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.
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
If you've ever been alarmed to find oddly-shaped red patches on your tongue, you can relax for the most part. Most likely, you're part of a small fraction of the population with a condition known as geographic tongue.
The name comes from the irregular shape of the patches that seem to resemble land formations on a map. Its medical name is benign migratory glossitis, which actually describes a lot about the condition. The patches are actually areas of inflammation on the tongue (“glossus” – tongue; “itis” – swelling) that appear to move around or migrate. They're actually made up of areas where the tiny bumps (papillae) you normally feel have disappeared: the patches feel flat and smooth compared to the rest of the tongue.
We're not sure why geographic tongue occurs. It often runs in families and seems to occur mostly in middle-aged adults, particularly women and non-smokers. It's believed to have a number of triggers like emotional stress, hormonal disturbances or vitamin or mineral deficiencies. There may also be a link between it and the skin condition psoriasis. Under a microscope the red patchiness of both appears to be very similar in pattern; the two conditions often appear together.
The bad news is we can't cure geographic tongue. But the good news is the condition is benign, meaning it's not cancerous; it's also not contagious. It poses no real health threat, although outbreaks can be uncomfortable causing your tongue to feel a little sensitive to the touch with a burning or stinging sensation. Some people may also experience numbness.
Although we can't make geographic tongue go away permanently, you should come by for an examination to confirm that is the correct diagnosis. Once we know for sure that you do have migratory glossitis, we can effectively manage discomfort when it flares up. You should limit your intake of foods with high acidity like tomatoes or citrus fruits, as well as astringents like alcohol or certain mouthrinses. We can also prescribe anesthetic mouthrinses, antihistamines or steroid ointments if the discomfort becomes more bothersome.
It may look strange, but geographic tongue is harmless. With the right care it can be nothing more than a minor annoyance.
If you would like more information on benign migratory glossitis, 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 “Geographic Tongue.”
Cancer treatment can be an all-out battle with intense side effects for your entire body. One particular area that can suffer is your mouth.
Chemotherapy and radiation target and destroy cancer cells, which can lead to non-cancerous cells caught in the crossfire and also destroyed. The salivary glands in the mouth are prone to such damage, which could greatly impact your ability to ward off dental disease.
Saliva, what salivary glands produce, plays a major role in oral health. The bodily fluid disseminates antibodies throughout the mouth that fight disease-causing bacteria. It also neutralizes acid, which can erode tooth enamel, and helps restore lost minerals to the enamel.
If the salivary glands become damaged, however, they may produce less saliva and create a condition called xerostomia or “dry mouth.” This is a common occurrence for cancer patients, which can rob them of saliva’s benefits and make them more susceptible to tooth decay or periodontal (gum) disease. The end result could be tooth loss.
There are things you and your dentist can do to prevent this. First, have a complete dental checkup before undergoing cancer treatment. If at all possible have any necessary dental work undertaken (with adequate recovery time afterward) before beginning chemo or radiation. Your dentist and oncologist (cancer specialist) may need to coordinate any planned dental work.
You should also practice daily oral hygiene with brushing and flossing, along with keeping up your regular dental cleanings. This will prevent the buildup on teeth of bacterial plaque, which in turn will reduce your chances for dental disease. Your dentist may also prescribe antibacterial as well as fluoride mouth rinses to help limit the growth of oral bacteria.
To minimize dry mouth, increase your water consumption as much as possible. You may also use saliva boosters like xylitol, an alcohol-based sweetener found in many gums or mints that promotes salivation (it also deters oral bacterial growth).
And don’t forget to maintain a healthy diet, which will not only benefit your stamina during cancer treatment but can also help you maintain better dental health. Providing good care for your mouth during this trying time will help ensure your teeth and gums stay as healthy as possible.
If you would like more information on oral care, 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 “Oral Health During Cancer Treatment.”
It's difficult to measure how x-ray imaging has transformed dentistry since its use became prominent a half century ago. As equipment and methods standardized, the technology revolutionized the way we diagnose tooth decay and other mouth-related issues.
One of the more useful of these methods is called the bitewing x-ray. The term comes from the shape of the device a patient holds between their teeth with the film attached on the side toward their tongue. We direct the x-ray beam to the outside of the patient's cheek, where it passes through the teeth to expose on the film. Its particular design provides clearer images since the patient's bite helps keep the film still and distortion-free, making it easier to view signs of early tooth decay.
Bitewing x-rays usually consist of four films, two on either side of the mouth, necessary to capture all of the teeth (children with smaller jaws, however, often only require one film per side). How frequently they're conducted depends on a number of factors, including the patient's age: children or young adolescents are usually filmed more frequently than adults, usually every six to twelve months. Frequency also depends on a patient's particular decay risk — the higher the risk the more frequent the x-ray.
Regardless of how often they're performed, a similar application principle applies with bitewing x-rays as with any other radiological method: As Low As Reasonably Achievable (ALARA). With the ALARA principle in other words, we're looking for that sweet spot where we're able to detect the earliest stages of dental disease with the least amount of radiation exposure.
Bitewings fit this principle well: a patient receives only a fraction of the radiation exposure from a four-film bitewing as they do from a daily dose of environmental radiation. Factor in new digital technology that reduces exposure rates and bitewings pose virtually no health risk to patients, especially if conducted in a prudent manner.
The benefits are well worth it. Thanks to bitewing x-rays we may be able to diagnose decay early and stop it before it causes you or your family member extensive tooth damage.
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