Posts for category: Dental Procedures

KeepYourNewStraightenedSmileStraightWithanOrthodonticRetainer

You can't correct a poor bite with braces or clear aligners overnight: Even the most cut-and-dried case can still require a few years to move teeth where they should be. It's a welcome relief, then, when you're finally done with braces or aligner trays.

That doesn't mean, however, that you're finished with orthodontic treatment. You now move into the next phase—protecting your new smile that took so much to gain. At least for a couple of more years you'll need to regularly wear an orthodontic retainer.

The name of this custom-made device explains its purpose: to keep or “retain” your teeth in their new, modified positions. This is necessary because the same mechanism that allows us to move teeth in the first place can work in reverse.

That mechanism centers around a tough but elastic tissue called the periodontal ligament. Although it primarily holds teeth in place, the ligament also allows for tiny, gradual tooth movement in response to mouth changes. Braces or aligner trays take advantage of this ability by exerting pressure on the teeth in the direction of intended movement. The periodontal ligament and nature do the rest.

But once we relieve the pressure when we remove the braces or aligners, a kind of “muscle memory” in the ligament can come into play, causing the teeth to move back to where they originally were. If we don't inhibit this reaction, all the time and effort put into orthodontic treatment can be lost.

Retainers, either the removable type or one fixed in place behind the teeth, gently “push” or “pull” against the teeth (depending on which type) just enough to halt any reversing movement. Initially, a patient will need to wear their retainer around the clock. After a while, wear time can be reduced to just a few hours a day, usually during sleep-time.

Most younger patients will only need to wear a retainer for a few years. Adults who undergo teeth-straightening later in life, however, may need to wear a retainer indefinitely. Even so, a few hours of wear every day is a small price to pay to protect your beautiful straightened smile.

If you would like more information on orthodontic retainers, 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 Importance of Orthodontic Retainers.”

By Cohrs Family Dentistry
October 09, 2020
Category: Dental Procedures
Tags: wisdom teeth  
WisdomTeethBearCloseMonitoringforFutureDentalHealth

One of the major signs that a young person's dental development is nearing completion is the eruption of the last four permanent teeth: the third molars, located rear-most on either side of both the upper and lower jaws. But the advent of these molars, also called wisdom teeth, isn't always a cause for celebration: They can give rise to serious dental problems.

Wisdom teeth often arrive on an already crowded jaw, making them subject to erupting out of position or becoming impacted, totally or partially submerged in the gums. This can cause harm not only to themselves, but also to other teeth: They can impinge on and damage the roots of their neighbors; impede brushing and flossing and increase the risk of disease; and skew the alignment of other teeth to create poor bites that affect dental health and function.

Wisdom teeth are considered so prone to these problems (an estimated 70% between ages 20 and 30 have at least one impacted molar) that it's been a common practice to remove them before they show signs of disease or poor bite development. As a result, third molar extractions are the most common surgical procedure performed by oral surgeons.

But the dental profession is now reevaluating this practice of early removal. On the whole, it's difficult to predict if the eruption of wisdom teeth in a particular person will actually lead to problems. It may be premature, then, to remove wisdom teeth before there's sufficient evidence of its necessity.

As a result, many dentists now follow a more nuanced approach to wisdom teeth management. An impacted wisdom tooth that's diseased or contributing to disease is an obvious candidate for removal. But if the eruption is proceeding without signs of impaction, disease or poor bite development, many providers recommend not removing them early. Instead, their development is allowed to continue, although monitored closely.

If signs of problems do begin to emerge, then removal may again be an option. Until then, a more long-term watchful approach toward wisdom teeth may be the best strategy for helping a young person achieve optimal dental health.

If you would like more information on managing wisdom teeth 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 “Wisdom Teeth: Coming of Age May Come With a Dilemma.”

By Cohrs Family Dentistry
September 19, 2020
Category: Dental Procedures
ZacEfronsSmileTransformationCouldHappentoYou

Actor Zac Efron has one of the top smiles in a business known for beautiful smiles. Bursting on the scene in 2006 at age 18 in High School Musical, Efron has steadily increased his range of acting roles. He recently starred as Ted Bundy on Netflix, wearing prosthetics to match the notorious serial killer's crooked teeth.

With his growing fame, Efron's attractive smile has become one of his more memorable attributes. But it wasn't always so. Before Hollywood, Efron's smile was less than perfect with small, uneven teeth and a gap between his top front teeth. Before and after pictures, though, make it quite apparent that the actor has undergone a significant smile makeover.

While fans are abuzz on the 411 regarding his dental work, Efron himself has been hush-hush about his smile transformation. We won't join the speculation: Instead, here are a few possible ways you can get a more attractive smile like Zac Efron.

Teeth whitening. A single-visit, non-invasive teeth whitening procedure can transform your dull, stained teeth into a brighter, more attractive smile. Although the effect isn't permanent, it could last a few years with a professional whitening and good oral practices. Having it done professionally also gives you more control over the level of shading you prefer—from soft natural white to dazzling Hollywood bright.

Orthodontics. Like Efron, if your teeth aren't quite in proper alignment, straightening them can make a big difference in your appearance (and your oral health as well). Braces are the tried and true method for moving teeth, but you may also be able to choose clear aligner trays, which are much less noticeable than braces. And don't worry about your age: Anyone with reasonably good dental health can undergo orthodontics.

Bonding. We may be able to correct chips and other slight tooth flaws with durable composite resins. After preparing your tooth and matching the material to your particular color, we apply it directly to your tooth in successive layers. After hardening, the unsightly defect is no more—and your smile is more attractive.

Veneers. Dental veneers are the next step up for more advanced defects. We bond these thin, custom-made layers of dental porcelain to the front of teeth to mask chips, heavy staining and slight tooth gaps. Although we often need to permanently remove a small amount of tooth enamel, veneers are still less invasive than some other restorations. And your before and after could be just as amazing as Zac Efron's.

Improving one's smile isn't reserved for stars like Zac Efron. There are ways to correct just about any dental defect, many of which don't require an A-lister's bank account. With a little dental “magic,” you could transform your smile.

If you would like more information about how to give your smile a boost, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “The Magic of Orthodontics” and “Porcelain Veneers.”

TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

2KindsofOrthodonticRetainersThatCanProtectYourNewSmile

While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.

Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.

But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.

The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.

While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.

An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.

A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.

If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.

If you would like more information on bonded retainers, 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 “Bonded Retainers.”