Posts for: April, 2019
It's difficult to measure how x-ray imaging has transformed dentistry since its use became prominent a half century ago. As equipment and methods standardized, the technology revolutionized the way we diagnose tooth decay and other mouth-related issues.
One of the more useful of these methods is called the bitewing x-ray. The term comes from the shape of the device a patient holds between their teeth with the film attached on the side toward their tongue. We direct the x-ray beam to the outside of the patient's cheek, where it passes through the teeth to expose on the film. Its particular design provides clearer images since the patient's bite helps keep the film still and distortion-free, making it easier to view signs of early tooth decay.
Bitewing x-rays usually consist of four films, two on either side of the mouth, necessary to capture all of the teeth (children with smaller jaws, however, often only require one film per side). How frequently they're conducted depends on a number of factors, including the patient's age: children or young adolescents are usually filmed more frequently than adults, usually every six to twelve months. Frequency also depends on a patient's particular decay risk — the higher the risk the more frequent the x-ray.
Regardless of how often they're performed, a similar application principle applies with bitewing x-rays as with any other radiological method: As Low As Reasonably Achievable (ALARA). With the ALARA principle in other words, we're looking for that sweet spot where we're able to detect the earliest stages of dental disease with the least amount of radiation exposure.
Bitewings fit this principle well: a patient receives only a fraction of the radiation exposure from a four-film bitewing as they do from a daily dose of environmental radiation. Factor in new digital technology that reduces exposure rates and bitewings pose virtually no health risk to patients, especially if conducted in a prudent manner.
The benefits are well worth it. Thanks to bitewing x-rays we may be able to diagnose decay early and stop it before it causes you or your family member extensive tooth damage.
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
A tooth that's been chipped doesn't mean it's no longer healthy. The same, unfortunately, can't be said about the attractiveness of your smile, especially if it's one of your front teeth. A chipped tooth can be quite noticeable and make you self-conscious.
The good news is a chipped tooth can be restored cosmetically to look just as normal and attractive as your other teeth. Depending on the application there are two different materials we commonly use: porcelains, a type of oven-fired ceramic most often found in veneers or crowns; or composite resins, a mixture of glass and plastic substances we apply in liquid form that hardens in built-up layers on the tooth's surface to ultimately resemble normal tooth shape and color.
So, which of these two materials is the best option for your tooth? That depends on the extent and location of the tooth damage. Composite resins are most often used for mild to moderate chipping or breaks in the enamel (and somewhat for the underlying dentin) or decayed areas in the front teeth. Porcelain veneers or crowns are better for more extensive damage or discoloration.
Both materials have their advantages and disadvantages. Composite resins can be applied in one office visit, but they require a skillful technique and an artistic eye to achieve a life-like appearance; although their strength has improved over the years, they're also limited in their durability and longevity compared to porcelain. Porcelain, on the other hand, is quite durable and has an excellent tooth-like appearance; they do, however, require removal of more tooth material than a composite resin to accommodate the new veneer or crown, along with more than one visit and the services of a dental lab to create the restoration.
The best way to find out which option is best for you is to visit us for a thorough dental examination. From there we can review with you our findings, our recommendations and the costs associated with each option. But whichever material we use, porcelain or composite resins, you can look forward to a new smile you'll be proud to display.
If you would like more information on cosmetic treatments for teeth, 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.”