Dental Porcelain is a Great Option for Creating a Natural Appearance

The mark of a great dental restoration is that you can’t see it. It’s there in plain sight, but others observing your new and improved smile can’t tell the difference between the restoration and your natural teeth. Everything looks, well, natural.

That’s the great advantage of dental porcelain. A dental technician with technical skill and artistic flair can form this inorganic, ceramic material into a life-like replica of your tooth, with a shape and color that blends in with the rest of your teeth. And because of its strength properties, porcelain restorations can hold up to the normal chewing and biting forces in your mouth, as long as you use prudence when biting down on hard substances.

Porcelain is also highly adaptable to different kinds of restorations. For natural teeth still viable but no longer attractive, porcelain can be the main ingredient in two very popular and effective restorations, the veneer and the crown. Although the porcelain material is the same for both, their construction and application are quite different.

Veneers are very thin laminated layers of dental porcelain custom-colored and shaped for bonding to the outer visible portion of a tooth. They’re a great solution for relatively decay-free teeth that have minor to moderate defects like chipping, slight misalignment or heavy staining. They often require some permanent removal of tooth enamel to ensure their appearance isn’t too bulky, but causes minimal impact to the tooth.

Crowns, on the other hand, are complete tooth replicas that are bonded in place over an existing tooth like a cap. They’re a good choice for teeth in which the root and inner layers are still viable, but the tooth has been significantly damaged by decay or trauma. They’re also useful as a protective cover for teeth that have undergone root canal treatment. But unlike the minimal impact of veneers, crowns require significant tooth alterations to accommodate them.

In either case, though, the end result is much the same: both crowns and veneers can be fashioned to precisely mimic the shape, color and texture of natural teeth. In skillful hands, these porcelain restorations can transform your smile for the better and no one but you and your dentist will ever need to know.

If you would like more information on porcelain restorations, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

Crowns can now be made In-Office with the CEREC System

The traditional way to restore a tooth with an artificial crown takes several weeks and multiple office visits: from tooth preparation and impression molding to crown production by a dental laboratory, followed by adjustments and cementing. There’s an alternative that reduces this process to a fraction of the time, and all from right inside our office.

Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) using CEREC is a digital system that enables dentists to create dental restorations with laboratory-grade materials in minutes rather than weeks. As it continues to innovate, you’ll see more and more dentists investing in the new technology for their patients.

A crown restoration with CAD/CAM begins like any other with decay removal and preparation of the tooth. It diverges, though, from the traditional in how an impression of your teeth and gums is obtained: instead of rubber-like molding materials to create a physical impression, we lightly dust the mouth interior with a reflective powder. Using a scanning wand, the reflective powder allows us to capture multiple, detailed images of your mouth that the CAD/CAM computer transforms into an accurate three-dimensional model.

We use the model to first assess if the tooth has been effectively prepared for a restoration. If so, the design feature of the system will provide us with thousands of tooth forms to choose from to match with your natural teeth. You’ll be able to view the proposed size and shape of the new crown via computer simulation before signing off on the design.

Next is the actual manufacture of the crown that takes place right in the dentist’s office. A pre-formed block of ceramic material is inserted in the milling equipment where, following the pre-determined computer design, the milling heads carve the ceramic block. After milling, we fine-tune the crown surface and apply stains or glazes fired to create a life-like color and texture that matches your natural teeth. We can then adjust the crown in your mouth and permanently affix it to the tooth.

While much of the CAD/CAM system is automated, ultimate success still depends on the dentist’s expertise and artistry. CAD/CAM enhances those skills with greater precision and in much less time than traditional crowns. It’s certainly a growing option for many people to restore the form and function of decayed teeth.

If you would like more information on computer-aided dental restorations, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Creating In-Office Dental Restorations with Computers.”

Focus on Prime Dental Health Risk Areas to Map Out Your Care Plan

Dental care is more than brushing and flossing every day, visiting the dentist at least twice a year and occasionally having a problem treated. To get the most out of your care, we need to consider the “big picture” of risk management: identifying where your oral health is most at risk and tailoring your treatment approach accordingly.

With that in mind, here are the 4 main risk areas we should address for your long-term dental health.

Support structures. Healthy gums and bone support healthy teeth. The loss of these support structures from dental disease puts your teeth at higher risk of loss. The focus then is keeping the gums and bone healthy through dedicated oral hygiene, regular checkups and office cleanings, lifestyle changes (like refraining from tobacco use), nutrition and early, proactive disease treatment.

Tooth health. Your teeth also need to be healthy and sound. When compromised by decay, erosion or injury, your risk for losing them increases. To manage that risk, we need to identify, treat or minimize the root causes of unhealthy teeth like disease-causing bacteria, high acid levels in the mouth or restricted saliva flow. It’s also important to repair damaged teeth as soon as possible through fillings, crowns or root canal treatments to give teeth a better chance of survival — and to know when a tooth is beyond salvage and should be replaced with an appropriate restoration.

Mouth function. Your teeth, muscles and jaw joints work like an intricate mechanism to help you eat, speak and even smile. When they don’t function properly, though, it can lead to significant dental problems. Tooth grinding habits, poor bites (malocclusions) or temporomandibular (jaw) joint issues can cause pain, compromised function, and even excessive tooth wear that may compromise dental health and affect appearance. It’s necessary to treat these underlying functional problems through conservative TMD treatments, night guards or lifestyle changes before attempting dental restoration or the damage will continue.

Smile appearance. Although subjective, how you feel about your smile is extremely important, and can have a profound effect on your self-image and relationships. Blemished, misaligned, or missing teeth pose a personal and social risk and deserve attention. While you should have realistic expectations about both your overall mouth condition and your financial ability, there are many options for improving your teeth’s appearance and ultimately your smile.

If you would like more information on comprehensive dental care, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Successful Dental Treatment.”

Pain Relievers like Ibuprofen are Effective and Safe - if Used Properly

Managing pain is an important part of dental care — alleviating pain caused by disease or trauma and reducing discomfort during and after treatments. In many of these instances we can do this effectively with mild, over-the-counter drugs like ibuprofen or aspirin.

These Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are safer and have fewer side effects than stronger prescription pain drugs, and have proven effective after extensive studies. Nevertheless, they can cause problems if not taken properly.

NSAIDs work by blocking prostaglandins, substances released by diseased or damaged tissues that have become inflamed (swollen). Inhibiting prostaglandins reduces inflammation that in turn eases pain. This differs from steroids that reduce inflammation by suppressing the immune system or narcotics like morphine or codeine that act on the brain to reduce pain.

Both steroids and narcotics are strong, prescription medications used only for severe pain, and can be addictive if abused. While NSAIDs aren’t as habit-forming and have milder side effects, they can cause significant health problems if overused. The most common is their tendency to act as a blood thinner, which decreases the blood’s ability to clot.

This can lead to serious complications: over-extended use of aspirin, for example, can damage stomach lining and give rise to ulcers or dangerous bleeding; ibuprofen can damage the kidneys. An estimated 100,000 Americans are hospitalized each year due to ulcers or gastrointestinal bleeding linked to chronic NSAID use for pain relief. They’re not recommended for patients who are pregnant, have preexisting stomach problems or heart disease.

In short, NSAIDs are best used for only brief periods to alleviate short-term discomfort. Unless otherwise directed by a physician, a single dose of 400-600 milligrams is safe and normally sufficient for about five hours of mild to moderate pain relief; daily dosages shouldn’t exceed 2400 milligrams.

NSAIDs remain the best approach for alleviating most dental pain and discomfort. Taken properly, they can help you cope with pain until you’re back on your feet again.

If you would like more information on managing pain associated with dental care, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Pain with Ibuprofen.”

4 Tips for Extending the Life of Your Oral Appliance

There are many different removable appliances — from dentures to retainers — that help people enjoy better mouth function and a more attractive smile. But like many things we use, they can wear out. Because they’re also spending a lot of time in the mouth they can become an attractive home for disease-causing bacteria.

You can extend your appliance’s life through regular cleaning and maintenance. Here are 4 tips to help you do it properly.

Use detergent — not toothpaste or bleach — for cleaning. Your appliance may look like teeth or gums, but it isn’t made of living tissue and shouldn’t be cleaned the same way. The abrasives in toothpaste can cause microscopic scratches in appliance materials that could harbor bacteria. Bleach is also a no-no — while it kills bacteria it also breaks down the composition of many appliance plastics. Ordinary household soaps like dish detergent work just fine.

Use warm — not hot or boiling — water. Boiling water also kills bacteria, but it and even hot tap water can soften many dental plastics and distort your appliance’s precise fit. Warm soapy water is sufficient for keeping your appliance clean. Be sure also to use a separate brush from your regular toothbrush, ideally one designed to clean appliances.

Consider using an ultrasonic cleaner. No matter how thorough you are, you won’t be able to fully access tiny crevices in your appliance with a brush. If you have a permanent appliance like a denture or retainer, consider purchasing an ultrasonic cleaner, a device that emits high frequency sound vibrations to loosen plaque in those hard to reach places.

Protect your appliance while it’s out of your mouth. Place a towel in the sink while you’re cleaning your appliance — an accidental drop onto a soft towel is less likely to damage it than on a hard porcelain or metal basin. Unless otherwise directed, it’s also best to remove your appliance while you sleep to help cut down on bacterial growth. But don’t leave it lying anywhere — pets or even young children may find it a fascinating “toy.” Be sure to store it in its case or in cleaning solution in a high place.

If you would like more information on taking care of an oral appliance, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “10 Tips for Cleaning Your Oral Appliance.”

3 Reasons Why Orthodontics is Worth the Effort - at Any Age

Think braces and you may conjure up the image of a teenager undergoing what is for many adolescents a rite of passage. But while correcting poor bites (malocclusions) is usually optimal between pre-adolescence and early adulthood, it’s just as viable an option for older adults.

Still, many people in their later years with malocclusions think orthodontics isn’t worth the bother — it’s simply too late for them or they don’t want the "embarrassment" of wearing metal braces at their age. But even if you’re older, it’s worth reconsidering treating that bad bite. Here are 3 reasons why.

Misaligned teeth can affect your oral health. If your teeth are out of position, then they will be much harder to keep clean, and may wear down at a higher rate than normally aligned teeth. You may also find chewing your food becomes easier with a straighter bite, which can improve your overall nutrition.

A More Aesthetic Option to Metal Braces. One of the biggest concerns for many older adults is the thought of wearing metal braces for an extended time. Clear aligners are a more attractive alternative. They are a series of computer-generated incremental clear plastic trays: each tray is worn for about two weeks moving teeth a small distance before changing to the next tray in the sequence until the end of treatment. Not only are they much less noticeable than metal braces, they can be removed for easier oral hygiene, or even for a rare special occasion.

Age Really isn’t a Factor. Not everyone is a good candidate for orthodontics. A person’s level of bone volume is a major consideration: if they have significant bone loss successful tooth movement may not be possible. Systemic conditions like diabetes, severe heart-valve disease or leukemia, or drugs for arthritis or osteoporosis can also make treatment difficult if not out of the question. But, if you’re in reasonably good health with adequate bone support, there’s no reason you can’t undergo orthodontics — at any age.

If you would like more information on orthodontic treatment at any age, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontics for the Older Adult.”

Preserving Baby Teeth Crucial to Future Dental Health

It’s easy to view your child’s primary (“baby”) teeth as less important than the permanent teeth replacing them. They’re temporary — the last of them will give way around ages 10 to 13 — so why go to extraordinary lengths to save them if they’re decayed?

Although relatively short in life, primary teeth are indeed important. They, of course, provide young children a means to speak and eat. But they’re also pivotal to your child’s mouth and facial development. A primary tooth lost early can lead to adverse effects in the permanent teeth and bite later.

A primary tooth holds open the space in the jaw for the permanent tooth as it develops below the gums. When it’s ready to come in, the roots of the primary tooth dissolves (resorbs), allowing it to be lost. If they are lost too early, though, it can disrupt this spacing, especially for a back tooth. If this happens, adjacent teeth can move or “drift” naturally into the open space, greatly increasing the chances of a bad bite (malocclusion). The permanent tooth may then come in the wrong position or perhaps not at all, setting up the need for costly future orthodontic treatment.

That’s why it’s better to save the tooth if we can, even employing a modified root canal treatment for deep decay if necessary. If, however, the primary tooth is lost prematurely due to disease or trauma, we can still attempt to preserve the space left behind. One way is to install a “space maintainer,” a metal orthodontic device that prevents adjacent teeth from moving into the space. This will still require constant monitoring and extra care to prevent the device from dislodging.

The best strategy for preserving primary teeth is, of course, prevention. By establishing daily brushing when the first teeth appear in the mouth, coupled with regular dental cleanings and checkups twice a year and a diet low in sugar-added foods, you can reduce the risk of dental disease. Further prevention with sealants or topical fluoride can also strengthen young teeth.

Keeping primary teeth healthy will help ensure they’ll continue until they’ve served their purpose. In the end they’ll set the stage for a lifetime of healthy teeth.

If you would like more information on caring for your child's primary teeth, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Importance of Baby Teeth.”