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By Gregory S. Herzler, DDS
May 22, 2019
Category: Uncategorized
Tags: dental implant   bridge  
YourTeenagernotReadyforanImplantHeresWhatWeCanDoInstead

Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.

For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.

But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.

While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.

During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.

Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.

It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.

If you would like more information on dental restorations for teenagers, 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 for Teenagers.”

By Gregory S. Herzler, DDS
November 23, 2018
Category: Uncategorized
Tags: gum recession  
GumRecessionCouldShortentheLifeofYourTeeth

Your teeth are meant to last a lifetime. Even with wear and tear from years of eating and biting they can continue to function properly and look attractive well into your senior years.

Teeth are resilient thanks in part to enamel, the hardest substance in the human body. But the gums also contribute to this resilience: besides attractively framing the teeth, they protect the dentin and roots below the enamel covering.

Unfortunately, the gums can shrink back or “recede” from their normal place. Not only does this look unattractive, the recession can also expose teeth to disease and cause tooth sensitivity to temperature changes or biting pressure.

There are a number of causes for gum recession, some of which you may have little control over. If, for example, your teeth come in off center from their bony housing, the gum tissues may not develop around them properly. You might also have inherited a thinner type of gum tissue from your parents: thinner tissues are more delicate and susceptible to recession.

But there are other causes for which you have more control. Over-aggressive brushing (too hard for too long), ironically, does more harm than good as it can injure your gums and cause them to recede. More likely, though, your recession is a direct result of neglecting proper hygiene for your teeth and gums.

When teeth aren't properly cleaned through daily brushing and flossing, a thin film of bacteria and food remnant called plaque builds up on tooth surfaces. This can trigger periodontal (gum) disease, which subsequently causes the gum tissues to detach from the teeth and often recede.

To reduce your risk of gum disease, you should gently but thoroughly brush and floss daily, and visit us for cleanings and checkups at least twice a year. If you have a poor bite (malocclusion), consider orthodontic treatment: malocclusions make it easier for plaque to accumulate and harder to remove.

Above all, if you begin to see signs of gum problems — swelling, bleeding or pain — see us promptly for an examination and treatment. Dealing with these issues early is the best way to ensure your gums continue to do their jobs for the long-term.

If you would like more information on the treatment and prevention of gum disease, please contact us or schedule an appointment for a consultation.

By Gregory S. Herzler, DDS
August 06, 2015
Category: Uncategorized
Tags: dental implants   crowns  
CementedorScrewedWhichImplantCrownAttachmentisBestforYou

In the realm of restorative dentistry, dental implants are king. A dental implant can replace a tooth with a permanent, life-like restoration with a solid reputation for durability.

Implants are also known for one other quality — variety. Not all implants are alike, and they have varied applications for use. Available in various shapes and sizes, they can be used for a single tooth or as part of a multiple tooth bridge or overdenture. And while their basic architecture is the same, you also have two options for how the permanent crown (the visible tooth portion) attaches to the implant: screwed or cemented.

A screw attachment can securely fasten a crown to an implant without the need for cement; it also allows for easy removal for repair or replacement should the crown become damaged or worn. On the other hand, it could pose a cosmetic problem — even though the access hole for the screw may be covered with a tooth-colored filling, it could still be distinguishable from the rest of the crown. There’s also a slight risk of the crown chipping around the access hole.

A crown cemented to the implant won’t have this cosmetic issue with an access hole, and will look just like a natural tooth. But unlike a screwed crown, removing a cemented crown can be more difficult. The cement may also cause gum inflammation and potential bone loss in sensitive patients.

The condition of your mouth, the type of implant you’re receiving and other circumstances will all factor into determining which method is best for you. If we’re “immediately loading” the crown (meaning we’re affixing a temporary crown to the implant immediately after placement in the jaw), then the screw method may be more advantageous. Aesthetically speaking, though, a cemented crown may be a better option in terms of final smile appearance.

But whichever method is used, you’ll still benefit from what implants do best — help you regain the function lost from a missing tooth and change your smile for the better.

If you would like more information on your options with dental implants, 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 “How Crowns Attach to Implants.”

TelevisionHostNancyODellProvidesAdviceforNewMothers

When her daughter Ashby was born in 2007, Nancy O'Dell was overjoyed; but she found the experience of pregnancy to be anxiety-provoking. O'Dell is host of the popular entertainment news show Entertainment Tonight.

After her baby was born she compiled her memories and thoughts into a book for first-time pregnant mothers. The book, “Full of Life: Mom to Mom Tips I Wish Someone Had Told Me When I Was Pregnant,” covers a wide range of topics — including oral health during pregnancy.

“While my dental health has always been relatively normal, pregnancy did cause me some concern about my teeth and gums. With my dentist's advice and treatment, the few problems I had were minimized,” O'Dell told Dear Doctor magazine. An example of her experience is a craving for milk that started at about the time the baby's teeth began to form. She felt that her body was telling her to consume more calcium.

As often happens with pregnant mothers, she developed sensitive gums and was diagnosed with “pregnancy gingivitis,” the result of hormonal changes that increase blood flow to the gums.

“I love to smile,” said O'Dell, “and smiles are so important to set people at ease, like when you walk into a room of people you don't know. When you genuinely smile you're able to dissolve that natural wall that exists between strangers.”

Contact us today to schedule an appointment to discuss your questions about dental health during pregnancy. You can also learn more by reading the Dear Doctor magazine article “Nancy O'Dell.”

ToothFairyBradyReiterWorksHerMagicforChildrensOralHealthCharity

Did you know that severe tooth decay is America's #1 chronic childhood disease? Actress Brady Reiter didn't know either — until she became the star of the movie Tooth Fairy 2, and then joined forces with the National Children's Oral Health Foundation: America's ToothFairy®.

“Before, I didn't even realize what can happen to kids if they don't take care of their teeth,” 11-year-old Brady recently told Dear Doctor magazine, after viewing photos of children suffering from severe tooth decay. “There are kids in America who don't know that it's important, or they just don't have the resources to be able to take care of their teeth or to go to the dentist.”

This young Tooth Fairy knows just how magical — and vital to a child's self-esteem — a beautiful smile can be.

“When you feel bad about opening up your mouth and smiling, a kid's confidence just goes down the drain,” she said.

NCOHF recently tapped 11-year-old Brady to head the America's ToothFairy Kids Club, which offers kids personalized letters from the Tooth Fairy along with lots of encouraging oral health tips and fun activities — free!

“I'm really excited to be part of it,” Brady told Dear Doctor. “Kids learn how to take care of their of smile by joining this club. By supporting America's ToothFairy, we can help kids in need get dental care and have a healthy smile too. It's really amazing!”

While lots of kids get an occasional cavity, millions of children have tooth decay so severe that it interferes with their ability to eat, sleep, and concentrate in school. The good news is that tooth decay, a bacteria-induced infection, is preventable.

“When kids join the club, they learn how to prevent tooth decay. When families support this great cause, we can help kids in need. And that's what feels great — that we really can make kids' futures better.”

If you would like to enroll your child in the club — it's free! — please visit www.AmericasToothFairyKids.org. And to make sure your child's teeth and your own are decay-free and as healthy as possible, please contact us today to schedule your next appointment.