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All Posts in Category: Teeth Talk

Dental Implants Explained

dr-jeffrey-field-lifestyle-smiles

Dr. Jeffrey Field, HBSC, DDS, Fellow ADSA and Diplomat NDBA

In this month’s Teeth Talk article, Senior Dentist Dr. Jeffrey Field explains all you need to know about dental implants, demystifying the terminology and various modern treatment options available to help you restore your smile.

Dental implants are titanium screws that replace missing teeth, or can be used to help anchor dentures more securely.

There are many options for missing teeth including dentures, porcelain bridges and implants.

Dentures are pieces of plastic or plastic and metal composites that look like teeth but that is where the approximation ends. They will never be as functional as your natural teeth, because, unlike your natural teeth dentures are not anchored to the bone.

Partial dentures have clasps on existing teeth to help hold the denture in place, but the dentures still can and do move with eating or speaking.

Full dentures are used when patients have no teeth. They rely suction between the denture and the empty gums to hold them in place. So as you can imagine, full dentures are not very secure during eating and talking.

A bridge is used to replace missing teeth where there are still teeth present on either side of the empty space. In this case the teeth on either side of the space are prepared for crowns, which means they are cut down in all dimensions. The crowns on the end teeth are attached to fake porcelain teeth in the middle, thus replacing the missing teeth. The problem is that crowns are meant to rebuild very damaged teeth. Often to provide a bridge we must cut down perfectly or relatively healthy teeth, thus permanently damaging them. Once a bridge is placed, over time you get recession of the gums or decay/cavities on the margins of the crowns, necessitating replacement of the bridge. As such the teeth your bridge are attached to get longer and less aesthetic over time. The gum recession and or cavities continue until you lose the  teeth that the bridge is attached to. So now you have lost 3 teeth minimum (the two end teeth plus the original missing tooth).

An implant is a free standing (does not rely on other teeth for support) and so if it fails you still have only lost one tooth unlike a failed bridge where you lose several teeth. Implants are titanium screws that are placed in the bone. Implants can be used to support crowns for single to multiple teeth or as bridge supports for longer spans of missing teeth. For patients missing all teeth in the upper, lower or both arches, implants can be used to help secure full dentures and make them more stable (move less).

If you would like to explore how dental implants could help your particular dental situation, please book a no obligation consult with Dr. Field or Dr. Antonoff to discuss your options.

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What You Need to Know About Wisdom Teeth

dr-jeffrey-field-lifestyle-smiles

Dr. Jeffrey Field, DDS HBSc

In this month’s Teeth Talk article, Senior Dentist Dr. Jeffrey Field explains what you need to know about wisdom teeth, including the risks and considerations regarding wisdom teeth removal.

Why should I get my wisdom teeth removed?

There are a number of valid reasons to remove wisdom teeth:

1) They are not functional. Studies have shown that most of chewing is done on the second bicuspid and first molar. That is we do not use our second molars let alone our wisdom teeth (third molars) to chew.

2) There is not enough room in the dental arch to allow them to completely erupt (fully emerge). As they remain partially submerged(partially impacted) they are very prone to recurrent infections. With each subsequent infection more and more jaw bone is destroyed, which in turn leads to a greater potential for re-infection and the cycle of infection after infection continues.

3) They are so far back in your mouth that you can’t properly clean them, leading to both dental decay(cavities) and periodontal diseases(gum infections)

4) They are growing close to nerves in the lower jaw and your sinus in the upper jaw. All teenagers should be assessed for wisdom teeth between the ages of 14-16 years old. Assessment at this age allows the dentist to see if wisdom teeth are present, their position, and likelihood of normal eruption. If any problems are noted, then this is the best time to remove them. The reason is, at this age the wisdom teeth will not have developed much of their roots and you can greatly decrease the chance of either nerve damage or damage to the sinus during their removal. If you wait till the person is 18 years old or older, the roots will be fully developed are therefore increase the risk of nerve or sinus damage.

What are the risks of having wisdom teeth removed?

For lower wisdom teeth there is a nerve that exits your brain in front of your ear and behind the jaw bone. This nerve provides feeling but no motor function to structures it innervates. The nerve splits into 2 pieces. One ends up supplying feeling to your lower lip and chin, but does not make your lower lip and chin move. So if this nerve is damaged your lip won’t droop in fact you will look no different, but you can have numbness to the lower lip and chin. This occurs in one patient out of every 5000 treated. The second branch of this nerves innervates the tongue supplying feeling and taste sensation to the side of the tongue. Numbness and loss of taste sensation can occur in one patient out of 15000 or 3 times less likely to occur than damage to the nerve to the lower lip and chin.

For upper wisdom teeth there are no nerves in the area, however upper wisdom teeth are close to the maxillary sinus (the air space under your eye that gets stuffed up when you have a cold. The risk is that extraction of upper wisdom can lead to an opening into the sinus. This is not a big issue and can be closed at the time of extraction. The only downside is that if this occurs you should not blow your nose for one month, just squeeze and wipe.

Where should I have my wisdom teeth removed?

Wisdom teeth can be removed either in a hospital operating room or in the dental office. In hospital you will have a general anesthetic and in the office you can either sedation plus local anesthetic (numbing) or just local anesthetic. However, except for the simplest of extractions we do recommend sedation for your comfort. Please see the information on general anesthesia versus sedation.

If you have questions about your wisdom teeth or that of your children, please book a no obligation consult with Dr. Field or Dr. Antonoff to discuss your options.

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Explore the Benefits of Intravenous Sedation

dr-jeffrey-field-lifestyle-smiles

Dr. Jeffrey Field, DDS HBSc

Is fear holding you back from getting the dental treatment you know you need? If so I can help. My name is Dr. Jeffrey Field and I have been providing dental sedation for 27 years.

Sedation will allow you have complicated and/or long dental treatments, as well as dental surgical procedures performed, while you drift in a dreamlike state. For most patients it will seem that no time has passed while your dental work has been completed.

Many patients ask how sedation differs from general anesthesia. Experientially for most patients there is little difference in that in both you have an intravenous line placed, through which medications are administered and you are sedated/become sleepy and the procedure is completed, often with you having no memory of the procedure.

The difference in fact is more technical.

With general anesthesia you are given larger doses of some of the same medications that are used in sedation as well as additional medications (general anesthetic gases and paralyzing agents) not used in sedation. You become deeply unconscious to a level that your breathing must be maintained by a machine. The additional medications used for in general anesthesia are the major causes of post-operative nausea and vomiting and have been associated with serious allergic reactions. Happily, none of the additional medications are used in sedation.

Finally, but less importantly patients having general anesthesia must arrive hours prior to their procedure and stay for usually several hours afterwards.

Sedation, in contrast has you drifting in a dreamlike state where you breathe on your own and your protective airway reflexes are intact. As such, you do not need to be intubated and breathe on your own. Sedation uses no general anesthetic gases or paralyzing agents and so post-operative nausea and vomiting are usually not an issue. As well, serious allergic reactions are far less common with sedation than with general anesthesia.

Sedation is a safer alternative for most dental procedures. This is not to imply that general anesthetics in trained hands are not safe, it is just they are not necessary for most dental procedures.

dental-sedation

With sedation you arrive 15 minutes prior to your procedure and go home about an hour afterwards.

If you feel intravenous sedation can be of benefit to you. Please call or send a website enquiry for a no obligation consultation with Dr. Jeff.

If you have any questions that you’d like to personally direct to Dr Jeff, please don’t hesitate to email: drjeff@lifestylesmiles.com.au

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What Makes a Beautiful Smile: Facial Proportions

Dr Warren Antonoff

Dr. Warren Antonoff

In today’s fourth article about modern Cosmetic Dentistry, Dr. Warren Antonoff explains how facial symmetry influences the perceptions of what makes a beautiful smile.

When it comes to a smile design, we typically begin by looking at your face. How is your smile related to your face, you might ask? Regardless of how attractive the teeth may appear, they need to be in balance with your facial elements. We look at the overall picture before homing in on the details of the smile – please have a look previous articles about how we also look at Lips & Gums and your Teeth.

The mid line is the most important parameter when it comes to any form of aesthetics. When things are centered, they naturally look nice. Usually, the dental mid line is co-linear with the facial mid line but often that is not the case. The most common culprit is actually the nose, the nose is the pillar of the centre of the face and yet in most people the nose slants off slightly in one direction or the other (especially for rugby players!).

Take Tom Cruise for example, do you notice that his dental mid line is off?

tom-cruise-facial-symmetry-teeth-smile

The most common way to observe facial symmetry is to divide the face in three proportions. The upper third is the height of the forehead, middle third measures the distance between the bottom of the nose to the upper border of the eye socket, and the lower third measures from the chin to the bottom of the nose.

Facial-Symmetry-Equal-Thirds

From a dental perspective, if the lower third is ill-proportioned to the upper sectors, that’s when you know that correcting the teeth alone via procedures such as braces, veneers, crowns will not achieve a “perfect smile”, and that other procedures such as jaw and chin surgery may need to be considered.

We hope you’ve found this series of articles on Cosmetic Dentistry informative and enjoyable. I aim to bring modern dental concepts to you in a more accessible and personal way. As always, please don’t hesitate to contact us should you have any questions or suggestions.

Until next time, happy smiling!

Dr. Warren Antonoff and all the staff at Lifestyle Smiles

At Lifestyle Smiles, we see a spectrum of patients at the clinic – some prefer an “understated, natural” look while others want a bright “Hollywood Smile”. Either way, as dental professionals it is our role to help you feel great about yourself, and over the decades we’ve been fortunate to help our patients achieve the look they desire using proven, safe and effective treatments.

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What Makes a Beautiful Smile: the Lips and Gums

Dr Warren Antonoff

Dr. Warren Antonoff

In today’s third article about modern Cosmetic Dentistry, Dr. Warren Antonoff explores how the lips and gums influence the perceptions of what makes a beautiful smile.

Lips and gums play a fundamental role in shaping a beautiful smile. If you have straight teeth but you can’t see them, what’s the point? On the other hand, too much gum might bring undesirable attention!

Let’s look at the upper lips first. Ideally, when a patient smiles the upper lips masks the upper border of the teeth. If the patient shows too much gum, there could be a few possible causes:

  • Increased upper lip movement
  • Enlarged upper jaw
  • Teeth are not fully erupted

In most instances it’s a combination of factors involved. Depending on the cause(s), treatment such as soft tissue laser surgery, gum lift, Invisalign, upper jaw surgery, or even Botox, are treatments available to correct those issues.

The gums and lips "package" the teeth and gives your smile its personality!
The gums and lips “package” the teeth to create the smile that’s distinctly you!

On the other hand, The lower lip should ideally cradle the edges of the teeth in an arc to compliment the upper lip. Showing some lower teeth is also considered aesthetically acceptable. Typically, the lower lip doesn’t move as much compared to the top lip, rather it’s been stretched by the surrounding musculature in order to show more teeth. The importance of the lower lips is taken into consideration when the patient elects to correct her smile through procedures such as porcelain veneers. It is then up to the dentist to design the top teeth so that the edges are finished nicely.

Smile 3 Jenifer Garner
Celebrities, such as Jennifer Garner, have transformed their smiles through modern Cosmetic Dentistry treatments.

Here’s a recent example of our patient, “Ms Genevive”, who decided to undergo gum surgery to attain her ideal smile…

genevive
Before (top left), during gum surgery (bottom left), and After (right)  shows how this treatment can help to improve the visual proportions of the teeth and gums to offer a more aesthetically pleasing result.


Here’s a photo of the gums about a week after surgery. You can see it’s healing quickly.

Genevive will be completing her treatment with Invisalign teeth straightening to get the perfect look. For more information, you might be interested in reading our previous article titled De-mystifying Teeth Straightening Treatments.

On the other hand, The lower lip should ideally cradle the edges of the teeth in an arc to compliment the upper lip. Showing some lower teeth is also considered aesthetically acceptable.

As always, please don’t hesitate to contact us should you have any questions at all.

Until next time, happy smiling!

Dr. Warren Antonoff and all the staff at Lifestyle Smiles

At Lifestyle Smiles, we see a spectrum of patients at the clinic – some prefer an “understated, natural” look while others want a bright “Hollywood Smile”. Either way, as dental professionals it is our role to help you feel great about yourself, and over the decades we’ve been fortunate to help our patients achieve the look they desire using proven, safe and effective treatments.

Read More