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Posts for category: Dental Procedures

By Ellie Dikegoros DMD Family Dental
December 17, 2018
Category: Dental Procedures
Tags: x-ray  
BitewingX-RaysSafelyRevealallAboutBackTeethtoPreventToothDecay

Modern dental care wouldn’t be the same without x-rays. Since dentists began capturing x-ray images a century ago to detect beginning tooth decay, billions of teeth have been preserved.

“Catching it early” is the key to staying ahead of this aggressive bacterial infection. Once it breaks through the protective defenses of tooth enamel, it can advance toward the center of the tooth, the pulp, damaging dentin as it goes. While we can effectively stop it at this point with a root canal treatment, it’s better for the tooth’s long-term health to detect and treat any decay early on with a less-invasive filling or other treatment method.

X-ray imaging helps make that possible, revealing decay much easier than we can see with the unaided eye. And while we can often detect decay in front teeth by visual examination or by using very bright lighting, that’s not as easy with the less accessible back teeth. For those teeth we use a special x-ray technique known as the bitewing.

The name comes from the small frame used to hold the film. It’s held in place in the mouth by the patient biting down on small tabs or “wings” extending from the frame. The x-ray beam travels through the outer cheek and teeth to the film being held in the frame on the back side of the teeth. When exposed, we’ll be able to view the interior of these back teeth: a set of four bitewings gives us a full view of all the upper and lower molars and pre-molars on each side of the jaws.

Like other forms of radiation energy, too much or too frequent exposures to x-rays can lead to serious health problems. But bitewing x-rays carry little risk to health. That’s because they fit well with the ALARA principle, meaning “As Low As Reasonably Achievable,” which helps guide our use of x-rays. Patients receive a fraction of the radiation exposure from routine bitewing x-rays than they receive annually from the natural environment.

Without bitewing x-rays and other diagnostic methods, the chances are high that tooth decay or other dental problems can go undetected in their early stages. Using this important tool can help us head off major damage before it occurs.

If you would like more information on the role of x-rays in dental care, 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 “Bitewing X-Rays: A Routine Part of Your Dental Exam.”

By Ellie Dikegoros DMD Family Dental
October 28, 2018
Category: Dental Procedures
Tags: fillings  
ItsanArtDeterminingToothColorinCompositeResinRestorations

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.”

By Ellie Dikegoros DMD Family Dental
October 18, 2018
Category: Dental Procedures
Tags: dental implants  
DentalImplantscanalsoSupportOtherTraditionalRestorations

If you’re thinking about getting dental implants, you’re in good company. Dentists have placed more than 3 million of these popular devices since their introduction in the early 1980s.

But if you have multiple missing teeth, you might think the cost of all those individual implants could put them out of your league. Yes, replacing multiple teeth with individual implants can be quite expensive—but implant technology isn’t limited to one tooth at a time. A few well-placed implants can impart their proven durability and stability to other types of restorations.

For example, we can incorporate implants into a bridge for a series of missing teeth. Conventional bridges are normally fixed in place by altering and then crowning natural teeth on each side of the missing teeth gap with a fixed row of prosthetic (false) teeth in the middle to fill it. Instead, two implants placed at the ends of the gap can support the bridge rather than natural teeth. This not only provides greater stability for the bridge, it also avoids permanent altering the natural teeth that would have been used.

Implants can also support a fixed bridge to restore complete tooth loss on a jaw. The new bridge is attached to a few strategically placed implants along the jaw line to equally distribute biting forces. This can result in a strong hold with excellent durability.

We can also use implants to improve traditional dentures. Dentures normally rest directly on the gums’ bony ridges, depending on a snug fit for stability. But bone loss, a natural consequence of missing teeth, can still occur while wearing dentures, which may in fact accelerate the rate of loss due to the appliance’s constant pressure and friction against the gums.

Instead, just a few implants placed along the jaw can, with attachments built into the denture, hold it securely in place. This not only decreases the pressure on the gums, but the natural bone growth that occurs around the implant may even deter bone loss.

Depending on your situation, there could be a viable restoration solution involving implants. Visit our office for a complete examination and evaluation to see if implants could help change your smile forever.

If you would like more information on implant restorations, 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 “Dental Implants 101: the Most Significant Innovation in the Past Century.”

By Ellie Dikegoros DMD Family Dental
October 08, 2018
Category: Dental Procedures
JanetJacksonEvenpopstarsgetinsecureabouttheirsmiles

Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.

Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:

Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.

Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.

Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.

Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.

Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.

After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.

For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”

By Ellie Dikegoros DMD Family Dental
September 08, 2018
Category: Dental Procedures
Tags: fillings  
DentalAmalgamContinuestobeaDurableandSafeToothFilling

Recently, a number of new filling materials that mimic tooth color have come into popular use and, so far, have proven more durable than past versions. Even so, the traditional metal-based dental amalgam remains a viable choice, especially for less visible back teeth and their higher biting forces.

Used for more than a century, dental amalgam is a metal alloy composed of silver, mercury, tin and copper. The mixture is carefully proportioned so that potentially hazardous mercury is kept to a minimum and bonded with the other metals. Amalgam in its initial form is quite pliable so that it can be molded into the tooth structure under repair. Afterward it sets hard to form a durable filling that can withstand the daily force generated when we bite and chew food.

Besides durability, dental amalgam rarely causes an allergic reaction in a patient, and it’s easy for trained dentists to apply. On the downside, however, it can cause temporary temperature sensitivity in the tooth just after filling, and the tooth itself may require some removal of healthy structure to help keep the filling in place. And from an aesthetic point of view, its metallic appearance is considered unattractive especially for front teeth.

The presence of mercury in amalgam has also raised concerns over the years. “Free” mercury — atoms that escape through vapor emitted by the metal — can enter the bloodstream and potentially harm the nervous system. But after extensive study and research, U.S. and international health bodies including the American Dental Association have concluded any free mercury released during chewing is extremely low and well below any harmful levels. These studies have also found no ill effects in either children or adults with dental amalgam fillings.

Deciding on the type of filling material to use — dental amalgam or a newer composite resin, resin ionomer or glass ionomer — depends on a number of factors including the location of the teeth to be filled, the extent of decay and your personal preferences. Taking these into account, we’ll be happy to discuss which type of filling will suit you best for repairing decayed teeth.

If you would like more information on filling material options including dental amalgam, 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 “Silver Fillings — Safe or Unsafe?