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TheDisappearingToothGap-MichaelStrahanPullsanEpicAprilFoolsPrank

If you're a fan of former NFL player and current host of Good Morning America Michael Strahan, then you're well aware of his unique smile feature—a noticeable gap between his front teeth. So far, Strahan has nixed any dental work to correct the gap, often saying it was part of "who I am."

But if you follow him on Twitter, you may have been shocked by a video he posted on March 30th of him sitting in a dentist's chair. Calling it a "moment fifty years in the making," Strahan said, "Let's do it." After some brief video shots of a dental procedure, Strahan revealed a new gapless smile.

But some of his Twitter fans weren't buying it—given the timing, they sniffed an elaborate April Fool's Day ruse. It turns out their spider senses were on target: Strahan appeared once again after the video with his signature gap still intact, grinning over the reaction to his successful prank.

The uproar from his practical joke is all the more hilarious because Strahan has let it be known he's truly comfortable with his smile "imperfection." But it also took him awhile to reach that point of acceptance, a well-known struggle for many people. On the one hand, they want to fix their dental flaws and improve their smile. But then again, they're hesitant to part with the little "imperfections" that make them unique.

If that's you, here are some tips to help you better navigate what best to do about improving your smile.

See a cosmetic dentist. A cosmetic dentist is singularly focused on smile enhancement, and particularly in helping patients decide what changes they want or need. If you're looking for such a dentist, seek recommendations from friends and family who've changed their smiles in ways you find appealing.

Get a "smile analysis." Before considering specific cosmetic measures, it's best to first get the bigger picture through an examination called a "smile analysis." Besides identifying the defects in your smile, a cosmetic dentist will use the analysis to gauge the effect any proposed improvements may have on your overall facial appearance.

Embrace reality. A skilled cosmetic dentist will also evaluate your overall oral health and assess how any cosmetic procedures might impact it. This might change your expectations if it whittles down the list of enhancement possibilities, but it may help determine what you can do to get the best improved smile possible.

A great cosmetic dentist will work diligently with you to achieve a new smile that's uniquely you. Even if, like Michael Strahan, you decide to keep a trademark "imperfection," there may still be room for other enhancements that will change your appearance for the better.

If you would like more information about a "smile makeover," please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cosmetic Dentistry.”

Same-DayImplantsOfferanAttractiveSmileThroughouttheProcess

With traditional implant methods, it could take months before you can enjoy your new replacement tooth. That's usually not a big deal for a back tooth that's mostly out of sight. It's a different story, however, for a highly visible front tooth—the extended time without a tooth can be embarrassingly uncomfortable for some.

There is, however, another option, one you may already have seen advertised: same-day tooth replacement. In effect, you receive the implant and a life-like temporary crown in a single dental visit.

During the conventional process, the dentist surgically installs the titanium implant post into a prepared channel in the jawbone. Once it's properly positioned, the dentist then sutures the gum tissue over the implant. This protects the implant while bone cells grow and attach themselves to the post to give it a strong and durable hold within the bone.

But now dentists have developed another method to help address the appearance problem posed by teeth that are more visible. With this method, the dentist affixes a temporary crown onto the implant post immediately after installing it. The patient thus walks out the same day without a missing tooth gap and a full smile.

This is a welcome alternative for people desiring to maintain an attractive smile throughout the implant process. But it does have one major qualification—the patient's underlying jawbone must be relatively healthy and supportive of the implant. If not, the implant may require a longer period of bone growth before and after surgery to fully secure it. In those cases, it may be better to use the conventional method.

As we've already noted, a "same-day" crown isn't the permanent one, especially with single tooth implants. That's because the implant still requires bone integration over several weeks to achieve full durability. For that reason, this initial crown is made slightly shorter than the surrounding teeth to limit its encounter with biting forces generated by daily chewing, from which those forces would likely damage the implant at this stage.

After completion of the bone integration stage, the patient returns to swap out the temporary crown for the fully functional permanent crown. The "same-day" crown has served its purpose—providing the patient a seamless full smile throughout the implant process.

If you would like more information on "same-day" implant restorations, 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 “Same-Day Tooth Replacement With Dental Implants.”

UncoveringtheCauseistheFirstSteptoRelievingToothSensitivity

For one out of three Americans, a bite of ice cream or a sip of hot coffee can set off a sudden jolt of pain. Fortunately, there are ways to reduce these painful episodes of tooth sensitivity and their severity.

To understand the primary reasons that people experience tooth sensitivity, we must first consider a little tooth anatomy. Just below a tooth's outer enamel is a layer of tooth structure called dentin, composed of tiny tunnels or tubules that transmit sensations of temperature or pressure to the nerves in the central pulp. These tubules are analogous to conduits through which electrical wires pass.

Enamel on the crown, along with gum tissue and a thin material called cementum covering the roots, help muffle sensations so as to prevent an overload on the nerves. But if either of those protective areas become compromised the nerves could in turn experience the full brunt of these sensations.

As such, softened and eroded enamel from tooth decay could expose the dentin. Receding gums, commonly caused by gum disease, can also expose dentin near the roots since the remaining cementum offers little protection. In either case, nerves in the pulp may become subject to extreme sensations caused by temperature or while biting down, which then causes them to fire off pain signals to the brain.

Thus, to treat sensitive teeth we must first determine whether it's the result of tooth decay, gum disease or some other condition, and then treat any underlying disease. If it's decay-related, we'll want to repair any cavities with a filling, or perform a root canal if the infection has spread deeper into the tooth.

For receded gums, we'll first want to treat any lingering gum disease. Once we've brought the infection under control, it's possible then for the gums to heal and regenerate, eventually treating the roots with desensitizing products. In some cases, though, we may have to surgically graft new tissue to the receded area to cover the roots.

The good news is that you can lower your chances of tooth sensitivity by preventing these dental diseases. To do that, be sure you're brushing and flossing daily to remove disease-causing plaque, and visiting your dentist at least twice a year for professional cleanings and checkups.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”

GumDiseaseAroundtheToothRootsCanBeDifficulttoAccessandTreat

Periodontal (gum) disease may begin superficially, but it can eventually work its way deeper below the gums to become a threat to the teeth and the underlying bone. The tooth roots are especially vulnerable to the disease with long-lasting implications to the tooth's survival.

An infection usually begins with dental plaque, a thin biofilm on tooth surfaces that harbor the bacteria that cause gum disease. The infection may eventually reach an area around the tooth roots called a furcation, where the roots branch off from the main tooth body. If the disease gains a foothold in a furcation, it could seriously erode the infected bone structure.

This often occurs in stages, commonly classified as early, moderate or advanced ("through and through"). In the first stage, the infected area exposes a slight groove in the tooth, but no significant structural loss. The next stage shows bone loss of at least two millimeters. In the most advanced stage, the bone loss now extends all the way beneath the tooth from one side to the other.

As with any situation caused by gum disease, it's best to catch a furcation involvement early and initiate treatment. As with any case of gum disease, the objective is to remove accumulated plaque and tartar (hardened plaque), which both fuel the infection. With plaque removed, the periodontal tissues can begin to heal and possibly regenerate.

It can be hard to achieve these outcomes because furcations are difficult to access. Although we may be able to clean the roots with tools like scalers (curettes) or ultrasonic equipment, we might still need to surgically access the area to completely remove the infection.

Initial treatment of furcations is often only the beginning. Someone with this level of gum disease usually needs continuous, heightened dental care and maintenance to prevent reinfection, often by an experienced hygienist working in consultation with a periodontist (gum specialist). It's also common to surgically alter the tissues around a furcation to make them easier to inspect and clean.

The best scenario, of course, is to avoid an infection altogether, or at least diagnose it before it becomes this advanced. The best way to stay gum (and tooth) healthy is to be sure you brush and floss every day, and see your dentist for cleanings and checkups at least twice a year.

If you would like more information on treating furcations, 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 “What are Furcations?

UnlikeBradPittYouDidntMeanToChipYourToothWeCanStillFixIt

It's not unusual for serious actors to go above and beyond for their roles. They gain weight (or lose it, like Matthew McConaughey for True Detective). They grow hair—or they shave it off. But perhaps nothing tops what Brad Pitt did to assume the character of Tyler Durden in the movie Fight Club—he had his dentist chip his teeth.

While a testament to his dedication to the acting craft, Pitt's move definitely falls into the category of "Kids, don't do this at home." Fortunately, people deliberately chipping their teeth isn't a big problem. On the other hand, accidentally chipping a tooth is.

Chipping a tooth can happen in various ways, like a hard blow to the jaw or biting down on something too hard. Chipping won't necessarily endanger a tooth, but the missing dental structure can put a damper on your smile.

But here's the good news: you don't have to live with a chipped tooth. We have ways to cosmetically repair the damage and upgrade your smile.

One way is to fit a chipped or otherwise flawed tooth with a dental veneer, a thin wafer of dental porcelain bonded to the front of a tooth to mask chips, discolorations, gaps or other defects. They're custom-made by a dental lab to closely match an individual tooth's shape and color.

Gaining a new smile via dental veneers can take a few weeks, as well as two or more dental visits. But if you only have slight to moderate chipping, there's another way that might only take one session in the dentist's chair. Known as composite bonding, it utilizes plastic-based materials known as composite resins that are intermixed with a form of glass.

The initial mixture, color-matched for your tooth, has a putty-like consistency that can be easily applied to the tooth surface. We apply the composite resin to the tooth layer by layer, allowing a bonding agent in the mixture to cure each layer before beginning the next one. After sculpting the composite layers into a life-like appearance, the end result is a "perfect" tooth without visible flaws.

Unlike Brad Pitt, it's pretty unlikely you'll ever find yourself in a situation requiring you to purposely damage your teeth. But chips do happen—and if it happens to you, we have more than one way to make your teeth as good as new.

If you would like more information about repairing dental flaws with veneers or composite bonding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”





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