My Blog

By C. Roger Macias Jr., DDS
July 18, 2021
Category: Dental Procedures
Tags: overdenture  
ABetterVersionofaDentureorBridgeWithDentalImplants

A wise sage once said the largest room in the world is the "room for improvement." Indeed, many modern advances would never have happened if someone hadn't first asked, "How can I make this better?"

Dentures and bridges are a case in point. Both of these tooth replacement methods have a long, successful track record in restoring functional, life-like teeth. But a recent development has made them even better: the incorporation of dental implants.

Most people associate implants, metallic posts imbedded in the jawbone, with single tooth replacements. But a few strategically placed implants can connect to and support a full removable denture (or overdenture). We can also use them to permanently affix a full or partial bridge without altering any remaining teeth as with a regular bridge.

There are two great benefits to using implants in this way. The most obvious is that they provide greater support for restorations than the traditional means for securing them in place. But there's also a less obvious benefit: They help sustain and improve bone health.

When you lose teeth, there's a high probability of bone loss. The bone is constantly forming new cells to replace older cells that have dissolved. The forces generated during chewing travel up through the teeth and help stimulate new bone growth. When teeth go missing, though, that stimulus disappears.

As a result, new cell formation can't keep up with the loss of older cells, causing the volume and density of jawbone to diminish over time. And this gradual bone loss continues to occur even with dentures or bridges, which can't replicate the chewing stimulus. Even worse, dentures irritating the bony ridges of the jaw may actually accelerate bone loss.

But the titanium in dental implants attracts bone cells, which readily grow and adhere to the implant surface. They can stop the progression of bone loss, or even help stimulate more growth. That bone growth benefit is also applicable when incorporated with dentures or bridges.

If you're looking at a denture or bridge restoration, consider implant support. It may even be possible to retrofit your existing dentures for implants. It could give you a more secure restoration and healthier bone.

If you would like more information on implant-supported dentures and bridges, 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 “Overdentures & Fixed Dentures.”

WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

By C. Roger Macias Jr., DDS
June 28, 2021
Category: Oral Health
Tags: oral hygiene  
ImprovingHygieneSkillsMaximizesRemovalofDisease-CausingPlaque

Your mouth is teeming with bacteria—millions of them. But don't be alarmed: Most are benign or even beneficial. There are, however, some bacteria that cause tooth decay or periodontal (gum) disease, which can damage your oral health.

These disease-causing bacteria feed and multiply within a thin biofilm of leftover food particles on tooth surfaces called dental plaque. To reduce these bacterial populations—and thus your disease risk—you'll need to keep plaque from building up through daily brushing and flossing.

Now, there's brushing and flossing—and then there's effective brushing and flossing. While both tasks are fairly simple to perform, there are some things you can do to maximize plaque removal.

Regarding the first task, you should brush once or twice a day unless your dentist advises otherwise. And "Easy does it" is the rule: Hard, aggressive scrubbing can damage your gums. A gentle, circular motion using a good quality toothbrush will get the job done. Just be sure to brush all tooth surfaces, including the nooks and crannies along the biting surfaces. On average, a complete brushing session should take about two minutes.

You should also floss at least once a day. To begin with, take about 18" of thread and wrap each end around an index or middle finger. Pulling taut and using your thumbs to help maneuver the thread, ease the floss between teeth. You then wrap it around each tooth side to form a "C" shape and gently slide the floss up and down. Continue on around until you've flossed between each tooth on both jaws.

You can get a rough idea how well you did after each hygiene session by rubbing your tongue against your teeth—they should feel slick and smooth. If you feel any grittiness, some plaque still remains. Your dentist can give you a more precise evaluation of your cleaning effectiveness at your regular dental visits. This is also when they'll clean your teeth of any missed plaque and tartar.

While professional dental cleanings are important, what you do every day to remove plaque is the real game changer for optimum oral health. Becoming a brushing and flossing "ninja" is the best way to keep your healthy smile.

If you would like more information on daily oral care, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

By C. Roger Macias Jr., DDS
June 18, 2021
Category: Dental Procedures
Tags: porcelain veneers  
VeneersCouldTurnBacktheClockonYourSmile

There's a lot to like about porcelain veneers, especially as you get older. For one, they can be less expensive and invasive than other cosmetic restorations. More importantly, though, they're versatile—they can solve a variety of dental appearance problems.

Veneers are thin shells of porcelain that are bonded to the front of teeth to alter their appearance—a work of custom art crafted by a dental technician to fit an individual patient's dental needs. They can turn back the clock on a less than attractive smile, and, with a little care, could last for years.

Here are some dental appearance problems you might encounter in your later years that veneers may help you improve.

Discoloration. As we get older, our teeth color can change—and not for the better. Teeth whitening temporarily brightens dull and dingy teeth, but the effect will fade over time. Additionally, there are some forms of staining, particularly those arising from within a tooth, for which external whitening can't help. Veneers can mask discoloration and give a new, permanent shine to teeth.

Unattractive shape. As we age, wearing on teeth can cause them to appear shorter and create sharper angles around the edges. Veneers can be used to restore length and soften the shape of teeth. Because veneers can be customized, we can actually create a tooth shape that you believe will improve your appearance.

Dental flaws. A lifetime of biting and chewing, not to mention a chance injury, can lead to chips, cracks or other dental defects. But veneers can cover over unsightly flaws that cause you to be less confident in your smile. Veneers can give you back the smile you once had or, if you were born with dental flaws, the smile you never had.

Misalignments. The biting forces we encounter throughout our lifetime can move teeth out of alignment, or widen gaps between them. You can undergo orthodontic treatment to correct these misalignments problems, but if they're relatively minor, we may be able to use veneers to “straighten” your smile.

If you're concerned about the effects of aging on your smile, veneers could help you look younger. Visit us for a full dental evaluation to see if a veneer restoration is right for you.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”

By C. Roger Macias Jr., DDS
June 08, 2021
Category: Dental Procedures
Tags: oral health  
CTImagingTechnologyCanImproveOutcomesforComplexDentalProblems

The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.

Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).

Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.

A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.

CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.

But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.

And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.

If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”





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