There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.
The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.
Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.
If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.
It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.
If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.
Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.
Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.
Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.
That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.
Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.
The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.
It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.
What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.
How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”
One of the biggest concerns we hear from parents is about their child's thumb sucking habit. Our advice: if they're under age 4, there's no need for concern — yet. If they're older, though, you should be concerned about the possible effect on their bite.
Thumb sucking is a universal habit among infants and toddlers and is related to their swallowing pattern during feeding. As they swallow, their tongue thrusts forward to create a seal with the lips around the breast or a bottle nipple. Many pediatricians believe thumb sucking replicates nursing and so has a comforting effect on infants.
Around age 4, though, this swallowing pattern begins to change to accommodate solid food. The tongue now begins to rest at the back of the top front teeth during swallowing (try swallowing now and you'll see). For most children, their thumb sucking habit also fades during this time and eventually stops.
But for whatever reason, some children don't stop. As the habit persists, the tongue continues to thrust forward rather than toward the back of the top front teeth. Over time this can place undue pressure on both upper and lower front teeth and contribute to the development of an open bite, a slight gap between the upper and lower teeth when the jaws are shut.
While late childhood thumb sucking isn't the only cause for an open bite (abnormal bone growth in one jaw is another), the habit is still a prominent factor. That's why it's important that you start encouraging your child to stop thumb sucking around age 3 and no later than 4. This is best accomplished with positive reinforcement like rewards or praise.
If they've continued the habit a few years after they should have stopped, we may also need to check to see if their swallowing mechanism has become stunted. If so, we may need to use certain exercises to retrain their tongue to take the proper position during swallowing.
While you shouldn't panic, it's important to take action to stop thumb sucking before it becomes a long-term problem. A positive, proactive approach will help avoid costly orthodontic problems later in their lives.
If you would like more information about thumb or finger sucking, 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 “How Thumb Sucking Affects the Bite.”
Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.Â Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.
Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.
A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.
Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.
If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.
If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”
Teething is an important phase in your baby's dental maturity. During the approximate two-year process, they will acquire their first set of teeth.
It can also be an unpleasant two years as each tooth sequentially breaks through the gums. The severity of teething problems differs with each child, but there are common signs: irritability, biting and gnawing, chin rash, drooling or ear rubbing among them. Although for most babies the discomfort isn't that great, the pain can occasionally be a lot for them — and their care-givers — to handle.
Although having a very unhappy infant can be nerve-jangling, there's no real cause for concern health-wise. If, however, they begin to run a fever or experience diarrhea, that could be a sign of something more serious. In those cases, you should see a doctor as soon as possible.
Otherwise, there are some things you can do to make them more comfortable during teething episodes. One thing to remember: cold items for biting or gnawing usually work wonders. So, be sure you have chilled teething rings or pacifiers (but not frozen — the extreme temperature could burn their gums). For older children, an occasional cold food like a popsicle can bring relief.
You can also try massaging the gums with your clean finger, which will help counteract the pressure of an erupting tooth. But avoid rubbing alcohol or aspirin on the gums, and you shouldn't apply numbing agents to children less than two years of age unless advised by your doctor.
If their pain persists, it's permissible to give them a mild pain reliever like the appropriate dosage for their age of baby acetaminophen or ibuprofen. Again, you should give this by mouth and avoid rubbing it on the gums.
By the time they're three, all their primary teeth should be in and teething symptoms should have largely dissipated. In the meantime, make them as comfortable as you can â?? in no time the unpleasantness of teething will pass.
If you would like more information on coping with your child's teething, 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 “Teething Troubles: How to Help Keep your Baby Comfortable.”
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