Posts for category: Dental Procedures

DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

WhatYouShouldKnowAboutVeneersforTeenagers

Porcelain veneers are a great way to enhance an unattractive smile. But are they appropriate for teenagers? The answer usually depends on a patient’s current development stage and the type of veneer used.

Veneers are thin layers of porcelain bonded to the front of teeth. But even though quite thin, they can appear bulky if we don’t first remove some of the tooth’s enamel surface. This is irreversible, so the tooth may require a restoration from then on.

This could be a major issue for teens whose permanent teeth are still developing. During this period the tooth’s central pulp is relatively large and the dentin layer not fully developed. As a result, the pulp’s nerves are often closer to the surface than in an adult tooth. This increases risk of nerve damage during veneer preparation; if nerve damage occurs, the tooth could ultimately require a root canal treatment to save it.

On the other hand, some types of veneers don’t require tooth alteration (or only very little) beforehand. These “no-prep” or “minimal prep” veneers are best for certain situations like abnormally small teeth, so we must first determine if using such a veneer would be appropriate for your teen.

In effect, we’ll need to weigh these and other factors before determining if veneers are a safe choice for your teen. That being the case, it may be more advisable to consider more conservative cosmetic techniques first. For example, if enamel staining is the main issue, you could consider teeth whitening. Although the often amazing results eventually fade, whitening could still buy some time until the teeth have matured to safely apply veneers.

Slight deformities like chipping can often be corrected by bonding tooth-colored composite material to the tooth. In artistic hands it’s even possible to create a full veneer effect with very little if any tooth preparation. How much we can apply, though, depends on tooth size, and it won’t be as durable as a porcelain veneer.

With that said, veneers could be the right solution to enhance your teen’s smile. But, we’ll need to carefully consider their dental situation to ensure their new smile remains a healthy one.

If you would like more information on cosmetic solutions for smile appearance problems, please contact us or schedule an appointment for a consultation.

WhyaBondedRetainerMightbeaBetterChoiceAfterBraces

A lot of time and effort goes into straightening your smile. But there’s a possibility it might not stay that way—and all that hard work could be lost. The same natural mechanism that enables your teeth to move with braces could cause them to revert to their old, undesirable positions.

So for a little while (or longer for some people) you’ll need to wear a retainer, an appliance designed to keep or “retain” your teeth where they are now. And while the removable type is perhaps the best known, there’s at least one other choice you might want to consider: a bonded retainer.

Just as its name implies, this retainer consists of a thin metal wire bonded to the back of the teeth with a composite material. Unlike the removable appliance, a bonded retainer is fixed and can only be removed by an orthodontist.

Bonded retainers have several advantages. Perhaps the most important one is cosmetic—unlike the removable version, others can’t see a bonded retainer since it’s hidden behind the teeth. There’s also no keeping up with it—or losing it—since it’s fixed in place, which might be helpful with some younger patients who need reminding about keeping their retainer in their mouth.

There are, however, a few disadvantages. It’s much harder to floss with a bonded retainer, which could increase the risks of dental disease. It’s also possible for it to break, in which case it will need to be repaired by an orthodontist and as soon as possible. Without it in place for any length of time the teeth could move out of alignment.

If you or a family member is about to have braces removed, you’ll soon need to make a decision on which retainer to use. We’ll discuss these options with you and help you choose the one—removable or bonded—that’s right for you.

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 article “Bonded Retainers: What are the Pros and Cons?

DontIgnoreToothPain-YouMayNeedaRootCanal

Tooth decay is one of the most common diseases in the world, nearly as prevalent as the common cold. It’s also one of the two major dental diseases—the other being periodontal (gum) disease—most responsible for tooth and bone loss.

Tooth decay begins with high levels of acid, the byproduct of oral bacteria feeding on food remnants like sugar. Acid can erode tooth enamel, leading to a cavity that will require removal of decayed material around it and then a filling.

Sometimes, though, decay can spread deeper into the tooth reaching all the way to its core: the pulp with its bundle of nerves and blood vessels. From there it can travel through the root canals to the bone. The continuing damage could eventually lead to the loss of the infected tooth.

If decay reaches the tooth interior, the best course of action is usually a root canal treatment. In this procedure we access the pulp through the crown, the visible part of the tooth, to remove all of the diseased and dead tissue in the pulp chamber.

We then reshape it and the root canals to receive a filling. The filling is normally a substance called gutta percha that’s easily manipulated to conform to the shape of the root canals and pulp chamber. After filling we seal the access hole and later cap the tooth with a crown to protect it from re-infection.

Root canal treatments have literally saved millions of teeth. Unfortunately, they’ve gained an undeserved reputation for pain. But root canals don’t cause pain—they relieve the pain caused by tooth decay. More importantly, your tooth can gain a new lease on life.

But we’ll need to act promptly. If you experience any kind of tooth pain (even if it goes away) you should see us as soon as possible for an examination. Depending on the level of decay and the type of tooth involved, we may be able to perform the procedure in our office. Some cases, though, may have complications that require the skills, procedures and equipment of an endodontist, a specialist in root canal treatment.

So, don’t delay and allow tooth decay to go too far. Your tooth’s survival could hang in the balance.

If you would like more information on tooth decay treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Root Canal Treatment: What You Need to Know.”

PartialDenturesanAffordableAlternativetoMoreExpensiveRestorations

Dental implants are today’s preferred choice for replacing missing teeth. They’re the closest restoration to natural teeth—but at a price, especially for multiple teeth. If implants are beyond your current financial ability, there’s an older, more affordable option: a removable partial denture (RPD).

Similar in concept to a full denture, a RPD replaces one or more missing teeth on a jaw. It usually consists of a lightweight but sturdy metal frame supporting a resin or plastic base (colored pink to mimic gum tissue). Prosthetic (false) teeth are attached to the base at the locations of the missing teeth. Unlike transitional dentures, RPDs are designed to last for many years.

Although simple in concept, RPDs certainly aren’t a “one-size-fits-all” option. To achieve long-term success with an RPD we must first consider the number of missing teeth and where they’re located in the jaw. This will dictate the type of layout and construction needed to create a custom RPD.

In addition, we’ll need to consider the health and condition of your remaining teeth. This can be important to an RPD’s design, especially if we intend to use them to support the RPD during wear. Support is a fundamental concern because we want to prevent the RPD from excessively moving in place.

Besides dental support we’ll also need to take into account how the jaws function when they bite. The RPD’s design should evenly distribute the forces generated when you eat and chew so as not to create undue pressure on the bony ridges of the jaw upon which the RPD rests. Too much pressure could accelerate bone loss in the jaw, a common issue with dentures.

It takes a lot of planning to create a comfortably-fitting RPD with minimal impact on your dental health. But you’ll also have to maintain it to ensure lasting durability. You should clean your RPD daily, as well as brush and floss the rest of your teeth to minimize the chances of developing tooth decay or periodontal (gum) disease. You can further discourage disease-causing bacterial growth by removing them at night while you sleep.

A RPD can be a viable alternative to more expensive restorations. And with the right design and proper care it could serve you and your smile for a long time to come.

If you would like more information on removable partial dentures, 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 “Removable Partial Dentures.”



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Merrell Family Dentistry

(828) 692-1210
713 Oakland St Hendersonville, NC 28791-3647