My Blog

Posts for: August, 2017

By Phil Hart, DDS
August 25, 2017
Category: Oral Health
KeepanEyeontheJawBoneAfteraTeenagersToothLoss

Accidents happen, especially to teenagers involved with sports or similar activities. In an instant they can lose one or more teeth and permanently alter their smile.

Fortunately we can restore a teenager’s lost teeth, but often not immediately as a permanent restoration with a dental implant requires maturity of their jaw structure. Our focus then turns to the age of the patient and the condition of the underlying bone. A future dental implant, your best choice for tooth replacement, depends on bone for support, but also the age of the patient as it relates to jaw development.

There are a couple of ways an accidental tooth loss can harm supporting bone: first and foremost, the impact of the accident itself can damage the bony socket. To find out for sure we may need to perform a cone beam scan, a type of x-ray that allows us to view the area three-dimensionally. If we do find damage, we can attempt to repair the socket through bone grafting.

Bone can also suffer from the long-term absence of a tooth. Bone has a growth cycle in which older cells dissolve and new ones form to take their place. The force generated by teeth when we eat or chew helps stimulate this growth. Without stimulation, as with a missing tooth, the bone may not grow at a healthy rate. In time, it could lose some of its volume and density and not be able to support an implant.

Installing an implant right after tooth loss could help avoid this situation. Bone has a natural affinity with the titanium post imbedded in the jaw and will naturally grow and adhere to it. But we can’t place an implant with a teenager. This is because the jaw is still developing so an implant would gradually become misaligned as the jaw grows. It’s best to install an implant later after full jaw development in early adulthood.

Today, we can place a bone graft in the empty socket right after tooth loss. The graft serves as a scaffold for bone cells to grow on and will help keep the bone volume at a healthy level until we can install an implant.

Timing is everything in restoring a teenager’s accidental tooth loss. But with coordination and care for the supporting bone, a teenager can eventually enter their adult years with their smile intact.

If you would like more information on restoring your teenager’s smile after tooth loss, 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 “Dental Implants for Teenagers.”


ALong-TermOrthodonticStrategyCouldHelpEnsureanAttractiveSmileLaterinLife

Orthodontics relies on certain mechanics in the mouth to move teeth to better positions. As the specialty has advanced, we've become ever more precise in moving teeth with braces, the “workhorse” of orthodontics, and other specialized appliances and techniques.

But although cooperating effectively with the mouth's natural ability for tooth movement is crucial for success, there's another aspect to consider if that success will be long-term: the growth and development of oral and facial structure. And not just development during childhood and adolescence: indeed, facial structure continues to change throughout a lifetime, including the senior years. Research has shown that although the rate of growth slows over time, it doesn't stop even for someone 80 years or older.

Our emerging understanding in this area has had an important impact on how and when we perform orthodontic treatment. As we develop a treatment strategy for an individual patient we consider not only the immediate outcome of a treatment, but also how it may change their facial appearance in the future. By taking continuing facial growth into consideration, we're more likely to achieve a new smile appearance that remains attractive later in life.

A key factor is to be sure we're initiating treatments at appropriate ages. We may detect developing bite problems as early as age 6, which might prompt preventive treatment at that time to diminish or even eliminate the problem. But it may also be prudent to wait on full-scale orthodontic treatment until late childhood or puberty. Furthermore, some form of orthodontic treatment might need to continue into early adulthood to ensure the most optimal outcome.

By taking a longer view of the treatment process, we're better able to work within the natural growth and development taking place now and in the future. As a result, a person is more likely to enjoy an attractive and youthful appearance even in their later years.

If you would like more information on aging factors for cosmetic enhancement, 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 “Understanding Aging Makes Beauty Timeless.”


By Phil Hart, DDS
August 09, 2017
Category: Oral Health
AnyTimeAnyPlaceCamNewtonsGuidetoFlossing

When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?

For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.

Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.

Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:

  • It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
  • A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
  • Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
  • Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!

Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!

If you would like more information about flossing and oral hygiene, contact us or schedule an appointment for a consultation.


By Phil Hart, DDS
August 01, 2017
Category: Dental Procedures
Tags: smile makeover  
3StepstoaBetterBiteandaMoreAttractiveSmile

Before you consider cosmetic changes to your smile, ask yourself one question: how's your bite? How your teeth are positioned and aligned doesn't just affect their function — it also affects your appearance. A proper bite is foundational to a beautiful smile — and it deserves your attention first.

Here are 3 important steps for addressing your bite problem on your way to a more attractive smile.

Get an orthodontic evaluation. Only a dentist or orthodontist can determine if your teeth are properly aligned and working well with each other — and if not, why. With their knowledge and expertise they'll be able to tell you what specific bite problem (malocclusion) you have and the best treatment to correct it to support any future cosmetic enhancement.

Consider your tooth-movement options carefully. If you have a malocclusion, your dentist or orthodontist may recommend correction before undertaking other cosmetic work. In most cases, you'll have two choices. The first is traditional metal braces, which uses wires held in place and anchored by brackets cemented to the teeth. They're effective, but must be fixed in place and aren't considered attractive. The other choice is clear aligners, which use custom removable plastic trays worn in sequence to gradually move teeth. They're easier for oral hygiene and are hardly noticeable to others, but may not work in every bite situation.

Don't slack on the retainer phase of treatment. The day will come when the braces or aligners come out of your mouth for good. But your realignment project isn't over — you'll need to wear a retainer appliance for a while. Re-aligned teeth can relapse to their former positions, so it's essential you wear a retainer to keep them where they've been moved. Without a retainer, all the time and effort invested in your bite will have been to no avail.

In a nutshell: get the big picture about your bite, choose the treatment best for you and follow through on every phase. The end result will be a solid platform for the smile you've always dreamed about.

If you would like more information on orthodontic treatments, 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 “The Magic of Orthodontics: The Original Smile Makeover.”