Predictable Dentistry

The ability to generate a smile design plan with a predictable end in mind is what sets a cosmetic dentist apart from other dentists. Traditionally, a patient comes to the dentist with a problem. The dentist looks at the problem and generates a solution. The patient has to trust the dentist's judgment and pretty much take whatever is produced. While there is nothing inherently wrong with this approach, it fails to take into account the specific needs of the patient where smile design is concerned. One dentist's beautiful smile may not be pretty at all to the patient. The cosmetic dentist employs various treatment planning tools that allow the patient to express what they are looking for and allow the dentist to show the patient what the final result might look like. This process can take as long as necessary and accomplishes two things. First, the dentist can develop as clear an idea as possible what specifically the patient is looking for. Second, the patient has input into the final outcome and is informed on the front end if their needs can be met. This process, known as co-diagnosis, is time-consuming and is part of the reason the best cosmetic dentists are considerably more expensive than average. It's also central to their success. Without careful planning and previewing, your chances of getting exactly what you want are greatly reduced. Give this due thought when you are considering cosmetic dentists.

Sensitive Teeth

Your teeth are made up of an incredibly hard, outer 'enamel' layer that allows you to bite and chew, a more porous 'dentin' layer extending from beneath the enamel to below the gumline, and an inner, soft tissue 'pulp' layer containing the tooth's vital nerves, blood vessels, and connective tissues. Damage such as receding gums or chipped, cracked, worn or broken enamel can allow underlying nerve endings to be exposed to air, hot, cold, and touch… resulting in 'sensitive teeth'. Once dentin is exposed, it's tough to correct the situation. In some cases, laser technology may successfully seal the tiny exposed tubules; in other cases it's necessary to simply treat the symptoms.

First, we may suggest a soft-bristled toothbrush to protect your gums from further irritation and recession; we may also recommend a special toothpaste formulated to block access to the nerve endings or to insulate the nerve itself; and finally, we may prescribe a fluoride rinse or gel. For a few weeks, as you wait for these measures to take effect, you'll need to monitor what you eat and drink-- avoiding very hot or cold foods and beverages, stopping any habitual, conscious grinding or clenching, and brushing very gently with a soft brush.

Xrays

Traditional x rays in a dental office use a technique that has not changed much in almost a century. Light energy, in this case x ray radiation, interacts with a chemical emulsion on the surface of a piece of film. This is developed in a dark-room using still more chemicals to produce an image which the dentist then squints at in front of a light to diagnose. We are taught in dental school to use magnification and a variable light source, but the reality is that few dentists do this. The results of this method are:

• diagnosis of the most obvious areas of decay.
• Several minutes waiting for the image to see if the thing we wanted to see is actually on the film.
• Several more minutes waiting to develop the retake.
• Much fretting when the film you want to see has been lost.
• You get the idea...

Using digital radiography, your dentist can now clearly identify all external and internal anatomical structures, and accurately diagnose your dental problems all within seconds and with minimal radiation exposure! What's even more amazing is that they can immediately translate that information into a large, clear, accurate image right next to your chair…ready for discussion.

Digital radiography’s technology improves and simplifies the way dentists care for their patients’ teeth, resulting in better dental evaluations and treatment decisions. A sensor placed in the mouth acts like a miniature digital camera with an x-ray sensitive chip, exposing you to 50%-90% less radiation exposure than with traditional x-ray techniques. The resulting highly detailed image of your mouth is almost instantaneously translated onto the computer screen, carrying with it all the conveniences of other digitized images. the dentist can rotate it, magnify it, adjust it for contrast, and even color-code it for educational purposes. Further, they can store it easily and efficiently in our computer files, eliminating paper files as well as image wear and tear. For insurance purposes, referrals or patient education, it can be easily, inexpensively and faithfully reproduced any number of times. And because it helps patients clearly understand the root issues behind their dental health, dentist and patient are able to work together to determine the very best treatment options for each case.

Lumineers

Lumineers are porcelain facings that are manufactured and marketed--heavily--by the DenMat corporation. The advertisements claim that the veneers can be placed with little or no tooth preparation or grinding and no shots. In some cases, this is true, but most often it is not. Be certain that your dentist has adequate training in cosmetic dentistry before agreeing to have this type of facing placed on your teeth. Improper placement can lead to bulky teeth, painful bite problems, and even tooth loss. Never be afraid to seek a second opinion. A competent dentist will have no problem with this.

Finding your best dentist

Occasionally, I will do a Google search on cosmetic dentistry just to see who the Google gurus think has the best match for the search term. The first several entries always go to the national organizations and advertising services, but generally their is one actual dentist on the list. For a long time, the first dentist was Shawn Keller in Seattle, but today's search brought up Dr Sun in Los Angeles...Dentist to the stars! Clearly, the stars have no trouble finding the dentist most suited to them. Dr Sun is an excellent clinician and has the credentials to prove it, but how does the average non-star find a good dentist?
The first place to check is with friends, family, and co-workers. Then, check to see if the dentist is a member of the major dental organizations: American Dental Association, Academy of General Dentistry, and American Academy of Cosmetic Dentistry. Call to see if the dentist will give you a free "get acquainted" visit or at least give you some time on the phone to ask questions. Your looking for someone skilled who is not in a hurry because they have to see 50 patients a day as many PPO dentists do. As with most things, you get what you pay for. For more on choosing a dentist click here. Happy hunting!

Bad Breath

Bad breath, halitosis, or mouth odor, is a common problem experienced by just about everyone at some time. Some people are plagued with the problem constantly. Others have it less frequently. Regardless of frequency or severity, mouth odor can be an embarrassing condition.

Oral odors can be generated in many ways. Various foods can contribute to bad breathe. Some of these may just smell bad on their own while others have oils and other components which are absorbed into the bloodstream and excreted through the lungs and oral tissues. Garlic, onions, and alcohol are examples of these odor causers. These odors generally have to just work their way out of the system. If food is not cleaned from between the teeth or from around dentures, it may rot and cause a bad odor. Tobacco products also act in the lungs to produce odors. Tobacco use also aggravates gum disease which is itself a major cause of mouth odors. Dry mouth can contribute to bad breath as well.

Bad breath may be a sign of a sinus infection or other local infection as well as other systemic diseases. Gastrointestinal, kidney, and liver disease all may have bad breath as a side effect. Also note that some medications may also cause mouth odor.

Obviously, finding and eliminating the underlying cause of the problem is the first best step in treatment. There are also many agents available over the counter to help mask oral odors. Your dentist may also prescribe antibacterial treatments Such as Peridex to help fight the root causes of the problem.

Occlusal Disease

As healthcare has improved over the past century, people have been living longer lives. One of the results of this is a population of people over the age of forty or fifty. We are now seeing and dealing with disease processes which were uncommon just a short time ago. The mouth is no exception. Fifty or sixty years ago, gum disease was almost unheard of. Most people of that time lost all their teeth or died long before they could develop gum problems. One condition that many experts see as an epidemic in our society is occlusal or bite disease. Signs of this problem are:

Biting surfaces of teeth worn flat, often with cupping where dentin is exposed.

Multiple chipped, cracked, and broken teeth and crowns(caps)

"divots" or "toothbrush Abrasion at the gumline (abfraction)

Thick bony growth over the tooth roots

Front teeth with even flat edges and teeth that are wider than they are long

deep creases or wrinkles at the corners of the mouth

Loose or shifting teeth



Occlusal disease may not be painful or uncomfortable to the patient. It can be a component of TMJ syndrome and can aggravate any pre-existing gum disease or periodontal problems. Occlusal Disease can also be a factor in cosmetic and esthetic dental problems.

Treatments for occlusal disease range from no treatment at all to full-mouth rehabilitation. Frequently the bite will need to be "opened up" to correct for the wear that has occurred over the years. It's important to find an experienced dentist who can deal with the complexities of bite reconstruction. Simply patching a worn tooth or "just fixing the teeth that show" are recipes for failure.