If you are dissatisfied with the way your smile looks, and your dentist is unhappy with the way your teeth fit together — but you don't like the idea of wearing braces — clear aligners may be your best solution. How much do you know about this teeth-straightening alternative? Below are some FAQs on the subject.

What do we mean by clear aligners? Clear aligners are a system for straightening teeth that uses clear plastic removable “trays” that fit over your teeth. As the teeth move to fit the trays, new trays are substituted that are designed to continue to move your teeth into the desired position. This system is an alternative to the traditional system of brackets and wires known as braces.

How can teeth be moved to new positions? The connection that holds a tooth in place in your jaws — the periodontal ligament — is not immobile. It constantly changes its position based on the normal forces of your bite. As the ligament is pushed on one side and pulled on the other, the living cells of your mouth respond by depositing bone and cementum (the protective covering of the tooth's root) on one side and dissolving it on the other. Normally this happens in a balance, maintaining your teeth in their position. We can manage these slight changes by applying constant light forces to move teeth in a predictable way.

How long does it take to move teeth to their optimum position using clear aligners? As with braces, the process is gradual. Total treatment time can range from six months to two years.

Do the trays have to be worn all the time? As you move through the sequence of trays, each is worn for 20 hours per day for two weeks. They may occasionally be removed for important social occasions.

How does an orthodontist design the sequential trays that are used? The trays are designed using a computer, based on an assessment and images of your mouth, teeth and jaws.

What kinds of problems can clear aligners correct? This method works well to correct mild to moderate crowding or spacing. If your back teeth already fit together as they should, the system may be ideal. If you have an extreme overbite or underbite, braces might work better.

Are clear aligners an alternative for everyone? Clear aligners are recommended for adults and recently, teenagers. They are not usually recommended for young children.

Why is it important to have your teeth straightened? Besides the obvious benefit of feeling better about yourself and your appearance, straight and well-aligned teeth work better. You will experience a better-functioning bite and can improve your oral health.

Contact us today to schedule an appointment to discuss your questions about orthodontics and clear aligners. You can also learn more by reading the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Moving Teeth With Orthodontics.”

Your self-image has a lot to do with how you feel about your appearance — and particularly your smile. If you are unhappy with the way you look, cosmetic dentistry may be the answer to your problems.

1. What do we mean by cosmetic dentistry? The word “cosmetic” refers to beneficial changes in appearance. Thus cosmetic dentistry is all dental work that restores or improves a person's appearance.
2. What is a cosmetic dentist? Every dentist learns to do procedures in a way that conserves or improves a patient's appearance. Some dentists continue to study and specialize in procedures that are done specifically for the purpose of enhancing a person's appearance.
3. What is a smile analysis? The first step to improving your smile, this analysis involves a study of all the elements of your smile — teeth appearance and alignment, gums, jaws — and also your facial features and how they all fit together.
4. How can I choose the right cosmetic dentist? Ask your dentist about his or her training and experience. Ask for photos of previous work. You may need to select more than one person, working as a team to take best advantage of each one's experience, skills, and training.
5. What can be done to improve a smile using 21st century techniques? We are fortunate to live in times in which numerous options are available. These include making teeth whiter; altering their size, shape, balance, color, and alignment; filling in parts of teeth that are missing because of decay or injury; and even replacing teeth that are missing entirely.
6. How can chipped or discolored front teeth be restored? This can often be done by bonding with composite resin.
7. How can damaged back teeth be restored? Back teeth with cavities or traumatic injuries can now be repaired with non-metallic tooth-colored material that bonds to the tooth substance.
8. What techniques can be used to correct more severe problems? Porcelain veneers, thin layers of porcelain material, can be used to change the appearance of misshapen or undersized teeth. Porcelain crowns can be used to replace the part of the tooth that rises above the gums.
9. How can we change the position of teeth that do not meet together well? Orthodontists are dentists who specialize in correcting malocclusions (bad bites). They use traditional braces or clear aligners to move teeth into more attractive and functional positions.
10. What if some teeth are missing? A dental implant replaces the root of a missing tooth. A porcelain crown that looks just like a natural tooth can then be connected to the implant.

Contact us today to schedule an appointment to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

Thinking or knowing you have an impacted wisdom tooth can be alarming news for some people. Unfortunately, one of the main reasons for this feeling is due to the mythology surrounding wisdom teeth...and especially impacted wisdom teeth. While an impacted wisdom tooth can cause intense pain, some people are quite shocked to learn that they even have impacted wisdom teeth, as it is causing no pain at all.

By definition, an impacted wisdom tooth is a third (and last) molar that gets jammed against an adjacent tooth or other important structures such as gum, bone nerves, blood vessels. And having an impacted wisdom tooth does have its consequences — even if you are unaware you have one. The most common issue is gum (periodontal) disease. This is the main reason why it is so important to have a problematic wisdom tooth removed early when you are young and before periodontal disease has started. If left untreated, you risk damaging and/or losing the impacted tooth and adjacent teeth.

The key to managing wisdom teeth is to monitor them closely through thorough routine examinations and x-rays between the ages of 17 and 25, the time when wisdom teeth typically appear. This is so vital because it allows us to predict the way your wisdom teeth will erupt (become visible) or come into proper position with useful biting function. We can use these visits and x-rays to monitor development so that we are best equipped to determine if or when wisdom teeth need to be treated or removed.

It is also important to contact us as soon as you think you may have an impacted wisdom tooth that is causing pain, swelling or even infection. We can put your mind at rest with the facts of what needs to be done after we've completed our exam.

If you feel that you or a family member has an impacted wisdom tooth, contact us today to schedule an appointment to discuss your questions. Or you can learn more now about the symptoms and treatment options of impacted wisdom teeth by continuing to read the Dear Doctor magazine article “Wisdom Teeth.”

Before determining if a bridge or an implant will work best for you, here is some useful background information. There are two main parts to a tooth; the crown or part that you see above the gum line and the root portion that is below the gum line and encased in bone — the part that is replaced by a dental implant.

A dental implant is inserted into the jawbone during a surgical procedure. The implant is actually a titanium screw-like device that is placed in contact with the bone. During a 3 to 6 month healing period, it subsequently fuses to the bone. A crown made from dental porcelain, gold or a combination of both is then attached to the implant to mimic a healthy, normal tooth.

There are two critical reasons why implants are the preferred method for permanently replacing an adult tooth. The first is that they are less susceptible to gum disease and they are not subject to tooth decay. The second is that because they attach to the jawbone and not to the adjacent teeth. And while an implant may cost a little more initially, when compared to the longevity and replacement cost of bridgework over a lifetime, they may cost less.

By contrast, a fixed bridge is also a non-removable restoration or prosthesis (replacement part) that is held in place by attaching it to your natural adjacent teeth. The treatment gets its name from the French word for bridge, “pont,” as the tooth being replaced is called a pontic. Before placing a bridge, the teeth on either side of the missing tooth must be prepared by removing layers of tooth enamel. Three new teeth are then crafted as a single unit from dental porcelain and/or precious metals with crowns on either side of the pontic. The pontic is held in place when the crowns are placed. Bridgework is at risk for gum disease and tooth decay and requires careful maintenance.

As with most dental procedures you have options and choices. Luckily, when it comes to determining whether a bridge or an implant will work best for you, you can rely upon our expertise. However, by having a clear understanding of these two options you are now better prepared for working with us should you require this treatment option. To learn more read the article, “Implants Vs. Bridgework.” Or, contact us to discuss your questions or to schedule an appointment.

What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.

What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.

Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.

Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.

What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.

What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.

Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.

Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.

Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”