Posts for: April, 2020
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.
Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.
But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.
The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.
One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.
NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.
Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.
Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.
The first week of April is National Public Health Week, putting the spotlight on health issues that impact us all. The popular practice of vaping is one of those top issues this year due to its connection with recent lung illnesses and deaths. But this isn't a new problem—dentists have been critics of vaping for some time now over the growing evidence of its effect on oral health.
Vaping is the popular term for inhaling aerosol vapors through an e-cigarette (or e-cig for short). The electronic device contains a small reservoir filled with flavored liquids that contain nicotine and other chemicals. The device heats the liquid, turning it into a vapor that's inhaled or “vaped” into the lungs.
Vaping has been touted by proponents as a safer alternative to cigarette smoking. But there's growing evidence that vaping isn't a kinder and gentler way to “smoke.” A good portion of that evidence comes from dentists who routinely treat oral problems caused or worsened by vaping.
In reality, the adverse effects of vaping on oral health aren't much different from smoking. Like smoking, vaping ingredients can irritate the inside of the mouth and cause dryness, an ideal environment for dental disease. And nicotine, the main chemical in both vaping and smoking, constricts blood vessels that deliver nutrients and disease-fighting antigens to the gums and teeth.
If these hazards weren't bad enough, recent clinical findings seem to indicate they're only the tip of the iceberg. Researchers from New York University's (NYU) College of Dentistry have found evidence from a combined study of cigarette smokers, e-cig users and non-smokers that vaping may significantly alter the mouth's microbiome to the ultimate detriment of oral health.
A “microbiome” is a term describing the intricate relationship between the millions of microorganisms inhabiting the human body and the body itself. While a few are malicious, many, namely in the gut and mouth, help the body obtain nutrients from food and fight against disease. Disrupting that delicate balance opens the door to diminished health.
The NYU researchers found that both smokers and e-cig users had higher levels of pathogenic bacteria in their saliva than non-smokers, suggesting both habits disrupted the mouth's microbiome balance enough to allow less benevolent bacteria to flourish. They also found that both smokers and e-cig users had significantly higher incidences of gum disease (72.5% and 42.5%, respectively) than non-smokers (28.2%).
If you're a smoker, a cessation program to quit the habit—not switching to vaping—is the way to a healthier life. If you would like more information about the effects of vaping on your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Vaping and Oral Health.”