Posts for: July, 2016
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
The CAT scan is a relatively recent technique in dentistry, used to get an image of what’s happening deep within your jaws. You may be wondering what a CAT scan tells us that a conventional x-ray picture does not, and whether it is worth the extra expense to get one. And how does a CAT scan compare with a conventional x-ray in terms of radiation exposure?
CAT stands for “computer assisted tomography.” Often it’s just called a CT scan, for “computerized tomography.” The word “tomography” comes from roots meaning “slice” and “write.” Tomographic techniques take repeated two dimensional pictures, similar to repeatedly slicing through an object, and then assembles them with a computer to produce a three dimensional (3-D) image.
The latest type of CT scan used in dentistry is called CBCT, or Cone Beam Computed Tomography. The Cone Beam refers to a spiral beam of x-rays, which is used to create a series of two dimensional images from which a computer creates a 3-D image. Such an image is of great value in assessing problems and planning treatment.
Here are just a few examples of how a CBCT scan can be used. Orthodontists can see skeletal structures and developing teeth that are still inside the jawbone while planning strategies for directing the teeth in order to arrive at a better bite. Oral surgeons can find impacted or missing teeth, see their locations, and view their proximity to nerves and sinuses, assisting them in planning surgeries. These scans are particularly useful for root canal specialists because they show root canals that are less than a millimeter wide and even reveal accessory canals that may not be visible on conventional x-rays. In cases of sleep disorders such as sleep apnea, a CBCT during sleep can be used to view a person’s airway and how it may be blocked by the tongue and other soft tissues in a person’s throat during sleep.
Compared to background radiation, the amount of radiation delivered in dental x-rays is minimal. A CBCT delivers a dose of radiation that is less than a typical full mouth x-ray series but more than a typical two dimensional panoramic radiograph. Generally CBCT scanners deliver lower doses than medical CT scanners.
With one low-dose CBCT scan, we can get an accurate idea of the internal structure of your bones and teeth and how they are situated in relation to each other. Prior to the availability of such images, many of these relationships had to be discovered in the course of a surgery or other treatment. Thus such a scan can aid greatly in the quality of treatment you will receive.
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”