Posts for: May, 2012
Why is it important to replace missing teeth with restorations such as dental implants? You might be surprised to find that the damage caused by missing teeth is much greater than the simple gaps left in your smile.
As the years go by, teeth lost early in adulthood cause structural changes in a person's face. By age 45 changes in facial structure are already visible in the form of sunken cheeks. By 60, cheeks and lips lose their support, resulting in an aging look. This process continues and if the teeth are not replaced, much of the structural support of the person's face is lost.
These changes are caused by loss of bone. Although it may seem static, bone is actually living tissue that needs constant stimulation to maintain its form and density. With normal stimulation it is in a constant state of resorption (breaking down) and deposition (building up). Teeth provide the needed stimulation for the bone that surrounds them (called alveolar bone) as they meet each other during biting, chewing, and speech. When the stimulation continues, the bone continues to rebuild itself. Without this stimulation, the bone resorbs, does not build up again, and loses substance.
Without stimulation, alveolar bone loses width, height, and volume. Since your teeth and their surrounding bone support your chin, cheeks, and lips, this has a powerful effect on your appearance. It may also affect your ability to chew and to speak.
As alveolar bone diminishes, the next layer of bone also begins to resorb. This is the bone of the jaw itself. The lower part of the face begins to collapse, and the cheeks become hollow. This effect is especially noticeable for people with no teeth (edentulous).
Usually the first tooth to be lost, due to infection and decay, is a molar (back tooth). In the past, a missing single back tooth was frequently replaced by a fixed partial denture (FPD). A crown is provided for each of the two teeth on the sides of the gap, called abutment teeth, to support a false tooth in the middle. However, if they are not well cared for, the abutment teeth may be the next to succumb to decay.
Today the treatment of choice is an implant. A dental implant is a tooth-root replacement made of titanium, which fuses with the bone — making it very stable. Above the gums it is covered by a crown that looks like a natural tooth. The benefit of the implant is that it continues to provide stimulation to the alveolar bone, preventing bone loss.
Implants are also a good choice in the case of multiple missing teeth. They can be used to support bridges or false teeth (dentures). The results are an improved, younger appearance and better functionality.
Contact us today to schedule an appointment to discuss your questions about missing teeth. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”
If you are dissatisfied with the way your smile looks, and your dentist is unhappy with the way your teeth fit together — but you don't like the idea of wearing braces — clear aligners may be your best solution. How much do you know about this teeth-straightening alternative? Below are some FAQs on the subject.
What do we mean by clear aligners? Clear aligners are a system for straightening teeth that uses clear plastic removable “trays” that fit over your teeth. As the teeth move to fit the trays, new trays are substituted that are designed to continue to move your teeth into the desired position. This system is an alternative to the traditional system of brackets and wires known as braces.
How can teeth be moved to new positions? The connection that holds a tooth in place in your jaws — the periodontal ligament — is not immobile. It constantly changes its position based on the normal forces of your bite. As the ligament is pushed on one side and pulled on the other, the living cells of your mouth respond by depositing bone and cementum (the protective covering of the tooth's root) on one side and dissolving it on the other. Normally this happens in a balance, maintaining your teeth in their position. We can manage these slight changes by applying constant light forces to move teeth in a predictable way.
How long does it take to move teeth to their optimum position using clear aligners? As with braces, the process is gradual. Total treatment time can range from six months to two years.
Do the trays have to be worn all the time? As you move through the sequence of trays, each is worn for 20 hours per day for two weeks. They may occasionally be removed for important social occasions.
How does an orthodontist design the sequential trays that are used? The trays are designed using a computer, based on an assessment and images of your mouth, teeth and jaws.
What kinds of problems can clear aligners correct? This method works well to correct mild to moderate crowding or spacing. If your back teeth already fit together as they should, the system may be ideal. If you have an extreme overbite or underbite, braces might work better.
Are clear aligners an alternative for everyone? Clear aligners are recommended for adults and recently, teenagers. They are not usually recommended for young children.
Why is it important to have your teeth straightened? Besides the obvious benefit of feeling better about yourself and your appearance, straight and well-aligned teeth work better. You will experience a better-functioning bite and can improve your oral health.
Contact us today to schedule an appointment to discuss your questions about orthodontics and clear aligners. You can also learn more by reading the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Moving Teeth With Orthodontics.”
For a bride, there is so much to remember when planning the wedding — invitations, a dress, flowers, the site, the caterers, the cake, the photographer — the list goes on and on. In the midst of all these things, don't let a very important piece of the plan be forgotten — your smile!
Your wedding will be celebrated every year on your anniversary and commemorated in beautiful photos at any time. It is a special occasion you, your family, and your friends will always remember. But how will you and your family look in those photos? You have an opportunity to get makeovers that will make your smiles shine radiantly, and not only in your album. Your makeover will improve your appearance, your self-confidence, and your oral health far into the future.
Start with a visit to your dentist to assess your current situation and discuss your goals and dreams. Each person's situation will be different. At a minimum you may need a professional cleaning to make sure that your teeth and gums are healthy. Get started on treating any cavities or gingivitis (gum inflammation). If you haven't already, now is a great time to establish healthy dental hygiene habits including proper daily brushing and flossing.
You may feel that your teeth are discolored and need to be whiter and brighter. Your upper and lower jaws may not meet properly for the most effective biting and chewing. Your teeth may be crowded or misshapen. All these things and more can be modified and repaired with today's dentistry.
Teeth can be whitened by bleaching in the dentist's office or with products that can be used at home under a dentist's supervision.
Orthodontia may be needed to repair your bite. Today orthodontia may be done either with traditional braces, or with clear aligners. Remember that this process works slowly, so start well in advance of your wedding day.
After your teeth are properly aligned, your dental team can work on subtle contouring, overall shape and color changes for individual teeth, using techniques such as porcelain laminate veneers. Temporary veneers can be made so that you can try out your new look before the final installation.
Wedding planning works best when started early. To make sure you, your new spouse, and your family look and feel their best, remember to include smile makeovers in your plan.
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.
- 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.”