My Blog

By Lopez
November 10, 2018
Category: Oral Health
Tags: oral health  
ThisNovemberBecomeaNon-Smoker

What does November make you think of? Pumpkins? Turkeys? Dry leaves and frosty mornings? How about cigarette butts?

If you’re wondering about the last item, remember that November 15 is the date of the Great American Smokeout—a day set aside for those who want to take the first steps toward quitting the tobacco habit. While the percentage of smokers in the U.S. has dropped to less than 16% in recent years, according to the American Cancer Society there are still some 38 million Americans who smoke cigarettes. Smoking causes over 480,000 deaths every year, and is the leading preventable cause of death in the U.S.

Even if it doesn’t kill you, the effects of tobacco use can be devastating to your entire body—including your mouth. Whether you smoke cigarettes or use chewing tobacco, your risk of oral cancer is greatly increased, as is your chance of developing periodontal (gum) disease. What’s more, smoking can mask the symptoms of gum disease, so your condition is actually worse than it appears. Severe gum disease is one reason why smokers tend to lose more teeth than non-smokers.

In addition, because smoking interferes with the natural healing process, smokers have a much greater chance of dental implant failure. Tobacco use also can lead to increased amounts of plaque, which results in tooth decay and other oral health problems. It also stains your teeth, reduces your senses of smell and taste, and gives you bad breath.

Ready to quit yet? If so, there are lots of resources to help you on the road to a healthier life. The American Cancer Society, sponsor of the Smokeout, can help you make a plan to quit tobacco—and stay off it. It’s not easy, but over a million Americans do it every year. See their website for more information, plans and tips on quitting. Your health care professionals are also a great source of information and help when it’s time to get off the tobacco habit. Feel free to ask us any questions you may have.

And here’s the good news: The moment you quit, your body begins to recover from the effects of tobacco use. In just one year, you’ll have cut your risk of heart attack and stroke in half. After 5 to 15 years, your risk of stroke, coronary heart disease, and several other conditions is the same as someone who has never smoked.

If you have questions about smoking and oral health, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Dental Implants and Smoking.”

VivicasVeneerstheMakingofaHollywoodSmile

What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.

"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."

But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.

"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."

What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.

Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.

To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.

Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?

"I love my veneers!" she declared, noting that they have held up well for over a decade.

For more information about veneers, please contact us or schedule an appointment for a consultation.

GumDiseaseisStillaThreattoYourDentalImplants

You’ve invested quite a bit in your new dental implants. And it truly is an investment: because of implants’ potential longevity, their long-term costs could actually be lower than other restorations whose upfront costs might be less.

But to better ensure their longevity, you’ll need to keep your implants and the natural tissues supporting them clean of bacterial plaque, a sticky biofilm that can cause periodontal (gum) disease. Although the implant itself is unaffected by disease, the natural tissues around it can be.  An infection could ultimately weaken the bone supporting the implant and lead to its failure.

Such an infection involving implants could advance rapidly because they don’t have the natural defenses of the original teeth. Our natural teeth are connected to the jaw through the periodontal ligament, a collagen network that attaches to both the teeth and the bone through tiny tissue fibers. This connection also provides access to antibodies produced by the body to fight infection.

By contrast, we place implants directly into the jawbone. While this creates a very secure attachment, the implant won’t have the same connection as teeth with the body’s immune system. That means any infection that develops in surrounding tissues can spread much more rapidly—and so must be dealt with promptly.

Treating this particular form of gum disease (known as peri-implantitis) is similar to infections with natural teeth and gums, with one important difference involving the tools we use to remove plaque from them. While natural teeth can handle metal scalers and curettes, these can create microscopic scratches in the porcelain and metal surfaces of an implant and create havens for further bacterial growth. Instead, we use instruments made of plastic or resin that won’t scratch, as well as ultrasonic equipment to vibrate plaque loose.

To avoid an infection, it’s important that you brush your implants and surrounding tissues just like you would your natural teeth (be sure you use a soft-bristled brush). And keep up regular dental visits for thorough cleanings and checkups to stay ahead of any developing gum infection. Maintaining your dentures will help ensure they continue to brighten your smile for a long time.

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 “Dental Implant Maintenance: Implant Teeth Must be Cleaned Differently.”

TreatingGumDiseasearoundToothRootsisHard-butNotImpossible

Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.

We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.

But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.

The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.

In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.

These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.

If you would like more information on treating gum disease, 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 “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”

NewMaterialsAddStrengthtoVeneersBeautifulLife-Likeness

With exciting innovations in cosmetic dentistry over the last few decades, we can now transform nearly any unattractive smile. One of the best and most cost-effective of these is the porcelain veneer. These thin layers of dental porcelain are bonded over the front of chipped, slightly misaligned or stained teeth to create an entirely new look.

Veneers have evolved over time, especially with the materials they contain that give them their beauty and life-likeness. The first veneers were made mainly of feldspathic porcelain, a mineral composition known for its similarity in color and translucence to natural teeth.

But because this early porcelain had a high amount of silica (in essence, glass), and because they were created through overlaying several thin layers that weren’t as strong as a single piece, they were prone to shattering. This made them problematic for teeth subject to heavy biting forces or patients with clenching or grinding habits.

The situation changed dramatically in the 1990s, when dental labs began adding Leucite, a sturdier glass-like mineral that didn’t diminish the porcelain’s translucence. Not only did Leucite make veneers more shatter-resistant, it also enabled dental technicians to fashion most of the veneer in one piece to further strengthen it.

More recent veneers may now incorporate an even stronger material called lithium disilicate. Because lithium disilicate has twice the strength of Leucite, veneers made with it can be as thin as 0.3 millimeters. Not only does this blend together the most desirable qualities expected of a veneer—strength, aesthetic appeal and easy fabrication—it allows for a broader range of situations and uses.

Both of these materials can be pressed or milled to assume the exact shape necessary to fit a particular tooth. The manufacturing process also allows for creating smaller veneers that can then be overlaid with porcelain for the most life-like appearance possible.

Thanks to these stronger materials enhancing the natural beauty of porcelain, we now have a wider creative palate for transforming your smile.  

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”





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