When are Dental Implants Recommended?

Dental implants are recommended only when the root of the tooth can no longer sustain itself in the jaw bone.  There are two general scenarios for the problem: 1.  The root has lost too much bone around it.  Bone loss can be caused by gum disease or excess bite trauma to a particular tooth.  Bone loss can happen in both vital teeth and root canal treated teeth.   If the bone loss is beyond the minimum volume for a sustainable implant, then bone grafting may be necessary before the implant can be placed.

2.  When the root is cracked from bite trauma.

a)  A vital tooth can crack from bite trauma, and the crack can extend deep into the root.  In this situation, root canal treatment and crown are not viable options because of the extent of the crack or fracture.

b)  Root canal treated teeth are essentially dead roots.   These roots are very brittle.  Even with a crown placed on the root canal treated tooth, that root can manifest a vertical crack line running along the length of the root.  In this case, bone loss begins to occur where the crack line exists, and the root is no longer salvageable.  Evidence of cracks in root canal treated teeth can be seen as an absess in the gum tissue surrounding the root.  Keeping these roots in the jaw for extended periods of time will result in more extensive bone loss, and the destruction can be seen on xrays of the surrounding bone area of the root.

The decision to extract and replace a particular root with a dental implant has to be substantiated by clinical evidence and radiographic evidence.

The following sample cases illustrate situations where the natural tooth root cannot be saved, and a dental implant would be an option to replace the tooth.

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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.

Bonding to Fix Chipped Front Teeth

Modern resin filling materials allow dentists the opportunity to easily fix chipped front teeth.  In the case below we were able to restore this patient's confidence in her smile by bonding various shades of composite resin materials, contouring, and polishing the surfaces to blend in with the natural tooth structure. This is an example of minimally invasive dentistry where restoring chipped teeth does not require aggressive removal of tooth structure.

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

How Come the Color Could Never Match For Crowns on the Front Teeth?

The two front teeth are the most commonly restored teeth.  They erupt into the mouth at about the age of eight, and being positioned in front of the mouth they often sustain the most damage. Color is not the only parameter required to match the two front teeth with the rest of the teeth in the smile.  Among other factors, we have to also match contour, surface texture, and shade variations of different areas of the teeth.  Matching the front teeth is like sculpting a portrait of what they used to look like. That is the only way they will blend in with the natural dentition. Furthermore, the two front teeth serve as a very important guidance for joint stability and function.  We must approach the front teeth in more than one dimension.

When done correctly,  restorations for the front teeth will disappear into the rest of the smile.  Here is a testimony from a recent case I delivered last week.

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Email dated 9/09/2011

Dear Dr. Alex,

I want to personally thank you for the wonderful job you did on my case. Although it took longer than I anticipated, it was worth the wait and I am very pleased with the end result. You definitely have the knack for how teeth should look and function. I really appreciate your thoughtfulness and professionalism. ...Again, I want to thank you for a job well done.

P.S. you will soon have another positive review on Yelp :)

Sincerely,

K

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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.

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.