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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?

DentalImplantsAreEvenMoreAdvancedThanksToTheseOtherTechnologies

When dental implants hit the scene in the 1980s, they revolutionized the field of dental restorations. But as groundbreaking as they were then, they're even more advanced now.

Some of the advancements have to do with improvements in implant design and manufacturing. Implant sizes and shapes were once quite limited, but today they come in a variety of forms to better match the types of teeth they replace.

But there has also been important progress in complementary technologies that help us realize better outcomes. Many of these other advances have had a positive impact on the planning and surgical stages of implant installation.

CT/CBCT scanning. For the best outcome, it's critical to install an implant at the most appropriate location on the jaw. This can be difficult to determine, however, because of the location of oral and facial structures like nerves or sinuses that might interfere with implant placement. But using a type of computer tomography (CT) scanning called cone beam CT, we can produce a 3-D computer graphic image that helps us navigate possible obstructions as we pinpoint the ideal location for an implant.

Digital smile displays. We're now able to produce digital models of the mouth, which can assist with more than implant placement—we can also use them to visualize what a new smile with implants will look like before we install them. This is especially helpful in situations where only a few teeth need to be replaced: We want to ensure that the new implant crowns blend seamlessly with the remaining teeth for the most natural appearance.

Custom-made surgical guides. We've been using surgical guides to mark the exact drilling locations during implant surgery for many years. But 3-D printing technology can now help us produce surgical guides that are even more useful and precise. Using a 3-D printer, we can produce oral devices based on the patient's individual dental dimensions captured through digital scanning. That produces a better fit for the guide on the teeth and more accurate implant placement.

Together, these and other technological advances are helping us achieve even more successful results. Not only can they help us produce implant outcomes that can last for years or even decades, but also the most beautiful smiles possible.

If you would like more information on dental implant restorations, 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 “How Technology Aids Dental Implant Therapy.”

By Gary Belenski, DDS
February 05, 2021
Category: Dental Procedures
Tags: crowns  
HeresWhatYouNeedToKnowAboutDentalInsuranceandChoosingaCrown

Millions of Americans rely on dental insurance to help them better afford dental care. Depending on the benefit package, an insurance policy can be useful in restoring dental health compromised by disease or injury.

But how life-like that restoration may appear is often a secondary concern with many insurance plans. For example, dental insurance will pay for a crown restoration that restores function to a tooth, but not necessarily of the highest aesthetic quality for achieving a truly life-like appearance.

To be sure, not all dental crowns are the same. Some are all metal, usually gold or silver. Some are “hybrids,” made of an interior metal shell with an outer fused porcelain shell (porcelain-fused-to-metal or PFM). In recent years all -ceramic crowns made of stronger life-like ceramics have become the most popular.

The type of crown used will depend a great deal on the type and location of the tooth. Teeth on the back of the jaw that encounter greater biting forces and are not as noticeable in the smile may do better with a metal or PFM crown. Visible side and front teeth are more likely candidates for all-ceramic. Your dentist will give you your best options as it pertains to your dental needs and appearance.

There's also a difference in crown workmanship. Dental laboratories now use milling machinery that sculpts a crown from a single block of material. Although some final handwork by skilled technicians is still necessary, milling has streamlined the process—and the cost—for producing a crown of high functioning quality.

But crowns that achieve the most natural smile appearance require more in the way of artistic craftsmanship. This in turn can increase the crown's price—beyond what many dental policies agree to cover. You may then be faced with a decision: an insurance-covered functional crown with an acceptable level of life-likeness or a more life-like crown for which you may have to pay more out-of-pocket.

Your dentist can advise you on your best options for a crown restoration, also factoring in what your insurance will cover. Ultimately, though, you'll have to weigh the kind of smile you desire with your dental situation and finances.

If you would like more information on dental crown restorations, 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 Dental Crowns.”

By Gary Belenski, DDS
January 26, 2021
Category: Dental Procedures
Tags: root resorption  
AlthoughRareThisConditionCouldDestroyaTooth

Most dental problems are caused by tooth decay or periodontal (gum) disease, easily preventable with dedicated daily hygiene and regular dental care.  But there are a few other rare conditions to be on alert for that could pose just as serious a threat to your dental health.

One of these is a phenomenon called root resorption. Put simply, certain cells arise within a tooth root that eat away and dissolve (resorb) tooth structure. Left unchecked, it could eventually lead to the tooth's demise.

Although its exact cause remains elusive, we suspect root resorption is associated with trauma to the gum ligaments earlier in life, perhaps from an injury or too much force applied during orthodontics. Other possible contributing factors include teeth-grinding habits or internal tooth bleaching procedures.

Root resorption in adults isn't that common, so your chances of experiencing it are low. But it is still possible, so you should be on the lookout for potential signs: Early on, it may appear as faint pink spots on teeth where the enamel has filled with the destructive cells eating away at the tooth. In time, these spots can increase to form cavities.

More than likely, though, your dentist may detect the problem during a dental exam. That's why regular dental cleanings and checkups are essential—a routine exam is a prime opportunity to uncover conditions like root resorption that silently undermine your teeth.

If found early, we can often treat root resorption effectively. We can often expose a small affected area with minor gum surgery, remove the harmful cells and fill any cavities with a tooth-colored filling. In some cases, we may recommend orthodontics beforehand to encourage a buildup of bone around the root by moving the affected tooth outward from the jawbone. If the resorption has affected the tooth pulp, you may also need a root canal treatment.

There is also the possibility with advanced resorption that the best course of action is to remove the tooth and replace it with a dental implant. So, keep up your regular dental visits—early detection and intervention can stop this destructive dental condition from destroying your tooth.

If you would like more information on root resorption, 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 “Root Resorption: An Unusual Phenomenon.”

By Gary Belenski, DDS
January 05, 2021
Category: Dental Procedures
6SignsYourChildCouldBeDevelopingaPoorBite

If your child has seen the dentist regularly, and brushed and flossed daily, there's a good chance they've avoided advanced tooth decay. But another problem might already be growing right under your nose—a poor dental bite (malocclusion).

A dental bite refers to the way the upper and lower teeth fit together. In a normal bite the teeth are in straight alignment, and the upper teeth slightly extend in front of and over the lower when the jaws are shut. But permanent teeth erupting out of position or a jaw developing abnormally can set the stage for a malocclusion.

Although the full effects of a malocclusion may not manifest until later, there may be signs of its development as early as age 6. If so, it may be possible to identify a budding bite problem and “intercept” it before it goes too far, correcting it or reducing its severity.

Here are 6 signs your school-age child could be developing a malocclusion.

Excessive spacing. If the spacing between teeth seems too wide, it could mean the size of your child's teeth are out of proportion with their jaw.

Underbite. Rather than the normal upper front teeth covering the lower, the lower teeth extend out and over the upper teeth.

Open bite. There's a space or gap between the upper and lower teeth even when the jaws are shut.

Crowding. Due to a lack of space on the jaw, incoming teeth don't have enough room to erupt and may come in misaligned or “crooked.”

Crossbites. Some of the lower teeth, either in front or back of the jaw, overlap the upper teeth, while the rest of the upper teeth overlap normally.

Protrusion or retrusion. This occurs if the upper front teeth or jaw appear too far forward (protrusion) or the lower teeth or jaw are positioned too far back (retrusion).

Besides watching out for the preceding signs yourself, it's also a good idea to have your child undergo a comprehensive bite evaluation with an orthodontist around age 6. If that does reveal something amiss with their bite, intervention now could correct or lessen the problem and future treatment efforts later.

If you would like more information on children's bite development, please contact us or schedule an appointment for a consultation.