When you look at the top row of a normal smile, you'll see symmetrical pairs: the central incisors in the middle, flanked by the lateral incisors and the canine (or eye) teeth on the outside of them.
Sometimes, though, teeth may not form as they should: in fact, it's one of the more common congenital defects with one in five people having missing or deformed teeth, often the upper lateral incisors. In the latter case, it's not uncommon for the eye teeth to drift into the missing lateral incisors' spaces next to the central incisors. This creates a smile even a layperson can tell is off.
There is a way to treat this with orthodontics and cosmetic dentistry that will transform that person's smile while restoring better mouth function too. It's often a long process, however, that's best begun early and must be precisely timed with dental development.
Using braces, we move the drifted teeth back to their proper positions, which will make room for a future dental restoration. It's usually best to begin this treatment during late childhood or early adolescence. The next step is to fill the newly-created space with prosthetic (false) teeth.
Dental implants are an ideal choice since they're durable and life-like, and won't require permanent alteration of adjacent teeth. They do, however, require a certain amount of bone volume at the site to support them; if the volume is insufficient we may have to place a bone graft to stimulate new growth.
It's also best not to install implants until the jaw has finished development, usually in the late teens or early adulthood. In the interim between tooth repositioning and implants we can customize a retainer or other removable appliance with a false tooth to occupy the space. This not only enhances the smile, it also prevents the repositioned teeth from drifting back.
These steps toward achieving a new smile take time and sometimes a team of specialists. But all the effort will be rewarded, as a person born without teeth can have a new smile and improved oral health.
If you would like more information on treating dental development deficiencies, 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.”
While it’s common for most of us to get an occasional cold sore, you may suffer from regular breakouts. If so, you know firsthand how uncomfortable and embarrassing they can be and seeming to erupt at the most inopportune moments.
What you’re experiencing is the result of a virus — the Herpes Simplex virus (HSV) Type I to be exact. Don’t let the name disturb you — although similar it’s different from the sexually transmitted virus known as HSV Type II. As with any virus the body responds by making and distributing antibodies to stop its attack. That’s typically the end of it but for some people the virus appears to be able to hide in the nerve roots of the mouth and elude the effects of the antibodies.
The sores associated with the virus tend to break out when a person is under stress, experiences trauma to the lip or even from sun exposure. The breakout begins with a slight itching or burning around the mouth that typically advances to more severe itching, swelling, redness and blistering. Eventually the sores will scab over and heal as the outbreak winds down. The period from breakout to final healing (during which you’ll also be contagious to others) usually lasts seven to ten days.
Although normally not a danger to health, cold sore outbreaks can be painful and irritating. In the past, most patients simply had to let the outbreak run its course with topical ointments to ease discomfort.Â In the last two decades, however, new anti-viral medication has proven effective in preventing the outbreaks in the first place or at least lessening their duration.
If you have regular bouts of cold sores prescription drugs like acyclovir or valcyclovir taken orally can help suppress the occurrences altogether, and have few side effects. Topical agents can also be used as a supplement to the drugs to help ease itching and other pain symptoms.
It’s important, though, that you undergo a complete oral examination to rule out more serious conditions associated with mouth sores. If we find that your problem is recurring cold sores, these new treatments could help you escape the cycle of discomfort.
If you would like more information on the treatment of chronic cold sore outbreaks, 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 “Cold Sores.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Do you need a deep cleaning? Scaling and root planing, otherwise known as deep cleaning, is considered the first line of treatment for patients with periodontal (gum) disease. Dr. Charles Felts and Dr. Elizabeth Felts Randall of Chattanooga Periodontics & Dental Implants, which is located in Chattanooga, TN, offer deep cleanings to their patients.
What is periodontal disease?
Periodontal disease is an infection of the structures around the teeth and is caused by plaque. The symptoms of gum disease include pain in your mouth, and swollen, red, or bleeding gums. Healthy gums should look pink and firm, not red and swollen. When gum disease is left untreated, it can worsen over time and impact the integrity of your gums and teeth in a serious way.
What is scaling and root planing?
Scaling and root planing helps improve the health of your gums, preventing bone and tooth loss. Scaling and root planing involves removing the plaque and calculus, also called tartar, on the root surfaces of periodontal pockets in order to get rid of the bacteria that cause periodontal disease.
When do you need a deep cleaning?
A deep cleaning is done if your dentist determines that you have calculus and plaque under your gums or your gums have started to pull away from your teeth. The American Academy of Periodontology recommends dental practitioners offer scaling and root planing when X-rays show bone loss and an exam reveals one or more periodontal pockets greater than 4 millimeters deep.
How effective are deep cleanings?
A deep cleaning is one of the most effective ways to treat periodontal disease before it becomes severe. If you maintain great dental hygiene after the procedure, the progression of periodontal disease should stop and your gums will eventually heal and become pink and firm again.
Left untreated, periodontal disease can wreak havoc on not only your oral health but also your overall health. Call Chattanooga Periodontics & Dental Implants at 423-756-2450 now to schedule an appointment for a deep cleaning in Chattanooga, TN. We will help you get rid of gum disease once and for all.
Dental implants are widely recognized as the best tooth replacement option available. For most people, though, it’s a long process: after a tooth is extracted the socket is allowed to heal and fill in with new bone before implant surgery: that can take anywhere from two to five months. Afterward, there’s usually a two– to three–month period after the implant is placed before the permanent crown (the visible tooth) can be attached.
Without adequate bone present the implant’s long-term stability might be compromised. Furthermore, the implant’s durability is dependent upon bone growth around and attaching to its titanium post after surgery in a process known as osseo-integration. These two considerations indeed serve a critical function in the implant’s ultimate success.
In recent years, however, a variation to this traditional implant process has emerged that allows for immediate implantation right after extraction. Besides combining extraction and implantation into one surgical procedure, immediate implants minimize the disruption to a person’s appearance (especially with visibly prominent front teeth) when combined with a provisional crown.
Immediate implants joined together that replace a full arch of teeth can receive biting forces and succeed. Individual implants that replace single teeth, however, won’t work in all situations and must be undertaken with care to ensure long-term success. Because there may be less available bone, the implant must fit snugly within the socket to maintain as secure a hold as possible. The surgeon must also take care not to damage too much of the gum and bone tissue when extracting the tooth, which could affect both the integrity of the implant and its appearance in the gum line.
Temporary crowns may be attached during the implant surgery, but they’re installed for appearance’ sake only. For individual crowns, they must be designed not to make contact with the teeth on the opposing jaw to avoid generating biting forces that will cause the implant to fail and stop the bone-healing process that occurs with osseo–integration.
If you’re considering dental implants, it’s important to discuss with us which type of procedure, traditional or immediate, would be best for you, and only after a comprehensive examination of your mouth and jaw structure. Regardless of the approach, our goal is to provide you with a smile-transforming restoration that will last for many years to come.
If you would like more information on the dental implant process, 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 “Immediate Implants.”
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