Posts for category: Dental Procedures

By Gray Yallaly & Black D.D.S.
December 17, 2020
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?

By Gray Yallaly & Black D.D.S.
November 17, 2020
Category: Dental Procedures
Tags: dental implant  
AToothinaDayImplantCouldGiveYouaPerfectSmileFromDayOne

Getting a new implant tooth in only one day sounds too good to be true. But it's true—up to a point. Whether or not you can undergo an immediate crown replacement (attaching a crown to an implant right after surgery) will depend mostly on the underlying bone.

Traditionally, an implant crown isn't attached until several weeks after surgery to allow bone cells to grow and adhere to an implant's titanium surface (osseointegration). The gums are sutured back in place to protect the metal implant until it develops a durable hold within the bone. But this also leaves you with a noticeable missing tooth gap during the integration period.

A “tooth in a day” procedure gives you a full smile right after implant surgery. There is one catch, though—this first crown will be temporary and it won't be able to receive biting pressure.

Until the bone and implant fully integrate, attaching a full-sized permanent crown can damage the implant. To avoid this, the initial crown is slightly shorter than the future permanent crown. This prevents it from contacting solidly with teeth on the other jaw while biting or chewing, which can generate enough force to potentially damage the implant.

If you undergo an immediate-load crown on your implant, you'll have to return later for the full-length permanent crown. In the meantime, though, you'll avoid the embarrassment of a missing tooth in your smile.

With that said, the target bone must be healthy and intact for you to undergo a “tooth in a day” procedure. That isn't always the case with missing teeth—over time, bone volume can gradually diminish. The subsequent loss can complicate implant placement, which must be exact to achieve the most natural outcome. If extensive bone loss exists, you may need grafting to build up enough bone to adequately support an implant.

Even if an implant can be placed, the bone may still be too weak to allow for immediate crown placement. In that case, the traditional procedure may be the best course to allow the bone and implant to fully bond.

To determine if you're a candidate for a “tooth in a day” implant procedure, you'll first need to have a thorough dental exam that includes an assessment of bone health. If it's sound, you may be able to have a full smile right after implant surgery.

If you would like more information on dental implant restorations, 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 “Same-Day Tooth Replacement With Dental Implants.”

By Gray Yallaly & Black D.D.S.
October 18, 2020
Category: Dental Procedures
Tags: dental implant  
CouldaMetalAllergyStopYouFromGettingDentalImplants

The subject of allergies covers a wide swath in medicine. Among other things, people have allergic reactions to animal fur, various foods and plant pollen. The effects are equally wide-ranging, anything from a mild rash to anaphylaxis, a life-threatening shutdown of the body's vital systems.

Approximately 5% of people are also allergic to various metals including nickel, cobalt, chromium and gold. Reactions to metal can occur when an allergic person comes in contact with items like jewelry, clothing or even mobile phones. There's even a chance of a metal allergy reaction from certain kinds of dental work.

It's unlikely, though, that you should be concerned if you're considering dental treatment or cosmetic work to upgrade your smile. Although allergic reactions like inflammation or a rash have been known to occur with amalgam “silver” fillings, it's quite rare. It's even less of a concern since “tooth-colored” materials for fillings are now outpacing the use of amalgam fillings, which are used in out-of-sight back teeth.

Of course, metal is used for other dental treatments besides fillings, including the most popular of tooth replacement systems, dental implants. An implant is essentially a metal post, usually made of pure titanium or a titanium alloy, which is imbedded into the jawbone. Even so, there's little chance you'll develop an allergic reaction to them.

For one thing, titanium is highly prized in both medical and dental treatments because of its biocompatibility. This means titanium devices like prosthetic joints and implants won't normally disrupt or cause reactions with human tissue. Titanium is also osteophilic: Bone cells readily grow and adhere to titanium surfaces, a major reason for dental implants' long-term durability.

That's not to say titanium allergies don't exist, but their occurrence is very low. One recent study detected a titanium allergy in only 0.6% of 1,500 implant patients who participated.

At worst, you may need to consider a different type of tooth replacement restoration in the rare chance you have a titanium allergy. More than likely, though, you'll be able obtain implants and enjoy the transformation they can bring to your smile.

If you would like more information on allergic reactions and dental restorations, 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 “Metal Allergies to Dental Implants.”

By Gray Yallaly & Black D.D.S.
September 28, 2020
Category: Dental Procedures
WhyKathyBatesChoseThisAlternativetoBracesandsoMightYou

Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.

Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.

Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.

Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.

While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.

That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.

Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.

With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.

The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.

If you would like more information about tooth straightening, please contact us or schedule a consultation.

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?