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By Edward Joseph, D.D.S.
April 01, 2020
Category: Dental Procedures
YoumayNeedOrthodonticWorkBeforeGettingaDentalImplant

For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.

But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.

We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.

But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.

Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.

There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.

If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.

If you would like more information on restoring your smile after losing teeth, please contact us or schedule an appointment for a consultation.

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By Edward Joseph, D.D.S.
March 27, 2020
Category: Dental Procedures
ConsiderClearAlignersInsteadofBracesforYourTeen

Your teenager is about to take a big step toward better health and a more attractive appearance — orthodontic treatment. You both know the benefits: better chewing function, lower risk of dental disease, and, of course, a straighter and more beautiful smile.

But your teen might also dread the next couple of years of wearing braces. And it's hard to blame them: although they're effective, wearing braces restricts eating certain snacks and foods, they require extra time and effort for brushing and flossing, and they're often uncomfortable to wear. And of high importance to a teenager, they may feel embarrassed to wear them.

But over the last couple of decades a braces alternative has emerged: clear aligners. This form of bite correction requires fewer food restrictions, allows greater ease in hygiene, and is considered more attractive than braces. In fact, most observers won't notice them when a wearer smiles.

Clear aligners are a series of clear plastic trays created by computer that are worn in a certain sequence. During wear each tray exerts pressure on the teeth to gradually move them in the desired direction. The patient wears a single tray for two weeks and then changes to the next tray in the sequence, which will be slightly different than the previous tray. At the end of the process, the teeth will have been moved to their new positions.

Clear aligners aren't appropriate for all bite problems. When they are, though, they offer a couple of advantages over braces. Unlike braces, a wearer can remove the aligner to brush and floss their teeth or for rare, special or important social occasions. And, of course, their appearance makes them less likely to cause embarrassment while wearing them.

In recent years, design improvements have increased the kinds of bites aligners can be used to correct. For example, they now often include “power ridges,” tiny features that precisely control the amount and direction of pressure applied to the teeth. They've also become thinner and more comfortable to wear.

If you're interested in clear aligners as a treatment option, talk with your orthodontist about whether your teen is a good candidate. If so, they could make orthodontic treatment for achieving a more attractive and healthy smile less of an ordeal.

If you would like more information on clear aligners as an orthodontic option, 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 “Clear Aligners for Teens.”

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By Edward Joseph, D.D.S.
March 22, 2020
Category: Dental Procedures
WatchforTheseDevelopingBiteProblemswithYourChildsTeeth

You may not always be able to tell if your child's bite isn't developing properly.  That's why you should have them undergo an orthodontic evaluation around age 6 to uncover any emerging problems with tooth misalignment.

Still, there are some visible signs all's not well with their bite. As the primary (baby) teeth give way, the permanent teeth erupt sequentially around ages 6 to 8. As they come in, you should notice that each tooth fits uniformly next to each other without excessive gaps or, on the other end of the spectrum, not crowded together in crooked fashion. Upper teeth should also fit slightly over the lower teeth when the jaws are shut.

If their teeth appearance deviates from these norms, they may have a bite problem. Here are 4 abnormalities you should watch for.

Underbite or deep bite. As we mentioned, the front teeth should cover the lower teeth with the jaws shut. In an underbite, the reverse happens — the lower teeth are in front of the upper teeth. It's also a problem if the upper teeth cover the lower teeth too much (often referred to as “deeply”).

Open bite. This occurs when there's a gap between the upper and lower front teeth while the jaws are shut together. One possible cause is late thumb sucking, which can put undue pressure on the front teeth and cause them to develop too far forward while forcing the bottom front teeth further backwards.

Crossbites. This kind of bite occurs when some of the teeth don't fit properly over their counterparts, while others do. Crossbites can occur anywhere in the mouth, for example the upper front teeth fitting behind the lower front teeth while the back teeth overlap normally, or the reverse (front normal, back abnormal).

Misalignments and Abnormal Eruptions. Sometimes upper teeth may align too far forward, a situation known as protrusion. Conversely, lower teeth (or the jaw itself) may come in too far back (retrusion). Because a primary tooth might be out of position or not lost in the proper sequence, a permanent tooth might noticeably erupt out of its proper position.

If you notice any of these situations with your child's teeth see your dentist or orthodontist soon for a full examination. If caught early, we may be able to take action that will lessen or even eliminate the problem.

If you would like more information on treating bite problems, please contact us or schedule an appointment for a consultation.

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By Edward Joseph, D.D.S.
March 17, 2020
Category: Dental Procedures
Tags: fillings  
Tooth-ColoredFillingsProvideaViableAlternativetoDentalAmalgam

For over a hundred years dental amalgam — a combination of silver, mercury, tin and other metals — has been an effective filling material for teeth damaged by decay. But it has one major drawback — its metallic appearance stands out in stark contrast to the natural color of teeth.

As an alternative, composite resin fillings can match the color, shape and texture of natural teeth. These materials and the techniques used to bond them are proving just as effective as and more aesthetically pleasing than dental amalgam.

Fillings help protect and preserve a decayed tooth. By first removing decayed tooth structure through drilling, the resulting void is filled with durable material that strengthens the tooth and provides it protection from further decay.

The ultimate goal for restoration is to return the tooth to as near normal form and function as possible. Dental amalgam serves well in terms of function, providing the tooth strength in the face of the daily biting forces it encounters. In contrast, composite resins excel in appearance, but haven’t always matched the durability of amalgam. They’re material construction has improved over time, though, as well as the techniques used to bond them to teeth.

Most of these bonding techniques incorporate layering. The first step is to seal the dentin (the porous, living tissue just below the enamel); we then build up the composite material layer by layer within the tooth using special bonding adhesive and curing lights. In some cases where a large volume of tooth structure must be replaced, the restoration is first formed on the tooth and then removed for curing before being cemented into the tooth or a separate restoration is formed by a dental lab.

The end result is a tooth which both looks and functions like a fully intact tooth. Though care must be taken not to subject composite resin restorations to undue forces (no cracking open nutshells, for example), your new filling should continue to serve you and look great for a long time to come.

If you would like more information on metal-free 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 “The Natural Beauty of Tooth Colored Fillings.”

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By Edward Joseph, D.D.S.
March 12, 2020
Category: Oral Health
Tags: gum disease  
UncoveringEarlyGumDiseaseThroughPeriodontalProbing

How do you know if you have periodontal (gum) disease? Sometimes your gums will tell you—when they’re red, swollen or bleed easily.

But your gums can also look and feel healthy while a gum infection still brews below the gum line. In this case, a regular dental visit could make the difference. Even without overt signs of infection, we may be able to detect gum disease with a slender metal instrument called a periodontal probe.

Gum disease is a bacterial infection that most of the time arises from dental plaque. This thin film of bacteria and food particles accumulates on tooth surfaces, especially because of poor or non-existent oral hygiene. A continuing infection can weaken gum tissues and cause them to pull away or detach from the teeth.

Normally, there’s a slight gap between the gums and teeth. But as the infected gums pull away, the gaps grow larger and deeper, forming what are known as periodontal pockets. They become filled with infection that soon spreads to the root and bone and increases the risk of tooth loss.

These pockets, though, could be the means for detecting a gum infection with the help of the periodontal probe. During a dental exam we gently insert the probe, which has millimeter depth markings etched on it, between a tooth and its adjacent gums. While a depth of 1 to 3 mm is normal, a probe measurement of 4 to 5 mm could be a sign of an early stage infection. A reading of 7 to 10 mm, on the other hand, may indicate more advanced disease.

Along with other factors, periodontal probing can be quite useful identifying both the presence and extent of a gum infection and then how to treat it. The goal of any treatment is to remove plaque and tartar (calculus) deposits that sustain the infection. But probing, along with other diagnostic methods like x-rays, could point to deeper infection below the gum line that require more extensive methods, including surgery, sometimes to access and remove the disease.

Achieving the best treatment outcome with gum disease often depends on finding the infection early. Periodontal probing helps to make that discovery more likely.

If you would like more information on diagnosing and treating gum disease, please contact us or schedule an appointment for a consultation.

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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
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