Posts for category: Dental Procedures
One in 700 babies are born each year with a cleft lip, a cleft palate or both. Besides its devastating emotional and social impact, this common birth defect can also jeopardize a child's long-term health. Fortunately, incredible progress has occurred in the last half century repairing cleft defects. Today's children with these birth defects often enter adulthood with a normal appearance and better overall health.
A cleft is a gap in the mouth or face that typically forms during early pregnancy. It often affects the upper lip, the soft and hard palates, the nose or (rarely) the cheek and eye areas. Clefts can form in one or more structures, on one side of the face or on both. Why they form isn't fully understood, but they seem connected to a mother's vitamin deficiencies or to mother-fetus exposure to toxic substances or infections.
Before the 1950s there was little that could be done to repair clefts. That changed with a monumental discovery by Dr. Ralph Millard, a U.S. Navy surgeon stationed in Korea: Reviewing cleft photos, Dr. Millard realized the “missing” tissue wasn't missing—only misplaced. He developed the first technique to utilize this misplaced tissue to repair the cleft.
Today, skilled surgical teams have improved on Dr. Millard's efforts to not only repair the clefts but also restore balance and symmetry to the face. These teams are composed of various oral and dental specialties, including general dentists who care for the patient's teeth and prevent disease during the long repair process.
Cleft repairs are usually done in stages, beginning with initial lip repair around 3-6 months of age and, if necessary, palate repair around 6-12 months. Depending on the nature and degree of the cleft, subsequent surgeries might be needed throughout childhood to “polish” the original repairs, as well as cosmetic dental work like implants, crowns or bridgework.
In addition to the surgical team's skill and artistry, cleft repair also requires courage, strength and perseverance from patients and their parents, and support from extended family and friends. The end result, though, can be truly amazing and well worth the challenging road to get there.
If you would like more information on repairing cleft birth defects, 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 “Cleft Lip & Cleft Palate.”
You're doing all the right things helping your child avoid tooth decay: daily brushing and flossing, regular dental visits and a low-sugar diet. But although occurrences are low, they're still getting cavities.
Some children still struggle with tooth decay even with proper dental care. If this is happening to your child, your dentist may be able to give them an extra preventive boost through topical fluoride.
Fluoride has long been recognized as a proven cavity fighter. Often added in small amounts to toothpastes and drinking water, fluoride strengthens tooth enamel against acid attacks that create cavities. With topical fluoride, a dentist applies a varnish, foam or gel containing a more concentrated amount of the chemical directly to the teeth.
The effectiveness of this method in reducing tooth decay is well-founded: A number of scientific studies involving thousands of children and adolescents found an average 28% reduction in occurrences of decay among those who received the treatment compared to those who didn't.
Still, many parents have concerns about the higher fluoride concentrations in topical applications. But even at this greater amount, fluoride doesn't appear to pose any long-term health risks. The most adverse effects—vomiting, headaches or stomach pain—usually occur if a child accidentally ingests too much of the solution during treatment.
Dentists, however, go to great lengths to prevent this by using guards to isolate the solution during an application. And in the case of a foam or gel application, parents can further lower the risk of these unpleasant side effects by not allowing their child to eat or drink for at least thirty minutes after the procedure.
The evidence seems to indicate that the benefits of regular topical fluoride applications for children at high risk outweigh the possible side effects. By adding this measure to your prevention strategy, you can further protect your child from this danger to their current and future dental health.
If you would like more information on tooth decay prevention for your child, 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 “Fluoride Gels Reduce Decay.”
You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.
The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.
But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.
Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.
His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.
One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.
In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.
Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.
If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”
To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.
With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.
The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…
Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.
A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.
And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.
One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.
If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.
If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”
Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.
Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.
Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).
But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.
Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.
But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.
Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.
If you would like more information on treating complex bite problems, 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 “Exposing Impacted Canines.”