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Gold or Porcelain Crowns? The Factors to Consider

May 12, 2014

Filed under: Dental Procedures — Tags: — drarakelian @ 7:39 pm

Gold is more than a financial commodity or a symbol of wealth — it’s one of the best materials for restoring damaged tooth crowns, the visible portion above the gum line. It’s extremely durable and can last for several decades if properly maintained. It also causes minimal wear to adjacent teeth.

But as new, more life-like materials have come into prominence, gold restorations have diminished in popularity. Dental porcelain in particular, a type of fired ceramic glass that mimics the look and color of teeth, has increased in popularity for use in highly visible areas.

But unlike gold, all porcelain crowns lack strength, tend to be more brittle and can abrade other teeth during biting and chewing. If they break, they can shatter beyond repair. All porcelain crowns are improving dramatically as newer space age materials become available. Historically, though, they are thought of as more unpredictable when used for back teeth; the greater biting forces make them more susceptible to failure than with front teeth.

A Porcelain-Fused-To-Metal (PFM) crown is a hybrid of these two materials that seeks to impart the strengths of both — the aesthetic appeal of porcelain and the durability of gold or platinum. But a PFM crown also has drawbacks: the porcelain surface may still abrade opposing teeth; they can lose their aesthetic appeal if the metal collar becomes visible if gum tissues recede; and they can fail if the porcelain fractures or separates from the metal.

To address some of porcelain’s weaknesses, some PFM variations reduce the amount of porcelain by placing it only on the visible side of a cast gold crown. In addition, other porcelain materials are now coming into use that may be more durable yet just as life-like.

Choosing which material to use for a crown depends on many factors: cost, the location of the crown, and, of course, the patient’s desires for the resulting smile appearance. It all begins with a comprehensive exam: from there, we can advise you on your options and help you make a choice — gold, porcelain or something in between — that’s durable and pleasing to the eye.

If you would like more information on your options regarding dental crowns, 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 “Gold or Porcelain Crowns?

Jamie Foxx Gets Into Character With Help From His Dentist

May 2, 2014

Filed under: Dental Procedures — Tags: , , — drarakelian @ 7:40 pm

If you were a well-known actor, how far would you go to get inside the character you’re playing in a movie? Plenty of stars have gained or lost weight to fit the role; some have tried to relate to their character by giving up creature comforts, going through boot camp, even trying out another occupation for a time. But when Jamie Foxx played a homeless musician in the 2009 film The Soloist, he went even further: He had part of his front tooth chipped out!

“My teeth are just so big and white — a homeless person would never have them,” he told an interviewer. “I just wanted to come up with something to make the part unique. I had one [tooth] chipped out with a chisel.”

Now, even if you’re trying to be a successful actor, we’re not suggesting you have your teeth chipped intentionally. However, if you have a tooth that has been chipped accidentally, we want you to know that we can repair it beautifully. One way to do that is with cosmetic bonding.

Bonding uses tooth-colored materials called “composite resins” (because they contain a mixture of plastic and glass) to replace missing tooth structure. The composite actually bonds, or becomes one, with the rest of the tooth.

Composite resins come in a variety of lifelike tooth shades, making it virtually impossible to distinguish the bonded tooth from its neighbors. Though bonding will not last as long as a dental veneer, it also does not require the involvement of a dental laboratory and, most often, can be done with minor reshaping of the tooth.

Cosmetic Bonding for Chipped Teeth
A chipped tooth can usually be bonded in a single visit to the dental office. First, the surface of the tooth may be beveled slightly with a drill, and then it is cleaned. Next, it is “etched” with an acidic gel that opens up tiny pores. After the etching gel is rinsed off, the liquid composite resin in a well-matched shade is painted on in a thin layer, filling these tiny pores to create a strong bond. A special curing light is used to harden this bonding material. Once the first layer is cured, another layer is painted on and cured. Layers can continue to be built up until the restoration has the necessary thickness. The bonding material is then shaped and polished. The whole procedure takes only about 30 minutes!

If you have questions about cosmetic bonding, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Artistic Repair of Chipped Teeth With Composite Resin.”

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.”

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