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Posts for: January, 2014

By Central Florida Cosmetic & Family Dentistry
January 28, 2014
Category: Oral Health
Tags: toothache  
IdentifyingtheSourceofMouthPainLeadstoMoreEfficientTreatment

You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.

This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.

We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.

Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.

The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.

Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.

If you would like more information on the various causes of tooth pain, 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 “Confusing Tooth Pain.”


By Central Florida Cosmetic & Family Dentistry
January 24, 2014
Category: Dental Procedures
Tags: dental implants  
AlthoughChallengingSmileZoneImplantscanAppearBeautifullyLife-Like

Dental implants have quickly become the restoration of choice for two basic reasons: they effectively restore the lost function of missing teeth and simultaneously rejuvenate the smile with their life-like appearance.

Achieving a life-like appearance, however, isn’t always a simple matter. A restoration in what we dentists call the “Smile Zone” (the upper front area that displays both teeth and the gum line when you smile) requires careful planning and technique to ensure they appear as life-like as possible.

Our first concern is whether there’s enough bone to fully anchor an implant. Bone is a living, dynamic tissue that goes through cycles of dissolving (resorption) and growth. The normal forces of biting and chewing transmit through healthy teeth and stimulate growth in the bone. When the teeth are missing and no longer transmit this pressure, the bone will eventually resorb only and not grow.

Adjacent teeth could also be affected with bone loss if the extraction was difficult and a bone graft was not placed into the extraction socket to preserve bone. This not only puts adjacent teeth at risk of gum and bone loss but can also have implications for the final smile appearance. This bone also supports the triangular tissue between teeth known as papillae which give teeth their arched appearance. If the bone isn’t adequate, there’s less hope that the papillae will regenerate.

With these concerns it’s very important to consider how the implant and crown emerges from the gums in the Smile Zone. Recent developments in implant design are helping in this regard. The design change of the top of the implant re-orients the gum tissues in relation to the implant from vertical to horizontal, which dentists call “platform switching.” This provides greater stabilization where bone mass is limited, and helps create a more aesthetically pleasing result. There are also other techniques, such as surgical tissue grafting of the papillae that can further enhance the final appearance.

Although creating a natural, life-like appearance in the Smile Zone is difficult, it’s not impossible. It’s important first to undergo a complete dental examination and profile, where we can advise you on your best options to achieve a beautiful smile.

If you would like more information on the relation of implants to the aesthetics of your smile, 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 “Implant Aesthetics.”


By Central Florida Cosmetic & Family Dentistry
January 16, 2014
Category: Dental Procedures
Tags: cosmetic dentistry  
YouCanPutOnaGreatFacewithVeneersandCrowns

Smiling feels great and makes others feel good as well. But if you are self-conscious about exposing teeth that are showing imperfections or excessive wear, you may not be smiling as broadly as you should be. Fortunately, there are ways to correct the esthetic issues that might be holding you back. One involves covering the natural tooth partly or completely with a natural-looking but flawless “facade.”

Perhaps you've heard about dental veneers and crowns? Both can achieve similar, eye-pleasing results by changing the shape and color of your teeth and even helping to compensate for uneven spacing or alignment. And both are custom-designed for your teeth. So what's the difference and which is right for you?

One distinguishing feature is the amount of tooth each covers. A veneer is a wafer-thin layer of dental porcelain that bonds to the front of your tooth. A crown, also fashioned from dental porcelain, fits over and covers the entire existing tooth, like a hood, right down to the gum. With either approach, to ensure the best, most natural fit, some of the natural tooth structure must be reduced by a minimal amount. In the case of veneers, up to 1 mm of tooth enamel — about the thinness of a fingernail — is removed. Crowns are generally thicker than veneers, so in their case the removal of at least 2 mm of tooth is needed.

Another difference between veneers and crowns is the situations in which one might be more suitable than the other to achieve the desired results. For example, a crown may be necessary when too much tooth structure has been lost to decay or other problems, or for use on back teeth that have to withstand greater impact from biting and chewing. A dental professional can make a recommendation based on your goals, the condition of the tooth or teeth in question, and other factors.

Either way, both veneers and crowns are an excellent solution for a range of esthetic concerns — from poor tooth color/staining, chips and cracks, and excessive wear at the bottom of teeth (from bruxism, a term for teeth grinding) to making small teeth look larger, closing minor gaps between teeth, and making slight corrections in alignment.

If you would like more information about veneers and crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Porcelain Veneers: Strength & Beauty As Never Before.”


By Central Florida Cosmetic & Family Dentistry
January 08, 2014
Category: Oral Health
Tags: oral health   blood pressure  
MonitoringBloodPressureisImportantforBothYourGeneralandOralHealth

It’s time for your semi-annual visit to our office. As we prepare for your examination and teeth cleaning, we may also take a moment to check your blood pressure.

No, you’re not in the wrong office. The fact is, blood pressure screenings in dental offices are becoming more prevalent. The reason is twofold: as one of your healthcare providers, we may be able to identify a problem with your blood pressure that has previously gone unnoticed; and hypertension (chronic high blood pressure) and any drugs you may be taking for it can affect your dental health and how we provide treatment.

Hypertension, the medical term for high blood pressure, is usually regarded as any sustained pressure greater than 125/80 mm Hg (millimeters of mercury). It’s been identified as a major cause of cardiovascular disease, a family of heart-related diseases that affect an astounding 80 million people in the United States. Chronic hypertension has gained a reputation as “the silent killer” — many people are unaware they have it and if left untreated can lead to more serious conditions such as stroke or heart attack. It’s also a symptom of diabetes, even in the absence of other symptoms.

As part of your healthcare team, we’re in a good position to screen for hypertension and other general health problems. At the same time, hypertension is an important factor in dental care, especially if you are on regulating medication. Many anti-hypertensive drugs have side effects, such as dry mouth, that can affect your oral health. Your pressure status and medications may also affect the types and dosages of local anesthetics we would use during procedures; many of these constrict blood vessels (known as vasoconstrictors), which can elevate blood pressure.

A simple blood pressure check could reveal a health problem you didn’t even know about. It also helps us provide you with better and safer dental care.

If you would like more information on the effects of high blood pressure on your dental health, 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 “Monitoring Blood Pressure.”