Posts for category: Dental Procedures

By Alan N. Parnes, DDS, PC
October 21, 2018
Category: Dental Procedures
Tags: crowns  
NotAllCrownsareAlikeKnowtheDifferencestoGettheLookyouWant

If you're in need of a crown to cover a damaged tooth, you have a lot of options. But before you choose, you need to know what you want. Would you be happy with an affordable, well-fitting crown that holds up well and allows you to chew comfortably? Or are you interested in a more expensive one that also provides the most attractive result?

Crowns have been a mainstay in dentistry for generations. The first were made of metals like gold or silver — durable and effective but not very attractive.

In time, a ceramic material known as dental porcelain began to make its appearance in crowns. Dental porcelain could be fashioned to resemble the color and texture of natural teeth, but it had a significant drawback: it could be brittle and subject to shattering under chewing pressure.

This problem was somewhat addressed with the innovation of a crown with a metal substructure fused with an outer layer of porcelain. These porcelain-fused-to-metal (PFM) crowns combined the best advantages of both materials: strength and life-likeness. Up until around the mid-2000s, PFM made up over 80% of crowns.

But later porcelains continued to improve in strength, beginning in 1993 with the introduction of a Lucite-reinforced material. Newer formulations like lithium disilicate or zirconium oxide (now considered the strongest porcelain) have made all-porcelain crowns a viable option. Today, an estimated 60% of new crowns are all-porcelain.

From an appearance standpoint, all-porcelain crowns achieve the best results. The most realistic crown can be costly — not because of the material but the level of artistry required. A skilled dental technician will spend several hours, including brushing on as many as fifteen coats of liquid porcelain to the crown, to achieve the most life-like outcome. Your insurance plan, if you have one, will most likely not pay as high a percentage for that type of crown.

In the end, it's your decision as to what type of crown you wish to have. We'll help you weigh your options and decide what's best for you and your budget.

If you would like more information on crown options, please contact us or schedule an appointment for a consultation.

PartialDenturesanAffordableAlternativetoMoreExpensiveRestorations

Dental implants are today’s preferred choice for replacing missing teeth. They’re the closest restoration to natural teeth—but at a price, especially for multiple teeth. If implants are beyond your current financial ability, there’s an older, more affordable option: a removable partial denture (RPD).

Similar in concept to a full denture, a RPD replaces one or more missing teeth on a jaw. It usually consists of a lightweight but sturdy metal frame supporting a resin or plastic base (colored pink to mimic gum tissue). Prosthetic (false) teeth are attached to the base at the locations of the missing teeth. Unlike transitional dentures, RPDs are designed to last for many years.

Although simple in concept, RPDs certainly aren’t a “one-size-fits-all” option. To achieve long-term success with an RPD we must first consider the number of missing teeth and where they’re located in the jaw. This will dictate the type of layout and construction needed to create a custom RPD.

In addition, we’ll need to consider the health and condition of your remaining teeth. This can be important to an RPD’s design, especially if we intend to use them to support the RPD during wear. Support is a fundamental concern because we want to prevent the RPD from excessively moving in place.

Besides dental support we’ll also need to take into account how the jaws function when they bite. The RPD’s design should evenly distribute the forces generated when you eat and chew so as not to create undue pressure on the bony ridges of the jaw upon which the RPD rests. Too much pressure could accelerate bone loss in the jaw, a common issue with dentures.

It takes a lot of planning to create a comfortably-fitting RPD with minimal impact on your dental health. But you’ll also have to maintain it to ensure lasting durability. You should clean your RPD daily, as well as brush and floss the rest of your teeth to minimize the chances of developing tooth decay or periodontal (gum) disease. You can further discourage disease-causing bacterial growth by removing them at night while you sleep.

A RPD can be a viable alternative to more expensive restorations. And with the right design and proper care it could serve you and your smile for a long time to come.

If you would like more information on removable partial dentures, 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 “Removable Partial Dentures.”

WhyemBigBangTheoryemActressMayimBialikCouldntHaveBraces

Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.

“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.

Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.

Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.

Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.

Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.

So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!

For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”

By Alan N. Parnes, DDS, PC
August 02, 2018
Category: Dental Procedures
TakingtheDreadOutofDentalVisits

We always look forward to seeing our patients, but not all of you look forward to seeing us! If you’re one of them, don’t worry — we don’t take it personally. Dental anxiety prevents many people from seeking the care they require to restore or maintain a healthy smile.

But if dental problems are allowed to progress, they can affect not only the beauty of your smile and health of your mouth, but your overall wellness, too. Infection can travel from the mouth to other areas of the body, and dental disease exacerbates chronic health conditions like heart disease or diabetes.

Overcoming Apprehension

Fear should never be an obstacle (in the immortal words of President Franklin Roosevelt, “…the only thing we have to fear is fear itself…”). And fortunately there are some safe options for those of us who can’t get past our anxiety when it comes to dental care:

Oral Sedation. A sedative medication can be prescribed that you take by mouth approximately an hour before your dental visit to minimize anxiety and promote relaxation.

Intravenous (IV; “intra” – inside, “venous” – vein) Sedation. If oral sedation isn’t entirely effective in facilitating treatment, then a medication combining a sedative for relaxation and a pain-blocking anesthetic can be delivered through or small needle or catheter that is gently inserted into a vein. This is referred to as “conscious sedation” because you are in a semi-awake state during which you are able to respond to verbal direction. It takes effect quickly, and you can come out of it quickly. However, you may not remember much about your procedure. It is very different from general anesthesia during which you are completely unconscious.

Safety First

Dentists who offer IV sedation receive extensive training after which we must pass an exam and apply for a special permit that we maintain through continuing education. We carefully screen patients for eligibility and monitor you throughout so you can rest easy before, during, and after your procedure.

If you would like more information about sedation in dental care, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “Oral Sedation Dentistry.”

By Alan N. Parnes, DDS, PC
July 23, 2018
Category: Dental Procedures
Tags: bonding   chipped teeth  
BondingwithCompositeResinsIdealforRestoringChippedTeeth

Accidents can happen to your mouth, especially if you have an active lifestyle. For example, a sudden blow to the jaw while playing sports or exercising could result in a chipped tooth. And, while the internal tooth structure may be fine, the effect on your appearance can be disheartening.

Fortunately, we have techniques and materials to restore your smile after an injury. Bonding with composite resin is one such procedure: it’s ideal for mild to moderate chipping, especially in highly visible front teeth.

Composite resin is a dental material made of various substances mixed to match the color and texture of natural teeth. The composite is usually made of inorganic glass filler blended with a plastic-based matrix and joined together with a chemical “coupling” agent. The ratio of filler to matrix will depend on the type of tooth and damage — for example, back teeth, which encounter higher biting forces, require a composite with more filler for added strength.

To begin the procedure, we first prepare the damaged tooth by applying microscopic etchings (often with a chemical solution) that create tiny depressions or “undercuts”: these help create a seamless bond between the composite and the natural tooth. We then apply the composite in layers with a bonding agent, building up layer upon layer until we’ve achieved the desired shape for the tooth involved.

Bonding with composite resins doesn’t require much tooth preparation, can be placed quickly and is relatively inexpensive. Because of the wide spectrum of color possibilities, composite resins are superior to traditional amalgam (metal) restorations in creating a more life-like appearance. Its application, however, can be limited by the amount of tooth structure needing to be replaced: because it isn’t as strong as the tooth structure it replaces, the more tooth structure the bonded composite resin attempts to replace the less likely it can stand up over time to normal bite forces.

Still, composite resins are ideal for mild to moderate damage or disfigurement. If you’ve suffered such an injury, be sure to visit us to see if bonding with life-like composites is the right solution for restoring your smile.

If you would like more information on bonding with 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 “Repairing Chipped Teeth.”