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Posts for category: Dental Procedures

By Benjamin T. Watson, DDS, MAGD
July 10, 2020
Category: Dental Procedures
WhyKathyBatesChoseThisAlternativetoBracesandsoMightYou

Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.

Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.

Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.

Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.

While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.

That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.

Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.

With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.

The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.

If you would like more information about tooth straightening, please contact us or schedule a consultation.

By Benjamin T. Watson, DDS, MAGD
June 30, 2020
Category: Dental Procedures
TeensMayNeedaTemporaryReplacementforMissingTeeth

Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.

The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.

Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.

Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.

All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.

If you would like more information on temporary tooth replacements for teens, please contact us or schedule an appointment for a consultation.

DeterminingtheRightWhiteningApproachisKeytoBrighteningaDullSmile

Bright, naturally white teeth are a key component in a beautiful smile. But the opposite is also true: nothing diminishes an otherwise attractive smile more than stained or discolored teeth.

There is good news, however, about tooth staining: it can be greatly reduced with the right whitening technique. But before taking action we need to first uncover the cause for the staining — whether from the outside or inside of the tooth, or a combination of both.

If it’s an external cause — known as extrinsic staining — our diet is usually the source. Foods and beverages that contain tannins, like red wine, coffee or tea fall in this category, as do foods with pigments called carotenes as found in carrots and oranges. Besides limiting consumption of stain-causing foods and maintaining daily oral hygiene, you can also diminish extrinsic staining with a bleaching application.

There are two basic ways to approach this: with either a professional application at our office or with a home kit purchased at a pharmacy or retail store. Although both types use similar chemicals, the professional application is usually stronger and the whitening effect is obtained quicker and may last longer.

Discoloration can also occur within a tooth, known as intrinsic staining, and for various reasons. It can occur during tooth development, as with childhood overexposure to fluoride or from the antibiotic tetracycline. Poor development of enamel or dentin (the main sources of natural tooth color), tooth decay, root canal treatments or trauma are also common causes of intrinsic discoloration.

There are techniques to reduce the effects of intrinsic staining, such as placing a bleaching agent inside the tooth following a root canal treatment. In some cases, the best approach may be to restore the tooth with a crown or porcelain veneer. The latter choice is a thin layer of dental material that is permanently bonded to the outer, visible portion of the tooth: it’s life-like color and appearance covers the discoloration, effectively renewing the person’s smile.

If you’ve been embarrassed by stained teeth, visit us for a complete examination. We’ll recommend the right course of action to turn your dull smile into a bright, attractive one.

If you would like more information on treatments for teeth staining, 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 “Teeth Whitening.”

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

By Benjamin T. Watson, DDS, MAGD
April 11, 2020
Category: Dental Procedures
Tags: porcelain veneers  
Ultra-ThinVeneersMightHelpYouAvoidEnamelRemoval

Dental veneers—thin, life-like layers of porcelain bonded to teeth—can turn a so-so smile into a beautiful one. But most veneers have a distinct drawback: To make them look as natural as possible, the teeth they're bonded with must have some of their surface enamel removed.

Even though they're 1 millimeter or less in thickness, veneers on an unprepared tooth can look bulky. Removing some of the surface enamel remedies this, but doing so permanently alters the tooth. The tooth will need a veneer or some other protective restoration from then on.

Now, though, there's an alternative veneer available for many dental patients. Known as No-Prep or Minimal-Prep, these new veneers are often as thin as a contact lens.

These new types of veneers can often be placed directly on the teeth just above the gum line without any enamel removal and look natural. At the most, the enamel beneath them may need reshaping with an abrasive tool. And, unlike traditional veneers with tooth alteration, these low-prep veneers can often be applied without anesthesia, and in as few as two appointments.

No- or Minimal-Preps are better suited for certain kinds of patients: those with small teeth or teeth that appear small due to larger mouth features; worn teeth from aging or teeth grinding or with small gaps; narrow smiles where the side teeth aren't as visible; and teeth that are slightly misshapen or with minor staining.

On the other hand, patients with oversized teeth or front teeth that jut forward may still encounter problems with an unnatural, bulky appearance even with ultra-thin veneers. The latter situation can often be corrected with orthodontic treatment first to realign the teeth to their proper positions. Once the bite is corrected, no-prep veneers may then become a viable option.

If you'd like to consider these minimal preparation veneers, see your dentist for an examination. The exam results will help determine what type of veneer solution is right for you. And whether you go with traditional or No-Prep veneers, the change in your smile can be amazing.

If you would like more information on porcelain veneers without enamel removal, 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 “No-Prep Porcelain Veneers.”