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Posts for category: Dental Procedures

KeepYourNewStraightenedSmileStraightWithanOrthodonticRetainer

You can't correct a poor bite with braces or clear aligners overnight: Even the most cut-and-dried case can still require a few years to move teeth where they should be. It's a welcome relief, then, when you're finally done with braces or aligner trays.

That doesn't mean, however, that you're finished with orthodontic treatment. You now move into the next phase—protecting your new smile that took so much to gain. At least for a couple of more years you'll need to regularly wear an orthodontic retainer.

The name of this custom-made device explains its purpose: to keep or “retain” your teeth in their new, modified positions. This is necessary because the same mechanism that allows us to move teeth in the first place can work in reverse.

That mechanism centers around a tough but elastic tissue called the periodontal ligament. Although it primarily holds teeth in place, the ligament also allows for tiny, gradual tooth movement in response to mouth changes. Braces or aligner trays take advantage of this ability by exerting pressure on the teeth in the direction of intended movement. The periodontal ligament and nature do the rest.

But once we relieve the pressure when we remove the braces or aligners, a kind of “muscle memory” in the ligament can come into play, causing the teeth to move back to where they originally were. If we don't inhibit this reaction, all the time and effort put into orthodontic treatment can be lost.

Retainers, either the removable type or one fixed in place behind the teeth, gently “push” or “pull” against the teeth (depending on which type) just enough to halt any reversing movement. Initially, a patient will need to wear their retainer around the clock. After a while, wear time can be reduced to just a few hours a day, usually during sleep-time.

Most younger patients will only need to wear a retainer for a few years. Adults who undergo teeth-straightening later in life, however, may need to wear a retainer indefinitely. Even so, a few hours of wear every day is a small price to pay to protect your beautiful straightened smile.

If you would like more information on orthodontic retainers, 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 “The Importance of Orthodontic Retainers.”

EvenCelebritiesHaveAccidentsSeeWhatTheyDotoRestoreTheirChippedTeeth

Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.

Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.

Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.

The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.

Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.

Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.

Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.

If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”

By Dr Henry Lee
October 26, 2020
Category: Dental Procedures
Tags: dentures  
TodaysDenturesAreMoreSecureandComfortabletoWear

Although teeth are quite durable, we can still lose them—even all of them—to disease or injury. The good news, though, is that we have effective ways to restore teeth after they're lost. One of these, the removable denture, has given people their teeth back for several generations. And with recent advances in technology, today's dentures are even better.

Although more advanced, today's dentures share the same basic structure as those from a century ago: prosthetic (false) teeth set in a plastic resin colored to resemble the gums. The traditional denture is molded to fit snugly over an individual patient's alveolar jaw ridges, which once supported the former natural teeth. The denture stays in place primarily through a suction effect between the denture and the ridges.

Modern technology, though, has greatly improved today's dentures. Digital imaging can be used to generate highly accurate impressions of the dental ridges that can lead to denture bases with better fit. Dentists using photographs of the patient, especially in earlier years, are better able to identify facial landmarks, which enables them to position the new teeth to more closely recreate the patient's former smile.

These technological aids now help dentists to create more attractive dentures with better support and comfort. But the fit that makes this possible may not last due to a particular weakness inherent in traditional dentures—continuing bone loss. When teeth are missing, the underlying jawbone can lose bone volume over time. Dentures don't stop this process and can accelerate it due to constant friction and pressure on the dental ridges.

But a new modification incorporating dental implants with dentures can help solve these problems. By placing a few strategically positioned implants in the jawbone that then connect with the denture, the appliance not only gains more stability, but also produces less pressure on the dental ridges. In addition, bone cells naturally grow and adhere to the titanium implant posts, which helps to stop or slow bone loss.

If you've experienced total tooth loss, dentures are an affordable and effective option. Thanks to modern dental advances, you can get back the smile and dental function you once lost.

If you would like more information on denture 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 “Removable Full Dentures.”

TargetedToothRemovalCouldAidTreatmentforCertainBiteProblems

Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?

Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.

This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.

For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.

If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.

But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.

Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.

Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.

If you would like more information on orthodontic techniques, 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.”

RemovableorBondedRetainersHelpProtectYourNewStraighterSmile

The straightening process for a crooked smile doesn't end when the braces come off. There's one more crucial phase to undergo to make sure we don't lose the progress you've achieved: wearing an orthodontic retainer.

Although often viewed as a nuisance, retainers are important because they prevent realigned teeth from reverting to their old positions. This is possible because the periodontal ligament, the gum attachment that allows us to move teeth in the first place, can contain “muscle memory” that naturally tries to draw teeth back to where they once were.

A retainer prevents this from happening: During wear the subtle pressure they exert keeps or “retains” the teeth in their new positions until they're firmly established, usually after several months. While most patients initially wear a retainer around the clock, this will gradually taper off until they're worn primarily during sleep hours.

While retainers come in many different styles and sizes, most fall into one of two categories: removable or non-removable (bonded). The first type, a custom-made appliance a patient can easily take in and out of the mouth, has its advantages. Removing it makes it easier to clean the teeth. They're also adaptable to reduced wear schedules for eating, brushing and flossing, or for special occasions.

But a removable retainer may be noticeable to others. Its removability can also lead to problems. Out of the mouth they're prone to be lost, resulting in additional replacement costs. And immature patients may be easily tempted to take them out too often—or not wear them at all.

A bonded retainer solves many of these potential problems. Because the retainer wire is securely bonded to the back of the teeth, it's not visible to others. And because it can't be removed except by an orthodontist, there's virtually no chance of losing it or haphazard wear.

On the other hand, bonded retainers can occasionally break, requiring repair or replacement. And flossing is more difficult than with a removable retainer, although a little training from a dental hygienist can make that easier.

The choice of retainer depends on the individual and their priorities. But whether removable or bonded, a retainer is absolutely essential for protecting your new, hard-earned smile.

If you would like more information on bonded retainers, 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 “Bonded Retainers.”