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Posts for category: Dental Procedures

By Charles R. Horin, DDS
October 29, 2020
Category: Dental Procedures
MikeTysonThePrizefighterPrizesHisUniqueSmile

Mike Tyson made a splash when he faced off against sharks during the Discovery Channel's Shark Week 2020. But there's bigger news for fans of the former undisputed world heavyweight champion: After a 15-year absence, he will enter the ring again for two exhibition matches in the Fall. However, it's not just Tyson's boxing action that made news during his 20-year career. His teeth have also gotten their fair share of press.

Tyson used to be known for two distinctive gold-capped teeth in the front left side of his mouth. He made headlines when he lost one of the shiny caps—not from a blow by a fellow pugilist but from being headbutted by his pet tiger as Tyson leaned in for a kiss. Tyson's teeth again garnered attention when he had his recognizable gold caps replaced with tooth-colored restorations. But the world champion may be best known, dentally at least, for his trademark tooth gap, or “diastema” in dentist-speak. Several years ago, he had the gap closed in a dental makeover, but he soon regretted the move. After all, the gap was a signature look for him, so he had it put back in.

That's one thing about cosmetic dentistry: With today's advanced technology and techniques, you can choose a dental makeover to suit your individual taste and personality.

An obvious example is teeth whitening. This common cosmetic treatment is not a one-size-fits-all option. You can choose whether you want eye-catching Hollywood white or a more natural shade.

If your teeth have chips or other small imperfections, bonding may be the solution for you. In dental bonding, tooth-colored material is placed on your tooth in layers and then hardened with a special light. The material is matched to your other teeth so the repaired tooth fits right in. This procedure can usually be done in just one office visit.

For moderate flaws or severe discoloration, porcelain veneers can dramatically improve your appearance. These thin, tooth-colored shells cover the front surface of the tooth—the side that shows when you smile. Veneers are custom-crafted for the ideal individualized look.

Dental crowns can restore single teeth or replace missing teeth as part of a dental bridge. Again, they are manufactured to your specifications. With restorations like crowns and veneers, the smallest detail can be replicated to fit in with your natural teeth—even down to the ridges on the tooth's surface.

And if, like Mike Tyson, you have a gap between your teeth that makes your smile unique, there's no reason to give that up if you opt for a smile makeover. Whether you would like a small cosmetic enhancement or are looking for a more dramatic transformation, we can work with you to devise a treatment plan that is right for you.

If you would like more information about smile-enhancing dental treatments, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Cosmetic Dentistry: A Time for Change.”

By Charles R. Horin, DDS
September 29, 2020
Category: Dental Procedures
Tags: dental injury  
ActQuicklyWithaKnockedOutToothtoEnsureItsLong-TermSurvival

We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.

Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.

That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.

Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.

Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:

  1. Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
  2. Reinsert the root end into the empty socket with firm pressure;
  3. Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
  4. Seek dental or emergency medical care immediately;
  5. If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.

You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.

If you would like more information on what to do in a dental emergency, 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 “When a Tooth is Knocked Out.”

2KindsofOrthodonticRetainersThatCanProtectYourNewSmile

While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.

Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.

But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.

The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.

While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.

An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.

A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.

If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.

If you would like more information on bonded retainers, 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 “Bonded Retainers.”

LingualBracesMightbeaBetterFitforYourActiveLifestyle

If you've decided to straighten your teeth, you've made a wise choice for both your dental health and your smile. Now you may be facing another decision—which method to use for bite correction.

Not too long ago people had only one choice—traditional braces all the way. But that changed with the introduction of clear aligners, a series of removable plastic trays worn one after the other to realign teeth. In all but a few situations, clear aligners accomplish the same outcome as braces but without the conspicuous appearance and, thanks to their removability, difficulty in brushing and flossing teeth.

And now, a recent innovation in orthodontics could give you a third option—lingual braces. These are braces fixed to the back of teeth adjacent to the tongue (hence the term “lingual”), rather than on the front as with traditional braces. They essentially perform the same action, only instead of “pushing” teeth like traditional braces, they “pull” the teeth to the target positions. Lingual braces may also ease certain disadvantages people find with traditional braces or clear aligners.

If you're into martial arts, for instance, you may encounter blows to the face that increase your injury risk while wearing traditional braces. Likewise, if you're highly social, clear aligners can be a hassle to take out and keep up with if you're frequently eating in public. Lingual braces answer both types of issues: They won't damage your lips or gums in the case of blunt force facial contact; and they remain out of sight, out of mind in social situations.

Before considering lingual braces, though, keep in mind that they may cost 15-35 percent more than traditional braces. They also take time for some people to get used to because of how they feel to the tongue. And, they're not yet as widely available as traditional braces, although the number of orthodontists who have received training in the new method is increasing.

If you'd like to know more about lingual braces and whether they're right for you, speak to your dentist or orthodontist. You may find that this new option for improving your dental health and your smile fits your lifestyle.

If you would like more information on lingual 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 “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

WhyKathyBatesChoseThisAlternativetoBracesandsoMightYou

Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.

Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.

Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.

Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.

While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.

That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.

Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.

With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.

The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.

If you would like more information about tooth straightening, please contact us or schedule a consultation.