Posts for: February, 2014

SolvingtheProblemofMissingTeethWithOrthodonticsandRestorations

Normally, teeth erupt and grow in a symmetrical alignment: on the top palate, for example, the two central incisors take center stage; on either side are the lateral incisors, and then beside these the canines (cuspids).

But what happens when teeth don’t grow in? The result can be a smile that just doesn’t quite look right; more importantly, normal function is impaired because the person can’t grasp and chew food correctly.

These missing teeth are the result of a congenital (“from birth”) defect. It’s estimated that almost a quarter of all people are missing one or more wisdom teeth, and more than 5% are missing one or more second premolars or upper lateral incisors.

In a normal arch (the upper or lower set of teeth), each tooth type performs a particular role during eating. A missing tooth causes the remaining teeth to compensate, but beyond their capacity. The remaining teeth also tend to move to fill in any gaps left by the missing teeth, as when the eye teeth move toward the central incisors in the absence of the lateral incisors. This puts them out of position, so they can’t cover (“occlude”) their counterparts on the other arch and grasp food properly.

To improve the smile and restore proper chewing function it’s necessary to first move these “out of position” teeth to their correct position through orthodontics. We would then fill the gaps that result with life-like restorations (preferably dental implants with crowns) that resemble the type of tooth that should be there.

The restoration needs to be timed carefully, especially for young patients whose jaw structure has not fully developed. If implants are installed before the jaw’s full maturity (usually late teens or early twenties), the implant crowns may not appear to be the right length as the jawbone continues to grow. Since bone growth depends on the normal pressures exerted by the teeth, there may also be insufficient bone mass in the gap area to support a dental implant. Growing bone with bone-grafting material may be necessary before installing implants.

The total process could take many months or even years, depending on age and other conditions. In the end, though, the results can be astounding — better function and a vibrant, new smile.

If you would like more information on developmental problems with teeth, 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 “When Permanent Teeth Don’t Grow.”


By Edward Joseph, D.D.S.
February 21, 2014
Category: Dental Procedures
PlanningYourWeddingDaySmileMakeover

You're planning for one of the most important days in your life — your wedding — and you want everything to be perfect. You've chosen the outfits, the setting, the flowers... but there's one more thing to think about. Is your smile just as bright as your hopes for the future? Do you wish you could improve its appearance in time for the big date?

Here's good news: You can! Depending on how much advance notice you have — and what level of enhancement you need — your wedding day smile makeover can range from a thorough dental cleaning to a full-scale orthodontic treatment program. Let's look at a few options that can help you look and feel your best on this very special day.

Getting your teeth thoroughly, professionally cleaned can help remove some surface stains and tartar in just one appointment! Depending on the level of discoloration, and how long it's been since your last cleaning, more than one session may be needed. You have this basic and effective treatment done every three to six months anyway — right? So, be sure and schedule one before your wedding!

Sometimes your smile needs more than just routine maintenance. If that's the case, there are many other options to help it look its best. Tooth whitening is a safe, effective and economical way to lighten teeth by several shades. In-office treatments are quicker and more predictable, but dentist-supervised at-home bleaching kits are also an option if you have more time.

Porcelain veneers offer a more striking and more permanent solution for discolored teeth. To get the optimum “wow” effect from this treatment, figure from two to four office visits, and a total treatment time of at least three months.

Cosmetic bonding is a great way to hide those little chips in the front teeth, or discolored old fillings in back. Using the newest high-tech materials and a dose of old-fashioned artistry, we can restore the shiny, translucent look of your natural teeth — only with fewer imperfections. After a thorough evaluation, cosmetic bonding can often be performed as a one-visit procedure.

If your smile needs even more help, don't despair — there are still plenty of ways to improve it.

Teeth that are damaged or missing can be restored by crowns or bridgework. When the roots are intact, a crown replaces the visible part of the tooth above the gum line. If the tooth is missing, a bridge is used to secure a false tooth to two abutments on either side. Properly done, these restorations may last a decade or more, and generally require two or more visits.

Dental implants are a great way to restore missing teeth. They offer a permanent, natural-looking tooth replacement with numerous advantages over other restorative treatments. Achieving these results requires careful planning and takes a bit more time. If you need tooth restoration, be sure to ask us whether dental implants might be right for you.

If you would like more information about a wedding-day smile makeover, don't hesitate to contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”


By Edward Joseph, D.D.S.
February 13, 2014
Category: Oral Health
Tags: tooth decay  
SavingaDiseasedPrimaryToothCouldBenefitFutureOralHealth

Dentists go to great lengths to save an adult permanent tooth. Even though restoration technology is incredibly advanced, none can completely replace the biological function of natural teeth. Treating a diseased tooth to preserve it is a high priority in dentistry.

It would seem, though, that a child’s primary (baby) tooth might not warrant the same treatment. Since the tooth eventually detaches from the jaw to make way for a permanent tooth, why save it?

It is worth the effort, because primary teeth provide more than a chewing function: they also serve as guides for their permanent successors. When they’re lost prematurely, the permanent teeth may not come in correctly, leading to a malocclusion (poor bite). Other areas of development, like speech and dental bone growth, may suffer as well from the longer time gap between the premature loss and the permanent tooth eruption.

Saving an infected primary tooth should be considered, especially if significant time remains in its lifespan. Due to differences between primary and permanent teeth, though, the treatment approach isn’t the same. For example, the body gradually absorbs the roots of a primary tooth (a process called resorption) as the permanent tooth beneath erupts applying pressure to the primary roots (this is what enables its eventual detachment). Dentists must factor this process into their diagnosis and treatment plan for a primary tooth.

The level of treatment may vary depending on how deep the infection has advanced. If the decay is limited to the tooth’s outer layers and only partially affects the pulp, the innermost layer of the tooth, a dentist may remove as much soft decay as possible, apply an antibacterial agent for any remaining hardened infection, and then restore the tooth with filling materials.

For deeper infection, the dentist may remove some or all of the pulp, disinfect and clean the area, and then fill and seal the empty space with a filling. A filling material like zinc oxide/eugenol paste should be used that’s capable of resorption by the body to coincide with the natural root resorption. After treatment, the tooth should continue to be monitored for changes in appearance or gum swelling, just in case the infection returns or advances.

Although it may seem counterintuitive, treating a primary tooth as you would its successor is worth the effort. Your child will reap the health benefits, both now and long after the primary tooth is gone.

If you would like more information on endodontic treatment for children, 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 “Root Canal Treatment for Children’s Teeth.”


By Edward Joseph, D.D.S.
February 05, 2014
Category: Oral Health
Tags: gum disease  
WhenShouldYouSeeAPeriodontist

Periodontal (gum) disease is sometimes called a “silent” malady — meaning that its symptoms don’t generally announce themselves with great fanfare (or pain, as conditions like tooth decay and root canal issues often do). Yet this disease is estimated to affect almost half of the adult population in the United States, causing deterioration of the gums and the bone surrounding the teeth… and possibly leading to bacterial infections, loss of teeth, and even systemic (whole-body) problems.

So what exactly is periodontal disease? Actually, it’s the broad name for a group of related diseases which attack the soft tissue of the gums and the tooth-supporting bone. Most periodontal diseases are caused by the buildup of harmful bacteria in a biofilm (thin, sticky layer), which coats teeth in the absence of effective oral hygiene. And yes, that means if you don’t brush and floss daily, you’re much more likely to develop gum disease.

Even the most attractive smile could have gum disease lurking beneath it. How do you know if you may be affected? Some early warning signs include redness or inflammation of the edges of the gums, a bad taste in your mouth or bad breath, plus any degree of bleeding when you brush your teeth (brushing should never cause gums to bleed). As the disease progresses, you may develop painful inflammation or a pus-filled abscess, bone loss, loose teeth… and eventually tooth loss.

But don’t wait until then to seek treatment! If you see your general dentist regularly, and if he or she notices signs of gum disease, you may be referred to a periodontist. But you don’t need a referral — you can simply make an appointment and come in for a check-up. That may be wise if you have noticed any warning signs — especially if it has been a while since you’ve had an exam. Periodontal disease may be a silent malady, but that doesn’t mean you have to let it affect your oral health.

If you would like more information about periodontal disease, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “When To See A Periodontist” and “Warning Signs of Periodontal (Gum) Disease.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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