Posts for: August, 2018
Implants are highly regarded by both dentists and patients for their versatility and durability. But it’s their life-like appearance that “seals the deal” as the restoration of choice — not only mimicking an individual tooth, but emerging from the gum line and blending indistinguishably with other teeth in color and symmetry.
To achieve this result, we must consider a few factors beforehand, particularly the amount of bone available at the intended implant site. An implant requires a certain amount of bone to properly position it for the most natural crown appearance. The bone present around adjacent teeth can also affect your appearance: in the absence of adequate bone the papillae, triangular shaped gum tissue between teeth, may not regenerate properly between the implant and the natural teeth. This can leave a noticeable void, what dentists call “black hole disease.”
Bone loss is a significant problem particularly after tooth loss. It’s quite possible for you to lose a quarter of the bone’s width in the first year after tooth loss. To avoid this, we often use bone grafting techniques immediately after extraction to lessen bone loss; if it’s already occurred we may be able to use similar reconstructive techniques to rebuild and encourage renewed bone growth. In the end, though, if there remains a significant level of bone loss it may be necessary to consider another option for tooth replacement other than implants.
The thickness of your gum tissue, a genetic trait, can also have an impact on the implant’s ultimate appearance. Thicker gum tissues are generally more resilient and easier to work with surgically. Thinner gum tissues are more susceptible to recession and tend to be more translucent, which could cause the underlying metal implant to be visible. Thus, working with thinner gum tissues requires a more delicate approach when trying to achieve a visually appealing result.
All these factors must be balanced, from implantation to final crown placement. But with careful planning and attention to detail throughout the process, many of these issues can be overcome to produce a satisfying result — a new and appealing smile.
If you would like more information on the aesthetics of dental implants, 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 “Matching Teeth & Implants.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
If you followed the 2018 FIFA World Cup Soccer games, you probably know that one of this year’s biggest surprises was the debut of the team from Iceland—the smallest country ever to earn a chance at the sport’s top prize. But here’s something you may not have known: When he’s not on the field, the team’s coach, Heimir Hallgrímsson, is a practicing dentist! Those two skill sets might not seem like a natural fit… but they came together dramatically at a recent contest.
At a local women’s game last summer, when a player was hit and her tooth was knocked out, Dr. Hallgrímsson took immediate action. “I jumped on the pitch and put the tooth back in, took her to a dental office and fixed it,” he said.
Not everyone has the special training or ability to fix a tooth that has been damaged or knocked out—but there are some simple things that you can do to help an adult who has suffered this kind of injury. Here’s a quick run-down:
- After making sure the person is stable and not otherwise seriously injured, try to locate the tooth.
- Handle it carefully, without touching root surfaces, and clean it gently with water if possible.
- Try to open and gently rinse out the mouth, and find where the tooth came from.
- Carefully place the tooth back in its socket, making sure it is facing the right way, and hold it in place with a soft cloth.
- If the tooth can’t be re-implanted, place it in a bag with a special preservative solution, milk or saliva, or have the person hold it between the cheek and gum—but make sure it isn’t swallowed!
- Rush to the nearest dental office or urgent care facility.
When these steps are followed and the person receives professional treatment as quickly as possible (ideally within minutes), their tooth will have the best chance of being saved. But even if it isn’t possible to preserve the tooth, receiving prompt and appropriate care can make replacing the tooth much easier.
Having Dr. Hallgrímsson on the sidelines was a lucky break for the injured soccer player—and as a coach, just getting to the World Cup is a remarkable achievement. But you don’t need to be a coach (or a dentist) to give first aid in a dental emergency. Taking the right steps can help ensure the best possible outcome… and might even save a tooth!
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “Knocked Out Tooth” and “The Field-Side Guide to Dental Injuries.”