Your otherwise beautiful smile has one noticeable flaw — one or more of your teeth are deeply discolored or stained. More than likely this staining is deep within the teeth, what we refer to as intrinsic staining. There are a number of reasons this can occur — from fillings or use of antibiotics, for example — and our first approach should be to attempt a whitening technique.
However, if that doesn't produce the desired result, porcelain laminate veneers are another option you might consider. Veneers are made of dental porcelain, a bio-compatible material that can be shaped and colored to closely match neighboring teeth. After a minimal amount of tooth reduction (removal of some of the enamel from the tooth surface) to prepare for the laminate, the veneers are then permanently bonded to the tooth surface and cover the discolored natural tooth. Besides changing the appearance of discolored or stained teeth, veneers can also be used to correct other imperfections such as chipped or misshapen teeth.
Patients, however, have a common question: how long will the veneers last? With proper care, veneers can last anywhere from seven years to more than twenty years. It's possible, though, to damage them — for example, you can break them if you bite down on something that goes beyond the porcelain's tolerance range, such as cracking nut shells with your teeth (not a good idea even for natural teeth!). You should also keep in mind that veneers are composed of inert, non-living material and are attached and surrounded by living gum tissue that can change over time. This process may eventually alter your appearance to the point that the veneer may need to be removed and reapplied to improve the look of your smile.
If a veneer is damaged, all is not necessarily lost. It may be possible to re-bond a loosened veneer or repair a chipped area. The worst case is replacement of the veneer altogether. Chances are, though, this will only happen after the veneer has already served you — and your smile — for many years.
If you would like more information on porcelain laminate veneers, 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 “Porcelain Veneers.”
You've probably heard about dental implants — today's best option for replacing missing teeth; maybe you even have one or more already. A dental implant is a tiny screw-shaped metal post that sits in your jawbone and supports a lifelike dental crown. Natural teeth and implant-supported teeth have differences and similarities.
The main difference between implants and natural teeth — besides the fact that you were born with one and not the other — is the way they attach to your bone. Implants actually fuse to the bone, becoming part of it. This is a unique property of titanium, the metal from which implants are made. Maintaining that attachment is extremely important; we will discuss how best to ensure that in a moment.
Natural teeth do not ever become part of the bone that surrounds them. Instead, they attach to it via the periodontal ligament (“peri” – around; “odont” – tooth), which is made up of tiny fibers that go into the tooth on one side and the bone on the other. These fibers form a sort of hammock for each tooth.
Another difference is that natural teeth can decay while implant-supported teeth can't. But that doesn't mean you don't have to worry about dental hygiene — far from it! And here's where we get to the main similarity: oral hygiene is extremely important to maintain both teeth and implants. Lax oral hygiene for either can result in bacterial infections that may lead to gum disease, and even bone loss.
The main enemy of a properly fused implant is a bacterial infection known as “peri-implantitis” (“peri” – around; implant “itis” – inflammation), which starts when bacterial biofilm (plaque) is allowed to build up on implant-supported crowns. Peri-implantitis can lead to a well-like or dish-shaped loss of bone around the implant, which in turn can cause the implant to lose its attachment to the bone. If this happens, the implant can no longer function. Fortunately, this infection is preventable with good brushing and flossing techniques at home, and regular professional cleanings here at the dental office.
So another similarity, then, is that natural teeth and implants can last a lifetime with proper care. And that's the result we're aiming for!
If you are one of the millions of Americans with missing teeth, then you're probably aware of some of the obvious side effects. You may feel self-conscious during conversations or simply avoid smiling altogether to conceal your dental issue. It is not uncommon for missing teeth to affect your confidence, but did you know that there are other problems that result from tooth loss?
For starters, if you have lost enough teeth, eating may become more difficult, in particular healthy foods, such as fruits and vegetables. This is one of the main reasons that inadequate dental care frequently results in nutritional deficiency.
Another very serious issue that results from missing teeth is bone loss. We sometimes refer to this as a “hidden consequence,” because you may not actually see or feel this issue right away. Did you know that bone is actually living tissue that needs constant stimulation to maintain its form and density? Thus, when a tooth is lost, the bone in the jaw that surrounded and supported that tooth melts away. There is a 25% decrease in width of bone during the first year after tooth loss and an overall 4 millimeters decrease in height over the next few years. The longer you have missing teeth, the greater the loss of bone.
As bone loss continues, it can actually affect the structure of your face. If you lose your teeth early in adulthood, by age 45 you might start to notice sunken cheeks. By age 60, your cheeks and lips will lose their support, resulting in a collapsed and aged look. If your teeth are not replaced, this process will continue, and you will be in danger of losing much of the structural support of your lips and cheeks.
Luckily, we can use dental implants to not only restore your smile, but also to halt this bone loss. Implants look, feel and function like your natural teeth and are made of titanium, which has the unique ability to fuse with your living bone. Among the many benefits of implants, they continue to provide stimulation to your bone, preventing further bone loss.
With a success rate of more than 95%, implants are the best long-term solution for tooth replacement.
If you would like more information about implants and bone loss, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”
One of our primary goals in dentistry is to deliver effective treatment to patients with the least amount of discomfort. This is especially true after a procedure — controlling pain and inflammation will actually help reduce recovery time.
There are many strong pain relievers available, including prescription opiates like morphine or codeine. It has been shown, however, that healing and comfort are enhanced with non-steroidal anti-inflammatory drugs (NSAID) because they not only minimize pain, but they also reduce inflammation after a procedure. One common NSAID is Ibuprofen, which works by blocking prostaglandins, a substance released by inflamed, damaged tissues. NSAIDs are very popular with dentists and other health professionals because they act primarily on the inflammation site and don’t impair consciousness like opiates. They’re also usually less expensive than pain medication requiring a prescription.
While relatively safe, NSAIDs do have side effects that could cause serious problems for some patients. The most common caution regards NSAID’s tendency to thin blood and reduce the natural clotting mechanism, especially if taken habitually over a period of time. They can damage the kidneys and the stomach lining (causing ulcers or dangerous bleeding), and they’ve also been linked to early miscarriages and heart attacks.
For these reasons, NSAIDs are not recommended for pregnant women, patients with a history of stomach or intestinal bleeding, or patients being treated for heart disease. In the latter case, NSAIDs may interfere with the effectiveness of low-dose aspirin therapy (another type of NSAID) to prevent future heart attacks or strokes.
Health officials recommend all patients limit their dosage of a NSAID to no more than 2400 milligrams a day for short term pain relief, unless otherwise advised by a doctor. For the most part, a single 400 mg dosage is usually sufficient for pain control during a post-procedure recovery.
Your dentist will typically obtain your medical history before you undergo a dental procedure, including the medications you’re taking. Depending on your current health status and the type of procedure you’re undergoing, your dentist will recommend a pain control regimen to follow after the procedure is over.
Following those recommendations, and alerting your healthcare provider if you encounter any side effects from pain medication, will help assure your recovery period after dental work is short, safe and uneventful.
If you would like more information on the use of NSAIDs to control discomfort after a dental procedure, 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 “Treating Pain With Ibuprofen.”
Dental implantation is the premier option for tooth replacement available today. While acquiring dental implants does involve a surgical procedure, don’t let that deter you — with proper preparation the procedure is relatively minor and routine.
Implants are root replacements inserted directly into the jawbone to which a life-like, artificial crown is secured (strategically placed implants can also support fixed bridges or removable dentures). They’re typically made of titanium, which is osseophilic or “bone-loving”: bone will grow and adhere to the implant over a few weeks time.
Pre-planning can help minimize discomfort during and after the implantation procedure. We first conduct a radiographic examination of the site with x-rays or CT imaging; this enables us to assess the site’s bone quality and quantity. We can also create a surgical guide from the imaging to pinpoint the precise location for an implant to ensure a successful outcome.
Before beginning the procedure, we numb the area with a local anesthesia (we can also administer a sedative or other relaxation medication if you’re experiencing mild apprehension). The procedure often begins by creating a flap opening in the gum tissue with a few small incisions to access the bone. Using the surgical guide, we then begin a drilling sequence into the bone that progressively increases the size of the hole until it precisely matches the size and shape of the implant.
When the site preparation is complete, we remove the implant from its sterile packaging (which minimizes the chance of infection) and immediately insert it into the prepared site. We verify proper positioning with more x-rays and then suture the flap opening of the gum tissue back into place.
Thanks to both the pre-planning and care taken during surgery, you should only experience minimal discomfort. While narcotic pain relievers like codeine or hydrocodone may be prescribed, most often non-steroidal anti-inflammatory drugs like aspirin or ibuprofen are all that’s needed. We may also prescribe an anti-bacterial mouthrinse (with chlorhexidine) to assist healing.
In just a few weeks your custom-made restorations will be attached to the implants. It’s the completion of a long but not difficult journey; the resulting smile transformation, though, can last for many years to come.
If you would like more information on dental implants, 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 “Dental Implant Surgery.”
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