My Blog

Posts for category: Dental Procedures

By C. Roger Macias Jr., DDS
January 14, 2022
Category: Dental Procedures
3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing teeth, 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 “When Permanent Teeth Don't Grow.”

By C. Roger Macias Jr., DDS
January 04, 2022
Category: Dental Procedures
Tags: dental implants  
3EmergingTechnologiesThatImproveDentalImplants

Historically speaking, implants are a recent blip on the centuries-long march of dental progress. But few innovations in dentistry can match the impact of implants in its short history on dental function and appearance.

Dental implant therapy has already established itself as a restoration game-changer. But it also continues to improve, thanks to a number of emerging technologies. As a result, implant restorations are far more secure and life-like than ever before.

Here are 3 examples of state-of-the-art technologies that continue to improve this premier dental restoration.

CT/CBCT scanning. Functional and attractive implants depend on precise placement. But various anatomical structures like nerves or sinuses often interfere with placement, so it's important to locate these potential obstructions during the planning phase. To do so, we're increasingly turning to computed tomography (CT). This form of x-ray diagnostics is the assembly of hundreds of images of a jaw location into a three-dimensional model. This gives us a much better view of what lies beneath the gums.

Digital-enhanced planning. Implant success also depends on careful planning. And, it isn't a one-sided affair: The patient's input is just as important as the dentist's expertise. To aid in that process, many dentists are using digital technology to produce a virtual image of a patient's current dental state and what their teeth may look like after dental implants. This type of imaging also allows consideration of a variety of options, including different sized implants and positions, before finalizing the final surgical plan.

Custom surgical guides. To transfer the final plan details to the actual implant procedure, we often create a physical surgical guide placed in the mouth that marks the precise locations for drilling. We can now produce these guides with 3-D printing, a process that uses computer software to produce or "print" a physical object. In this case, the 3-D printer creates a more accurate surgical guide based on the exact contours of a patient's dental arch that's more precise than conventional guides.

Obtaining a dental implant is a highly refined process. And, with the aid of other advances in dental technology, it continues to provide increasing value to patients.

If you would like more information on restoring teeth with dental implants, 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 “How Technology Aids Dental Implant Therapy.”

By C. Roger Macias Jr., DDS
December 25, 2021
Category: Dental Procedures
Tags: crowns  
WhatYouNeedToKnowToChoosetheRightDentalCrown

In the realm of dental restorations, not all crowns are alike. And, one type isn't necessarily superior to the others. One type of crown may work better for a particular tooth, while a different crown is better suited to another.

Therefore, knowing your options can help you make a more informed choice with your dentist regarding the best crown for your needs. Here, then, is a quick primer on the main types of dental crowns used today.

Metal crowns. Early in the last century, crowns made of gold, silver or other metals were the go-to dental restoration. Because of their strength and durability, metal crowns are still used today, mainly in back teeth that encounter heavy biting forces. Their drawback: They're decidedly not the color of natural teeth and so can stand out if they're placed in the visible "smile zone."

PFM crowns. The first crowns made with dental porcelain solved the appearance problem, but couldn't adequately handle biting forces as well as metal. Out of this came the porcelain fused to metal (PFM) crown, which contains an inner core of metal overlaid with tooth-colored porcelain. Providing both strength and life-likeness, PFM crowns were immensely popular until the mid-2000s.

All-Ceramic crowns. The development of porcelains more durable than earlier versions eventually dethroned the PFM (although the latter is still used today). Sixty percent of the crowns installed in recent years are all-ceramic, many reinforced with a strength material known as Lucite. Many all-ceramic crowns reaching the 15-year mark are still in place and functioning.

All of these crowns continue to be viable options for dental patients. The biggest factor in choosing one particular crown over another is the type of tooth involved and its location. As mentioned before, metal or PFM crowns are usually better for back teeth where durability is a higher priority than aesthetics. All-ceramics work well in high-visibility front teeth that normally encounter lighter biting forces than back teeth.

Regardless of which kind eventually caps your tooth, any of today's modern crowns will function as intended. But the best crown for you will be the one that both protects your tooth and enhances your smile.

If you would like more information on dental crown restorations, 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 Dental Crowns.”

By C. Roger Macias Jr., DDS
December 05, 2021
Category: Dental Procedures
Tags: dental implants  
DoYouHaveEnoughSupportingBoneforanImplant

Upgrades can be exciting—moving on to a larger house, the latest smartphone, or maybe a new car. And, the same can apply with tooth replacements: Maybe you're ready now to upgrade your existing restoration to a dental implant, the most advanced tooth replacement method now available.

But you might encounter a speed bump in your plans: whether or not you have enough bone available for an implant. Here's why your bone may not be adequate.

Like any other cellular tissue, bone has a life cycle: older cells die and newer cells form to take their place. This process stays on track because of the forces generated when we chew, which stimulates new growth.

But that stimulus disappears when a tooth goes missing. This slows the bone growth cycle to the point that bone volume can gradually dwindle. You could in fact lose up to a quarter of bone width in just the first year after losing a tooth.

And, you'll need adequate bone to provide your implants with sufficient strength and stability, as well as the best possible appearance alongside your other teeth. If you don't have enough bone, we must either enhance its current volume or opt for a different restoration.

Fortunately, we may be able to do the former through bone augmentation or grafting. With this method, we place a graft of bone tissue in the area we wish to regenerate. The graft becomes a scaffold upon which new bone cells build upon. It's possible for grafting to produce up to 5 mm in additional width and 3 mm in height to supporting bone.

We can also use this method to prevent bone loss by placing a graft immediately following a tooth extraction. Some studies show the graft can help preserve bone up to 10 years, giving patients time to consider or prepare for a dental implant.

 There are circumstances, though, where bone loss has been too extensive to make up enough ground to place an implant. If so, there are other effective and life-like restorations to replace missing teeth. But there's still a good chance augmentation can restore the bone you need for a new smile with dental implants.

If you would like more information on dental implant restorations, 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 “Dental Implants After Previous Tooth Loss.”

By C. Roger Macias Jr., DDS
November 25, 2021
Category: Dental Procedures
Tags: oral hygiene   dentures  
DoThese2ThingsForYourHealthsSakeIfYouWearDentures

Today's dentures are more comfortable, more functional and more life-like than ever before—so much so that you might forget you have them in. Even so, dentures do have some downsides, and constant wear only amplifies those.

Our biggest concern is the effect dentures can have on bone health. Older bone is constantly replaced by newer bone, and the forces generated while chewing help stimulate this new growth. When a tooth is lost, however, this growth stimulus vanishes with it for that area of the bone. This may result in a slower growth rate, which can eventually lead to lost bone volume and density.

Dentures can't restore this lost stimulus, and may even make the situation worse. That's because traditional dentures rest on the bony ridges of the gums where the teeth once were. This can put pressure on the underlying bone, which can accelerate bone loss—and even more so when wearers leave their dentures in continuously.

Dentures can also contribute to disease if they're not regularly removed and cleaned. Besides oral yeast infections, bacteria-laden dentures can contribute to the production of a protein called interleukin-6 produced by the white blood cells. If a significant amount of this protein passes into the blood stream, it can increase body-wide inflammation and foster a systemic environment conducive to serious diseases like pneumonia.

If you wear dentures, then, it's good for your health (oral and otherwise) to incorporate two practices into your daily life. The first is to remove your dentures at night while you sleep. Not only will this help slow the progression of bone loss, it will also give your gums a chance to rest and recover from denture wear.

It's also important to regularly clean your dentures, either with an antibacterial soap or a special denture cleanser. During storage, keep your dentures in clean water or a peroxide-based solution designed for dentures. This will reduce the accumulation of bacteria on your dentures that can cause disease.

Dentures restore the dental function and smile appearance that a person loses with their teeth. Taking care of your dentures (and giving your mouth a daily rest from them) will help promote good oral and general health for you and a longer life for your dentures.

If you would like more information on denture 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 “Sleeping in Dentures.”



Contact Us

Office Hours
Monday:8:30 AM - 5:00 PM
Tuesday:7:30 AM - 2:30 PM
Wednesday:8:30 AM - 5:00 PM
Thursday:7:30 AM - 2:30 PM
Friday:7:30 AM - 11:00 AM
Saturday:Closed
Sunday:Closed