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Posts for category: Dental Procedures

By Jennifer L. Toy, D.M.D.
November 21, 2021
Category: Dental Procedures
Tags: crowns  
WhatYouNeedToKnowToChoosetheRightDentalCrown

In the realm of dental restorations, not all crowns are alike. And, one type isn't necessarily superior to the others. One type of crown may work better for a particular tooth, while a different crown is better suited to another.

Therefore, knowing your options can help you make a more informed choice with your dentist regarding the best crown for your needs. Here, then, is a quick primer on the main types of dental crowns used today.

Metal crowns. Early in the last century, crowns made of gold, silver or other metals were the go-to dental restoration. Because of their strength and durability, metal crowns are still used today, mainly in back teeth that encounter heavy biting forces. Their drawback: They're decidedly not the color of natural teeth and so can stand out if they're placed in the visible "smile zone."

PFM crowns. The first crowns made with dental porcelain solved the appearance problem, but couldn't adequately handle biting forces as well as metal. Out of this came the porcelain fused to metal (PFM) crown, which contains an inner core of metal overlaid with tooth-colored porcelain. Providing both strength and life-likeness, PFM crowns were immensely popular until the mid-2000s.

All-Ceramic crowns. The development of porcelains more durable than earlier versions eventually dethroned the PFM (although the latter is still used today). Sixty percent of the crowns installed in recent years are all-ceramic, many reinforced with a strength material known as Lucite. Many all-ceramic crowns reaching the 15-year mark are still in place and functioning.

All of these crowns continue to be viable options for dental patients. The biggest factor in choosing one particular crown over another is the type of tooth involved and its location. As mentioned before, metal or PFM crowns are usually better for back teeth where durability is a higher priority than aesthetics. All-ceramics work well in high-visibility front teeth that normally encounter lighter biting forces than back teeth.

Regardless of which kind eventually caps your tooth, any of today's modern crowns will function as intended. But the best crown for you will be the one that both protects your tooth and enhances your smile.

If you would like more information on dental crown 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 “Porcelain Dental Crowns.”

By Jennifer L. Toy, D.M.D.
November 11, 2021
Category: Dental Procedures
Tags: Dental Implant  
ShouldYouTakeanAntibioticBeforeImplantSurgery

Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.

But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.

But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.

If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.

Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.

Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.

Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.

If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.

If you would like more information about dental implant surgery, 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 “Implants & Antibiotics.”

RussellWilsonsFunnyVideoAsideRemovingWisdomTeethisNoLaughingMatter

There are plenty of hilarious videos of groggy patients coming out of wisdom teeth surgery to keep you occupied for hours. While many of these have turned everyday people into viral video stars, every now and then it really is someone famous. Recently, that someone was Seattle Seahawks quarterback Russell Wilson.

The NFL star underwent oral surgery to remove all four of his third molars (aka wisdom teeth). His wife, performer and supermodel, Ciara, caught him on video as he was wheeled to recovery and later uploaded the clip to Instagram. As post-wisdom teeth videos go, Wilson didn't say anything too embarrassing other than, "My lips hurt."

Funny videos aside, though, removing wisdom teeth is a serious matter. Typically, the third molars are the last permanent teeth to erupt, and commonly arrive late onto a jaw already crowded with other teeth. This increases their chances of erupting out of alignment or not erupting at all, remaining completely or partially submerged within the gums.

This latter condition, impaction, can put pressure on the roots of adjacent teeth, can cause abnormal tooth movement resulting in a poor bite, or can increase the risk of dental disease. For that reason, it has been a common practice to remove wisdom teeth preemptively, even if they aren't showing any obvious signs of disease.

In recent years, though, dentists have become increasingly nuanced in making that decision. Many will now leave wisdom teeth be if they have erupted fully and are in proper alignment, and they don't appear to be diseased or causing problems for other teeth.

The best way to make the right decision is to closely monitor the development of wisdom teeth throughout childhood and adolescence. If signs of any problems begin to emerge, it may become prudent to remove them, usually between the ages of 16 and 25. Because of their location and root system, wisdom teeth are usually removed by an oral surgeon through one of the most common surgeries performed each year.

This underscores the need for children to see a dentist regularly, beginning no later than their first birthday. It's also a good idea for a child to undergo an orthodontic evaluation around age 6. Both of these types of exams can prove helpful in deciding on what to do about the wisdom teeth, depending on the individual case.

After careful monitoring throughout childhood and adolescence, the best decision might be to remove them.  If so, take it from Russell Wilson: It's worth becoming the star of a funny video to protect both current and future dental health.

If you would like more information about wisdom teeth removal, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”

By Jennifer L. Toy, D.M.D.
October 22, 2021
Category: Dental Procedures
Tags: crowns   bridgework  
AreImplantsaNo-GoforYouConsiderTheseOtherRestorationOptions

Our primary aim as dentists is to preserve teeth. There are times, however, when preserving a tooth is no longer worth the effort and we must recommend removing it. Fortunately, extracted teeth can be replaced with a functional and attractive restoration.

Today's top tooth-replacement option is the dental implant. Composed of a titanium metal post imbedded into the jawbone, a single dental implant can replace an individual tooth or a series of implants can support other restorations for multiple teeth. Besides being incredibly life-like, dental implants are highly durable and can last for decades.

But dental implants aren't an optimal choice for everyone. Their cost often matches their status as the premier tooth replacement method. And because they require a minimum amount of bone for proper implantation, they're not always feasible for patients with extensive bone loss.

But even if dental implants aren't right for you, and you want a fixed restoration rather than dentures, you still have options. What's more, they've been around for decades!

One is a bonded crown, which works particularly well for a tooth excessively damaged by decay, excessive wear or fractures. After removing all of the damaged portions and shaping the remaining tooth, we cement a life-like crown, custom created for that particular tooth, over the remaining structure.

Besides improving appearance, a crown also protects the tooth and restores its function. One thing to remember, though, is although the crown itself is impervious to disease, the remainder of the natural tooth isn't. It's important then to brush and floss around crowned teeth like any other tooth and see a dentist regularly for cleanings.

Dental bridges are a fixed solution for extracted teeth. It's composed of prosthetic teeth to replace those missing bonded together with supporting crowns on both ends. These crowned teeth are known as abutments, and, depending on how many teeth are being replaced, we may need to increase the number of abutments to support the bridge.

Although durable, crowns or bridges typically don't match the longevity of an implant. And, implants don't require the permanent alteration of support teeth as is necessary with a bridge. But when the choice of implants isn't on the table, these traditional restorations can be an effective dental solution.

If you would like more information on crown or bridge 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 “Crowns & Bridgework.”

By Jennifer L. Toy, D.M.D.
October 02, 2021
Category: Dental Procedures
Tags: dental implants   crowns  
WhichImplantCrownAttachmentMethodisBestforYou

If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.

As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.

Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.

But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.

Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.

So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.

In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.

If you would like more information on 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 “How Crowns Attach to Implants.”