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Posts for category: Dental Procedures

By City Dental DC
January 15, 2021
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?

ThisLaserProcedurePromisesBigBenefitsforGumDiseaseTreatment

Over the years, dentists have become quite proficient in treating even the most severe periodontal (gum) disease. Many of these positive outcomes are achieved through manual effort using simple hand instruments called scalars and conventional periodontal surgery.

But that might be changing soon: Periodontists (specialists who care for the gums and other supporting dental structures) are starting to use a different kind of tool for gum disease treatment—surgical lasers.

Although lasers are more commonplace in other fields of medicine, recent developments hint at a more prominent future role for them in dentistry. One of these developments is a laser procedure called Laser Assisted New Attachment Procedure (LANAP®) that treats deep spaces of infection called periodontal pockets, which develop advanced gum disease.

These pockets form as infected gums gradually detach from a tooth as the supporting bone is lost. This widens the normally narrow gap between the teeth and gums. The ensuing pocket fills with infection that must be removed to adequately treat the gum disease. As the pocket extends down to the root, it's often necessary to perform a surgical procedure through the adjacent gum tissue to fully access it.

But with the LANAP® procedure, the dentist can use a laser to access a deep pocket without opening the gums. Moving from above into the gap between the tooth and gums, the light from the laser has the ability to remove diseased tissue without damaging healthy tissue.

The dentist follows this with ultrasonic equipment and manual scalers to further decontaminate the tooth root surface. The laser is then employed once again to facilitate the formation of a blood clot between the teeth and gums to seal the area with a fibrin clot. Once treated, the dentist will monitor the tooth to ensure maximum bone regeneration and gum reattachment.

Although outcomes are the same for the most part, this laser technique for periodontal pockets may have some advantages over conventional surgery. Studies so far show that LANAP® causes less tissue removal and bleeding, less potential for gum recession and less discomfort experienced by patients.

It's not likely that lasers will fully replace conventional gum disease treatments any time soon. But if the encouraging evidence thus far continues, the laser will one day become as commonplace alongside the other tools used for gum disease treatment.

If you would like more information on treatments for gum disease, 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 “Treating Gum Disease With Lasers.”

PorcelainVeneersTransformRealHousewivesStarsSmileSpoiledbyTeethGrinding

Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.

Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).

Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.

So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.

There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.

And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.

Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.

If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.

If you would like more information on teeth grinding habits and their effects, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”

ThisOrthodonticDeviceCouldReducetheNeedforFutureBraces

Each year, millions of children and teenagers wear braces or clear aligners to straighten a crooked smile. But there may be a way to treat some of these bite problems and avoid braces—by intercepting the problem at an earlier age.

This can often be done if the bite problem stems from abnormal jaw development rather than misaligned teeth. An example of this occurs when the upper jaw growth outpaces the lower jaw, causing the upper teeth to protrude beyond the lower teeth. Aside from the effect on appearance, protruding front upper teeth may extend beyond the protection of the lip and be more prone to injury.

A device called a Herbst appliance could prevent this from happening. The top of the device has two hinged metal tubes that connect to elastic bands bonded to the back teeth on both sides of the upper jaw. The bottom also has tubes affixed in the same way to the bottom teeth, except they're slightly smaller and fit within the upper tubes.

The lower tubes sliding within the upper tubes produces slight pressure against the lower jaw to ease it forward. This gradually influences the lower jaw to grow at a pace equal with the upper jaw to decrease the chances of poor bite development. Unlike other corrective methods, the Herbst appliance fixed in place and out of the way won't interfere with sports or other physical activities.

An installed Herbst appliance may change a patient's sensations during swallowing, eating or speaking, but most children adapt to the changes within a few days. And, because the device can create challenges for keeping the back teeth clean, many dentists recommend adding a fluoride rinse to daily brushing and flossing as an added boost against tooth decay.

The Herbst appliance is most effective during the period of most rapid physical growth between the ages of 11 and 14, but if the teeth are already beginning to protrude it can be undertaken as early as 8 or 9. Either way, this important orthodontic tool could help address a complicated bite problem and reduce the need for more costly orthodontic treatment later on.

If you would like more information on early interventions for poor bites, 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 “The Herbst Appliance.”

AgeDoesntHavetoStopYouFromStraighteningYourSmile

Cowboys wear Stetsons; ballerinas wear tutus; and teenagers wear…braces.

At least that's the popular conception. In actuality, one in five orthodontic patients is an adult, a number that continues to grow. Even adults over fifty are straightening their teeth and improving their smiles.

But it's still a big step and many adults are wary to take it because they think it's too late. Not necessarily: If you're an older adult toying with the idea of straightening your teeth, toy no more. Here's the lowdown on late in life orthodontics.

It's not just about the smile. While wanting a more attractive smile may have started you thinking about orthodontics, it's not the primary reason for considering it. Straightening your teeth can improve your health. Because misaligned teeth are more difficult to keep clean of disease-causing plaque, realigning them properly can improve your hygiene and lower your risk of dental disease. You'll also gain new chewing efficiency and comfort, which can improve your overall health and nutrition.

Health, not age, is the determining factor. Even if you're well advanced in years you can have your teeth straightened—as long as you're healthy. If your teeth, gums and supporting bone aren't in the best of shape, the stresses associated with tooth movement might be further damaging. Some systemic conditions may also interfere, so a full assessment of your overall health will be needed before treatment.

Only you and your dentist need to know. A lot of adults are embarrassed by the prospect of wearing braces. But you might be a candidate for an alternative to braces called clear aligners. These clear plastic trays are worn in a series to gradually move the teeth to their desired positions. You can remove the trays for eating or hygiene, as well as for rare special occasions. But best of all, they're nearly invisible to others.

If you're serious about straightening your teeth, take the next step by undergoing a complete dental exam. If the results of the exam show you're a good candidate for orthodontics, we can discuss your options for transforming your crooked teeth into a more attractive smile, regardless of your age.

If you would like more information on adult orthodontics, 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 “Orthodontics for the Older Adult.”