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By Primary Dental
November 07, 2019
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

DontAllowYourAgetoStopYoufromaNewSmilewithOrthodontics

Think you’re too old to have your teeth straightened? In reality, healthy teeth can be moved at any age to better positions. For the many adults who have some form of malocclusion (bad bite), orthodontics is still a viable option even in later years.

As important as it is to self-image and confidence, treating misaligned teeth can benefit you more than just improving your smile. Misaligned teeth may be harder to keep clean, setting up a mouth environment advantageous to the development of tooth decay or periodontal (gum) disease, the risks of both rising with age. And normally aligned teeth are easier to chew with than those misaligned.

Age isn’t the determining factor for whether you’re a good candidate for orthodontics — but your dental health is. Gum disease in particular can cause supporting bone loss, which can complicate orthodontic treatment. It’s important then that we first perform a complete oral examination and attempt to treat problems such as decay or gum disease first before attempting tooth movement.

What type of orthodontic treatment you’ll need will depend on the type of malocclusion you have and its relationship to the way your jaws fit together. Because your adult jaws have fully developed you may need orthognathic (“jaw straightening”) surgery to address certain advanced forms of malocclusion. If your bite problems aren’t that severe (the majority of situations) they can be treated with braces or, an increasingly popular alternative, clear aligners. These customized clear plastic trays are nearly invisible compared to metal braces and are effective for most patients.

Following the completion of tooth movement and other bite procedures, you will most likely need to wear a retainer to help prevent the teeth from reverting to their older positions. You may need to wear the retainer for a longer period than a younger patient, or perhaps indefinitely. Even with this mild inconvenience, though, you’ll still experience the positive effects of healthier and better functioning teeth and a great new smile.

If you would like more information on orthodontic treatment, 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 “Orthodontics for the Older Adult.”

AnchorageToolsHelpOrthodontistsCorrectComplexBiteProblems

While braces are often the stars for straightening smiles, they're not the only cast members in an orthodontic production. Orthodontists occasionally turn to other appliances if the bite problem is challenging. Whatever the tool, though, they usually have something in common—they use the principle of anchorage.

To understand anchorage, let's first consider the classic kid's game Tug of War. With teams on either end of a rope, the object is to pull the opposing team across the center line before they pull you. To maximize your pulling force, the player at the back of your rope, usually your stoutest member, holds steady or "anchors" the rest of the team.

Like a Tug of War team, braces exert force against the teeth. This stimulates the supporting periodontal ligament to remodel itself and allow the teeth to move. The braces use the teeth they are attached to as anchors, which in a lot of cases are the back teeth. By attaching a thin wire to the brackets or braces on the teeth, the orthodontist includes all the teeth on the arch, from one end to the other. Anchored in place, the wire can maintain a constant pressure against the teeth to move them.

But not all bite situations are this straightforward. Sometimes an orthodontist needs to influence jaw growth in addition to teeth movement. For this purpose, they often use orthodontic headgear, which runs around the back of the head or neck and attaches to orthodontic brackets on the teeth. It still involves an anchor but in this case it's the patient's own skull.

In some situations, an orthodontist may feel he or she needs more anchorage as the teeth alone may not be enough. For this, they might establish a separate or additional anchor point using a temporary anchorage device (TAD). A TAD resembles a tiny screw that's inserted into the jawbone near the tooth intended for movement. The orthodontist can then attach the TAD to braces hardware using some form of elastics. After treatment, they remove the TAD.

These are just a couple examples of specialized tools an orthodontist can use for bite correction. Thanks to them and similar devices, even the most complex bite problem can be overcome to create a healthier and more attractive smile.

If you would like more information on correcting a poor bite, 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 “Orthodontic Headgear & Other Anchorage Appliances.”

By Primary Dental
October 08, 2019
Category: Oral Health
MakeYourBabyasComfortableasPossibleDuringTeething

Your sweet, good-natured baby has seemingly gone from zero to grumpy overnight. The reason is simple: They’re teething.

Teething is a natural process in which a baby’s first teeth (primary teeth) begin to break through the gums, usually between six and nine months of age. This process continues intermittently until all twenty of the primary teeth erupt, sometime around age 3.

This uncomfortable and sometimes painful experience can cause gum swelling, biting and gnawing, chin rash and drooling. Your child may become irritable not only from this physical discomfort but also from disrupted sleep patterns and decreased appetite that often accompanies teething.

While you may have an unhappy baby while they’re teething, there’s usually no cause for concern. This is a natural process all children encounter, and the best thing you can do is make them as comfortable as possible. An exception would be accompanying diarrhea, fever or lingering crankiness—these could be symptoms of a more serious condition. If you begin to notice these, consult your doctor as soon as possible.

During teething there are a number of things you can do to reduce irritation. For one, allow your child to chew on clean, chilled (not frozen) teething rings, or a cold wet washcloth. The cold will help numb their irritated gum tissues. Massaging their gums with a clean finger can also help counteract the pressure caused by the incoming tooth.

If your doctor advises, you can also give your child over-the-counter pain relievers like acetaminophen or ibuprofen in an age-appropriate dosage. But be sure you give these medications orally and not rub them on the gums—some ingredients in them could burn the tissues. You should also not apply rubbing alcohol to the gums for the same reason. And avoid products with the numbing agent Benzocaine┬« in children less than two years of age unless your doctor advises otherwise.

Teething isn’t always a pleasant time for your baby or you, but it’s necessary—and temporary. In no time at all this discomfort will pass, and in its place will be their first set of teeth.

If you would like more information on teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”

FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”





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