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Posts for: April, 2020

Ultra-ThinVeneersMightHelpYouAvoidEnamelRemoval

Dental veneers—thin, life-like layers of porcelain bonded to teeth—can turn a so-so smile into a beautiful one. But most veneers have a distinct drawback: To make them look as natural as possible, the teeth they're bonded with must have some of their surface enamel removed.

Even though they're 1 millimeter or less in thickness, veneers on an unprepared tooth can look bulky. Removing some of the surface enamel remedies this, but doing so permanently alters the tooth. The tooth will need a veneer or some other protective restoration from then on.

Now, though, there's an alternative veneer available for many dental patients. Known as No-Prep or Minimal-Prep, these new veneers are often as thin as a contact lens.

These new types of veneers can often be placed directly on the teeth just above the gum line without any enamel removal and look natural. At the most, the enamel beneath them may need reshaping with an abrasive tool. And, unlike traditional veneers with tooth alteration, these low-prep veneers can often be applied without anesthesia, and in as few as two appointments.

No- or Minimal-Preps are better suited for certain kinds of patients: those with small teeth or teeth that appear small due to larger mouth features; worn teeth from aging or teeth grinding or with small gaps; narrow smiles where the side teeth aren't as visible; and teeth that are slightly misshapen or with minor staining.

On the other hand, patients with oversized teeth or front teeth that jut forward may still encounter problems with an unnatural, bulky appearance even with ultra-thin veneers. The latter situation can often be corrected with orthodontic treatment first to realign the teeth to their proper positions. Once the bite is corrected, no-prep veneers may then become a viable option.

If you'd like to consider these minimal preparation veneers, see your dentist for an examination. The exam results will help determine what type of veneer solution is right for you. And whether you go with traditional or No-Prep veneers, the change in your smile can be amazing.

If you would like more information on porcelain veneers without enamel removal, 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 “No-Prep Porcelain Veneers.”


TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”


CertainFactorsMayRaiseYourRiskandtheIntensityofGumDisease

Periodontal (gum) disease is mainly caused by bacterial plaque built up on tooth surfaces due to ineffective oral hygiene. For most cases, treatment that includes plaque and calculus (tartar or calcified plaque) removal and renewed daily hygiene is highly effective in stopping the disease and restoring health to affected gum tissues.

However, you might have additional health factors that may make it more difficult to bring the disease under control. If your case is extreme, even the most in-depth treatment may only buy time before some or all of your teeth are eventually lost.

Genetics. Because of your genetic makeup, you could have a low resistance to gum disease and are more susceptible to it than other people. Additionally, if you have thin gum tissues, also an inherited trait, you could be more prone to receding gums as a result of gum disease.

Certain bacteria. Our mouths are home to millions of bacteria derived from hundreds of strains, of which only a few are responsible for gum disease. It’s possible your body’s immune system may find it difficult to control a particular disease-causing strain, regardless of your diligence in oral care.

Stress. Chronic stress, brought on by difficult life situations or experiences, can have a harmful effect on your body’s immune system and cause you to be more susceptible to gum disease. Studies have shown that as stress levels increase the breakdown of gum tissues (along with their detachment from teeth) may also increase.

Disease advancement. Gum disease can be an aggressive infection that can gain a foothold well before diagnosis. It’s possible, then, that by the time we begin intervention the disease has already caused a great deal of damage. While we may be able to repair much of it, it’s possible some teeth may not be salvageable.

While you can’t change genetic makeup or bacterial sensitivity, you can slow the disease progression and extend the life of your teeth with consistent daily hygiene, regular cleanings and checkups, and watching for bleeding, swollen gums and other signs of disease. Although these additional risk factors may make it difficult to save your teeth in the long-run, you may be able to gain enough time to prepare emotionally and financially for dental implants or a similar restoration.

If you would like more information on the treatment of gum disease, 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 (Gum) Treatment & Expectations.”