Posts for: October, 2014
Once upon a time, a well-known Hollywood actress might have hired a private eye to keep unflattering pictures from appearing in the media. Today, that’s no longer the case. Take timeless beauty Demi Moore: In a widely circulated set of photos, her gap-toothed grin showed she was actually missing one of her front teeth!
It turns out the actress released the pictures herself, as she live-tweeted the tooth replacement procedure from her dentist’s office. Moore later explained that the tooth fell out suddenly as she was sitting at her desk.
Celebrities are just like regular folks… except they have more followers on twitter. So we’re happy when they show us that no matter how bad a dental problem may seem, there’s almost always a way to regain a gorgeous-looking smile. We’re not sure exactly how Demi’s dentist chose to restore the damaged tooth — but depending on the individual circumstances, modern dentistry offers a number of ways to close the gap.
A crown (or cap) is a replacement for the entire visible area of the tooth. It may be needed due to accident or trauma, or as a follow-up to root canal therapy. Placing a crown usually requires more than one office visit. First, the tooth is prepared by removing any decay and shaping it, and a precise model is made of the bite. Next, the permanent crown is custom-made in a dental laboratory; this is placed during a subsequent visit. Advances in technology, however, have made it possible in some instances to deliver the permanent crown in a single office visit. If the tooth still has a healthy root structure, a crown is usually a viable option — even when most of the visible part is gone.
What if the entire tooth, including the roots, are missing? Then your replacement options could include bridgework or a dental implant. A fixed bridge is a series of crowns joined together as one unit. The teeth on either side of the gap are prepared just as they would be for crowns, and the bridge (including a replacement for the missing tooth in the middle) is attached. Bridges have been used successfully for many years, but they have a drawback: They require enamel to be removed from the healthy teeth on either side of the gap, which could lead to a greater chance of decay, gum disease, or a root canal in the future.
The optimal solution, however, might be a dental implant. With this remarkable technology, the replacement tooth is solidly anchored into the jaw via a screw-shaped post made of titanium — a metal which actually becomes fused with the living bone tissue. A custom-made, lifelike crown is then securely attached to the metal implant. Dental implants are the most successful tooth-replacement procedure; they help preserve bone quality in the jaw — and with regular care, they can last a lifetime.
So if your smile is making you camera-shy, why not talk to us about your tooth-restoration options? If you would like additional information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Dental Implants.”
Without effective treatment, periodontal (gum) disease can eventually lead to tooth loss. That’s why it’s imperative to remove bacterial plaque and calculus — the main cause of the disease — from all teeth and gum surfaces. For moderate to advanced gum disease, this could require a procedure known as flap surgery to gain access to deeper infected areas.
This type of procedure involves making scalpel incisions into the gum tissue to create a flap opening. Through this opening we’re able to gain access to the deeper pockets that have formed because of the tissue detachment that occurs following bone loss. The flap opening allows for better access to the root surfaces for removal of plaque and calculus (tartar). Once we’ve finished, we then suture the flap back into place to reduce the pockets and allow the area to heal.
While effective, flap surgery is considered moderately invasive and may produce mild post-procedural discomfort. Recently, however, a specially designed laser for periodontal therapy shows promise of less invasiveness and patient discomfort than traditional flap surgery.
A laser is an intense and narrow beam of light of a single wavelength. A periodontal laser can pass without effect through healthy cell tissue (like sunlight through a window pane) but interacts and “vaporizes” the darkly pigmented bacteria in diseased tissue. The laser energy is delivered in pulses to minimize any heat-related damage to healthy cells.
The periodontal laser can precisely remove diseased tissue, even where it mingles with healthy tissue. Once it’s removed, the root surfaces can be cleaned with ultrasonic scalers and/or hand instruments. And because a medical laser seals the tissue it cuts, it doesn’t produce open incisions as with flap surgery that require suturing afterward.
Studies of post-operative recovery after laser surgery showed similar infection reduction and renewed bone and tissue growth as with traditional surgery. Patients, however, reported much less discomfort after the laser procedure. Although more research is needed, it initially appears periodontal laser treatments can effectively treat gum disease with minimal interference with healthy tissue and greater comfort for patients.
Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.
Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.
Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.
There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.
If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.
In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.