Give the gift of a beautiful smile

If you are looking for a holiday gift for that special someone, I have a suggestion for you.  Give the gift of a beautiful smile.  This is a gift that goes with everything, is more valuable than jewelry, always fits, and subtracts years from your face.

Although there are several ways to achieve a beautiful smile, I would like to discuss porcelain veneers.  Most of you are familiar with veneers though reality makeover shows, but I want to assure you that veneers are not only for the rich and famous or those people lucky enough to be on a television show.  You would be surprised at how many people, with whom you come in contact, are reaping the benefit of veneers.

Porcelain veneers are thin shells, prepared in a dental laboratory, that are permanently affixed to prepared teeth.  A good analogy is a laminate countertop or artificial fingernails.  These shells, which are usually done in multiples on the top teeth, are precisely placed by the dentist in his office, and are usually completed in two visits, the first for the preparation and the second visit for the placement.

Candidates for veneers have healthy gum tissue and have had decay problems resolved by restorations (fillings) and/or crowns.  Veneers can be placed in conjunction with crown and bridge work with very natural looking results.  Once the veneers are placed, and the bite is perfected, you can expect to “wear” your veneers without being aware of them.  You will only think about the veneers when you see your smile.

You can reasonably expect your “holiday gift” to last 10 to 15 years, and a good dentist will guarantee his work.  What other gifts, other than fine jewelry, have that kind of life span?

One last thought – maybe this is the year to give yourself the gift of a beautiful smile!  Have a wonderful holiday season.

A Filling or a Crown?

Most general dental offices are in the business of restoring teeth.  The reason for restoring a tooth is basic – the tooth has decay in it, sometimes around an existing (old) filling.  Tooth decay will worsen in time, so it must be handled.

Tooth restorations are usually done by one of three methods – a filling (either amalgam or white composite), an onlay, or a crown.  An amalgam filling is the least expensive, but also the least esthetic, option. The white composite filling is more expensive than amalgam, but is very natural looking.  The gold or porcelain onlay and the gold or porcelain crown are fairly close in price and are the most expensive.

So when does a filling become a crown?  What is the dentist considering when he determines that a filling is not the correct solution to the decay problem?

The answer is simple – it is a judgment call.  In dental school we were taught parameters, based on the width of the decay on the top surface of the tooth, to determine when an onlay or crown is needed.  Additionally, years of experience suggest to me when decay in the tooth is too large to be handled with a filling.

When a tooth which has too much decay is filled, the structure of the tooth is compromised.  It becomes more likely to develop fractures, causing many problems, sometimes including root canal or extraction with the necessity of an implant.

Occasionally, the dentist will begin to fill a tooth, only to determine that the decay is too extensive and a crown is in order.  While this can be upsetting to the patient, it can be blamed on the nature of radiography.  Since the x-ray is a two dimensional view of the tooth, and the tooth is actually three dimensional, more extensive decay than expected is sometimes found.

In the future, I will discuss the differences between onlays and crowns and also the pros and cons of amalgam versus composite restorations.  For now, however, be assured that when your doctor recommends a crown, it is not a cavalier decision based on his bottom line.  It is an assessment of the current condition of the tooth, with an eye to the future.



Back to school sports with protective mouth guards

It’s back to school time, which means that the kids are running back onto the soccer and football fields in droves.  Other sports are also getting into gear, so it is a time to revisit the idea of protective mouth guards.

The mouth guard is a wonderful tool to help avoid sports related dental injuries.  It is an essential piece of equipments for all people who play contact sports.   I also recommend protective mouth guards for my patients who skateboard and participate in other activities that involve risk.

The custom fitted mouth guard is individually designed and fitted in the dental office, using an impression made of the teeth.  While more expensive than the store purchased option, I believe that these mouth guards are well worth the money. They are more comfortable to wear and offer much better protection than the cheaper store version.  My experience is that an athlete will not wear a mouth guard if it is uncomfortable, making the store purchased guard not such a good deal when it remains in the gym bag.

Another point needs to be made about sports injuries to the mouth.  It is essential that immediate medical/dental treatment be sought, especially if the tooth has been knocked out.  Rinse the dirt off the tooth with milk or water and, if possible, place inside the cheek of the child, or in a small container of milk.  Do not touch the root surface and do not let the tooth rest dry!  Get to the dentist immediately for re-implantation.

Your dentist will monitor a re-implanted tooth for years.  Sometimes a root canal and/or additional treatment become necessary.  Speaking from experience, my son knocked his front tooth out (jumping off the bed at a friend’s house, so he wasn’t wearing a mouth guard!) at the age of 7.  Eighteen years later, after rushing to the dental office with the tooth in a cup of milk and re-implanting the tooth, the tooth remains in his mouth as strong and functional as ever!

From the Office of Dr. Spadafora

The Problem of Dental Erosion- The Effects of Sugary Drinks and Foods on your Teeth

The summer is upon us, complete with graduation parties, vacations, and plenty of opportunities to indulge in food and drinks that could negatively affect your dental health.  I am talking foods that cause dental erosion.

 Have you ever noticed, after enjoying a soft drink or eating something acidic, that your teeth feel “funny”?  This is probably dental erosion, a common dental problem associated with diet.  Erosion is the dissolving of the enamel surfaces of the teeth by acids found in popular soft drinks, carbonated cola beverages, natural fruit juices, sports drinks and some foods.

 This erosion is not the same as typical tooth decay (cavities), where the outer surface of the enamel is destroyed by the acid found in plaque.  Typically, cavities are found in specific sites on the tooth surface and at the gum line.  Dental (chemical) erosion will attack the entire exposed surface of the tooth and can cause long term dental problems.

 Another difference between typical cavities and dental erosion is that tooth brushing, while effective in decay prevention and plaque removal, can actually make erosion even worse.  This happens after excessive consumption of acidic foods and cola beverages, when the tooth surface actually becomes microscopically “softened”.  Brushing may completely remove the affected tooth layer.  Waiting 30-60 minutes before brushing will allow the saliva to neutralize the acid and the teeth to re-mineralize.

 The problem of dental erosion is especially important for our children, since the enamel hasn’t been sufficiently exposed to fluoride.  Fluoride makes the enamel harder and more resistant to acid dissolution.

 What to do?  Of course, the best plan would be to eliminate the “bad” foods and drinks in our diets and the diets of our children, but this is not always realistic. Use common sense.  Reduce the frequency of these food and beverages, and try to limit them to mealtimes.  Avoid prolonged swishing of these drinks in the mouth before swallowing and use a straw, which will limit the contact of the acid with your teeth.  Finally, consult with your dentist to make sure that you and your family are getting the appropriate amounts of fluoride.