By James Tilger, DDS
February 12, 2022
Category: Dental Procedures
Tags: celebrity smiles   crowns  
HowCelineDionOvercameHerSmileObstacle

For over three decades, Celine Dion has amazed audiences and fans with her powerful singing voice. Best known for her recording of "My Heart Will Go On," the theme song for the movie Titanic, Dion has amassed global record sales topping 200 million. In her early singing days, though, she struggled with one particular career obstacle: an unattractive smile.

The Canadian-born performer had a number of dental defects including crooked and discolored teeth, and—most prominent of all—abnormally large cuspid or "canine" teeth (located on either side of the four front incisors). They were so noticeable that one Quebec celebrity magazine gave her the unflattering nickname "Canine Dion."

This isn't an unusual problem. Since human canines are already the longest teeth in the mouth, it doesn't take much for them to stand out. Our ancient hunter-gatherer ancestors needed these large, pointed teeth to survive. But with the evolution of agriculture and industry, canine teeth have become gradually smaller—so much so that when they're abnormally large, they don't look right in a smile.

So, what can be done if your canines embarrassingly stand out from the rest? Here are some of the options to consider.

Reduce their size. If your canines are just a tad too long, it may be possible to remove some of the enamel layer in a procedure called contouring. Using this technique, we can reduce a tooth's overall size, which we then re-shape by bonding composite resin to the tooth. It's only a good option, though, if your canines have an ample and healthy layer of enamel.

Repair other teeth. The problem of prominent canine teeth may actually be caused by neighboring teeth. When the teeth next to the canines are crooked, the canines can appear more prominent. Alternatively, other teeth around the canines may be abnormally small. Braces or clear aligners can correct crooked incisors, and applying porcelain veneers to smaller teeth could help normalize their length.

Apply dental crowns. In some instances, we can reduce the canines in size and then bond porcelain crowns to them. This is the option that Dion ultimately chose. The natural teeth are still intact, but the crowning process transforms them into properly proportioned, life-like teeth. There is, however, one caveat: The alteration to these teeth will be permanent, so they will need a crown from then on.

Besides crowning her canine teeth, Dion also underwent other dental work to straighten and whiten her other teeth. As a result, this superstar performer now has a superstar smile to match and so can you if your teeth are less than perfect. These or other cosmetic enhancements can give you the look you truly desire. All it takes is an initial visit with us to start you on the road to a transformed smile.

If you would like more information about various cosmetic solutions for your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”

DentistsSometimesUseAdditionalWeaponsintheFightAgainstGumDisease

The term periodontal disease refers to bacterial infections that target the gums. These infections typically start as inflammatory responses to dental plaque, a bacterial biofilm collecting on tooth surfaces, especially around the gum line.

Early on, we can often stop the infection and minimize damage by removing accumulations of dental plaque and tartar (hardened plaque), which tend to fuel the disease. This process, known as debridement, effectively "starves" the infection and allows the gums and other infected tissues to heal.

But if gum disease is anything, it's stubborn: An infection can continue to advance rapidly. As it does, it weakens gum attachment and causes bone loss, both of which could eventually cause tooth loss.

When it reaches this state, advanced gum disease can turn into a long-term siege of keeping the infection at bay and trying to limit bone loss. To stay ahead of it, we may turn to additional treatments besides debridement, especially for difficult-to-treat areas around the roots.

Mouthrinses. Dentists often prescribe antimicrobial agents to patients with advanced gum disease to help further control bacterial plaque buildup. The most common of these is chlorhexidine, typically in a 0.12% solution mouthrinse. Chlorhexidine is quite effective in controlling bacteria, but prolonged use can lead to tooth staining.

Topical antibiotics. Dentists may also apply antibiotic treatments, usually tetracycline, directly to affected areas. Topical applications like these are often more effective in penetrating hard-to-reach areas than manual cleaning tools. Dentists must be selective, though, in using this tool, because long-term application could disrupt "good" oral bacteria along with the bad.

Other medications. In addition to antibiotics, dentists may also use other drug treatments like chlorhexidine chips or doxycycline gel that continues to deliver effects over a long period. These "sustained release" medications continue to suppress bacteria, and are often used in conjunction with mechanical cleaning to reduce inflammation.

These additional tools can improve the overall treatment outcomes for advanced gum disease. But they must be used prudently and only in those cases where the benefits of better gum health outweigh the risks.

If you would like more information on preventing and treating gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”

By James Tilger, DDS
February 02, 2022
Category: Dental Procedures
Tags: loose tooth  
CallYourDentistASAPifYouHaveaLooseTooth

If you notice a loose tooth, don't wait! Call your dentist ASAP. That loose tooth may be in danger of being lost or damaged permanently—and you won't know if that's true without having the tooth examined.

To understand why, let's first consider how your teeth are normally held in place—and contrary to popular belief, it's not primarily through the bone. The actual mechanism is a form of gum tissue called the periodontal ligament attaching the tooth to the bone. This ligament secures teeth in place through tiny collagen fibers that attach to both the tooth and bone.

The periodontal ligament can effectively secure a tooth while still allowing for some movement. However, these ligaments can come under attack from periodontal (gum) disease, a bacterial infection primarily caused by dental plaque. Without aggressive treatment, the infection can destroy these tissues, causing them to eventually detach from the teeth.

This can result in loose teeth, which is, in fact, a late sign of advanced gum disease. As such, it's a definite alarm bell that you're in imminent danger of losing the teeth in question.

Treating a gum infection with accompanying loose teeth often has two components. First, we want to stop the infection and begin the healing process by removing any and all plaque and tartar (hardened plaque) on tooth surfaces. This includes deposits below the gum line or around the roots of the tooth, which may require surgery to access them.

Second, we want to help stabilize any loose teeth while we're treating the infection, which can take time.  We do this by using various methods from doing a bite adjustment of individual teeth tat are getting hit harder when you put your teeth together to splinting loose teeth to healthier neighboring teeth. We may also employ splinting when the tooth is loose for other reasons like trauma. This provides a loose tooth with needed stability while the gums and bone continue to heal and reattach.

Securing a loose tooth and treating the underlying cause isn't something you should put off. The sooner we address it, the more likely you won't lose your tooth.

If you would like more information on permanent teeth that become loose, 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 “When Permanent Teeth Become Loose.”

By James Tilger, DDS
January 28, 2022
Category: Dental Procedures
Tags: wisdom teeth  
DecidingtheFateofWisdomTeethMoreNuancedThaninthePast

If you're of a certain age, there's a good chance you've had your third molars—wisdom teeth—removed. At one time, extracting these particular teeth was a common practice, even if they hadn't shown any signs or symptoms of disease or dysfunction. But now, if you have a son or daughter coming of age, your dentist may recommend leaving theirs right where they are.

So, what's changed?

Wisdom teeth have longed been viewed as problematic. As the last of the permanent teeth, they often erupt on a jaw already crowded with other teeth. This can cause them to come in out of position—or not at all, remaining partially or totally submerged (impacted) beneath the gums.

Misaligned teeth are more difficult to keep clean of bacterial plaque, which in turn raises the risk of tooth decay or gum disease. Impacted teeth can put pressure on the roots of neighboring teeth, which further increases the risk for disease or bite problems.

To avoid these common problems associated with wisdom teeth, dentists often remove them as a preemptive measure. Given their size and possible root complexity, this is no small matter: Removing them usually requires oral surgery, making wisdom teeth extraction one of the top oral surgical procedures performed each year.

Today, however, many dentists are taking a more nuanced approach to wisdom teeth. While they still recommend removal for those displaying signs of disease or other problems, they may advise leaving them in place if the teeth are healthy, not interfering with their neighbors, and not affecting bite development.

That's not necessarily a final decision, especially with younger patients. The dentist will continue to monitor the wisdom teeth for any emerging disease or problems, and may put extraction back on the table if the situation merits it.

The key is to consider each patient and their dental needs regarding wisdom teeth on an individual basis. If warranted, removing the wisdom teeth may still be warranted if will help prevent disease, keep bite development on track and optimize oral health overall.

If you would like more information on wisdom teeth, 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.”

MikeTysonThePrizefighterPrizesHisUniqueSmile

Mike Tyson made a splash when he faced off against sharks during the Discovery Channel's Shark Week 2020. But there's bigger news for fans of the former undisputed world heavyweight champion: After a 15-year absence, he will enter the ring again for two exhibition matches in the Fall. However, it's not just Tyson's boxing action that made news during his 20-year career. His teeth have also gotten their fair share of press.

Tyson used to be known for two distinctive gold-capped teeth in the front left side of his mouth. He made headlines when he lost one of the shiny caps—not from a blow by a fellow pugilist but from being headbutted by his pet tiger as Tyson leaned in for a kiss. Tyson's teeth again garnered attention when he had his recognizable gold caps replaced with tooth-colored restorations. But the world champion may be best known, dentally at least, for his trademark tooth gap, or “diastema” in dentist-speak. Several years ago, he had the gap closed in a dental makeover, but he soon regretted the move. After all, the gap was a signature look for him, so he had it put back in.

That's one thing about cosmetic dentistry: With today's advanced technology and techniques, you can choose a dental makeover to suit your individual taste and personality.

An obvious example is teeth whitening. This common cosmetic treatment is not a one-size-fits-all option. You can choose whether you want eye-catching Hollywood white or a more natural shade.

If your teeth have chips or other small imperfections, bonding may be the solution for you. In dental bonding, tooth-colored material is placed on your tooth in layers and then hardened with a special light. The material is matched to your other teeth so the repaired tooth fits right in. This procedure can usually be done in just one office visit.

For moderate flaws or severe discoloration, porcelain veneers can dramatically improve your appearance. These thin, tooth-colored shells cover the front surface of the tooth—the side that shows when you smile. Veneers are custom-crafted for the ideal individualized look.

Dental crowns can restore single teeth or replace missing teeth as part of a dental bridge. Again, they are manufactured to your specifications. With restorations like crowns and veneers, the smallest detail can be replicated to fit in with your natural teeth—even down to the ridges on the tooth's surface.

And if, like Mike Tyson, you have a gap between your teeth that makes your smile unique, there's no reason to give that up if you opt for a smile makeover. Whether you would like a small cosmetic enhancement or are looking for a more dramatic transformation, we can work with you to devise a treatment plan that is right for you.

If you would like more information about smile-enhancing dental treatments, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Cosmetic Dentistry: A Time for Change.”





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