The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
What makes an attractive smile? Of course, shiny, straight and defect-free teeth are a big factor. But there’s another equally important element: all your teeth have come in.
Sometimes, though, they don’t: one or more teeth may remain up in the gums, a condition known as impaction. And if they’re in the front like the upper canines (the pointed teeth on either side of the front four incisors) your smile’s natural balance and symmetry can suffer.
Impaction usually happens due to lack of space on a small jaw. Previously erupted teeth crowd into the space of teeth yet to come in, preventing them from doing so. As a result the latter remain hidden within the gums.
While impaction can interfere with the smile appearance, it can cause health problems too. Impacted teeth are at higher risk for abscesses (localized areas of infection) and can damage the roots of other teeth they may be pressing against. That’s why it’s desirable for both form and function to treat them.
We begin first with an orthodontic examination to fully assess the situation. At some point we’ll want to pinpoint the impacted teeth’s precise location and position. While x-rays are useful for locating impacted teeth, many specialists use cone beam CT (CBCT) technology that produces highly detailed three-dimensional images viewable from different vantage points.
If the tooth is in too extreme a position, it might be best to remove it and later replace it with a dental impact or similar restoration once we’ve completed other necessary orthodontic treatment. But if the tooth is in a reasonable position, we might be able to “move” the tooth into its proper place in the jaw in coordination with these other tooth-movement efforts to make room for it.
To begin this process, an oral surgeon or periodontist surgically exposes the tooth crown (the normally visible portion) through the gums. They then bond a small bracket to the crown and attach a small gold chain. An orthodontist will attach the other end to orthodontic hardware that will exert downward pressure on the tooth to gradually bring it into normal position.
Dealing with impacted teeth of this nature is often part of a comprehensive effort to correct the bite. If we’re successful, it could permanently transform both the smile and overall dental health.
If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”
There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause for gum disease, from all tooth and gum surfaces.
The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They're also time-consuming: full treatment can take several sessions, depending on how extensive the infection has spread.
In recent years, we've also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.
Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.
Dentists who have used lasers in this way do report less tissue damage, bleeding and post-treatment discomfort than traditional treatments. But because research is just beginning, there's not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.
At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.
If you would like more information on treating gum disease, 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
Root canal treatments are an essential part of dental care — countless teeth with deep decay would be lost each year without it. Now, this traditional dental care procedure is advancing to a new level of precision through lasers.
Root canal treatments have a simple goal: access a tooth's infected pulp and root canals, clean out the infected tissue and fill the empty pulp chamber and canals with a special filling. Once filled, the access is sealed and a porcelain crown later placed for additional protection against re-infection.
In the traditional procedure, we perform these steps manually with a dental drill and hand instruments. We may also need to remove a good portion of tooth structure, both healthy and infected tissue. A laser, on the other hand, is a highly focused beam of light with the ability to interact with healthy and infected tissues differently: destroying infected tissue while having no effect on nearby healthy tissue. The end result: we may be able to remove less healthy tissue with lasers than with the conventional procedure.
Lasers are also helpful with softening and precisely molding the filling material within each canal's particular shape. And, early reports seem to indicate a higher degree of comfort for patients (less drill noise and need for anesthesia), less bleeding and faster recovery times than the conventional approach.
But as a tool for root canal treatments, lasers do have a couple of disadvantages. While light travels in a straight line, root canals are rarely straight — conventional instruments with curved designs usually accommodate odd canal shapes better than a laser. Lasers can also raise temperatures within a tooth that can damage healthy tissue, both within the pulp and outward into the dentin.
Still, lasers for root canal treatments appear promising with some dentists using a combination of lasers and manual techniques to garner benefits from both approaches. While you won't see lasers replacing the traditional root canal treatment anytime soon, the future looks bright for more efficient ways to treat deep tooth decay.
If you're well past your teen years, you probably have several reasons for not straightening your crooked smile: the expense, the time and the embarrassment of being a 30-, 40- or 50+- something wearing braces. But we have five reasons why adult orthodontic treatment can be a smart choice: Tom Cruise, Kathy Bates, Carrie Underwood, Danny Glover and Faith Hill.
That's right: Each of these well-known entertainers and performers—and quite a few more—underwent treatment to improve a poor dental bite. And not as teenage unknowns: Each on our list wore braces or clear aligners as famous adults (the paparazzi don't lie!).
Here are a few of the reasons why these celebrities chose to change their smile through orthodontics—and why you can, too.
Age isn't a factor. Straightening misaligned teeth isn't reserved only for tweens and teens—there are a growing number of adults well into their middle and senior years undergoing orthodontic treatment. As long as your teeth are relatively sound and your gums are healthy, it's altogether appropriate to undergo bite correction at any age.
A boost to your dental health. Gaining a more attractive smile through orthodontics is in some ways an added benefit. The biggest gain by far is the improvement straightening your teeth can bring to your long-term health. Misaligned teeth are more difficult to keep clean of dental plaque, which can increase your disease risk. They also may not function as well as they should while chewing food, which can affect your digestion.
Traditional braces aren't the only way. If the thought of displaying all that hardware makes you cringe, it's not your only option. One of the most popular alternatives is clear aligners, custom plastic trays that are nearly invisible on your teeth—and you can take them out, too. Another method growing in popularity are lingual braces: All the hardware is behind the teeth and thus out of sight. And you can, of course, opt for traditional braces—just ask Tom Cruise!
Oh, yes—a new smile! Orthodontics was truly the first “smile makeover.” It can improve your appearance all by itself, or it can be part of a comprehensive plan to give you an entirely new look. While the gains to your health are primary, don't discount what a more attractive smile could do for you in every area of your life.
The best way to find out if orthodontics will work for you is to visit us for an initial exam and consultation. Just like our A-list celebrities, you may find that orthodontics could be a sound investment in your health and self-confidence.
If you would like more information about orthodontic treatments, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “The Magic of Orthodontics: The Original Smile Makeover.”
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