My Blog

By James L. Schumacher, DMD
June 19, 2018
Category: Dental Procedures
Tags: bonding  
3AdvantagesforImprovingYourSmilewithCompositeResins

Are you embarrassed by your front teeth? Maybe it’s just moderate defects—a chipped tooth here, an irregularly shaped tooth there—but it’s enough to make you less confident to smile.

There are a number of ways to transform your teeth’s appearance like porcelain veneers or crowns. But a relatively inexpensive method that’s less involved is to bond dental material called composite resin to your teeth to correct defects. Made of synthetic resins, these restorative materials can mimic your own natural tooth color. We can also artistically shape them to create a more natural look for an irregular tooth.

If you’re looking to change the way your front teeth look, here are 3 reasons to consider composite resins to restore them.

They can be applied in one office visit. Although effective, veneers, crowns and similar restorations are typically outsourced to dental labs for custom fabrication. While the results can be stunning, the process itself can take weeks. By contrast, we can colorize, bond and shape composite resins to your teeth in just one visit: you could gain your “new smile” in just one day.

They don’t require extensive tooth alteration. Many restorations often require tooth structure removal to adequately accommodate them, which can permanently alter the tooth. Thanks to the bonding techniques used with composite resins, we can preserve much more of the existing tooth while still achieving a high degree of artistry and lifelikeness.

Composite resins are stronger than ever. Over the years we’ve learned a lot about how teeth interact with each other to produce the forces occurring during chewing and biting. This knowledge has contributed greatly to the ongoing development of dental materials. As a result, today’s composite resins are better able to handle normal biting forces and last longer than those first developed a few decades ago.

Composite resins may not be suitable for major cosmetic dental problems, but you might still be surprised by their range. To learn if composite resins could benefit your situation—even a large defect—see us for a complete examination.

If you would like more information on composite resin 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 “Artistic Repair of Front Teeth with Composite Resin.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By James L. Schumacher, DMD
May 30, 2018
Category: Oral Health
Tags: oral health   cancer  
BeAlerttotheUnintendedConsequencesofCancerTreatmenttoOralHealth

Thanks to treatments like chemotherapy and radiation, your chances of surviving cancer are greater than ever. These treatments, however, often produce unwelcome side effects. Treating throat or oral cancer, for example, could damage your mouth's salivary glands or bone.

Saliva is essential to oral health, providing antibodies to curb the growth of disease-causing bacteria and neutralizing acid, which can erode enamel. But salivary glands damaged during cancer treatment may not be able to produce enough saliva. The resulting “dry mouth” creates an environment conducive to bacterial growth and elevated acid levels.

You can help reduce the effects of dry mouth during your treatment (and after, if the damage is permanent) by drinking more water or by using substances that stimulate saliva. Cutting back on acidic foods and beverages will also help lower your mouth's acidity. And be sure to keep up daily oral hygiene and regular dental visits.

The more ominous threat to oral health during cancer treatment, though, is osteoradionecrosis. This occurs when radiation targets specific areas of bone. The bone can lose blood supply and living cellular tissue, which inhibit its ability to heal or replenish itself. If this occurs in the jawbone of teeth that may be lost, the bone tissue could be adversely affected during healing.

Depending on your treatment needs, your risk for osteoradionecrosis might be unavoidable if teeth are to be lost. It's important we discuss that risk because it could impact future dental treatment. In the worst case, before cancer treatment, we may not be able to save affected teeth and your restorative options might be limited.

If your risk of osteoradionecrosis is minimal, though, we may be able to restore any resulting damaged or missing teeth with a wide range of options like dental implants or crowns before or after your cancer treatment.

As with other aspects of health, taking care of your teeth and gums while undergoing cancer treatment can be challenging; some problems may be unavoidable. But with a proper dental treatment plan during and after chemotherapy and radiation, we can minimize those problems and help to eventually restore your smile.

If you would like more information on smile restoration after cancer, please contact us or schedule an appointment for a consultation.

By James L. Schumacher, DMD
May 20, 2018
Category: Dental Procedures
Tags: dental implants  
3PossibleTimingScenariosforGettingYourNewImplant

If you have a problem tooth we’ve recommended removing, those “Tooth in one day” ads—a tooth removed and an implant placed at the same time—might start to pique your interest. But there are a few factors we must consider first to determine if this procedure is right for you. Depending on your mouth’s health conditions, you may need to wait a little while between tooth extraction and implantation.

Here are 3 timing scenarios for receiving your implant after tooth removal, depending on your oral health.

Immediately. The “tooth in one day” scenario can be much to your liking, but it could also be tricky in achieving the best results. For one, the implant may fit too loosely—the bone around the socket might first need to heal and fill in or undergo grafting to stimulate regeneration. In other words, immediate implant placement usually requires enough supporting bone and an intact socket. Bone grafting around the implant is usually needed as well.

After gum healing.  Sufficient gum coverage is also necessary for a successful outcome even if the bone appears adequate. To guard against gum shrinkage that could unattractively expose too much of the implant, we may need to delay implant placement for about 4 to 8 weeks to allow sufficient gum healing and sealing of the extraction wound. Allowing the gums to heal can help ensure there’s enough gum tissue to cover and protect the implant once it’s placed.

After bone healing. As we’ve implied, implants need an adequate amount of supporting bone for best results. When there isn’t enough, we might place a bone graft (often immediately after tooth extraction) that will serve as a scaffold for new bone to grow upon. Depending on the degree of bone loss, we may wait until some of the bone has regenerated (about 2 to 4 months) and then allow the natural process of bone cells growing and adhering to the implant (osseointegration) to complete the needed bone growth. If bone loss is extensive, we may need to wait until full healing in 4 to 6 months to encourage the most stable outcome.

If you would like more information on the process of obtaining 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 “Implant Timelines for Replacing Missing Teeth.”

By James L. Schumacher, DMD
May 10, 2018
Category: Dental Procedures
Tags: porcelain veneers  
WhatYouShouldKnowAboutVeneersforTeenagers

Porcelain veneers are a great way to enhance an unattractive smile. But are they appropriate for teenagers? The answer usually depends on a patient’s current development stage and the type of veneer used.

Veneers are thin layers of porcelain bonded to the front of teeth. But even though quite thin, they can appear bulky if we don’t first remove some of the tooth’s enamel surface. This is irreversible, so the tooth may require a restoration from then on.

This could be a major issue for teens whose permanent teeth are still developing. During this period the tooth’s central pulp is relatively large and the dentin layer not fully developed. As a result, the pulp’s nerves are often closer to the surface than in an adult tooth. This increases risk of nerve damage during veneer preparation; if nerve damage occurs, the tooth could ultimately require a root canal treatment to save it.

On the other hand, some types of veneers don’t require tooth alteration (or only very little) beforehand. These “no-prep” or “minimal prep” veneers are best for certain situations like abnormally small teeth, so we must first determine if using such a veneer would be appropriate for your teen.

In effect, we’ll need to weigh these and other factors before determining if veneers are a safe choice for your teen. That being the case, it may be more advisable to consider more conservative cosmetic techniques first. For example, if enamel staining is the main issue, you could consider teeth whitening. Although the often amazing results eventually fade, whitening could still buy some time until the teeth have matured to safely apply veneers.

Slight deformities like chipping can often be corrected by bonding tooth-colored composite material to the tooth. In artistic hands it’s even possible to create a full veneer effect with very little if any tooth preparation. How much we can apply, though, depends on tooth size, and it won’t be as durable as a porcelain veneer.

With that said, veneers could be the right solution to enhance your teen’s smile. But, we’ll need to carefully consider their dental situation to ensure their new smile remains a healthy one.

If you would like more information on cosmetic solutions for smile appearance problems, please contact us or schedule an appointment for a consultation.





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