Lansing's Dental Discussion

Posts for category: Dental Procedures

WantToBuyaDentalCrownTheKingofRockandRollsIsUpforSale

Although Elvis Presley left us more than four decades ago, he still looms large over popular culture. It's not uncommon, then, for personal items like his guitars, his revolver collection or even his famed white jumpsuit to go on sale. Perhaps, though, one of the oddest of Elvis's personal effects recently went on auction (again)—his gold-filled dental crown.

It's a little hazy as to how the "King" parted with it, but the crown's list of subsequent holders, including a museum, is well-documented. Now, it's looking for a new home with a starting bid of $2,500.

The interest, of course, isn't on the crown, but on its original owner. Dental crowns weren't rare back in Presley's day, and they certainly aren't now. But they are more life-like, thanks to advances in dental materials over the last thirty years.

Crowns are an invaluable part of dental care. Though they can improve a tooth's cosmetic appeal, they're more often installed to protect a weak or vulnerable tooth. In that regard, a crown's most important qualities are strength and durability.

In the early 20th Century, you could have utility or beauty, but usually not both. The most common crowns of that time were composed of precious metals like silver and, as in Presley's case, gold. Metal crowns can ably withstand the chewing forces teeth encounter daily.

But they simply don't look like natural teeth. Dental porcelain was around in the early days, but it wasn't very strong. So, dentists devised a new kind of crown that blended durability with life-likeness. Known as porcelain-fused-to-metal (PFM) crowns, they were essentially hybrids, a metal crown, which fit over the tooth, overlayed with a porcelain exterior shell to give it an attractive appearance.

PFMs became the most widely used crown and held that title until the early 2000s. That's when a new crown leader came into its own—the all-ceramic crown. In the decade or so before, the fragility of porcelain was finally overcome with the addition of Lucite to the tooth-colored ceramic to strengthen it.

Additional strengthening breakthroughs since then helped make the all-ceramic crown the top choice for restorations. Even so, dentists still install metal and PFM crowns when the situation calls for added strength in teeth that aren't as visible, such as the back molars. But for more visible teeth like incisors, all-ceramic usually stands up to biting while looking life-like and natural.

For a star of his magnitude, Presley's crown was likely state-of-the-art for his time. In our day, though, you have even more crown choices to both protect your tooth and enhance your smile.

If you would like more information about crown restorations, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”

By Holly Scott-Hetchler DDS
April 21, 2022
Category: Dental Procedures
Tags: dental implant  
WhatsInvolvedinGettingaDentalImplant

Although the term "surgery" is broad enough to drive a proverbial truck through, we can roughly categorize procedures as either major or minor. Installing an implant is decidedly in the minor column.

Akin to having a tooth extraction, implant surgery can be done painlessly in a dentist's office with very little discomfort afterward. If you're considering a dental implant, going through this surgical procedure shouldn't worry you.

Still, it's hard not to feel a little nervous about any type of surgery, even one as minor as getting an implant. That's where shining a little more light in the way of information can help dissolve any lingering anxiety. Here, then, is an overview of dental implant surgery from start to finish.

First, a little planning. Preparation beforehand helps eliminate any potential snags during surgery. During earlier visits, your dentist will completely map out the procedure with x-rays or CT scanning of your jaws to locate any obstacles, followed by the preparation of a surgical guide placed in the mouth to direct drilling.

Numbing the pain. The dentist begins the surgery by completely deadening the area with local anesthesia. This is usually done with an anesthetic swab of the surface gums to numb the needle prick, which is then used to deliver the remaining anesthetic to the deeper tissues and bone.

Creating the channel. After ensuring the area is fully anesthetized, the dentist will expose the bone by making small incisions in the gums. Then, using the surgical guide, they'll drill a small hole, incrementally enlarging it until it matches the size of the implant post.

Installing the implant. After drilling, the dentist removes the implant from its sterile packaging and directly places it into the prepared channel. The dentist then ensures the implant positioning is correct, often checking with additional x-rays. They'll then suture the gums back into place to protect the implant.

You may initially have a few days of mild discomfort, usually manageable with over-the-counter pain relievers. Over the next few weeks new bone cells will form and adhere to the implant to create a durable bond. You'll then be ready for the attachment of a life-like crown.

Surgery is one step in a long process. But it's an important step—and with the resulting smile outcome, well worth it.

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 “Dental Implant Surgery.”

ThisTemporaryRPDCouldSustainYourSmileWhileYouWaitForImplants

Dental implants are often the ideal choice to replace missing teeth. Unfortunately, "ideal" and "affordable" don't always align simultaneously for people. Even if implants are right for you, you may have to put them off to a more financially appropriate season.

In the meantime, though, you're still missing teeth—and perhaps some of them are right square in the middle of your smile. What can you do now, even if temporarily?

The solution might be a flexible removable partial denture (RPD). These newer types of RPD fit somewhere between the lightweight "flipper" and the more traditional rigid plastic appliances often made for permanent use. The flexible RPD is made of nylon plastic (technically known as a super-polyamide), which although lightweight, is highly durable.

Super-polyamides change their shape under high heat, a characteristic dental technicians take advantage of by injection molding heated material into flexible denture bases, to which they then attach the replacement teeth. Like other RPDs, a flexible RPD is custom-designed for the individual patient to match their jaw contours, as well as the types and locations of their missing teeth.

Flexible RPDs also differ from other RPD types in how they stay in place. While the more rigid RPD depends on metal clasps that grip to some of the remaining natural teeth, a flexible RPD uses finger-like extensions of the nylon material to fit around teeth near the gum line where they're difficult to see. As such, the flexible RPD is both comfortable and securely held in place.

A flexible RPD, like their counterparts, does require regular maintenance. Any RPD can accumulate dental plaque, a thin biofilm buildup on teeth that causes dental disease. For this reason, wearers should regularly remove their RPD and clean it thoroughly with an antibacterial soap (never toothpaste). All RPDs should also be removed at night to limit bacterial growth.

With a little care, a flexible RPD could last for several years. It could be just the solution to buy you time while you're waiting to obtain dental implants.

If you would like more information on restoration options for missing 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 “Flexible Partial Dentures.”

By Holly Scott-Hetchler DDS
March 22, 2022
Category: Dental Procedures
Tags: dental implants  
4ReasonstoChooseDentalImplantstoRestoreMissingTeeth

Many of your friends and family—and perhaps even your dentist—tell you that dental implants are the way to go replacing your lost teeth. Even so, you're still hesitant about choosing them.

For one thing, you're anxious about undergoing the surgical procedure needed to place and secure the implant (although it's relatively minor, and usually only requires local anesthesia). It could also be weeks, perhaps months, before you complete the process. Last, but not least, dental implants are more expensive than other dental restorations.

Is it really worth the time, effort and expense to obtain dental implants? Here are 4 reasons why the answer is a resounding yes.

They look and feel like real teeth. Unlike other restoration methods, a dental implant replaces the root as well as a tooth's visible crown. This gives them more of the feel of real teeth when you're biting or chewing. And with its root replacement design, we're better able to achieve good positioning that makes the final tooth look incredibly natural and life-like.

They're strong and durable. After surgical placement, the implant begins to integrate with the surrounding bone. Bone cells "like" titanium, the most commonly used metal in implants, and readily grow and adhere to the implant surface. This integration process results in an incredibly strong hold that can last for several years, if not decades.

They're adaptable to other restorations. People missing multiple teeth often shy away from implants for financial reasons. It's true: Replacing multiple teeth individually with implants can be extremely expensive. But we can also use a few strategically placed implants to support a bridge or denture. Not only is this often a more cost-effective option, the implants may also improve the traditional restoration's stability.

Long-term costs may actually be lower. While it's true an implant's initial costs are usually higher than other restorations, it could cost you less over time. Because of their durability, more than 95% of implants are still intact after ten years, and most last much longer. You may find maintenance and replacement costs for other restorations could eventually exceed what you'll pay with dental implants.

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 “Dental Implants.”

By Holly Scott-Hetchler DDS
March 12, 2022
Category: Dental Procedures
Tags: tooth decay  
TreatingDecayedBabyTeethProtectsFuturePermanentTeeth

Primary ("baby") teeth may look cute and adorable, but they're a big player in your child's dental health. A primary tooth lost prematurely could eventually lead to a major bite problem.

Primary teeth fulfill a number of functions, most notably enabling young children to eat solid foods, speak and relate to people with a normal smile. But they also serve as placeholders and guides for future permanent teeth developing within the gums.

Problems arise, though, when a child loses a primary tooth early due to disease or trauma, leaving an open space on the jaw. Nearby teeth tend to drift in to fill the space intended for the permanent tooth, leaving little to no room for it when it's time to erupt. This can cause it to erupt out of position, which in turn could force other teeth out of alignment. The end result is a poor bite.

You can, however, avoid this costly outcome by either treating and preserving a decayed baby tooth, or preventing other teeth from drifting into a vacancy left by a lost primary tooth until the permanent tooth comes in.

Depending on the level of decay, treating a diseased primary tooth can include fillings, crowns or modified root canal therapy. For children at high risk for decay, a dentist may also apply sealant to the teeth to inhibit plaque buildup. Although some of these procedures can be extensive, they're often worth the time and effort to prevent a poor bite.

If, on the other hand, we eventually lose the tooth, we can still intervene by installing a space maintainer. This is essentially a loop of wire securely attached to a tooth on one side of a gap, while the other end of the loop butts up against the tooth on the other side. This prevents either tooth from migrating into the space until the permanent tooth is ready to come in.

Primary teeth may not seem all that important, but in the greater picture, they truly are. By taking care of them, you'll be doing your child's soon arriving permanent teeth a favor.

If you would like more information on pediatric dental 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 “Importance of Baby Teeth.”

SupermodelAshleyGrahamsUnpleasantDentalEncounterWithaFrozenCookie

Ashley Graham has a beautiful and valuable smile—an important asset to her bustling career as a plus-size model and television host. But she recently revealed on Instagram a “confrontation” between one of her teeth and a frozen oatmeal cookie. The cookie won.

Holding her hand over her mouth during the video until the last moment, Graham explained how she sneaked a cookie from her mom's freezer and took a bite of the frozen treat. Taking her hand from her mouth, she revealed her broken tooth.

Okay, maybe it wasn't an actual tooth that was broken: the denticle in question appeared to have been previously altered to accommodate a porcelain veneer or crown. But whatever was once there wasn't there anymore.

Although her smile was restored without too much fuss, Graham's experience is still a cautionary tale for anyone with dental work (and kudos to her for being a good sport and sharing it). Although dental work in general is quite durable, it is not immune to damage. Biting down on something hard, even as delicious as one of mom's frozen oatmeal cookies, could run you the risk of popping off a veneer or loosening a crown.

To paraphrase an old saying: Take care of your dental work, and it will take care of you. Don't use your teeth in ways that put your dental work at risk, tempting as it may be given your mouth's mechanical capabilities.

 Even so, it's unwise—both for dental work and for natural teeth—to use your teeth and jaws for tasks like cracking nuts or prying open containers. You should also avoid biting into foods or substances with hard textures like ice or a rock-hard cookie from the freezer, especially if you have veneers or other cosmetic improvements.

It's equally important to clean your mouth daily, and undergo professional cleanings at least twice a year. That might not seem so important at first since disease-causing organisms won't infect your dental work's nonliving materials. But infection can wreak havoc on natural tissues like gums, remaining teeth or underlying bone that together often support dental enhancements. Losing that support could lead to losing your dental work.

And it's always a good idea to have dental work, particularly dentures, checked regularly. Conditions in the mouth can change, sometimes without you noticing them, so periodic examinations by a trained dental provider could prevent or treat a problem before it adversely affects your dental work.

We're glad Ashley Graham's trademark smile wasn't permanently harmed by that frozen cookie, and yours probably wouldn't be either in a similar situation. But don't take any chances, and follow these common sense tips for protecting your dental work.

If you would like more information on care and maintenance of cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty as Never Before” and “Dental Implant Maintenance.”

By Holly Scott-Hetchler DDS
February 10, 2022
Category: Dental Procedures
3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing 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 “When Permanent Teeth Don't Grow.”

UnlikeBradPittYouDidntMeanToChipYourToothWeCanStillFixIt

It's not unusual for serious actors to go above and beyond for their roles. They gain weight (or lose it, like Matthew McConaughey for True Detective). They grow hair—or they shave it off. But perhaps nothing tops what Brad Pitt did to assume the character of Tyler Durden in the movie Fight Club—he had his dentist chip his teeth.

While a testament to his dedication to the acting craft, Pitt's move definitely falls into the category of "Kids, don't do this at home." Fortunately, people deliberately chipping their teeth isn't a big problem. On the other hand, accidentally chipping a tooth is.

Chipping a tooth can happen in various ways, like a hard blow to the jaw or biting down on something too hard. Chipping won't necessarily endanger a tooth, but the missing dental structure can put a damper on your smile.

But here's the good news: you don't have to live with a chipped tooth. We have ways to cosmetically repair the damage and upgrade your smile.

One way is to fit a chipped or otherwise flawed tooth with a dental veneer, a thin wafer of dental porcelain bonded to the front of a tooth to mask chips, discolorations, gaps or other defects. They're custom-made by a dental lab to closely match an individual tooth's shape and color.

Gaining a new smile via dental veneers can take a few weeks, as well as two or more dental visits. But if you only have slight to moderate chipping, there's another way that might only take one session in the dentist's chair. Known as composite bonding, it utilizes plastic-based materials known as composite resins that are intermixed with a form of glass.

The initial mixture, color-matched for your tooth, has a putty-like consistency that can be easily applied to the tooth surface. We apply the composite resin to the tooth layer by layer, allowing a bonding agent in the mixture to cure each layer before beginning the next one. After sculpting the composite layers into a life-like appearance, the end result is a "perfect" tooth without visible flaws.

Unlike Brad Pitt, it's pretty unlikely you'll ever find yourself in a situation requiring you to purposely damage your teeth. But chips do happen—and if it happens to you, we have more than one way to make your teeth as good as new.

If you would like more information about repairing dental flaws with veneers or composite bonding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”

By Holly Scott-Hetchler DDS
January 01, 2022
Category: Dental Procedures
Tags: dental implant  
ShouldYouTakeanAntibioticBeforeImplantSurgery

Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.

But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.

But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.

If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.

Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.

Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.

Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.

If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.

If you would like more information about dental implant surgery, 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 “Implants & Antibiotics.”



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