Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, 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.”
When you hear the word “surgery,” your first thought might be of a high-charged operating room with a surgeon operating intently as a nurse mops sweat from their brow. While there are high-stakes surgeries, most aren’t quite that dramatic.
Dental implant surgery falls into the latter category. It does qualify as a surgical procedure because we make incisions and tissue alterations for the implant. But it’s no more rigorous than a surgical tooth extraction.
Still, if you’re new to implant surgery, it’s natural to feel some apprehension about it. To calm any nervousness, here’s a rundown of what to expect before, during and after the procedure.
Pre-Planning. Implant surgery is usually a routine affair because of meticulous planning beforehand. Often, we map out the implant site using CT scanners or other high-level imaging, identifying obstacles like nerves, blood vessels and sinus cavities, verifying there’s enough bone present to support an implant. With this information we can create a surgical plan or guide for placement in the mouth to accurately situate the implant.
Site Prep. On the day of the surgery we’ll first administer local anesthesia to numb the entire work area to pain. We’ll start with a few small gum incisions to expose the bone. Then using the surgical plan or guide, we’ll create a small channel for the implant with a drilling sequence that successively enlarges it until we achieve the best fit for the implant.
Implant Placement. Once we’ve completed drilling the channel, we’ll remove the implant from its sterile packaging and install it in the channel. After we’ve made any necessary adjustments and verified proper placement with x-rays, we’ll suture the gum tissue back into place.
After the Surgery. You might experience mild to moderate discomfort afterward that’s usually manageable with over-the-counter pain relievers like ibuprofen or acetaminophen. We can, if necessary, prescribe medication if you require something stronger. We may also prescribe an anti-bacterial mouth rinse for a short time to reduce the risk of infection.
After the implant has integrated with the bone which usually takes about 8-12 weeks, we’ll install your life-like crown or restoration. Your new smile and improved dental function will be well worth the process.
If you would like more information on the process for obtaining 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 Implant Surgery.”
To have a beautiful, healthy smile you’ll need to keep those pearly whites clean and plaque-free. Good dental hygiene, though, isn’t a solo act: It’s a duet best performed by you and your dental health provider. While you’re responsible for brushing and flossing every day, your dental hygienist gives your teeth a thorough cleaning every six months (or more). The American Dental Hygienists Association commemorates every October as National Dental Hygiene Month to recognize both the importance of hygiene and the professionals who assist you in keeping your teeth as clean as possible.
The focus for this emphasis on brushing, flossing and professional cleaning? A slick, slimy substance called dental plaque. This thin film of bacteria and food particles builds up on tooth surfaces after eating and gives rise to infections that cause tooth decay and gum disease. And it doesn’t take long without proper brushing and flossing, for a gum infection called gingivitis to start in only a matter of days. Daily hygiene reduces your risk of that happening: Brushing removes plaque from the broad, biting surfaces of the teeth, while flossing takes care of the areas between teeth that brushing can’t access.
So, if you can remove most of the plaque yourself, why see a dental hygienist? For two reasons: First, while daily hygiene takes care of the lion’s share of plaque, it’s difficult to clear away all of it. Over time, even a small amount of missed plaque can increase your disease risk. However, a professional cleaning that uses special hand tools and ultrasonic equipment can easily clean away this leftover plaque.
Second, some of the soft plaque can interact with saliva to form a hardened, calcified form called calculus or tartar. It can harbor bacteria just like the softer version, and it’s next to impossible to dislodge with brushing and flossing. Again, a trained hygienist with the right tools can effectively break up and remove calculus.
There are also additional benefits that come from regular dental visits to your hygienist. For one, hygienists can provide practical instruction and tips to help you brush and floss more effectively. And, after cleaning your teeth, they can point out areas with heavy plaque and calculus deposits. That can help you focus more of your future brushing and flossing efforts on those areas.
So, a shout-out to all the dental hygienists out there: These dedicated professionals work hard to keep your teeth clean. And a big high-five to you, too: Without your daily commitment to brushing and flossing, your smile wouldn’t be as beautiful—and healthy.
If you would like more information about best dental hygiene practices, please contact us to schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Hygiene Visit” and “10 Tips for Daily Oral Care at Home.”
There are plenty of good reasons to quit smoking. Here's one more if you're considering replacing a missing tooth with a dental implant: smoking increases your risk of implant failure.
By and large, dental implants are the most reliable and durable tooth replacement option, with more than a 95% success rate after ten years. But that still leaves a small percentage that fail — and twice as many of those failures are in smokers than in non-smokers.
To understand why, we need to look at how smoking affects oral health. Besides burning and thickening the surface skin cells inside the mouth, inhaled smoke can also damage salivary glands and lead to dry mouth. Reduced saliva creates an environment friendly to bacteria, which increases the risk of infection and disease.
The nicotine in tobacco also restricts the myriad of blood vessels that course through the teeth and gums. The resulting reduced blood flow deprives teeth and gums not only of nutrients but disease-fighting antibodies. The mouth takes longer to heal and can't fight infection as well.
The key to an implant's success lies with its titanium post imbedded in the jaw bone to take the place of the tooth root. Titanium attracts bone cells, which grow and adhere to the post over a period of time and create a stronger hold. But the health effects of smoking inhibit this process. Furthermore, slower healing caused by smoking increases the risk of infection, the number one cause of early implant loss.
If you want to improve your chances for a successful implant — not to mention improve your overall health — you should quit smoking. The prospect of a dental implant could be a useful incentive to enroll in a smoking cessation program.
At the very least we suggest you stop smoking a week before implant surgery and then for at least two weeks after to help promote good healing. And you should pay close attention to your daily oral hygiene — brushing and flossing at least once — and regular, semi-annual dental visits for cleanings and checkups.
Smoking can harm your health. If you're considering an implant, it could also harm your chances of a successful outcome.
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 & Smoking.”
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
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