My Blog
By Rocco Ciccone MS. DDS
March 04, 2021
Category: Dental Procedures
Tags: veneers  
YourTeensTeethMayNotBeReadyforVeneers

Teenagers can have the same smile-disrupting tooth flaws as adults. But not all cosmetic treatments available to adults are appropriate for teenagers—at least not until they get a little older. Dental veneers fall into that category.

A veneer is a thin porcelain shell custom-made by a dental lab, and bonded by a dentist to the face of a tooth to mask chips, stains, gaps or other imperfections. Because they're less invasive than other measures, veneers are highly popular as a cosmetic dental solution. They do, however, usually require some enamel removal so that they'll appear more natural.

This enamel removal typically won't impact an adult tooth other than it permanently requires it to have veneers or other restorations after alteration. But there is a risk of damage to a teenager's tooth, which hasn't fully developed.

Adolescent teeth usually have a larger pulp chamber (filled with an intricate network of nerves and blood vessels) than adult teeth. And because the enamel and dentin layers may not yet be fully developed, the pulp is much nearer to the tooth's surface.

We must be very careful then in removing enamel and dentin for veneers or we may penetrate the pulp and risk damaging it. Alternatively, there is the possibility of no-prep veneers which are very conservative but often are unable to be done because of the need to often remove tooth structure to make the veneers look natural.

Another cosmetic problem can occur if we place veneers on a patient's teeth whose jaws and mouth structures are still growing. Eventually, the gums could recede and an unsightly gap form between the veneer and the adjacent natural tooth.

Fortunately, there are other techniques we can use to improve a tooth's appearance. Mild chipping can be repaired by bonding composite resin material to the tooth. Some forms of staining may be overcome with teeth whitening. These and other methods can address a teenager's smile appearance until their teeth are mature enough for veneers.

Whether or not a tooth is ready for veneers will depend on its level of development, something that can often be ascertained with x-rays or other diagnostic methods. And if a tooth has already undergone a root canal treatment, there isn't as much concern. In the meantime, though, it may be better for your teen to wait on veneers and try other techniques to enhance their smile.

If you would like more information on dental restoration for teenagers, 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 “Veneers for Teenagers.”

DentalImplantsAreEvenMoreAdvancedThanksToTheseOtherTechnologies

When dental implants hit the scene in the 1980s, they revolutionized the field of dental restorations. But as groundbreaking as they were then, they're even more advanced now.

Some of the advancements have to do with improvements in implant design and manufacturing. Implant sizes and shapes were once quite limited, but today they come in a variety of forms to better match the types of teeth they replace.

But there has also been important progress in complementary technologies that help us realize better outcomes. Many of these other advances have had a positive impact on the planning and surgical stages of implant installation.

CT/CBCT scanning. For the best outcome, it's critical to install an implant at the most appropriate location on the jaw. This can be difficult to determine, however, because of the location of oral and facial structures like nerves or sinuses that might interfere with implant placement. But using a type of computer tomography (CT) scanning called cone beam CT, we can produce a 3-D computer graphic image that helps us navigate possible obstructions as we pinpoint the ideal location for an implant.

Digital smile displays. We're now able to produce digital models of the mouth, which can assist with more than implant placement—we can also use them to visualize what a new smile with implants will look like before we install them. This is especially helpful in situations where only a few teeth need to be replaced: We want to ensure that the new implant crowns blend seamlessly with the remaining teeth for the most natural appearance.

Custom-made surgical guides. We've been using surgical guides to mark the exact drilling locations during implant surgery for many years. But 3-D printing technology can now help us produce surgical guides that are even more useful and precise. Using a 3-D printer, we can produce oral devices based on the patient's individual dental dimensions captured through digital scanning. That produces a better fit for the guide on the teeth and more accurate implant placement.

Together, these and other technological advances are helping us achieve even more successful results. Not only can they help us produce implant outcomes that can last for years or even decades, but also the most beautiful smiles possible.

If you would like more information on dental implant restorations, 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 “How Technology Aids Dental Implant Therapy.”

By Rocco Ciccone MS. DDS
February 12, 2021
Category: Dental Procedures
Tags: tooth decay  
3ReasonsWhyTreatingCavitiesIsBecomingMoreEffective

If you've ever had a run-in with cavities, you know the drill (no pun intended): After getting a local anesthetic for pain, the dentist removes any decayed dental tissue, as well as some healthy tissue, and then fills the cavity to restore the tooth. It's an effective treatment protocol we've been using for well over a century.

It does, however, have its drawbacks. For one, although necessary, removing healthy dental tissue can weaken the overall tooth structure. The dental drill used during the procedure is also unpleasant to many people: Although it doesn't cause any pain thanks to the anesthetic, the sounds and pressure sensations associated with it can be unsettling.

But advances in dental tools, technology and techniques are addressing these drawbacks in traditional tooth decay treatment. In other words, treating a tooth with cavities today is taking on a lighter touch. Here are 3 reasons why.

Earlier detection. The key to effective treatment is to find tooth decay in its earliest stages. By doing so, we can minimize the damage and reduce the extent of treatment needed. To do this, we're beginning to use advanced diagnostic tools including digital x-rays, intraoral cameras and laser fluorescence to spot decay, often before it's visible to the naked eye.

Re-mineralizing enamel. One of the advantages of early detection is to catch tooth enamel just as it's undergoing loss of its mineral content (demineralization) due to contact with acid. At this stage, a tooth is on the verge of developing a cavity. But we can use minimally invasive measures like topically applied fluoride and CPP-ACP (a milk-based product) that stimulates enamel re-mineralization to prevent cavity formation.

Less invasive treatment. If we do encounter cavities, we no longer need to turn automatically to the dental drill. Air abrasion, the use of fine substance particles under high pressure, can precisely remove decayed material with less loss of healthy tissue than a dental drill. We're also using newer filling materials like composite resins that don't require enlarging cavities as much to accommodate them.

These and other techniques—including laser technology—are providing superior treatment of tooth decay with less invasiveness. They can also make for a more pleasant experience when next you're in the dentist's chair.

If you would like more information on effectively treating dental 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 “Minimally Invasive Dentistry.”

WhetherVotingforaCandidateorWisdomTeethYouCanChooseWisely

During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.

With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”

That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.

Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.

Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.

Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.

But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.

This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.

Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.

If you would like more information about what's best to do about wisdom teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”

HopingtoShowYourSmileAgainin2021BeSureYoureReady

As part of the fight against COVID-19, many of us have been wearing some form of face mask in public for most of 2020. While it's intended for good, mask wear has had some unintended consequences. For one, it's inhibited the expression of one of our most important social abilities—smiling.

We're all hoping, though, that 2021 will be different—that our smiles will once more shine out from behind our masks. If and when that happens, you'll want to be ready: Here are a few things you can do in the new year to give your smile a nice upgrade.

Teeth whitening. Fighting teeth yellowing is an ongoing battle. Certain foods, staining beverages and habits like smoking can take the gleam from your smile in no time. But you can brighten up dull teeth with a professional whitening treatment. And because our bleaching solutions are stronger than you'll find in your local retail store, the shine could last for years with only an occasional touchup.

Orthodontics. Straightening teeth orthodontically not only can improve your dental health and function, it could revamp your smile (you might call it the original “smile makeover”). Even if you're well past your teens, an orthodontic correction may still be a viable option. And if you're concerned about your appearance during treatment, you might be able to take advantage of nearly invisible clear aligners.

Bonding. A chipped tooth can certainly detract from an otherwise attractive smile, but it may not take extensive means to repair it. Many chipped or disfigured teeth can be made whole through dental bonding. This technique bonds a color-matched dental material called composite resin directly to the tooth. Best of all, the treatment may only take one visit.

Veneers and crowns. For more extensive chipping or staining, you can step up to a custom-made porcelain veneer or crown. Veneers are thin layers of porcelain that are bonded to the face of teeth to mask imperfections. Crowns cover a damaged but otherwise viable tooth to protect it and give it a more attractive appearance.

Dental Implants. If you have a missing tooth—or one that's simply past saving—consider replacing it with a dental implant. A dental implant attached to a crown is the closest thing we have to a natural tooth in both appearance and function. In fact, most people with implant-supported replacement teeth forget they have dental implants. We can also merge implants with other restorations like dentures or bridges for a more secure, comfortable hold and a more natural smile.

These and other cosmetic enhancements could make a big difference in your smile. To find out how, see us for a complete dental examination and consultation. We want you to be ready for what we hope will soon be a “mask-free” 2021.

If you would like more information about improving the look of your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cosmetic Dentistry.”





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