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Posts for category: Dental Procedures

By Raul A. Montalvo, D.D.S.
May 08, 2021
Category: Dental Procedures
Tags: veneers  
YouMayNotNeedPermanentToothAlterationWithTheseUltra-ThinVeneers

If you're looking for a cosmetic enhancement with a “light” touch, you can't beat dental veneers. These custom-made wafers of dental porcelain are bonded to the front of teeth to mask chips, heavy staining or gaps, revitalizing your smile.

But with traditional veneers, a minimal impact doesn't mean no impact at all. Although they're quite thin—often a millimeter or less—they can still look bulky when bonded to unprepared teeth. Dentists usually remove a small amount of surface enamel to help them appear more natural.

The alteration itself is painless, and only the bare minimum of enamel is removed. Even so, the alteration is permanent—the tooth will require a veneer or other form of restoration from then on. But a new kind of veneer may make it possible to avoid any enamel removal, or much less. These no-prep or minimal-prep veneers are even thinner, between 0.3 and 0.5 millimeters.

With these ultra-thin veneers, your dentist may only perform a little minor enamel re-shaping, particularly the sides of the teeth, to ensure a good fit. As thin as they are—akin to that of a contact lens—no-prep veneers can be bonded to the teeth surface without the need for fitting them under the gum line.

No-prep veneers are ideal for people with smaller than normal teeth, or that appear smaller due to other facial features. This also includes teeth that have worn down from age or teeth grinding, or those that are misshapen in some way. They also work well with people who have a narrow smile where less teeth than normal are visible in the “smile zone.”

They can also be used with patients who have oversized or prominent teeth, but it may still require some enamel removal. The only qualification for anyone receiving ultrathin veneers is that their enamel is in reasonably good health.

Because there's little to no alteration of the teeth, no-prep veneers can be reversed. Removing them, though, is no easy task, so you'll still need to think long-term before obtaining one. All in all, though, no-prep veneers in the right setting can still transform your smile without much permanent change to your teeth.

If you would like more information on no-prep veneers, 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 “No-Prep Porcelain Veneers.”

By Raul A. Montalvo, D.D.S.
April 18, 2021
Category: Dental Procedures
Tags: veneers  
YourTeensTeethMayNotBeReadyforVeneers

Teenagers can have the same smile-disrupting tooth flaws as adults. But not all cosmetic treatments available to adults are appropriate for teenagers—at least not until they get a little older. Dental veneers fall into that category.

A veneer is a thin porcelain shell custom-made by a dental lab, and bonded by a dentist to the face of a tooth to mask chips, stains, gaps or other imperfections. Because they're less invasive than other measures, veneers are highly popular as a cosmetic dental solution. They do, however, usually require some enamel removal so that they'll appear more natural.

This enamel removal typically won't impact an adult tooth other than it permanently requires it to have veneers or other restorations after alteration. But there is a risk of damage to a teenager's tooth, which hasn't fully developed.

Adolescent teeth usually have a larger pulp chamber (filled with an intricate network of nerves and blood vessels) than adult teeth. And because the enamel and dentin layers may not yet be fully developed, the pulp is much nearer to the tooth's surface.

We must be very careful then in removing enamel and dentin for veneers or we may penetrate the pulp and risk damaging it. Alternatively, there is the possibility of no-prep veneers which are very conservative but often are unable to be done because of the need to often remove tooth structure to make the veneers look natural.

Another cosmetic problem can occur if we place veneers on a patient's teeth whose jaws and mouth structures are still growing. Eventually, the gums could recede and an unsightly gap form between the veneer and the adjacent natural tooth.

Fortunately, there are other techniques we can use to improve a tooth's appearance. Mild chipping can be repaired by bonding composite resin material to the tooth. Some forms of staining may be overcome with teeth whitening. These and other methods can address a teenager's smile appearance until their teeth are mature enough for veneers.

Whether or not a tooth is ready for veneers will depend on its level of development, something that can often be ascertained with x-rays or other diagnostic methods. And if a tooth has already undergone a root canal treatment, there isn't as much concern. In the meantime, though, it may be better for your teen to wait on veneers and try other techniques to enhance their smile.

If you would like more information on dental restoration for teenagers, 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 “Veneers for Teenagers.”

HowYouTooCouldHaveLindseyVonnsViralVideoSmileMakeover

Instagram, America's humongous digital photo and video album, is chock-full of the silly, mundane, and poignant moments of people's everyday lives. That includes celebrities: Tom Hanks buying a used car; Ryan Reynolds sporting tiny sunglasses; Taylor Swift and Ed Sheeran taking a hike. And then there's former Olympic alpine skier, Lindsey Vonn—posting a video of her recent dental visit.

Winner of several World Cup competitions and the first woman to gain the gold for downhill racing at the 2010 Winter Olympics, Vonn broke her two front teeth during a—you guessed it—skiing competition a few years ago. This past September, she went to the dentist to update her restoration and gave her followers a fascinating firsthand look at dental bonding, a technique for repairing a chipped or broken tooth.

Although dental bonding has been around for decades, it's taken a leap forward in the last few years because of improvements in bonding material. A mixture of plastic and glass components, composite resins can produce a strong and durable result when bonded to teeth. To begin the technique, the tooth's surface is prepared so that the composite resin can better adhere. Along with an adhesive agent, the bonding material is applied as a paste, which makes it easier to shape and sculpt for the most realistic look. This is usually done layer by layer, with each individual layer hardened with a curing light.

The technique allows us not only to achieve the right tooth shape, but also to incorporate your natural tooth color. We can tint the composite resin as we work so that your restored tooth blends seamlessly with the rest of your natural teeth. The result: A “new” tooth that's both beautiful and natural-looking.

What's more, dental bonding is more affordable than veneers or crowns and can often be done in a single visit. You will, however, need to exercise care with your new restoration. Although highly durable, it can be damaged if you bite into something hard. You'll also need to watch foods and beverages like tea or coffee that can stain the dental material.

Even so, we can help you regain the smile you once had before you took your teeth skiing—Lindsey Vonn-style—or whatever you were doing that resulted in a “whoopsie.” All it takes is a call for an appointment to start you on the path to a more attractive smile.

If you would like more information about cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Artistic Repair of Front Teeth With Composite Resin.”

By Raul A. Montalvo, D.D.S.
February 17, 2021
Category: Dental Procedures
Tags: dentures  
FlexibleRPDs-aSoundTemporaryWayToReplaceMissingTeeth

The timing around losing a tooth may not always sync with your financial ability. It's not unusual for people to postpone getting a dental implant—by far the best option for replacing a missing tooth—because of its expense.

So, if you have to postpone dental implants until you can afford them, what do you do in the meantime to keep your smile intact? One affordable option is a temporary restoration known as a flexible removable partial denture (RPD).

Composed of a kind of nylon developed in the 1950s, flexible RPDs are made by first heating the nylon and injecting its softened form into a custom mold. This creates a gum-colored denture base to which prosthetic (false) teeth are affixed at the exact locations for missing teeth.

Differing from a permanent RPD made with rigid acrylic plastic, a nylon-based RPD is flexible and lightweight, making them comfortable to wear. They're kept in place with small nylon extensions that fit into the natural concave spaces of teeth. And, with a bit of custom crafting, they can look quite realistic.

RPDs are helpful in another way, especially if you're waiting for an implant down the road: They help preserve the missing tooth space. Without a prosthetic tooth occupying that space, neighboring teeth can drift in. You might then need orthodontic treatment to move errant teeth to where they should be before obtaining a permanent restoration.

Flexible RPDs may not be as durable as acrylic RPDs, and can be difficult to repair or reline if needed to adjust the fit. Though they may not stain as readily as acrylic dentures, you'll still need to clean them regularly to help them keep looking their best. This also aids in protecting the rest of your mouth from dental disease by removing any buildup of harmful bacterial plaque on the RPD.

But even with these limitations, patients choose RPDs for the simple fact that they're affordable and temporary. And the latter is their greatest benefit—providing you a “bridge” between losing a tooth and replacing it with a durable dental implant.

If you would like more information on tooth replacement options, 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 “Flexible Partial Dentures.”

By Raul A. Montalvo, D.D.S.
January 28, 2021
Category: Dental Procedures
Tags: tooth decay  
3ReasonsWhyTreatingCavitiesIsBecomingMoreEffective

If you've ever had a run-in with cavities, you know the drill (no pun intended): After getting a local anesthetic for pain, the dentist removes any decayed dental tissue, as well as some healthy tissue, and then fills the cavity to restore the tooth. It's an effective treatment protocol we've been using for well over a century.

It does, however, have its drawbacks. For one, although necessary, removing healthy dental tissue can weaken the overall tooth structure. The dental drill used during the procedure is also unpleasant to many people: Although it doesn't cause any pain thanks to the anesthetic, the sounds and pressure sensations associated with it can be unsettling.

But advances in dental tools, technology and techniques are addressing these drawbacks in traditional tooth decay treatment. In other words, treating a tooth with cavities today is taking on a lighter touch. Here are 3 reasons why.

Earlier detection. The key to effective treatment is to find tooth decay in its earliest stages. By doing so, we can minimize the damage and reduce the extent of treatment needed. To do this, we're beginning to use advanced diagnostic tools including digital x-rays, intraoral cameras and laser fluorescence to spot decay, often before it's visible to the naked eye.

Re-mineralizing enamel. One of the advantages of early detection is to catch tooth enamel just as it's undergoing loss of its mineral content (demineralization) due to contact with acid. At this stage, a tooth is on the verge of developing a cavity. But we can use minimally invasive measures like topically applied fluoride and CPP-ACP (a milk-based product) that stimulates enamel re-mineralization to prevent cavity formation.

Less invasive treatment. If we do encounter cavities, we no longer need to turn automatically to the dental drill. Air abrasion, the use of fine substance particles under high pressure, can precisely remove decayed material with less loss of healthy tissue than a dental drill. We're also using newer filling materials like composite resins that don't require enlarging cavities as much to accommodate them.

These and other techniques—including laser technology—are providing superior treatment of tooth decay with less invasiveness. They can also make for a more pleasant experience when next you're in the dentist's chair.

If you would like more information on effectively treating dental disease, 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 “Minimally Invasive Dentistry.”



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