Posts for: June, 2020
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.”
If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.
You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.
An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.
Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.
The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.
There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.
During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.
If you would like more information on dental implants, 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 Dental Implants.”
Like the rest of healthcare, antibiotics have transformed dentistry. Advanced oral infections that once eluded successful treatment are routinely stopped with the use of these “wonder drugs.” But their overuse over the years has given rise to dangerous “superbugs” resistant to many antibiotics.
Antibiotics are one of the 20th Century's most significant healthcare achievements. Drugs like penicillin played a major role ending the global threat of tuberculosis, cholera and bacterial meningitis. Over the last few decades, more antibiotics have been developed to defend against an even wider array of bacterial dangers.
But along the way doctors and dentists began prescribing antibiotics for all manner of illnesses including viral infections like colds or flu for which they're less effective. They've also been increasingly used as a preventive measure, including inclusion in animal feed to fight disease.
But our tiny biological nemeses are adaptable. As bacterial strains come in contact with greater amounts of antibiotics, individual bacterium that survive transmit their resistance to subsequent generations. This can produce new strains like Staphylococcus aureus (MRSA) that are resistant to methicillin and other common antibiotics that once contained them.
There's deep concern that these new resistant strains, often recent incarnations of old diseases once thought defeated, will lead to higher rates of sickness and death. Increasing resistance could also make common procedures like those performed by dentists and oral surgeons, much riskier to undertake.
To combat this, pharmaceutical companies are racing to create new drugs to compensate. Recently, they've received an encouraging sign of hope in this battle from an unlikely source: viruses. Researchers in Tel Aviv, Israel have discovered an antagonistic protein to bacteria among a group of viruses called bacteriophages. The protein, injected into a bacterium, commandeers the cell's DNA function to aid virus reproduction, which kills the host.
In the words of one researcher, this makes these particular “enemy of our enemy” viruses our “friend.” Although the discovery is still a long way from practical use in antibiotics, harnessing it in future drug versions could help pack a greater punch against resistant bacteria.
In the meantime, providers and patients alike must practice and advocate for stricter protocols regarding the use of antibiotics. The viability of tomorrow's healthcare is on the line.