Of all the of amazing procedures in today's dentistry, surgery that causes new bone to grow — in places where it had previously been lost — is high on the list of the most extraordinary. (When bone is lost or resorbed, it is broken down into its mineral components, which are dissolved into the bloodstream. Resorption of tooth-supporting bone often takes place after teeth are lost.) Dental techniques that cause new bone growth are important because a certain amount of bone is needed to replace lost teeth with dental implants.

Today's dental implants themselves are an amazing innovation. Implants consist of a replacement for the tooth's root, usually made of a metal called titanium. A replacement for the crown, the part of the tooth that is visible above the gums, is attached to the titanium root. Titanium has the remarkable quality of being able to fuse with the bone in which it is anchored. This process, first discovered in the 1950s, is called osseointegration.

In the case of missing upper back teeth, many people who wanted dental implants in the past were told that they did not have enough bone to anchor the implants and that they had to get removable dentures instead.

But now a new surgery called maxillary sinus augmentation can cause your body to regenerate bone where it was lost and is needed to anchor dental implants.

Bone in the upper jaw or maxilla usually supports your upper back teeth. Inside the maxilla, on either side of your upper jaw, are air spaces in the bone, which are lined with a membrane. These spaces, called the maxillary sinuses, are generally shaped like pyramids; but their shape and size is different in each person. The new surgical procedures involve lifting up the sinus membrane in the area where bone is needed and filling the space thus created with a bone grafting material. Your body then creates new bone to fill the space. This usually takes about six months. If you have almost enough bone to stabilize the implants, they can be placed simultaneously with the graft, thus saving time and avoiding a second surgical procedure.

All grafting materials used today are approved by the Food and Drug Administration (FDA) and must be prepared according to their guidelines. They are specially treated to render them completely safe for human use.

After the surgery there is usually no more than mild to moderate swelling and some discomfort, about the same as having a tooth removed.

If you are missing upper back teeth, contact us to schedule an appointment to evaluate your upper jaw. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery.”

If you are dissatisfied with the way your smile looks, and your dentist is unhappy with the way your teeth fit together — but you don't like the idea of wearing braces — clear aligners may be your best solution. How much do you know about this teeth-straightening alternative? Below are some FAQs on the subject.

What do we mean by clear aligners? Clear aligners are a system for straightening teeth that uses clear plastic removable “trays” that fit over your teeth. As the teeth move to fit the trays, new trays are substituted that are designed to continue to move your teeth into the desired position. This system is an alternative to the traditional system of brackets and wires known as braces.

How can teeth be moved to new positions? The connection that holds a tooth in place in your jaws — the periodontal ligament — is not immobile. It constantly changes its position based on the normal forces of your bite. As the ligament is pushed on one side and pulled on the other, the living cells of your mouth respond by depositing bone and cementum (the protective covering of the tooth's root) on one side and dissolving it on the other. Normally this happens in a balance, maintaining your teeth in their position. We can manage these slight changes by applying constant light forces to move teeth in a predictable way.

How long does it take to move teeth to their optimum position using clear aligners? As with braces, the process is gradual. Total treatment time can range from six months to two years.

Do the trays have to be worn all the time? As you move through the sequence of trays, each is worn for 20 hours per day for two weeks. They may occasionally be removed for important social occasions.

How does an orthodontist design the sequential trays that are used? The trays are designed using a computer, based on an assessment and images of your mouth, teeth and jaws.

What kinds of problems can clear aligners correct? This method works well to correct mild to moderate crowding or spacing. If your back teeth already fit together as they should, the system may be ideal. If you have an extreme overbite or underbite, braces might work better.

Are clear aligners an alternative for everyone? Clear aligners are recommended for adults and recently, teenagers. They are not usually recommended for young children.

Why is it important to have your teeth straightened? Besides the obvious benefit of feeling better about yourself and your appearance, straight and well-aligned teeth work better. You will experience a better-functioning bite and can improve your oral health.

Contact us today to schedule an appointment to discuss your questions about orthodontics and clear aligners. You can also learn more by reading the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Moving Teeth With Orthodontics.”

If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.

When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.

If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.

If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.

When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.

Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.

Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”

The term “root canal” strikes fear into many dental patients. But rest assured that this procedure is the best solution to many severe dental problems. It can be pain-free and will actually relieve pain and suffering from infections and dental injuries.

Why would you need root canal treatment? This procedure becomes necessary when the pulp, the nerve tissue on the inside of a tooth's root, becomes inflamed or infected because of deep decay, or when it has suffered a severe injury as a result of an accident or blow to the mouth. The pulp is composed of living tissues including nerves and blood vessels.

Root canal treatment may be necessary if you have a wide variety of signs or symptoms. The pain can feel sharp or intense when biting down, or linger after eating hot or cold foods. Sometimes it can be a dull ache or there may be tenderness and swelling in your gums near the site of the infection.

After trauma, the pulp of a tooth can be exposed or damaged because a tooth has fractured or cracked, necessitating root canal treatment. And the procedure is often needed for permanent teeth that have been dislodged or knocked out.

What exactly is root canal treatment? Root canal treatment is also called endodontic treatment, from the Greek roots “endo” meaning “inside” and “odont” meaning “tooth.” During the procedure, the area is numbed to relieve pain. A small opening is created in the chewing surface of the tooth and very small instruments are used to remove dead and dying tissue from the inside. The pulp is needed during a tooth's growth and development, but a mature tooth can survive without it. The canal is disinfected and then sealed with filling materials. Sometimes root canal specialists use microscopes to work at an intricate level of detail on these tiny areas of the tooth's root.

By having root canal treatment, you prevent inflammation and infection from spreading from the root of a particular tooth to other nearby tissues. Infection can result in resorption, an eating away of the root and its anchoring bone, and you could lose your tooth or teeth. So please don't hesitate when we recommend this treatment. It's not as bad as you think, and you will feel significantly better afterwards.

Contact us today to schedule an appointment to discuss your questions about root canal treatment. You can also learn more by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Trauma & Nerve Damage to Teeth.”

In a recent online poll conducted by Dear Doctor, the premier oral healthcare resource for consumers, 77% of those polled planned on visiting their dentist prior to their wedding. For some, this includes a thorough cleaning to remove stains and freshen both their smile and breath. However, a growing number of brides, grooms, and parents of the couple are seeking cosmetic dentistry or more specifically, a smile makeover, to transform their smile for their special day as well as their future.

If this describes your situation, take the first step towards the smile you have always wanted. To create your ideal smile, we will first meet with you to get to know you better and hear your concerns, goals, expectations and wedding day timeline. Bringing in photos or magazine images of smiles that you consider beautiful will help to ensure that we understand what you find attractive, as beauty can vary greatly from individual to individual. During this initial consultation, you will also learn about your smile makeover treatment options and what you could expect immediately prior, during and following each option.

Some subtle improvements we may consider are teeth whitening and bonding. Both of these options can take place in just a few office visits and produce very attractive results. Porcelain veneers and crowns can provide you with longer-term results that can last from 10 to 20 years. However, because they typically require 1 to 4 months advance notice, it is important to see us as soon as possible to ensure you have enough time before your special day. Another procedure that can play a dramatic role in your smile makeover is periodontal plastic surgery to improve and alter your gum tissues and their relationship to your teeth. For example, the appearance of “short” teeth can be corrected by lengthening them during a surgical procedure that has minor discomfort yet results in a life-long change.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”