Porcelain veneers have become a popular way to transform a smile. They're ideal for stained, chipped or slightly misaligned teeth. But although they don't need as much tooth preparation as crowns or other bridgework, the traditional veneer still requires some permanent tooth alteration.
Now, there's an alternative: no-prep veneers. With this option we can avoid any tooth structure removal or keep it to a minimum. And it may not even require local anesthesia while applying them.
Veneers are as their name implies: a wafer-thin layer of tooth-colored porcelain that's bonded to the outside of a tooth, much like siding on a house. Although the traditional veneer is usually no more than a millimeter in width, they can still add an unnatural bulky look and feel to a tooth. To compensate, we remove portions of the enamel. A tooth permanently altered this way will henceforth require some form of restoration.
No-prep veneers are much thinner; they also don't extend under the gum line like traditional veneers. At the most the new veneers may only require us to perform some minor reshaping of the enamel, but not to the extent of traditional veneers. And because your tooth isn't permanently altered, we could presumably remove the veneer and return the tooth to its natural state and appearance (although removing the bonding might not be that easy).
There are some situations where some tooth alteration may still be necessary, like oversized or forward-jutting teeth. A bad bite (malocclusion) may require orthodontic treatment first — which in some cases could be an alternative treatment to veneers altogether.
To find out if you're a candidate for no-prep veneers, visit us for a complete examination. From there we can discuss your options and whether we can transform your smile with little change to your teeth.
Dental implants are widely considered by both dentists and patients as the premier choice for replacing missing teeth. Unfortunately, implants aren’t the appropriate choice for teenagers with missing teeth.
That’s because their jaws won’t fully finish most of their growth and development until early adulthood. An implant placed too early could become misaligned as the jaw matures. The best approach for a teenager is a temporary restoration until they’re old enough for an implant.
There are a couple of good options. One is a removable partial denture (RPD), prosthetic (false) teeth set in an acrylic base that mimics gum tissue at the locations of the missing teeth. RPDs, which stay in place by way of metal clips that fit over other teeth, are easy to wear and maintain.
On the downside, an RPD can break if you bite into something too hard. They can lose their fit and may need to be replaced with a new one. And, some teens aren’t quite keen on wearing a “denture.”
Another option is a bonded or Maryland bridge, a kind of fixed bridge. We bond dental material to the back of a prosthetic tooth with portions of the material extending out from either side of it.Â We then bond these extending tabs to the back of the teeth on either side of the prosthetic tooth to hold it in place. Unlike traditional bridges, we can eventually remove it without any permanent alterations to the teeth it’s attached to.
Before we undertake a bonded bridge, though, we must make sure the gums and bone of the surrounding teeth are free from periodontal (gum) disease and are healthy and strong enough to support the bridge. We also need to be sure the patient doesn’t have a deep bite or a teeth grinding habit, which could cause the teeth to make contact with the tabs and break them.
The patient also needs the maturity to responsibly perform diligent oral hygiene: this type of bridge has a tendency to build up disease-causing plaque, so brushing twice and flossing once every day is critical. Not doing so increases the risk of tooth decay or periodontal (gum) disease, which could complicate a future implant.
We can discuss these options after a thorough dental examination of your teenager. Either way, we’ll be able to restore your teen’s smile until we can undertake a more permanent restoration.
Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.
“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.
Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.
Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.
Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.
If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.
When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.
Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.
The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues. Â The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.
Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.
The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.
Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.
Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.
Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.
In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.
As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.
If you would like more information on the effect of eating disorders on 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 “Bulimia, Anorexia & Oral Health.”
If you’re committed to providing your family nutritional, low-sugar snacks, you’re not only helping their physical well-being but their dental health too. If you have school-age children, though, you might be concerned about other snacks available to them while away from home.
To begin with, any potential problems at school with available snack items might not be as bad as you think. A few years ago the U.S. Department of Agriculture (USDA) established new snacking guidelines for public schools. Known as the Smart Snacks in Schools initiative, the new guidelines require schools to only allow snacks sold on school grounds that meet minimum nutritional standards. In addition, these guidelines promote whole grains, fruits, vegetables and low-fat dairy products.
Still, the guideline standards are only a minimum, which could leave plenty of room for snacks that don’t meet your nutritional expectations. And school-offered snacks aren’t the only ones available on campus: there are also those brought by other students, which often get swapped around. The latter represent tempting opportunities for your child to consume snacks that aren’t the best for dental health.
But there are things you can do to minimize the lure of these poor snacking opportunities at school. First and foremost is to educate your child on why some snacks are better for them than others. In other words, make nutrition an instilled family value—and, of course, practice what you preach.
You can also send them with snacks you deem better for them than what’s available at school. Of course, you’ll be competing with a lot of exciting and enticing snacks, so try to inject a little “pizzazz” into yours like a dusting of cinnamon or a little parmesan cheese on popcorn. And use a little creativity (even getting your kids involved) to make snack choices fun, like using cookie-cutters to shape whole-grain bread and cheese into shapes.
And consider getting involved with other parents to encourage school administrators to adopt stricter snack standards over and above the Smart Snacks in Schools initiative. This not only may improve the nutritional content of available snacks, but also transform a “family value” into a community-wide appreciation for snacks that promote healthy teeth and gums.
If you would like more information on dental-friendly snacking, 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 “Snacking at School.”
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