The old saying, “If it ain't broke, don't fix it,” doesn't really apply when discussing your wisdom teeth. It's great if they are not bothering you, but don't wait for problems to develop before you take action. This may seem counter-intuitive, but you should know that the best time to have your wisdom teeth removed is when they are not causing problems.

Why do wisdom teeth cause problems?

Wisdom teeth are so-called because they appear at ages 17 to 25, the age of supposedly attaining wisdom. They are also known as third molars and are farthest back in your jaws. For some people they come through the gum-line only partially, or they may not erupt into the mouth at all. Unerupted they have the potential to cause problems associated with the neighboring teeth and surrounding gums.

You may have heard of “impacted” wisdom teeth. This means that they are impacted or forced against neighboring structures, teeth or bone that prevent them from coming into the mouth in correct biting position. Since they are your last teeth to come in, space for them may be severely limited. They may push into the teeth that are already in place, becoming stuck as they try to erupt. When wisdom teeth are trapped like this below the gum line and are pushing against neighboring teeth, these molars can cause problems such as infections, cysts, or gum disease.

My wisdom teeth seem OK, so why remove them?

The dilemma is that if you wait until you feel pain connected with your wisdom teeth, their neighboring teeth may already be in trouble.

Another reason to remove these back teeth before they cause problems is that it's a good idea to have your surgery while you are young. Younger, healthy patients with no infections at the site have the best chance of having their wisdom teeth extracted without complications, with an easier recovery and uneventful healing.

Of course, each situation is different. Make an appointment with us for an examination and a consultation to discuss the risks and benefits of removing your wisdom teeth. For more information read the article “Removing Wisdom Teeth” in Dear Doctor magazine.

Are you unhappy with the appearance of your smile? Do you get anxious about smiling in social settings? Have you ever wished you had teeth like your favorite celebrity? If you have answered yes to any of these questions it might be time to discuss a smile makeover with us!

During our initial meeting we will ask you exactly what look you are hoping to achieve. Open communication will help ensure ultimate success and satisfaction — you need to tell us what you want and we need to tell you what is actually possible. Then we can plan a solution that is both aesthetically pleasing and functional.

We will also decide which cosmetic materials and techniques to use; this can range from composite resins (tooth-colored fillings), porcelain veneers (thin layers of dental ceramic that are bonded to your tooth enamel) or porcelain crowns (which replace the entire external form of a tooth).

Essentially, most people seem to want one of two looks — a “perfect” Hollywood smile or a more “natural” look. For those who want a “perfect” smile, we will focus on achieving symmetry so that your smile appears perfectly balanced. We will also focus on achieving uniform and maximum tooth brightness and whiteness.

For those who want a more “natural” smile, we can enhance your smile by gently improving brightness while maintaining a more normal symmetry to each tooth shape and size. This can produce a more elegant, youthful smile, not just a Hollywood white smile. We can also maintain slight color, shape and shade variations throughout your mouth.

The best tool for testing our vision is with the use of a tool we call a “provisional restoration.” During this phase of the process we will actually create your new smile using temporary materials, allowing you to “test drive” your new look before committing to permanent materials. This way we can make sure you get exactly what you want. Once you give us the green light, these restorations will be replaced with your permanent new teeth.

Call our office today so we can get started! For more information on the importance of communication between dentist and patient during a smile makeover, read the Dear Doctor magazine article “Great Expectations: Is What You Get What You Want?”

You've taken good care of your teeth all your life, with brushing, flossing and regular visits to the dentist. But chances are that someday (or maybe even now) you may be told that you need a restoration on one or more of your teeth. Oftentimes, that means a crown.

But what exactly is a crown, and why is it used? We're glad you asked!

In the course of time, natural teeth may need to be restored for a variety of reasons. As we age, our teeth may eventually become chipped or discolored. They can become weak and prone to cracking, or actually break due to tooth decay or trauma. Treating tooth decay may require a filling so large that there isn't much tooth surface left. Or, getting a dental implant (which replaces the roots of the tooth) means that you will need a replacement for the visible part of the tooth as well.

A crown (sometimes called a cap) is a common type of dental restoration. It's a way of replacing the tooth structure, in part or in full. A crown can cover the whole visible portion of the tooth, right down to the gum line. Since it's custom-made just for you, it is designed to fit in and function just like the rest of your teeth. And because it's composed of an extremely hard substance (gold, porcelain, ceramic, or some combination of these materials) it's made to last for a long time.

If a dental examination shows that you need a crown, here's how the process works: First, any decay is removed from the affected tooth, and it is prepared for restoration. Then, a 3-D replica of the tooth (and adjacent teeth) is made. This model is used to create a crown that matches your natural teeth. If you're getting a tooth-colored crown, the exact shade of the adjacent teeth will be duplicated as closely as possible.

After the crown has been fabricated, the tooth is made ready to receive the restoration. The crown is adjusted to mesh perfectly with the prepared tooth, and to function with the whole bite. Then, it is cemented or bonded into place. When it's all done, it can be hard to tell that you had any dental work done at all.

If you're thinking that it's a challenge to make an “artificial” tooth fit in with your natural teeth, you're right — but we do it all the time! Creating a superb-looking restoration is a blend of science and art. It takes a careful eye to match tooth colors and to adjust biting surfaces and spacing for a perfect fit. But when experienced dental professionals and patients work together, the results can make us both proud of the achievement.

If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Gold or Porcelain Crowns.”

Dental implants are a great choice for many people who need to permanently replace a missing tooth. Reliable and long-lasting, they offer a highly successful outcome, and can even help reduce long-term bone loss and damage to adjacent teeth. One of the best features of implants is that the titanium metal of which they're made actually becomes fused with your natural, living bone tissue.

But sometimes, an examination may show that where you have missing teeth, you may not have enough bone remaining to properly place an implant. Does this mean you're out of luck? Not necessarily!

Employing the refined techniques of bone grafting, regenerating bone tissue has become a standard procedure in periodontal and oral surgery. In many cases, it's possible to build up just the right amount of bone using a variety of grafting materials, in combination with other special techniques. This can enable patients who wouldn't otherwise be good candidates to enjoy the benefits of dental implants.

How does it work? Basically, by helping your body repair itself.

You may already know that bone is a living tissue, which can respond to its environment positively (by growing) or negatively (by resorbing or shrinking). When you've lost bone tissue, the trick is to get your body to grow more exactly where you want it. Once we know where — and how much — replacement bone is needed, we can place the proper amount of bone grafting material in that location. Then, in most cases, the body will use that material as a scaffold to regenerate its own bone.

Bone grafting is often done at the time of tooth removal as a preventive procedure or prior to the placement of an implant, to give the body time to re-grow enough of its own tissue. The procedure is generally carried out under local anesthesia, or with the aid of conscious sedation. Sometimes, if there is enough natural bone to stabilize it, it's even possible to place an implant and perform a bone graft at the same time.

So if you're considering dental implants, let us advise you on what's best for your particular situation. We have the knowledge and experience to help you make the right choices, and achieve the most successful outcome.

If you would like more information about bone grafting, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Can Dentists Rebuild Bone?”

The best method for permanently replacing a missing tooth is with a dental implant. But did you know that there are two main techniques for placing implants? Implants can be placed either using a one stage or a two stage surgical technique, and as their names suggests, one is performed in one step while the other requires a second surgery.

With a one-stage procedure, a healing abutment is placed at the time of surgery. An abutment is a connector that attaches the implant from the bone into the mouth and which protrudes through the gum tissues. Following a 3 to 6 month healing period in which the implant fuses to the bone, a crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good, guaranteeing good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.

Under special conditions an implant can be placed and a crown placed on top of it at the same time. However, this is a very special circumstance requiring ideal conditions and surgical experience as well as crown fabrication know-how. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone.

A two-stage procedure is typically used for replacing teeth where there is no immediate need for a cosmetic solution and when more of a margin of safety is required. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. They are not exposed to the mouth, but stay buried and left to heal. Once healed, a second surgery is performed to attach an abutment for securing the crown in place. This approach is used when there is poorer bone quality or quantity. This may make it necessary to regenerate bone around the implant at the time of its placement. There may also be other health considerations dictating that a two-stage approach may be indicated.

Depending on your individual situation and medical status, our implant team will determine which approach is best for you. To learn more about these two procedures, read the Dear Doctor article, “Staging Surgery In Implant Dentistry.” You are also welcome to contact us to discuss your questions or to schedule an appointment.