastic. They also have a propensity to stain from beverages like tea, coffee or wine.

But there's a more recent version called a flexible RPD that addresses these and other concerns. It's made of a pliable nylon that's durable, yet comfortable to wear. Rather than metal clasps, they're secured in place with thin, finger-like nylon extensions that fit into the small, natural depressions in the crowns of the teeth around the gum line.

Flexible RPDs are also highly adaptable to appear life-like in many situations. We can fashion the nylon base to cover areas around natural teeth where the gums may have receded due to gum disease.

They do, however, have a few downsides. Unlike traditional dentures, they're difficult to reline or repair. Like any oral appliance, they can suffer from wear and neglect, so you must properly clean and maintain them. And, like any RPD their best role is as a temporary bridge rather than a permanent restoration.

In the meantime, though, you can count on a flexible RPD to restore your ability to eat and speak proficiently, as well as smile with confidence. It's a great affordable way to address a few missing teeth.

If you would like more information on dentures as a restoration option, 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 “Flexible Partial Dentures.”

By George Mui, DDS, Ltd. Gentle Dental Care
August 29, 2020
Category: Dental Procedures
Tags: porcelain veneers  
PorcelainVeneersMightnotbetheBestOptionforTeenagers

For chipped, stained, or slightly crooked teeth, dental veneers might be the ideal solution. These thin layers of porcelain bonded directly over the teeth with the perfect blend of color, sizes and shapes, can transform a person’s smile for a relatively modest cost.

But if the teeth belong to a teenager, veneers might not be appropriate. This is because in most cases, we’ll need to remove some of the tooth enamel so that the applied veneers won’t look unnaturally bulky. This alteration is permanent, so the teeth will require some form of restoration from then on.

While not usually a major issue with fully matured adult teeth, it could be with the developing teeth of pre-teens and teens. During childhood and adolescence the tooth’s inner pulp plays an important role in dentin production, and so the pulp chamber is relatively large compared to an adult tooth. This larger size places the pulp closer to the enamel surface than with an adult tooth.

Because of its proximity to the enamel, there’s a greater chance veneer alterations could damage a teenager’s tooth pulp and its nerve bundles. If that happens, we may need to perform a root canal treatment to save the tooth—also not an optimal situation for a developing tooth.

That’s why we need to take into consideration a patient’s age and stage of dental development first, including x-raying the affected teeth to measure the depth of the tooth pulp. If we deem it too risky at the moment, there are other ways to improve dental appearance at least temporarily. This includes whitening externally stained teeth with a bleaching agent, or applying tooth-colored composite resin material to chipped areas. We can also apply a composite material veneer that, although not as durable as traditional porcelain, doesn’t require much if any tooth alteration.

To know your options, have your teenager undergo a thorough dental examination. Your dentist will then be able to discuss with you whether veneers can be safely attempted. And be sure the dentist who may perform the work has experience performing cosmetic procedures on teenagers.

If you would like more information on restoration choices for teenagers, 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 “Veneers for Teenagers.”