My Blog

Posts for category: Dental Procedures

CrownLengtheningCouldHelpwithTreatingHardtoReachCavities

There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.

But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.

But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.

After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.

As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.

This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.

If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”

By Dale C. Evans, DDS
February 18, 2019
Category: Dental Procedures
Tags: porcelain veneers  
GetRidofThoseUnattractiveTeethwithPorcelainVeneers

Those unattractive teeth you see in the mirror are what are standing between you and a truly beautiful smile. If only you could make them go away.

In a way, you can do just that—with dental veneers. For the past three decades dentists have been covering the imperfections of problem teeth with these thin layers of porcelain. What's more, they're usually less involved and expensive than other restorations.

Veneers work best on teeth with moderate flaws like chipping, heavy staining or wearing, or slight misalignments like crookedness or gaps. The dental porcelain used is a ceramic material that so closely mimics the color and translucence of natural teeth it often takes a trained eye to notice any difference.

The first step to getting veneers is to plan your new look with a full examination and a diagnostic mock-up, a temporary application of tooth-colored filling materials applied directly to the teeth. This gives you and your dentist a better visual idea of how veneers will look on your teeth, and to make any adjustments ahead of time. A dental lab will use these findings to create your custom veneers.

In the meantime we'll prepare your teeth to accommodate your veneers. Although they're usually only 0.3 to 0.7 millimeters thick, veneers can still appear bulky when placed straight on the teeth. To adjust for their width we usually must remove some of the teeth's surface enamel so the veneers look more natural. Because enamel can't be replaced, the removal permanently alters the teeth and will require some form of restoration from then on.

When the veneers are ready we'll attach them with special cement so they'll form an almost seamless bond with the teeth. You'll then be able to use them just as before—but with a little caution. Although quite durable, veneers can break under too much force, so avoid biting on hard objects like ice, hard candy or nuts. And be sure you practice good dental care on your veneered teeth with daily brushing and regular dental cleanings and checkups.

The end result, though, is well worth the upkeep. Porcelain veneers can rejuvenate your smile and provide you a new level of confidence for years to come.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Your Smile—Better than Ever.”

CompositeResinCouldAmpupYourTeethsAttractivenessinJustOneVisit

It might not rise to the level of a miracle, but cosmetic dentistry can achieve some amazing outcomes with unattractive teeth. A skilled and experienced dentist can turn "ugly ducklings" into beautiful "swans." And that achievement might not be as in-depth or expensive as you might think, thanks to the increased use of dental materials called composite resins.

Composite resins are pliable, tooth-colored materials we apply directly to tooth surfaces. They're most often used with broken, chipped or misshapen front teeth—the composite material replaces the missing tooth structure.

Composite resins have been around for decades, but haven't been widely used because they didn't have the strength of dental porcelain. In recent years, though, dentists have perfected techniques for bonding and shaping composites to teeth that have increased their durability. With just the right skill and artistry, composites can look like natural teeth.

We can correct many tooth flaws using composite resins right in our office. After roughening up the outer enamel surface of the tooth and performing other steps to aid bonding, we begin applying liquid resins to form a base layer that we then harden with a special light source. We continue to add layers to increase the color depth and shape of the restoration, before finally polishing it to resemble natural teeth.

Composite restorations are ideal for moderate tooth structure loss, but may not be appropriate for heavily worn, previously root canal-treated or fractured teeth. These and other kinds of flaws may require a different solution such as a dental porcelain restoration with veneers or crowns. Where composites can be used, though, they provide an affordable option that doesn't require an outside dental lab for fabrication—we can often perform it in one visit.

If you'd like to consider a composite resin restoration for a less than perfect tooth, see us for a complete examination and consultation. If your situation appears to be compatible for using this particular technique, composite resins could change your smile for the better in just a few minutes.

If you would like more information on how we can improve your smile, 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 “Artistic Repair of Front Teeth with Composite Resin.”

By Dale C. Evans, DDS
January 29, 2019
Category: Dental Procedures
Tags: crown lengthening  
CrownLengtheningHelpsusTreatHardtoReachCavities

While we often associate tooth decay with cavities forming in a tooth’s visible or biting surfaces, the occurrence of this all too common disease isn’t limited to those areas. Cavities can develop in any part of a tooth exposed to bacteria.

Gum recession, the shrinking back of the gums from the teeth, can cause such exposure in areas normally covered by the gums. Because these areas are usually more vulnerable to infection when exposed, cavities can develop at or right below the gum line. Because of their location it can be difficult to fill them or perform other treatments.

One way to make it less difficult is to perform a crown lengthening procedure. While the term sounds like we’re increasing the size of the tooth, we’re actually surgically altering the gums to access more of the affected tooth surface for treatment. It’s typically performed in a dental office with local anesthesia by a general dentist or a periodontist, a specialist in the gums.

During the procedure, the dentist starts by making small incisions in the gums to create a tissue “flap” that can be lifted out of the way. This exposes the underlying bone, which they then reshape to support the gum tissue once it’s re-situated in its new position. The dentist then sutures the gums back in place. Once the gums heal, the decayed area is ready for treatment.

Crown lengthening is also useful for other situations besides treating cavities. If a tooth has broken off at the gum line, for example, there may not be enough remaining structure to support a crown. Crown lengthening can make more of the underlying tooth available for the crown to “grab” onto. It’s also useful in some cases of “gummy smiles,” in which too much of the gum tissue is visible in proportion to the tooth size.

Because crown lengthening often involves removing some of the bone and is thus irreversible, you should discuss this procedure with your dentist in depth beforehand. It could be, though, this minor procedure might make it easier to preserve your teeth and even make them look more attractive.

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

YoumayNeedOrthodonticTreatmentBeforeObtainingImplants

You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.

While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.

When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.

If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.

Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.

Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.

If you would like more information on your dental restoration options, 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 “Straightening a Smile before Replacing Lost Teeth.”