Case Presentation: Anterior Crowns

Just like our skin and hair, teeth age with time. Enamel becomes discolored, the gum lines recede and years of tiny chips and wear all create the appearance of an older smile. For today's patient, the six front (anterior) teeth showed signs of recession, crowding and staining along the gum line. After preparing the teeth, six Emax lithium disilicate units were bonded to the teeth. The new crowns straightened the teeth while creating a natural and desirable contour. The slight color gradient from the gum line to the tooth edges also established the appearance of younger dental enamel. Overall, a fantastic transformation!

If you would like to know more about the cosmetic services we offer, please give our office a call. No two smiles are the same, and we approach each patent's needs individually. Contact us today to set up an examination or consultation appointment!

Wisdom Tooth Extraction

Wisdom tooth extraction is the most common oral surgery procedure performed on high school and college aged patients. Depending on how the teeth grow in, they can be painful, irritating or harmful to the adjacent teeth. Read on to learn about wisdom teeth and what to expect at your extraction appointment!

Wisdom teeth (or "third molars" in technical terms) are the last molars on the upper and lower arches of teeth, typically coming in between the ages of 17 and 20. They are the most common congenitally missing teeth, with 10-45% of the population missing at least one. When they erupt, wisdom teeth often grow in at angles that limit their usefulness in the mouth. In fact, they can increase the risk of decay and bone loss around adjacent teeth, depending on their position. 

Most dentists will recommend extraction of wisdom teeth if there is any sign of positioning problems or pain. Even if the teeth are "questionable," extraction is usually recommended if the patient is young and healthy. If you choose to wait until the teeth become infected or painful, there could be more complications with the procedure or recovery. In many cases, wisdom teeth will be impacted, or stuck beneath the gums and/or bone. Because of this, and because they are positioned so far in the back of the mouth, wisdom teeth are usually removed by an Oral Surgeon. Surgeons have the skills and instruments to remove more complicated teeth more quickly and with less trauma to the surrounding tissue. 

When you have you wisdom teeth removed, you will likely be given the option of being sedated for the procedure. No matter what type of sedation or anesthesia the surgeon uses, you will need to have someone drive you to and from your appointment. Additionally, plan on missing work/school for the rest of that day and the following day for recovery (at a bare minimum). Your cheeks can be swollen for the first week after the procedure. Pain usually peaks at about two days after and begins feeling completely normal in about a week. As with any tooth extraction, keeping the socket clean and healthy for the first two weeks is crucial. No smoking, sucking on straws or spitting with force!

We refer all wisdom tooth extractions to our network of trusted oral surgeons. If you would like to discuss your referral or better understand the extraction process, feel free to give our office a call. We are always here to alleviate any dental concerns or fears!

Case Presentation: Premolar Crown

Premolars can be very difficult teeth to repair. They are both functional (absorbing about half the chewing force of molars) and cosmetic (adding to the "corridors" of the smile). Often times, fillings cannot satisfy all these needs when restoring tooth decay or a fracture. A full coverage crown is usually recommended to provide a solution that will both look great and help protect the underlying tooth. For today's patient, an Emax lithium disilicate crown was used to restore their right first premolar. Notice how the shade and opacity blends in with the enamel of the adjacent teeth. The result is a virtually undetectable dental treatment- good as new!

If you would like to know more about fillings, crowns, implants or veneers please give our office a call. We specialize in providing cosmetic treatments that stand the test of time and would love to discuss your options!

Case Presentation: Smile Makeover

What makes a beautiful smile? Is it the size of the teeth? The shape? Color? As this case demonstrates, the answer is all of the above! Careful details help us reconstruct a smile that is not only beautiful but appropriate for the patient's face shape, age and mouth size. The goal is to create natural appearing teeth while avoiding the "chiclet" look that can come from too little color or shape variation

For this patient, we used Emax lithium disilicate crowns to restore the cracked and decayed anterior teeth. Additionally, you can see where a bridge was used to replace the patient's missing canine on the photo right. As you study these pictures, take note of the subtle color gradient from the edges of the teeth to the gum line. This gradual darkening mimics natural teeth and creates a very convincing profile. Overall, we could not be happier with the results!

If you would like to know more about cosmetic dentistry, crowns, veneers or dental implants, please give our office a call. We are always excited to restore the natural beauty and luster to deserving smiles!

Lower Arch Reconstruction

Today's patient came to us with porcelain and metal crowns on all of their lower teeth. With time, these restorations had become chipped and worn, making it obvious that they were not natural teeth. Additionally, gum recession had revealed the dark metal collars around these crowns, creating an obvious transition from enamel to porcelain. Finally, porcelain and metal crowns are inherently opaque (do not transmit light) to block out the inner metal layer. This contrasts harshly with the natural translucency of dental enamel and makes the teeth look "old" or yellow. 

After considering the many options, Dr. Kari Ann Hong and the patient decided to replace the existing crowns with new Emax lithium disilicate restorations. Emax provides increased durability over porcelain and metal crowns with better esthetics and more design possibilities. The results speak for themselves! The new crowns have a much more natural shape and contouring, while the shade and translucency better matches natural enamel. Additionally, the increased wear resistance will help ensure these teeth for years to come. If you would like to know more about dental crowns, fillings and other cosmetic procedures, please give our office a call! 

Cosmetic Gum Line Fillings

Another great cosmetic filling from Thousand Oaks Family Dentistry! Today's patient came to us with abfraction lesions on their upper premolars. These cavities are usually caused by the forces of biting, chewing and clenching causing stress on the enamel around the necks of the teeth. After an indentation develops in this area, it becomes a perfect trap for food and plaque. This often leads to decay, thus advancing the process of wear on the tooth. 

We repaired these teeth by removing any compromised enamel and smoothing out the cavity edges. They were then filled with a flexible and esthetic material that both seals out decay and restores the natural beauty of the teeth. While the upper premolars are not directly visible in the smile line, their profiles often contribute to smile "width." For this reason, a cosmetic filling is desirable in maintaining a natural appearance. If you would like to know more about tooth decay, fillings or other cosmetic dental procedures, please give our office a call!

Cosmetic Incisal Bonding

Today's patient came to us with a chipped maxillary central incisor that did not extend to the tooth's nerve. They had no symptoms of pain and simply wanted the tooth fixed. This is a very typical dental injury- particularly with young children and patients who play contact sports. The maxillary incisors are the most commonly chipped teeth due to their vulnerable position in the mouth and thin enamel edge. 

After discussing treatment options, we decided to solve the cosmetic concern with composite bonding. Here, filling material is added to the tooth using a special adhesive and bonding technique. Once the restoration was cured to the tooth, Dr. Kari Ann Hong reshaped it to match the contours and length of the neighboring incisor. Since this material closely matches the optical properties of natural teeth, the effect is a natural and unnoticeable restoration!

It is important to note that not every type of chipped tooth can be fixed with composite bonding. Chips extending to the tooth nerve will need a root canal and crown to treat any residual pain and remove the inflamed tissue. Larger chips will also require veneers to reliably replicate large amounts of tooth structure. Finally, certain types of occlusion (the way the teeth come together when you bite) will limit the amount of repair that can actually be done to the teeth. It is impossible to decide what treatment option is best without a complete examination. For more information on dental bonding, crowns, veneers and other cosmetic treatment, please give our office a call!

Laser Dentisty

While it may sound like something out of a sci-fi film, lasers have found a permanent place in many healthcare fields. Dentistry is no exception, with many offices taking advantage of the special properties of laser therapy. Read on to learn how we use this technology at Thousand Oaks Family Dentistry.

Lasers are focused beams of light in a uniform wavelength. They exist in the infrared spectrum and thus produce no harmful radiation. Most of the lasers used in medicine and dentistry are not visible to the naked eye, but interact with certain tissues in specific ways. For example, many lasers will cut soft tissues like skin or gums, but cannot affect hard substances like teeth or bones. As you may imagine, this tissue specific targeting is extremely useful. 

Dentists usually use lasers for soft tissue therapy. While hard tissue lasers that cut teeth are beginning to enter the market, the technology is still in its infancy. Lasers safely remove frenums, trim gums and cauterize tissues after surgery with exceptional healing properties. At our office, we use lasers as a way to shape gum tissues for dental implants. Before this technology, taking an impression of an implant took two appointments: one to adjust the soft tissue and a recall visit to capture the impression after it healed. With lasers, the gums stop bleeding almost instantaneously, allowing us to combine these two appointments into one. 

At Thousand Oaks Family Dentistry, we pride ourselves in staying current with the latest in treatment technology. However, we always make sure that new technologies are thoroughly developed before offering them to our patients. If you would like to know more about dental lasers and what they can do for you, please give our office a call. 

Gum Line Fillings

Have you noticed notching or pitting on your teeth near the gum line? You are not alone! Decay in this area (called the "cervical" portion of the tooth) is extremely common, particularly in patients over the age of 25. While they come from a few different causes, fixing them is typically straightforward and yields great results. 

Defects in these areas are most commonly caused by a phenomenon called abfraction. Here, chronic tooth clenching and grinding causes the dental enamel to flex. As it stresses and strains, the enamel around the gum line becomes weakened and erodes away. This is not unlike how a toothpick weakens in the middle if you repeatedly bend it back and forth. The second most common cause is erosion from aggressive brushing or consumption of acidic foods and beverages. Tooth decay also often plays a role, usually secondary to abfraction or erosion after a food/bacteria trap is created. 

Repairing these defects is usually very straightforward. Often times, the tooth will only need minimal modification before a filling can be placed. We usually use more flexible materials to better prevent the filling from falling out. The result is a cosmetic restoration that blends in with your natural dental enamel. 

As with any dental procedure, there are certain circumstances that make these fillings difficult to place. Decay close to the gum line may be impossible to treat due to access and moisture problems. Additionally, deep decay always presents a risk for irritating the nerve of the tooth, thus requiring a root canal. If you think you might need a filling near your gum line, the first step is to stop by our office for a complete dental exam. If you have any more questions about fillings, materials or what causes tooth decay, please give us a call!

Deep Cleanings

If you're one of the millions of Americans with Periodontal Disease, there is a good chance you have either been offered or received a deep cleaning. You may also still be unclear on what this procedure can accomplish and why we do it. In this article, we hope to remove the mystery from this very beneficial treatment. 

For starters, periodontal disease refers to a state of gum health where the moucosal tissues and/or bone have shrunken away from the teeth. In most cases, this is due to accumulation of hard tartar around the necks of the teeth and down the roots. Patients are left with deep gum pockets that serve as protective space for more tartar to form. 

Healthy gum pockets range between 1-4 millimeters. With a toothbrush and floss, you can reliably clean to about three millimeters of depth. Beyond this, it takes a special set of skills and tools to get the teeth completely clean. If you have healthy gums or inflammation of the moucosal tissues only (gingivitis), a typical "prophy" dental cleaning will serve you well. However, generalized pockets of five millimeters or more will require a deep cleaning, also known as scaling and root planing. 

A quick infographic explaining the transition from healthy gums to disease. An important note- healthy gums can naturally have a pocket of 1-4mm. 

Scaling and root planing is a procedure that is administered to one quadrant of the mouth at a time, as opposed to the "whole mouth" approach of a normal cleaning. You may only have one or two quadrants of teeth that actually require a deep cleaning. To effectively provide this service, we need to numb your gums with some type of anesthesia. This may be in the form of a topical jelly or a traditional injection. We then use a combination of ultrasonic scalers and hand instruments to clean the teeth to the depths of their pockets, removing hard deposits and smoothing the tooth root surface. The ultimate goal of this treatment is to leave behind a healthy, bacteria-free root for new tissue to attach, thus creating a shallower pocket. 

Deep cleanings are ideally only administered once and followed with a tight recall cleaning schedule. However, this depends largely on you body's ability to heal and your own home hygiene practices. It is also important to understand the limitations of a deep cleaning. While you may have a decrease in pocket depth, new bone is impossible to reform without surgery. Additionally, no amount of cleaning will save teeth with severe periodontal damage. To fully appreciate what a deep cleaning can do for your mouth, a complete dental exam with x-rays is absolutely necessary. To schedule an appointment or find out more about the different types of dental cleanings, please give our office a call!