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Posts for category: Dental Procedures

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

Ultra-ThinVeneersMightHelpYouAvoidEnamelRemoval

Dental veneers—thin, life-like layers of porcelain bonded to teeth—can turn a so-so smile into a beautiful one. But most veneers have a distinct drawback: To make them look as natural as possible, the teeth they're bonded with must have some of their surface enamel removed.

Even though they're 1 millimeter or less in thickness, veneers on an unprepared tooth can look bulky. Removing some of the surface enamel remedies this, but doing so permanently alters the tooth. The tooth will need a veneer or some other protective restoration from then on.

Now, though, there's an alternative veneer available for many dental patients. Known as No-Prep or Minimal-Prep, these new veneers are often as thin as a contact lens.

These new types of veneers can often be placed directly on the teeth just above the gum line without any enamel removal and look natural. At the most, the enamel beneath them may need reshaping with an abrasive tool. And, unlike traditional veneers with tooth alteration, these low-prep veneers can often be applied without anesthesia, and in as few as two appointments.

No- or Minimal-Preps are better suited for certain kinds of patients: those with small teeth or teeth that appear small due to larger mouth features; worn teeth from aging or teeth grinding or with small gaps; narrow smiles where the side teeth aren't as visible; and teeth that are slightly misshapen or with minor staining.

On the other hand, patients with oversized teeth or front teeth that jut forward may still encounter problems with an unnatural, bulky appearance even with ultra-thin veneers. The latter situation can often be corrected with orthodontic treatment first to realign the teeth to their proper positions. Once the bite is corrected, no-prep veneers may then become a viable option.

If you'd like to consider these minimal preparation veneers, see your dentist for an examination. The exam results will help determine what type of veneer solution is right for you. And whether you go with traditional or No-Prep veneers, the change in your smile can be amazing.

If you would like more information on porcelain veneers without enamel removal, 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 “No-Prep Porcelain Veneers.”

By Tressa Priehs DDS
April 14, 2020
Category: Dental Procedures
Tags: celebrity smiles   veneers  
HowVeneersRestoredHowieMandelsWinningSmile

You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.

The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.

But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.

Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.

His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.

One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.

In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.

Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.

If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”

PlanAheadtoMakeYourSmiletheBestitcanbeforYourBigDay

The big day you've waited for all your life is just around the corner — your wedding day! And to make that day as special as possible you've been working on making yourself more attractive.

In all your preparations, don't forget your smile. There are many ways to make it shine, some requiring little time or effort. A professional dental cleaning and polishing, for example, can do wonders for brightening your smile. If you have above normal staining, you can also undergo professional whitening to remove stains and enhance your teeth's natural color.

Some problems, though, like chipped, slightly misaligned or heavily stained teeth may require more than a cleaning or whitening session. In these cases, you might consider covering these less attractive teeth with porcelain veneers to transform their appearance. As the name implies, veneers are a thin layer of tooth-colored, translucent porcelain custom designed for you and bonded permanently to the visible tooth.

While veneers can significantly change your smile, it can't fix every appearance problem. Some teeth require more extensive dental work, like a porcelain crown that completely covers a tooth, or dental implants to replace missing teeth. In more complex situations you may want to look at orthodontics to repair an unattractive bite, or plastic surgery to change the look of a gummy smile.

Keep in mind, though, many of such treatments take time: installing dental implants can take months and some orthodontic treatments, years. As soon as you can, you should discuss your smile appearance with your dentist and what can be done to enhance it in the time you have.

With the help of your dentist, orthodontist or other specialist, you can change your smile. And that, along with all your other preparations, will help make that once in a lifetime day even more special.

If you would like more information on undergoing a smile makeover, 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 “Planning Your Wedding Day Smile.”

By Tressa Priehs DDS
January 05, 2020
Category: Dental Procedures
DoYouHaveAdequateBonetoSupportanImplant

Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.

Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.

Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.

Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.

However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.

Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow. ¬†After several months, we may have enough regenerated bone to support an implant.

If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.