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By Randall Furman DDS
January 16, 2021
Category: Dental Procedures
Tags: dentures  
FlexibleRPDs-aSoundTemporaryWayToReplaceMissingTeeth

The timing around losing a tooth may not always sync with your financial ability. It's not unusual for people to postpone getting a dental implant—by far the best option for replacing a missing tooth—because of its expense.

So, if you have to postpone dental implants until you can afford them, what do you do in the meantime to keep your smile intact? One affordable option is a temporary restoration known as a flexible removable partial denture (RPD).

Composed of a kind of nylon developed in the 1950s, flexible RPDs are made by first heating the nylon and injecting its softened form into a custom mold. This creates a gum-colored denture base to which prosthetic (false) teeth are affixed at the exact locations for missing teeth.

Differing from a permanent RPD made with rigid acrylic plastic, a nylon-based RPD is flexible and lightweight, making them comfortable to wear. They're kept in place with small nylon extensions that fit into the natural concave spaces of teeth. And, with a bit of custom crafting, they can look quite realistic.

RPDs are helpful in another way, especially if you're waiting for an implant down the road: They help preserve the missing tooth space. Without a prosthetic tooth occupying that space, neighboring teeth can drift in. You might then need orthodontic treatment to move errant teeth to where they should be before obtaining a permanent restoration.

Flexible RPDs may not be as durable as acrylic RPDs, and can be difficult to repair or reline if needed to adjust the fit. Though they may not stain as readily as acrylic dentures, you'll still need to clean them regularly to help them keep looking their best. This also aids in protecting the rest of your mouth from dental disease by removing any buildup of harmful bacterial plaque on the RPD.

But even with these limitations, patients choose RPDs for the simple fact that they're affordable and temporary. And the latter is their greatest benefit—providing you a “bridge” between losing a tooth and replacing it with a durable dental implant.

If you would like more information on tooth replacement options, 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 “Flexible Partial Dentures.”

TopicalFluorideCouldBoostYourChildsAvoidanceofToothDecay

Tooth decay is perhaps the biggest danger your child's teeth can face. Not only can it rob them of primary teeth now, but the loss of teeth at this early age could also lead to future bite problems.

That's why it's important to reduce the risk of tooth decay through daily brushing and flossing and regular dental cleanings. You child may also benefit from another measure that enhances those other hygiene efforts—topical fluoride applied directly to tooth surfaces.

Fluoride is a naturally occurring chemical that's been demonstrated to strengthen tooth enamel against contact with acid, the main cause of tooth decay. Today, fluoride is added not only to toothpastes and other dental hygiene products, but also in minute amounts to drinking water supplies across the country.

Even if your child takes in fluoride through one or more of these sources, there may still be a benefit to a topical application. For one, topical applications are usually stronger than fluoride toothpaste or fluoridated water supplies and can have greater effect. And because fluoridated water is ingested first before traveling through the bloodstream to the teeth, directly applied fluoride can strengthen them much faster.

But are these stronger concentrations of topical fluoride safe? Studies have shown no long-term health risk, but there can be temporary side effects like stomach pain, vomiting or headaches if the patient accidently swallows too much of the solution during the application. These side effects, however, can be minimized through safety measures dentists put in place during the procedure.

One study by the Cochrane Oral Health Research Group seems to show that the long-term benefit of topical fluoride is well worth this minor risk of side effects. After reviewing several scientific studies involving thousands of patients, the group found an overall 28% reduction in decayed, filled or missing teeth over a number of years among those who received a topical fluoride treatment.

Because of these and other forms of evidence, fluoride applications in either gel, foam or varnish forms have become a routine part of preventive care for children. Discussing it with your dentist, you may find it could be an extra weapon for your child in fighting tooth decay.

If you would like more information on how to protect your child's teeth from decay, 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 “Fluoride Gels Reduce Decay.”

SomeBiteProblemsMayRequiretheHelpofOtherToolsinConjunctionWithBraces

If you're into social media, you might have run across the idea that there's nothing to straightening your teeth. According to some SM influencers, you can even do it yourself with a few rubber bands. But the truth is, the mechanics of moving teeth are much more complex—and taking orthodontics into your own hands can cause extensive dental damage.

In reality, all bite problems (malocclusions) require the advanced knowledge and expertise of an orthodontist to correct them safely and effectively. Some, in fact, may require other devices along with braces or clear aligners to achieve the desired outcome for a particular malocclusion.

Here are a few of those additional tools an orthodontist may use and why they may be needed.

Headgear. Some malocclusions result not just from misaligned teeth, but problems with jaw or facial structure development. To accommodate additional factors like this, an orthodontist may include headgear during treatment, usually a strap running around the back of a patient's head or neck and attached in the front to brackets bonded to the teeth (usually the molars). Wearing this headgear for several hours a day can improve jaw and facial development.

Elastics. Unlike basic rubber bands DIYers might use to move their teeth (often with damaging results), elastics are specialized bands designed for targeted tooth movement. They're needed for bite problems that require moving some teeth and not moving others. As such, elastics can be applied in conjunction with braces to perform either intended task—move or prevent movement for specific teeth.

Anchorage. One of the tools often used with elastics for targeted tooth movement are temporary anchorage devices (TADs). These are typically tiny screws imbedded into the jawbone a short distance from fixed braces. An elastic band connected to the braces at a specific point is then attached to the TAD, which serves as an anchor point for the elastic.

These and other devices can help orthodontists achieve a successful correction for certain individual bite problems. And unlike the DIY methods touted on the Internet, these additional tools help them do it safely.

If you would like more information on straightening teeth through orthodontics, 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 “Orthodontic Headgear & Other Anchorage Appliances.”

TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

By Randall Furman DDS
October 28, 2020
Category: Dental Procedures
DIYOrthodonticsisaRecipeforDentalDisaster

Do-It-Yourself (DIY) is a deeply held American trait for building, renovating or repairing things without the services of a professional. The Internet has only made this tradition easier: There are scores of videos showing people how to do things on their own like build a deck, fix a dryer or bake an award-winning soufflé.

But some things are best left to the experts, which if you tried to do using too little knowledge or a lot less training could turn out disastrous. A prime example is becoming your own orthodontist and using dubious home methods to straighten your teeth. If that sounds preposterous, the American Association of Orthodontists recently reported it does happen, with one in ten of their members saying they have treated patients who attempted their own smile-straightening projects.

Often found on social media, these methods usually involve household items like rubber bands or dental floss to straighten teeth. Like other forms of DIY, the object is to save money. In the end, though, these self-orthodontic methods could result in dental damage that could cost much more to repair (if indeed it's repairable) than what might have been spent with professional orthodontics in the first place.

Utilizing extensive training, experience and artistry, orthodontists work with the mouth's natural ability to move teeth in a precise manner for a planned outcome. They carefully consider each individual patient's jaw and facial structures, along with the severity and complexity of their bite problem, as they design and implement a treatment plan involving braces, clear aligners or other orthodontic appliances.

A rigged homemade device to move teeth can't adequately take these factors into account. As a result, you may be risking permanent gum and bone damage—and you may even lose teeth in the process. Even if repairable, such damage could require oral surgery, cosmetic dentistry or more extensive orthodontic procedures.

In the end, you're highly unlikely to be successful at DIY orthodontics—and you won't save any money. A healthy and beautiful smile is well worth the cost of professional, high-quality orthodontics.

If you would like more information on orthodontic options, please contact us or schedule an appointment for a consultation.