While it may not be one of your favorite features in the dental office, the dental drill is nevertheless necessary for treating problem teeth. It’s used primarily for removing decayed or damaged structure and preparing a tooth for fillings or other restorations.
Dental drills have been used for decades and are quite effective — but they have their drawbacks. Their rotating burrs often remove portions of healthy tooth structure along with decayed material. Friction from the drill action can cause discomfort, so local anesthesia is usually needed. Drills can also emit a high-pitched machine noise that’s unsettling to many patients.
There’s a growing alternative to the drill, known as air abrasion. Although the technology has been around since the 1950s, the development of new suction pumps that capture the resulting dust from its use has made it more palatable as an option to the traditional drill.
Also known as particle abrasion, the technique uses a pressurized stream of fine particles (usually aluminum oxide, an abrasive powder) directed at teeth to wear away (abrade) the tooth’s structural surface. We can be quite precise in the amount of surface material removed, so it’s useful for diminishing stains or roughing the surface for bonding materials like composite resin. We’re also able to remove decayed material with very little impact on surrounding healthy structure, and you may not need anesthesia during the procedure.
While this quiet alternative to the noisier drill is quite versatile, it does have its limitations. It’s not that efficient for preparing larger cavities for restoration or for removing older amalgam fillings. The teeth to be treated must be carefully isolated to prevent the fine particle dust produced from being swallowed by the patient or spread into the air. High-volume suction equipment is a must or the procedure will create a “sandstorm” of particles in the room.
Still, for situations suited to it and with proper isolation measures, air abrasion can be effective and comfortable. If the technology continues to improve, the dental drill may soon become a relic of the past.
If you would like more information on procedures using air abrasion, 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 “Air Abrasion Technology.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Congratulations—you’re engaged! It’s a stupendous (and hectic) time in your life as you plan your upcoming wedding.
You want to look your best for the big day—which means you may be dieting, exercising or making changes to your hairstyle and makeup. Be sure, though, to consider another important part of your appearance—your teeth and gums. Here are a few options that could help your wedding day smile shine even more.
Cleanings and whitening. While dental cleanings are primarily about removing disease-causing plaque and tartar they can also give your teeth that clean and polished look. And if you want an extra boost in brightness, consider whitening—we may be able to lighten up your teeth’s stain-induced dullness.
Bonding. If your teeth have slight imperfections—chipping, slight gaps or staining that doesn’t respond well to whitening, consider bonding techniques to repair or cover these defects. Composite resin is a dental material that can be shaped and bonded to teeth to reform a deformed tooth—and with color matching as well. For more extensive defects you can cover the front of imperfect teeth with bonded porcelain veneers or completely cap a tooth with a custom crown.
Tooth restorations. If you have missing teeth marring your smile, you have several options. The top choice: dental implants, which replaces the root of the tooth and will be able to have a crown attached to it. An implant can thus restore both better function and appearance. For more affordable options, you can also turn to fixed bridges or removable dentures. The latter can be custom designed to replace all the teeth on a jaw arch or just a few in different locations.
Gum enhancements. Teeth aren’t the only part of your smile that might need a helpful touch—your gums’ appearance might also be a problem. There are cosmetic procedures including plastic surgery and tissue grafting that can help correct overly prominent “gummy” smiles or, at the other end of the spectrum, longer appearing teeth because of gum recession.
Orthodontics. If you have extended time before the wedding date, we may be able to correct crooked teeth or a poor bite (malocclusion) that’s adversely impacting your smile. In some cases, you may be able to choose clear aligners, removable plastic trays that are hardly noticeable to others, over more visible braces to correct your bite.
Each part of the human body is an intricate wonder. Take your teeth, for example: they’re so woven into everyday life we don’t notice them, yet they each work seamlessly with the jaws and mouth so we can eat, speak and even smile.
Here, then, are a few facts to help you understand — and appreciate — these tiny, amazing wonders we call teeth.
Layer Upon Layer. Rather than one solid mass, teeth are composed of different layers of slightly different tissues each with a unique role in protecting and enabling a tooth to function. Innermost is the pulp filled with connective tissue encasing blood vessels and nerves that transmit sensations to the brain. The next layer out is the dentin, a bone-like material sensitive to touch and other stimuli, which also absorbs some of the forces generated when biting or chewing. The outermost layer is enamel, the hardest material in the body and the tooth’s first defense against infection and other dangers.
Front and Center. Teeth perform different functions depending on their type and location. Front teeth are our “onstage performers” — they help us to speak and enunciate words clearly and, of course, contribute to our smile. They’re also adept at cutting through food when it first enters our mouths.
The Support Team. In keeping with our theater analogy, back teeth are our “backstage crew”: they help support our facial height, provide balance for the jaws as we swallow and protect the front teeth from too much vertical force. They’re also able to crush food before we finally swallow, which aids in the digestive process.
Intended for a Lifetime. If you consider all the environmental factors our teeth face — acidic foods, biting forces and temperature swings to name a few — you then can appreciate their resiliency. Of course, teeth have their enemies: decay, infection and trauma. With daily brushing and flossing and at least a couple of visits a year to our office for cleanings and checkups, you can help thwart many of those enemies. With both our efforts we can make sure your teeth really do last a lifetime.
So, you’ve just acquired an attractive restoration with dental implants. You may be thinking at least with these teeth you won’t have to worry about dental disease.
Think again. While the implants and their porcelain crowns are impervious to decay the surrounding gums and bone are still vulnerable to infection. In fact, you could be at risk for a specific type of periodontal (gum) disease called peri-implantitis (inflammation around the implant).
Bacterial plaque, the thin bio-film most responsible for gum disease, can build up on implant crowns just as it does on natural tooth surfaces. If it isn’t removed with daily brushing and flossing and regular dental cleanings the bacteria can trigger an infection in the gums.
Besides weakening gum tissues, gum disease can also cause bone loss, of critical importance to dental implants. An implant depends on the bone they’re inserted in to hold them in place. If the bone around an implant becomes infected it could begin to be lost or dissolve (resorb), which could lead to loss of the implant.
That’s why it’s critical to keep the natural tissue structures supporting your implants infection-free. Not only is daily hygiene a must, but your implants and any remaining natural teeth should undergo professional cleaning at least twice a year or more if your dentist recommends it.
Cleanings involving implants will also be a bit different from natural teeth. While the dental materials used in the crown and implant post are quite durable, regular cleaning instruments can scratch them. Although tiny, these scratches can become hiding places for bacteria and increase your risk of infection.
To avoid this, your hygienist will use instruments (known as scalers and curettes) usually made of plastics or resins rather than metal. The hygienist may still use metal instruments on your remaining natural teeth because their enamel can tolerate metal without becoming scratched creating a smoother surface.
While keeping implants clean can sometimes be a challenge, it’s not impossible. Implants on average have a long-term success rate above 95%. With both you and your dentist caring and maintaining these state-of-the-art restorations, you may be able to enjoy them for decades.
If you would like more information on caring for 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 Maintenance: Implant Teeth must be Cleaned Differently.”
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