Dental Care - An Ongoing Commitment

This week I received a beautiful flower arrangement from a patient.  It really marks over twenty five years that I have been taking care of her teeth.  Our professional relationship goes back to the days when I was still a dental student in the early 90's.  My patient is committed to the upkeep of her dental health, and I try hard to deliver my best dental care to her.

Indeed, dental care requires a commitment from both the patient and the dentist.  It really does not matter how well we perform the dentistry at the office.  If the patient is not committed to home care, then dental problems will continue to worsen.  Home care is not just about flossing and brushing.  For example:  in cases where the patient's bite and joints are considered at risk, staying committed to wearing the night guards will help minimize problems of excess wear and fractures of teeth and restorations in the mouth. 

When the patient and the dentist develop a mutual understanding of the patient's dental condition and what it takes to maintain optimum dental health, the result can be long lasting, manageable, and predictable.

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Dental Bridges Pros and Cons

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Tooth under bridge snapped off at the gum line

A dental bridge is a common prothesis used to replace missing teeth. Typically the two teeth on the side of the space are crowned to anchor the false tooth or teeth in between them.
Bridges are effective to address both functional and esthetic needs until they have problems. If one side of the anchor teeth becomes detached from the bridge, the entire unit has to be removed and replaced. Decay and bite pressure can cause loosening of bridges.

This X-Ray shows a bridge that lasted over 12 years in the patient’s mouth until one side of the anchor teeth broke off at the gum line. Depending on how the tooth breaks, sometime it is impossible to replace with a new bridge.

A better alternative to bridges is to use dental implant to replace just the missing tooth if the space in between them is optimized. By treating teeth independently we can better manage the physical force of the bite on the teeth and the prosthesis.

The Importance of the Canine Tooth

In some cultures, the impacted canine is perceived as a charming character in the smile. It draws attention, and is considered a beauty mark.

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The clinical reality of the canines is that they are very important when properly positioned in the mouth.  Created with extremely long roots, the canine teeth provide support when the jaw grinds from side to side.  A properly aligned dentition is supported by the canines in the side way movements, so that none of the back teeth or teeth on the opposite sides should come into contact.  This important feature prevents wear facets and fractures to the back teeth.

With the advancement of clear aligner orthodontics, realigning the malpositioned canine can be achieved easily.  This patient spent fifteen months in clear aligner orthodontic to move her impacted canine back into proper position.  The treatment also straightened other misaligned teeth.

The end result is a pleasing smile with all functional guidance and stability established. 

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 Note only the canines are in contact during grinding movements.

Note only the canines are in contact during grinding movements.

 Note only the canines are in contact during grinding movements.

Note only the canines are in contact during grinding movements.