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Tooth Trauma Doesn’t Have to Mean Tooth Loss

April 17, 2014

Filed under: Oral Health — Tags: , — drarakelian @ 7:42 pm

Tooth decay and other oral diseases aren’t the only dangers your teeth face — accidental injuries also pose a risk. Fortunately, much can be done to save injured teeth, if you act quickly.

Dental injuries where part of the enamel crown has chipped off are the most common. Even if only one tooth appears damaged, adjacent teeth and bone might also have been damaged internally. Most chip injuries can be repaired either by reattaching the broken crown or with a tooth-colored filling or veneer. If the damage has extended into the inner tooth pulp then a root canal treatment might ultimately be necessary.

Teeth that have been knocked loose from normal alignment (dislodged) or where the entire tooth with its root has separated from the socket (avulsed) are rare but severe when they occur. It’s imperative to see a dentist as soon as possible — even more than five minutes’ of elapsed time can drastically reduce the tooth’s survivability. Dislodged teeth are usually splinted to adjacent teeth for several weeks; we would then carefully monitor the healing process and intervene with endodontic treatment (focused on the tooth’s interior) should something unfavorable occur.

With the possible exception of a primary (baby) tooth, an avulsed tooth should be placed back in the socket as soon as possible. This can be done by someone on scene, as long as the tooth is handled gently, the root not touched, and the tooth rinsed with cold, clean water if it has become dirty. If no one is available to do this, the tooth should be placed in milk to avoid drying out the root, and the patient and tooth transported to a dentist immediately. Once in the socket, the treatment is similar as for a dislodged tooth with splinting and careful watching.

The damaged tooth should be checked regularly. Your body’s defense mechanism could still reject it, so there’s a danger the root could be eaten away, or resorbed. Some forms of resorption can’t be treated — the aim then is to preserve the natural tooth for as long as possible, and then replace it with a life-like restoration to regain form and function.

If you would like more information on the treatment of injured 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 “Trauma & Nerve Damage to Teeth.”

Cosmetic Dentistry and the Urban Legend

April 2, 2014

Filed under: Dental Procedures — Tags: , — drarakelian @ 7:43 pm

He once lived in Australia, wore his hair in a mullet, and played guitar in a band called The Ranch. Today, country music star Keith Urban looks different than he did when he started out — and it’s not just the mullet that’s changed. As before-and-after pictures show, he’s had a smile makeover. His teeth, which were dull yellow in color, and used to have a large gap in front, are now white and shiny. The gap is still there — though it has been reduced to a more modest size. How did he manage to upgrade his image, yet keep part of his signature “look” intact?

Cosmetic dentistry has a number of ways to improve the appearance of a smile like Keith’s. One is tooth whitening. It’s a simple procedure that can be done in our office or at your home; either way, it’s an effective treatment that offers great value. In-office whitening, using the most concentrated solutions under our direct supervision, will give you the fastest results. We can also prepare a take-home kit, with custom-made trays and safe bleaching gels you can use at home. You’ll get similar results, but it will take a bit longer.

Of course, whitening isn’t permanent (though it can be repeated when necessary); not all teeth can be lightened as much as you might like; and it doesn’t correct gaps or unevenness. There’s another treatment that does, however: dental veneers. These are wafer-thin coverings made of porcelain, which are bonded to the prepared surfaces of your teeth. They are available in a number of shades — from natural to “Hollywood white” — and can even hide minor chips or spacing problems. That’s why veneers are often the treatment of choice when you’re looking for a “red carpet” smile.

Perhaps the best thing about veneers is that they give you plenty of choices when it comes to designing your smile. You can choose how white you’d like your smile to be, and even fix some “flaws” — or not! So how much you choose to close that gap in your teeth is up to you… but if you’re asking our opinion, the mullet has to go.

If you would like more information on dental veneers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “Porcelain Veneers.”

Do Clear Orthodontic Aligners Really Work?

March 18, 2014

Filed under: Dental Procedures — Tags: , , , — drarakelian @ 7:44 pm

Compared to traditional braces, orthodontic clear aligners seem miraculous in many ways, almost too good to be true. You may be wondering if they really work. The answer is yes — but they are not for everyone.

What are orthodontic aligners and how do they work?

Clear orthodontic aligners are an alternative to traditional braces that are used to move your teeth and transform your smile without much interference to your daily life. They are removable trays made of a clear plastic material that is essentially invisible.

When using aligners, a sequence of slightly different trays is custom-made to fit over your teeth. You must wear each one 20 hours a day for two weeks before changing to the next in the series. The aligners are computer generated, designed by state-of-the-art techniques based on models and images of your own teeth. They work because slight changes in the sequential aligners gradually shift your teeth. If they are worn consistently, the process takes from six months to two or three years.

Advantages over traditional braces are:

  • The aligners can be removed for eating, drinking, brushing, flossing and social occasions.
  • They have no rough edges or wires, making them more comfortable.
  • Changes become visible quickly as your teeth move into their new, better positions.

Clear aligners are a good solution for correcting mild to moderately crowded or incorrectly spaced teeth. They are most effective if your back teeth already fit together properly. Clear aligners are usually effective in correcting simpler or tipping movements of teeth in two dimensions. For more complex movements, traditional braces may be required. Clear aligners are usually recommended for adults whose teeth and jaws are fully developed, and not for children.

When do you need traditional fixed braces?

Traditional braces are fixed brackets attached to the teeth through which narrow, flexible wires are threaded. They may be necessary if your teeth do not meet properly, creating too much overbite or underbite. Closing spaces where teeth are missing, rotating teeth, or other complicated situations probably make you a better candidate for traditional braces.

Each particular situation is unique. To find out if clear aligners are right for you, make an appointment with us for an assessment and diagnosis of your own situation. For more information see the Dear Doctor magazine article “Clear Orthodontic Aligners.”

Immediate Dentures Bridge the Gap Between Tooth Loss and Restoration

February 21, 2014

Filed under: Dental Procedures — Tags: — drarakelian @ 7:45 pm

Losing all of your teeth can be both physically and emotionally traumatic. Patients in this condition may need a period of transition from this loss to their permanent restoration. That’s the purpose of “immediate” dentures.

An immediate denture is a tooth appliance available for placement immediately after the final extraction so the patient’s ability to eat and speak isn’t unduly hampered (it also helps preserve their facial appearance). An immediate denture is a temporary measure until a more permanent replacement is achieved; hence, they’re not intended for long-term use.

Over time an immediate denture’s fit will deteriorate. This is because as the gums heal after extraction, and without the natural teeth present, the underlying bone and gum tissues will shrink significantly. The denture fit becomes looser, which leads to movement of the denture within the mouth. This can cause a good deal of discomfort emotionally and physically, and make it more difficult to eat and speak. It’s possible, however, to reline the immediate denture to fit the gum shrinkage and gain more service from it.

At some point, though, it’s necessary to transition from the immediate denture to the permanent restoration. If the permanent solution is a removable denture, we will need to wait until the gums have completely healed. At that time we will make a new and accurate impression of your mouth that reflects any changes since extraction. Even with this high level of accuracy, though, the final fit will depend on the amount of remaining bone and gum tissue needed to support the denture.

There are other options besides a removable denture. We can install a pair of implants in conjunction with a removable denture that can stabilize and retain it in the mouth; implants can also support a fixed bridge. You should weigh all the advantages and disadvantages to these options (including cost), to determine which one is the best solution for you.

In the meantime, the immediate denture will enable you to function in a normal manner, as well as aid with your appearance. Remember, though, it’s only meant for a short period of time — at some point you will need to transition from “immediate” to a more permanent and satisfying replacement.

If you would like more information on dentures, 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 “Immediate Dentures.”

Fitness Expert Jillian Michaels Helps Kick Sleep Apnea

January 23, 2014

Filed under: Oral Health — Tags: , — drarakelian @ 7:48 pm

Jillian Michaels, personal trainer and star of television’s The Biggest Loser isn’t afraid of a tough situation — like a heart-pumping exercise routine that mixes kickboxing with a general cardio workout. But inside, she told an interviewer from Dear Doctor magazine, she’s really a softie, with “a drive to be one of the good guys.” In her hit TV shows, she tries to help overweight people get back to a healthy body mass. And in doing so, she comes face-to-face with the difficult issue of sleep apnea.

“When I encounter sleep apnea it is obviously weight related. It’s incredibly common and affects millions of people,” she says. Would it surprise you to know that it’s a problem dentists encounter as well?

Sleep apnea is a type of sleep-related breathing disorder (SRBD) that’s associated with being overweight, among other things. Chronic loud snoring is one symptom of this condition. A person with sleep apnea may wake 50 or more times per hour and have no memory of it. These awakenings last just long enough to allow an individual to breathe — but don’t allow a deep and restful sleep. They may also lead to other serious problems, and even complications such as brain damage from lack of oxygen.

What’s the dental connection? Sleep apnea can sometimes be effectively treated with an oral appliance that’s available here at the dental office. The appliance, worn at night, repositions the jaw to reduce the possibility of the tongue obstructing the throat and closing the airway. If you are suffering from sleep apnea, an oral appliance may be recommended — it’s a conservative treatment that’s backed by substantial scientific evidence.

As Michaels says, “I tell people that [sleep apnea] is not a life sentence… It will get better with hard work and a clean diet.” So listen to the trainer! If you would like more information about sleep-related breathing disorders, please contact us for a consultation. You can learn more in the Dear Doctor magazine article “Sleep Disorders and Dentistry.”

Technique Just as Important With Powered Toothbrushes as With Manual

January 8, 2014

Filed under: Oral Health — Tags: , — drarakelian @ 7:52 pm

Electric-powered toothbrushes have been in use for decades, and continue to enjoy wide popularity. But since their inception in the 1950s, there’s been a continuous debate not only about the best choice among powered toothbrushes, but whether powered toothbrushes are as effective in removing plaque as manual toothbrushes.

These debates are fueled by a large body of research over many years on powered toothbrushes. For instance, an independent research firm known as the Cochrane Collaboration has evaluated over 300 hundred studies of powered toothbrushes (over a thirty-year span) using international standards to analyze the data.

Surprisingly, they found only one type of powered toothbrush (using a rotation-oscillation action) that statistically outperformed manual toothbrushes in the reduction of plaque and gingivitis. Although from a statistical point of view the difference was significant, in practical terms it was only a modest increase in efficiency.

In all actuality, the most important aspect about toothbrushes in effective oral hygiene isn’t the brush, but how it’s used — or as we might say, “it’s not the brush so much as the hand that holds it.” The fact remains, after first flossing, a manual toothbrush can be quite effective in removing plaque if you brush once or twice a day with a soft-bristle brush using a gentle brushing motion.

Although a powered toothbrush does much of the work for you, it still requires training to be effective, just as with a manual toothbrush. We would encourage you, then, to bring your toothbrush, powered or manual, on your next cleaning visit: we would be happy to demonstrate proper technique and give you some useful tips on making your brushing experience more effective.

Remember too: brushing your teeth and flossing isn’t the whole of your oral hygiene. Although a critical part, brushing and flossing should also be accompanied with semi-annual professional cleanings to ensure the removal of as much disease-causing plaque as possible.

If you would like more information on types of toothbrushes, 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 “Manual vs. Powered Toothbrushes.”

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