Posts for category: Dental Procedures
One of the key elements in a child’s development is their first set of teeth. Although primary (“baby”) teeth last only a few years, they’re critically important for enabling a child to eat solid foods, speak and smile.
But they also provide one more important benefit—they hold the space in the jaw reserved for the permanent teeth developing just under the gums until they erupt. But if a child loses a primary tooth prematurely because of disease or injury, other teeth may drift into the vacant space and crowd it out for the intended permanent tooth. It may then come in misaligned or remain stuck within the gums (impaction).
To avoid this, we try to treat and preserve a diseased primary tooth if at all practical. For a primary molar, one of the large teeth in the back of the mouth, this might include capping it with a stainless steel crown.
Why a metal crown? Primary molars normally don’t fall out until around ages 10-12, so it may be years for a younger child before their permanent molars erupt. All during that time these particular teeth will encounter heavier biting forces than teeth in the front.
A steel crown is often the best solution for a molar given their longer lifespans and encountered biting forces. The crown’s metal construction can stand up to these forces while still protecting the tooth from re-infection from decay. And because molars are typically outside of the “smile zone” occupied by more visible front teeth, the crown’s metal appearance isn’t usually an aesthetic issue.
Crowning a molar usually takes one visit, a dentist typically performing the procedure with local anesthesia and possibly a mild sedative like nitrous oxide gas (“laughing gas”). After removing any decayed structure from the tooth, the dentist will then fit a pre-formed crown over the remaining structure, sized and shaped to match the original tooth as close as possible.
A stainless steel crown is a cost-effective way to added needed years to a primary molar that could otherwise be lost prematurely. Preserving it may help a child avoid bite problems and expensive future treatments.
If you would like more information on dental care for primary 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 “Stainless Steel Crowns for Kids: A Safe and Effective Way to Restore Primary Molars.”
Roughly 75% of American adults are missing at least one tooth, mostly from disease, trauma or extraction for other dental reasons. A few missing teeth, though, never erupted in the first place.
It’s a rare occurrence, but sometimes people are born without certain teeth, usually back molars or premolars that may not be as visible. Occasionally, though, it’s the more visible upper lateral incisors positioned on either side of the central incisors (the two front teeth on either side of the midline of the face).
Missing incisors can lead to poor bites and create difficulties for speech development and nutrition. But these highly visible (or in this case, “invisible”) teeth can also detract from an otherwise attractive smile.
There are ways, however to correct a smile with missing lateral incisors. Here are 3 of those ways.
Canine substitution. We can fill the vacancy created by the missing incisors by orthodontically moving the canines (the “eyeteeth,” normally next to them) into the space. Braces can close the gap in a conservative way, while possibly correcting any existing bite problems. Because canines are larger than incisors, its often necessary to re-contour them and restore them with a crown, veneer or bonding material to look more natural.
Fixed bridge. A second way to fill the space is with a dental bridge. A bridge consists of a series of crowns fused together in a row. The middle crowns replace the missing teeth; the end crowns cap the natural teeth on either end of the gap, which establishes support for the bridge. Another variation is a cantilever bridge in which only one natural tooth is capped for support. With either type, though, the capped teeth will be permanently reduced in size to accommodate the crowns.
Dental implants. This popular restoration is also a favorite for correcting missing incisors. Implants provide a life-like and durable replacement for missing teeth, while not requiring any alterations to existing teeth as with a bridge. But they are more expensive than the other options, and they require adequate space between the adjacent teeth for insertion, as well as healthy bone for proper placement and anchorage. This is also an option that must wait until the jaw has fully matured in early adulthood.
If you would like more information on treating congenitally missing 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 “When Permanent Teeth Don't Grow: Treatment Options for Congenitally Missing Lateral Incisors.”
You have a winning smile except for one small flaw — one of your front teeth is chipped. In functional terms the defect is insignificant: your tooth is healthy and can still do its job. But with regard to your smile that chip is like a smudge on a masterpiece painting: it stands out — and not in a good way.
The good news is you have options to repair the chip and vastly improve your appearance. One option is to bond a custom porcelain veneer to the outside of the tooth to cover the chip. But that would also mean removing a slight bit of tooth enamel so the veneer won't appear too bulky. Although not as much as with a crown, the alteration still permanently affects the tooth — it will always require a restoration of some kind.
There's another choice that doesn't involve removing any of your enamel: composite resin. This treatment is a mixture of materials with a glass-like binder in liquid form that we apply to a tooth in successive coats. As we build up the layers we can match the tooth's shape, texture and various shades of its natural color. We're able to fill in the defect and make the tooth appear as natural as possible.
Unlike porcelain restorations, composite resins don't require a dental lab or a period of weeks to prepare. We can transform your simile in our office in as little as one visit.
Composite resin isn't the answer for every tooth defect. Teeth that have become worn, fractured or have undergone a root canal treatment are best treated with a porcelain restoration such as a veneer or crown. But where the defect is relatively minor, composite resin may be the answer.
To learn if you can benefit from a composite resin restoration, you'll need to undergo a dental exam. If we determine you're a candidate, we can use this state-of-the-art dental material to make your teeth look flawless.
If you would like more information on composite resins, 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 “Artistic Repair of Front Teeth with Composite Resin.”
Sometimes, Nature neglects creating a well-aligned smile. Crookedness, gaps, bite problems, and more can challenge personal appearance, self-image, and health. At Design a Smile in Miami, Drs. Romay, Barrera, and Sosa understand the complexities of orthodontics and its health benefits, too.
What's your problem?
Orthodontic issues are no joke. If your teeth are crooked, gapped, crowding, or missing, you won't look or function at your best. The American Association of Orthodontists strongly recommends smile alignment evaluation with your dentist by the age of seven. If you miss that window of jaw growth and fluidity, don't worry. Teens and adults--really, people of all ages--can wear braces from your Miami dentist.
Once you're evaluated, your dentist will craft a treatment plan to move your teeth into healthier, better functioning, and more attractive positions. Appliances available at Design a Smile include:
- Palatal expanders which make more room in the jaw for larger teeth
- Conventional metal, lingual and ceramic braces
- Removable and discreet Invisalign aligners for mild to moderate alignment problems
- Clear MTM aligners for minor dental corrections
The health benefits of orthodontic treatment
The Academy of General Dentistry says that most patients wear braces for one to two years depending on the details of their individual cases. Plus, dentists usually recommend a removable or bonded retainer afterwards to keep smiles in perfect alignment for the long term.
Even during treatment, the health benefits of wearing braces start becoming evident. They include:
- Better oral hygiene habits (brushing, flossing, and a healthier diet)
- Resolution of crowding
- Ease of cleaning resulting in fewer cavities and less gum disease
- Fewer headaches, earaches and facial pain
- Proper jaw alignment
- Less teeth clenching, grinding, and premature enamel wear
- Preservation of jaw bone integrity
- Resolution of speech, breathing, and digestive difficulties
A wonderful smile in every way
Orthodontics provides a sure path to a smile that looks, feels, and functions well, helping it to last for a lifetime. Are braces or aligners in your future, or are you considering them for a loved one? Call one of the Miami, FL, offices of Design a Smile for a complimentary consultation. For the 40th Street office, phone (305) 667-8887. For the 88th Street office, call (305) 408-3388. Our dentists would love to talk to you!
It takes a lot of skill, experience, talent and artistry to create tooth restorations that look so natural that no one can tell them apart from the originals. To do so requires understanding of the normal anatomy of a tooth as well as of the interactions of light and color.
How the anatomy of a tooth determines color
The color that we perceive when looking at a tooth results from the combined appearance of the tooth’s center core (dentin layer) and its covering enamel. Going from the outside in, the enamel is made of tightly packed crystals of calcium, which cause it to be one of the hardest substances naturally produced by animals. The crystals are also responsible for a tooth’s brilliance and translucence. The dentin is more like bone, a porous living tissue composed of microscopic tubes, interspersed with more calcium crystals. In the very center of the tooth is a central chamber containing the pulp and nerves.
Each of these layers has its own physical and optical properties. Since the enamel is translucent and the dentin is more opaque, most of the tooth’s color comes from the dentin and is transmitted through the enamel layer. Factors that affect this transmission include the thickness and age of the enamel as well as external tooth whitening.
If the enamel is more translucent, more of the color of the dentin shows through. If it is more opaque, the enamel absorbs and reflects light so that less color is visible and the enamel looks brighter.
The language of color composition and reflected light
Color means the whole spectrum in the rainbow. The spectrum is made up of the three primary colors — red, blue, and green. When all are combined, they create white light.
Hue refers to the brightest forms of the colors. The color we perceive depends on the dominant wavelength of light that is reflected by an object.
Value refers to a color’s lightness or darkness. A brighter color has a higher value.
Chroma is the amount of identifiable hue in a color. An achromatic color (without hue) appears gray.
Saturation is a measure of a color’s intensity.
This terminology of color is used not only by dentists and dental technicians, but also by a wide range of artists. It implies expertise and understanding of how colors work, how they vary and change and affect one another.
Contact us today to schedule an appointment or to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor article, “Artistic Repair of Front Teeth with Composite Resin.”