Grand Oaks Dental Blog

Posts for category: Dental Procedures

BeSuretohaveThese3EssentialsCoveredBeforehandforVeneerSuccess

For over three decades, veneers have helped mask dental imperfections like chipping, staining or gaps and improve the appearance of millions of teeth. As the name implies, this thin layer of porcelain covers a tooth's visible surface and accurately mimics the texture, color and translucence of natural teeth.

Veneers could be just the solution you need for a more attractive smile. But before you begin treatment, be sure you have these 3 essentials in place to ensure a successful outcome.

True expectations. While the transformation of a tooth's appearance with a veneer can be astounding, veneers in general do have their limitations. You need an adequate amount of the tooth's structure present for a veneer to properly adhere — if not, you may need to consider a porcelain crown instead. Likewise, gaps and other misalignments may be too great for a veneer to cover: in that case, you should consider orthodontics. A thorough examination beforehand will determine if veneers are the best option for you.

An artisan team. Every veneer is custom made to match an individual patient's tooth shape and color, handcrafted by a skilled dental technician. There's also an art to the dentist preparing the tooth beforehand and then properly positioning the veneer for bonding to achieve the most attractive result. Be sure, then, that your veneer "team" comes highly recommended by others.

The best materials. The first porcelains were powdered glass ceramics mixed with water to form a paste. Technicians shaped the paste in successive layers and as it oven-cured it took on the beautiful translucence of natural teeth. Unfortunately, this type of porcelain could be brittle and prone to shattering when subjected to heavy biting forces. In recent years, though, we've begun to use ceramics reinforced with other materials like Leucite for added strength. Today, the materials dentists use have much better durability.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”

AStainlessSteelCrownCouldHelpaStrugglingPrimaryMolarLastLonger

Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.

If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.

With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.

Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.

That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).

While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12).  And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.

Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.

If you would like more information on caring for primary teeth, 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 “Stainless Steel Crowns for Kids.”

26MillionFansLikeJustinBiebersChippedTooth

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”

NeilPatrickHarrisWhattheOscarsHostTreasuresMost

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

AnInfectedorInjuredPrimaryToothCanBeSaved-butitsComplicated

Primary (baby) teeth don't last long. But despite their short life span, they do a number of important things, like enabling a child to eat solid food. But perhaps their most important long-term function is “paving” the way for their permanent replacements.

If one is lost prematurely, though, the permanent tooth might not come in properly aligned. That's why if a primary tooth is in danger of loss due to decay or injury, we'll do our best to save it.

But that could get a little tricky if the infected or damaged part of the tooth is the innermost pulp. If it were an adult tooth, the best course might be a root canal treatment: access the pulp, clear out the diseased tissue, and then fill the space with a special filling. But with a primary tooth (or a young permanent tooth for that matter) that may not be advisable.

That's because the pulp plays a more important role in a child's tooth than an adult's. Its nerves and other tissues stimulate dentin growth; a full root canal could disrupt that growth and weaken the tooth in the long run.

With a child's tooth, we proceed carefully depending on how infected or damaged the pulp might be. If it's only slightly exposed or not at all, we try then to remove as much decayed tooth material outside the pulp as necessary, then apply antibacterial agents or dentin growth stimulators.

If we do have pulp exposure, we'll try to remove only as much of the affected pulp as necessary through a procedure called a pulpotomy. This technique will only be used if the remaining pulp looks healthy or restorable to health.

If not, we may need to perform a pulpectomy to remove the entire pulp. Most like a typical root canal, it's a last resort: without the pulp, dentin growth could be stunted and the tooth won't develop as healthy as it should.

Of course, the best approach is to prevent teeth from developing such problems in the first place. So, be sure to practice effective daily hygiene with your child and keep up regular dental visits beginning at age one.

If you would like more information on treating decayed primary teeth, 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 “Root Canal Treatment for Children's Teeth.”