My Blog

Posts for category: Dental Procedures

By Gregory S. Herzler, DDS
January 22, 2020
Category: Dental Procedures
Tags: extractions  
SimpleToothExtractionsareaCommonDentalProcedure

When a tooth is beyond repair due to disease or injury, it may be necessary to remove it. A “simple” tooth extraction is among the most common in dentistry and certainly not the agonizing procedure depicted in common lore.

They’re referred to as simple extractions because the shape of the tooth and root allows for a fairly straightforward and uncomplicated removal. An example would be the normally cone-shaped upper front tooth that doesn’t offer a lot of resistance during the extraction process.

The process itself is fairly straightforward. Teeth are held in place by the periodontal ligament, an elastic tissue made of tiny fibers that attaches the tooth to the supporting bone. These fibers can be dislodged from the tooth with some careful manipulation — in the hands of an experienced dentist there’s a deft “feel” to the fibers loosening. Once they’ve detached, it requires little effort to remove the tooth; with the aid of local anesthesia, you won’t feel anything but a little pressure.

Immediately after the tooth is removed, we commonly insert bone grafting material in the socket to minimize bone loss until a permanent replacement like a dental implant can be installed after tissue healing. We then place sterile gauze over the site for a few minutes to control bleeding and, depending on the size of the wound opening, we may also place a few stitches to close it. We then give you instructions for caring and cleaning the site over the next few days, and prescribe antibiotics to reduce the chance of infection and anti-inflammatory drugs for any discomfort.

Although a simple extraction is a routine procedure, it’s important to perform a proper assessment of the tooth and the surrounding bone beforehand, including x-rays to determine the tooth’s exact shape and position. If we discover a complication that makes a simple extraction impractical (like multiple roots at acute angles), we may then refer you to an oral surgeon for a more complicated surgical extraction.

It’s our hope you’ll have your natural teeth for as long as you live. But if you must have one removed, you can rest assured it’s a common — and uneventful — experience.

If you would like more information on tooth extraction, 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 “Simple Tooth Extraction.”

NewBehindtheTeethBracesCouldGiveYoutheAdvantageofInvisibility

Orthodontic braces are a familiar sight, especially among tweens and teens: metal brackets and wires attached to the front of the teeth for all to see. Now imagine the opposite: much the same hardware, but now positioned out of sight on the back of the teeth.

It's not your imagination: It's the latest development in orthodontic technology called lingual braces. Developed simultaneously by two orthodontists in Japan and Beverly Hills, these appliances are placed on the tongue or “lingual” side of the teeth rather than the traditional labial or “lip-side.”

Generally, lingual braces can correct any bite problem labial braces can. The difference lies in how each method does its job: Traditional braces exert pressure or “push” against the teeth, while lingual braces “pull” the teeth into better alignment.

So, why choose lingual over labial? For one, they're “invisible” to others: all the hardware is on the backside of the teeth, out of sight. They're also not as readily exposed to blunt force facial trauma, which can damage traditional braces (a driving impetus for the Japanese doctor to develop them for his martial arts patients, and his American counterpart for a law enforcement patient working in a rough area).

Patients may also prefer lingual braces over removable clear aligners, another popular tooth-movement option. Fixed lingual braces achieve the same quality of “invisibility” as removable aligners, but without the inconvenience of removing them as patients must with aligners for eating, snacking or cleaning.

They can, however, be costly, running 15-35% more than labial braces. Patients may also have difficulty adjusting to them because they can affect speech and tongue comfort. However, any discomfort and initial regret with choosing lingual braces tends to fade as most patients grow more accustomed to them after a week or so.

There's one other “perk” to lingual braces—unlike patients with traditional braces who have to wait for their removal to see the finished bite correction, patients with lingual braces get an unobstructed view of their progress all during wear. That can definitely boost morale during the long treatment period!

Lingual braces haven't been around long, so not every orthodontist offers them. But the list is growing, and there soon may be a provider near you for this new teeth-straightening alternative.

If you would like more information on lingual braces, 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 “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

By Gregory S. Herzler, DDS
December 28, 2019
Category: Dental Procedures
YouMayNeedOrthodonticsBeforeReplacingaMissingTooth

Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.

A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.

When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.

The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).

Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.

If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.

Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.

If you would like more information on dental solutions for improving your smile, please contact us or schedule an appointment for a consultation.

ItTakesArtistryandSkilltoAchievetheRightColorBalanceforYourVeneers

Getting a new smile doesn’t have to be an elaborate affair. If your teeth have minor to moderate chips, stains or tooth gaps, dental veneers could be the answer. These thin wafers of dental porcelain mask tooth imperfections and completely change your smile’s dynamic—and without a huge impact to your wallet.

To achieve that effect, though, your personal set of veneers will require the expertise of both your dentist and a dental lab technician to design and create your veneers. And while there are numerous considerations in achieving a truly life-like appearance with veneers, one of the most important is their color.

We always associate the color white with teeth. And while it is the dominant hue, actual tooth color is more complex. An individual tooth is comprised of multiple shades and tints, that range in variation from its biting edge to the gums. Likewise, tooth color in general can differ from person to person.

Your dentist must take these individual color variations into account while designing your new veneers, especially if you’ll be getting them for some but not for all your teeth. In that case, it’s important for the veneer color to blend seamlessly with the color of your natural teeth without veneers.

Your new smile expectations and desires are also important and should be considered when designing veneer coloring. For instance, do you want a more natural look—or would you prefer a smile with more “dazzle”? This could have an impact on color.

Your dentist takes all of this information (including your input) and communicates it clearly to the dental lab technician creating the veneers. That process is a combination of both science and artistry, using a variety of techniques to achieve an accurate, life-like texture and color result. For example, a technician may paint the edges of the veneers with a ceramic paste that when cured produces a life-like translucency.

This meticulous attention to color detail is necessary to create beautiful veneers that look natural. If the color is right, you’re sure to enjoy the change your veneers bring to your smile for many years to come.

If you would like more information on transforming your smile with dental veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”

By Gregory S. Herzler, DDS
December 13, 2019
Category: Dental Procedures
Tags: oral health   braces  
ChronicMouthBreathingCouldCreateConditionsforaPoorBite

Breathing: You hardly notice it unless you're consciously focused on it—or something's stopping it!

So, take a few seconds and pay attention to your breathing. Then ask yourself this question—are you breathing through your nose, or through your mouth? Unless we're exerting ourselves or have a nasal obstruction, we normally breathe through the nose. This is as nature intended it: The nasal passages act as a filter to remove allergens and other fine particles.

Some people, though, tend to breathe primarily through their mouths even when they're at rest or asleep. And for children, not only do they lose out on the filtering benefit of breathing through the nose, mouth breathing could affect their dental development.

People tend to breathe through their mouths if it's become uncomfortable to breathe through their noses, often because of swollen tonsils or adenoids pressing against the nasal cavity or chronic sinus congestion. Children born with a small band of tissue called a tongue or lip tie can also have difficulty closing the lips or keeping the tongue on the roof of the mouth, both of which encourage mouth breathing.

Chronic mouth breathing can also disrupt children's jaw development. The tongue normally rests against the roof of the mouth while breathing through the nose, which allows it to serve as a mold for the growing upper jaw and teeth to form around. Because the tongue can't be in this position during mouth breathing, it can disrupt normal jaw development and lead to a poor bite.

If you suspect your child chronically breathes through his or her mouth, your dentist may refer you to an ear, nose and throat (ENT) specialist to check for obstructions. In some cases, surgical procedures to remove the tonsils or adenoids may be necessary.

If there already appears to be problems brewing with the bite, your child may need orthodontic treatment. One example would be a palatal expander, a device that fits below the palate to put pressure on the upper jaw to grow outwardly if it appears to be developing too narrowly.

The main focus, though, is to treat or remove whatever may be causing this tendency to breathe through the mouth. Doing so will help improve a child's ongoing dental development.

If you would like more information on treating chronic mouth breathing, 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 Trouble With Mouth Breathing.”