You could have an unattractive smile because of a chipped tooth or one slightly out of alignment. Or, it could be both of the above, plus some heavy staining to boot. Correcting each flaw individually might require a combination of different methods like orthodontics or porcelain crowns, which can take an extended period of time to complete.
But you may be able to correct numerous smile flaws with just one method—and in no more than a couple of treatment visits. It's called direct veneers.
Unlike regular veneers, direct veneers don't require a dental technician to craft a thin porcelain shell to bond over teeth. Rather, a dentist applies a tooth-colored material called composite resin to the problem teeth and "sculpts" an entirely new look that can correct multiple dental flaws at one time.
The dentist usually begins the process by creating a model ("wax-up") of proposed changes based on physical impressions of the jaw and teeth. Both dentist and patient can study the model and modify it if necessary, when finalizing the treatment plan.
At a subsequent appointment, the dentist prepares the tooth surface for bonding by removing a thin layer of tooth enamel, then shapes the teeth to better accommodate the composite resin. This tooth prep is similar to that done with traditional veneers, so it's permanent—the teeth will require some form of restoration from then on.
After applying an etchant and a bonding agent, the dentist applies the composite resin in small amounts, hardening each layer with a special light before applying the next one. With each subsequent layer, the dentist sculps the composite material to eventually resemble the wax-up model.
After completing the composite application, the dentist then uses hand tools and a dental drill to complete shaping, as well as an abrasive strip between teeth to aid future flossing. After just a few hours, the transformation is complete.
Direct veneers are durable, but not to the same extent as regular veneers or other cosmetic enhancements. They can also pick up stains over time, and may require re-treatment at some point. Still, direct veneers are a cost-effective way to improve the appearance of teeth with multiple flaws that could radically change your smile for the better.
Accidents do happen, especially if you or a family member has an active lifestyle. One such risk, especially for someone playing a contact sport, is having a tooth knocked out.
But as extreme as this injury can be, it doesn't necessarily mean the tooth is lost forever. Gum (or periodontal) cells remaining on the tooth root can regenerate and regain their attachment with the periodontal ligament that holds teeth in place. But you have to act quickly—the longer the tooth is out of the socket, the more likely these cells will dry out and die.
So, by doing the following within 5-20 minutes of the injury (and the earlier the better), that knocked-out tooth has a reasonable chance of survival.
Locate and clean the tooth. Your first priority is to find the missing tooth and clean it of any debris with clean water. Be sure not to touch the root of the tooth and only handle the tooth by the crown (the visible part of a tooth when it's in the mouth).
Insert the root end into the empty socket. Still holding the tooth by the crown, insert the opposite root end into the empty socket. Orient the crown properly, but don't worry about getting it in just right—the follow-up with the dentist will take care of that. You will, however, need to apply some pressure to get it to seat firmly.
Secure the tooth. Place a piece of clean gauze or cloth between the reinserted tooth and its counterpart on the other jaw. Then, have the person bite down on the cloth and hold it. This will help secure the tooth in place while you travel to the dentist.
Seek dental care immediately. It's important to see a dentist immediately to adjust the tooth's position and to possibly splint the tooth to better secure it while it heals. If a dentist isn't available, then visit a local emergency room instead.
Taking these actions on the scene could mean the difference between saving and losing a tooth. But act quickly—the sooner you initiate first aid for a knocked-out tooth, the better its chances for long-term survival.
If you would like more information on what to do during dental emergencies, 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 “When a Tooth is Knocked Out.”
For over three decades, Celine Dion has amazed audiences and fans with her powerful singing voice. Best known for her recording of "My Heart Will Go On," the theme song for the movie Titanic, Dion has amassed global record sales topping 200 million. In her early singing days, though, she struggled with one particular career obstacle: an unattractive smile.
The Canadian-born performer had a number of dental defects including crooked and discolored teeth, and—most prominent of all—abnormally large cuspid or "canine" teeth (located on either side of the four front incisors). They were so noticeable that one Quebec celebrity magazine gave her the unflattering nickname "Canine Dion."
This isn't an unusual problem. Since human canines are already the longest teeth in the mouth, it doesn't take much for them to stand out. Our ancient hunter-gatherer ancestors needed these large, pointed teeth to survive. But with the evolution of agriculture and industry, canine teeth have become gradually smaller—so much so that when they're abnormally large, they don't look right in a smile.
So, what can be done if your canines embarrassingly stand out from the rest? Here are some of the options to consider.
Reduce their size. If your canines are just a tad too long, it may be possible to remove some of the enamel layer in a procedure called contouring. Using this technique, we can reduce a tooth's overall size, which we then re-shape by bonding composite resin to the tooth. It's only a good option, though, if your canines have an ample and healthy layer of enamel.
Repair other teeth. The problem of prominent canine teeth may actually be caused by neighboring teeth. When the teeth next to the canines are crooked, the canines can appear more prominent. Alternatively, other teeth around the canines may be abnormally small. Braces or clear aligners can correct crooked incisors, and applying porcelain veneers to smaller teeth could help normalize their length.
Apply dental crowns. In some instances, we can reduce the canines in size and then bond porcelain crowns to them. This is the option that Dion ultimately chose. The natural teeth are still intact, but the crowning process transforms them into properly proportioned, life-like teeth. There is, however, one caveat: The alteration to these teeth will be permanent, so they will need a crown from then on.
Besides crowning her canine teeth, Dion also underwent other dental work to straighten and whiten her other teeth. As a result, this superstar performer now has a superstar smile to match and so can you if your teeth are less than perfect. These or other cosmetic enhancements can give you the look you truly desire. All it takes is an initial visit with us to start you on the road to a transformed smile.
If you would like more information about various cosmetic solutions for your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”
Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.
There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.
Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.
Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.
An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.
But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.
Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).
The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.
So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.
If you would like more information on diabetes and dental health, 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 & Diabetes.”
Here's the bad news: One of your teeth has tooth decay. But here's even worse news: The decay has entered the pulp and root canals in the heart of the tooth. You're well on your way to losing that tooth.
But cheer up—root canal therapy might save your decayed tooth. We use root canal therapy to remove the infection from within a tooth and then fill the resulting empty spaces to prevent further infection. This routine procedure has saved millions of teeth.
But alas, along the way root canals somehow became a cultural symbol for unpleasantness. In reality, there's nothing further from the truth—the procedure itself is painless, and may even stop any pain caused by tooth decay.
So, let's take the mystery out of root canal therapy—the more you know, the less wary you'll feel. Here's what to expect if you undergo this tooth-saving procedure.
Preparation. We start by numbing the tooth and surrounding gums with local anesthesia. While we're waiting for the anesthesia to take full effect, we isolate the tooth with a dental dam to prevent cross-contamination to other teeth.
Access. Next, we drill a small opening into the tooth to access the pulp and root canals. If it's one of the large back teeth, we drill the hole in the tooth's biting surface; in a narrower front tooth, we make the access opening in the rear surface.
Removal. We remove tissue from the pulp and root canals using special instruments. Afterward, we thoroughly disinfect the pulp and canal interiors with an antibacterial solution to ensure we've stopped the infection.
Filling. After re-shaping the root canals, we fill them and the pulp chamber with gutta percha, a rubber-like material ideal for this type of dental situation. We then fill and seal the access hole. In a few weeks, you'll return to have a permanent crown installed to further protect the tooth.
You may have some minor discomfort that's usually manageable with mild pain relievers, and should dissipate over a few days. The good news, though, is that we've more than likely saved a tooth that might have otherwise been lost.
If you would like more information on treating a decayed tooth, 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 “A Step-By-Step Guide to Root Canal Treatment.”
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