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Posts for category: Dental Procedures

By Charles L. Sours, Jr. D.D.S.
July 03, 2020
Category: Dental Procedures
WhyKathyBatesChoseThisAlternativetoBracesandsoMightYou

Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.

Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.

Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.

Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.

While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.

That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.

Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.

With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.

The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.

If you would like more information about tooth straightening, please contact us or schedule a consultation.

By Charles L. Sours, Jr. D.D.S.
May 14, 2020
Category: Dental Procedures
Tags: tooth pain  
ToothPainHereAreSomePossibleCauses

“My tooth hurts…or maybe more than one. Or, it might be my gums.”

If you're having trouble describing the pain in your mouth, don't feel bad. Although our body's pain mechanism is great for alerting us to a problem, it can't always tell us the true cause and location of that problem.

That's especially true of tooth pain. It could be a sign, for instance, of decay within a tooth's inner pulp. When under attack, the nerves in the pulp often send out pain signals that could be sharp, dull, continuous, intermittent, seeming to come from one tooth or several.

If this is the case, depending on how deep the decay is, you could need a filling to resolve the problem or, if it's more extensive, possibly a root canal treatment to save the affected tooth. If you need a root canal, after removing the pulp's diseased tissue, the procedure calls for filling the empty pulp chamber and root canals to prevent future infection.

Another possibility for the pain is gum disease that has also infected the tooth. Gum disease usually begins with the bacteria in dental plaque, a thin biofilm that builds up on tooth surfaces, which infect the gums. If not treated promptly, the infection can advance below the gum line to the tooth roots and supporting bone. From there, it could invade the tooth and travel through the root canals to the interior pulp.

In this scenario, we'll need to treat the gum disease by removing plaque and tartar (hardened plaque) deposits from all tooth and gum surfaces. This is usually done manually with hand instruments or ultrasonic equipment, but it may also require surgical access to infected areas around the roots. If the tooth's nerve has become involved, we may also need to perform a root canal treatment as described above.

There are three key points to take from these two tooth pain scenarios. First, the only way to determine the true cause of your pain (and what treatment you'll need) is with a dental exam. Second, the sooner your pain is diagnosed and you begin treatment, the better your outcome—so see your dentist at the first sign of pain or other symptoms like swollen or bleeding gums.

And finally, you may be able to prevent these and other dental problems by removing disease-causing plaque through daily brushing and flossing and professional teeth cleaning every six months. Prevention through effective oral hygiene may help you avoid a future bout of mysterious tooth pain.

If you would like more information on treating tooth pain, 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 “Confusing Tooth Pain.”

By Charles L. Sours, Jr. D.D.S.
March 25, 2020
Category: Dental Procedures
Tags: chipped tooth  
OneVisitMayBeAllYouNeedtoRestoreaChippedTooth

As tough as teeth are, life can take its toll on them and sometimes lead to parts of them chipping off. Although it might not affect a tooth's overall health, it can certainly downgrade its appearance.

But we can restore a chipped tooth like new, and it may not require extensive dental work. Thanks to a versatile dental material called composite resin, we can often bring back a tooth's natural appearance in just one visit.

Tooth-colored resins have been around for decades, but their application has been limited due to issues with durability. Recently developed bonding techniques, though, have made them a workable option for restoring mild to moderate tooth defects.

We do this by applying and bonding the composite resin to a tooth to “fill in” the missing portion. While it's often a short process, it does require a thorough understanding of tooth anatomy, function and aesthetics.

We begin with a comprehensive exam to assess the true condition of a chipped tooth. Some dental defects might be better served with a porcelain restoration like a veneer or crown for best results. Still, there are a wide range of defects for which composite resins is a solid repair choice.

Once we've determined bonding is appropriate, we prepare the tooth by first roughening its outer surface and then etching it with an acid solution to increase bonding strength. We then apply a luting agent, a kind of dental cement, also to aid with bonding.

We then begin applying the composite resin in liquid form, one layer at a time. This layering process helps simulate the color depth and shape of the tooth, and to further incorporate strength into the restoration. We're also careful at this point to match the variations of color with those of the surrounding teeth so that it looks as natural as possible.

As we finish each layer, we apply a curing light to harden the resin. We can then polish the finished product and make adjustments for the bite. The end result is a tooth that not only looks whole, but natural and blended with the rest of your teeth. Bonding could truly change your smile in just one visit.

If you would like more information on cosmetic dental restorations, 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 “Artistic Repair of Front Teeth With Composite Resin.”

By Charles L. Sours, Jr. D.D.S.
February 24, 2020
Category: Dental Procedures
Tags: teeth whitening  
DeterminingtheRightWhiteningApproachisKeytoBrighteningaDullSmile

Bright, naturally white teeth are a key component in a beautiful smile. But the opposite is also true: nothing diminishes an otherwise attractive smile more than stained or discolored teeth.

There is good news, however, about tooth staining: it can be greatly reduced with the right whitening technique. But before taking action we need to first uncover the cause for the staining — whether from the outside or inside of the tooth, or a combination of both.

If it’s an external cause — known as extrinsic staining — our diet is usually the source. Foods and beverages that contain tannins, like red wine, coffee or tea fall in this category, as do foods with pigments called carotenes as found in carrots and oranges. Besides limiting consumption of stain-causing foods and maintaining daily oral hygiene, you can also diminish extrinsic staining with a bleaching application.

There are two basic ways to approach this: with either a professional application at our office or with a home kit purchased at a pharmacy or retail store. Although both types use similar chemicals, the professional application is usually stronger and the whitening effect is obtained quicker and may last longer.

Discoloration can also occur within a tooth, known as intrinsic staining, and for various reasons. It can occur during tooth development, as with childhood overexposure to fluoride or from the antibiotic tetracycline. Poor development of enamel or dentin (the main sources of natural tooth color), tooth decay, root canal treatments or trauma are also common causes of intrinsic discoloration.

There are techniques to reduce the effects of intrinsic staining, such as placing a bleaching agent inside the tooth following a root canal treatment. In some cases, the best approach may be to restore the tooth with a crown or porcelain veneer. The latter choice is a thin layer of dental material that is permanently bonded to the outer, visible portion of the tooth: it’s life-like color and appearance covers the discoloration, effectively renewing the person’s smile.

If you’ve been embarrassed by stained teeth, visit us for a complete examination. We’ll recommend the right course of action to turn your dull smile into a bright, attractive one.

If you would like more information on treatments for teeth staining, 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 “Teeth Whitening.”

By Charles L. Sours, Jr. D.D.S.
January 15, 2020
Category: Dental Procedures
Tags: fillings  
DentalAmalgamContinuestobeaDurableandSafeToothFilling

Recently, a number of new filling materials that mimic tooth color have come into popular use and, so far, have proven more durable than past versions. Even so, the traditional metal-based dental amalgam remains a viable choice, especially for less visible back teeth and their higher biting forces.

Used for more than a century, dental amalgam is a metal alloy composed of silver, mercury, tin and copper. The mixture is carefully proportioned so that potentially hazardous mercury is kept to a minimum and bonded with the other metals. Amalgam in its initial form is quite pliable so that it can be molded into the tooth structure under repair. Afterward it sets hard to form a durable filling that can withstand the daily force generated when we bite and chew food.

Besides durability, dental amalgam rarely causes an allergic reaction in a patient, and it’s easy for trained dentists to apply. On the downside, however, it can cause temporary temperature sensitivity in the tooth just after filling, and the tooth itself may require some removal of healthy structure to help keep the filling in place. And from an aesthetic point of view, its metallic appearance is considered unattractive especially for front teeth.

The presence of mercury in amalgam has also raised concerns over the years. “Free” mercury — atoms that escape through vapor emitted by the metal — can enter the bloodstream and potentially harm the nervous system. But after extensive study and research, U.S. and international health bodies including the American Dental Association have concluded any free mercury released during chewing is extremely low and well below any harmful levels. These studies have also found no ill effects in either children or adults with dental amalgam fillings.

Deciding on the type of filling material to use — dental amalgam or a newer composite resin, resin ionomer or glass ionomer — depends on a number of factors including the location of the teeth to be filled, the extent of decay and your personal preferences. Taking these into account, we’ll be happy to discuss which type of filling will suit you best for repairing decayed teeth.

If you would like more information on filling material options including dental amalgam, 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 “Silver Fillings — Safe or Unsafe?