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Posts for category: Dental Procedures

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
April 28, 2019
Category: Dental Procedures
Tags: porcelain veneers  
TransformingYourSmilewithVeneersStepbyStep

Dental veneers are a great way to transform a smile without the expense or effort often required of other restorations. These thin layers of dental material adhere to the front of teeth as a "mask" to cover chips, heavy staining or other blemishes.

Still, veneers require attention to detail for a successful outcome. Here's a step-by-step look at changing your dental appearance with veneers.

Step 1: Considering your options. While most veneers are made of dental porcelain, composite resin materials are increasingly popular. Although more prone to chipping or staining, composite veneers don't require a dental lab for fabrication. Another option, depending on your dental situation, are ultra-thin veneers that require little to no tooth preparation. Your dentist will help you decide which options are best for you.

Step 2: "Test driving" your new smile. We can help you "see" your future smile with special software that creates a computer image of your teeth with the planned veneers. We can also use composite material to fabricate a "trial smile" to temporarily place on your teeth that can give you the feel as well as the look of your future smile.

Step 3: Preparing your teeth. Unless you're getting no-prep veneers, we'll need to modify your teeth before attaching veneers. Although only 0.3 to 0.7 millimeters thick, veneers can still appear bulky on unprepared teeth. They'll look more natural if we first remove a small amount of enamel. A word of caution, though: although slight, this enamel removal permanently alters your teeth that will require them to have some form of restoration from then on.

Step 4: Attaching your new veneers. After the planning phase (which includes color matching to blend the veneers with the rest of your teeth), a dental lab creates your veneers if you've opted for porcelain. After they're delivered, we'll clean and etch the teeth with a mild acidic gel to increase the bonding effect. We'll then permanently attach the veneers to your teeth with a very thin but ultra-strong resin luting cement that creates a unified bond between the veneers and teeth.

Following these steps is the surest way to achieve a successful outcome. With due care you're sure to enjoy the effects for a long time to come.

If you would like more information on changing your smile with veneers, 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 “Porcelain Veneers: Your Smile—Better than Ever.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
April 08, 2019
Category: Dental Procedures
Tags: tooth decay  
YourSinusInfectionMightbeaSignofaToothProblem

Each year thousands of people develop sinus infections from various causes. But there's one cause for sinusitis that might surprise you—tooth decay.

Tooth decay begins when the acid produced by oral bacteria erodes a tooth's enamel protection to create a small hole or cavity. Left untreated, the infection can move into the inner pulp of the tooth and tiny passageways leading to the roots called root canals. The decay can then infect and break down the structure of the supporting jawbone.

This could affect the sinus cavities, hollow air-filled spaces in the upper portion of the face. The maxillary sinus in particular sits behind the cheek bones just above the upper jaw. Tooth roots, particularly in back teeth, can extend quite near or even poke through the floor of the maxillary sinus.

If decay affects these roots, the bone beneath this floor may begin to break down and allow the bacterial infection to enter the sinus. We call this particular kind of sinus infection maxillary sinusitis of endodontic origin (MSEO), "endodontic" referring to the interior structure of teeth.

While advanced decay can show symptoms like pain or sensitivity with certain hot or cold foods, it's also possible to have it and not know it directly. But a recurring sinus infection could be an indirect indication that the root of your suffering is a deeply decayed tooth. Treating the sinus infection with antibiotics won't cure this underlying dental problem. For that you'll need to see a dentist or an endodontist, a specialist for interior tooth issues.

The most common way to treat deep tooth decay is with root canal therapy. In this procedure, the dentist enters the decayed tooth's pulp (nerve chamber) and root canals and removes the diseased tissue. They will then fill the empty pulp and root canals with a special filling and seal the tooth to prevent future infection. The procedure stops the infection and saves the tooth—and if you have MSEO, it eliminates the cause of the sinus infection.

So, if you're suffering from chronic sinus infections, you might talk with your dentist about the possibility of a tooth infection. A thorough examination might reveal a decayed tooth in need of treatment.

If you would like more information on how dental problems can affect your overall health, please contact us or schedule an appointment for a consultation.

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
March 19, 2019
Category: Dental Procedures
Tags: palatal expander  
PalatalExpansionCouldHeadOffFutureOrthodonticTreatment

People mainly identify orthodontics with braces. But while they’re a major part of it, braces aren’t the only way this important dental specialty can make a difference in a person’s bite.

For example, orthodontics can help guide the development of a younger patient’s facial structure that could head off future upper teeth misalignment. The area of focus is the upper jaw and palate (the roof of the mouth) that jointly make up a structure called the maxilla. The maxilla is actually formed by two bones fused together in the center of the palate along what is known as the midline suture running from front to back in the mouth.

The two bones remain separated until puberty, which helps accommodate rapid structural growth during childhood. But problems can arise if the upper jaw is too narrow, causing a “cross-bite” where the lower back teeth bite abnormally outside the upper ones. This can crowd upper permanent teeth and cause them to erupt improperly.

Using a technique called palatal expansion we can correct this abnormality if we act before the maxillary bones fuse. The technique employs a custom-made appliance called a palatal expander that attaches to the posterior teeth of the upper arch. Expanders have two halves joined by a small screw device to increase tension against the teeth to widen the jaw. A parent or the patient (if old enough) increases the tension by using a special key to turn the adjustment screw a tiny amount each day. This may cause minor discomfort that normally eases in a few minutes.

The patient wears the device until the jaw expands to the desired width and then allows the bones to stabilize in the new position. This can sometimes create a small gap between the upper front teeth, but it often closes on its own or it may require braces to close it.

While palatal expanders are not for every case, they can help normalize development and improve the bite, and thus preclude more extensive orthodontic treatment later. But time is of the essence: after the maxilla has fused, surgery will be necessary to separate them and widen the palate. It’s important then not to delay if your child could benefit from this effective treatment.

If you would like more information on palatal expanders and other orthodontic treatments, 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 “Palatal Expanders.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
March 09, 2019
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
February 07, 2019
Category: Dental Procedures
Tags: composite resin  
CompositeResinCouldAmpupYourTeethsAttractivenessinJustOneVisit

It might not rise to the level of a miracle, but cosmetic dentistry can achieve some amazing outcomes with unattractive teeth. A skilled and experienced dentist can turn "ugly ducklings" into beautiful "swans." And that achievement might not be as in-depth or expensive as you might think, thanks to the increased use of dental materials called composite resins.

Composite resins are pliable, tooth-colored materials we apply directly to tooth surfaces. They're most often used with broken, chipped or misshapen front teeth—the composite material replaces the missing tooth structure.

Composite resins have been around for decades, but haven't been widely used because they didn't have the strength of dental porcelain. In recent years, though, dentists have perfected techniques for bonding and shaping composites to teeth that have increased their durability. With just the right skill and artistry, composites can look like natural teeth.

We can correct many tooth flaws using composite resins right in our office. After roughening up the outer enamel surface of the tooth and performing other steps to aid bonding, we begin applying liquid resins to form a base layer that we then harden with a special light source. We continue to add layers to increase the color depth and shape of the restoration, before finally polishing it to resemble natural teeth.

Composite restorations are ideal for moderate tooth structure loss, but may not be appropriate for heavily worn, previously root canal-treated or fractured teeth. These and other kinds of flaws may require a different solution such as a dental porcelain restoration with veneers or crowns. Where composites can be used, though, they provide an affordable option that doesn't require an outside dental lab for fabrication—we can often perform it in one visit.

If you'd like to consider a composite resin restoration for a less than perfect tooth, see us for a complete examination and consultation. If your situation appears to be compatible for using this particular technique, composite resins could change your smile for the better in just a few minutes.

If you would like more information on how we can improve your smile, 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 “Artistic Repair of Front Teeth with Composite Resin.”