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Posts for category: Dental Procedures

YouDontHavetoLivewithaGummySmileHeresHowWeCanChangeit

A beautiful smile is a balanced smile, especially in regard to your gums. A normal smile usually shows 4 mm or less of gum tissue along with about 10 mm of tooth length. But if your gums show more than that, your smile may seem too gummy. In terms of perceived balance, this could detract from your smile's attractiveness.

Fortunately, you don't have to live with a gummy smile—there are various ways to correct or minimize its effect. First, though, we'll need to determine the underlying cause before deciding on the best treatment. And, there are several possible causes, the obvious being too much gum tissue present. Teeth that appear shorter due to wear or incomplete eruption could also make the gums appear larger.

We may be able to correct these size problems by surgically removing and reshaping excess gum tissues and possibly the underlying bone to reveal more of the teeth. We can also bond composite resins or porcelain veneers to shorter teeth to make them appear larger.

But not all gummy smile problems pertain directly to the teeth and gums; instead, it could be your upper lip moves too far up as you smile (hypermobility). Or, your upper jaw may be too long for your face, which can also cause too much of the gums to show during smiling.

With upper lip hypermobility, we may be able to inhibit the lip muscles' movement temporarily with Botox injections that partially paralyze the muscles (the effect eventually wears off, so this treatment will need to be repeated). A periodontist, an oral surgeon, or a plastic surgeon could also permanently alter the upper lip movement through a surgical procedure. Surgery may also be necessary for an abnormally long upper jaw: orthognathic surgery re-positions the jaw to the skull, which can lessen the amount of gums showing.

If your smile is too gummy, we can transform it. But first, let's find out what the real cause is with a comprehensive dental examination. Once we know, we can better advise you on the best way to bring beautiful balance to your smile.

If you would like more information on improving a gummy 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 “Gummy Smiles.”

ATraditionalBridgeMightbetheRightSolutionforYourMissingTeeth

We can do a great many things to preserve diseased teeth, from filling cavities to crowning damaged but still viable teeth to protect them and restore their attractiveness. But there may come a point where continued treatment just isn't worth it, and it may be time to remove and replace your troubled teeth.

Dental implants have become the premier restoration for missing teeth. But they have some anatomical limitations and may not work for some situations like excessive bone loss or close nerve proximity. And while a removable partial denture is a solid option, perhaps you'd rather have a fixed solution.

You might then want to consider a fixed bridge to replace one or more missing teeth. This tried and true option has been a mainstay in dentistry for several decades; and while implants may have surpassed them in popularity, they're still available and effective as a restorative option.

A traditional fixed bridge is composed of three or more life-like crowns that are fused together like pickets in a fence. The crown or crowns in the middle fill the empty tooth space; the outside crowns fit over and are bonded to the natural teeth on either side of the empty space to support the bridge. These natural teeth must be reduced in size to accommodate the crowns to fit over them.

Depending on how many teeth are missing, fixed bridges can be a more affordable alternative to dental implants and can achieve life-like results in both form and dental function. But the alterations required for the supporting teeth are permanent and can weaken them. The interface between the natural teeth and the bridge crowns has a higher risk of decay and periodontal disease, so you'll need to be extra vigilant with daily hygiene and regular dental cleanings and checkups.

And even though implants can be more expensive in the short-term, they typically have better durability and less maintenance costs than other restorations. Over the long-term, an implant restoration might actually incur less cost than a fixed bridge.

Still, a fixed bridge can be an effective way to replace missing teeth. Depending on your finances and your overall dental health, a bridge could help you regain an attractive smile.

If you would like more information on options for replacing 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 “Crowns & Bridgework.”

YoullExperienceLittletoNoDiscomfortDuringandAfterImplantSurgery

You’ve decided to obtain dental implants for your missing teeth. It’s a good choice — they provide the closest restoration to the function and appearance of natural teeth. You will, however, need to undergo a surgical procedure to imbed the implants’ threaded titanium posts into supporting bone.

It’s understandable if you’re a little apprehensive about undergoing surgery. We’re here, though, to set your mind at ease: implantation is a relatively minor procedure carefully planned in advance. Most patients experience no discomfort during the procedure and very little afterward.

We begin by completely numbing the surgical site with a local anesthetic. If you have a high level of anxiety, we can also administer a sedative or similar medication to help you relax. We then access the underlying bone through a series of incisions that create a flap in the gum tissue that we’ll later suture closed.

It’s quite common to have prepared a surgical guide or template beforehand. The template placed in the mouth marks the exact site for a small channel (or hole) we create in the bone. We then incrementally increase the size of the hole by drilling until it matches precisely the implant’s size and shape. This takes time to avoid overheating and damaging the bone.

We then remove the implant from its sterile packaging and insert it into the opening. We’ll also take x-rays to ensure correct positioning, which is critical for achieving an attractive result. We then suture the gum flap in place using stitches that will eventually dissolve. The implant will then integrate with the bone for a few weeks to create a strong, durable hold before we continue with the restoration.

Most patients can manage any post-surgical discomfort with mild anti-inflammatory pain relievers like aspirin or ibuprofen, although we can prescribe something stronger if you need it. We may also prescribe a mouthrinse with an anti-bacterial agent like chlorhexidine for you to use while the gums are healing to reduce the risk of infection.

Implant surgery is part of a long process that will eventually result in regaining the function of your lost teeth. What’s more, undergoing this minor procedure will also help you regain something just as important — a beautiful smile.

If you would like more information on dental implant restoration, 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.”

By Daniel J Poticny DDS
March 01, 2019
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Daniel J Poticny DDS
December 31, 2018
Category: Dental Procedures
Tags: dental implants  
3CausesforImplantFailureandWhatYoucandoAboutThem

First introduced in the 1980s, dental implants are a popular and reliable tooth replacement option. Numerous studies show that after ten years 95% are still in place. Much of this success owes to the implant’s titanium post imbedded directly into the jaw, which then attracts bone growth. This additional growth securely anchors the implant in place for an unrivaled durability among other replacement options.

Still, a small percentage of implants fail — some in the first few months and others after a few years. Here are 3 reasons why, and how you can overcome them.

Poor bone quantity and quality. Implants need a certain amount of existing bone to succeed. Sometimes, though, there isn’t enough because prolonged absence of a tooth causes bone loss around the empty socket. Conditions like diabetes, osteoporosis or tobacco use can also compromise bone health. It’s often possible to increase bone volume with grafting, especially right after tooth extraction.

Teeth grinding habits. This occurs when you unconsciously grind or clench your teeth, usually during sleep. The habit can create forces far in excess of what’s normal when we bite or chew and can damage or even break the crown attached to an implant. Besides reducing stress (a major factor for teeth grinding), you can also alleviate the abnormal force generated by wearing a night guard.

Periodontal (gum) disease. Although your implants are impervious to disease or infection, supporting gums and bone aren’t. Plaque, a film of food and bacteria that builds up on tooth surfaces, can cause gum disease that weakens the supporting tissues (gums and bone) of the implant. This can give rise to a specific condition with implants known as peri-implantitis where the infected gum tissues and bone around it deteriorate, leading to the implant’s catastrophic loss. To avoid this, practice consistent daily hygiene, including around the implant. And see us regularly for checkups and cleanings, or as soon as possible if you see signs of gum problems.

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: A Tooth-Replacement Method that Rarely Fails.”