Posts for: August, 2014

By Anthony Gazzola, Jr., DMD
August 29, 2014
Category: Dental Procedures
PadmaLakshmisSmileARecipeforBeauty

Before she began hosting the long-running TV competition Top Chef, Padma Lakshmi was a well-known model and successful cookbook author. (Appropriately, she is said to have been “discovered” by a modeling agent while sitting in a café in Madrid.) Yet the Indian-born beauty's striking look — at once exotic and familiar — doesn't come from any cookie-cutter mold.

So when Lakshmi had cosmetic work done on her teeth, early in her career, her dentist didn't use a cookie-cutter approach either: Instead, her smile was carefully designed, using small amounts of bonding material to brighten her teeth and to bring their shape and spacing into harmony with her facial features.

Dentistry by Design
What exactly is smile design — and what could it do for you? Essentially, it's the process of evaluating your smile in concert with the appearance of your entire face, and visualizing the changes — some dramatic and some subtle — that will make it really shine. Some aspects we consider include the face's shape, the proportion or “balance” of facial features, the complexion, eye and lip color and form, and the overall dimensions of the smile.

Based on dental aesthetics and clinical experience, we will probably have a number of suggestions to make on how you can improve your smile. Your input will also be very important; while some individuals prefer perfectly even teeth and a sparkling “Hollywood white” smile, others are looking for a result that's more in keeping with a “natural” look: slight irregularities in tooth shape, spacing, and even color.

There's no right or wrong answer here: Having a “perfect” smile means what's perfect for you, so it's very important for dentists and patients to communicate openly during the smile design process. But sometimes, words alone just aren't enough to convey the subtle dimensions of beauty.

The Trial Smile
Fortunately, it's now possible to preview your “perfect” smile using a number of different techniques. Advances in computer imaging make this the first step in previewing your new smile — you can see the changes before a single tooth is touched! Still, many people find that having a more concrete picture is helpful. The next step is to make a 3-D mock-up the proposed dental work on an actual model of your mouth. That way, you can see a physical representation of the final results — and even turn it around and hold it in your hands.

There's still one more way to really experience the difference cosmetic treatments can make without committing to a permanent change: the provisional restoration. Here, tooth-colored bonding material and other techniques are used to actually create the new smile — temporarily. This gives you time to “live with it,” and see if the proposed changes work for you. If everything goes well with the provisional work, the permanent restoration is guaranteed to please.

So if you want holiday treats, get out the cookie cutter — but if you're looking for a smile that's uniquely yours, and one that enhances your own individual appearance… call our office and ask about a smile design consultation. You can learn more in the Dear Doctor magazine articles “Great Expectations — Perceptions in Smile Design” and “Beautiful Smiles by Design.”


By Anthony Gazzola, Jr., DMD
August 14, 2014
Category: Oral Health
AntibacterialSolutionscanHelpFightAdvancedGumDiseaseInfections

Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.

A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.

If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.

The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.

Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.

These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.

If you would like more information on treatments for gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”


By Anthony Gazzola, Jr., DMD
August 01, 2014
Category: Dental Procedures
TheGapIsNoMore

This is the story of a well-known man, fearless in most respects, who was afraid of the dentist. Even though his fears had resulted in neglect and serious damage to his teeth, modern dentistry and a talented dental team were able to restore his smile to health. If you share this fear, his story may inspire you to take action.

We're talking about William Perry, former defensive lineman and fullback for the Chicago Bears. Here is a man who could fearlessly face a football squad — but not a visit to the dentist. Nicknamed “The Refrigerator” for his 380-pound massive frame, Perry played for ten years in the NFL before retiring in 1994. Since retiring he founded and operated a construction company in South Carolina in addition to making celebrity appearances.

With his celebrity in mind, a team composed of a talented restorative dentist, implant surgeon, and lab technician agreed to give “The Fridge” a makeover. After discussing modern technology and virtually pain-free dentistry with him, they managed to overcome Perry's fears. “I had been in constant pain for many years and I neglected myself, not having had any dental care for over 20 years, not even emergency care. Unfortunately, as I grew older my teeth started to get loose,” Perry told an interviewer. He had lost many teeth and became known for his gap-toothed smile.

Perry had severe gum disease and many of his remaining teeth were loose. In the past his only option would have been a full set of dentures. But his new dental team was able to place dental implants (permanent tooth replacements) supporting fixed bridges. In most cases dental bridges are attached to healthy teeth, but in Perry's case the implants served as anchors for the bridges. They also stabilized his jawbone, which would otherwise “resorb” or melt away after his teeth were lost. This is important because it helps preserve the contours of his face.

After careful planning “The Fridge” had eight dental implants placed in his upper jaw and seven in his lower. The final bridgework was completed four months later. It turned out that even though the gap between his teeth had become his trademark, “the Fridge” never really liked it. He was thrilled with his new smile.

Even if you have some fears, don't hesitate to follow Perry's example and make an appointment with us for a consultation about dental implants, smile makeovers, or bridgework. For more information about William “The Refrigerator” Perry, see the Dear Doctor magazine article “How Immediate Implants Saved 'Refrigerator' Perry's Smile.”