Posts for category: Dental Procedures
Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.
After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.
More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.
Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.
Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.
Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.
A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.
Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.
If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?”
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
It takes a lot of skill, experience, talent and artistry to create tooth restorations that look so natural that no one can tell them apart from the originals. To do so requires understanding of the normal anatomy of a tooth as well as of the interactions of light and color.
How the anatomy of a tooth determines color
The color that we perceive when looking at a tooth results from the combined appearance of the tooth’s center core (dentin layer) and its covering enamel. Going from the outside in, the enamel is made of tightly packed crystals of calcium, which cause it to be one of the hardest substances naturally produced by animals. The crystals are also responsible for a tooth’s brilliance and translucence. The dentin is more like bone, a porous living tissue composed of microscopic tubes, interspersed with more calcium crystals. In the very center of the tooth is a central chamber containing the pulp and nerves.
Each of these layers has its own physical and optical properties. Since the enamel is translucent and the dentin is more opaque, most of the tooth’s color comes from the dentin and is transmitted through the enamel layer. Factors that affect this transmission include the thickness and age of the enamel as well as external tooth whitening.
If the enamel is more translucent, more of the color of the dentin shows through. If it is more opaque, the enamel absorbs and reflects light so that less color is visible and the enamel looks brighter.
The language of color composition and reflected light
Color means the whole spectrum in the rainbow. The spectrum is made up of the three primary colors — red, blue, and green. When all are combined, they create white light.
Hue refers to the brightest forms of the colors. The color we perceive depends on the dominant wavelength of light that is reflected by an object.
Value refers to a color’s lightness or darkness. A brighter color has a higher value.
Chroma is the amount of identifiable hue in a color. An achromatic color (without hue) appears gray.
Saturation is a measure of a color’s intensity.
This terminology of color is used not only by dentists and dental technicians, but also by a wide range of artists. It implies expertise and understanding of how colors work, how they vary and change and affect one another.
Contact us today to schedule an appointment or to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor article, “Artistic Repair of Front Teeth with Composite Resin.”
It’s a common problem for denture wearers: after years of a comfortable fit, your dentures now seem to be uncomfortably loose. The reason, though, may have more to do with bone loss than the dentures.
Bone is a living tissue with a life cycle — it forms, it ages, and it eventually dies and dissolves (resorbs). It’s replaced with new bone and the cycle repeats. Additionally, the forces generated when we bite or chew are transmitted from the teeth to the jaw, which helps stimulate new bone growth. When the natural teeth are missing, however, the bone no longer receives this stimulus. Resorbed bone isn’t replaced at a healthy rate, which leads over time to bone loss.
Denture construction can also contribute to bone loss. The denture palate rests for support on the bony ridges that once held the teeth. Over time the compressive forces of the dentures apply damages and reduces the volume of gum tissue and eventually does the same to the bone. Combining all these factors, the reduced gum and bone volume will eventually alter the denture fit.
There are a few alternatives for correcting loose dentures. One is to reline them with new plastic, as either a temporary fix performed during an office visit or a more permanent relining that requires sending your dentures to a dental lab. Depending on the rate of bone loss, a patient could go through several denture relinings to accommodate ongoing changes in the jaw. At some point, though, it may be necessary to create a new set of dentures.
A third alternative that’s becoming increasingly useful is to incorporate dental implants into the denture design. Implants can of course be used to replace individual teeth, but a few strategically placed implants (usually of smaller dimension) can serve as a support platform for a removable denture. This relieves some of the compression force of a traditionally worn denture and can slow bone loss.
If you’re having problems with your denture fit, call us for an appointment. We’ll help you decide on the best alternative to improving the fit and making your dentures more comfortable and secure.
If you would like more information on refitting loose dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Dentures.”
Your teeth and gums are filled with nerves that make the mouth one of the most sensitive areas in the body. But thanks to local anesthesia, you won't feel a thing during your next dental procedure.
The word anesthesia means “without feeling or pain.” General anesthesia accomplishes this with drugs that place the patient in an unconscious state. It's reserved for major surgery where the patient will be closely monitored for vital signs while in that state.
The other alternative is local anesthesia, which numbs the area that needs treatment, while allowing the patient to remain conscious. The anesthetics used in this way are applied either topically (with a swab, adhesive patch or spray) or injected with a needle.
In dentistry, we use both applications. Topical anesthesia is occasionally used for sensitive patients before superficial teeth cleaning, but most often as an “opening act” to injected anesthesia: the topical application numbs the gums so you can't feel the prick of the needle used for the injectable anesthetic. By using both types, you won't feel any pain at all during your visit.
Because of possible side effects, we're careful about what procedures will involve the use of local anesthesia. Placing a sealant on the exterior of a tooth or reshaping enamel doesn't require it because we're not making contact with the more sensitive dentin layer beneath. We've also seen advances in anesthetic drugs in which we can now better control the length of time numbness will persist after the procedure.
All in all, though, local anesthesia will make your dental care more comfortable — both for you and for us. Knowing you're relaxed and comfortable allows us to work with ease so we can be unhurried and thorough. By keeping pain out of the equation, your dental care has a better chance for a successful outcome.
If you would like more information on managing discomfort during dental care, 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 “Local Anesthesia for Pain-Free Dentistry.”