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Posts for: November, 2018

By Advanced Dental Concepts
November 21, 2018
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”


By Advanced Dental Concepts
November 11, 2018
Category: Oral Health
Tags: sensitive teeth  
ThereareVariousWaystoTreatSensitivity-DependingonitsCause

You may be among the one in three Americans who suffer from the pain of tooth sensitivity. Before attempting treatment, though, we must first identify the cause.

Your teeth are made of layers of different organic tissue. The pulp at the center of the tooth contains nerves that transmit pain or pressure sensation to the brain. The pulp is encased by dentin, a layer of tissue composed of tiny tubules that conduct temperature and pressure changes from outside the tooth to the pulp nerves. The hard outer enamel shell shields the dentin from over-stimulation from these sensations.

There are, however, some instances where the dentin may become exposed and cause sensitivity in the tooth. This can occur when the gum tissue recedes and the root of the tooth is exposed to the oral environment. If the root loses its surface coating (referred to as cementum, a cement-like outer layer around the root surfaces) because of over-aggressive brushing (too hard for too long) or advanced periodontal (gum) disease, sensitivity is often the result.

Another instance is enamel erosion. Although made of the hardest substance in the human body, enamel has one major enemy — acid. A high oral acid level brought on by over-consuming acidic foods and beverages or as a symptom of gastric reflux disease dissolves (de-mineralizes) the enamel’s mineral content. Brushing just after eating actually contributes to de-mineralization because the enamel is in a softer state. It requires forty-five minutes to an hour for your saliva to neutralize acid and restore minerals to the enamel — you may actually be brushing away enamel with this practice.

Once we know the underlying cause, we can use an appropriate method to reduce sensitivity. One way is to reduce nerve sensitivity in the dentin’s tubules or block them altogether. There are several chemical products for both home and dental office application that can reduce sensitivity and encourage enamel re-mineralization (as can the fluoride added to toothpaste). We can also strengthen enamel and provide a mechanical barrier to acid through concentrated fluoride in a varnish applied to tooth and root surfaces. And, life-like restorations like crowns or veneers not only improve the appearance of your teeth, they can also provide coverage for exposed dentin.

If you are experiencing painful sensitivity, make an appointment to visit us. Once we know the source, we can treat the problem and reduce your discomfort.

If you would like more information on tooth sensitivity and how to treat it, 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 “Treatment of Tooth Sensitivity.”


By Advanced Dental Concepts
November 01, 2018
Category: Oral Health
Tags: oral health  
TakingCareofOralHealthCrucialtoQualityofLifeforHIVPositivePatients

In the early Eighties, dentists began noticing symptoms among a few patients that indicated something far more serious. They were, in fact, among the first healthcare providers to recognize what we now know as HIV-AIDS.

Today, about 1.2 million Americans have contracted the Human Immunodeficiency Virus (HIV). It’s a retrovirus, somewhat different than other viruses: it can invade immune system cells and hijack their replication mechanism to reproduce itself. Untreated it eventually destroys these cells to give rise to the more serious, life-threatening disease Acquired Immunodeficiency Syndrome (AIDS).

Thanks to antiretroviral drugs, most HIV positive patients live somewhat normal lives and avoid the more serious Acquired Immunodeficiency Syndrome (AIDS). But while antiretroviral therapy effectively inhibits the action of the virus, it isn’t a cure — the virus is a permanent resident of the body and can still affect health, especially in the mouth.

In this regard, one of the more common conditions associated with HIV is Candidiasis, a fungal infection also known as thrush, which causes cracking of the mouth corners and lesions or white patches on the surface of the tongue or roof of the mouth. HIV patients may also experience limited saliva flow that causes dry mouth (xerostomia) with effects that range from bad breath to a higher risk of tooth decay.

The most serious effect, though, of HIV on oral health is the body’s lower resistance to fight periodontal (gum) disease. HIV patients are especially susceptible to a severe form known as Necrotizing Ulcerative Periodontitis (NUP), a sign as well of immune system deterioration and the beginning of AIDS. This painful condition causes gum ulcerations, extensive bleeding, and the rapid deterioration of gum attachment to teeth.

If you or a family member is HIV positive, you’ll need to pay close attention to oral health. Besides diligent brushing and flossing, you or they should also regularly visit the dentist. These visits not only provide diagnosis and treatment of dental problems, they’re also an important monitoring point for gauging the extent of the HIV infection.

Taking care of dental problems will also ease some of the discomfort associated with HIV. Thanks to proper oral care, you or someone you love can experience a higher quality of life.

If you would like more information on oral and dental health for patients with HIV, please contact us or schedule an appointment for a consultation.