Posts for: May, 2018
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.”
Tooth loss is a problem that affects many seniors—and since May is Older Americans Month, this is a good time to talk about it. Did you know that more than a quarter of adults over age 75 have lost all of their natural teeth? This not only affects their quality of life, but poses a significant health risk.
According to a study in The Journal of Prosthodontics, significant tooth loss is associated with increased risk for malnutrition—and also for obesity. If this seems like a contradiction, consider that when you have few or no teeth, it’s much easier to eat soft, starchy foods of little nutritional value than it is to eat nutritious fresh fruits and vegetables.
That’s just one reason why it’s important to replace missing teeth as soon as possible. There are several ways to replace a full set of missing teeth including removable dentures, overdentures, and fixed dentures.
Removable dentures are the classic “false teeth” that you put in during the day and take out at night. Dentures have come a long way in terms of how convincing they look as replacement teeth, but they still have some disadvantages: For one thing, they take some getting used to—particularly while eating. Also, wearing removable dentures can slowly wear away the bone that they rest on. As that bone gradually shrinks over time, the dentures cease to fit well and require periodic adjustment (re-lining).
Overdentures are removable dentures that hook onto a few strategically placed dental implants, which are small titanium posts placed in the bone beneath your gums. Strong and secure, implants prevent the denture from slipping when you wear it. Implants also slow the rate of bone loss mentioned above, which should allow the denture to fit better over a longer period of time. But overdentures, too, are not meant to be worn all of the time.
Fixed dentures are designed to stay in your mouth all the time, and are the closest thing to having your natural teeth back. An entire row of fixed (non-removable) replacement teeth can usually be held in place by 4-6 dental implants. Dental implant surgery is an in-office procedure performed with the type of anesthesia that’s right for you. After implants have been placed and have integrated with your jaw bone—generally a period of a few months—you can enjoy all of your favorite foods again without worry or embarrassment.
When you first received your removable dentures the fit was firm and comfortable. Lately, though, they’ve become loose, making it difficult to eat or speak without slippage.
The problem may not be with your denture, but with bone loss. Human bone goes through a natural cycle of dissolving (known as resorption) and new growth to take the lost bone’s place. The jawbone receives further stimulation to grow from the forces generated by natural teeth when we bite or chew.
When natural teeth are missing, however, the jawbone lacks this stimulation, which over time results in bone loss and gum tissue shrinkage. Traditional dentures can’t transmit this stimulating force to the jawbone either, so the bone and gum structure under a denture will also shrink. This results in a looser fit for the denture.
The simplest option to correct a loose-fitting denture (especially if it’s the first occurrence) is to reline the dentures with additional material to re-form the fit to the new conditions in the mouth. A permanent relining will require sending your dentures to a dental laboratory to apply the new material based on a mold of your current anatomy beneath the denture.
If, however, your dentures have already undergone a few relinings, or after examining your gums we determine a relining won’t provide the fit and stability needed, then it may be time for a new denture. Although this is more costly than a relining, a new appliance could provide a more accurate fit to the current contours in your mouth.
The latter option may also give you a chance to benefit from advancements in denture technology or materials since you received your current denture. One such advancement is a removable denture that’s supported by implants. It’s possible to achieve this new supporting foundation for the denture with as few as two strategically-placed implants in the lower jaw.
If you’ve begun to notice denture looseness, be sure to make an appointment for an examination. From there, we can advise you on what will work best in your particular case.
If you would like more information on your options regarding removable dentures, 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 “Loose Dentures.”