Posts for: November, 2013
Root canal treatments are an important method for stopping the disease process within an infected tooth and ultimately saving it. However, one of the few side effects could have an aesthetic impact on your smile. Leftover blood pigments or the filling materials themselves can cause a darkening of the tooth — the tooth could eventually stand out in an unsightly way from surrounding teeth.
There is, however, one possible solution: a whitening technique known as internal or non-vital bleaching can lighten a darkened, non-vital tooth. For this procedure, we would insert a bleaching mix (usually sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a short period of time. The chemical reaction of the mix whitens the tooth from within.
Our first step is to make sure by x-rays that the root canal filling in the tooth is still intact and still has a good seal. We then create a small opening in the rear of the tooth just above the root canal filling, irrigate it with water to remove any debris, and then add a special cement at the point where the root canal filling begins to seal it from any leakage of the bleaching solution into the root canal filling.
We then insert the bleaching solution into the empty pulp chamber. This is covered with a cotton pellet, which is then sealed in with a temporary filling. We repeat this application over a number of days until we see a noticeable change in the tooth color (normally after one to four visits). At this point, we would remove any residual solution and apply a permanent filling to seal the tooth.
This procedure can be performed instead of more extensive procedures such as veneers and crowns as a cover for the discolored tooth, or as a way to lighten teeth before applying a veneer or crown to help prevent discoloration from showing through. Either way, non-vital bleaching can help remove unsightly discoloration and restore vibrancy to your smile.
If you would like more information on internal or non-vital bleaching, 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 “Whitening Traumatized Teeth.”
Before she began hosting the long-running TV competition Top Chef, Padma Lakshmi was a well-known model and successful cookbook author. (Appropriately, she is said to have been “discovered” by a modeling agent while sitting in a café in Madrid.) Yet the Indian-born beauty's striking look — at once exotic and familiar — doesn't come from any cookie-cutter mold.
So when Lakshmi had cosmetic work done on her teeth, early in her career, her dentist didn't use a cookie-cutter approach either: Instead, her smile was carefully designed, using small amounts of bonding material to brighten her teeth and to bring their shape and spacing into harmony with her facial features.
Dentistry by Design
What exactly is smile design — and what could it do for you? Essentially, it's the process of evaluating your smile in concert with the appearance of your entire face, and visualizing the changes — some dramatic and some subtle — that will make it really shine. Some aspects we consider include the face's shape, the proportion or “balance” of facial features, the complexion, eye and lip color and form, and the overall dimensions of the smile.
Based on dental aesthetics and clinical experience, we will probably have a number of suggestions to make on how you can improve your smile. Your input will also be very important; while some individuals prefer perfectly even teeth and a sparkling “Hollywood white” smile, others are looking for a result that's more in keeping with a “natural” look: slight irregularities in tooth shape, spacing, and even color.
There's no right or wrong answer here: Having a “perfect” smile means what's perfect for you, so it's very important for dentists and patients to communicate openly during the smile design process. But sometimes, words alone just aren't enough to convey the subtle dimensions of beauty.
The Trial Smile
Fortunately, it's now possible to preview your “perfect” smile using a number of different techniques. Advances in computer imaging make this the first step in previewing your new smile — you can see the changes before a single tooth is touched! Still, many people find that having a more concrete picture is helpful. The next step is to make a 3-D mock-up the proposed dental work on an actual model of your mouth. That way, you can see a physical representation of the final results — and even turn it around and hold it in your hands.
There's still one more way to really experience the difference cosmetic treatments can make without committing to a permanent change: the provisional restoration. Here, tooth-colored bonding material and other techniques are used to actually create the new smile — temporarily. This gives you time to “live with it,” and see if the proposed changes work for you. If everything goes well with the provisional work, the permanent restoration is guaranteed to please.
So if you want holiday treats, get out the cookie cutter — but if you're looking for a smile that's uniquely yours, and one that enhances your own individual appearance… call our office and ask about a smile design consultation. You can learn more in the Dear Doctor magazine articles “Great Expectations — Perceptions in Smile Design” and “Beautiful Smiles by Design.”
Even though they eventually fall out, primary (baby) teeth play several vital roles in your child's development. Among other things, they serve as important guides for the developing permanent teeth that will replace them. If any are lost prematurely, the remaining baby teeth start to shift, migrating forward, decreasing the space necessary for the permanent teeth to erupt into their proper positions. This could result in a need for future orthodontics that may have been unnecessary. So it's important to keep primary teeth healthy and in place until they are ready to come out naturally.
Signs & Symptoms of Teething
Primary (baby) teeth typically begin emerging between six and nine months, though as early as three or as late as 12 months can occur. Usually, but not necessarily, the two lower front teeth appear first. All 20 primary teeth are generally in by the age of three.
Some typical signs of teething include: irritability, gum swelling, gnawing, drooling (due to increased saliva production), chin (facial) rash (due to excessive drooling), disrupted sleeping patterns, ear rubbing, and decreased appetite. Symptoms generally start about four days before a tooth emerges, are most intense during the week when the tooth breaks through the gum, and subside about three days following the event.
You may notice small, bluish, translucent “eruption cysts” on your baby's gum where a tooth is breaking through; sometimes blood mixes with the fluid in a cyst, at which point it's called an eruption hematoma. Both generally disappear on their own when the tooth erupts and pops them.
Suggestions for Soothing
To help keep your teething baby as comfortable as possible, try the following:
- A chilled rubber teething ring, pacifier, or cold wet washcloth
- Gentle gum massage using a clean finger
- Cold foods like popsicles when your child is old enough (just be careful about feeding him or her too much sugar, which can cause decay even in newly emerging/emerged teeth)
- Over-the-counter pain medication such as ibuprofen or acetaminophen in the appropriate dosage
The onset of teething is the perfect time to begin focusing on your child's pediatric dental care. Even though baby teeth eventually fall out, the quality of their care will have a direct and long-lasting impact on the health of the permanent teeth that follow.
If you would like more information about baby teething, 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 “Teething Troubles.”