Why Should Adults Consider Orthodontic Treatments?

It is not uncommon that I recommend my patients to consider orthodontic treatments to straighten their teeth.  Sometimes my adult patients' initial reaction would sound something like:  "I am too old for that, and I never thought about the cosmetics of my smile..." Having straight teeth is not ALL about cosmetics.

The misalignment of teeth can cause a variety of problems ranging from TMJ issues, to bone loss, to excess fractures and wear facets on the teeth.  This type of break down in the dentition can take many years to manifest. Unfortunately, sometimes when the patient starts to notice the problems, the solutions may require a complex combination of orthodontics and restorative treatments.

Properly aligned teeth actually follow very scientific principles created by nature to establish the most stable functional foundation.  When teeth are properly aligned, certain functional movements of the jaw allow for optimum chewing, relaxed muscle state, and ideal joint health.  The cosmetics of the smile is automatically achieved secondarily when the functional foundation is established.  Finding the right orthodontist is key to successful treatment.

Hence, when you choose to have orthodontic treatment done, you are stabilizing the most important aspect of the dentition:  To allow you to sustain life by being able to chew effectively throughout the course of your life span.  As the human life span continues to lengthen, it is extremely important to make sure that you will continue to have a stable dentition for your chewing needs.

In the photos below you will find a smile with "crooked teeth".  Whereas the patient was never concerned with the cosmetics of her smile before, she has lately been concerned with the fractures lines and wear facets indicated by the red arrows.  Her question to me at the last check-up was:  "What would my teeth look like...say ten years down the line..."

My answer to her was:  "They would look more broken down, and you will also notice problems with the back teeth as well."

So as you can see... My recommendation for this patient to choose orthodontic treatment was based on achieving proper function, and not ALL about cosmetics.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

My tooth hurts. Does it mean that I have a cavity?

Today I will tell you that the answer to this blog heading is:  NO ! Sometimes when a tooth comes into contact with the opposing teeth in a way that directs excess force to the neck of the tooth,  this can cause micro-fracture of the enamel there.  When the outside layer of the tooth (enamel) is stripped, the inside layer (dentin) is exposed.  The tooth can become sensitive to substances that are cold, sweet, sour, etc...

There is no cavity in the photographs below, but the symptoms make the patient think that a cavity is there.

Take a look at the indentation (the notch) at the neck of this tooth:

Now...

Observe how the same tooth is the only one that contacts the lower teeth when the patient moves her jaw from side to side.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

How can I have a cavity if my tooth does not hurt?

Your tooth will only hurt if the cavity penetrates the chamber which houses the nerve inside your tooth. A cavity begins from the outside surface of your tooth and usually balloons inwards until it penetrates the nerve.  Bacteria from the cavity and temperature exposure will cause the nerve to become inflamed and eventually ... die.  That's when it really hurts.

The best way to diagnose the extent of a cavity is to use proper radiographs. Regular check-ups allow your dentist to catch cavities in their early stages of development.  A small cavity is much easier and inexpensive to fill, than to wait until that cavity dictates the need for root canal, build-up, and crown treatments.

The Xray below shows 3 cavities on a patient who has not been to the dentist in a number of years.  This patient has no pain in her dentition, yet it is a matter of time before these cavities become big problems for her dental health.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

What Brand or Type of Porcelain Should We Use for the Best Cosmetic Result?

A recent new patient consultation this week has inspired me to write this blog entry... Sometimes I hear this question during my discussions with the patients.  In reality, as a patient you should not have to worry about the "name" or "type" of porcelain.  In fact, it is always the "technique" employed by the dentist that makes a difference in the outcome of a case.

In the photo below, three front teeth are marked with arrows. They look different from the rest of the restorations because our eyes can see dark areas on the teeth.  In particular, the patient was most bothered by the tooth on the far right of the screen.  This lateral incisor had an extremely dark tooth structure build-up underneath.  When the same "type" of porcelain is used in a series of teeth, color differences of the underlying tooth structure will affect how the final restorations look.

In this case, proper technique can be used to mask out the dark underlying tooth structure in order to allow better color blend.  This "technique" is a coordination between the dentist and the ceramist, and it is not a choice that the patient would have to make.

In order for your restorations to look natural, a number of factors must come into play.  Those factors are not limited to just ... the porcelain.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

Smiles of Regret. Who Do You Choose to Restore Your Teeth?

Over the years I have had the opportunity to see cases of patients who came to me for initial consultation but ended up elsewhere for the completion of their dental work.  Here are some cases where the patients returned to me a few years later to express their discontent and to complain about problems with their teeth.  These are smiles of regret. Who do you choose to restore your teeth?  Sometimes people will make their choices based on beautiful advertisements that they see.  Sometimes the choice may be based on a price tag that may fit their budget at that particular moment.   The key to remember is that an unsuccessful restorative case may eventually cost you more time and money to have the work redone.

CASE I:  Excess cement materials left under the gum line and around every single restoration.  This caused chronic inflammation of the gum and bone loss over time.  The patient was also unhappy with the esthetic result.

CASE II:  Restorations done without regards to the foundation of this patient's bite.  After 3 years, there are gaps between teeth, crowns with open margins, crowns that are breaking away, and discomfort on chewing. There are even teeth left unrestored.  The patient was also unhappy with the esthetic result.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.