Posts for: February, 2015

By Edward Joseph, D.D.S.
February 27, 2015
Category: Dental Procedures
AreTooth-ColoredFillingsRightforYou

When you say “ahhhhh,” are you worried about all your unsightly metal fillings? If so, did you know that your dentist can resolve your concerns through the use of tooth-colored fillings?

The public's demand for aesthetic tooth-colored (metal free) restorations (fillings) together with the dental profession's desire to preserve as much natural tooth structure as possible has led to the development of special adhesive tooth-colored restorations. And the demand is not limited to just the front teeth. In fact, many people are opting to replace all of their metal fillings — not just those in the front teeth — so that all of their teeth appear younger, fresher and as if they have never had any cavities.

Can you really mimic natural teeth? Proper tooth restoration is a lot more than just filling holes. It is a unique art applied with scientific understanding. Each tooth's internal shape and structure is the guide to how it must be rebuilt to successfully restore it. However, choosing which material to use to restore or rebuild teeth is a critical one based on scientific understanding, experience and clinical judgment — expertise we use daily in our office. The most popular options include composite resins and porcelains, as they allow us to mimic natural tooth colors and shapes. But for the most life-like, natural tooth-colored filling, your best option is porcelain. Porcelain, which is built up in layers, can be made to mimic the natural translucency and contours of tooth enamel.

But what about matching the color? Will it really match? Absolutely! Whether we use resins or porcelain, through our artistry we will create absolute tooth-like replicas. You will never know your teeth have fillings! And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, thus stabilizing and strengthening them. These techniques are even suitable for children's teeth and can incorporate fluoride to reduce decay.

Still undecided? If so, we understand. Feel free to contact us today to schedule an appointment to discuss your questions about tooth-colored restorations. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”


By Edward Joseph, D.D.S.
February 19, 2015
Category: Oral Health
Tags: dental injuries  
TimingisEverythingWhenitComestoTreatingMouthInjuries

When you or a family member takes a traumatic hit to the mouth, what should you do? Besides immediate first aid, your next action will depend on the extent of damage to any teeth. What you do and when you do it may even determine whether an injured tooth is eventually saved or lost.

If a tooth has been completely knocked out, you have about five minutes to replace the tooth in the socket to give it the best chance of reattachment and long-term survival. While we can certainly perform this action in our office, getting to us within five minutes may not be possible. Fortunately, any person can perform this action on site (see the article linked below for basic instructions on replantation). If for some that's not possible, you should control bleeding at the tooth site with direct pressure, place the recovered tooth in milk or the patient's saliva, and see us as soon as possible.

If, however, the injured tooth has been obviously knocked out of line but not completely detached from its socket, you have a small cushion of time to seek dental treatment — but not much. For this degree of injury, you should see us within six hours of the incident. We will be able to determine the exact nature of the injury, and treat the condition by moving the teeth back into proper position and splinting them.

You have up to twelve hours for broken or chipped teeth still in their normal position. Try to locate and save any broken-off fragments — it may be possible to re-bond them to the teeth. Although it may not be as urgent as other situations, you should still seek treatment as soon as possible. A broken tooth could leave the inner pulp exposed — a situation that left untreated could lead to eventual tooth loss.

Traumatic injuries to the mouth can have serious consequences for your long-term dental health. With our consultation and treatment efforts, we can help you save an injured tooth.

If you would like more information on caring for dental injuries, 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 Field-Side Guide to Dental Injuries.”


PayingAttentiontoCertainFactorsHelpsEnsureSuccessfulImplantOutcomes

Implants are highly regarded by both dentists and patients for their versatility and durability. But it’s their life-like appearance that “seals the deal” as the restoration of choice — not only mimicking an individual tooth, but emerging from the gum line and blending indistinguishably with other teeth in color and symmetry.

To achieve this result, we must consider a few factors beforehand, particularly the amount of bone available at the intended implant site. An implant requires a certain amount of bone to properly position it for the most natural crown appearance. The bone present around adjacent teeth can also affect your appearance: in the absence of adequate bone the papillae, triangular shaped gum tissue between teeth, may not regenerate properly between the implant and the natural teeth. This can leave a noticeable void, what dentists call “black hole disease.”

Bone loss is a significant problem particularly after tooth loss. It’s quite possible for you to lose a quarter of the bone’s width in the first year after tooth loss. To avoid this, we often use bone grafting techniques immediately after extraction to lessen bone loss; if it’s already occurred we may be able to use similar reconstructive techniques to rebuild and encourage renewed bone growth. In the end, though, if there remains a significant level of bone loss it may be necessary to consider another option for tooth replacement other than implants.

The thickness of your gum tissue, a genetic trait, can also have an impact on the implant’s ultimate appearance. Thicker gum tissues are generally more resilient and easier to work with surgically. Thinner gum tissues are more susceptible to recession and tend to be more translucent, which could cause the underlying metal implant to be visible. Thus, working with thinner gum tissues requires a more delicate approach when trying to achieve a visually appealing result.

All these factors must be balanced, from implantation to final crown placement. But with careful planning and attention to detail throughout the process, many of these issues can be overcome to produce a satisfying result — a new and appealing smile.

If you would like more information on the aesthetics of dental implants, 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 “Matching Teeth & Implants.”


By Edward Joseph, D.D.S.
February 03, 2015
Category: Dental Procedures
Tags: bonding   chipped teeth  
BondingwithCompositeResinsIdealforRestoringChippedTeeth

Accidents can happen to your mouth, especially if you have an active lifestyle. For example, a sudden blow to the jaw while playing sports or exercising could result in a chipped tooth. And, while the internal tooth structure may be fine, the effect on your appearance can be disheartening.

Fortunately, we have techniques and materials to restore your smile after an injury. Bonding with composite resin is one such procedure: it’s ideal for mild to moderate chipping, especially in highly visible front teeth.

Composite resin is a dental material made of various substances mixed to match the color and texture of natural teeth. The composite is usually made of inorganic glass filler blended with a plastic-based matrix and joined together with a chemical “coupling” agent. The ratio of filler to matrix will depend on the type of tooth and damage — for example, back teeth, which encounter higher biting forces, require a composite with more filler for added strength.

To begin the procedure, we first prepare the damaged tooth by applying microscopic etchings (often with a chemical solution) that create tiny depressions or “undercuts”: these help create a seamless bond between the composite and the natural tooth. We then apply the composite in layers with a bonding agent, building up layer upon layer until we’ve achieved the desired shape for the tooth involved.

Bonding with composite resins doesn’t require much tooth preparation, can be placed quickly and is relatively inexpensive. Because of the wide spectrum of color possibilities, composite resins are superior to traditional amalgam (metal) restorations in creating a more life-like appearance. Its application, however, can be limited by the amount of tooth structure needing to be replaced: because it isn’t as strong as the tooth structure it replaces, the more tooth structure the bonded composite resin attempts to replace the less likely it can stand up over time to normal bite forces.

Still, composite resins are ideal for mild to moderate damage or disfigurement. If you’ve suffered such an injury, be sure to visit us to see if bonding with life-like composites is the right solution for restoring your smile.

If you would like more information on bonding with composite resins, 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 “Repairing Chipped Teeth.”




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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