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Posts for: August, 2018

By Gregory Palmer, D.M.D. Family & Cosmetic Dentistry
August 21, 2018
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”


By Gregory Palmer, D.M.D. Family & Cosmetic Dentistry
August 11, 2018
Category: Dental Procedures
WorldCupSoccerCoach-DentistSavestheDay

If you followed the 2018 FIFA World Cup Soccer games, you probably know that one of this year’s biggest surprises was the debut of the team from Iceland—the smallest country ever to earn a chance at the sport’s top prize. But here’s something you may not have known: When he’s not on the field, the team’s coach, Heimir Hallgrímsson, is a practicing dentist! Those two skill sets might not seem like a natural fit… but they came together dramatically at a recent contest.

At a local women’s game last summer, when a player was hit and her tooth was knocked out, Dr. Hallgrímsson took immediate action. “I jumped on the pitch and put the tooth back in, took her to a dental office and fixed it,” he said.

Not everyone has the special training or ability to fix a tooth that has been damaged or knocked out—but there are some simple things that you can do to help an adult who has suffered this kind of injury. Here’s a quick run-down:

  • After making sure the person is stable and not otherwise seriously injured, try to locate the tooth.
  • Handle it carefully, without touching root surfaces, and clean it gently with water if possible.
  • Try to open and gently rinse out the mouth, and find where the tooth came from.
  • Carefully place the tooth back in its socket, making sure it is facing the right way, and hold it in place with a soft cloth.
  • If the tooth can’t be re-implanted, place it in a bag with a special preservative solution, milk or saliva, or have the person hold it between the cheek and gum—but make sure it isn’t swallowed!
  • Rush to the nearest dental office or urgent care facility.

When these steps are followed and the person receives professional treatment as quickly as possible (ideally within minutes), their tooth will have the best chance of being saved. But even if it isn’t possible to preserve the tooth, receiving prompt and appropriate care can make replacing the tooth much easier.

Having Dr. Hallgrímsson on the sidelines was a lucky break for the injured soccer player—and as a coach, just getting to the World Cup is a remarkable achievement. But you don’t need to be a coach (or a dentist) to give first aid in a dental emergency. Taking the right steps can help ensure the best possible outcome… and might even save a tooth!

If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “Knocked Out Tooth” and “The Field-Side Guide to Dental Injuries.”


By Gregory Palmer, D.M.D. Family & Cosmetic Dentistry
August 01, 2018
Category: Dental Procedures
Tags: dental implants  
3CausesforImplantFailureandWhatYoucandoAboutThem

First introduced in the 1980s, dental implants are a popular and reliable tooth replacement option. Numerous studies show that after ten years 95% are still in place. Much of this success owes to the implant’s titanium post imbedded directly into the jaw, which then attracts bone growth. This additional growth securely anchors the implant in place for an unrivaled durability among other replacement options.

Still, a small percentage of implants fail — some in the first few months and others after a few years. Here are 3 reasons why, and how you can overcome them.

Poor bone quantity and quality. Implants need a certain amount of existing bone to succeed. Sometimes, though, there isn’t enough because prolonged absence of a tooth causes bone loss around the empty socket. Conditions like diabetes, osteoporosis or tobacco use can also compromise bone health. It’s often possible to increase bone volume with grafting, especially right after tooth extraction.

Teeth grinding habits. This occurs when you unconsciously grind or clench your teeth, usually during sleep. The habit can create forces far in excess of what’s normal when we bite or chew and can damage or even break the crown attached to an implant. Besides reducing stress (a major factor for teeth grinding), you can also alleviate the abnormal force generated by wearing a night guard.

Periodontal (gum) disease. Although your implants are impervious to disease or infection, supporting gums and bone aren’t. Plaque, a film of food and bacteria that builds up on tooth surfaces, can cause gum disease that weakens the supporting tissues (gums and bone) of the implant. This can give rise to a specific condition with implants known as peri-implantitis where the infected gum tissues and bone around it deteriorate, leading to the implant’s catastrophic loss. To avoid this, practice consistent daily hygiene, including around the implant. And see us regularly for checkups and cleanings, or as soon as possible if you see signs of gum problems.

If you would like more information on dental implants, 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: A Tooth-Replacement Method that Rarely Fails.”




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