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Posts for category: Dental Procedures

By Nathan Gelder DMD
June 02, 2020
Category: Dental Procedures
WhatReallyHappensDuringaRootCanalTreatment

Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.

You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.

But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?

First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.

Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.

Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.

Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.

You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.

If you would like more information on root canal therapy, 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 “A Step-By-Step Guide to Root Canal Treatment.”

TheseHigh-TechToolsHelpYourVeneersLookAttractiveandNatural

Porcelain veneers have been used for several decades to enhance a dental patient's smile. These thin wafers of color-matched dental porcelain are bonded to the visible surface of teeth to mask chips, disfigurements, discoloring or slight misalignments and gaps. Thanks to the artistry of dentists and dental lab technicians, the average observer often can't distinguish a veneered tooth from a natural one.

Veneers are great—but they're even more life-like and versatile thanks to recent technological advances. Here are a few of these high tech means that can help make your veneers as attractive as possible.

Digital photography. There's a lot that goes into making sure an individual's veneers seamlessly blend in with other teeth. Photographs in digital form that can be transferred electronically to dental labs are invaluable, especially for accurate color matching. A high resolution photograph can also relay an enormous amount of information about a patient's existing teeth including shape, size, length and position.

Computer imaging. We want you to be satisfied with your final veneer appearance. The best way to ensure that—and to relax any jitters you may have over the process—is to enable you to “see” your new smile before your veneers are even made. We can do that with computer imaging software that modifies a current photo of your smile to look as it will be with veneers. It's also a great tool for making changes to the veneer plan based on what you see in the model.

Tryout veneers. We can even take it a step further, by letting you see how your proposed veneers will look like on your own teeth. We do this by creating provisional veneers made of composite materials that we temporarily bond to your teeth. You can try them out for a while (and get others' impressions) until your permanent veneers are ready. And as with computer imaging, tryout veneers can guide updates to your veneer schematics before they're made.

Using these and other advanced techniques can help fine-tune the design of your new veneers to make sure they're the best they can be. They're great tools in achieving our ultimate goal with your veneers—a beautiful smile that everyone thinks is natural.

If you would like more information on the smile-transforming power of dental veneers, 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 Veneers: Your Smile—Better Than Ever.”

NewMaterialsAddStrengthtoVeneersBeautifulLife-Likeness

With exciting innovations in cosmetic dentistry over the last few decades, we can now transform nearly any unattractive smile. One of the best and most cost-effective of these is the porcelain veneer. These thin layers of dental porcelain are bonded over the front of chipped, slightly misaligned or stained teeth to create an entirely new look.

Veneers have evolved over time, especially with the materials they contain that give them their beauty and life-likeness. The first veneers were made mainly of feldspathic porcelain, a mineral composition known for its similarity in color and translucence to natural teeth.

But because this early porcelain had a high amount of silica (in essence, glass), and because they were created through overlaying several thin layers that weren’t as strong as a single piece, they were prone to shattering. This made them problematic for teeth subject to heavy biting forces or patients with clenching or grinding habits.

The situation changed dramatically in the 1990s, when dental labs began adding Leucite, a sturdier glass-like mineral that didn’t diminish the porcelain’s translucence. Not only did Leucite make veneers more shatter-resistant, it also enabled dental technicians to fashion most of the veneer in one piece to further strengthen it.

More recent veneers may now incorporate an even stronger material called lithium disilicate. Because lithium disilicate has twice the strength of Leucite, veneers made with it can be as thin as 0.3 millimeters. Not only does this blend together the most desirable qualities expected of a veneer—strength, aesthetic appeal and easy fabrication—it allows for a broader range of situations and uses.

Both of these materials can be pressed or milled to assume the exact shape necessary to fit a particular tooth. The manufacturing process also allows for creating smaller veneers that can then be overlaid with porcelain for the most life-like appearance possible.

Thanks to these stronger materials enhancing the natural beauty of porcelain, we now have a wider creative palate for transforming your smile.  

If you would like more information on porcelain veneers, 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 Veneers: Your Smile—Better Than Ever.”

TheresaGoodReasonforAdultstoConsiderOrthodontics-BetterOralHealth

You’ve had crooked teeth since you could remember. Perhaps you and your parents talked about braces when you were a teenager, but it never happened. Now you’re well into your adult years and you’re comfortable with how you look — so why go through the expense and time now to have them straightened?

There’s a good reason to consider orthodontics at any age — improved health. While we mainly associate teeth straightness with an improved smile, the more serious impact of misaligned teeth is on function — how we bite, chew and speak. As with many other areas of life, good form usually makes for good function. When we have crooked teeth, we may not be able to chew our food properly or speak as well as we could if our teeth were aligned properly.

Misaligned bites (malocclusions) can also have an impact on individual tooth health. Because they don’t interact efficiently with their opposing counterparts during chewing or biting, teeth can become loose or migrate further out of alignment.

While improvement in oral health is the primary reason for considering treatment for a malocclusion, don’t discount the benefit of orthodontics to your appearance. Your smile impacts many aspects of your life, including career and social relationships. A straighter, more attractive smile could also boost your self-confidence: even if you think you’ve grown accustomed to your smile, straightening your teeth could vastly change how you view yourself and how you believe others view you.

And if you’re dreading the look and feel of metal braces, orthodontic treatments have made giant strides in the last few decades. Clear aligners, for example, are much less noticeable than traditional fixed braces (and can be removed for special occasions), but still effective for moving teeth. There’s never been a better time to consider straightening your teeth — and change the course of your health and your life.

If you would like more information on orthodontics for adults, 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 “Why Straighten Teeth.”

By Nathan Gelder DMD
March 04, 2020
Category: Dental Procedures
IfYoureConsideringBracesHeresHowTheyWork

If you or a family member has problems with teeth alignment or your bite, you may be considering braces. This tried and true method can straighten out most smiles — but there's more to braces than you may realize.

For one thing, orthodontic treatment wouldn't work if it weren't for the natural mechanism for tooth movement that already exists in the mouth. It may seem your teeth are rigidly set in the jawbone but that's not how they maintain their attachment: that's the job of an elastic connective tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament has tiny fibers that attach to the tooth on one side and to the bone on the other to actually hold the teeth in place, much like a hammock secured between two posts.

The ligament attachment also allows the teeth to move incrementally in response to environmental factors or the aging process. We harness this natural movement ability with braces to move teeth to a more desirable position. We first attach small brackets to the front crowns of the teeth (the visible portion) and then string arch wires through them. We then attach the wires to anchor points where we can adjust the amount of tension they're exerting through the brackets against the teeth. By gradually increasing that tension, the teeth respond as they would when any force is applied against them and begin to move.

By precisely controlling that movement we can transform a patient's smile. But we believe the advantages are more than cosmetic: the teeth will function better and will be easier to care for and keep clean. These benefits, though, have to be balanced with heightened risks for root resorption (something that occurs only about 10% of the time) in which the ends of the roots can shrink, or loss of mineral content in teeth enamel where the hardware makes it more difficult to remove bacterial plaque. These risks can be reduced by closely monitoring dental health during the entire treatment process and through stepped up efforts in daily oral hygiene.

The starting point for deciding on an orthodontic treatment is a thorough dental examination with x-rays or CT scan imaging. Once we have a complete picture of your misalignment problems and any other extenuating circumstances, we can recommend a treatment plan just for you.

If you would like more information on orthodontic treatment, 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 “Moving Teeth with Orthodontics.”