Posts for: July, 2012

By Wayne J. Gary II D.D.S.
July 25, 2012
Category: Oral Health
Tags: CAT scans  
UnderstandingtheNewStandardinDentistryCATScans

CAT scans or Computer Assisted Tomograph scans have been around for years. However, it is quickly becoming the new standard in dentistry. The reasons are clear both literally and figuratively, as they provide our office with millions of pictures so that we can combine them together to create 3-dimensional (3-D) images. Prior to this technology, we could only image the body in 2-dimensions with x-rays (radiographs) — a technology first developed by Roentgen.

One of the best features of CAT scans and CBCT (Cone Beam Computed Tomography) scanning is that they enable us to see and experience the body from the inside. Having this ability changes (and many times) improves upon the way we diagnose. Here's how they work in very simplistic terms. Picture your favorite multi-layered cake with each layer representing an image. A three-layer cake requires just three images. For us to build a 3-D image similar to the cake, we require millions of very thin layers (images) that we put together, one on top of another, until our results, one 3-D image. And by having so many thin layers, we are best able to diagnose. For example, in our cake analogy, it is easier to determine if the cake contains finely chopped nuts, berries or other ingredients when you cut numerous very thin slices of cake to examine versus having one large chunk of cake.

It is important to note that in our office we may not recommend using this technology in all cases, as it may not be necessary for your particular diagnosis and/or treatment. While the technology can prove invaluable, it is quite expensive and a simple 2-D x-ray may provide everything we need. However, some dental specialty areas where CAT scans are currently used include:

  • Orthodontists and pediatric dentists
  • Cosmetic dentists and tooth replacement specialists (prosthodontists)
  • Oral surgeons
  • Root canal specialists (endodontists)
  • Gum specialist (periodontists)

To learn more about CAT scans and how they are used in the various specialty areas, read the Dear Doctor magazine article “CAT Scans in Dentistry.” Or you can contact us today to schedule an appointment to discuss your specific questions.


By Wayne J. Gary II D.D.S.
July 17, 2012
Category: Dental Procedures
CanYouWhitenTraumatizedTeeth

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

  1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
  2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
  3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
  4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
  5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.


UnderstandingTheTypesOfDentalImplantsAndRestorations

Thanks to technological advances, today there are more than 40 types of traditional or standard implants. A traditional dental implant actually replaces the root of a tooth, upon which a crown is built — the part you see in the mouth. There are 2 others types that are quite similar to standard implants. Mini implants are most like traditional implants except they are smaller in diameter. Micro-mini implants are an even smaller variation with an even narrower, more screw-like appearance. Micro-mini implants are also designed to be used on a temporary basis, thus can easily be removed. Together all of these types of implants provide us with a wide variety of options for permanently replacing missing teeth.

The following list details the types of implant restorations:

  • Single tooth replacements: As the name suggests, these implants are used to replace single teeth.
  • Multiple tooth replacements: Implants can be used to replace multiple teeth in a variety of ways. This includes acting as bridge supports to permanently replace missing teeth.
  • Combinations of fixed and removable bridgework: Dental implants can be used to support permanently fixed in teeth, bridgework or removable bridges or dentures. Their biggest advantage over dentures alone is that they stabilize the dentures and preserve the jawbone to which they attach, thus preventing the jawbone from melting away under the pressure of dentures.
  • Over-dentures: These restorations are now considered the new gold standard. In this application two or more standard implants (or multiple mini-implants) are used to attach and stabilize full dentures. Over-dentures are especially useful for tooth replacement in the lower jaw, where denture stability is often problematic.
  • Temporary Anchorage Devices (TADS): These special implants are a tool that orthodontists can use to obtain a stable, non-movable anchor for moving teeth more quickly and easily. They are small, easy to place and easy to remove once their job is done.
  • Temporary bridgework: In this case, mini-implants are used to support temporary bridgework. They are placed between permanent implants and later removed when the permanent implants have healed and teeth are permanently placed on them. Mini-implants ensure that a person is never without teeth during the process of teeth replacement.

To learn more on this topic, read the Dear Doctor article, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.


By Wayne J. Gary II D.D.S.
July 01, 2012
Category: Oral Health
Tags: dental implants   tooth loss  
NotJustFillingintheGapsLostTeethHaveUnexpectedConsequences

Why is it important to replace missing teeth with restorations such as dental implants? You might be surprised to find that the damage caused by missing teeth is much greater than the simple gaps left in your smile.

As the years go by, teeth lost early in adulthood cause structural changes in a person's face. By age 45 changes in facial structure are already visible in the form of sunken cheeks. By 60, cheeks and lips lose their support, resulting in an aging look. This process continues and if the teeth are not replaced, much of the structural support of the person's face is lost.

These changes are caused by loss of bone. Although it may seem static, bone is actually living tissue that needs constant stimulation to maintain its form and density. With normal stimulation it is in a constant state of resorption (breaking down) and deposition (building up). Teeth provide the needed stimulation for the bone that surrounds them (called alveolar bone) as they meet each other during biting, chewing, and speech. When the stimulation continues, the bone continues to rebuild itself. Without this stimulation, the bone resorbs, does not build up again, and loses substance.

Without stimulation, alveolar bone loses width, height, and volume. Since your teeth and their surrounding bone support your chin, cheeks, and lips, this has a powerful effect on your appearance. It may also affect your ability to chew and to speak.

As alveolar bone diminishes, the next layer of bone also begins to resorb. This is the bone of the jaw itself. The lower part of the face begins to collapse, and the cheeks become hollow. This effect is especially noticeable for people with no teeth (edentulous).

Usually the first tooth to be lost, due to infection and decay, is a molar (back tooth). In the past, a missing single back tooth was frequently replaced by a fixed partial denture (FPD). A crown is provided for each of the two teeth on the sides of the gap, called abutment teeth, to support a false tooth in the middle. However, if they are not well cared for, the abutment teeth may be the next to succumb to decay.

Today the treatment of choice is an implant. A dental implant is a tooth-root replacement made of titanium, which fuses with the bone — making it very stable. Above the gums it is covered by a crown that looks like a natural tooth. The benefit of the implant is that it continues to provide stimulation to the alveolar bone, preventing bone loss.

Implants are also a good choice in the case of multiple missing teeth. They can be used to support bridges or false teeth (dentures). The results are an improved, younger appearance and better functionality.

Contact us today to schedule an appointment to discuss your questions about missing teeth. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”


















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