Posts for: March, 2017
Orthodontics relies on certain mechanics in the mouth to move teeth to better positions. As the specialty has advanced, we've become ever more precise in moving teeth with braces, the “workhorse” of orthodontics, and other specialized appliances and techniques.
But although cooperating effectively with the mouth's natural ability for tooth movement is crucial for success, there's another aspect to consider if that success will be long-term: the growth and development of oral and facial structure. And not just development during childhood and adolescence: indeed, facial structure continues to change throughout a lifetime, including the senior years. Research has shown that although the rate of growth slows over time, it doesn't stop even for someone 80 years or older.
Our emerging understanding in this area has had an important impact on how and when we perform orthodontic treatment. As we develop a treatment strategy for an individual patient we consider not only the immediate outcome of a treatment, but also how it may change their facial appearance in the future. By taking continuing facial growth into consideration, we're more likely to achieve a new smile appearance that remains attractive later in life.
A key factor is to be sure we're initiating treatments at appropriate ages. We may detect developing bite problems as early as age 6, which might prompt preventive treatment at that time to diminish or even eliminate the problem. But it may also be prudent to wait on full-scale orthodontic treatment until late childhood or puberty. Furthermore, some form of orthodontic treatment might need to continue into early adulthood to ensure the most optimal outcome.
By taking a longer view of the treatment process, we're better able to work within the natural growth and development taking place now and in the future. As a result, a person is more likely to enjoy an attractive and youthful appearance even in their later years.
If you would like more information on aging factors for cosmetic enhancement, 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 “Understanding Aging Makes Beauty Timeless.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”