Posts for: August, 2018
When your braces finally come off, you’ll hopefully be astounded by what you see –once-crooked teeth replaced by a more attractive smile. But you might also see something you didn’t expect: noticeable white spots on some of your teeth.
These spots called white spot lesions (WSLs) appear lighter than the surrounding tooth enamel due to mineral loss just beneath the surface. This happens because bacterial or food acids have contacted the enamel surface for too long and dissolved the underlying calcium and other minerals. This results in a small discolored and chalky-like area in the enamel.
WSLs are common during orthodontics because wires and brackets create hard to reach places for brushing and flossing, which can accumulate bacterial plaque. The bacteria produce acid, which weakens the enamel at these places. The tiny white spots that result are more than just unattractive—they can become entry points into the tooth for decay. That’s why they should be dealt with as soon as possible—and preferably before they’re created.
To that end, you’ll need to do as thorough a job as possible brushing and flossing while undergoing orthodontic treatment. To improve your thoroughness try using an interproximal toothbrush that can maneuver more closely around braces hardware than a regular brush. You can also improve your flossing with a floss threader or a water flosser, a device that sprays pressurized water to loosen and flush away plaque.
If you do develop WSLs, there are some things we can do to treat them. We can attempt to re-mineralize the affected enamel with the help of topical fluoride (either pastes or gels for home use or with an office application) or a re-mineralizing agent. We can also use techniques like microabrasion, which restores damaged areas beneath the surface, or inject a liquid, tooth-colored resin beneath the WSL’s surface to improve appearance and protect against decay.
If while wearing braces you do notice any white spots or other tooth discoloration let your dentist or orthodontist know right away. The sooner your dental providers can begin dealing with potential WSLs the better your chances for a healthy and beautiful outcome after braces.
If you would like more information on oral hygiene while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
If your smile is, to put it mildly, “unattractive,” you may think only extensive and expensive dental work can change it. But depending on your teeth’s actual condition, you might be able to obtain a new smile with a less-invasive option: porcelain veneers.
As their name implies, veneers are thin layers of dental porcelain bonded to the front of teeth to cover imperfections. They’re custom designed and manufactured by a dental technician to match the natural color, shape and size of the teeth they’re covering and to blend with neighboring teeth.
Veneers are quite effective for heavily stained, chipped or moderately misaligned teeth that are otherwise healthy. They can even be used to address slight gaps between teeth and restore worn teeth to make them appear larger and more youthful.
Overall, they’re less invasive than other dental restorations. That said, though, most veneers will still require some alteration of the affected teeth. This is because although quite thin they can still appear bulky after they’re bonded to the teeth. We can minimize this by removing a small amount of a tooth’s outer enamel. While this alteration is modest compared to other restorations, it’s nonetheless permanent– your teeth will require some form of restoration from then on.
Veneers also require special consideration while biting. You’ll need to exercise care and avoid biting hard items like candies (or using your teeth as tools) or the veneer could break. Similarly if you have a teeth grinding habit, you may want to consider having a custom guard created that you wear at night to prevent solid contact between your teeth. The excessive force generated while grinding or clenching teeth could also shatter veneers.
Veneers may not be the answer in all cosmetic dental situations, such as extensive disfigurements or bite problems. To know for sure if your particular dental condition could benefit, see your dentist for a complete dental examination and discuss whether obtaining veneers is a viable option for you. If so, you may be able to gain a much more attractive smile from this less invasive but no less effective option.
If you would like more information on porcelain veneers and other dental restorations, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”
The CAT scan is a relatively recent technique in dentistry, used to get an image of what’s happening deep within your jaws. You may be wondering what a CAT scan tells us that a conventional x-ray picture does not, and whether it is worth the extra expense to get one. And how does a CAT scan compare with a conventional x-ray in terms of radiation exposure?
CAT stands for “computer assisted tomography.” Often it’s just called a CT scan, for “computerized tomography.” The word “tomography” comes from roots meaning “slice” and “write.” Tomographic techniques take repeated two dimensional pictures, similar to repeatedly slicing through an object, and then assembles them with a computer to produce a three dimensional (3-D) image.
The latest type of CT scan used in dentistry is called CBCT, or Cone Beam Computed Tomography. The Cone Beam refers to a spiral beam of x-rays, which is used to create a series of two dimensional images from which a computer creates a 3-D image. Such an image is of great value in assessing problems and planning treatment.
Here are just a few examples of how a CBCT scan can be used. Orthodontists can see skeletal structures and developing teeth that are still inside the jawbone while planning strategies for directing the teeth in order to arrive at a better bite. Oral surgeons can find impacted or missing teeth, see their locations, and view their proximity to nerves and sinuses, assisting them in planning surgeries. These scans are particularly useful for root canal specialists because they show root canals that are less than a millimeter wide and even reveal accessory canals that may not be visible on conventional x-rays. In cases of sleep disorders such as sleep apnea, a CBCT during sleep can be used to view a person’s airway and how it may be blocked by the tongue and other soft tissues in a person’s throat during sleep.
Compared to background radiation, the amount of radiation delivered in dental x-rays is minimal. A CBCT delivers a dose of radiation that is less than a typical full mouth x-ray series but more than a typical two dimensional panoramic radiograph. Generally CBCT scanners deliver lower doses than medical CT scanners.
With one low-dose CBCT scan, we can get an accurate idea of the internal structure of your bones and teeth and how they are situated in relation to each other. Prior to the availability of such images, many of these relationships had to be discovered in the course of a surgery or other treatment. Thus such a scan can aid greatly in the quality of treatment you will receive.