In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
We most often associate plastic surgery with cosmetic enhancements to our outer appearance. While this is their primary purpose, some forms of reconstructive surgery restore lost function and health as well as improve appearance. A classic example is cosmetic periodontal (gum) surgery that restores receded gum tissues that have exposed more of the tooth than is visually appealing.
Gum recession occurs primarily because of excessive brushing (too hard or for too long) or because of periodontal (gum) disease, a bacterial infection that ultimately causes gum tissue to detach and pull away from the teeth. Gum recession not only affects the appearance of the teeth, it can expose the tooth’s root surface to further infection and decay. Without treatment, the disease could progress causing further damage with the potential for the tooth to be eventually lost.
In conjunction with plaque removal to stop gum disease and possibly other treatments like orthodontics to correct misaligned teeth, cosmetic gum surgery is used to rejuvenate lost gum tissues around teeth through tissue grafting. In these procedures, a combination of surgical approaches and/or grafting materials are attached to the area of recession to stimulate the remaining tissue to grow upon the graft and eventually replace it.
Donor grafts can originate from three sources: from the patient (an autograft); another person (an allograft); or another animal species, usually a cow (a xenograft). Tissues from outside the patient are thoroughly treated to remove all cellular material and bacteria to eliminate any possibility of host rejection or disease transmission.
Depending on the nature of the gum recession and tooth condition, the procedure can take different forms. It could involve completely detaching the graft tissue from the host site and re-attaching it to the recipient site. But if more of the tooth root is exposed, the surgeon may cover the graft with tissue adjacent to the host site to supply blood to the graft, and affix the loosened pedicle to the graft site. While any technique requires advanced training and experience, the latter procedure involves microsurgical techniques that require the highest levels of technical skill and art.
Cosmetic gum surgery can result in healthier gum tissues and teeth that are less susceptible to infection and loss. No less important, though, these procedures can return a more natural look to your teeth and gums — and a more pleasing smile.
If you would like more information on gum tissue reconstruction, 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 “Periodontal Plastic Surgery.”
In summer, there is no shortage of occasions to show off your smile. Whether attending a wedding, graduation celebration, family reunion or neighborhood barbecue, you’ll want to look your best. But if your smile doesn’t shine as brightly as you’d like, a trip to the dental office may just be the confidence-booster you’re looking for. Here are some popular techniques to enhance your smile:
Teeth cleaning. A professional cleaning can make your mouth feel fresh and add sparkle to your smile. The dental hygienist uses special tools to get rid of plaque and tartar that you cannot remove during your oral hygiene routine at home. In addition, hygienists use a tooth-polishing tool that removes surface stains.
Professional whitening. Professional teeth whitening can achieve excellent results in one short office visit. But if you have several weeks before the big event on your calendar, you can also get winning results at home using custom-made whitening trays from the dental office. Either way, your smile can sparkle at summer celebrations.
Cosmetic bonding. If your teeth have small chips or cracks, cosmetic bonding may be a good option for you. In bonding, tooth-colored material is shaped to the tooth and hardened with a curing light. The procedure—generally done in one office visit without anesthesia—is relatively inexpensive, and the result is very natural-looking.
Porcelain veneers. If you are unhappy with the color, shape, size or spacing of your teeth, long-lasting dental veneers can give your smile a whole new look. Veneers are wafer-thin porcelain shells that are bonded to the tooth’s surface. Because they may be crafted in a dental lab, they may require two to three visits to the dental office over a few-week period.
With so many options, it’s easy to put your best smile forward at all your summer gatherings. We can help. If you have any questions about brightening your smile, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers.”
Many people consider a root canal treatment to be potentially an unpleasant experience. You might even feel a few butterflies fluttering in your stomach if we were to recommend one for you.
But there’s nothing actually to dread about this common and very effective treatment. The procedure doesn’t cause pain; in fact, it most likely relieves tooth pain. What’s more, it could save a tooth that would be otherwise lost.
The name comes from narrow passageways extending from the tip of the root to the innermost tooth pulp. The pulp contains nerves and other structures once vital to early tooth development. And although they’re not as important in a fully mature tooth, those nerves still function. In other words, they can still feel stimulation or pain.
That shouldn’t be a problem with a healthy tooth. But if tooth decay invades the inner pulp, those nerves now under attack will begin firing. You’ll know something’s wrong. As bad as it feels, though, the toothache isn’t your worst problem: if the decay isn’t stopped, it can spread through the root canals to the bone that could eventually lead to losing the tooth.
A root canal treatment removes the decayed pulp tissue and protects the tooth from re-infection. We first deaden the tooth and surrounding tissues with a local anesthesia and set up a rubber dam around the tooth to protect it from contamination from the surrounding environment. We then drill a small access hole through the enamel and dentin to reach the pulp chamber and root canals.
Using special instruments, we remove all the diseased tissue from the pulp and flush out the empty chamber and root canals with antibacterial solutions. After re-shaping the root canals, we fill them and the pulp chamber with gutta-percha, a rubber-like biocompatible material that conforms well to the root canal walls. We seal the gutta-percha with adhesive cement and then fill the access hole. Later, we’ll give the tooth further protection with a custom crown.
After the procedure, you may experience short-term minor discomfort usually manageable with over-the-counter pain relievers like ibuprofen. The good news, though, is that the excruciating nerve pain from within the tooth will be gone—and your tooth will have a new lease on life.
If you would like more information on saving a problem tooth with root canal treatment, 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: What You Need to Know.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
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