Posts for category: Dental Procedures

By Ken Yasuhara, DDS - Aesthetic and Restorative Dentistry
July 02, 2020
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

By Ken Yasuhara, DDS - Aesthetic and Restorative Dentistry
June 02, 2020
Category: Dental Procedures
NeedanEffectivebutAffordableToothReplacementLookataFlexibleRPD

People with missing teeth have more replacement options than ever before, including the ever popular but often more expensive dental implant. But there has also been an expansion of choice on the more affordable side of dental restorations. The flexible removable partial denture (RPD) is one such choice. 

Though RPDs have been around for some time, the newer flexible RPD offers some advantages over the more rigid traditional RPD. They’re made of a kind of nylon that’s pliable but also strong and durable. This material is thermoplastic, meaning when heated it can be injected into molds based on a patient’s individual mouth to form an accurate denture base. The gum-colored base can also be formed to cover any receded areas of the gums, which can greatly improve smile appearance.

Older versions of RPDs are made of rigid acrylic plastic that stay in place in the mouth with metal clasps that attach to remaining teeth. The flexible RPD, on the other hand, is secured with finger-like nylon extensions that fit and hold in the natural teeth’s concavities near the gum line. This, along with its relatively light weight, offers a more comfortable fit.

But aside from these benefits, flexible RPDs do have a few drawbacks. Although fracture-resistant, they’re not easy to repair or reline to readjust the fit to accommodate mouth changes. They can stain (though not as much as a traditional RPD), so they require diligent cleaning and maintenance.

We consider the whole category of RPDs as “temporary” restorations, meaning they’re intended as a transitional phase between tooth loss and a permanent restoration like a natural tooth-supported fixed bridge or dental implants. For some, however, the flexible RPD might be a more long-term solution. As mentioned before, to extend their life as much as possible they should be removed daily and cleaned thoroughly. And like any form of denture, they should not be worn overnight.

In either case, flexible RPDs offer an effective way to restore not only dental function diminished by missing teeth but an improved appearance as well. With careful maintenance, they could serve you well for some time to come.

If you would like more information on flexible partial dentures, 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 “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”

By Ken Yasuhara, DDS - Aesthetic and Restorative Dentistry
April 23, 2020
Category: Dental Procedures
Tags: x-rays  
BitewingX-RaysanImportantToolinEarlyToothDecayDetection

It's difficult to measure how x-ray imaging has transformed dentistry since its use became prominent a half century ago. As equipment and methods standardized, the technology revolutionized the way we diagnose tooth decay and other mouth-related issues.

One of the more useful of these methods is called the bitewing x-ray. The term comes from the shape of the device a patient holds between their teeth with the film attached on the side toward their tongue. We direct the x-ray beam to the outside of the patient's cheek, where it passes through the teeth to expose on the film. Its particular design provides clearer images since the patient's bite helps keep the film still and distortion-free, making it easier to view signs of early tooth decay.

Bitewing x-rays usually consist of four films, two on either side of the mouth, necessary to capture all of the teeth (children with smaller jaws, however, often only require one film per side). How frequently they're conducted depends on a number of factors, including the patient's age: children or young adolescents are usually filmed more frequently than adults, usually every six to twelve months. Frequency also depends on a patient's particular decay risk — the higher the risk the more frequent the x-ray.

Regardless of how often they're performed, a similar application principle applies with bitewing x-rays as with any other radiological method: As Low As Reasonably Achievable (ALARA). With the ALARA principle in other words, we're looking for that sweet spot where we're able to detect the earliest stages of dental disease with the least amount of radiation exposure.

Bitewings fit this principle well: a patient receives only a fraction of the radiation exposure from a four-film bitewing as they do from a daily dose of environmental radiation. Factor in new digital technology that reduces exposure rates and bitewings pose virtually no health risk to patients, especially if conducted in a prudent manner.

The benefits are well worth it. Thanks to bitewing x-rays we may be able to diagnose decay early and stop it before it causes you or your family member extensive tooth damage.

If you would like more information on the importance of x-rays in dentistry, please contact us or schedule an appointment for a consultation.

By Ken Yasuhara, DDS - Aesthetic and Restorative Dentistry
April 13, 2020
Category: Dental Procedures
MileyCyrussLittleSecretStraighteningHerSmileWithLingualBraces

Miley Cyrus's rise to fame began when she was cast in the Disney series Hannah Montana. She played the title character, Hannah Montana, a famous singing star hiding her true identity, ordinary girl, Miley Stewart. In her real life at the time, Miley Cyrus had her own little secret—she was undergoing orthodontic treatment to straighten her smile.

Like many teenagers (as well as many adults), Cyrus's dental bite wasn't in proper alignment. She could have gone the traditional way by straightening her smile with braces fixed to the front of her teeth. It's an effective treatment, but the metallic hardware can overwhelm a person's appearance.

With her various roles in the public spotlight, Cyrus and her family wanted an effective but out-of-sight method for moving her teeth. They chose a relatively new one called lingual braces. Unlike traditional braces, the hardware for lingual braces is fixed on the back of the teeth (or the tongue side, hence the term “lingual”).

Lingual braces can correct any bite problem labial (“lip”) braces can, just through different mechanics of movement. Its main appeal is that the hardware is hidden behind the teeth, so only you and your orthodontist need know you're wearing braces.

There is also less risk of damage to the mouth or the braces themselves if you're in a sport or profession where you're at high risk for facial blows. And unlike patients with traditional braces, you'll have an unobstructed view of your progress over the course of treatment.

Lingual braces do tend to cost more than traditional braces. Some patients also have difficulty at first with speaking and tongue comfort, though most grow accustomed to the braces within a couple of weeks. Because lingual braces are relatively new, there's been a limited number of orthodontists offering it.

But lingual braces are just one of the ways to straighten teeth. Modern dentistry offers several ways to give you your dream smile. If you have dental problems or would like to improve the look of your smile, please contact us or schedule a consultation, and we can discuss your options. To learn more, read the Dear Doctor magazine articles “Lingual Braces” and “The Magic of Orthodontics.”

By Ken Yasuhara, DDS - Aesthetic and Restorative Dentistry
March 14, 2020
Category: Dental Procedures
Tags: gummy smile  
IsYourSmileTooGummyHeresHowWeMightBeAbletoImproveit

Your gums not only support and protect your teeth they also help present them in a visually attractive way. But some people’s gums seem to stand out too much — what’s commonly called a gummy smile — which diminishes their smile appeal. There’s no precise definition, but as a rule of thumb we consider a smile too gummy if four or more millimeters (about an eighth of an inch) of the gums show.

Fortunately, there are some techniques to improve a gummy smile. Which technique is best for you, though, will depend on why the gums are prominent — and causes vary. For example, you could have a gummy smile because your teeth appear too short compared to your gums.

Permanent teeth normally erupt to about 10 mm of visible length. But less than that, say 8 mm, could skew the visible proportion of gums to teeth too much toward the gums. Teeth can also appear shorter due to accelerated wear caused by grinding habits. Another cause could be the amount of upper lip rise when you smile. The lip may rise too high in a condition called hypermobility. This could reveal too much of the gums when you smile.

It’s important then to match the treatment to the cause. For example, we can enhance the appearance of shorter teeth through a surgical procedure known as crown lengthening. During this procedure a surgeon reshapes the gum tissues and underlying bone to expose more of the tooth’s length.

For upper lip hypermobility, we can restrict movement with Botox, a drug that paralyzes tiny parts of the involved muscles. This approach, though, will wear off in a few months — a more permanent solution is surgery to reposition the muscle attachments so as to prevent excessive movement.

If you’re concerned about a gummy smile, see us for a full examination and consultation. Once we know the reason why, we can offer a solution that will make your smile more attractive.

If you would like more information on enhancing the appearance of your gums, 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 “Gummy Smiles.”