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Posts for: January, 2014

By Gregory J. Gauthier DDS, LLC
January 28, 2014
Category: Oral Health
Tags: missing teeth  
ReplacingMissingBackTeethDeservesaHighPriority

For most people, replacing missing front teeth takes a higher priority over missing back teeth. The reason is obvious: others can see those missing in front, but not necessarily those in the back.

From a functional view, however, you should still consider replacing missing back teeth. Not only will it improve your chewing ability, it may also prevent a chain reaction of negative effects to your remaining teeth.

Teeth are held in place in the jawbone by a membrane called the periodontal ligament. The ligament is a living tissue that allows teeth to move to keep contact with adjacent and opposing teeth as natural wear occurs. When a space is created by a missing tooth, this natural movement accelerates and the teeth may shift beyond normal ranges.

As a result you can encounter excessive mobility of teeth from bite irregularities, uneven tooth wear, bone loss, potential painful problems with the temporo-mandibular joints (connecting the lower jaw to the skull), and a loss in facial height.

There are three basic options for this kind of tooth replacement. The best option is dental implants: these free-standing replacements don't normally affect surrounding teeth, they're easier to clean, and they help support the bite. On the downside, there must be enough remaining bone to support the implant.

The next best option is a fixed bridge. This option only works, however, if there are teeth on either side of the missing tooth space capable of supporting the bridge, and they must be reduced in size by removing the enamel with the dental drill. They also have a tendency to retain plaque, the main cause of gum disease.

That leaves the last, and least favorable, option, a removable partial denture. They may also trap food and be difficult to wear. They can move in the mouth, stressing — and possibly loosening — the remaining teeth that hold them in place. With all its drawbacks, though, if a partial denture is the only solution to missing back teeth, it's a better alternative than doing nothing and risking long-term problems.

If you would like more information on replacement options for back 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 Back Teeth.”


By Gregory J. Gauthier DDS, LLC
January 24, 2014
Category: Dental Procedures
ArePorcelainLaminateVeneersRightForYou

Porcelain laminate veneers are one of the innovative techniques dentistry has developed for restoring teeth to improve their color and shape so that they look as good as or better than the originals.

What are porcelain veneers? Porcelain is a ceramic material that is baked in a high-heat oven until it becomes glass-like. Your grandmother's antique china teacups are probably made of porcelain. Dental porcelains are especially made to perfectly mimic the color, reflectivity and translucency of natural tooth enamel. A veneer is a covering or shell, a false front; dental porcelains can be fashioned into veneers used to restore the enamel surfaces of teeth.

What is a laminate? A laminate is a structure created by uniting two or more layers of material together. Dental porcelain laminate veneers refer to the combination of tooth enamel bonding material and porcelain veneer.

When are porcelain laminate veneers used? Porcelain veneers are used to enhance the color of stained, darkened, decayed and heavily restored teeth. They are also used to: correct spaces between teeth; straighten slightly rotated teeth; correct problems in tooth shape and some bite problems. They can be good solutions for broken teeth or teeth that have been worn by habitual tooth grinding.

What is the process of placing the veneers? Room generally needs to be created to place a veneer; generally requiring about half a millimeter of reduction of tooth enamel. Artistic dental laboratory technicians fabricate veneers. About a week of laboratory time is usually needed to construct your veneers.

How do I know whether I will like the way my new veneers look? Computer imaging can be used to digitally replicate your teeth and create images of the proposed changes. Models of your teeth can be cast and changes can be made in white wax for your preview. Temporary veneers can also be fabricated as a test drive before the final veneers are fabricated.

How long will porcelain veneers last? Veneers can last 20 years or more. They are very strong but like glass, they can break if extreme force is applied to them. You should avoid such activities as opening bottles, cracking nuts, or biting into candy apples with your veneers.

How do I look after my new veneers? Once the veneers are placed, you should continue daily brushing and flossing. There is no higher incidence of decay around them than with your natural teeth. However, the more dental work you have in your mouth, the more vigilant you need to be. Of course, keeping your sugar consumption low helps to protect all of your teeth from decay.

Contact us today to schedule an appointment or to discuss your questions about porcelain laminate veneers. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”


By Gregory J. Gauthier DDS, LLC
January 16, 2014
Category: Dental Procedures
ActorEdHelmsTooth-YankingTrickItWasaDentalImplant

The lengths that some comedians will go to for a laugh! Actor Ed Helms, as dentist Stu Price, pulled out his own tooth in the movie The Hangover. Or did he? Turns out Helms really is missing a tooth, which never grew in. When he was in his late teens, he received a dental implant to make his smile look completely natural.

Helms told People magazine he wasn't exactly eager to remove the implant crown that had served him so well for almost 20 years, but there was no better way to do the famous tooth-pulling scene.

“We started to do different tests with prosthetics and blacking it out and nothing worked,” Helms told the magazine. Helms' dentist said it would be okay to take the implant crown out. “My dentist was really into it,” Helms said. The rest is movie history!

Congenitally missing (“con” – together with; “genital” – relating to birth) teeth are inherited and actually quite common. More than 20% of people lack one or more wisdom teeth, for example. These would not usually be replaced if missing (in fact, wisdom teeth are often removed) but it's a more serious issue when the missing tooth is in the front of the mouth — and not just for aesthetic reasons.

When a particular type of tooth is missing, it disrupts the pattern and function of the teeth. If left alone, sometimes the existing teeth will shift to close the gap. It's like removing a brick from an arch — the rest of the bricks would fall together in a different formation (or collapse entirely). And when upper and lower teeth don't come together properly, they can't function well.

The best treatment for this type of situation is the one Ed Helms had: a dental implant. They look and function like real teeth and do not attach to or damage adjacent teeth as other tooth-replacement options might.

It is important that a child with a congenitally missing tooth wait until jaw growth is complete — different for every person but usually in the late teens — before getting an implant. Otherwise, the artificial tooth might eventually appear too short when the person has stopped growing. In the meantime, there are temporary tooth replacements that can be made.

If you would like more information about options for congenitally missing teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow.” Dear Doctor also has more on “Teenagers & Dental Implants.”


By Gregory J. Gauthier DDS, LLC
January 08, 2014
Category: Oral Health
Tags: oral health  
TakingCareofThatAnnoyingBumpinYourMouth

Your mouth’s biting and chewing function is an intricate interplay of your teeth, jaws, lips, cheeks and tongue. Most of the time everything works in orderly fashion, but occasionally the soft tissues of the tongue or cheeks get in the way and are accidentally bitten. The resultant wound creates a traumatic fibroma, an overgrowth of tissue that develops to cover the affected area.

A fibroma consists of fibrous tissue made up of the protein collagen; this traumatized tissue functions much like a callous on a tender spot of skin by binding together the new tissues forming as the wound heals. But because the fibroma is raised on the surface of the cheek more than normal tissue, the chances are high it will be bitten again and reinjured, even multiple times. If this occurs the fibroma becomes tougher and more pronounced.

As it becomes raised and hardened in this way, it becomes more noticeable. More than likely, though, it poses no danger other than as an inconvenience. If it becomes too much of a nuisance, or you have concerns that it’s more than a benign growth, it can be removed with a simple fifteen-minute procedure. An oral surgeon, periodontist or dentist with surgical training will first anesthetize the area with a local anesthetic; the fibroma is then completely excised (removed) and the wound opening sutured with two or three small sutures. Any post-procedure discomfort should be mild and easily managed by pain medication like aspirin or ibuprofen.

Although it’s highly unlikely the fibroma is cancerous, the excised tissue should then be sent for biopsy. Viewing the tissue microscopically is the only definitive way to determine the true nature of the tissue and confirm any diagnosis that the tissue is benign. This is no cause for alarm as it’s a standard healthcare procedure to biopsy this particular kind of excised tissue.

“Bumps and lumps” are common occurrences in the mouth. It’s a good idea to point them out to us during your regular checkups or at any time if you have a concern. In either case, this bothersome problem can be easily treated.

If you would like more information on traumatic fibromas, 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 “Common Lumps and Bumps in the Mouth.”