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By Advanced Dental Concepts
July 18, 2017
Category: Dental Procedures
Tags: missing teeth  
TeenswithMissingTeethmayneedaTemporaryFixUntilTheyreOlder

Dental implants are widely considered by both dentists and patients as the premier choice for replacing missing teeth. Unfortunately, implants aren’t the appropriate choice for teenagers with missing teeth.

That’s because their jaws won’t fully finish most of their growth and development until early adulthood. An implant placed too early could become misaligned as the jaw matures. The best approach for a teenager is a temporary restoration until they’re old enough for an implant.

There are a couple of good options. One is a removable partial denture (RPD), prosthetic (false) teeth set in an acrylic base that mimics gum tissue at the locations of the missing teeth. RPDs, which stay in place by way of metal clips that fit over other teeth, are easy to wear and maintain.

On the downside, an RPD can break if you bite into something too hard. They can lose their fit and may need to be replaced with a new one. And, some teens aren’t quite keen on wearing a “denture.”

Another option is a bonded or Maryland bridge, a kind of fixed bridge. We bond dental material to the back of a prosthetic tooth with portions of the material extending out from either side of it.  We then bond these extending tabs to the back of the teeth on either side of the prosthetic tooth to hold it in place. Unlike traditional bridges, we can eventually remove it without any permanent alterations to the teeth it’s attached to.

Before we undertake a bonded bridge, though, we must make sure the gums and bone of the surrounding teeth are free from periodontal (gum) disease and are healthy and strong enough to support the bridge. We also need to be sure the patient doesn’t have a deep bite or a teeth grinding habit, which could cause the teeth to make contact with the tabs and break them.

The patient also needs the maturity to responsibly perform diligent oral hygiene: this type of bridge has a tendency to build up disease-causing plaque, so brushing twice and flossing once every day is critical. Not doing so increases the risk of tooth decay or periodontal (gum) disease, which could complicate a future implant.

We can discuss these options after a thorough dental examination of your teenager. Either way, we’ll be able to restore your teen’s smile until we can undertake a more permanent restoration.

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

By Advanced Dental Concepts
July 03, 2017
Category: Oral Health
ActorDavidRamseySaysDontForgettoFloss

Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.

“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.

Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.

“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.

Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?

Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.

Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a third to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.

Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”

Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.

If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”

YoullExperienceLittletoNoDiscomfortDuringandAfterImplantSurgery

You’ve decided to obtain dental implants for your missing teeth. It’s a good choice — they provide the closest restoration to the function and appearance of natural teeth. You will, however, need to undergo a surgical procedure to imbed the implants’ threaded titanium posts into supporting bone.

It’s understandable if you’re a little apprehensive about undergoing surgery. We’re here, though, to set your mind at ease: implantation is a relatively minor procedure carefully planned in advance. Most patients experience no discomfort during the procedure and very little afterward.

We begin by completely numbing the surgical site with a local anesthetic. If you have a high level of anxiety, we can also administer a sedative or similar medication to help you relax. We then access the underlying bone through a series of incisions that create a flap in the gum tissue that we’ll later suture closed.

It’s quite common to have prepared a surgical guide or template beforehand. The template placed in the mouth marks the exact site for a small channel (or hole) we create in the bone. We then incrementally increase the size of the hole by drilling until it matches precisely the implant’s size and shape. This takes time to avoid overheating and damaging the bone.

We then remove the implant from its sterile packaging and insert it into the opening. We’ll also take x-rays to ensure correct positioning, which is critical for achieving an attractive result. We then suture the gum flap in place using stitches that will eventually dissolve. The implant will then integrate with the bone for a few weeks to create a strong, durable hold before we continue with the restoration.

Most patients can manage any post-surgical discomfort with mild anti-inflammatory pain relievers like aspirin or ibuprofen, although we can prescribe something stronger if you need it. We may also prescribe a mouthrinse with an anti-bacterial agent like chlorhexidine for you to use while the gums are healing to reduce the risk of infection.

Implant surgery is part of a long process that will eventually result in regaining the function of your lost teeth. What’s more, undergoing this minor procedure will also help you regain something just as important — a beautiful smile.

If you would like more information on dental implant restoration, 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 “Dental Implant Surgery.”

By Advanced Dental Concepts
June 10, 2017
Category: Dental Procedures
MasterIllusionistBenefitsfromtheMagicofOrthodontics

Magician Michael Grandinetti mystifies and astonishes audiences with his sleight of hand and mastery of illusion. But when he initially steps onto the stage, it’s his smile that grabs the attention. “The first thing… that an audience notices is your smile; it’s what really connects you as a person to them,” Michael told an interviewer.

He attributes his audience-pleasing smile to several years of orthodontic treatment as a teenager to straighten misaligned teeth, plus a lifetime of good oral care. “I’m so thankful that I did it,” he said about wearing orthodontic braces. “It was so beneficial. And… looking at the path I’ve chosen, it was life-changing.”

Orthodontics — the dental subspecialty focused on treating malocclusions (literally “bad bites”) — can indeed make life-changing improvements. Properly positioned teeth are integral to the aesthetics of any smile, and a smile that’s pleasing to look at boosts confidence and self-esteem and makes a terrific first impression. Studies have even linked having an attractive smile with greater professional success.

There can also be functional benefits such as improved biting/chewing and speech, and reduced strain on jaw muscles and joints. Additionally, well-aligned teeth are easier to clean and less likely to trap food particles that can lead to decay.

The Science Behind the Magic

There are more options than ever for correcting bites, but all capitalize on the fact that teeth are suspended in individual jawbone sockets by elastic periodontal ligaments that enable them to move. Orthodontic appliances (commonly called braces or clear aligners) place light, controlled forces on teeth in a calculated fashion to move them into their new desired alignment.

The “gold standard” in orthodontic treatment remains the orthodontic band for posterior (back) teeth and the bonded bracket for front teeth. Thin, flexible wires threaded through the brackets create the light forces needed for repositioning. Traditionally the brackets have been made of metal, but for those concerned about the aesthetics, they can also be made out of a clear material. Lingual braces, which are bonded to the back of teeth instead of the front, are another less visible option. The most discrete appliance is the removable clear aligner, which consists of a progression of custom-made clear trays that reposition teeth incrementally.

How’s that for a disappearing act?!

If you would like more information about orthodontic treatment 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 “The Magic of Orthodontics.”

TechniquesforKeepingImpactedCanineTeethfromSpoilingYourSmile

Although usually an orderly process, some permanent teeth don't come in as they should. In fact, they may not come in at all and remain hidden in the gum — a situation called impaction. This creates multiple problems for function, health and, in the case of front canines, appearance.

Canines are the longer and more pointed teeth on each side of the front-most incisors. They help tear and cut food during chewing, a function impaction eliminates. Besides a higher risk for developing abscesses (isolated areas of infection) and cysts, they can also put pressure on neighboring teeth and damage their roots or cause them to erupt abnormally.

Dentists often remove impacted wisdom and other back teeth to lessen these potential problems. Removing canines, though, has additional considerations: besides compromising ideal chewing function, missing canines often create an unattractive smile.

But before considering removal, there's another technique we might be able to use to save the canines and actually draw them down through the gums to their correct position. It's usually part of an overall orthodontic plan to correct a poor bite (malocclusion).

After pinpointing their exact position with x-rays or CT scanning, a surgeon surgically exposes the impacted canines' crowns through the gums. They then bond small brackets to the crowns and attach a small gold chain to each bracket. They fasten the other end of the chains to orthodontic hardware that exerts downward pressure on the impacted teeth. Over several months this pressure can help move the teeth into their normal positions.

Unfortunately, this technique isn't always advisable: one or more of the impacted teeth may be in a difficult position to attempt it. It's usually best in these situations to remove the teeth, usually sooner rather than later for the sake of neighboring teeth.

Fortunately, with today's advanced restorative techniques, we can eventually replace the canines with dental implants, although that's best undertaken after the patient enters adulthood. In the meantime, we can utilize orthodontic means to preserve the open space and provide a temporary restorative solution.

Whatever route taken, these teeth don't have to become a source of problems, especially for your appearance. Whether through orthodontics or restorative dentistry, impacted canines don't have to ruin your smile.

If you would like more information on various orthodontic procedures, 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 “Exposing Impacted Canines.”





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