Posts for: January, 2015
Although they may appear inert, teeth are anything but — they grow and change like other bodily tissues until complete maturation. Teeth roots are especially adaptable; teeth with multiple roots develop much like forks in a road as each root takes a different path toward the jawbone.
This fork where they separate is called a furcation. It’s normal for lower molars and premolars to have two furcations, while upper molars traditionally have three. Furcations pose difficulties for teeth cleaning and maintenance. If bone loss has occurred around them, a condition called a furcation invasion has occurred. This loss is most likely due to periodontal (gum) disease, an inflammation arising from bacterial plaque on the teeth that hasn’t been removed through proper oral hygiene.
We identify furcation invasions through x-ray imaging and tactile probing. They’re classified in three stages of development: Class I describes early onset in which marginal bone loss has occurred, exposing a groove that leads to the beginning of the furcation; Class II is moderate bone loss where a space of two or more millimeters has developed horizontally into the furcation; and, Class III, advanced bone loss whereby the bone loss has extended from one side of the tooth to the other, or “through and through furcation.”
Our first step in treatment is to remove any detectable plaque and calculus on the tooth surface, including the roots (known as scaling and root planing). These areas can be difficult to access, especially near furcations, and requires special instruments known as scalers or curettes. We may also employ ultrasonic scalers that use high-frequency vibrations coupled with water to break up and flush out the plaque and calculus.
We then apply antimicrobial or antibiotic medicines to further disinfect the area and inhibit bacterial growth while the affected tissues heal. As the infection and inflammation subsides, we then turn our attention during subsequent visits to address the bone loss around the furcation. This may involve surgical procedures to aid in re-growing gum tissue and bone and to create better access for cleaning and maintaining the area.
Finally, it’s important to establish good oral hygiene habits and regular checkups and cleanings to prevent further complications or a reoccurrence of the disease. Maintaining these habits will help you avoid tooth loss and other problems with your oral health.
If you would like more information on furcations, 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 “What are Furcations?”
Many Hollywood luminaries use porcelain veneers to enhance their smiles. Take actress and singer Hilary Duff, who, according to People magazine, had veneers placed on her two front teeth after chipping them on a microphone during what must have been an extremely energetic performance.
Well, you don't have to be a Hollywood star to benefit from a smile enhanced with porcelain veneers. If you have small chips, cracks, slight tooth rotations or minor spacing problems, veneers may be able to give you back your smile — or an even better one.
The word “veneer” refers to a super-thin covering, and in dentistry a veneer is a thin layer of porcelain that replaces your natural tooth enamel. Porcelain is the material of choice because of its strength, translucency, and ability to resist erosion.
In the right hands, dental porcelain can mimic tooth enamel perfectly. To make veneers, a skilled dental technician will mix porcelain powder (in a shade specified by the dentist) with water and then fire the material in an oven like pottery; the porcelain is built up in layers for a truly lifelike effect.
Before a veneer is bonded to a tooth, often we need to remove a tiny bit of the tooth's existing enamel so that the final effect will not be too bulky. The procedure is virtually painless and can be completed in as little as two visits. Because enamel is removed, this particular cosmetic treatment is not reversible. Sometimes veneers can be added directly onto the tooth surface without any tooth reduction and therefore are reversible if used in this way.
Once you have veneers, please keep in mind that while extremely strong, porcelain veneers are not indestructible; you won't want to do things like crunch ice or break nuts open with your teeth. And if you are a teeth-grinder, you should wear a nightguard to protect your beautiful new smile. With proper care, your veneers will last 20 years or more.
If you would like more information about porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced With Porcelain Veneers.” Dear Doctor also has more on “Cosmetic Dentistry: A Time For Change.”