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By Dentistry by Design
September 03, 2019
Category: Uncategorized
Tags: dental implant  

Compared to other dental restorations—a few of which have been around for over a century—implants are a relatively recent development. But even though it's just now entering its fourth decade, recent advances have catapulted implant therapy well beyond where it began.

That's due mainly to digital technology. Two examples of this, computed tomography (CT) and 3-D printing, are increasing the accuracy and efficiency of implant placement.

Properly placing an implant is one of the most important elements in achieving a natural and attractive result. But finding the best location is often difficult due to a lack of suitable bone volume, the patient's bite or the proximity of anatomical structures like nerves and blood vessels. CT imaging, especially Cone Beam CT scanners (CBCT), is helping to make implant placement planning easier.

Unlike the static, two-dimensional views of standard x-rays, CBCT takes hundreds of images and digitally blends them together to create a virtual 3-D model of the patient's jaw and face. Dentists can view this highly detailed model on a computer monitor from various vantage points and better identify possible obstructions. With better information about what "lies beneath," they can more accurately pinpoint the best implant site.

Creating the ideal plan is one thing—successfully implementing it is another. Dentists often create a surgical guide that helps them drill in precisely the right positions during surgery. The guide, which resembles a mouthguard, fits over the gums and contains marker locations for drilling.

Many dentists are now using 3-D printing to create these surgical guides. A 3-D printer turns a digital model of the guide based on measurements of the patient's mouth and proposed implant locations into an actual physical object "printed out" layer by layer of special polymer material. The end product can be more precise than guides created by other means.

These and other technological developments are helping implant therapy rise to a new level of success. With the resulting increase in accuracy, efficiency and less treatment time, tomorrow's implant patients will be the ultimate beneficiaries.

If you would like more information on restoring missing teeth with dental implants, 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 “How Technology Aids Dental Implant Therapy.”

By Dentistry by Design
December 07, 2018
Category: Uncategorized
Tags: pulp capping  

There’s one sure thing about tooth decay: you can’t ignore it. In fact, the best outcomes result from finding it early and treating it before it enters the pulp in the center of the tooth, often a filling or similar treatment.

If it does advance to the pulp, you may need a root canal treatment to save the tooth. This is a moderately invasive procedure where we access the pulp and root canals, tiny passageways leading to the root and supporting bone. We then remove all the diseased tissue and fill the empty pulp chamber and root canals with a special filling. Later we’ll crown the tooth for added protection against future infection or fracture of the tooth.

But there’s also another less-invasive method than a root canal called pulp capping. It’s only appropriate to use, however, if the pulp has become exposed or almost exposed by decay, but hasn’t yet shown signs of disease.

Pulp capping can be either direct or indirect. We use direct pulp capping if the healthy pulp has been exposed by the disease process. We first isolate the tooth from the rest of the mouth to prevent contamination and then proceed to remove all of the tooth’s decayed dentin structure. We then apply a biocompatible material directly over the pulp to protect it from further decay and to facilitate healing. We then restore the tooth, usually with a filling, to its proper function and life-like appearance.

When the pulp is threatened by decay but not yet exposed, we may then use the indirect method. In this approach we first remove most of the decayed dentin, but leave a small amount next to the pulp to keep it covered. We then treat this remaining dentin with a material to help it heal and re-mineralize, followed by a temporary filling of the tooth. A few months later we’ll remove this filling and inspect the treated dentin. If it has regenerated sufficiently, we remove any remaining decay and permanently restore the tooth.

As we said, pulp capping is only used with patients with deep decay whose pulp tissue is healthy. But when we can use it we can avoid some of the permanent alterations that often come with a root canal treatment and still save the tooth.

If you would like more information on treatments for tooth decay, 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 “Pulp Capping: A Procedure that May Save a Decayed Tooth.”

By Dentistry by Design
May 01, 2018
Category: Uncategorized

At the first-ever Players Weekend in August 2017, Major League Baseball players wore jerseys with their nicknames on the back. One player — Cleveland Indians shortstop, Francisco Lindor — picked the perfect moniker to express his cheerful, fun-loving nature: “Mr. Smile.” And Lindor gave fans plenty to smile about when he belted a 2-run homer into the stands while wearing his new jersey!

Lindor has explained that he believes smiling is an important part of connecting with fans and teammates alike: “I’ve never been a fan of the guy that makes a great play and then acts like he’s done it 10,000 times — smile, man! We’ve got to enjoy the game.”

We think Lindor is right: Smiling is a great way to generate good will. And it feels great too… as long as you have a smile that’s healthy, and that looks as good as you want it to. But what if you don’t? Here are some things we can do at the dental office to help you enjoy smiling again:

Routine Professional Cleanings & Exams. This is a great place to start on the road toward a healthy, beautiful smile. Even if you are conscientious about brushing and flossing at home, you won’t be able to remove all of the disease-causing dental plaque that can hide beneath the gum line, especially if it has hardened into tartar, but we can do it easily in the office. Then, after a thorough dental exam, we can identify any problems that may be affecting your ability to smile freely, such as tooth decay, gum disease, or cosmetic dental issues.

Cosmetic Dental Treatments. If your oral health is good but your smile is not as bright as you’d like it to be, we can discuss a number of cosmetic dental treatments that can help. These range from conservative procedures such as professional teeth whitening and bonding to more dramatic procedures like porcelain veneers or crowns.

Tooth Replacement. Many people hide their smiles because they are embarrassed by a gap from a missing tooth. That’s a shame, because there are several excellent tooth-replacement options in a variety of price ranges. These include partial and full dentures, bridgework, and dental implants. So don’t let a missing tooth stop you from being Mr. (or Ms.) Smile!

If you’d like more information about oral health or cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”

October 22, 2015
Category: Uncategorized
Tags: Untagged

When elderly people are asked whether they have any regrets in life, a common answer is that they wish they had taken better care of their teeth. We all know that daily brushing and flossing is important, but one of the most vital steps you can take to ensure your dental – and overall – health is to visit your dentist for regular checkups. The American Dental Association recommends visiting a dentist for a regular checkup every six months, and most dental insurance provides for two checkups each year.

Part of a regular dental checkup is a cleaning, usually performed by a dental hygienist. Dental offices feature cleaning tools that provide a deeper clean than you can achieve at home with your toothbrush. Hygienists remove plaque and tartar from teeth with special instruments like scalers and polishers. Scalers are particularly useful for the removal of plaque buildup in hard-to-reach areas, like between teeth. Polishers remove buildup and stains from teeth. Hygienists will also floss your teeth and point out any areas of concern with your flossing technique.

In addition to a professional cleaning, which should leave your teeth feeling smooth and clean, your dentist will check for cavities and examine the health of your gums. You may have X-rays taken to screen for cavities. Your dentist will also look at your mouth, throat, and tongue for any signs of disease or cancer. Identifying problems before they become serious is the most important aspect of a dental checkup. 

During your checkup, your dentist can also identify a host of other oral concerns, including bite problems, signs of bruxism (teeth grinding), and problems related to the temporomandibular joints (TMJ) of your lower jaw. TMJ disorders can cause more widespread symptoms, such as headaches and back, neck, and shoulder pain, so visiting your dentist might be your first step to alleviating chronic pain in other areas of your body.

From tooth decay to vitamin deficiencies to cancer, regular dental visits can uncover oral concerns before they become serious or life threatening. If your dentist identifies any problems, he or she will suggest a treatment plan that may involve anything to a change in your personal oral hygiene habits to getting a cavity filled to more extensive therapies like a root canal or oral surgery.

Good oral health provides a foundation for good overall health. Just as you should visit your physician yearly for a medical checkup, so should you adhere to a regular schedule of dental checkups. And if you have any questions or concerns about your dental health, your dentist will be able to address them face to face.

Would you like to know more? Visit www.SmileShrewsbury.com, www.smileandover.com, and www.smilesbystiles.com for more information.

October 22, 2015
Category: Uncategorized
Tags: Untagged

Keeping up with your dental health should always be a priority

Did you know that hormonal and physical changes during pregnancy can have an impact on your teeth? While taking good care of your teeth and keeping up with your dental health should always be a priority, a little extra attention should be exercised when you become pregnant.

Here are a few pregnancy-related dental issues to watch for:

• Inflamed gums. Just as other mucous membranes in the body can become inflamed during pregnancy, so can your gums. Pregnancy gingivitis can develop in as many as 50% of pregnant women and is characterized by swollen and bleeding gums. The best defense against problems with your gums is to brush and floss regularly but with care to avoid further irritation in sensitive spots. Try a fluoridated mouth rinse with an ADA seal to ensure it's a trusted brand. Also, more regular cleanings is a preventative way to avoid gingivitis or any like conditions. 

• Morning sickness. Frequent vomiting can be hard on your teeth, so make certain that you are rinsing your mouth out with water or a dental rinse following a bout of sickness. Morning sickness can also involve an aversion to the taste of toothpaste. If this is a problem for you, speak to your dentist regarding recommendations for a different brand or a palatable rinse that is less likely to induce nausea.

• Diet. Just as you're going to monitor what you're eating to promote the health of your unborn child, your diet can affect your oral health. Frequent snacking can lead to an increased risk of tooth decay due to the increased exposure to sugar for the cavity-causing bacteria to feed on. And that old adage about "eating for two" can also make a difference in the development of your child's teeth in utero. Within three months of conception, a baby's teeth begin to form, which means eating healthy dairy products like yogurt and cheese is important to the babies' the mineralization of teeth as well as bones. Also, try to stay away from foods high in sugar; this is good not only for the health of your teeth but also for the development of your baby. 

• Pregnancy complications. Untreated dental problems can lead to infection, and any infection in the body during pregnancy can pose a risk to an unborn child. It's important to make every effort to avoid any such infections. If an infection does develop, work with your dentist and doctor to treat it immediately.

In order to catch any emerging dental problems before they become serious, make sure to see your dentist at least once during your pregnancy for a checkup and cleaning.

According to the Massachusetts Birth Report for 2011-2012, only 46% of women had their teeth cleaned during pregnancy. If possible, schedule a checkup before you plan to try to conceive so that you can be proactive about any potentially serious problems that may arise. However, even is complications were to occur, it is safe to get x-rays done if needed. Frequent trips to the dentist during pregnancy are not only safe but also encouraged.

Once your baby is born, schedule an appointment with your dentist to make sure your mouth is healthy and address any non-urgent problems that have arisen during your pregnancy. The most important step you can take to ensure your dental health while pregnant is to pay attention to what your mouth is telling you.