Posts for category: Dental Procedures

By Ali Soulati, DDS
October 22, 2018
Category: Dental Procedures
Tags: oral health   dental visit  
WhyYouNeedaLong-TermDentalCarePlan

Today’s healthcare patients are asking questions. They want to know the “why” behind the “what” that their care providers are recommending for their health.

There’s a similar trend in dentistry — and it’s one we dentists encourage. We want you to know the “why” behind your treatment options — because you’re as much a participant in your own dental health as we are. The more informed you are, the better equipped you’ll be to make decisions to maintain or improve your health and the appearance of your smile.

As your dental care partner, it’s also essential we help you develop a long-term care plan based on your needs. There are aspects of dental care that are routine: daily brushing and flossing, an oral-friendly diet, and regular dental cleanings and checkups to assess your oral health. But we also need to think strategically, especially if you have risk factors that could impact your future dental health.

To do this we follow a four-step dental care cycle. In Step 1 we identify all the potential risk factors you personally face. These include your potential for dental disease, which could lead to bone and tooth loss, and the state of your bite and jaw structure that could complicate future health. We’ll also take into account any factors that could now or eventually affect your smile appearance.

Once we’ve identified these various factors, we’ll then assess their possible impact on your health in Step 2, not just what may be happening now but what potentially could happen in the future. From there we move to Step 3: treating any current issues and initiating preventive measures to protect your future health.

In Step 4 we’ll monitor and maintain the level of health we’ve been able to reach with the preceding steps. We’ll continue in this stage until we detect an emerging issue, in which we’ll then repeat our cycle of care.

Maintaining this continuum will help reduce the chances of an unpleasant surprise in your dental health. We’ll be in a better position to see issues coming and help reduce their impact now so you can continue to have a healthy mouth and an attractive smile.

If you would like more information on planning your dental 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 “Successful Dental Treatment: Getting the Best Possible Results.”

By Ali Soulati, DDS
September 22, 2018
Category: Dental Procedures
Tags: crowns  
NotallDentalCrownsSharetheSameQualityofLife-Likeness

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.

If you would like more information on dental restorations, please contact us or schedule an appointment for a consultation.

By Ali Soulati, DDS
September 12, 2018
Category: Dental Procedures
Tags: dental implants  
3PossibleTimingScenariosforGettingYourNewImplant

If you have a problem tooth we’ve recommended removing, those “Tooth in one day” ads—a tooth removed and an implant placed at the same time—might start to pique your interest. But there are a few factors we must consider first to determine if this procedure is right for you. Depending on your mouth’s health conditions, you may need to wait a little while between tooth extraction and implantation.

Here are 3 timing scenarios for receiving your implant after tooth removal, depending on your oral health.

Immediately. The “tooth in one day” scenario can be much to your liking, but it could also be tricky in achieving the best results. For one, the implant may fit too loosely—the bone around the socket might first need to heal and fill in or undergo grafting to stimulate regeneration. In other words, immediate implant placement usually requires enough supporting bone and an intact socket. Bone grafting around the implant is usually needed as well.

After gum healing.  Sufficient gum coverage is also necessary for a successful outcome even if the bone appears adequate. To guard against gum shrinkage that could unattractively expose too much of the implant, we may need to delay implant placement for about 4 to 8 weeks to allow sufficient gum healing and sealing of the extraction wound. Allowing the gums to heal can help ensure there’s enough gum tissue to cover and protect the implant once it’s placed.

After bone healing. As we’ve implied, implants need an adequate amount of supporting bone for best results. When there isn’t enough, we might place a bone graft (often immediately after tooth extraction) that will serve as a scaffold for new bone to grow upon. Depending on the degree of bone loss, we may wait until some of the bone has regenerated (about 2 to 4 months) and then allow the natural process of bone cells growing and adhering to the implant (osseointegration) to complete the needed bone growth. If bone loss is extensive, we may need to wait until full healing in 4 to 6 months to encourage the most stable outcome.

If you would like more information on the process of obtaining 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 “Implant Timelines for Replacing Missing Teeth.”

JimmyFallonCanrsquotCatchaBreak-ExceptinHisTooth

Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.

What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!

Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.

If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.

For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.

Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.

Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.

So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.

If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”

ATeenwithaMissingToothMayNeedtoWaitonaDentalImplant

There’s a lot to like about replacing a missing tooth with a dental implant. This state-of-the-art restoration is by far the most durable and life-like option available. And unlike other replacement options implants stimulate bone growth, a major concern after tooth loss.

For that reason we encourage getting an implant as soon as possible — for adults, that is. We don’t recommend implants for younger patients because even a teenager’s jaws haven’t yet reached full maturity. Because it attaches to the jaw differently, an implant can’t move with the growing jaw as real teeth do. It would eventually look as if it were sinking into the jaw below the gum line or being left behind as the rest of the jaw grows.

It’s best, then, to postpone placing an implant until the jaw fully matures, usually in a patient’s early twenties. In the meantime, there are some things we can do to prepare for a future implant while also restoring the tooth with a temporary replacement.

As previously mentioned, our biggest concern is bone health. Like other living tissue, bone has a growth cycle of older cells dissolving and newer ones forming in their place. The teeth transmit the pressure produced when we chew to the bone to stimulate this growth. With the absence of a tooth, the adjacent bone no longer receives this stimulation — the growth cycle slows and may eventually lead to bone loss.

We can help this situation by placing a bone graft in the missing tooth socket at the time of extraction. The graft serves as a scaffold that’s eventually taken over and replaced by new bone growth. We can also try to control how fast the graft is replaced by using grafting material that’s slowly removed and lasts longer — often a preferable situation if an implant is years away.

As for appearance, we can create a custom partial denture or even a type of bridge that bonds a prosthetic tooth to neighboring teeth without significantly altering them. If the patient undergoes orthodontic treatment it’s also possible to add prosthetic teeth to an orthodontic appliance.

Eventually, we’ll be able to provide the permanent solution of a dental implant. With careful planning and measures to preserve bone health, there’s a good chance the outcome will be worth the wait.

If you would like more information on treatments for lost teeth in children and teenagers, 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 “Dental Implants for Teenagers.”