Posts for category: Dental Procedures

By John G. Rutland Family & Cosmetic Dentistry
April 15, 2015
Category: Dental Procedures
AToothlessTiger

Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?

Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?

Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.

Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.

But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?

In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.

Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.

What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.

If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”

By John G. Rutland Family & Cosmetic Dentistry
March 16, 2015
Category: Dental Procedures
EdenSherandtheLostRetainer

Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!

If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.

If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?

As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.

And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!

If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?

By John G. Rutland Family & Cosmetic Dentistry
February 12, 2015
Category: Dental Procedures
50CentHasHisOwnStyle-EveninHisSmile

On his way to the top of the urban contemporary charts, the musician, actor and entrepreneur known as 50 Cent (born Curtis James Jackson III) earned his street credibility the hard way; his rise from youthful poverty to present-day stardom is chronicled in many of his rhymes. So when it came time for the rapper to have cosmetic work performed on his teeth, he insisted on doing it in his own way.

“I told [the dentist] to leave [my front teeth] a little bigger than the other ones, because I need to still see me when I look in the mirror,” he told his co-host on the New York radio station Power 105.1. “Don't give me no whole ’noter guy — I like me!”

We understand how 50 Cent feels — in fact, we think it's a perfectly reasonable request.

Cosmetic dentistry has come a long way in recent years, as we strive to meet the increasing expectations of our patients. We realize that different people have different perceptions of what makes a smile attractive — and that in dental aesthetics, beauty really is in the eye of the beholder. That's why, before we begin cosmetic work, we want to hear what you like and don't like about your smile as it is now. In addition, we can also perform what is called a “smile analysis.”

This procedure doesn't cause any discomfort — but it's a crucial part of cosmetic enhancement. In doing the analysis, we look at the various parts of an individual's smile: the spacing, size and alignment of the teeth; the health and position of the gum line; the relationship of the upper and lower jaws; and the relative shape and size of the face. All of these features combine to make a person's smile unique. By looking at them closely, we can help determine the best way for you to improve your smile.

But how can you tell if the cosmetic changes you're contemplating will end up being just right for you? Fortunately, with today's technology, it's easier than ever. Computer imaging offers a chance to visualize the final outcome before we start working on your teeth; it's even possible to offer previews of different treatment options. If you want to go a bit further, we may be able to show you a full-scale model of your new smile.

In some situations, we can even perform a provisional restoration — that is, a trial version of the new smile, made with less permanent materials. If the “temporary” smile looks, feels, and functions just right, then the permanent one will too. If not, it's still possible to make changes that will make it work even better.

Whether you're thinking about having teeth whitening, cosmetic bonding, porcelain veneers, or dental implants to improve your smile, you probably have a picture in your mind of how the end result should look. Will your teeth be perfectly even and “Hollywood white” — or more “natural,” with slight variations in size, spacing and color allowed? Either way, we can help you get the smile you've always wanted.

If you would like more information about smile makeovers and options in cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry.”

By John G. Rutland Family & Cosmetic Dentistry
January 28, 2015
Category: Dental Procedures
DiagnosingtheExactInjuryisKeytoTreatingJawPain

Your lower jaw is an integral part of eating, speaking and other tasks involving the mouth. But what happens if you suffer an injury to one of the two joints that connect it to the skull? The result could be serious pain and the inability to bring the upper and lower teeth together properly.

The exact types of injuries causing the pain and disability can vary, like the displacement of a tooth or a group of teeth. Another is swelling in the joint space that prevents the head of the joint (the condyle) from fully seating in the joint space; you could also experience a joint dislocation as the condyle is forced completely out of the joint space. Either swelling or dislocation can prevent the back teeth on the side of the affected joint from fitting together properly.

Another traumatic injury is a fracture of the bone at or near the joint; one of the most common is known as a “sub-condylar” fracture where the break occurs just below the condyle and results in more severe pain than inflammation or dislocation. A more serious fracture may involve the joint itself.

To treat the symptoms properly, it’s important to determine which of these injuries has occurred. This requires a full examination, including x-ray imaging, to determine if the injury involves soft tissue, bone or both. In the case of inflammation, we would prescribe anti-inflammatory and muscle relaxant medication. The latter is especially helpful because trauma often leads to muscle spasms that lock the jaw in place to reduce further damage (nature’s splint, if you will). A dislocation may also require gentle manipulation to seat the condyle back into the joint.

Fractures are treated generally by repositioning the broken portions of the bone into their normal position and then immobilizing them while they heal. Immobilization is accomplished by joining the upper and lower teeth together, either by external or internal means. The latter option requires a surgical procedure.

If you’ve suffered an injury that results in any of these symptoms you should contact our office immediately. Only a complete diagnosis can point the way to the proper treatment that will relieve your discomfort.

If you would like more information on the causes and treatment of jaw 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 “Jaw Pain — What’s the Cause?

By John G. Rutland & Kenneth L. Vandervoort, Jr Family & Cosmetic Dentistry
December 11, 2014
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and your oral 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 “Removing Wisdom Teeth.”