In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
Porcelain veneers have become a popular way to transform a smile. They're ideal for stained, chipped or slightly misaligned teeth. But although they don't need as much tooth preparation as crowns or other bridgework, the traditional veneer still requires some permanent tooth alteration.
Now, there's an alternative: no-prep veneers. With this option we can avoid any tooth structure removal or keep it to a minimum. And it may not even require local anesthesia while applying them.
Veneers are as their name implies: a wafer-thin layer of tooth-colored porcelain that's bonded to the outside of a tooth, much like siding on a house. Although the traditional veneer is usually no more than a millimeter in width, they can still add an unnatural bulky look and feel to a tooth. To compensate, we remove portions of the enamel. A tooth permanently altered this way will henceforth require some form of restoration.
No-prep veneers are much thinner; they also don't extend under the gum line like traditional veneers. At the most the new veneers may only require us to perform some minor reshaping of the enamel, but not to the extent of traditional veneers. And because your tooth isn't permanently altered, we could presumably remove the veneer and return the tooth to its natural state and appearance (although removing the bonding might not be that easy).
There are some situations where some tooth alteration may still be necessary, like oversized or forward-jutting teeth. A bad bite (malocclusion) may require orthodontic treatment first — which in some cases could be an alternative treatment to veneers altogether.
To find out if you're a candidate for no-prep veneers, visit us for a complete examination. From there we can discuss your options and whether we can transform your smile with little change to your teeth.
Today’s healthcare patients are asking questions. They want to know the “why” behind the “what” that their care providers are recommending for their health.
There’s a similar trend in dentistry — and it’s one we dentists encourage. We want you to know the “why” behind your treatment options — because you’re as much a participant in your own dental health as we are. The more informed you are, the better equipped you’ll be to make decisions to maintain or improve your health and the appearance of your smile.
As your dental care partner, it’s also essential we help you develop a long-term care plan based on your needs. There are aspects of dental care that are routine: daily brushing and flossing, an oral-friendly diet, and regular dental cleanings and checkups to assess your oral health. But we also need to think strategically, especially if you have risk factors that could impact your future dental health.
To do this we follow a four-step dental care cycle. In Step 1 we identify all the potential risk factors you personally face. These include your potential for dental disease, which could lead to bone and tooth loss, and the state of your bite and jaw structure that could complicate future health. We’ll also take into account any factors that could now or eventually affect your smile appearance.
Once we’ve identified these various factors, we’ll then assess their possible impact on your health in Step 2, not just what may be happening now but what potentially could happen in the future. From there we move to Step 3: treating any current issues and initiating preventive measures to protect your future health.
In Step 4 we’ll monitor and maintain the level of health we’ve been able to reach with the preceding steps. We’ll continue in this stage until we detect an emerging issue, in which we’ll then repeat our cycle of care.
Maintaining this continuum will help reduce the chances of an unpleasant surprise in your dental health. We’ll be in a better position to see issues coming and help reduce their impact now so you can continue to have a healthy mouth and an attractive smile.
If you would like more information on planning your dental 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 “Successful Dental Treatment: Getting the Best Possible Results.”
Among the “to-do” items on your pre-dive checklist like “Pack wetsuit” or “Fill scuba tanks,” be sure to add one other: “Check my dental health status.”
While that may seem like an odd concern, the changes in atmospheric pressure you encounter while diving (or flying, for that matter) could amplify oral sensitivity and intensify pain if you have pre-existing teeth or jaw problems.
The reason for this is the effect of basic physics on the body. All anatomical structures, including organs, bones and muscles, equalize external pressures the body encounters. We don’t notice this at normal atmospheric pressure, but when we encounter an extreme — either lower pressure during air flight or higher pressure during a scuba dive — we may feel the effects of the pressure on any structure with a rigid-walled surface filled with either air or fluid. These structures can’t equalize the pressure as fast as other areas, resulting in pain or discomfort. This is known medically as “barotrauma,” or more commonly as a “squeeze.”
One structure in particular could have an effect on your upper teeth and jaws: the sinus cavities of the skull, particularly the maxillary sinuses just below the eyes. Their lower walls are right next to the back teeth of the upper jaw and, more importantly, share the same nerve pathways. It’s quite possible, then, for pain from one area to be felt in the other, commonly known as “referred pain.” A toothache could then be felt in the sinus region, and vice-versa.
During a squeeze, then, pain levels from existing problems in the teeth and jaws that were previously tolerable (or even unnoticed) may well become amplified as the pressure from the sinus cavity impinges upon the jaw. That dull toothache you’ve been having may suddenly become excruciating at 30,000 feet — or 30 meters under the surface.
That’s why it’s important to see us if you’ve experienced any signs of tooth decay, gum disease or TMD, including pain, before your next dive or air flight. And, if you encounter any significant pain while flying or diving, be sure you consult with us as soon as possible when you return. Taking action now could help you avoid a miserable, and potentially dangerous, flying or diving experience in the future.
If you would like more information on pressure changes and dental health, 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 “Pressure Changes can Cause Tooth and Sinus Pain.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
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