Posts for category: Dental Procedures

By Mario A. Vilardi, DMD
June 07, 2019
Category: Dental Procedures
Tags: loose tooth  
SeeYourDentistASAPtoSaveYourLooseTooth

A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.

Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.

While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.

Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.

There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).

If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.

Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.

If you would like more information on treating loose 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 “Treatment for Loose Teeth.”

By Mario A. Vilardi, DMD
May 28, 2019
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Mario A. Vilardi, DMD
May 18, 2019
Category: Dental Procedures
Tags: dental implant   bone loss  
AnImplantRestorationCouldPreventBoneLoss

Losing teeth continues to be an all too common experience for people, especially those in their senior years. Fortunately, there are several ways to replace them, ranging from partial or full dentures to implants.

Some, though, postpone or simply choose not to replace a lost tooth, often because of the cost. But putting off a dental restoration could have a long-term impact on your health, and not in a good way. Continuing bone deterioration is one of the top consequences of delayed restoration.

Like other bones in the body, the jawbone is living tissue with cells that form, grow and eventually wear out. At the end of their life, these older cells give way to new cells. Eating and chewing play an important role in maintaining this growth cycle: the forces we generate as we chew travel up through the tooth roots to stimulate bone growth in the jaw.

When a tooth goes missing, though, the stimulus ends. Over time the bone cell replacement rate can fall off and the bone slowly loses volume. To make matters worse, bone loss can continue beyond the immediate bone underlying the tooth and affect the rest of the jawbone. The jaw can shrink in height and width, and in time become weaker overall and more susceptible to fracture.

But dental implant restorations in particular could help stop or even reverse bone deterioration at the site of the missing teeth. The titanium post implanted in the jaw attracts bone cells, which grow and adhere to its surface. Over time the bone fills in and becomes stronger.

You don't want to wait too long, though, because implants depend on a minimum amount of bone present for secure placement. You should therefore undergo an implant restoration as soon as it's practical after tooth loss. Otherwise, although we may be able to restore some of the lost bone with bone grafting, you may need to consider another restorative option.

When it comes to replacing missing teeth, time isn't on your side. But the right kind of dental restoration undertaken promptly can make for a brighter, healthier future.

If you would like more information on restoring lost 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 “The Hidden Consequences of Losing Teeth.”

IsLaserTreatmentaGoodOptionforControllingGumDisease

Although techniques for treating periodontal (gum) disease can vary, they all boil down to one objective: remove the bacterial plaque and calculus (hardened plaque deposits) that cause the infection. The initial treatment usually involves two techniques known as scaling and root planing.

Scaling uses hand instruments, ultrasonic equipment or a combination of both to manually remove plaque and calculus from the tooth and root surfaces. Root planing takes it a step further by minutely “shaving” infected material from the root surfaces. While more invasive techniques (including surgery) may be needed, scaling and root planing are the first line of treatment for any recent diagnosis of gum disease.

In recent years, an adaptation to these treatments has emerged using the Nd: YAG laser. The laser uses a particular crystal that’s adaptable for many different types of surgery. In the case of gum disease, it’s been found as effective as traditional methods for removing the infected linings of periodontal pockets. Voids created by detaching gum tissues as bone loss occurs, enlarge the small natural gap between the teeth and gums, which fill with pus and other infected matter. Removing the diseased lining from these pockets reduces bacteria below the gum line and speeds healing.

Periodontal laser therapy may have one advantage over traditional treatments: less tissue damage and swelling, and hence reduced post-treatment discomfort. While some research seems to confirm this, more controlled studies are needed to render a verdict on this claim.

Regardless of whether you undergo traditional scaling and root planing or a laser alternative, the aim is the same — to bring the disease under control by removing plaque and calculus and reestablishing good daily oral hygiene practices. Stopping gum disease as soon as possible will help ensure you’ll have healthy teeth and gums for a long time.

If you would like more information on treatments for periodontal (gum) 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 “Lasers versus Traditional Cleanings for Treating Gum Disease.”

By Mario A. Vilardi, DMD
March 09, 2019
Category: Dental Procedures
LadyGagaWasntBornThisWay

Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"

"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.

The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.

Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.

Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).

The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.

Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.

So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”



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