When choosing among different ways to solve a problem, knowledge is power. In the case of selecting the best repair for a dental problem, count on your team of dental professionals to advise you. But you as the patient make the final decision, and it helps to thoroughly understand the different options, their advantages and disadvantages. If you have a chipped or broken front tooth, your likely repair options are composite resin or porcelain veneer.

Composite resins are synthetic materials that can be colored to match your natural teeth. The material is bonded to the tooth surface using adhesives that become part of the tooth structure, strengthening the original tooth. The repair looks as good as, or even better than, your original tooth. Such repairs can be used to restore small to large chips and other damage caused by decay or trauma.

Since the composite resin repair is applied directly to the tooth in the dental office, the repair can be made in a single appointment. You do not need to use a temporary repair while waiting for the final replacement to be made at a dental laboratory. This also means that the repair will cost less.

Another advantage of composite resin is that less of the healthy tooth needs to be removed to prepare the tooth to receive the replacement, since it bonds directly to the original tooth structure.

Porcelain veneers are very thin layers of tooth-colored porcelain that are also bonded to the tooth. They are usually recommended in situations with more serious injury or risk to the tooth, such as teeth that have been fractured, treated for root canal, or injured in contact sports.

Application of porcelain veneers may require more tooth preparation (in which more of the original tooth material must be removed) before the restoration can be bonded in position. Bonded porcelain veneers are likely to be longer-lasting than composite resins. They must be fabricated in a laboratory, so they require more than one visit and cost more.

All of the above are factors to consider in choosing composite resin or porcelain veneer to restore your chipped or damaged tooth. As usual in making such decisions, the final choice will depend on your individual situation.

Contact us today to schedule an appointment to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth with Composite Resin.”

How much do you know about dental implants? Test yourself with this quiz.

1. Earliest recorded attempts at using dental implants were from
1. Medieval England
2. The ancient Mayans
3. U.S.A. in the 1950s
2. Dental implants are called endosseous. What does this mean?
1. They fuse with the bone
2. They are inside the mouth
3. They are not real teeth
3. What are most dental implants made of?
1. Aluminum
2. Titanium
3. Steel
4. What part of the tooth does an implant replace?
1. The implant is the root replacement
2. The implant is the root plus the crown
3. The implant is the crown
5. What is the success rate of dental implants?
1. 50 percent or less
2. 75 percent
3. 95 percent or more
6. What could cause an implant to fail?
1. Smoking or drug use
2. Poor bone quality and quantity at the implant site
3. Both of the above
7. What is a tooth's emergence profile?
1. The implant and crown's shape as it emerges from beneath the gum line
2. A measure of the urgency of the tooth replacement
3. A measure of the time it takes for you to be able to chew on the new implant
8. What are some of the factors that go into the aesthetics of designing the crown?
1. Choice of materials
2. Color matching
3. Both of the above

1. b. The concept of dental implants goes back to the Mayan civilization in 600 AD.
2. a. The word endosseous (from endo meaning within and osseo meaning bone) refers to the implant's ability to fuse with or integrate with the bone in which it is placed.
3. b. Most implants are made of a titanium alloy, a metallic substance that is not rejected by the body and is able to fuse with the bone.
4. a. The term “implant” refers to the root replacement, which is anchored in the gum and bone. A crown is put around the implant where it emerges from the gumline.
5. c. The majority of studies have shown long term success rates of over 95 percent.
6. c. Factors that could cause an implant to fail include general health concerns such as smoking and drug use, osteoporosis, or a compromised immune system; poor bone quality or quantity; and poor maintenance such as lack of proper brushing and flossing.
7. a. The emergence profile has a lot to do with the implant's natural appearance. It involves the way the crown, which attaches to the implant, seemingly emerges through the gum tissue like a natural tooth.
8. c. Choices such as materials, color, and position can be worked out in the design of a customized temporary crown, which acts as a template or blueprint for a final crown.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”

When speaking about veneers in dentistry, many people wonder what they are really made from and how they produce such natural results. The answer is dental porcelain...and yes, it really is a type of porcelain or glass. Even though they are made of porcelain, not all porcelains are the same. This is one reason there can be such a wide price range when comparing porcelain veneer pricing from one dentist to another. For example, the quality of the dental porcelain used and the expertise of the dental lab artisans greatly impact the price of a veneer — just like other pieces of fine art, pricing depends upon the materials used and the artistry of the person creating them.

Dental porcelains are used to create veneers because of their near ideal optical properties in mimicking natural teeth in shine, opacity, and translucence. And when you combine these facts with the artistry of the lab technician and your dentist skill's in placing the veneers, you begin to understand how veneers are virtually undetectable in cosmetically-enhanced teeth. Another reason for using dental porcelain is that they can be made in many colors, shades and translucencies to enhance the optical properties and natural beauty of whiter, brighter, and visually appealing teeth. However, do not let the word porcelain, fool you when it comes to durability. While veneers are not as strong as natural teeth they are not so fragile that you should worry about breaking or damaging them with normal wear and tear. However, you should avoid biting into extremely hard substances; using your veneers as a tool in lieu of scissors, tweezers, or pliers (you should not use your natural teeth as a tool either!); and twisting your veneers when biting into harder substances.

To learn more about veneers, continue reading, “Smile Design Enhanced With Porcelain Veneers.” Or, contact us today to discuss your questions or to schedule a consultation.

Because our main goal is to help you maintain optimal oral health, we use the latest proven technologies, techniques, and treatments to ensure we achieve them. One tool, radiographs or x-ray pictures, has been around for a long time with an inordinate amount of scientific research backing up both its safety and value. Here's a brief summary of why.

X-rays are a form of electromagnetic radiation just like natural daylight, except that they can easily penetrate soft bodily tissues, such as skin and muscles, without causing any harm if used properly. And as you may have guessed, we use them to examine what we can't see with the naked eye. For example, they enable us to see inside tooth structure, bones, and joints of the jaws. This ability makes x-rays a critical tool that we rely upon to monitor your oral health.

How often you need x-rays really depends upon your individual health needs and often is different from family member to family member given their age and oral health. During adolescence, we may need to take x-rays more often, so we can closely monitor the development of the teeth and jaw to check for normal growth and abnormalities, which can be corrected with early diagnosis. We may also need to use x-rays to diagnose trauma if you or any family member has experienced injury or disease. This will enable us to ensure the correct treatment is given and, in fact, is working and that there are no other related concerns.

Today's ultra-sensitive technology uses extremely low dosage x-rays and ensures early diagnosis and monitoring of your oral and dental health in safety and with confidence.

Learn more about the safety of x-rays by reading the Dear Doctor magazine article “X-ray Frequency And Safety.” If you need to schedule an appointment, contact us today.

If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.

Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.

Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.

Advantages of prepless veneers include:

• Tooth preparation or reduction is not needed, leaving the original tooth whole.
• They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
• They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
• They can be used to “lengthen” teeth that have been worn down by grinding.
• Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.

Disadvantages include:

• There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
• Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
• Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
• They do not usually work for lower teeth because of space restrictions.
• They cannot replace lost or damaged enamel.

Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.

Contact us today to schedule an appointment to discuss your questions about prepless veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”