Posts for: September, 2018
Primary (baby) teeth might not last long, but their impact can last a lifetime. Their first set of teeth not only allows young children to eat solid foods, but also guide permanent teeth to form and erupt in the proper position.
Unfortunately, primary teeth aren't immune to tooth decay. If the decay is extensive, the tooth may not last as long as it should. Its absence will increase the chances the permanent teeth won't come in correctly, which could create a poor bite (malocclusion) that's costly to correct.
If a primary tooth is already missing, we can try to prevent a malocclusion by installing a “space appliance.” This keeps nearby teeth from drifting into the empty space intended for the permanent tooth. The best approach, though, is to try to save a primary tooth from premature loss.
We can often do this in much the same way as we would with a permanent tooth — by removing decayed material and filling the prepared space. We can also perform preventive applications like topical fluoride or sealants that strengthen or protect the tooth.
It becomes more complicated, though, if the pulp, the interior of the tooth, becomes decayed. The preferred treatment for this in a permanent adult tooth is a root canal treatment. But with a primary tooth we must also consider the permanent tooth forming below it in the jaw and its proximity to the primary tooth. We need to adapt our treatment for the least likely damage to the permanent tooth.
For example, it may be best to remove as much decayed structure as possible without entering the pulp and then apply an antibacterial agent to the area, a procedure known as an indirect pulp treatment. We might also remove only parts of the pulp, if we determine the rest of the pulp tissue appears healthy. We would then dress the wound and seal the tooth from further infection.
Whatever procedure we use will depend on the extent of decay. As we said before, our number one concern is the permanent tooth beneath the primary. By focusing on the health of both we can help make sure the permanent one comes in the right way.
If you would like more information on caring for children's primary teeth, 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 “Root Canal Treatment for Children's Teeth.”
If your smile is, to put it mildly, “unattractive,” you may think only extensive and expensive dental work can change it. But depending on your teeth’s actual condition, you might be able to obtain a new smile with a less-invasive option: porcelain veneers.
As their name implies, veneers are thin layers of dental porcelain bonded to the front of teeth to cover imperfections. They’re custom designed and manufactured by a dental technician to match the natural color, shape and size of the teeth they’re covering and to blend with neighboring teeth.
Veneers are quite effective for heavily stained, chipped or moderately misaligned teeth that are otherwise healthy. They can even be used to address slight gaps between teeth and restore worn teeth to make them appear larger and more youthful.
Overall, they’re less invasive than other dental restorations. That said, though, most veneers will still require some alteration of the affected teeth. This is because although quite thin they can still appear bulky after they’re bonded to the teeth. We can minimize this by removing a small amount of a tooth’s outer enamel. While this alteration is modest compared to other restorations, it’s nonetheless permanent– your teeth will require some form of restoration from then on.
Veneers also require special consideration while biting. You’ll need to exercise care and avoid biting hard items like candies (or using your teeth as tools) or the veneer could break. Similarly if you have a teeth grinding habit, you may want to consider having a custom guard created that you wear at night to prevent solid contact between your teeth. The excessive force generated while grinding or clenching teeth could also shatter veneers.
Veneers may not be the answer in all cosmetic dental situations, such as extensive disfigurements or bite problems. To know for sure if your particular dental condition could benefit, see your dentist for a complete dental examination and discuss whether obtaining veneers is a viable option for you. If so, you may be able to gain a much more attractive smile from this less invasive but no less effective option.
If you would like more information on porcelain veneers and other dental restorations, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”
Dental crowns are an essential means for restoring damaged or unattractive teeth. A well-crafted crown not only functions well, it looks and blends seamlessly with the rest of the natural teeth.
Crowns are artificial caps that cover an entire visible tooth, often used for heavily decayed or damaged teeth or as added protection after a root canal treatment. Most crowns are produced by a dental lab, but some dentists are now creating them in-office with computer-based milling equipment. On the whole, the various crowns now available function adequately as teeth—but they can vary in their appearance quality.
In the early to mid 20th Century the all-metal crown was the standard; but while durable, it could be less than eye-pleasing. Although more life-like dental porcelain existed at the time, it tended to be brittle and could easily shatter under chewing stress.
Dentists then developed a crown that combined the strength of metal with the attractiveness of porcelain: the porcelain fused to metal or PFM crown. The PFM crown had a hollow, metal substructure that was cemented over the tooth. To this metal base was fused an outer shell of porcelain that gave the crown an attractive finish.
The PFM reigned as the most widely used crown until the mid 2000s. By then improved forms of porcelain reinforced with stronger materials like Lucite had made possible an all-ceramic crown. They’re now the most common crown used today, beautifully life-like yet durable without the need for a metal base.
All-ceramics may be the most common type of crown installed today, but past favorites’ metal and PFM are still available and sometimes used. So depending on the type and location of the tooth and your own expectations, there’s a right crown for you.
However, not all crowns even among all-ceramic have the same level of aesthetic quality or cost—the more life-like, the more expensive. If you have dental insurance, your plan’s benefits might be based on a utilitarian but less attractive crown. You may have to pay more out of pocket for the crown you and your dentist believe is best for you.
Whatever you choose, though, your modern dental crown will do an admirable, functional job. And it can certainly improve your natural tooth’s appearance.