Posts for category: Dental Procedures
Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.
From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.
In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.
The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.
The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.
You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.
If you would like more information on 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 “Staging Surgery in Implant Dentistry.”
To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.
With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.
The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…
Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.
A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.
And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.
One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.
If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.
If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”
If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.
The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.
Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.
The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.
If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.
The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.
Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.
If you would like more information on restoring missing teeth with 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.”
X-rays are such a routine part of dental care that it's easy to overlook how much this technology has revolutionized detecting and treating tooth decay. It's safe to say x-rays have helped save hundreds of millions of teeth over the last hundred years.
Thanks to its unique properties these invisible electro-magnetic waves give us precise images of the interior structure of teeth and gums. It's so precise that we can clearly detect even a small spot of softened, decayed tooth structure on an exposed x-ray film, often before it becomes visible to the naked eye. As a result, we can begin treating the decay earlier, minimizing the damage and increasing the chances for preserving the tooth.
There are a variety of ways we can utilize x-ray technology in diagnosing dental problems. The one, though, that's used the most is called the bitewing. The name comes from wing-like tabs extending out from a thin frame holding a segment of unexposed film. A technician places the frame inside the patient's mouth with the film on the tongue side of the teeth, and has them bite down on the tabs to hold the frame still. They then aim a camera at the patient's outer cheek, which then emits a very short burst of x-ray energy to expose the film.
Bitewings are popular because they give a full view of the back and side teeth, where decay is often hard to detect, with very little radiation exposure to the patient. And as x-ray technology has progressed over the years with digital processing and more efficient equipment, we can acquire sharper images with even less exposure. We've also developed standard protocols for when and how often we perform x-rays, so that we're getting the most diagnostic benefit for the least amount of exposure time.
Those few minutes getting an x-ray may seem routine, but the benefits to your dental health are truly amazing. The bitewing and other forms of x-rays play a huge role in helping us keep your teeth as healthy as they possibly can.
If you would like more information on x-ray diagnostics, 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 “Bitewing X-Rays.”
You may think all crowns are alike—but there can be a world of difference between one crown and another. Getting the crown your dentist recommends and one that's satisfactory to you will depend on a number of factors, including what you'll ultimately have to pay.
Here are 3 things you need to know about crowns before undergoing a crown restoration.
Different materials. Although porcelain is the most life-like material used, earlier types of this glass-based material weren't strong enough to withstand biting forces, especially in back teeth. Years ago, all-metal crowns were most often used until the development of a hybrid porcelain crown with an inner metal substructure for strength. In recent years stronger all-porcelain crowns have risen in popularity. The material type that works best often depends on the tooth to be crowned—all-porcelain may work for a visible front incisor, but a porcelain-metal hybrid might be needed for a back molar.
Level of artistry. While new computer manufacturing systems allow dentists to produce patient crowns in-office, most still require the services and skills of a dental lab technician. The cost difference between crowns usually occurs at this juncture: the more life-like and customized the crown, the more artistry and time required by a technician to produce it. This can increase the cost of the crown.
Limited choices. While you and your dentist want your crown choice to be as individualized and life-like as possible, your dental insurance may limit your options. Many policies only provide benefits for the most basic crown restoration—enough to regain functionality and have an acceptable, but not always the most aesthetic, appearance. To get a higher quality of crown you may have to supplement what your policy and deductible will cover.
Deciding which crown is best will depend on where it will be needed, the level of attractiveness you desire and your insurance and financial comfort level. And your dentist can certainly help guide you to a crown choice that's right for you.
If you would like more information on restorative crown choices, 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 Dental Crowns.”