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

September 11, 2011 alexnguyen

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,

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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?

June 22, 2011 alexnguyen

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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Another Case of Sensitivity after Resin Filling

April 22, 2009 alexnguyen

Here is another case where voids in resin fillings will cause the tooth to be sensitive. This patient's complaint was "I had some fillings done on my upper left quadrant, and the teeth on that side have been sensitive since." The black arrow points to a distinct void underneath the white filling. To correct the problem, we will need to redo this filling for the patient.

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SEM proves zero bond between Amalgam and Tooth

April 18, 2009 alexnguyen

I have warned a patient that this particular part of his tooth will break at some point. It finally broke. With the patient being a Chemical/Mechanical/Material Engineer... the fractured tooth was placed under a Scanning Electron Microscope. Interestingly enough, my patient reenforced my everyday discussion that "Amalgam fillings have no true bond to tooth structure."

Based on the information interpreted by the SEM, the fractured piece of enamel showed no bond to the silver filling.

Thanks BM for your insight and photos.

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