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Posts for category: Dental Procedures

By George R. Shepley, DDS
April 02, 2021
Category: Dental Procedures
Tags: smile makeover  
PlanYourSmileMakeovertoGettheMostSatisfyingResults

If you think your smile is beyond hope, you might be in for a happy surprise: Today's dental cosmetics can improve even the most forlorn dental situation. It could be a one-visit tooth whitening—or a total “smile makeover.”

If it's the latter, your transformation journey could take months or even years—so you need some idea of where this journey will take you. That will come through initial discussions with your dentist about your dreams and desires for a new smile.

But you'll also need to consider what your dental condition will practically allow: Although your goal is a more attractive appearance, the higher priority is your long-term dental health. There's also cost—dental enhancements can be expensive, so you may have to adjust your dream smile to match the reality of your finances.

With the big picture in focus, the next step is to refine the details of your makeover plan. Nothing does this better—for you and your dentist—than to “see” your proposed smile ahead of time. This is possible with computer technology: Your dentist can modify a digitized photo of your face and smile to show the proposed changes to your teeth and give you a reasonable view of your future smile.

Another way is to create a “trial smile.” Using composite dental material, your dentist fashions a temporary restoration that fits over your teeth. Unlike the digitally enhanced still photo, a trial smile let's you see what your new appearance will look like while moving, talking or smiling. Although it's removed before you leave the office, you can have photos taken to show friends and family.

You and your dentist can use these methods to make adjustments to your makeover plan before applying the real enhancements. It also eliminates any unpleasant surprises after all the work is done—you'll already know what your future smile will look like.

These initial steps are just as important as the actual procedures you'll undergo. Through careful planning, you'll gain a new smile that can improve your life.

If you would like more information on smile transformations, 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 “Beautiful Smiles by Design.”

By George R. Shepley, DDS
February 20, 2021
Category: Dental Procedures
WeMayBeAbleToTreatSomeBiteProblemsEarly

In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.

But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.

The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.

A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.

Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.

Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.

Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.

If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”

By George R. Shepley, DDS
January 11, 2021
Category: Dental Procedures
Tags: partial denture   bridge  
TwoGoodOptionsforTemporarilyReplacingaTeenagersMissingTooth

While anyone can lose a permanent tooth, the cause often varies by age group. Adults usually lose their teeth to disease, while those under twenty lose a tooth to accidents.

For adults, a dental implant is usually the best way to replace a missing tooth. Teenagers and younger, on the other hand, must wait to get implants until their jaws fully develop. An implant placed on an immature jaw will eventually look and feel out of place.

For most, their jaws won't reach full maturity until their early twenties. Even so, they still have a couple of good options for restoring their smiles in the meantime, albeit temporarily.

One is a removable partial denture or RPD, a device with the replacement prosthetic (false) tooth or teeth set in a gum-colored acrylic base. Of the various types of RPDs, most teenagers do well with a rigid but lightweight version called a “flipper,” called so because it can be flipped in and out of place with the tongue.

These RPDs are affordable, their fit easily adjusted, and they make cleaning the rest of the teeth easier. But they can break while biting down hard and—because they're dentures—aren't always well accepted among teenagers.

The other option is a bonded bridge. Unlike a traditional bridge secured with crowns cemented to natural teeth, a bonded bridge uses a strip of dental material affixed to the back of the prosthetic tooth with the ends of the strip extending outward horizontally. With the prosthetic tooth inserted into the empty space, these extended ends are bonded to the backs of the natural teeth on either side.

Though not as secure as a traditional bridge, a bonded bridge is more aesthetic and comfortable than an RPG. On the other hand, patients who have a deep bite or a teeth-grinding habit, both of which can generate abnormally high biting forces, run a higher risk of damaging the bridge. A bridge can also make hygiene tasks difficult and time-consuming, requiring a high degree of self-discipline from the patient.

Whichever you choose, both options can effectively replace a teenager's missing tooth while waiting for dental implants. Although temporary, they can make the long wait time for a teenager more bearable.

If you would like more information on restorations for children and teens, please contact us or schedule an appointment for a consultation.

By George R. Shepley, DDS
December 21, 2020
Category: Dental Procedures
Tags: dental implant  
TwoMajorCausesforImplantFailureandHowYouCanPreventThem

Dental implants are a reliable way to replace teeth. More than 95% of implants survive ten years after their installation, and many of these could conceivably continue for decades.

But that still leaves a tiny few that don't reach the ten-year mark. Some fail early because the implant didn't integrate fully with the bone to create a durable hold. But others fail later—usually for one of two major causes.

Some failures occur due to over-stressing of the implant from abnormally high biting forces, usually because of teeth grinding. People who have this involuntary habit generate excessive force as they grind their teeth, which can damage implants (as well as natural teeth). To reduce this force, a patient's dentist can fit them with a biteguard they wear in the mouth to prevent teeth from making solid contact with each other during a grinding episode.

Fortunately, teeth grinding isn't that prevalent among adults—but that can't be said about the other major cause for implant failure: periodontal (gum) disease. This is a bacterial infection caused by dental plaque, a thin, bacterial film that accumulates on teeth. The implant itself isn't affected by the infection, but the gums and underlying bone supporting the implant can be.

Implants are most in peril from a form of gum disease called Peri-implantitis, which spreads deeper into the gum tissues around implants faster than infections around natural teeth. That's because implants lack the gum attachment of real teeth, which supply a collagen barrier that slows the spread of infection. Peri-implantitis can quickly infect the supporting bone and eventually weaken its connection with the implant.

Because of its aggressiveness and speed, we must diagnose and treat peri-implantitis as soon as possible to limit any damage to the support structures around an implant. If you notice any swollen, reddened or bleeding gums, you should call your dentist as soon as possible for an examination.

And in light of this potential danger to your implants, you should also strive to prevent gum disease through daily oral hygiene. Brushing and flossing your teeth, including around your implants, removes harmful plaque buildup. This daily habit and regular dental cleanings will help you avoid a costly gum infection and ensure your implants are there for years to come.

If you would like more information on 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 “Dental Implants: A Tooth-Replacement Method That Rarely Fails.”

By George R. Shepley, DDS
October 01, 2020
Category: Dental Procedures
Tags: dental implants  
ImplantsCanMakeItEasiertoRestoreMissingTeethinStages

A fair number of people with total tooth loss have arrived at this point after a long history of dental issues. It's quite likely they've had a series of bridges or partial dentures over the years to accommodate lost teeth at various times before moving to full dentures.

For many, it often seems easier to extract any remaining teeth at some point and simply move on to a total restoration. It's often better for oral health, however, to preserve any remaining teeth for as long as possible and update restorations as needed. Dental implants could make this type of staged restoration strategy much easier to manage.

Implants are tiny metal posts surgically imbedded in a patient's jawbone. Over time, bone cells grow and adhere to the implant's titanium surface, creating a strong and durable hold. Its most familiar application is as a replacement for an individual tooth.

But because of their strength and durability, this advanced dental technology is also used to support other restorations like bridges and partial or full dentures by way of a few strategically placed implants. And it's in that role that they can be useful in planning and implementing future restoration upgrades when needed.

Under this strategy, we add implants to supplement pre-existing implants from earlier restorations to support the updated dental work. For example, we might have previously placed an implant supporting a single tooth or a small bridge. When the need later arises for a partial denture, we can add additional implants to be used with the earlier one to support the new denture.

If the earlier implants have been well-placed, we need only to add enough implants necessary to support a full denture when the time comes. How many will depend on the particular type of denture: A removable lower denture may only require one additional implant with one already in place. A fixed upper or lower denture will require enough to bring the number to between four and eight.

Taking this long-term approach can be more cost-effective in the long-run. More importantly, it can make for a smoother path for the patient and help preserve remaining teeth for as long as possible.

If you would like more information on restoration options for lost teeth, 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 “Replacing All Teeth but Not All at Once.”