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Posts for category: Dental Procedures

KeepYourNewStraightenedSmileStraightWithanOrthodonticRetainer

You can't correct a poor bite with braces or clear aligners overnight: Even the most cut-and-dried case can still require a few years to move teeth where they should be. It's a welcome relief, then, when you're finally done with braces or aligner trays.

That doesn't mean, however, that you're finished with orthodontic treatment. You now move into the next phase—protecting your new smile that took so much to gain. At least for a couple of more years you'll need to regularly wear an orthodontic retainer.

The name of this custom-made device explains its purpose: to keep or “retain” your teeth in their new, modified positions. This is necessary because the same mechanism that allows us to move teeth in the first place can work in reverse.

That mechanism centers around a tough but elastic tissue called the periodontal ligament. Although it primarily holds teeth in place, the ligament also allows for tiny, gradual tooth movement in response to mouth changes. Braces or aligner trays take advantage of this ability by exerting pressure on the teeth in the direction of intended movement. The periodontal ligament and nature do the rest.

But once we relieve the pressure when we remove the braces or aligners, a kind of “muscle memory” in the ligament can come into play, causing the teeth to move back to where they originally were. If we don't inhibit this reaction, all the time and effort put into orthodontic treatment can be lost.

Retainers, either the removable type or one fixed in place behind the teeth, gently “push” or “pull” against the teeth (depending on which type) just enough to halt any reversing movement. Initially, a patient will need to wear their retainer around the clock. After a while, wear time can be reduced to just a few hours a day, usually during sleep-time.

Most younger patients will only need to wear a retainer for a few years. Adults who undergo teeth-straightening later in life, however, may need to wear a retainer indefinitely. Even so, a few hours of wear every day is a small price to pay to protect your beautiful straightened smile.

If you would like more information on orthodontic retainers, 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 “The Importance of Orthodontic Retainers.”

By Gregory S. Herzler, DDS
October 23, 2020
Category: Dental Procedures
Tags: wisdom teeth  
WisdomTeethBearCloseMonitoringforFutureDentalHealth

One of the major signs that a young person's dental development is nearing completion is the eruption of the last four permanent teeth: the third molars, located rear-most on either side of both the upper and lower jaws. But the advent of these molars, also called wisdom teeth, isn't always a cause for celebration: They can give rise to serious dental problems.

Wisdom teeth often arrive on an already crowded jaw, making them subject to erupting out of position or becoming impacted, totally or partially submerged in the gums. This can cause harm not only to themselves, but also to other teeth: They can impinge on and damage the roots of their neighbors; impede brushing and flossing and increase the risk of disease; and skew the alignment of other teeth to create poor bites that affect dental health and function.

Wisdom teeth are considered so prone to these problems (an estimated 70% between ages 20 and 30 have at least one impacted molar) that it's been a common practice to remove them before they show signs of disease or poor bite development. As a result, third molar extractions are the most common surgical procedure performed by oral surgeons.

But the dental profession is now reevaluating this practice of early removal. On the whole, it's difficult to predict if the eruption of wisdom teeth in a particular person will actually lead to problems. It may be premature, then, to remove wisdom teeth before there's sufficient evidence of its necessity.

As a result, many dentists now follow a more nuanced approach to wisdom teeth management. An impacted wisdom tooth that's diseased or contributing to disease is an obvious candidate for removal. But if the eruption is proceeding without signs of impaction, disease or poor bite development, many providers recommend not removing them early. Instead, their development is allowed to continue, although monitored closely.

If signs of problems do begin to emerge, then removal may again be an option. Until then, a more long-term watchful approach toward wisdom teeth may be the best strategy for helping a young person achieve optimal dental health.

If you would like more information on managing wisdom teeth treatment, 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 “Wisdom Teeth: Coming of Age May Come With a Dilemma.”

By Gregory S. Herzler, DDS
October 18, 2020
Category: Dental Procedures
DIYOrthodonticsisaRecipeforDentalDisaster

Do-It-Yourself (DIY) is a deeply held American trait for building, renovating or repairing things without the services of a professional. The Internet has only made this tradition easier: There are scores of videos showing people how to do things on their own like build a deck, fix a dryer or bake an award-winning soufflé.

But some things are best left to the experts, which if you tried to do using too little knowledge or a lot less training could turn out disastrous. A prime example is becoming your own orthodontist and using dubious home methods to straighten your teeth. If that sounds preposterous, the American Association of Orthodontists recently reported it does happen, with one in ten of their members saying they have treated patients who attempted their own smile-straightening projects.

Often found on social media, these methods usually involve household items like rubber bands or dental floss to straighten teeth. Like other forms of DIY, the object is to save money. In the end, though, these self-orthodontic methods could result in dental damage that could cost much more to repair (if indeed it's repairable) than what might have been spent with professional orthodontics in the first place.

Utilizing extensive training, experience and artistry, orthodontists work with the mouth's natural ability to move teeth in a precise manner for a planned outcome. They carefully consider each individual patient's jaw and facial structures, along with the severity and complexity of their bite problem, as they design and implement a treatment plan involving braces, clear aligners or other orthodontic appliances.

A rigged homemade device to move teeth can't adequately take these factors into account. As a result, you may be risking permanent gum and bone damage—and you may even lose teeth in the process. Even if repairable, such damage could require oral surgery, cosmetic dentistry or more extensive orthodontic procedures.

In the end, you're highly unlikely to be successful at DIY orthodontics—and you won't save any money. A healthy and beautiful smile is well worth the cost of professional, high-quality orthodontics.

If you would like more information on orthodontic options, please contact us or schedule an appointment for a consultation.

By Gregory S. Herzler, DDS
September 28, 2020
Category: Dental Procedures
Tags: dental implant  
ReplaceYourTeethinStagesWiththeHelpofDentalImplants

Complete tooth loss is a common condition among older adults, gradually occurring one or two teeth at a time. There often comes a point of realization, though, that all the teeth will eventually be lost.

This can create a dilemma: Do you replace teeth as they're lost, or go ahead and have all of them removed at one time?

Up until recently, the latter choice seemed the most practical and affordable. But most dentists would agree that keeping natural teeth for as long as practical is better for a person's overall oral health and to slow any potential bone loss.

The emergence of dental implants has made this less of a dilemma: We can use this technology to more affordably replace teeth in stages rather than all at once. This is because an implant is technically a root replacement: a dentist inserts a titanium metal post into the jawbone. Because of an affinity with titanium, bone cells grow and adhere to the implant surface, which creates a stronger hold. It also impedes bone loss.

We can, of course, use implants as individual tooth replacements. But the expense of this approach with multiple teeth puts it well out of reach financially for many people. But implants can also be used as connective points between the patient's jaw and other kinds of dental restorations like bridges, partial dentures, and full removable or fixed dentures.

Using this approach, we can adopt a strategy of allowing healthier teeth to remain until it's necessary to remove them. We initially place implants to support a bridge, for example; later we can use the same implants along with additional ones to support a larger restoration, even a fixed full denture.

An implant-supported restoration is typically more expensive than traditional bridges or dentures, but far less than replacing teeth with individual implants. And because the stages of restorations may occur over a long period of time, the cost can be spread out to make it more manageable.

If you're facing a future where it's likely you'll lose all your teeth, you don't have to lose them all at once. Staged restorations with implants could help you hold on to your natural teeth for as long as possible, slow bone loss and make for a healthier mouth.

If you would like more information on the wide array of dental restoration options, 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 “Replacing All Teeth But Not All at Once.”

SomeSimpleCosmeticTechniquesCouldHelpYourSmileAgeGracefully

We all want to look young and vibrant, or at least “age gracefully.” If you're seeking to reduce the visible effects of aging for a more youthful appearance, be sure you include one very important feature—your smile.

Like other aspects of body and health, our teeth and gums can be affected by aging. Even if you've managed for the most part to avoid the ravages of disease or injury, teeth will still naturally wear from a lifetime of biting and chewing food. The attractive shine of young teeth can also give way to yellowing and other discolorations later in life.

But there are ways to turn back the clock, so to speak, through cosmetic dentistry. And you won't necessarily break the bank to gain a more youthful smile: Many cosmetic procedures are quite affordable and minimally invasive.

If your teeth have become worn and edgy, for example, we may be able to soften those sharper edges with a dental drill. Known as enamel contouring (or reshaping), the single-visit procedure is relatively minor and inexpensive, usually without the need for anesthesia. For heavily worn teeth, you may need to step up to veneers, thin layers of tooth-colored porcelain, or crowns that cover the teeth and make them appear longer.

Mild enamel yellowing and staining often responds well to professional teeth whitening. Using a safe bleaching solution, we can temporarily restore brightness to your teeth that you may be able to maintain for a few years with proper care and occasional touchups. For a more permanent solution you can also turn to veneers, crowns or dental bonding for a brighter smile, especially for discolorations that don't respond well to teeth whitening.

While these techniques can restore a youthful appearance to your smile, don't discount the effect of daily care and regular dental visits. Brushing and flossing are fundamental to healthy teeth and gums—and health and beauty go hand in hand.

Age can take its toll on all of us, especially our smiles. But with proper care and perhaps a little cosmetic magic, you can have an attractive smile throughout your lifetime.

If you would like more information on improving your smile as you age, 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 Your Dentist Can Help You Look Younger.”