Posts for category: Dental Procedures
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.”
For decades, traditional braces were the only orthodontic choice for moving misaligned teeth. Although they’re quite effective, they can cause discomfort and, for teens especially, embarrassment due to their noticeable metallic appearance.
In recent years, though, technology has produced an alternative to braces that’s proven effective for many types of patients. Besides being less cumbersome and disruptive to everyday life than braces, clear aligners have another advantage that appeals to teens — they’re much less visible.
Introduced in the late 1990s, clear aligners are a system of individual trays made of nearly invisible polyurethane plastic worn over the upper teeth. The trays are computer-generated based on the patient’s individual mouth structure captured in photographs and x-rays. Each tray in the sequence is incrementally smaller in size; the patient begins wearing the first aligner in the series for about two weeks, 20 to 22 hours a day. They then switch to the next tray in the series for about the same amount of time, and continue in this fashion until they’ve worn each aligner in the series.
Besides their improvement in appearance, aligners also have another advantage: unlike traditional braces, aligners can be removed from the mouth for eating or on a limited basis for rare important social occasions. Brushing and flossing are also much easier with aligners, which don’t pose the same access problems as traditional braces.
Clear aligners were once only effective with select types of orthodontic patients, which didn’t always include teens. Over the last decade, however, significant changes to design and additional implements have widened their application to more patients, especially teens. For example, we can now add tiny “power ridges” to the aligner design that give greater precision over desired tooth movement to create a more controlled and efficient force on the teeth. More recent aligners are also being produced with a thinner, more comfortable material.
A thorough orthodontic exam will tell whether your teen is a good candidate for clear aligners. If so, they’ll benefit from a more comfortable and less embarrassing experience while gaining a new smile for life.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.
In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.
This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.
For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.
Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.
If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”
If you’re considering different options for tooth replacement, dental implants are likely high on your list. Implants have a proven reputation for both durability and life-like appearance that can restore mouth function and revitalize your smile.
There is one aspect concerning implants, however, which gives people pause — the surgical procedure required to place the implants in the jawbone. If you’re leery about undergoing this procedure we can put your mind at ease — for most patients implant surgery is a minor, pain-free process with little discomfort afterward.
While there are variations in style, implants generally have two major components: a titanium post that’s implanted into the jawbone and a permanent life-like crown that’s affixed 6 to 12 weeks after implant surgery. Titanium is the metal of choice because of its affinity with bone cells; over time bone will grow to and attach itself around the implant, a process known as osseo-integration. The metal post is normally spiral in shape, allowing it more surface area for bone to adhere to.
In the beginning of the procedure we administer local anesthesia to fully numb the area before proceeding. After accessing the bone through tiny incisions in the gum tissue, we create a small channel in the exposed bone. A surgical guide may be used to prepare the precise location for the implant with a series of drilling sequences that increases the channel until it matches the implant size. While this takes place, you should only feel a mild vibration and a little pressure from the drill.
The implants are then removed from their sterile packaging and placed immediately into the prepared site. The gum tissues are then sutured into place with self-absorbing sutures. Most people have only mild discomfort after the surgery that can be managed with a prescription-strength non-steroidal anti-inflammatory drug like ibuprofen. We may also prescribe antibiotics and other care instructions to ensure successful gum tissue healing.
With proper planning and precise implant placement by skilled hands, implant surgery is an easy and uneventful procedure. And, with your new crowns in place, your new, beautiful smile will make the experience a distant memory.
If you would like more information on dental implants, 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 “Dental Implant Surgery.”