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.”
Did you ever brush your teeth and find that your gums were bleeding slightly? This unwelcome discovery is more common than you might think — and it might have something to tell you about your oral health. Here are five things you should know about bleeding gums.
- As much as 90% of the population occasionally experiences bleeding gums. It happens most often while brushing — and it’s often a sign of trouble, indicating that your gums are inflamed and/or you aren’t brushing or flossing optimally.
- Bleeding gums can be an early warning sign of gum disease. In its earliest stages, this malady is called gingivitis, and it’s quite common. About 10 to 15 percent of people with gingivitis go on to develop a more serious form of gum disease, called periodontitis. If left untreated, it can lead to gum recession, bone loss, and eventually tooth loss.
- A professional exam is the best way to tell if you have gum disease. Your dentist or hygienist may use a small hand-held instrument called a periodontal probe to check the spaces between your teeth and gums. When gum tissue becomes detached from the teeth, and when it bleeds while being probed, gum disease is suspected.
- Other symptoms can confirm the presence of gum disease. These include the presence of pus and the formation of deep “pockets” under the gums, where gum tissues have separated from teeth. The pockets may harbor harmful bacteria, and need to be treated before they cause more damage.
- Several factors may influence the health of your gums. How effectively you brush and floss has a major impact on the health of your gums. But other factors are important too: For instance, women who are pregnant or taking birth control pills sometimes have bleeding gums due to higher hormone levels. Diabetics and people with compromised immune systems often tend to have worse problems with periodontal disease. Certain drugs, like aspirin and Coumadin, may cause increased bleeding; smoking, by contrast, can mask the presence of gum disease by restricting blood flow.
It’s never “normal” to have bleeding gums — so if you notice this problem, be sure to have an examination as soon as you can. If you have questions about bleeding gums or periodontal disease, contact us or schedule a consultation. You can read more in the Dear Doctor magazine article “Assessing Risk For Gum Disease.”
One of the unfortunate aspects of aging is tooth wear. Depending on your diet, years of biting and chewing can cause enamel along the biting surfaces to erode. Your body also can't replace enamel — so when it comes to teeth it's not a question of if, but how much your teeth will wear during your lifetime.
To make matters worse, certain conditions cause tooth wear to accelerate. Teeth softened by acids or tooth decay, for example, erode faster than healthier teeth. So will grinding habits: often fueled by stress, these include chewing on hard items like nails, pencils or bobby pins.
You may also grind your teeth, usually while you sleep. Normal biting and chewing produces pressure of about 13 to 23 pounds per square inch: grinding your teeth at night can well exceed this, even up into the hundreds of pounds.
There are some things we can do to alleviate these issues. For clenching and grinding habits, one primary step is to address stress through counseling or biofeedback therapy. For nighttime teeth grinding we can create a bite guard to wear while you sleep that will prevent your teeth from generating abnormal forces.
Finally, it's important that you take care of your teeth through daily oral hygiene, regular office cleanings and checkups, and a nutritious diet for maintaining strong bones and teeth. Keeping your teeth free from diseases that could compromise your enamel as well as other aspects of your mouth will help them stay as strong as possible.
If you would like more information on slowing the rate of tooth wear as you age, 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 and Why Teeth Wear.”
Dental implants are widely recognized as the best tooth replacement option available. For most people, though, it’s a long process: after a tooth is extracted the socket is allowed to heal and fill in with new bone before implant surgery: that can take anywhere from two to five months. Afterward, there’s usually a two– to three–month period after the implant is placed before the permanent crown (the visible tooth) can be attached.
Without adequate bone present the implant’s long-term stability might be compromised. Furthermore, the implant’s durability is dependent upon bone growth around and attaching to its titanium post after surgery in a process known as osseo-integration. These two considerations indeed serve a critical function in the implant’s ultimate success.
In recent years, however, a variation to this traditional implant process has emerged that allows for immediate implantation right after extraction. Besides combining extraction and implantation into one surgical procedure, immediate implants minimize the disruption to a person’s appearance (especially with visibly prominent front teeth) when combined with a provisional crown.
Immediate implants joined together that replace a full arch of teeth can receive biting forces and succeed. Individual implants that replace single teeth, however, won’t work in all situations and must be undertaken with care to ensure long-term success. Because there may be less available bone, the implant must fit snugly within the socket to maintain as secure a hold as possible. The surgeon must also take care not to damage too much of the gum and bone tissue when extracting the tooth, which could affect both the integrity of the implant and its appearance in the gum line.
Temporary crowns may be attached during the implant surgery, but they’re installed for appearance’ sake only. For individual crowns, they must be designed not to make contact with the teeth on the opposing jaw to avoid generating biting forces that will cause the implant to fail and stop the bone-healing process that occurs with osseo–integration.
If you’re considering dental implants, it’s important to discuss with us which type of procedure, traditional or immediate, would be best for you, and only after a comprehensive examination of your mouth and jaw structure. Regardless of the approach, our goal is to provide you with a smile-transforming restoration that will last for many years to come.
If you would like more information on the dental implant process, 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 “Immediate Implants.”
Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.
In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.
For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.
Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.
It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.
That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”
We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?”
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