Lasers in Dentistry

Photo: Contributed

Just the other day I was meeting with a new patient and we were talking about some of her aesthetic concerns. Specifically she did not like the way her gum tissue looked around a couple of her upper front teeth. I was counseling her on treatment options and the subject of laser re-contouring came up. She stopped me immediately and said “lasers???”

It occurred to me then that perhaps the public is not in tune with the advancements in modern dentistry. In this piece I will specifically talk about lasers, but there will be more technology pieces to come in future columns.

Lasers, once the subject matter of James Bond films and science fiction writings, are now in fact available and used in some dental offices. Their uses are quite varied.

Lasers can be used to help detect cavities. The enamel, or eggshell of the tooth, is the hardest part of your body. It protects a second layer that is about 8 times softer. This means that a small defect on the outside can result in a much larger problem inside the tooth. A problem that can grow undetected by conventional methods. Cavity detection lasers can catch issues early while the solutions are smaller and much more economical. This helps save you pain and money.

Lasers can be used to treat pain and promote healing through biomodulation. Treatment with different laser light frequencies can induce the movement of healing cells and cell activity in areas of injury or stress. This same technique can be used to help reduce the pain, size, and duration of both apthous ulcers (canker sores) and cold sores.

Lasers can be used to remove unhealthy or unaesthetic gum tissues during treatment. There is no bleeding and because the laser “sterilizes” the area the healing is quicker and there is no need for stitches. Speaking of gum tissue issues, lasers can be used in a “targeted” fashion to specifically kill only the bacteria responsible for gum tissue infections. This is invaluable for patients suffering from periodontal disease. This can help avoid gum surgery in a lot of cases.

Still another use of lasers sees the treatment of some cavities. Hard tissue lasers can treat some cavities without the use of the more conventional dental drill. For some people that fear the drill above all else, this can be a lifesaver.

Ask your dentist or hygienist about whether or not lasers are appropriate for your care. Ask about technology and the advancements that are taking place in the profession leading to benefits in your care. As always, you are welcome to contact me at [email protected] to discuss this matter or any other.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.

Dental implants

Not that long ago I had a friend call me late at night. There had been an accident. A soccer ball to the face actually. All I made out on the phone was that there was blood and missing pieces of tooth. When I arrived at the clinic and had a look I discovered that one of the teeth was so badly broken that it could not be saved. My friend was upset. After all, it was right in the front of his smile.

I told him that although this was very unfortunate he shouldn’t worry. I let him know that we could “fix” this and give him back his smile. I told him we could use a dental implant. Having never needed one before he didn’t know what I was talking about. It was then that it occurred to me that probably a lot of people haven’t heard about dental implants, and if they have, they don’t really understand what they are.

Photo: Thinkstock.com

I went on to explain that a dental implant is literally the placement of a “false root” back into the jawbone where the old natural root used to be. Of course the immediate question was, “how much will that hurt, and will I be knocked out?” I let him know that you actually don’t feel much at all. The implant is placed slowly and carefully so as not to damage the remaining bone. I also let him know that often it is done under only local anesthetic – although the more nervous patients can be sedated if they wish. The false root (surgical titanium – like hip or knee replacements) then heals in the bone for approximately four months. During that time we would put a temporary tooth in place of the missing one so that no one notices. After the four months of healing is over we are able to build a new tooth on top of the new root/implant.

Dental implants have some very significant upsides. First, there is no need to do anything to the adjacent teeth, as they are not needed for support of the implant (not like a bridge where the teeth on either side need significant alteration). Second, the implant and new tooth are titanium and porcelain so there is never a risk for cavities in that area. It should be noted that it still needs to have healthy gum and bone tissues – this means regular visits to the hygienist still. Finally, the aesthetics are fantastic. Since it is a single tooth it looks just like the one it replaced.

Dental implants can be used to replace any single tooth as well as multiple missing teeth. They can even be used to anchor teeth when a person is missing all their teeth. Dental implants can be like having a third set of teeth offering the predictability of stable teeth to chew and smile confidently with. If you are missing one or more teeth and would like to know more about how dental implants can help restore your health, function and smile – then give us a call.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.

Single visit crowns

I thought over the next few columns that I would talk about some of the technology that is leading edge and available now in dentistry. I wrote earlier about dental crowns, explaining the details of what crowns are and also why a crown might be required. I talked about the benefits of the treatment, but I didn’t talk much about the experience.

Traditionally, and most commonly, the dentist will perform the corrective procedures on the tooth needing the crown by eliminating the decay and creating room for the new restoration. At that stage the dentist then takes a series of molds with a variety of impression materials. These impressions are sent to a lab to have them fabricate a long lasting crown out of porcelain (or sometimes gold). That will be followed with the fabrication and insertion of a temporary crown. This temporary crown is made of acrylic (hard resin/plastic) and placed with temporary cement designed to let the dentist remove the temporary later. This temporary is to be worn for around two weeks requiring the patient to be careful with what they eat, how they clean the area, and it can be sensitive. Breaking the temporary is possible, having it come loose is possible, and sometimes bacteria can work under it as well creating sensitivity and tooth nerve insult. After the two-week period is up you need to go back to the dentist for a second visit, have more numbing/freezing put in, and then have the final crown inserted.

There is another way; however, using CAD/CAM (computer aided design and milling) technology called CEREC Omnicam. Instead of goopy impressions we record the information with a camera. This is great for those that have strong gag reflexes. The dentist then designs your crown on a computer using a 3-dimensional virtual model. You can watch! Next, the camera images/data are sent to a milling chamber. This is a machine inside the office that utilizes two diamond “drill bits” to multi-axis mill (cut) a perfect crown (could be a bridge, implant crown, veneer, inlay, onlay) out of a block of porcelain. This process is remarkably quick and absolutely precise. At this stage your new crown can be bonded in place. No need for a temporary, no need for a second visit, no need to interrupt your schedule twice, and no need to be frozen twice.

Photo: Contributed

The technology really has to be seen to be believed. Call our office if you would like a demonstration, or if you would like a single visit crown.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.

Teeth whitening

Today I met with a new client in our office and as part of our discussion we landed on a topic that we cover often – teeth whitening. I am always struck by two constants. First, people want it, and second, hardly anyone understands it.

There are a great many things that we can do with modern dentistry that have a profound impact on a person’s health and well being that are never seen or appreciated by anyone really. Cleanings, crowns on back teeth, treatment of abscesses to name a few. Everyone on the other hand, appreciates teeth whitening. Very few people don’t desire to have a whiter and brighter smile, and fewer yet fail to notice one.

Photo: Thinkstock.com

However, there are some general concerns around the topic. “Will it make my teeth more porous?”, “Will it make my teeth weaker?”, “Does it remove parts of my teeth?”, “Does whitening make me more prone to cavities, or make my teeth more sensitive?” I field these questions almost every time the subject comes up.

The reality is your tooth is made up of a bunch of tiny crystals – just like a sugar cube is made up of a bunch of little grains. Your tooth is sealed with a layer called a pedicle. Over time, color rich things such as coffee, red wine, blueberries, and other such items leach color or chroma through the pedicle and settle between the little crystals. Whitening products simply temporarily remove the pedicle and set to work on removing the color particles from between the crystals. The structure of the tooth is unchanged and unharmed. Once the whitening process is completed the pedicle will reform taking approximately 36 – 48 hours to do so.

There are a variety of products available to whiten and brighten your smile. Each will have its advantages and disadvantages. In addition, there are some situations that may result in your not being a good candidate for whitening. These are discussions to be had with your dentist. Once we have the opportunity to assess your particular situation and any associated particular challenges/concerns then we will be able to make the best possible recommendations for you.

A whiter, brighter smile will have you smiling with more confidence and more frequency. Smiles are contagious, and I recently read a quote stating, “Your day will go the direction the corners of your mouth turn.” Look into having your smile improved with simple and effective teeth whitening today.

If you have any questions, concerns, or topics you’d like me to address, simply email me at [email protected].

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.