Posts for: August, 2016
Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.
To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.
Â While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.
The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter.Â It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.
Â Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.
Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.
If you would like more information on your treatment options for gum disease, 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
Does my tooth need to be refilled if a composite filling becomes discolored or stained?
The composite filling can become stained or become more yellow with time. When this happens, people often inquire about the need for their replacement; it is evident in discussion threads on online health forums and Q&A sites like this one here.
It is not always necessary to replace a discolored composite restoration. Usually, if I inspect a discolored or stained composite restoration, and it appears intact and well sealed, I will try to remove a tiny bit of the surface with a sandpaper disk or a fine diamond bur, to ascertain if the stain or yellow color is superficial. Often it is, and afterward, my patient no longer feels the need to replace their restoration.
Why does this surface staining or discoloration happen? Composite restorations are made partly of plastic resin and this resin can at least at the surface become porous and can either pick up stains or appear more yellow. Fortunately, this discoloration is often just on the surface and after removing a few microns of the composite, it appears "refreshed. Assuming that a tooth is still well filled, having its length of service extended is a good thing since more frequent refilling may make it more likely that the tooth will eventually require a crown or a root canal.
Patients can help themselves extend the life expectancy of their tooth-colored composite restorations by having excellent oral hygiene, since composite fillings that are kept clean tend to exhibit less staining and discoloration. Using your toothbrush and floss correctly will tend to keep these fillings looking good and maintain their proper color.
A stained restoration may need to be replaced due to decay. Still, if a restoration has stained and did not have decay, it may be polished or buffed with polishing discs to revitalize it. This will help the restoration to blend naturally with the tooth again and improve the overall aesthetics. Hence, it depends on from individual to individual as the shade of each restoration has to be tailored to suit the person's needs.
Another reason for replacing white fillings is after whitening. Here the teeth will brighten, but any composite will not change color. Therefore, they may need to be replaced to match in with the new shade.
White fillings can gather staining, particularly in the edges. This is usually treated by smoothing down the edges, but sometimes replacement is needed to get an acceptable result. Do note that white fillings may also change color over time. This is more likely with older materials. As things in the world, they undergo wear and tear.
Hope that provides you with some alternatives to consider when you notice your fillings become discolored over time.
As a member of the best-selling pop group Spice Girls, Mel C (AKA Sporty Spice) enjoyed her share of musical superstardom. At the band’s peak in the Nineties, the young singer’s signature look featured baggy sweatpants, an assortment of tattoos, a nose stud and a gold-capped incisor, front and center in her mouth. Today, Melanie Chisholm is still singing — but now she’s a mom, an amateur triathlete… and that gold tooth is just a memory. Not only that, her smile looks more evenly spaced and whiter than it did when she was referred to as the “tomboy” of the group.
What happened? In our view, it all boils down to changing tastes — plus a little bit of help from dental professionals. As the “wannabe” singer proves, there’s no single standard when it comes to making your teeth look their best. Your own look is unique to you — and your smile can reflect that individuality.
For example, crowns (caps) are substantial coverings that may be placed on teeth when they are being restored. They are available in three types: gold, all-porcelain, or porcelain-fused-to-metal. The latter two are tooth-colored, while the gold is — well, shiny like gold bling. Which one is right for you? In many cases, it’s your choice.
Likewise, dental veneers — wafer-thin shells that can correct cosmetic issues by covering the surface of your teeth — can be made in a variety of shades. Their hues may range from natural ivory to Hollywood white, and everything in between. What’s the best color for you? Only you can say.
Some people opt for a “smile makeover” that uses small irregularities in the spacing and color of teeth to create a more “natural” look. Other folks want a perfectly even, brilliant white smile that dazzles the eye. Still others are looking to match or restore the smile they once had — perhaps even re-creating a signature gap between the teeth. As long as there are no other dental issues involved, the choice is yours.
So if you’re unhappy with your smile — or if you feel it doesn’t reflect the person you “wannabe” — why not talk to us about a smile makeover? Just call our office to schedule a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”