Posts for category: Dental Procedures

By Susanne M. Sanford, D.D.S.
June 19, 2021
Category: Dental Procedures
Tags: veneers  
ThisOneCosmeticMethodCouldImproveaMultipleofToothFlaws

You could have an unattractive smile because of a chipped tooth or one slightly out of alignment. Or, it could be both of the above, plus some heavy staining to boot. Correcting each flaw individually might require a combination of different methods like orthodontics or porcelain crowns, which can take an extended period of time to complete.

But you may be able to correct numerous smile flaws with just one method—and in no more than a couple of treatment visits. It's called direct veneers.

Unlike regular veneers, direct veneers don't require a dental technician to craft a thin porcelain shell to bond over teeth. Rather, a dentist applies a tooth-colored material called composite resin to the problem teeth and "sculpts" an entirely new look that can correct multiple dental flaws at one time.

The dentist usually begins the process by creating a model ("wax-up") of proposed changes based on physical impressions of the jaw and teeth. Both dentist and patient can study the model and modify it if necessary, when finalizing the treatment plan.

At a subsequent appointment, the dentist prepares the tooth surface for bonding by removing a thin layer of tooth enamel, then shapes the teeth to better accommodate the composite resin. This tooth prep is similar to that done with traditional veneers, so it's permanent—the teeth will require some form of restoration from then on.

After applying an etchant and a bonding agent, the dentist applies the composite resin in small amounts, hardening each layer with a special light before applying the next one. With each subsequent layer, the dentist sculps the composite material to eventually resemble the wax-up model.

After completing the composite application, the dentist then uses hand tools and a dental drill to complete shaping, as well as an abrasive strip between teeth to aid future flossing. After just a few hours, the transformation is complete.

Direct veneers are durable, but not to the same extent as regular veneers or other cosmetic enhancements. They can also pick up stains over time, and may require re-treatment at some point. Still, direct veneers are a cost-effective way to improve the appearance of teeth with multiple flaws that could radically change your smile for the better.

If you would like more information on the direct veneer method, please contact us or schedule an appointment for a consultation.

By Susanne M. Sanford, D.D.S.
April 30, 2021
Category: Dental Procedures
RemovingTeethMightMakeItEasierToStraightenaSmile

Dentists remove millions of teeth each year, often because of tooth decay or gum disease. But disease isn't the only reason—a tooth extraction might make it easier to straighten a crooked smile.

Realigning teeth for therapeutic or cosmetic reasons is a regular undertaking in dentistry, but the process itself often differs from person to person. Each individual patient requires their own treatment plan taking into account factors like the kind of bite problem involved, the size of the jaw and the space available to move teeth.

This plan could indeed involve removing teeth. For example, an abnormally small jaw could cause crowding. Not only can crowding move teeth out of position, it may also leave little to no room for moving teeth. Although dentists can minimize crowding by influencing jaw development in early childhood, removing teeth for more space is usually the only option available to older adolescents and adults.

Similarly, teeth can fail to erupt properly and remain partially or fully submerged beneath the gums (known as impaction). There is an orthodontic method for pulling an impacted tooth fully onto the jaw, but only if the tooth isn't too far out of alignment. Otherwise, it may be better to remove the impacted tooth and then correct any gaps with braces or a dental implant.

There's also a situation on the opposite side of the spectrum that could benefit from teeth removal—when one or more permanent teeth fail to form, known as congenitally missing teeth. This can cause gaps in the smile or a “lopsided” appearance where a tooth on one side of the jaw is present while its counterpart on the opposite side of the jaw is missing.

The missing tooth can be replaced by an implant, bridge or other restoration. But another option may be to remove the existing counterpart tooth, and then close the gaps. This can result in a much more attractive smile that might be simpler and less costly than replacing the missing tooth.

Again, the decision to remove teeth to improve smile appearance depends on the patient and their particular dental condition. But in the right situation, it could make straightening a smile easier and more effective.

If you would like more information on orthodontic treatments, 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 “Removing Teeth for Orthodontic Treatment.”

By Susanne M. Sanford, D.D.S.
April 10, 2021
Category: Dental Procedures
Tags: celebrity smiles   crown  
WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

By Susanne M. Sanford, D.D.S.
March 31, 2021
Category: Dental Procedures
Tags: dental implants  
ImplantsCouldHelpYouKeepRemainingTeethLonger

It's a common practice among people slowly losing their teeth to have their remaining teeth removed. They find dentures to be less costly than replacing one tooth at a time or caring for those that remain. On the other hand, it's usually healthier for the mouth to preserve remaining teeth as long as possible, replacing them only as necessary.

This latter strategy has up to now been difficult and expensive to achieve. But dental implants are changing that—using these imbedded titanium metal devices with a variety of restorations, we're able to better plan and implement staged tooth replacement.

Most people associate implants with single tooth replacements of a life-like crown cemented or screwed into an abutment attached to the implant post. This can play an early role in a staged replacement plan, but at some point, multiple single-tooth implants can become quite expensive.

Implants, however, have a much broader range of use. A few strategically placed implants can support a variety of restorations, including bridges and removable or fixed dentures. Four to eight implants, for example, can secure a fixed denture replacing all teeth on a jaw, far fewer than the number needed to replace the teeth individually.

Implants may also improve the function of traditional restorations. For instance, dentures can't stop the bone loss that often results from tooth loss—in fact, they will accelerate it as they rub and irritate the bony ridges of the jaw. By contrast, implants stimulate bone growth, slowing or even stopping the process of bone loss.

In a traditional bridge, the outer crowns of the restoration are bonded to the teeth on either side of the missing tooth gap (the middle crowns fill the gap). These support teeth must be permanently altered to accommodate the crowns. But an implant-supported bridge doesn't depend on other teeth for support, thus eliminating the need to permanently alter any teeth.

More importantly, previously placed implants often become part of the next stages of tooth replacement, like building on an addition onto an existing house. All in all, including implants in your ongoing dental restoration can help you enjoy the benefits of preserving your natural teeth for much longer.

If you would like more information on dental restoration options, 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 “Replacing All Teeth but Not All at Once.”

By Susanne M. Sanford, D.D.S.
March 11, 2021
Category: Dental Procedures
Tags: dental implant  
OvercomingBoneLossPreventingYouFromGettinganImplant

Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.

But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.

This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.

This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.

But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.

Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.

Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.

If you would like more information on dental implant restoration, 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 Implants After Previous Tooth Loss.”