Indianapolis Downtown Dental Office Blog
Posts for: May, 2018
The mark of a great dental restoration is that you can’t see it. It’s there in plain sight, but others observing your new and improved smile can’t tell the difference between the restoration and your natural teeth. Everything looks, well, natural.
That’s the great advantage of dental porcelain. A dental technician with technical skill and artistic flair can form this inorganic, ceramic material into a life-like replica of your tooth, with a shape and color that blends in with the rest of your teeth. And because of its strength properties, porcelain restorations can hold up to the normal chewing and biting forces in your mouth, as long as you use prudence when biting down on hard substances.
Porcelain is also highly adaptable to different kinds of restorations. For natural teeth still viable but no longer attractive, porcelain can be the main ingredient in two very popular and effective restorations, the veneer and the crown. Although the porcelain material is the same for both, their construction and application are quite different.
Veneers are very thin laminated layers of dental porcelain custom-colored and shaped for bonding to the outer visible portion of a tooth. They’re a great solution for relatively decay-free teeth that have minor to moderate defects like chipping, slight misalignment or heavy staining. They often require some permanent removal of tooth enamel to ensure their appearance isn’t too bulky, but causes minimal impact to the tooth.
Crowns, on the other hand, are complete tooth replicas that are bonded in place over an existing tooth like a cap. They’re a good choice for teeth in which the root and inner layers are still viable, but the tooth has been significantly damaged by decay or trauma. They’re also useful as a protective cover for teeth that have undergone root canal treatment. But unlike the minimal impact of veneers, crowns require significant tooth alterations to accommodate them.
In either case, though, the end result is much the same: both crowns and veneers can be fashioned to precisely mimic the shape, color and texture of natural teeth. In skillful hands, these porcelain restorations can transform your smile for the better and no one but you and your dentist will ever need to know.
If you would like more information on porcelain 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 “Porcelain Crowns & Veneers.”
There’s more to teeth than meets the eye. Hidden beneath the visible crown are the tooth’s roots set within the jawbone, secured and protected by the gums from bacteria and infection. But if the gums shrink back (recede), the roots become exposed and susceptible to disease, especially at the points where multiple roots branch from each other, areas called furcations.
It all begins with periodontal (gum) disease caused by built-up bacterial plaque from insufficient brushing and flossing. The infection triggers inflammation that over time weakens gum tissues. They begin to detach from the teeth, which can eventually lead to gum recession and root exposure.
This also causes bone loss, especially at the furcations. We can detect any loss (known as a furcation invasion) and how far along it may be with x-ray imaging or by manually probing with an instrument called a periodontal probe.
There are three general classes measuring furcation invasions. In the earliest, Class I, we can feel the invasion as a slight groove; in Class II, it increases to two or more millimeters across. In Class III the bone loss extends from one side of the root all the way to the other (a “through and through”).
At this stage a patient is in danger of losing the tooth, so we’ll have to act promptly. This means first removing accumulated dental plaque and calculus (tartar) to stop the infection and allow the gums to heal. With severe damage, we may need to assist healing with bone and gum tissue grafting, in which we place donor grafts to serve as scaffolding for the appropriate tissue to grow upon.
You can help prevent this situation by practicing effective daily hygiene and visiting your dentist for thorough cleanings at least twice a year (or more if recommended). And at the first signs of a gum infection—swollen, reddened or bleeding gums—make an appointment as soon as possible to have it checked. The sooner we can detect and treat gum disease, the less likely a furcation invasion or worse will be in your future.
Porcelain veneers are a great way to enhance an unattractive smile. But are they appropriate for teenagers? The answer usually depends on a patient’s current development stage and the type of veneer used.
Veneers are thin layers of porcelain bonded to the front of teeth. But even though quite thin, they can appear bulky if we don’t first remove some of the tooth’s enamel surface. This is irreversible, so the tooth may require a restoration from then on.
This could be a major issue for teens whose permanent teeth are still developing. During this period the tooth’s central pulp is relatively large and the dentin layer not fully developed. As a result, the pulp’s nerves are often closer to the surface than in an adult tooth. This increases risk of nerve damage during veneer preparation; if nerve damage occurs, the tooth could ultimately require a root canal treatment to save it.
On the other hand, some types of veneers don’t require tooth alteration (or only very little) beforehand. These “no-prep” or “minimal prep” veneers are best for certain situations like abnormally small teeth, so we must first determine if using such a veneer would be appropriate for your teen.
In effect, we’ll need to weigh these and other factors before determining if veneers are a safe choice for your teen. That being the case, it may be more advisable to consider more conservative cosmetic techniques first. For example, if enamel staining is the main issue, you could consider teeth whitening. Although the often amazing results eventually fade, whitening could still buy some time until the teeth have matured to safely apply veneers.
Slight deformities like chipping can often be corrected by bonding tooth-colored composite material to the tooth. In artistic hands it’s even possible to create a full veneer effect with very little if any tooth preparation. How much we can apply, though, depends on tooth size, and it won’t be as durable as a porcelain veneer.
With that said, veneers could be the right solution to enhance your teen’s smile. But, we’ll need to carefully consider their dental situation to ensure their new smile remains a healthy one.