Posts for category: Dental Procedures
As Spring turns to Summer, millions of students will depart high school in the time-honored rite of passage called graduation. At the same time, quite a few of these graduates will be experiencing another maturity milestone: the eruption (coming in) of their last permanent teeth.
Typically, these are the back third molars, better known as “wisdom teeth,” emerging on either end of both the top and bottom jaws sometime between the ages of 18 and 24. Their arrival heralds the end of a long development process that began in infancy.
But this auspicious event can give rise to dental problems. Because they’re the last to come in, wisdom teeth often erupt in an environment crowded by earlier teeth. Depending on jaw size and other factors, there may not be enough room for a normal eruption.
Wisdom teeth can thus erupt out of position, creating a poor bite (malocclusion). Or they might not erupt at all—becoming stuck fully or partially within the gums and bone, a condition known as impaction. Impacted teeth can also cause problems for the adjacent teeth, damaging the roots of the second molars or disrupting the surrounding gum tissue, making them more susceptible to periodontal (gum) disease.
Because of these and other issues, impacted wisdom teeth are among the most common type of teeth removed: an estimated 10 million each year. And many of these are removed before they show signs of disease or complications as a preemptive strike against developing dental problems.
Although unnecessary surgery should always be avoided, according to some research, there’s a one in three chance that erupting wisdom teeth that are not showing signs of trouble will eventually become problematic. And the earlier they’re removed, the lower the risk of post-extraction complications.
Wisdom teeth should always be evaluated on a case by case basis. Those with obvious signs of disease or complications do require prompt treatment, including possible extraction. Others that are asymptomatic can be monitored over time: If they’re tending to become problematic, we can adjust the treatment plan accordingly. Our goal is to ensure these particular teeth signaling the end of childhood won’t detract from dental health in adulthood, so a measured approach seems to be the best and safest one.
If you would like more information on treatment options for wisdom teeth, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Wisdom Teeth: Coming of Age May Come With a Dilemma” and “Wisdom Teeth: To Be or Not to Be?”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
Each year thousands of people develop sinus infections from various causes. But there's one cause for sinusitis that might surprise you—tooth decay.
Tooth decay begins when the acid produced by oral bacteria erodes a tooth's enamel protection to create a small hole or cavity. Left untreated, the infection can move into the inner pulp of the tooth and tiny passageways leading to the roots called root canals. The decay can then infect and break down the structure of the supporting jawbone.
This could affect the sinus cavities, hollow air-filled spaces in the upper portion of the face. The maxillary sinus in particular sits behind the cheek bones just above the upper jaw. Tooth roots, particularly in back teeth, can extend quite near or even poke through the floor of the maxillary sinus.
If decay affects these roots, the bone beneath this floor may begin to break down and allow the bacterial infection to enter the sinus. We call this particular kind of sinus infection maxillary sinusitis of endodontic origin (MSEO), "endodontic" referring to the interior structure of teeth.
While advanced decay can show symptoms like pain or sensitivity with certain hot or cold foods, it's also possible to have it and not know it directly. But a recurring sinus infection could be an indirect indication that the root of your suffering is a deeply decayed tooth. Treating the sinus infection with antibiotics won't cure this underlying dental problem. For that you'll need to see a dentist or an endodontist, a specialist for interior tooth issues.
The most common way to treat deep tooth decay is with root canal therapy. In this procedure, the dentist enters the decayed tooth's pulp (nerve chamber) and root canals and removes the diseased tissue. They will then fill the empty pulp and root canals with a special filling and seal the tooth to prevent future infection. The procedure stops the infection and saves the tooth—and if you have MSEO, it eliminates the cause of the sinus infection.
So, if you're suffering from chronic sinus infections, you might talk with your dentist about the possibility of a tooth infection. A thorough examination might reveal a decayed tooth in need of treatment.
Untreated tooth decay can destroy your teeth; prompt action as soon as its diagnosed will help prevent that undesirable outcome. And even if decay has advanced into the tooth's pulp and root canals, there's still a good chance we can stop it with a root canal treatment. Using this procedure, we can clean out the infection and refill the tooth's interior space with a special filling to protect it from further infection.
Although root canal treatments have gained an unwarranted reputation for pain, they rarely cause even the mildest discomfort. More importantly, they work, which is why they're the go-to treatment dentists use for advanced decay.
But sometimes a unique dental situation might make performing a root canal extremely difficult—possibly even doing more harm than good. For example, trying to access the interior of a tooth with a crown restoration might require removing the crown, which could further weaken or damage the tooth. In other cases, the root canals might have become calcified due to trauma or aging and become too narrow to access.
Even so, we may still be able to save a tooth through a minor surgical procedure called an apicoectomy. Rather than access the diseased area through the tooth crown as with a root canal treatment, an apicoectomy makes access to the infected tissue at the root end.
An apicoectomy also differs from a root canal treatment in that we'll need to surgically go through the gum tissue. After numbing the area with a local anesthetic, we'll make a small incision through the gums at the level of the infection. After removing any infected tissue, we would then fill the space with a small filling to prevent re-infection. We then close the incised gum tissues with sutures and allow them to heal.
With the help of fiber optic lighting and surgical microscopes, endodontists (specialists in interior tooth problems) can perform an apicoectomy quickly and with very little trauma at the surgical sight. If you undergo an apicoectomy, you should be back to normal activity in a day or two at the most. And like its sister procedure the root canal, an apicoectomy could help preserve your teeth for many years to come.
If you would like more information on this and other treatments for tooth decay, 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.
"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."
But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.
"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."
What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.
Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.
To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.
Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?
"I love my veneers!" she declared, noting that they have held up well for over a decade.