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Posts for category: Dental Procedures

CrownLengtheningCouldHelpwithTreatingHardtoReachCavities

There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.

But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.

But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.

After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.

As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.

This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.

If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”

By Robert D. Ory, D.D.S.
June 22, 2019
Category: Dental Procedures
Tags: dental implant  
GettingaNewToothinaDayWillDependonYourBoneHealth

If you know anyone with a dental implant, you may know it can be a long process in getting one. Several weeks or months can pass between removing the old tooth and placing the implant, and then several more weeks before affixing the permanent crown.

But with recent advances in implant technology, some patients don't have to wait as long for a new implant and crown. In fact, one procedure commonly known as "tooth in one day," allows patients to walk in with a problem tooth and out the same day with a new "one."

Not every implant patient, however, can undergo this accelerated procedure. If you're considering implants, the state of your bone health will determine whether or not you can.

Implants need a certain amount of available bone for proper placement. But bone loss, a common consequence of missing teeth or dental disease, can reduce bone volume to less than what's needed to place an implant. The patient may first need to undergo grafting to regenerate the bone or choose another restorative option.

If your supporting bone is sound, your dentist might then proceed with the implant. But you will still have to wait a while for your new crown. The implant needs to integrate with the bone to improve its hold. This integration process can take anywhere from a minimum of six weeks to more commonly twelve weeks. After the attachment is mature, the dentist may need to undo the gum covering before taking impressions for the formation of the new crown.

But it is possible to have a tooth or teeth in a day. For a single tooth, your dentist may be able to immediately attach a crown right after implant surgery if the implant is very stable. Even so, this crown will need to be temporary, slightly shorter than a permanent crown so that it won't make contact with other teeth and put too much pressure on the new implant. After further healing from bone integration, impressions will be taken so that you'll receive your permanent crown shortly.

Immediate crown placement can allow you to have the cosmetic and limited functional benefit of a new tooth right from the start. If multiple implants are placed in one arch in a day, it's possible to have immediate teeth if enough implants are attached together with a temporary restoration.

This is different from a single implant replacing a single tooth and does create confusion for patients when they read about teeth in a day.┬áRegardless, no final tooth crown can be placed at the time of an implant—only a temporary restoration.

If you would like more information on your options for 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 “Same-Day Tooth Replacement with Dental Implants.”

By Robert D. Ory, D.D.S.
June 02, 2019
Category: Dental Procedures
Tags: porcelain veneers  
AffordableVeneersCanGiveYouaNewSmile

Your teeth are sound and healthy—but appearance-wise, they're nothing to write home about. It's nothing major: a chip, some heavy staining or perhaps a slight gap between the front teeth. But whatever the blemish, it bothers you every time you look in the mirror.

There's an affordable way to improve your smile without a lot of extensive treatment: porcelain veneers. These thin layers of dental porcelain are bonded to the teeth's exterior to mask the blemishes beneath. All you and others can see, though, are beautiful teeth blending seamlessly with the rest of your natural teeth.

Changing your smile with veneers begins with a consultation with your cosmetic dentist. During your visit you'll discuss what you would like to improve and how you would like your smile to appear afterward. It's helpful to take along magazine photos or other images of how you'd like your teeth to look.

After making impressions and getting other necessary measurements, your dentist may then be able to show you what your new veneers will look like. One way is through computer software that superimposes your proposed new look onto a photograph of your face. Your dentist may also be able to create test veneers with acrylic or other dental materials and apply them to your teeth. These aren't your permanent veneers, but they can still give you a realistic view of your future smile.

Once your measurements are on the way to the dental lab to custom create your veneers, your dentist must prepare your teeth for bonding. Although veneers are quite thin, they may still appear bulky when bonded to the teeth. To create a more natural look, you'll probably need some of the enamel layer of your teeth removed to accommodate the extra width. Even though this is a small amount, it will permanently alter your teeth and require some form of restoration from then on.

After your veneers arrive, the dentist will attach them with a translucent cement that will bond them seamlessly to the natural teeth. You and others won't be able to see where the veneer ends and the natural tooth begins. What you will see, though, is a new look for your teeth and a more attractive smile.

If you would like more information on porcelain veneers, 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.”

By Robert D. Ory, D.D.S.
May 28, 2019
Category: Dental Procedures
Tags: dental implant   bone loss  
AnImplantRestorationCouldPreventBoneLoss

Losing teeth continues to be an all too common experience for people, especially those in their senior years. Fortunately, there are several ways to replace them, ranging from partial or full dentures to implants.

Some, though, postpone or simply choose not to replace a lost tooth, often because of the cost. But putting off a dental restoration could have a long-term impact on your health, and not in a good way. Continuing bone deterioration is one of the top consequences of delayed restoration.

Like other bones in the body, the jawbone is living tissue with cells that form, grow and eventually wear out. At the end of their life, these older cells give way to new cells. Eating and chewing play an important role in maintaining this growth cycle: the forces we generate as we chew travel up through the tooth roots to stimulate bone growth in the jaw.

When a tooth goes missing, though, the stimulus ends. Over time the bone cell replacement rate can fall off and the bone slowly loses volume. To make matters worse, bone loss can continue beyond the immediate bone underlying the tooth and affect the rest of the jawbone. The jaw can shrink in height and width, and in time become weaker overall and more susceptible to fracture.

But dental implant restorations in particular could help stop or even reverse bone deterioration at the site of the missing teeth. The titanium post implanted in the jaw attracts bone cells, which grow and adhere to its surface. Over time the bone fills in and becomes stronger.

You don't want to wait too long, though, because implants depend on a minimum amount of bone present for secure placement. You should therefore undergo an implant restoration as soon as it's practical after tooth loss. Otherwise, although we may be able to restore some of the lost bone with bone grafting, you may need to consider another restorative option.

When it comes to replacing missing teeth, time isn't on your side. But the right kind of dental restoration undertaken promptly can make for a brighter, healthier future.

If you would like more information on restoring lost 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 “The Hidden Consequences of Losing Teeth.”

By Robert D. Ory, D.D.S.
May 13, 2019
Category: Dental Procedures
Tags: dental implants   dentures  
DentureswithImplantsCouldHelpYouAvoidBoneLoss

Even with modern prevention and treatment advances, losing teeth in later life is still a sad but common part of human experience. Just as generations have before, many today rely on dentures to regain their lost dental function and smile.

But although effective, dentures have their weaknesses. The most serious: they can't prevent jawbone deterioration, a common problem associated with tooth loss.

Bone health depends on chewing forces applied to the teeth to stimulate replacement growth for older bone cells. When teeth are gone, so is this stimulation. Dentures can't replicate the stimulus and may even accelerate bone loss because they can irritate the bone under the gums as they rest upon them for support.

But there's a recent advance in denture technology that may help slow or even stop potential bone loss. The advance incorporates implants with dentures to create two hybrid alternatives that may be more secure and healthier for the supporting bone.

The first is known as an overdenture, a removable appliance similar to a traditional denture. But instead of deriving its support from the gums alone, the overdenture attaches to three to four implants (or only two, if on the lower jaw) that have been permanently set into the jawbone. This not only increases stability, but the implants made of bone-friendly titanium attract and foster increased bone growth around them. This can help slow or even stop the cycle of bone loss with missing teeth.

The second type is a fixed denture. In this version, four to six implants are implanted around the jaw arch. The denture is then secured in place to these implants with screws. It's a little more secure than the overdenture, but it's also more expensive and requires good quality bone at the implant sites.

If you've already experienced significant bone loss you may first need bone grafting to build up the implant sites for these options, or choose traditional dentures instead. But if you're a good candidate for an implant-supported denture, you may find it provides better support and less risk of continuing bone loss than traditional dentures.

If you would like more information on implant-supported 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 “Overdentures & Fixed Dentures.”