Pretty Teeth for Everyone?

Start 2012 with a beautiful new smile!

We all see them, those flashy smiles full of beautifully white, perfectly aligned and proportioned teeth. Why were all the models and big names in TV blessed with such good teeth genetics? The truth is that most of them weren’t genetically favored; rather their smiles have been touched up a bit to create a little teeth envy in the rest of us. The good news? Those same “touch ups” are readily available through the miracle of modern cosmetic dentistry, making great smiles attainable by those of us with a little less camera exposure.

In our last post, we discussed ideas for a new smile in the upcoming New Year. We’d like to continue that discussion by looking more in depth at an option often chosen by the people we see on the screen: dental veneers (also known as porcelain veneers or laminates).

Porcelain veneers can drastically improve your smile

Porcelain veneers are extremely thin shells of tooth colored material that are individually crafted to fit each person’s teeth. Veneers are designed to fit over the surface of teeth, primarily to improve appearance. Specially formulated bonding material is used to permanently bond the veneers to your teeth, ensuring they keep the flashy good looks in place without cracking or falling off. Porcelain resists stains, and has the ability to reflect light in much the same way as natural teeth, making them less noticeable. Veneers can give you a screen-worthy smile, producing shapely, balanced teeth that are sparkly white and beautifully aligned. They also serve to protect damaged teeth, and can sometimes avert more extensive work.

The reasons for getting porcelain veneers are almost as varied as the people who get them, including:

●      Uneven teeth – Face it, most of us weren’t blessed with teeth that make a neat, well-proportioned line in our mouths. Veneers are an easy way to correct that.

●      Stained enamel – The thin, hard substance that covers the surface of your teeth can become stained as a result of drinking coffee, tea, or soft drinking. Smoking is another major contributor, as well as genetic factors and medications.

●      Chips, cracks, or breaks – accidents happen, and the result can be unsightly damage to teeth. Porcelain veneers are a simple solution.

●      Gaps between teeth

●      Worn teeth

Veneers are designed to fit over the surface of teeth

So, how hard is it to get these veneers? Getting porcelain veneers is a much easier process than getting a crown or dental implants. NYC cosmetic dentists can usually produce brighter smiles in just two or three visits to the office. The first visit involves a consultation to determine your goals and if veneers are right for you. This may be combined with the next step on the same visit: preparation. Your teeth need to be prepared for veneers by the removal of about ½ millimeter of enamel from the surface of the tooth.

This is approximately the same amount which will be added by the veneer. The dentist will then take an impressing of your teeth that will be sent off to a professional dental laboratory, which will custom make veneers for your teeth. The final visit is the most intensive, and involves the actual bonding of the veneers to your teeth. Your dentist will be very careful to check for proper fit, color match with your other teeth, and correct placement. Once all of these have been verified, he will apply the bonding to your teeth and you will walk out of the office flashing that beautiful smile you never dreamed could be yours.

What Exactly Are Teeth Anyway?

With a few exceptions, teeth don’t heal by themselves. Every cartoon with an elderly character will show them taking out their false teeth. For many Americans, teeth simply don’t stand the test of time. They contain one of the few tissues in the body that is finite. Most people have heard of enamel from toothpaste ads, but that tissue is only 1 of the 4 that comprise a tooth. Enamel, dentin, cementum, and pulp are the four major tissues that round out a mouth full of pearly whites. Most of the previous blog entries talk about a specific dental disorder or problem and offer remedies to it. This one will be a bit of primer, a basic introduction to what teeth are, and what can go wrong for each part.

Dental pulp is soft tissue in the center of the tooth; it contains the nerve, blood and lymphatic vessels, and connective tissue. The pulp forms the main bulk, or core, of each tooth and extends almost the entire length of the tooth. It is covered by enamel on the crown portion and by cementum on the roots. The pulp consists of cells, tiny blood vessels, and a nerve and occupies a cavity located in the center of the tooth. If the pulp becomes infected, it is removed by root canal.

Cementum is the thin surface layer of bone like material covering the tooth’s root. It is yellowish and softer than either dentin orenamel. The fibers of the periodontal membrane, which holds the tooth in lace, are embedded in cementum. Deposition of cementum continues throughout life, especially in response to stresses. When the tooth’s crown is gradually worn down, new cementum is deposited on the roots so that the tooth can slowly rise to maintain a good bite.

Elephant tusks (Ivory) are solid dentin. Ivory was the preferred material for billiard balls, as dentin has an elastic quality

Dentin is the yellowish tissue that makes up the bulk of all teeth. It is harder than bone but softer than enamel and consists mainly of apatite crystals of calcium and phosphate. Sensitivity to pain, pressure, and temperature is transmitted via the tubes to and from the nerve in the pulp. Secondary dentine, is a less well-organized form of tubular dentine, is produced throughout life as a patching material where cavities have begun, where the overlying enamel has been worn away, and within the pulp chamber as part of the aging process.

Veneers are often the only solution to severely worn enamel.

Enamel is the hardest tissue in the body. It covers part of or the entire crown of the tooth. Enamel is not living and contains no nerves. The thickness and density of enamel vary over the surface of the tooth; it is hardest at the biting edges, or cusps. Normal enamel may vary in color from yellow to gray. The surface enamel is harder and contains more fluoride than the underlying enamel. It is very resistant to tooth decay. Enamel is also finite. Worn enamel is a symptom of most dental problems: erosion, attrition, abrasion, and the first part of the tooth to decay from cavities. A loss of enamel over time can lead to transparent and fragile teeth. Sensitive teeth can be relieved with desensitizing toothpastes, which often contain ingredients such as potassium nitrate, potassium chloride or potassium citrate seem to make the tooth less receptive to pain. In the case of severely worn enamel, veneers are often the only option.

This concludes the reading for dental anatomy 101. I hope that it provides a greater understanding to the past and future blog entries. And if you didn’t much care for the anatomy of your chompers, there is good news. With good dental hygiene, the dentist won’t have to bother you with any of these terms and explanations; you can just take a free toothbrush and be on your way.

Long in the Tooth

Aside from the usual worries like gum disease and cavities, there is a whole other realm of dental problems that most people may be unaware of. Teeth are finite, they will not last forever if they are not carefully preserved and protected. There are three major ways that teeth can wear away: attrition, abrasion, and erosion. With the proper knowledge and dental advice, tooth wear away won’t be a problem until you’re long in the tooth.

 

Attrition – Wear away of tooth surface by chewing, one of its primary causes is Bruxism.

Abrasion – When brushing too vigorously wears away the tooth surface. (Usually evident where the gum and tooth meet)

Erosion – When acid wears away the tooth’s structure.

Attrition is a disorder usually brought on by stress, it also known as Bruxism. A mouth guard for nighttime use is usually recommended to prevent further deterioration. Severe attrition may only be able to treat with extensive too replacement, through either caps or crowns.

Abrasion is another one. This disorder is usually seen where the tooth meets the gum in a wedge or a v shaped mark. A hard bristle tooth brush is one of the biggest contributing factors to abrasion victims, although a hard brushing with a soft bristled brush can be just as harmful. Tooth abrasion can be repaired by bonding a tooth colored filling to the damaged area. The recommended way to brush your teeth is to place the brush at a 45 degree angle toward the junction of the gum and tooth and move the brush in a gentle circular motion. To make sure you’ve brushed properly try discoloring tablets, bright pink tablets that are chewed before brushing. Any place that hasn’t been brushed properly will be slightly tinged pink.

Tooth erosion is caused by acid. Teeth and acid do not mix. Acid is the bacterial by-product that causes cavities. Food and drink that are highly acidic can cause the enamel and the dentine to break down. The acid dissolves the calcium in the tooth. All soft drinks are acidic, including any carbonated: soda, diet soda, sports drinks, diet sports drinks, and sparkling mineral water. Soft drinks are a major cause of tooth erosion and the degree of erosion directly correlates to the amount and frequency of soft drink consumption. Other acidic foods include: citrus fruits, fruit juices, pickles, vinegar, and yogurt. Stomach acid is very powerful, strong enough to dissolve any food along with whatever tooth and bone fragments that might accidentally be ingested. When stomach contents are regurgitated acid comes into contact with the teeth. Any condition that causes repetitive vomiting will result in tooth erosion. The dentist is often the first one to the notice the problem because the back of the tooth is more susceptible to erosion. When a tooth is sufficiently eroded, the enamel will give way and expose the dentine, which can result in pain and increased sensitivity to: sweet, hot, and cold food or drinks. Erosion is a serious problem. If the nerves or blood vessels have been affected, those teeth will require a root canal and a replacement crown. To prevent tooth erosion, it is important to limit your exposure to acidic food and drink. It is also shown that chewing sugar-free gum can dilute acidity by increasing saliva flow.

Ask the dentist about tooth wear away. An early diagnosis and treatment regimen can be the difference between a $10 mouth guard, and a Cadillac’s worth of oral surgery.

Do I Need a Root Canal?

People often have the misconception that root canal therapy is a painful experience and mistakenly believe that having an infected tooth removed is a preferable choice. Also known as endodontic (“endo” – inside; “dont” – tooth) treatment, a root canal will relieve the severe pain that is caused when the tooth nerve has become inflamed. Unfortunately, extracting an infected tooth can introduce many additional problems that could be avoided with a root canal.

A root canal may be necessary if a deep cavity or trauma to the tooth has occurred, causing the inside pulp to become infected or inflamed. Often, pressure develops inside the core of the tooth which is the source of sharp, lingering pain when biting down or when exposed to temperature changes, particularly from hot foods and liquids. Sometimes, a dull ache may be present and the gum may be sensitive to pressure. Left untreated, an abscess may develop and infection can spread from the tooth to the surrounding bone, and even into the bloodstream.

Immediate dental treatment for a suspected endodontic infection is always the best course of action, and the treatment is relatively pain free and is performed under a local anesthetic administered by the dentist. First, the dentist will have to x-ray the suspicious tooth to diagnose the problem and will sometimes test the tooth to determine whether the nerve is in the process of dying. Once it has been determined that an infected tooth requires a root canal, and the tooth and surrounding area are numb, a small opening is made into the tooth, just as if one were having a filling placed. The infected, dying nerve and blood vessels are removed and the root canals are smoothed, cleaned, disinfected and filled with a rubber material. Some patients feel slight tenderness around the tooth for a day or two, but generally aspirin or ibuprofen will provide sufficient relief. After the nerve has been removed a tooth is no longer living, and the lack of blood supply causes it to become brittle over time. Your dentist will almost always advise you to have a crown placed on an endodontically treated tooth to protect it.

Most of the time a root canal can be performed in a single appointment and the crown will require two more visits to complete. The end result is that you will have kept your natural tooth and restored it to full function. Because bone loss and shifting of the remaining teeth often result when a tooth is extracted, the root canal avoids these complications as well.If you are confronted with the recommendation to have root canal treatment, or if you are experiencing unexplained pain when chewing or to temperature, don’t hesitate to inquire about your options or ask for further information about endodontic treatment to restore your smile and comfort. Have you had a positive experience with root canal therapy? We would like to hear your comments… and they may even help alleviate the concerns of others.