Posts for category: Dental Procedures

ALong-TermOrthodonticStrategyCouldHelpEnsureanAttractiveSmileLaterinLife

Orthodontics relies on certain mechanics in the mouth to move teeth to better positions. As the specialty has advanced, we've become ever more precise in moving teeth with braces, the “workhorse” of orthodontics, and other specialized appliances and techniques.

But although cooperating effectively with the mouth's natural ability for tooth movement is crucial for success, there's another aspect to consider if that success will be long-term: the growth and development of oral and facial structure. And not just development during childhood and adolescence: indeed, facial structure continues to change throughout a lifetime, including the senior years. Research has shown that although the rate of growth slows over time, it doesn't stop even for someone 80 years or older.

Our emerging understanding in this area has had an important impact on how and when we perform orthodontic treatment. As we develop a treatment strategy for an individual patient we consider not only the immediate outcome of a treatment, but also how it may change their facial appearance in the future. By taking continuing facial growth into consideration, we're more likely to achieve a new smile appearance that remains attractive later in life.

A key factor is to be sure we're initiating treatments at appropriate ages. We may detect developing bite problems as early as age 6, which might prompt preventive treatment at that time to diminish or even eliminate the problem. But it may also be prudent to wait on full-scale orthodontic treatment until late childhood or puberty. Furthermore, some form of orthodontic treatment might need to continue into early adulthood to ensure the most optimal outcome.

By taking a longer view of the treatment process, we're better able to work within the natural growth and development taking place now and in the future. As a result, a person is more likely to enjoy an attractive and youthful appearance even in their later years.

If you would like more information on aging factors for cosmetic enhancement, 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 “Understanding Aging Makes Beauty Timeless.”

HowKathyBatesRetainsHerMovie-StarSmile

In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.

When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”

Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.

There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.

By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.

So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.

BondedRetainersProvideaLessNoticeableOptionforKeepingTeethStraight

If you're currently undergoing orthodontic treatment, you're no doubt looking forward to the day your braces come off. But that won't end your treatment just yet — you'll need to wear a retainer.

Teeth are held secure in the bone of the jaw by an elastic tissue known as the periodontal ligament. As the braces “pull” the teeth to their new position, the ligament stretches and the bone remodels around the teeth. But the ligament also has a tendency to rebound as the tension eases when the braces are removed. The teeth could then return to their original position, especially during the first few months.

To prevent this patients wear an orthodontic appliance known as a retainer. It maintains some of the tension once supplied by the braces to help keep or “retain” the teeth in their new position. Depending on your age and other factors, you'll have to wear one for at least eighteen months; some patients, especially adults, may have to wear one indefinitely.

You may be familiar with a removable retainer, one you can take in and out of your mouth. But there's another type called a bonded retainer that's fixed to the teeth and can only be removed by a dentist. With this retainer a dentist bonds a thin piece of wire to the back of the teeth where it can't be seen. You can feel it, though, with the tongue: an unusual sensation at first, but one easily grown accustomed to.

Unlike their removable counterparts, bonded retainers aren't noticeable, either to others or the wearer. They're especially appropriate for patients who may not be as diligent in wearing a removable retainer.

It does, though, have some disadvantages. The position of the wire running horizontally across several teeth can make flossing difficult. And as with any retainer, removing it could increase the risk of the teeth moving out of alignment.

There are a number of factors to discuss with your orthodontist about which type of retainer is best for your situation. If you do choose a bonded retainer, be sure you work with the dental hygienist on how best to floss the affected teeth. And if you do have it removed, have a removable retainer prepared so you can preserve that smile you've invested so much into obtaining.

If you would like more information on bonded retainers following braces, please contact us or schedule an appointment for a consultation.

AvoidPermanentToothAlterationwithNo-PrepVeneers

Porcelain veneers have become a popular way to transform a smile. They're ideal for stained, chipped or slightly misaligned teeth. But although they don't need as much tooth preparation as crowns or other bridgework, the traditional veneer still requires some permanent tooth alteration.

Now, there's an alternative: no-prep veneers. With this option we can avoid any tooth structure removal or keep it to a minimum. And it may not even require local anesthesia while applying them.

Veneers are as their name implies: a wafer-thin layer of tooth-colored porcelain that's bonded to the outside of a tooth, much like siding on a house. Although the traditional veneer is usually no more than a millimeter in width, they can still add an unnatural bulky look and feel to a tooth. To compensate, we remove portions of the enamel. A tooth permanently altered this way will henceforth require some form of restoration.

No-prep veneers are much thinner; they also don't extend under the gum line like traditional veneers. At the most the new veneers may only require us to perform some minor reshaping of the enamel, but not to the extent of traditional veneers. And because your tooth isn't permanently altered, we could presumably remove the veneer and return the tooth to its natural state and appearance (although removing the bonding might not be that easy).

There are some situations where some tooth alteration may still be necessary, like oversized or forward-jutting teeth. A bad bite (malocclusion) may require orthodontic treatment first — which in some cases could be an alternative treatment to veneers altogether.

To find out if you're a candidate for no-prep veneers, visit us for a complete examination. From there we can discuss your options and whether we can transform your smile with little change to your teeth.

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

Implant-SupportedDenturesCouldHelpYouAvoidBoneLoss

Not long ago, the most affordable option for total tooth loss was a removable denture. Dentures, prosthetic (false) teeth set in gum-colored acrylic plastic bases, can effectively restore function and appearance. But the appliance continues to have one major drawback: it can accelerate bone loss in the jaw.

Like other living tissues, older bone cells die and become absorbed into the body (resorption). Normally they're replaced by newer cells. The forces generated when we chew our food travel through the teeth to stimulate this new growth. This stimulus ends when we lose our teeth, and so cell replacement can slow to an abnormal rate. Eventually, this causes bone loss.

Removable dentures can't provide this stimulation. In fact, the pressure generated as they compress the gums' bony ridges can even accelerate bone loss. That's why over time a denture's fit can become loose and uncomfortable — the bone has shrunk and no longer matches the contours of the dentures.

In recent years, though, a new development has been able to provide greater support to dentures while at the same time slowing or even stopping bone loss. We can now support dentures with dental implants.

Implants are best known as individual tooth replacements: a titanium metal post replaces the root, while a life-like porcelain crown attaches to the post to replace the visible tooth. In addition to providing a longer-lasting alternative to removable dentures, implants provide a very important health benefit: they improve bone density because they mimic the function of natural teeth. Bone cells are naturally attracted to the titanium; they adhere to the titanium post and are stimulated to grow through the action of chewing, increasing bone density and securing the implant's hold in the jaw.

Using the same technology we can support removable dentures, or even full fixed bridges. Rather than rest directly on the bony ridges, a denture can make a secure connection through a coupling system with just a few strategically placed implants. We can also permanently attach a full bridge by fastening it to a few implants with screws.

Not only do we eliminate the pressure from dentures compressing the gums and bone tissue, we can actually stimulate bone growth with the implants. Although more costly upfront than traditional dentures, unlike traditional dentures which must be replaced every five to seven years, long-lasting implants may be more cost-effective over the long-run.

If you would like more information on implant-supported tooth replacement, 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 “New Teeth in One Day.”