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Posts for category: Dental Procedures

By Lynda V. Butler, DDS
January 29, 2022
Category: Dental Procedures
Tags: oral surgery  
HereAre5CommonOralBirthDefectsorTraitsandHowToTreatThem

According to the CDC, three out of one hundred infants born each year in the U.S. have a birth defect. A fair percentage of these abnormalities involve the mouth, teeth or gums.

Fortunately, though, we often have a solution for even the most serious of these oral abnormalities. In recognition of National Birth Defects Awareness Month in January, here are 5 common birth or genetic defects that affect oral health and what we can do about them.

Orofacial clefts. This birth defect occurs when the tissues of the upper lip, face or palate don't knit together during pregnancy, leaving a noticeable gap or "cleft." Clefts not only disrupt a baby's appearance, but they can also interfere with their ability to nurse or even breathe. Modern surgical procedures, however, are often effective in restoring normal appearance and function.

Missing teeth. One in five people have at least one missing tooth that failed to develop, skewing their smile and possibly creating a problem bite. But there are ways to compensate for these missing teeth, depending on their type and normal location. The most common way is to move any teeth that have invaded the missing tooth space back to their proper position, and then installing an implant to replace the missing tooth.

Weak enamel. Enamel hypoplasia, a genetic disorder prevalent among children with Down, Treacher-Collins or Turner syndromes, occurs when adequate tooth enamel fails to develop. As a result, children with this condition have a heightened risk for tooth decay. Brushing and flossing daily, as well as applied sealants and fluoride treatments to protect and strengthen the weakened enamel, help minimize the threat of decay.

Jaw abnormalities. A child's genetics can also influence their jaw development, which in turn may eventually affect their bite. A narrower than normal upper jaw, for example, may not allow enough space for later teeth coming in, causing them to erupt out of position. We may be able to address this situation if caught early enough with a device known as a palatal expander that widens the jaw as it grows.

Gum thickness. We inherit gum tissue thickness from our parents. If your gums are on the thinner side, you're more likely to encounter problems like sensitivity to cold (as what might occur while eating ice cream) or a higher risk of gum disease. It's important, then, that anyone with thin gum tissues keep an eye on their gum health, and see a dentist regularly for checkups.

The best outcome for many of these genetic traits and defects is to diagnose and initiate treatment as early as possible. Starting regular dental care by age one is the best way to stay ahead of a birth-related dental issue.

If you would like more information about birth defects and oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”

By Lynda V. Butler, DDS
January 19, 2022
Category: Dental Procedures
Tags: dental care  
ProperDentalWorkCareWillExtendTheirLongevity

Modern dental restorations are not only more life-like than past generations, but also more durable. Today's fillings, crowns and bridges can last for years or even decades.

But that doesn't mean you can set them and forget them—they all require some level of maintenance and care. Here are 3 common restorations and what you need to do to make them last.

Fillings. Whether traditional dental amalgam ("silver") or tooth-colored composites, fillings today are incredibly strong and durable. But they do have one point of vulnerability, especially larger ones—the seam where the filling material meets the natural tooth. Bacteria tend to build up along this seam, which could lead to decay and the formation of a new cavity that weakens the filling. To avoid this, be sure you're brushing and flossing everyday and seeing your dentist at least twice a year.

Veneers. Dentists bond these thin shells of tooth-colored porcelain over the visible surface of teeth to hide chips, stains or other blemishes. But although the bonding agents we use create an incredibly strong hold, the bond between the veneer and tooth could weaken when subjected to higher than normal biting forces produced by nail-biting, ice-chewing or a tooth grinding habit. If you have such a habit, see your dentist about ways to minimize it and protect your veneers.

Bridges. Traditional bridges consist of an array of artificial crowns with those in the middle substituting for the missing teeth, while those on the end attach to the natural teeth on either side of the gap to support the bridge. Bridges can also be supported by dental implants. In either case, tooth decay or gum disease could undermine the natural teeth or bone supporting a bridge. To avoid a bridge failure, keep the areas around supporting teeth or implants clean and regularly checked by a dentist.

Above all, the danger dental disease poses to natural tissues also threatens the restorations that depend on them. Keeping your mouth free of disease is your best strategy for ensuring your dental work enjoys a long, functional life.

If you would like more information on protecting your dental work, 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 “Extending the Life of Your Dental Work.”

By Lynda V. Butler, DDS
December 20, 2021
Category: Dental Procedures
3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing 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.”

TheDisappearingToothGap-MichaelStrahanPullsanEpicAprilFoolsPrank

If you're a fan of former NFL player and current host of Good Morning America Michael Strahan, then you're well aware of his unique smile feature—a noticeable gap between his front teeth. So far, Strahan has nixed any dental work to correct the gap, often saying it was part of "who I am."

But if you follow him on Twitter, you may have been shocked by a video he posted on March 30th of him sitting in a dentist's chair. Calling it a "moment fifty years in the making," Strahan said, "Let's do it." After some brief video shots of a dental procedure, Strahan revealed a new gapless smile.

But some of his Twitter fans weren't buying it—given the timing, they sniffed an elaborate April Fool's Day ruse. It turns out their spider senses were on target: Strahan appeared once again after the video with his signature gap still intact, grinning over the reaction to his successful prank.

The uproar from his practical joke is all the more hilarious because Strahan has let it be known he's truly comfortable with his smile "imperfection." But it also took him awhile to reach that point of acceptance, a well-known struggle for many people. On the one hand, they want to fix their dental flaws and improve their smile. But then again, they're hesitant to part with the little "imperfections" that make them unique.

If that's you, here are some tips to help you better navigate what best to do about improving your smile.

See a cosmetic dentist. A cosmetic dentist is singularly focused on smile enhancement, and particularly in helping patients decide what changes they want or need. If you're looking for such a dentist, seek recommendations from friends and family who've changed their smiles in ways you find appealing.

Get a "smile analysis." Before considering specific cosmetic measures, it's best to first get the bigger picture through an examination called a "smile analysis." Besides identifying the defects in your smile, a cosmetic dentist will use the analysis to gauge the effect any proposed improvements may have on your overall facial appearance.

Embrace reality. A skilled cosmetic dentist will also evaluate your overall oral health and assess how any cosmetic procedures might impact it. This might change your expectations if it whittles down the list of enhancement possibilities, but it may help determine what you can do to get the best improved smile possible.

A great cosmetic dentist will work diligently with you to achieve a new smile that's uniquely you. Even if, like Michael Strahan, you decide to keep a trademark "imperfection," there may still be room for other enhancements that will change your appearance for the better.

If you would like more information about a "smile makeover," please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cosmetic Dentistry.”

By Lynda V. Butler, DDS
October 31, 2021
Category: Dental Procedures
Tags: tooth decay  
WereImprovingOurEffectivenessinTreatingToothDecay

For several decades, dentists have been saving teeth from tooth decay following a few basic guidelines: 1) Identify decay as soon as possible; 2) Thoroughly remove decayed tooth structure; and 3) Fill any cavities. With millions of diseased teeth rescued, observing these simple steps have proven a rousing success.

But as with most things, even this successful protocol isn't perfect. For one, some healthy tissue gets removed along with the diseased portions. The average percentage of "collateral damage" has dropped over the years, but it still happens—and a reduction in healthy tissue can make a tooth less structurally sound.

Another drawback, at least from the patient's perspective, is the dental drill used for removing decay and preparing cavities for filling. Many people find drilling unpleasant, whether from its vibrations in the mouth or its high-pitched whine. The drill's burr head design also contributes to greater healthy tissue loss.

But those weaknesses have lessened over the last few years, thanks to innovations on a number of fronts.

Better risk management. Tooth decay doesn't occur out of thin air—it arises out of risk factors unique to an individual patient like personal hygiene, bacterial load, saliva production or even genetics. Taking the time to identify a patient's "tooth decay risk score" can lead to customized treatments and practices that can minimize the occurrence of decay.

Earlier detection. Like other aspects of dental health, the sooner we detect decay, the less damage it causes and the more successful our treatment. X-rays remain the workhorse for detecting decay, but now with improvements like digital film and better equipment. We're also using newer technologies like laser fluorescence and infrared technology that can "see" decay that might otherwise go undetected.

Less invasive treatment. The dental drill is now being used less with the advent of air abrasion technology. Air abrasion utilizes a concentrated spray of particles to remove diseased tooth structure more precisely than drilling. That means less healthy tissue loss—and a more pleasant (and quieter!) experience for the patient.

In effect, "less is more" could describe these improvements to traditional decay treatment. They and other methods promise healthier teeth and happier patients.

If you would like more information on current treatments for tooth decay, 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: When Less Care is More.”



Lynda V. Butler, DDS

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