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2KindsofOrthodonticRetainersThatCanProtectYourNewSmile

While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.

Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.

But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.

The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.

While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.

An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.

A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.

If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.

If you would like more information on bonded retainers, 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 “Bonded Retainers.”

InterceptiveOrthodonticsStoppingPoorBitesBeforeTheyDevelop

Approximately 4 million tweens and teens are currently undergoing orthodontic treatment for a poor bite (malocclusion) that can cost their families thousands of dollars in braces or clear aligners. But treatment doesn't always have to follow this track: Found early, many malocclusions can be corrected or minimized before they fully develop.

Known as interceptive orthodontics, this particular approach to bite correction often begins as early as 6-10 years of age. Rather than move existing teeth, interceptive orthodontics focuses instead on redirecting jaw growth and intervening in other situations that can cause malocclusions.

For example, a child's upper jaw may not be growing wide enough to accommodate all incoming permanent teeth, crowding later arrivals out of their proper positions. But taking advantage of a gap during early childhood that runs through the center of the palate (roof of the mouth), orthodontists can increase jaw width with a device called a palatal expander.

The expander fits up against the palate with “legs” that extend and make contact with the inside of the teeth. With gradually applied pressure, the expander widens the central gap and the body naturally fills it with new bone cells. The bone accumulation causes the jaws to widen and create more room for incoming teeth.

Another way a malocclusion can develop involves the primary or “baby” teeth. As one of their purposes, primary teeth serve as placeholders for the future permanent teeth forming in the gums. But if they're lost prematurely, adjacent teeth can drift into the vacant space and crowd out incoming teeth.

Dentists prevent this with a space maintainer, a thin metal loop attached to the adjoining teeth that puts pressure on them to prevent them from entering the space. This spacer is removed when the permanent tooth is ready to erupt.

These and other interceptive methods are often effective in minimizing the formation of malocclusions. But it's often best to use them early: Palatal expansion, for example, is best undertaken before the central gap fuses in early puberty, and space maintainers before the permanent tooth erupts.

That's why we recommend that children undergo an orthodontic evaluation around age 6 to assess their early bite development. If a malocclusion looks likely, early intervention could prevent it and reduce future treatment costs.

If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics.”

EvenCelebritiesHaveAccidentsSeeWhatTheyDotoRestoreTheirChippedTeeth

Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.

Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.

Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.

The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.

Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.

Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.

Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.

If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”

By Magnum Opus Dental
June 20, 2020
Category: Dental Procedures
WhatReallyHappensDuringaRootCanalTreatment

Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.

You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.

But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?

First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.

Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.

Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.

Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.

You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.

If you would like more information on root canal therapy, 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.”

By Magnum Opus Dental
May 21, 2020
Category: Dental Procedures
LadyGagaWasntBornThisWay

Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"

"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.

The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.

Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.

Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).

The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.

Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.

So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”



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