Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.
Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.
Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.
Appliances called implant bridges are attached to an area below the gum tissue, or the bone.
By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist
When your tooth becomes infected, it is clinically known as an abscessed tooth. The main reason for an abscessed tooth is tooth decay. An abscessed tooth can lead to serious damage including rotting of the pulp, and core of the tooth. This can even lead to pus buildup near the jawbone.
Failure to seek treatment can even cause damage to the surrounding bone and tissue.
The most common treatment for an abscessed tooth is a root canal. A root canal is a procedure where the infected tissue is cleaned, the canal is sealed, and the top of the tooth is crowned or capped.
By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist
What’s in a Filling?
Amalgams, the clinical term for fillings, are made out of synthetic materials that are used to repair a part of the tooth that has been damaged due to traumatic injury or decay. There are three main materials that are used for fillings including metal alloys and gold.
The standard synthetic material used in fillings is a silver colored material. In fact, many amalgams are comprised of various metallic alloys such as mercury, silver, tin, and copper. In recent years, mercury has come under the scrutiny of health experts for its possible long term health problems.
Is Mercury in a Dental Filling Safe?
The ADA (American Dental Association) has cautioned the public about over-reactions to the recent studies that have claimed the amalgams are responsible for an assortment of disease. According to the ADA, there is no evidence to support that amalgams are harmful due to the minute amounts of mercury, and the ADA has shown it does not pose a threat to human safety. There have been cases of patients having allergic reactions to the amalgams, but these cases have been rare.
Porcelain and composite resin are alternatives for the standard gold and metal amalgams. These new materials are colored to match the original color of the tooth enamel. The only downside to the porcelain and composite resin materials is composite resin is not as durable as the other amalgams (silver and gold), and thus has to be replaced more.
- Composite fillings -A mixture of fine particles and resin created to replicate the color of the natural teeth. Composite fillings provide an aesthetically pleasing appearance, but are not as strong as dental amalgam.
- Ionomers – These materials, like composite resin, are tooth colored. Ionomers are also made from a mixture of materials. This includes acrylic resin and ground glass. Ionomers serve several purposes. These fillings are placed near the tooth root or gum line, where there is not much biting pressure. Ionomers are more fragile than the dental amalgam. Ionomers release a small quantity of fluoride to help fortify the teeth enamel in the affected area.
- Porcelain (ceramic) – Porcelain is usually made of a mixture of ceramic, powder, glass and porcelain. The typical candidates for porcelain fillings are inlay and onlays, veneers, and crowns. Porcelain fillings, unlike ionomers, are more durable, but more susceptible to fracture when exposed to biting pressure for a prolonged time.
 http://ocean-newjersey-dentist.com/restoring-decayed-teeth.php, accessed December 26, 2011
By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist
The dental community has highly regarded the use of fluoride for decades as being an important mineral for strengthening teeth enamel because fluoride mineralized the enamel of the teeth. This strengthening of the teeth prevents the deterioration of tooth structures and decay.
Did you know that almost all U.S. community public drinking places and services have sodium fluoride in the water because it helps fight cavities and it is safe?
In other places like private wells, there is naturally fluorinated water.
What is fluoride?
Fluoride is a naturally occurring compound that is safe. It is even found in the air we breathe.
Why is fluoride important to teeth?
Fluoride fortifies bones and teeth by absorbing into these structures. Thus, fluoride makes bones and teeth resistant to decay and fractures. This process is called “reminiarlizaion”, a process in which the fluoride repairs damage caused by decay.
How do I get fluoride?
You can take fluoride as simply as drinking water. Water contains certain amounts of fluoride protection. Health professionals for many years supported fluoride supplement intake with some dietary products, toothpastes with topical fluorides, and even some kind of mouth rinses. Some beverages, such as soda and tea, also contain fluoride. Even some dental gels and varnishes may be applied on the teeth to increase fluoride intake.
It is unsafe to swallow mouth rinses, toothpastes, and other products that contain fluoride. In rare cases, people have suffered fluorosis due to over-exposure to high levels of fluoride. These rare cases of fluoride can result in dark stains on the enamel of the teeth.
 http://pidcgr.com/index.php/treatments/preventative-treatments/fluoride, accessed December 22, 2011
SNORING AND SLEEP APNEA
In September 1995 the American Sleep Disorder Association (ASDA) endorsed oral appliance therapy as the third currently acceptable treatment modality for snoring and sleep apnea. The two most common solutions include continuous positive air pressure or the removal of either the excess palatal tissue or the uvula.
It has been estimated that 60% of men and 40% of women between the ages of 40 and 60 years of age snore. Snoring occurs when there is a partial obstruction of the airway which causes the palatal tissues to vibrate. Obstructive sleep apnea occurs when the airway is completely blocked for certain periods of time. As many as 20 million people in North America may have sleep apnea. Snoring is a social problem, particularly for the spouse, but obstructive sleep apnea poses a significant health risk for the patient in that it can lead to irregular heartbeat, high blood pressure, heart attacks and strokes.
Sleep apnea is a type of breathing disorder which is a serious, potentially life-threatening condition characterized by brief interruptions of breathing during sleep. There are basically three types of apnea:
1. Central Apnea
The upper airway is open, but no oxygen is getting into the system. This occurs because the patient is not getting a chemical response from the brain to stimulate the lungs and the diaphragm to assist with breathing.
2. Obstructive Sleep Apnea
The lungs and the diaphragm are functioning normally, but no oxygen is entering the system because there is an obstruction in the upper airway.
3. Mixed Apnea
This is a combination of central and obstructive sleep apnea.
Oral appliances are only indicated for use in patients suffering from obstructive sleep apnea (OSA). The signs and symptoms of OSA include snoring, excessive daytime sleepiness, gasping or choking during the night, non-refreshed sleep, fragmented sleep, clouded memory, irritability, personality changes, decreased sex drive, impotence, and morning headaches.
Factors that affect obstructive sleep apnea are as follows:
Sedative Hypnotics (sleeping pills)
Children can also snore and suffer from obstructive sleep apnea. Often they are highly allergic and their airway is blocked due to enlarged adenoids, tonsils or swollen nasal mucosa. Clinical signs would indicate a turned up nose, allergic shiners under the eyes, mucous draining out of the nose, mouth breathing, and a nasal sound to the voice. Other signs are bed wetting, irritability, difficulty in concentrating at school and hyperactivity
At the present time, obstructive sleep apnea is defined as a medical problem and the diagnosis must be made by a medical doctor or sleep physician (pulmonologist) who is specially trained in the area of sleep medicine.
The dental profession has an important role to play in the treatment of patients with snoring and sleep apnea. If 60% of men and 40% of women between forty and sixty years of age snore, this is a huge problem. Snoring is a serious social problem for the spouse, but obstructive sleep apnea can be a life threatening situation for the patient in that it can lead to irregular heartbeat, high blood pressure and strokes.
At the present time, obstructive sleep apnea is a medical condition that is being controlled and treated mainly by the medical profession. Despite the fact that in September 1995, the American Sleep Disorder Association finally endorsed oral appliance therapy as the third currently acceptable treatment method for snoring and sleep apnea, the vast majority of the medical doctors are not aware of the value of oral appliances
As time goes on, the public is going to become more aware of the health risks associated with snoring and sleep apnea. It is the dental professionals responsibility to educate their members, the public and the medical profession about the important role that dentists and oral appliances play in the treatment of snoring and obstructive sleep apnea.
People choose aesthetic dental procedures/surgery for various reasons-to repair a defect such as a malformed bite or crooked teeth, treat an injury, or just improve their overall appearance. Whatever the reason, the ultimate goal is to restore a beautiful smile.
For these and many other reasons, aesthetic dentistry has become a vital and important part of the dental profession.
Common aesthetic dental procedures can be performed to correct misshaped, discolored, chipped or missing teeth. They also can be used to change the overall shape of teeth-from teeth that are too long or short, have gaps, or simply need to be reshaped.
Some of the more common procedures involve:
Bonding – A procedure in which tooth-colored material is used to close gaps or change tooth color.
Contouring and reshaping – A procedure that straightens crooked, chipped, cracked or overlapping teeth.
Veneers – A procedure in which ultra-thin coatings are placed over the front teeth. Veneers can change the color or shape of your teeth. For example, veneers have been used to correct unevenly spaced, crooked, chipped, oddly shaped or discolored teeth.
Whitening and bleaching – As the term implies, whitening and bleaching, a rapidly increasing procedure, are used to make teeth whiter.
Implants – A procedure that gives another option for replacing a missing tooth or teeth. They are so well designed that they mimic the look and feel of natural teeth.
Crowns – A procedure to cover and protect the tooth. While a crown can be used for many different reasons such as restoring a tooth that has been broken, has advanced decay or compromised in another way, it can also be used to improve the esthetics of your smile.
Which techniques should be used to improve your smile? A dental exam will take many factors into consideration, including your overall oral health.
When facial reconstruction, including procedures involving the oral cavity, is called for, a specialist is needed. Surgical procedures of the neck and head area are performed by a maxillofacial surgeon.
Common maxillofacial procedures include denture-related procedures and jaw surgery.
Protruding chins, crooked or buck teeth or misaligned teeth are good candidates for maxillofacial surgery.
In some people, jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. This can cause problems other than appearance issues; an improperly aligned jaw can cause problems with the tongue and lips, and speech and chewing problems as well. Jaw surgery can move jaws into their proper place.
Other kinds of maxillofacial surgery can correct problems with upper facial features such as the nose and cheek.
In addition to correcting jaw problems surgically, orthodontic appliances such as braces may be needed to restore bite relationship and ensure continued proper alignment of the jaw. In some cases, tiny wires or small rubber bands may be needed to keep the jaws in place and promote faster healing. In other cases, small “fixation” screws or plates may need to be inserted in the jaws to facilitate easy movement of the jaws following surgery.
In extreme cases, maxillofacial surgery, including bone grafts, manipulation of soft tissues or even jaw realignment, may be performed to correct such problems.
People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth.
One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.
People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.
Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.
Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves an arthritic condition of the jaw joint. Traumatic injuries also can cause jaw dislocation.
In these cases, jaw surgery, may be required to correct the condition. Some jaw surgery can be performed arthroscopically.
Some people have problems with gums that don’t conform to their teeth as well as they should. Gums should be snug around the base of teeth so the teeth can be anchored firmly and grow properly.
Conditions such as prolonged or untreated gum disease can actually cause gums to separate from teeth and form opportunistic pockets for bacteria and other debris; decay can also cause further deterioration.
Left untreated, these pockets can lead to serious infections that cause bone loss, making tooth extraction very likely.
A procedure called pocket reduction, or flap surgery, was developed to correct this problem. The procedure involves scraping away hard deposits such as tartar or calculus and reshaping damaged bone, with the eventual goal of reducing the size of the pocket and allowing the tissues to firm up around the teeth.
Advanced gum disease sometime requires the dentist to clean below the gum line to remove stubborn, crusty deposits called tartar or calculus, and to remove damage near the tooth root. This is done to prevent further damage and restore and stabilize the tooth.
For some patients, a local anesthetic is administered to the affected area. Then, a small scaling instrument and/or ultrasonic cleaning device are used to remove the deposits.
After cleaning, the root may need to be smoothed, or planed, to restore it as much as possible to its original shape. Planing also allows your gum tissue to better attach itself and heal properly.