TheSimpleBitewingX-RayisaGameChangerforMaintainingDentalHealth

X-rays are such a routine part of dental care that it's easy to overlook how much this technology has revolutionized detecting and treating tooth decay. It's safe to say x-rays have helped save hundreds of millions of teeth over the last hundred years.

Thanks to its unique properties these invisible electro-magnetic waves give us precise images of the interior structure of teeth and gums. It's so precise that we can clearly detect even a small spot of softened, decayed tooth structure on an exposed x-ray film, often before it becomes visible to the naked eye. As a result, we can begin treating the decay earlier, minimizing the damage and increasing the chances for preserving the tooth.

There are a variety of ways we can utilize x-ray technology in diagnosing dental problems. The one, though, that's used the most is called the bitewing. The name comes from wing-like tabs extending out from a thin frame holding a segment of unexposed film. A technician places the frame inside the patient's mouth with the film on the tongue side of the teeth, and has them bite down on the tabs to hold the frame still. They then aim a camera at the patient's outer cheek, which then emits a very short burst of x-ray energy to expose the film.

Bitewings are popular because they give a full view of the back and side teeth, where decay is often hard to detect, with very little radiation exposure to the patient. And as x-ray technology has progressed over the years with digital processing and more efficient equipment, we can acquire sharper images with even less exposure. We've also developed standard protocols for when and how often we perform x-rays, so that we're getting the most diagnostic benefit for the least amount of exposure time.

Those few minutes getting an x-ray may seem routine, but the benefits to your dental health are truly amazing. The bitewing and other forms of x-rays play a huge role in helping us keep your teeth as healthy as they possibly can.

If you would like more information on x-ray diagnostics, 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 “Bitewing X-Rays.”

By Shapiro & Rollman DDS
July 07, 2017
Category: Dental Procedures
DentalMagicTransformsSmiles

Magician Michel Grandinetti can levitate a 500-pound motorcycle, melt into a 7-foot-tall wall of solid steel, and make borrowed rings vanish and reappear baked inside bread. Yet the master illusionist admits to being in awe of the magic that dentists perform when it comes to transforming smiles. In fact, he told an interviewer that it’s “way more important magic than walking through a steel wall because you’re affecting people’s health… people’s confidence, and you’re really allowing people to… feel good about themselves.”

Michael speaks from experience. As a teenager, his own smile was enhanced through orthodontic treatment. Considering the career path he chose for himself — performing for multitudes both live and on TV — he calls wearing an orthodontic device (braces) to align his crooked teeth “life-changing.” He relies on his welcoming, slightly mischievous smile to welcome audiences and make the initial human connection.

A beautiful smile is definitely an asset regardless of whether you’re performing for thousands, passing another individual on a sidewalk or even, research suggests, interviewing for a job. Like Michael, however, some of us need a little help creating ours. If something about your teeth or gums is making you self-conscious and preventing you from smiling as broadly as you could be, we have plenty of solutions up our sleeve. Some of the most popular include:

  • Tooth Whitening. Professional whitening in the dental office achieves faster results than doing it yourself at home, but either approach can noticeably brighten your smile.
  • Bonding. A tooth-colored composite resin can be bonded to a tooth to replace missing tooth structure, such a chip.
  • Veneers. This is a hard, thin shell of tooth-colored material bonded to the front surface of a tooth to change its color, shape, size and/or length; mask dental imperfections like stains, cracks, or chips, and compensating for excessive gum tissue.
  • Crowns. Sometimes too much of a tooth is lost due to decay or trauma to support a veneer. Instead, capping it with a natural-looking porcelain crown can achieve the same types of improvements. A crown covers the entire tooth replacing more of its natural structure than a veneer does.

If you would like more information about ways in which you can transform your smile, please contact us or schedule an appointment for a consultation. You can also learn more about the techniques mentioned above by reading the Dear Doctor magazine articles “Teeth Whitening,” “Repairing Chipped Teeth,” and “Porcelain Crowns & Veneers.”

BoneGumsandImplants-KeepingaHealthyBalanceforaBeautifulSmile

Restoring a smile with implants involves more than the surgical procedure itself. We must also take into consideration the quality of the bone they’re placed into and the gums that will surround them — the “canvas” that showcases your new beautiful smile.

Bone — not only at the missing tooth site but supporting neighboring teeth as well — is the foundation for a successful implant. Without an adequate amount of bone, we can’t place an implant to achieve a final life-like appearance. Inadequate bone can be a problem if the tooth has been missing for awhile — without the stimulation of biting forces from the tooth, the bone can shrink gradually over time. Periodontal (gum) disease and other dental conditions can also cause bone loss.

The health of your gums — as well as the tissue type you’ve inherited from your parents, thin or thick — can also determine how natural the implant crown looks as it emerges from them. If they’ve receded due to gum disease they may not regenerate sufficiently, making your teeth longer-looking or leaving the triangular bit of gum tissue between the teeth, the papillae, noticeably missing. If you’ve inherited thin tissue gums, you’re also more susceptible to gum recession and there’s less margin for error during implant surgery.

There are some things we can do to minimize these problems. Tooth removal to make room for the new implant needs to be done carefully with as little tissue trauma as possible; it’s also helpful to place grafting material in the empty socket immediately after extraction, especially if there’s going to be a time gap before implant placement. If bone loss has already occurred, we can also use similar grafting techniques to rebuild the bone.

Likewise we need to take special care during implant surgery when dealing with thin or diseased gums. With the latter, it’s usually necessary to bring the gum disease under control and allow the gums to heal first. In extreme cases, cosmetic gum surgery may also help restore lost tissues and create a more natural look between the gums and the implant crown.

Creating a natural appearance with implants is a blend of technical skill and artistic insight. Keeping the balance between all these factors will produce a smile you’ll be proud to show.

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 “Matching Teeth & Implants.”

By Shapiro & Rollman DDS
June 07, 2017
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 Shapiro & Rollman DDS
May 23, 2017
Category: Dental Procedures
Tags: dental implants  
WhattoExpectBeforeDuringandAfterImplantSurgery

People are choosing dental implants at an increasing rate to replace missing teeth, either as an individual tooth or as a support for other restorations. But unlike other replacement options, we must surgically install the titanium post at the heart of the system directly into the jawbone.

While the term “surgery” might make you nervous, there's nothing at all to worry about. Here's what you need to know about before, during and after this relatively minor procedure.

Before. While the actual procedure is no more complicated than a tooth extraction, it ultimately depends on careful planning beforehand. Using x-ray diagnostics, we prepare a precise surgical guide to help us locate the best position to place them for a successful outcome. We'll also need to check bone volume to make sure there's an adequate amount to securely anchor the implant. If the bone is insufficient you may need bone grafting to build up the site or another replacement option.

During. The actual procedure begins, of course, with local anesthesia to numb the site — you should feel no pain and very minimal discomfort. We access the bone through the gums; often using a surgical guide for alignment, we create a small channel or hole with a sequence of drills that gradually increase the size until it can accommodate the implant. We remove the implants from their sterile packaging and install them immediately into the channel. After confirming their proper positioning with x-rays, we can close the gum tissues over it for protection during healing or attach a healing abutment that extends through the gum tissue thereby avoiding a second surgical procedure.

After. Because we disrupt relatively little of the soft tissue and bone, there's only minimal discomfort afterward easily managed with aspirin, ibuprofen or similar anti-inflammatory medication. We may also prescribe antibiotics to guard against infection while the gums heal. During the next several weeks, the titanium post, which has an affinity to bone, will become more secure as bone cells grow and adhere to it. It's also during this time that a dental lab creates your permanent crown or other restoration that matches the color and tooth shape so it will blend with your other teeth.

This process is complete when we install the final restoration onto the implant. You'll have a new smile and better function.

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 Surgery.”





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