COSMETIC TREATMENT OPTIONS FOR YOUR SMILE

1.  BONDING

                Bonding involves applying tooth colored filling materials to the tooth, and in some cases can be considered a reversible procedure.  It is used to mask deep stains in the tooth structure, close gaps between teeth, repair chips and/or  cracks in teeth, cover exposed root surfaces to help protect from cavities/sensitivity, or to fill in small cavities.   This procedure is usually completed in one appointment and usually does not require the use of local anesthetic.  Because tooth colored filling material is NOT as strong as tooth enamel, it is important to remember that it could be more prone to chipping and/or staining, resulting in the need for it to be replaced or repaired periodically. 

2.  RECONTOURING AND SHAPING

                Recontouring of the teeth involves polishing, filing and smoothing of the tooth enamel.  It can be used to smooth rough areas on a tooth, to change the contour on a tooth surface or to change the shape of a tooth.  This procedure is generally completed in one visit and does not require the use of local anesthetic.  Recontouring is very commonly used when a patient has worn small chips on the edges of his/her front teeth, in order to very easily remove these rough spots and give a more cosmetic smile.

3.  WHITENING

                Whitening, or teeth bleaching, is any procedure used to lighten, and brighten, the tooth structure along with helping to remove any surface staining.  It can be done in the dental office or with one of the many at home whitening products.  There are some stains that are inside the tooth structure (internal tooth stains) which will NOT be affected by these external whitening products.  Because of this, it is important to discuss with your dentist whether you are a good candidate for external tooth whitening.  Some patients may experience some tooth sensitivity while bleaching his/her teeth.  Usually this sensitivity is of a temporary nature and can be decreased by using sensitivity toothpaste both before and during the bleaching process.

4. GUM SURGERIES (Gingivoplasty)

                Gingivoplasty is a minor gum surgery which is done to reshape healthy gum tissue around the teeth.   A gingivoplasty can be used when the gum line on adjacent teeth is not even, as a means to make the gum line even and more cosmetic.  This procedure is usually done in one appointment that requires the use of local anesthetic, with a follow-up appointment about 7-10 days later to check on healing.  Minor discomfort is normal and expected for a few days after this procedure.  Some patients may benefit from a combination of gingivoplasty and gingival graft.  If you do not like how your gum tissue looks along the teeth, talk to your dentist to find out what your different treatment options are.

5.  ORTHODONTICS

                Orthodontic treatment is used to move the teeth into a more desirable position.  It can be used to align crooked teeth, to help close spaces between teeth, to correct bite discrepancies and to help reduce symptoms from TMD.  Orthodontic options range from comprehensive orthodontic treatment, which is used to get the patient to an ideal bite with their back teeth along with straight front teeth, to more short term orthodontic treatment with the primary goal of aligning the visible teeth without any predictable change in the patient’s bite.  The orthodontic treatment options available utilize metal braces, tooth colored/ceramic braces, clear plastic aligners or retainer type aligners or any combination of the above.  The treatment time, depending on each patient’s desired outcome, can range from a few months to a couple years.  If you are interested in your orthodontic options, it is important to talk with your dentist to find out the advantages and disadvantages of all orthodontic treatment options based on your individual chief complaint and oral situation.

6.  VENEERS

                Veneers are a thin coating made of porcelain or resin material that fits on your front teeth in order to change the appearance of your smile.  They are custom made, and because of this usually require two appointments to make.  They can be used to cover teeth that are discolored due to medication or age, repair front teeth that are worn or chipped, close existing spaces between teeth, or give a straight appearance to crooked teeth.  They are cemented to the front and sides of your teeth.  Because they are NOT as strong as tooth enamel, they may be more prone to staining or breakage than your natural tooth structure, so care must be used with your veneers.  It is important to talk to your dentist if you are interested in veneers, because not every patient is a great candidate for veneers.

7.  CROWNS

                Crowns (or caps) are made of porcelain, metal or some combination of the two, to create a custom fitted “cover” for your prepared tooth.  Crowns may be the best recommended treatment for a tooth with a larger cavity, a cracked or broken tooth, to replace an existing poor fitting crown, to cosmetically change the shape/appearance of a tooth, to make crooked teeth appear straight or to make a tooth/teeth taller in order to change a patient’s bite.  Making a crown usually requires two appointments and the use of local anesthetic.  Crowns on front teeth can usually be made of all porcelain to ensure a superior shade match to your natural teeth, while some crowns for back teeth will require a porcelain-metal crown or an all metal crown, due to the limited space and the increase in biting forces on these back teeth.

8.  IMPLANTS

                Dental implants are usually made of titanium and are used to replace a missing tooth or to create a support structure replacing multiple teeth.  They can be used to support crowns, bridges, partial dentures and dentures.  They require multiple visits with the dentist/oral surgeon in order to have the minor surgical procedure to place the implant, followed by regular visits to monitor healing.  Not everyone is a candidate for implants, so it is important to discuss the different treatment options you have for replacing teeth with your dentist.  Even though a dental implant cannot get a cavity, they do not have a 100% success rate, and maintaining regular dental checkups along with quality home care is of the utmost importance.

FLUORIDE

FLUORIDE FACTS

            -fluoride is a natural mineral

            -it hardens tooth enamel and protects teeth by neutralizing the acid that causes decay

            -most of us get fluoride from the tap water that we drink

            -almost all of us get fluoride from toothpaste and fluoride rinses

            -children and some adults receive fluoride treatments at the dental office

            -it is inexpensive, safe and effective

FLUORIDE BENEFITS

            -fluoridated water can reduce tooth decay by 50-60%

            -fluoride gels given at your dentist’s office twice a year can reduce tooth decay by 40%

            -regular use of fluoride toothpaste can reduce tooth decay up to 25%

            -it can help rebuild areas of tooth demineralization (softening)

            -it decreases the amount of plaque bacteria in your mouth

HOW IT WORKS

            -it hardens the enamel on teeth thus reducing the risk of decay

            -it can stop and reverse the progress of newly formed cavities

            -it can help to reduce root surface temperature sensitivity

            -fluoride in tap water is used by your body cells that build your teeth to make the enamel stronger

            -topical fluoride that is applied to the teeth, makes the crystals that form enamel more durable

            -topical fluoride makes the enamel crystals more resistant to acids in your diet

FLUORIDE AMOUNTS

            -fluoride intake should be strictly monitored in patients under the age of 6

                        -ingesting too much fluoride before the age of 6 can cause a condition of the permanent teeth called fluorosis which

                        appears as white or brown lines or spots on the permanent teeth

            -when mixing powder formula for your baby, use water that is fluoride free to help reduce any chance of fluorosis

            -until your child understands to spit out the toothpaste and not swallow it (usually around age 3), have him/her use

            fluoride-free toothpaste to help reduce any chance of fluorosis

             -be sure to watch and help your child with brushing his/her teeth to help ensure that toothpaste is not swallowed

             -when using fluoride toothpaste, whether you are a child or adult, it is only necessary to use no more than a pea-sized

             amount of toothpaste twice daily

            -in areas that do not have fluoride present in tap water, it may be necessary to use a fluoride supplement at home

             depending on your age and risk level for new cavities

                        -talk to your dentist for more information

To find out if you and your family are getting enough fluoride, talk with your dentist or hygienist.  There are some risks present such as fluorosis of the teeth or fluoride toxicity if guidelines are not followed and a patient ingests fluoride in very high amounts.  As long as the guidelines of fluoride intake and topical fluoride use are followed and administered or instructed by a dental professional, its use along with regular brushing, flossing and dental checkups and a diet low in sugars and acidic foods can result in strong, healthy teeth.

SIX MONTH SMILES

~WHAT IS IT:

            -it is an orthodontic service that over 3000 dentists across the U.S. are providing to their patients, and we are now making it available as a treatment option to our patients

            -it is a cosmetic, limited orthodontic treatment with the primarily goal of giving you, the patient, an attractive smile and straight teeth in approximately six months

(ASK YOURSELF, HOW WOULD YOU LIKE TO HAVE STRAIGHTER TEETH BY THE TIME OF YOUR NEXT CHECK-UP AND CLEANING?)

            -it can take as long as 8-9 months or as short as 4 months, but the average treatment time is 6 months

            -the orthodontic treatment is complete when you are happy with how your smile looks

            -by straightening your teeth, it can make it easier for you to clean your teeth, and easier for Dr Sara and Dr Greg to restore your teeth

            -it uses translucent braces and tooth colored wires so it is a very esthetic orthodontic treatment option

            -it is 3-4 times faster than comprehensive orthodontic treatment

            -it is cheaper than comprehensive orthodontic treatment

            -in comparison to comprehensive orthodontic treatment

                        -the goal of comprehensive orthodontic treatment is to straighten your teeth AND get your bite as close to ideal as possible regardless of treatment time

                        -total treatment time can take years

                        -this is the IDEAL treatment for patients under the age of 16, or patients who cannot function properly or pain free with how their bite is, and need their bite changed

~WHO CAN BE TREATED WITH SIX MONTH SMILES:

            -patients with

                        -crowded front teeth

                        -extra space between front teeth

                        -one or two top front teeth behind the bottom front teeth (a cross bite)

                        -healthy gums and no gingivitis or periodontitis

                        -who are over the age of 16 years old

~PATIENTS WHO ARE NOT A GOOD CANDIDATE FOR SIX MONTH SMILES:

            -patients whose chief complaint is a large over jet

                        -Six Month Smiles MAY decrease a large over jet, but if getting your over jet to an ideal measurement of 1mm is your main treatment goal, then the ideal orthodontic treatment is comprehensive orthodontic treatment

            -patients whose chief complaint is their midline is off

                        -the ideal treatment to ensure that the midline discrepancy can be fixed, is comprehensive orthodontic treatment

            -patients who want to change their facial profile

                        -the ideal treatment to change your facial profile is comprehensive orthodontic treatment

            -patients who want to change their bite

                        -the ideal treatment to change your bite is comprehensive orthodontic treatment

~HOW DOES SIX MONTH SMILES COMPARE TO ALIGNERS/INVISALIGN:

                        -Six Month Smiles generally has a shorter treatment time

                        -aligners are not as good as Six Month Smiles at fixing a rotated tooth

                        -aligners are not as good as Six Month Smiles at changing the height of a tooth

~WHAT SHOULD THE PATIENT EXPECT DURING SIX MONTH SMILES TREATMENT:

            -some patients might have minor discomfort during treatment, but most patients don’t complain

            -if teeth are crowded, then during treatment we will do some polishing of the teeth to help decrease friction and allow them to slide into a straight position more quickly

            -IT IS A SHORT TERM INCONVENIENCE FOR A LONG TERM CONVENIENCE

            -it is an investment in a more attractive and esthetic smile

~BECAUSE THIS IS A “COSMETIC” TREATMENT OPTION, WILL MY INSURANCE COVER ANY PART OF THE COST:

            -if your insurance plan covers orthodontic treatment on a patient your age, then yes, they should cover at least part of the cost of Six Month Smiles orthodontic treatment

~WHAT ARE OTHER COSMETIC TREATMENT OPTIONS FOR ME TO CONSIDER:

            -veneers

            -crowns

            -bonding

            -whitening (in office or at home)

            -comprehensive orthodontic treatment

If you have any questions regarding Six Month Smiles as an orthodontic treatment option or about any of the other cosmetic treatment options, visit their website (www.sixmonthsmiles.com) or call our office (402-483-7000) or contact us via our website to set up a time to do an orthodontic consultation.

SIPPING, SNACKING AND ORAL HEALTH

The American Dental Association has long recognized the link between quality oral health and a sound nutrition.  The association has continued to recommend that adults and children limit eating and drinking between meals, and when they must snack, give preference to nutritious foods as identified by the US Department of Agriculture’s dietary guidelines. 

Let’s start with the USDA’s food guide pyramid and dietary guidelines.  The food guide pyramid classifies foods into five major, and one minor, food groups:

          1-breads, cereals and other grains

          2- fruits

          3- vegetables

          4- meat, poultry, fish, dry beans, eggs and nuts

          5- milk, cheese and yogurt

          6- fats, oils, and sweets

(for more information visit http://www.nal.usda.gov/fnic/Fpyr/pmap.htm)

The food pyramid is to be used as a general guide to help you customize a healthy diet for yourself and your family.  It is important to eat a variety of foods in order to maintain a well balanced diet.  The USDA’s dietary guidelines encourage consumers to aim for a healthy weight, build a healthy base and choose sensibly. 

We live in a very fast paced society where the overwhelming tendency is shifting towards “eating on the run”.  Although there are many more nutritious options available, many consumers continue to opt for fast food.  The eating habits that we adopt for ourselves transfer very easily to the eating habits of our children and future generations.  These eating patterns and food choices are very important factors that affect how quickly patients of all ages may develop tooth decay.  This occurs due to the sticky film of bacteria, called plaque that constantly forms on our teeth and gums.  When bacteria in this plaque comes in contact with sugar and starches from our food and drink, the bacteria produce acid.  This acid can attack the teeth for 20 minutes or more and can eventually lead to tooth decay.  When consumers have a diet that limits the amount of unnecessary fats, oils and sweets they are eating, they can reduce the amount of acid attacks that their teeth must withstand, and help improve their teeth’s ability to fight off cavities.

Besides monitoring and making appropriate choices regarding what we, and our children, are eating, it is equally important to make healthy decisions when choosing a beverage.  In the past 50 years, the amount of soda, fruit juice and sports drinks those American consumers drink has increased by 500%.  Today, one in every four beverages consumed in America is a soft drink.  It has become clear that soft drinks have displaced other nutritious beverages and foods from the diet. 

These beverages (soda, fruit juice and sports drinks) contain sugar (yes even diet soda) and contain phosphoric acid and/or citric acid.  The sugar present in these beverages causes the bacteria on the plaque to produce acid which can weaken the enamel on our teeth, plus the acids present in these beverages also works to weaken the enamel.  These acids can lead to increased tooth decay and erosion or thinning of the enamel.  Some consumers think they are benefiting from switching to diet sodas, but the sweeteners present in these drinks are also very acidic and will potentially cause the same enamel erosion as a regular, non-diet soda. 

Just as important as limiting the amount of sweet and sugary food and drinks in our diet, it is also important to limit the number of acidic foods and drinks in our diet.  The normal pH of our saliva is around 6.5, which is healthy for our teeth.  When the pH in our saliva and mouth drops below 5.5, the enamel on our teeth begins to dissolve.    The degree to which the enamel erodes depends on a few factors:

          1- how often you drink these acidic beverages

          2- what the pH of the beverage is – the lower the pH the faster the erosion can occur

          3- how long the beverage stays in contact with the enamel

The pH of some of your favorite beverages may surprise you:

          powerade              ph of 2.75                      gatorade                pH of 2.95

          orange juice          pH of 3.5                       apple juice            pH of 3.2

          coca cola/pepsi     pH of 2.5                      tomato juice          pH of 4.1

          propel water          pH of 3.2                       beer                        pH of 4

http://www.oralanswers.com/2010/03/nine-drinks-that-can-dissolve-your-teeth/

Some tips to reduce the amount of tooth erosion:

          1- don’t slowly sip on acidic drinks

                   -drink it as quickly as possible to limit the contact time with your teeth

          2- drink acidic beverages through a straw

                   -this can potentially avoid some direct contact with your teeth because

                     you are pushing the drink directly to the back of your mouth

          3- rinse your mouth out after drinking acidic beverages

                   -drink water or milk after the acidic drink to help flush away some of the

                   acid

          4- don’t brush your teeth right after drinking acidic beverages

                   -the acid in the drinks can erode the enamel, leaving behind softened

                   tooth structure

                   -the calcium in your saliva combined with increasing the pH in your

                   mouth can help harden the soft tooth structure

                   -if you brush right after drinking the acidic beverage, then you could be

                   brushing away the softened tooth structure, thus making it impossible

                   for the damage caused by the acid to be repaired

When it comes to our diets, it is important to maintain well balanced, health diets and consume the sweets and acid beverages and foods in moderation. 

If you have a history of consuming high amounts of acidic foods and beverages, regular visits to your dentist are very important.  There are dental services and products available from your dentist, that can help strengthen enamel that has been weakened due to acid attacks.

TEMPOROMANDIBULAR DISORDER (TMD)

TMD is made up of several disorders that affect the jaw joint and the muscles that control chewing.  TMD’s occur as a result of problems with the jaw, jaw joint and the surrounding facial muscles that control chewing and moving the jaw.  The disorder can be as minor as slight clicking or popping sensations when the mouth is opened or closed, or as serious as chronic pain extending into the face, neck and shoulders. 

UNDERSTANDING THE TEMPOROMANDIBULAR JOINT (TMJ)

The TMJ is the hinge joint that connects the lower jaw (the mandible) to the temporal bone of the skull, located immediately in front of the ear on each side of your head.  These are flexible joints and allow the jaw to move up and down and side to side, enabling you to talk, chew and yawn.  Muscles that are attached to and surrounding the jaw joint control the movement and position of the jaw. 

WHAT CAUSES TMD?

The exact cause of TMD is unclear, but dentists believe that the symptoms arise from problems with the muscles of the jaw, or with the parts of the joint. 

Factors that can contribute to TMD include:

1-     head trauma

2-     head or neck injuries (whiplash injury)

3-     lost teeth

4-     arthritis in the jaw joint

5-     misaligned or unstable bite (unstable occlusion)

6-     jaw muscles working improperly

7-     grinding or clenching of the teeth

8-     stress (mental or physical)

9-     dislocation of the disc in the jaw joint

WHAT ARE SYMPTOMS OF TMD?

Patients with TMD can present with a range of symptoms, and these symptoms can be temporary or last for many years.  TMD has show to affect women more frequently than men. 

Symptoms of TMD include:

1-     tenderness in the jaw area, in/around the ear, or in the neck/shoulders

2-     clicking or popping noises when opening or closing your mouth

3-     limited or painful opening of your mouth

4-     jaw gets “locked” either open or closed

5-     ringing or stuffy feeling in ears

6-     frequent headaches

7-     jaw muscles feel tired

8-     difficulty chewing or bite feels as if teeth do not fit together properly

9-     swelling in the side of your face

10-tooth pain

HOW IS TMD DIAGNOSED?

Your dentist will conduct a thorough patient history and dental exam, to determine the cause(s) of your symptoms.  Sometimes the dentist will also use x-rays, MRI’s  and/or CT scans to further analyze your jaw joint. 

HOW IS TMD TREATED?

There is a wide range of treatments for TMD, depending on the cause and how severe and frequent the symptoms are.  They can range from self-care, “at home”, treatments, to injections and surgeries.  Ideally, we prefer to start with the more conservative, non-surgical treatments, with TMJ surgery being used as a last resort treatment. 

Short-term treatments can include:

1-     prescription and nonprescription ant inflammatory, pain or muscle relaxant medications

2-     ice packs or heat packs

3-     eating a softer diet

4-     cut food into small pieces

5-     avoid chewing on hard foods

6-     avoid “repetitive chewing” such as chewing gum

7-     muscle stretching exercises

If it is determined that the TMD symptoms are due to you grinding your teeth or due to you having a “deep bite” then the ideal treatment may be a type of custom made jaw splint.  This splint is made to help reposition the mandible to a more relaxed position, which in turn helps to reduce the tension in the jaw joint and associated muscles, thus reducing the severity and frequency of the TMD symptoms.

If the symptoms are determined to be due to missing some teeth or due to a misaligned or unstable bite, then the ideal treatment is to replace the missing teeth and making crowns or doing orthodontic treatment to gain a more ideal position of the teeth. 

In rare cases, surgery may be required to treat a TMD.  Surgery is the last resort treatment, and is a viable option after other forms of treatment have been tried unsuccessfully.

At our office, we provide a wide range of treatment options for TMD, including the following:

1-     bite adjustment

2-     custom mouth guards

3-     custom jaw splints

4-     prescription medication (if indicated)

5-     replace missing teeth

6-     restore an unstable bite with crowns and restorative work or with orthodontic work

If you experience any of the above symptoms or think you may have a TMD, contact our office for more information.