My Blog

Posts for category: Dental Procedures

By Dr. Edward Portnoy and Dr. Grace D'oria
November 24, 2019
Category: Dental Procedures
Tags: dental implant  
GettingaNewToothinOneDayWillDependonYourBoneHealth

If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.

The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.

Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.

The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.

If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.

The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.

Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.

If you would like more information on restoring missing teeth 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 “Implant Timelines for Replacing Missing Teeth.”

By Dr. Edward Portnoy and Dr. Grace D'oria
November 04, 2019
Category: Dental Procedures
MileyCyrussLittleSecretStraighteningHerSmileWithLingualBraces

Miley Cyrus's rise to fame began when she was cast in the Disney series Hannah Montana. She played the title character, Hannah Montana, a famous singing star hiding her true identity, ordinary girl, Miley Stewart. In her real life at the time, Miley Cyrus had her own little secret—she was undergoing orthodontic treatment to straighten her smile.

Like many teenagers (as well as many adults), Cyrus's dental bite wasn't in proper alignment. She could have gone the traditional way by straightening her smile with braces fixed to the front of her teeth. It's an effective treatment, but the metallic hardware can overwhelm a person's appearance.

With her various roles in the public spotlight, Cyrus and her family wanted an effective but out-of-sight method for moving her teeth. They chose a relatively new one called lingual braces. Unlike traditional braces, the hardware for lingual braces is fixed on the back of the teeth (or the tongue side, hence the term “lingual”).

Lingual braces can correct any bite problem labial (“lip”) braces can, just through different mechanics of movement. Its main appeal is that the hardware is hidden behind the teeth, so only you and your orthodontist need know you're wearing braces.

There is also less risk of damage to the mouth or the braces themselves if you're in a sport or profession where you're at high risk for facial blows. And unlike patients with traditional braces, you'll have an unobstructed view of your progress over the course of treatment.

Lingual braces do tend to cost more than traditional braces. Some patients also have difficulty at first with speaking and tongue comfort, though most grow accustomed to the braces within a couple of weeks. Because lingual braces are relatively new, there's been a limited number of orthodontists offering it.

But lingual braces are just one of the ways to straighten teeth. Modern dentistry offers several ways to give you your dream smile. If you have dental problems or would like to improve the look of your smile, please contact us or schedule a consultation, and we can discuss your options. To learn more, read the Dear Doctor magazine articles “Lingual Braces” and “The Magic of Orthodontics.”

By Dr. Edward Portnoy and Dr. Grace D'oria
October 15, 2019
Category: Dental Procedures
3ReasonsWhyCorrectingaPoorBiteIsWorthwhileatAnyAge

October is National Orthodontic Health Month, and the more than 18,000 members of the American Association of Orthodontists want you to know the importance of a good bite. Correcting a bite problem can do wonders for your health and well-being—and the added benefit of a more attractive smile can do wonders for your self-image and relationships.

Perhaps, though, you’re well past your teenage years and think you might be too old to consider having your teeth straightened. Not at all: Even if you’re a senior adult, you can still undergo bite correction as long as your overall periodontal health is sound.

But then why go through the effort and expense of orthodontic treatment? Here are 3 top reasons why correcting a poor bite is worth it at any age.

Improve digestion. As we chew during eating, our teeth turn food into digestible bits that our body can easily process for nutrients. Misaligned teeth, though, aren’t as efficient at this first step in the digestion process, causing less efficiency at retrieving nutrients along the way. Correcting your bite could therefore improve your digestion and your health.

Prevent dental disease. While you need to brush and floss every day to prevent tooth decay or gum disease, it’s a lot easier if your teeth are properly aligned. Crooked teeth are more prone to collect and harbor disease-causing plaque that can “hide” from brushing and flossing. Correcting your bite can make it easier to remove plaque, thereby decreasing your risk of a tooth-destroying infection and gum disease that can contribute to chronic inflammation in the body.

Renew your confidence. While the previous two therapeutic reasons are primary for orthodontic treatment, don’t discount the power of an improved smile. Gaining a more attractive smile can boost your confidence in social and business situations—which could change your life. Consider it the added “cherry on top” that accompanies better health and wellness when you correct your bite.

If you’re interested in a healthier life and a more attractive smile, see us for a complete orthodontic evaluation. Even if you’re an older adult, you may still be a good candidate for bite correction. And you might not even need to wear braces: depending on your condition, we may be able to correct your bite with clear aligners that are nearly invisible to others while you’re wearing them.

There are good reasons for improving your bite. The sooner you do, the greater the benefits to your health and confidence.

If you would like more information about orthodontic treatment, please contact us to schedule a consultation. To learn more, read the Dear Doctor magazine articles “Moving Teeth With Orthodontics” and “Orthodontics for the Older Adult.”

By Dr. Edward Portnoy and Dr. Grace D'oria
October 05, 2019
Category: Dental Procedures
TheBeforeDuringandAfterofRootCanalTreatments

Root canal treatments have suffered a bad rap over the years—and undeservedly. While we applaud root canal therapy for the millions of decayed teeth the procedure has saved, the worn-out cliché that it's painful still lingers on.

So, let's set the record straight: a root canal treatment doesn't cause pain, it most often relieves it. Let's look a little closer at what actually happens before, during and after this tooth-saving treatment.

Before: a tooth in crisis. Tooth decay can damage more than a tooth's outer enamel. This aggressive bacterial infection can work its way into a tooth's interior, destroying the nerves and blood vessels in the pulp, before moving on to the roots and supporting bone through the root canals. Untreated, this devastating process can lead to tooth loss. A root canal treatment, however, can stop the invading decay and save the tooth.

During: stopping the disease. The dentist first numbs the tooth and surrounding gum tissues with local anesthetic—the only thing you might normally feel during treatment is a slight pressure. They then drill into the tooth to access the inner pulp and root canals and remove all diseased tissue. Once the interior spaces of the tooth have been disinfected, the dentist then fills the empty pulp chamber and root canals with a pliable filling called gutta percha to prevent future infection.

After: preventing re-infection. With the filling complete, the dentist then seals the access hole. There may be some minor soreness for a few days, similar to the aftermath of a routine filling, which can usually be managed with over-the-counter pain relievers like ibuprofen. Sometime later, the dentist will normally finish the treatment with a new crown on the tooth. This accomplishes two things: It helps strengthen the tooth against stress fracturing and it provides another layer of protection against future decay.

Root canal treatments have an exceptional track record for giving diseased teeth a second chance. There's nothing to fear—and everything to gain for your troubled tooth.

If you would like more information on root canal 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 “Root Canal Treatment: What You Need to Know.”

By Dr. Edward Portnoy and Dr. Grace D'oria
September 25, 2019
Category: Dental Procedures
AToothlessTiger

Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?

Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?

Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.

Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.

But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?

In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.

Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.

What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.

If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”