My Blog

Posts for category: Dental Procedures

By Ellie Dikegoros DMD Family Dental
April 06, 2019
Category: Dental Procedures
WorldCupSoccerCoach-DentistSavestheDay

If you followed the 2018 FIFA World Cup Soccer games, you probably know that one of this year’s biggest surprises was the debut of the team from Iceland—the smallest country ever to earn a chance at the sport’s top prize. But here’s something you may not have known: When he’s not on the field, the team’s coach, Heimir Hallgrímsson, is a practicing dentist! Those two skill sets might not seem like a natural fit… but they came together dramatically at a recent contest.

At a local women’s game last summer, when a player was hit and her tooth was knocked out, Dr. Hallgrímsson took immediate action. “I jumped on the pitch and put the tooth back in, took her to a dental office and fixed it,” he said.

Not everyone has the special training or ability to fix a tooth that has been damaged or knocked out—but there are some simple things that you can do to help an adult who has suffered this kind of injury. Here’s a quick run-down:

  • After making sure the person is stable and not otherwise seriously injured, try to locate the tooth.
  • Handle it carefully, without touching root surfaces, and clean it gently with water if possible.
  • Try to open and gently rinse out the mouth, and find where the tooth came from.
  • Carefully place the tooth back in its socket, making sure it is facing the right way, and hold it in place with a soft cloth.
  • If the tooth can’t be re-implanted, place it in a bag with a special preservative solution, milk or saliva, or have the person hold it between the cheek and gum—but make sure it isn’t swallowed!
  • Rush to the nearest dental office or urgent care facility.

When these steps are followed and the person receives professional treatment as quickly as possible (ideally within minutes), their tooth will have the best chance of being saved. But even if it isn’t possible to preserve the tooth, receiving prompt and appropriate care can make replacing the tooth much easier.

Having Dr. Hallgrímsson on the sidelines was a lucky break for the injured soccer player—and as a coach, just getting to the World Cup is a remarkable achievement. But you don’t need to be a coach (or a dentist) to give first aid in a dental emergency. Taking the right steps can help ensure the best possible outcome… and might even save a tooth!

If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “Knocked Out Tooth” and “The Field-Side Guide to Dental Injuries.”

By Ellie Dikegoros DMD Family Dental
March 17, 2019
Category: Dental Procedures
DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

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.”