You might see your teeth and gums as separate parts of your mouth. But we dentists see them as a unified biological system, each of them contributing to your mouth's various functions: eating, speaking and, of course, smiling.
The teeth-gum-mouth relationship is also a factor when things aren't going well. Tooth decay, for example, doesn't suddenly appear — conditions have to be present in the mouth to cause it. The same can be said for periodontal (gum) disease or bite problems.
So the best approach in dental care is to consider the whole — to first learn all we can about your mouth. We need to understand not only your current problems but also your health history and the unique features of your mouth. With this deeper understanding we can formulate a long-term plan that addresses all your individual needs.
We specifically want to identify your individual oral health risks, from your genetic makeup to any past problems with dental disease or the bite. We then want to assess your current state of health: do you have any presence of dental disease? Is any past dental work failing or in need of updating? Are there any biomechanical issues with the bite or bone loss that need to be addressed?
With this more complete picture, we can then prioritize your care and treatment. Some things like gum disease require immediate attention. Other areas such as bite problems or cosmetic issues may require planning and time to fully address. Our aim, though, is to eventually bring you to as high a level of health as your individual situation will permit.
Once we've achieved an acceptable level of health, our aim is to then maintain that level. This includes monitoring for changes in your oral health and intervening when necessary.
As you can see, establishing a care strategy is only the beginning — and care will always be ongoing. In fact, we'll need to modify your care as new issues arise or you experience the effects of aging. Our end goal, however, always remains the same — to help you achieve and keep the most healthy and attractive mouth possible.
If you would like more information on getting the most from your dental care, 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 “Successful Dental Treatment: Getting the Best Possible Results.”
If while watching a Seattle Seahawks game you thought you saw wide receiver D. K. Metcalf sucking on a “binky,” your eyes weren’t deceiving you. Well, sort of not—he’s actually been known to wear a mouth and lip guard shaped like a child’s pacifier.
Metcalf isn’t the only pro football player customizing this essential piece of safety equipment. Broncos running back Ronnie Hillman has been seen sporting “vampire fangs.” And Odell Beckham Jr., wide receiver with the Cleveland Browns, has a series of interchangeable guards with various designs and colors.
You may say, “That’s the NFL, so of course players have the money and fame to dress up their mouthguards with a little flair.” But custom mouthguards aren’t out of reach for the average athlete—in fact, it’s actually a sound idea. Not so much for expressing personality, but for the comfort and protective advantages that a custom mouthguard may have over retail varieties.
Usually made of high-resistant plastic, an athletic mouthguard absorbs blows to the face and mouth during hard contacts in sports like football, basketball and hockey. Mandated by many organized sports associations, mouthguards can prevent dental and facial injuries like chipped or knocked out teeth, gum abrasions or jaw fractures. There’s even some evidence they reduce the risk of concussion.
Many amateur players use what is known as a “boil and bite” mouthguard, available in retail sporting goods stores. They’re softened first, usually in hot water, and then placed in the mouth and clenched between the jaws to obtain a somewhat individualized fit.
Although they do provide some level of protection, a boil and bite mouthguard can’t match the accuracy of a custom mouthguard produced by a dentist based on impressions and measurements of an individual player’s mouth. As a result, custom mouthguards can be made thinner than many boil and bite guards, increasing their comfort while being worn. More importantly, their accurate fit enhances their protective capabilities.
As you might imagine, custom mouthguards are more expensive than their retail counterparts, and with younger athletes whose mouth structures are still growing, it may be necessary to upgrade a custom guard after a few seasons. Still, the cost of a custom mouthguard may be well worth the superior protection it provides for your own little star athlete. And although it may not necessarily look like a binky or vampire fangs, a custom mouthguard could make their playing experience safer and more comfortable.
Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.
Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.
Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.
Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.
However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.
Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow. After several months, we may have enough regenerated bone to support an implant.
If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.
You have a winning smile except for one small flaw — one of your front teeth is chipped. In functional terms the defect is insignificant: your tooth is healthy and can still do its job. But with regard to your smile that chip is like a smudge on a masterpiece painting: it stands out — and not in a good way.
The good news is you have options to repair the chip and vastly improve your appearance. One option is to bond a custom porcelain veneer to the outside of the tooth to cover the chip. But that would also mean removing a slight bit of tooth enamel so the veneer won't appear too bulky. Although not as much as with a crown, the alteration still permanently affects the tooth — it will always require a restoration of some kind.
There's another choice that doesn't involve removing any of your enamel: composite resin. This treatment is a mixture of materials with a glass-like binder in liquid form that we apply to a tooth in successive coats. As we build up the layers we can match the tooth's shape, texture and various shades of its natural color. We're able to fill in the defect and make the tooth appear as natural as possible.
Unlike porcelain restorations, composite resins don't require a dental lab or a period of weeks to prepare. We can transform your simile in our office in as little as one visit.
Composite resin isn't the answer for every tooth defect. Teeth that have become worn, fractured or have undergone a root canal treatment are best treated with a porcelain restoration such as a veneer or crown. But where the defect is relatively minor, composite resin may be the answer.
To learn if you can benefit from a composite resin restoration, you'll need to undergo a dental exam. If we determine you're a candidate, we can use this state-of-the-art dental material to make your teeth look flawless.
If you would like more information on composite resins, 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 “Artistic Repair of Front Teeth with Composite Resin.”
Dental amalgam—also known as “silver fillings”—has been used for nearly a hundred years to treat cavities. There are several reasons why this mixture of metals has been the go-to material among dentists: Malleable when first applied, dental amalgam sets up into a durable dental filling that can take years of biting forces. What’s more, it’s stable and compatible with living tissue.
But there’s been growing concern in recent years about the safety of dental amalgam, with even some wondering if they should have existing fillings replaced. The reason: liquid mercury.
Mercury makes up a good portion of dental amalgam’s base mixture, to which other metals like silver, tin or copper are added to it in powder form. This forms a putty that can be easily worked into a prepared cavity. And despite the heightened awareness of the metal’s toxicity to humans, it’s still used in dental amalgam.
The reason why is that there are various forms of mercury and not all are toxic. The form making headlines is known as methylmercury, a compound created when mercury from the environment fuses with organic molecules. The compound builds up in the living tissues of animals, particularly large ocean fish, which have accumulated high concentrations passed up through their food chain.
That’s not what’s used in dental amalgam. Dentists instead use a non-toxic, elemental form of mercury that when set up becomes locked within the amalgam and cannot leach out. Based on various studies, treating cavities with it poses no health risks to humans.
This also means there’s no medical reason for having an existing silver fillings removed. Doing so, though, could cause more harm than good because it could further weaken the remaining tooth structure.
The most viable reason for not getting a dental amalgam filling is cosmetic: The metallic appearance of amalgam could detract from your smile. There are newer, more life-like filling options available. Your dentist, though, may still recommend dental amalgam for its strength and compatibility, especially for back teeth. It’s entirely safe to accept this recommendation.
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