The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.
Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).
Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.
A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.
CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.
But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.
And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.
If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”
It's a common practice among people slowly losing their teeth to have their remaining teeth removed. They find dentures to be less costly than replacing one tooth at a time or caring for those that remain. On the other hand, it's usually healthier for the mouth to preserve remaining teeth as long as possible, replacing them only as necessary.
This latter strategy has up to now been difficult and expensive to achieve. But dental implants are changing that—using these imbedded titanium metal devices with a variety of restorations, we're able to better plan and implement staged tooth replacement.
Most people associate implants with single tooth replacements of a life-like crown cemented or screwed into an abutment attached to the implant post. This can play an early role in a staged replacement plan, but at some point, multiple single-tooth implants can become quite expensive.
Implants, however, have a much broader range of use. A few strategically placed implants can support a variety of restorations, including bridges and removable or fixed dentures. Four to eight implants, for example, can secure a fixed denture replacing all teeth on a jaw, far fewer than the number needed to replace the teeth individually.
Implants may also improve the function of traditional restorations. For instance, dentures can't stop the bone loss that often results from tooth loss—in fact, they will accelerate it as they rub and irritate the bony ridges of the jaw. By contrast, implants stimulate bone growth, slowing or even stopping the process of bone loss.
In a traditional bridge, the outer crowns of the restoration are bonded to the teeth on either side of the missing tooth gap (the middle crowns fill the gap). These support teeth must be permanently altered to accommodate the crowns. But an implant-supported bridge doesn't depend on other teeth for support, thus eliminating the need to permanently alter any teeth.
More importantly, previously placed implants often become part of the next stages of tooth replacement, like building on an addition onto an existing house. All in all, including implants in your ongoing dental restoration can help you enjoy the benefits of preserving your natural teeth for much longer.
If you would like more information on dental restoration options, 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 “Replacing All Teeth but Not All at Once.”
Two important practices boost your protection from dental disease: twice-a-year dental visits; and daily brushing and flossing. Of the two, that second one could be the most important.
Personal oral hygiene cleans the teeth of dental plaque, a thin film of bacteria and food particles that accumulates on them each day. This plaque buildup is the number one cause for both tooth decay and periodontal (gum) disease, so removing it reduces your risk of an infection.
But it's not just a matter of doing these tasks—it's also doing them well. A quick once-over isn't going to have the same preventive power as a more thorough job.
Here then are 4 tips for improving your daily oral hygiene efforts.
Time yourself brushing. It usually takes about two minutes to thoroughly brush all tooth surfaces. So, set a timer for two minutes, focusing on methodically brushing the front, back and biting surfaces of each tooth.
Easy does it. Brushing teeth requires only a gentle bit of manual force as the mild abrasives and detergents in your toothpaste provide most of the action of loosening plaque. In fact, aggressive brushing can lead to enamel and gum damage. Practice gentle scrubbing action when you brush.
Don't neglect flossing. While brushing gets most of the hygienic attention, it can't effectively get to areas between teeth where over half of built-up plaque can accumulate. Be sure then to floss at least once a day to remove plaque between teeth that brushing can miss.
Test yourself. Your dentist may be the ultimate judge for the quality of your hygiene, but you can check your effectiveness between visits. For instance, run your tongue across your teeth—it should feel smooth, not rough or gritty. Using a plaque disclosing agent periodically can also reveal missed plaque.
And don't forget to keep up your regular dental visits, which are necessary for removing plaque you might have missed or tartar that may have formed. They're also a great time to get advice from your dentist or dental hygienist on how you can further improve your own efforts in daily dental care.
If you would like more information on best oral hygiene practices, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
It's been a rough year for all of us, but especially for Simon Cowell. The famous entrepreneur and brutally honest talent judge on American Idol and America's Got Talent underwent emergency back surgery in August after an accident on a new electric bike. But the good news is he's well on his way to recovery—and well enough in October to undergo another, less-stressful, procedure: a smile makeover with dental veneers.
This latest trip to the dentist wasn't Cowell's first experience with the popular restoration, wanting this time to update his smile to more closely resemble what he had when he was younger. He even brought along some older photos for reference.
Veneers aren't exclusive to celebrities like Simon Cowell, as thousands of people who get them every year can attest. These thin wafers of porcelain bonded to teeth can mask a wide range of defects, from chips, wear or discoloration to slight tooth gaps or misalignments. And every veneer is custom-made to match an individual patient's dental dimensions and coloring.
If you're thinking about a smile upgrade, here are a few reasons to consider dental veneers.
More bang for your buck. Compared to other transformative cosmetic options, veneers are relatively affordable, with the cost dependent largely on the extent of your dental needs. Still, dental veneers are an investment that can give long-lasting yields of a more attractive smile and even a completely new look.
Little to no tooth alteration. In most veneer cases, we need only remove a small amount of enamel so the veneers don't appear bulky (the alteration is permanent, though, so you'll need a veneer on the tooth from then on). It's also possible to get “no-prep” veneers requiring little to no alteration.
Durable and long-lasting. Continuing improvements in porcelain and other dental ceramics have led to stronger forms that can better withstand the biting forces your teeth encounter every day. Although you'll still need to be careful biting into hard items, your veneers can last for several years.
Easy to maintain. Veneer cleaning and maintenance is much the same as with natural teeth—daily brushing and flossing, and regular dental cleanings and checkups. Outside of that, you'll need to watch what you chomp down on: Veneers are strong, but not indestructible, and they can break.
As Simon Cowell knows, getting veneers isn't difficult. It starts with an initial visit so we can evaluate your dental health and needs. From there, we can present options on how to update your smile.
If you would like more information about dental veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “No-Prep Porcelain Veneers.”
Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.
But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.
This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.
This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.
But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.
Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.
Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.
If you would like more information on dental implant restoration, 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 Implants After Previous Tooth Loss.”
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