Dental Questions: Why does it take two weeks to make a crown?

In today's world of on demand service, it may seem strange that a dental crown takes two weeks to make. Your confusion is probably compounded by news of "same day" crowns available at some dental offices. The reality is that many crowns are created (at least partially) by hand and take time, expertise and effort. Read on to learn how dental labs recreate and help replace lost teeth. 

After your first crown appointment, there is typically a two week wait until the new restoration is ready to be cemented to your tooth. In this time, a lab has to receive the impression, create a stone model and make a wax replica of your tooth. While many offices are using computer aided design and digital scanners to simplify this process, most of it is still done by hand to some degree. Converting the wax replica to metal, zirconia, porcelain, or other ceramics involves delicate processing and layering to maintain the initial structure. Finally, most crowns are colored and glazed (textured) by hand to expertly match them to the adjacent teeth. Currently, there is no computer or machine that can visually blend a tooth color to the rest of the mouth like a skilled lab technician. 

Some dental offices currently offer "same day" or "one visit" dental crowns. Here, a digital impression is taken after your tooth is prepared and the crown is milled out of a ceramic block while you wait. You will leave the office that same day with your permanent crown cemented. While this technology is fantastic in some applications and has a very promising future, our office feels that it needs a little more refining before we offer it to our patients. Studies show that the margins (where the tooth and crown meet) can be less precise with these digitally milled crowns. Additionally, many machines require additional tooth structure to be removed in order to create a shape that is compliant with the milling process. Overall, there is nothing wrong with this style of dental crown, but we feel the benefits of using a lab created restoration outweigh the drawbacks of a waiting period. 

Dental crown placement is one of the most common procedures carried out at dental offices nation wide. At our office, we specialize in creating crowns that are beautiful, functional and feel natural in your mouth. If you would like to know more about crowns, veneers, fillings or other dental procedures, please give our office a call!

Dental Questions: Should I try to reattach a lost crown?

If you've had a crown fall off unexpectedly, you're probably familiar with the feeling of shock, confusion and horror as you gaze down at part of your tooth in your hand! While your first instinct may be to try and re-cement the lost restoration, this can come with some serious consequences. The best bet is to let your dentist evaluate and repair your tooth with the proper materials and techniques.

Temporary dental cements are available at almost every drug store and pharmacy. While these products may seem like a good idea, they can lead to a number of problems. If you don't use enough cement (or don't apply it properly), you run the risk of dislodging the crown again and potentially chipping a tooth or swallowing it. If you put on too much cement, the crown can seat too high and cause a sore jaw or excess material can ooze below the tooth and irritate your gums. Either way, it's best to have a dentist examine and recement the crown in-office. Crown usually fall off for a reason, and it is important to discern that the tooth and restoration are healthy enough to be reattached before creating a new set of problems. Additionally, never try to recement a crown with super glue, epoxy or any other household adhesives!

More common than losing a permanent crown is dislodging a temporary crown. These provisional restorations are used to save space between the first preparation appointment and delivery of the final crown. Thus, they are made and cemented with easy removal in mind. If you lose a temporary crown, it is important to return to your dentist ASAP. Waiting until the permanent crown is finished  can leave the underlying tooth vulnerable to chipping, nerve irritation or movement from the adjacent teeth. 

At Thousand Oaks Family Dentistry, we always make time for our patients' urgent problems. Wether a lost crown, tooth ache or broken appliance, we are here to help. If you would like to know more about what do to during various dental emergencies, please give our office a call!

Dental Questions: Does Invisalign work for everyone?

Invisalign (generically known as "clear aligners") is a relatively new orthodontic option for patients who desire straighter teeth. They offer a number of benefits over traditional bracket-and-wire braces, including less visible hardware, easier cleaning and less trauma to the lips and cheeks. However, Invisalign is not necessarily a great choice for everyone. While most patient have needs that can be addressed through clear aligners, it is important to note the limitations of this treatment option. 

For starters, Invisalign needs to be worn at least 20+ hours a day (ideally 22+ hours). If you are unable to adhere to this requirement, your treatment will take much longer. This is one of the primary reasons Invisalign is not recommended for young and poorly compliant kids. It is better to wait until the patient is ready to commit to treatment rather than stay in trays for additional months or years. 

While Invisalign is easier to clean than normal braces, it can pose a higher tooth decay risk for individuals who choose to eat or drink with their trays in (water being the exception). The clear plastic creates a cover that can hold in sugars and carbohydrates while blocking out the remineralizing/protective saliva. Oral hygiene is of utmost importance when considering any appliance, and Invisalign is no exception. 

Finally, there is a small subset of orthodontic conditions that Invisalign either cannot treat or treats very slowly. Severe deviations from normal dentition and drastic tooth movements may be better managed with traditional braces. Here, the wires and brackets can act as anchors on which to push, pull or slide teeth. In certain cases, a combination of Invisalign and other appliances may be needed to achieve an ideal smile. There is only so much a removable device can do in straightening teeth. 

At Thousand Oaks Family Dentistry, we offer Invisalign aligners as a treatment option to our established patients. However, we evaluate each patient individually and decide if their needs are better managed by one of the orthodontists in our specialist network. If you would like to know more about Invisalign, braces or cosmetic dentistry, please give our office a call!

Antibiotics in Dentistry

Antibiotic overuse is one of the most pressing issues in healthcare today. On top of the well-covered rise of MRSA infections, new strains of resistant bacteria are becoming more prevalent. With this in mind, clinicians around the world are working hard to cut back on antibiotic prescriptions and only use them when absolutely necessary. In the dental setting, many infections are not effected by antibiotics, and their use can potentially cause more harm than good. 

Most bacterial diseases of the mouth are addressed by either removing the bacteria or the "food source" for the infection. For example, a root canal works by disinfecting the inside of the tooth, removing the dead/dying tissue, and sealing the nerve canal with a rubber material. By cutting off the infection source, the immune system can naturally eliminate the bacteria from your body. Research has shown that adding antibiotics to this treatment does not improve healing or decrease chances of re-infection. Likewise, deep cleanings to treat periodontitis work by removing tartar/ infected tissue and giving the body a clean surface to reattach the gums and teeth. Again, the typical patient will not benefit from an antibiotic prescription (though antimicrobial rinses may be used to work locally in the mouth). 

Antibiotics are used in dentistry for instances of severe infection, pain and swelling that spreads away from the tooth. In these cases, the immune system may be "losing" its fight against the bacteria, and can benefit from some outside help. If you are prescribed antibiotics, take the entire bottle as directed, even if you start to feel better earlier. Finishing only part of a regimen puts you at risk for developing a new, stronger infection. For more information on dental infections, antibiotics and tooth pain, please give our office a call. 

What causes tooth decay? - A Halloween refresher

With Halloween around the corner, we would like to take a moment to remind kids of all ages about the tooth decay process. While those sugary treats might make you happy now, they can cause a lot of problems if you aren't careful. Like many things in life, moderation is key to keeping your teeth protected from bacteria and cavities. 

The biggest point in understanding cavities is that duration, not amount, of sugar consumed is the main factor in the tooth decay process. Every time we eat or drink anything other than water, our mouth drops into an acidic state for the next hour. With this in mind, someone who snacks on candy all day will spend 24 hours bathing their teeth in acid and fueling bacteria with carbohydrates. If that same person ate the same amount of candy after a single meal, there would be a much less drastic effect on the teeth. 

Furthermore, it is important to remember that all carbohydrates can contribute to enamel demineralization and decay. Even foods that aren't necessarily sweet like goldfish crackers and pretzels are harmful to the teeth. Additionally, naturally sweetened or organic foods like fruits cause decay all the same as processed sugars. In fact, raisins are one of the most tooth-harmful snacks, due to their high sugar content, dryness and ability to stick to dental enamel. 

What can you do to prevent tooth decay? For starters, limit snacking and candy consumption to set times or pair them with scheduled meals. Do not let yourself graze on sweet food all day or take multiple hours to finish food. Additionally, rinsing your mouth out with water after eating sweets is an easy way to clear the carbohydrates from your teeth and limit their contact. Finally, brushing twice a day with fluoride toothpaste and flossing daily is the gold standard in preventing dental diseases. If you have other questions about tooth decay, candy or tooth healthy snacks, please give our office a call!

Dental Questions: What Should I Use to Floss my teeth?

From wax floss to water flossers and dental picks, there are a number of products on the market that you can use to clean between your teeth. If you have struggled with using traditional floss in the past, you've probably considered switching to another method. Generally speaking, all types of accepted dental flossers do a satisfactory job of cleaning between the teeth. Take a look to find out what type of product is best for your specific needs!

The most common method of cleaning between the teeth is via dental floss. Countless research papers show that using floss once a day between the teeth helps prevents cavities, gum disease and the growth of bacteria in these areas. If you have had issues with using floss in the past, you may have more success with handle flossers like the Reach Access Flosser. These products are easier to manipulate in the mouth and provide the same cleaning motion as traditional string floss. If you still want to use regular floss but find it shreds between your teeth or hurts your gums, consider switching to a waxed floss like Oral B Glide. No matter what type or brand, always floss in an up and down motion, bringing the floss against one tooth, down to the gum level and back up, then repeating this motion on its neighbor. 

Some patients will prefer pick or brush type flossers over traditional string floss. In fact, research shows that individuals with severe recession or large spaces between their teeth will benefit more from products like the GUM Proxabrush than traditional floss. The key is that it still needs to be used once a day on every tooth. With these products, it is important to make sure that you are not traumatizing your gums or causing prolonged bleeding. This can be a sing of erosive wear that can lead to more recession. 

Water flossers like Waterpik can also be used to clean out plaque, bacteria and food from in between the teeth. A side benefit is their ability to clear out packed-in food from the pits and grooves of the tooth biting surfaces. The biggest concern with these products is that they can be quite abrasive to the gums and dental enamel. Be aware of the water stream strength and tip you use, particularly if you are using a water flosser every day. Also, never add anything other than water to the flosser's tank without consulting a dentist first. 

The type of flossing method you use is largely a matter of personal preference. The most important part is that you are cleaning between your teeth once a day, every day. Flossing daily takes about a minute of your time but can save thousands of dollars long term. For more information on oral hygiene, flossing or toothbrushes, please give our office a call!

Dental Implant vs Bridge: Single Tooth Replacement

For most patients missing a single tooth, a fixed (non removable) and natural looking replacement is the number one priority. Historically, dental bridges offered these results by crowning the teeth adjacent to the missing space and "bridging" it with a false tooth. However, the rise of dental implants has created new opportunities to restore missing teeth without needing to modify the neighboring dentition. The best choice for your mouth depends on a number of biological and cosmetic factors. Take a look!

Dental bridges are an excellent way to restore missing teeth without requiring surgery or implant placement. The most obvious drawback is that the adjacent teeth need to be modified to receive crowns to support the bridging tooth. However, if both teeth already have crowns or large fillings, a bridge can seem like a more attractive option. The biggest hesitation towards placing a bridge is when one of the neighboring teeth is completely healthy and free of any previous dental work. From a oral hygiene standpoint, bridging two teeth creates a potential food trap and an area that is difficult to floss. You will probably need to use floss threaders to clean under and around this area. Cosmetics are difficult to judge on bridges. The height of remaining soft tissue, space to be covered by the false tooth and angulation of adjacent teeth will all influence the final outcome. 

Likewise, implants allow dentists to restore missing teeth independently of neighboring teeth. In fact, an implant does not even need a tooth on both sides of it to be placed. This is why implants are the first choice for replacement when the last teeth in the dental arch are lost. Since an implant is placed surgically, cosmetics can be managed via bone remodeling and gum grafting. A well placed implant is indistinguishable from natural teeth. However, implants have a long healing time, typically requiring 6+ months from insertion to final crown placement. In the meantime, patients are provided with a temporary denture called a flipper if cosmetics are a concern. Another consideration with implants is bone height and health. There needs to be ample space and width for the implant to be placed without damaging nerves, blood vessels or sinuses. Not every patient will qualify for implant surgery. 

Deciding between an implant or a bridge is ultimately your choice. However, an exam and conversation with your dentist can alleviate concerns and help guide you towards the option that suits your needs best. If you would like to schedule an exam or consultation, please give our office a call today!

Dental Questions: Are root canals painful?

If there was a ever a classic trope of bad dental experiences, it would certainly be the root canal. From cartoons to movies to TV shows, we are taught from a young age that root canals are the most painful of all dental procedures. Fortunately, this bad press is entirely undeserved. Root canal treatment offers relief from excruciating pain and a near instant improvement of symptomatic teeth!

For starters, a "root canal" is a dental procedure where the nerve inside the tooth is removed and replaced with sealing material. It is usually performed on a tooth with an infection (where the now-dead tissue is feeding bacteria) or with an inflamed nerve. In either circumstance, removing the internal nerve pulp and cleaning the inside of the tooth relieves symptoms of extreme pain and pressure. After performing a root canal, the tooth will most likely need a crown and/or post placement to add strength back to its structure. 

A root canal procedure will not be more painful than any other dental treatment. Endodontists (root canal specialists) require that the patient is completely numb so that there are no undue delays or interruptions to the root canal process. The most common complaint after receiving this therapy is a sore jaw from staying open for the duration of the procedure. In cases of extreme infection, some teeth may be difficult or impossible to fully anesthetize. In these cases, the endodontist may elect to use antibiotics or mild sedation to maximize the numbing effect. Either way, you will be completely comfortable for the entire appointment. 

If you have dental pain and think you might need a root canal, don't panic! Tooth pain comes from a number of different causes and requires a complete dental exam to diagnose. If you would like to schedule an appointment today, please give our office a call!

What is your mouth telling you?

If you pay attention, your mouth does a great job of cluing you into its problems. From color changes to random aches and pains, the oral cavity responds very vividly to alterations in environment. With this in mind, we made a list of some of the most common complaints at dental exams and screenings nationwide. However, this article isn't a substitute for an actual diagnosis. Only a dental professional in a clinical setting can give you the full story! Read on to see how and why we respond to these common complaints:

Red/puffy/bleeding gums- This usually indicates some type of disease process occurring in the periodontal tissues. While fixing the problem involves a dental checkup and cleaning, it usually starts with better brushing and flossing techniques at home. 

Sensitive teeth near the gum line- Gingival recession (where the gums wear away from the necks of the teeth) affects about 50% of the adult population and almost 90% of those over 65. As the gums recede back, they reveal bare tooth root material, called cementum. This layer conducts cold to the nerves much quicker than enamel. We recommend switching to a sensitivity toothpaste like Sensodyne to help ease the shock with cold foods. 

Sore teeth/jaw on both sides- This is typically an indication of clenching or grinding. While we can make a custom fitted night guard to protect dental enamel, grinding itself is a psychological process that occurs subconsciously. 

Tooth sensitive to chewing after a filling- While post-filling sensitivity can indicate many problems, pain to chewing is a telltale sign of a high spot in the new material. This is easily fixed at a follow up appointment to re-contour the biting surface. 

Lingering pain to temperatures- Prolonged sensitivity to hot and cold usually means the nerve within the tooth is irritated irreversibly. That tooth will most likely need a root canal or other nerve therapy. 

Cracked lips or burning gums after switching toothpaste- Many toothpastes contain a compound called sodium lauryl sulfate (SLS). Some patient's soft tissues will become irritated, red or swollen after being exposed to this chemical. For those with more sensitive gums, we recommend seeking out a milder product like Sensodyne or Biotene paste while avoiding products with SLS.

 Food constantly stuck between two back teeth- This usually indicates that a physical space has opened between two adjacent teeth. With time, the teeth move as they adapt to changes in jaw space and biting forces. An opening between two posterior chewing teeth should be addressed to protect the gums and bones in this area. Constant food impaction will speed up the progression of periodontal disease exponentially. 

In general, it is difficult (or impossible) to properly diagnose a dental problem without an exam and appropriate x-rays. This list serves as a general idea of how a dentist may interpret your complaint into a treatment or recommendation. It does not take into account your personal dental history, medical history or any other specific information. If you would like more information on dental exams, diagnosis or emergency treatments, please give our office a call!

Dental Questions: Will my teeth be whiter after a dental cleaning?

Have you ever had your teeth cleaned only to see no noticeable difference in their appearance? Your mouth may feel cleaner, but the shade of your dental enamel probably didn't change too much. Read on to find out why this is the case, and what a routine cleaning actually achieves!

For the majority of the population, yellow and discolored teeth are caused by something called intrinsic staining. Here, the teeth pick up pigment in the dentin layer beneath the outer enamel. No amount of brushing, scrubbing or abrasive products will remove these compounds. A smaller portion of the population will be effected by extrinsic staining. This occurs when a combination of deeply colored foods, plaque and tartar discolor the surface of the teeth. This staining most commonly effects smokers, heavy coffee drinkers and those with deficiencies in their daily oral care. Because this staining only involves the outermost layer of the teeth, brushing and flossing will have some control over its presence.

As you can probably see, dental cleanings will have little to no affect on intrinsic staining. To take care of dentin layer staining, you will need to use a specific bleaching system like white strips, bleach trays or ZOOM whitening. However, extrinsic staining will be readily addressed by a routine "prophy" cleaning. Since these stains are adhered to the surface of the teeth, mechanical polishing and scaling will eliminate them with ease. 

Your routine cleaning serves three general purposes: to remove plaque and tartar from the teeth, allow a dental professional to asses changes in your oral health, and provide feedback on your home care between visits. The combined goal of these objectives is to protect the teeth from periodontal disease and the progression of tooth decay. Any improvements in the cosmetic appearance of the teeth after a cleaning is a celebrated secondary benefit. If you would like to know more about dental cleanings, dental staining or whitening, please give our office a call!