I am talking about products like Crest Pro-Health, Listerine Total Care, etc. Routinely, I am seeing more problems caused by these mouth rinses rather than benefits for my patients.  The most common side effect manifests as sore spots on the gum tissue, the cheek tissue inside the mouth, and the inside borders of the lips.

If you have unexplained sore spots and have recently switched to some of these multi-purpose rinses and tooth pastes, try going back to just using the basic fluoride tooth paste.  It may just be the solution to your problem if your family doctor cannot pin point the cause.

Simply put, you can rinse with any magic potion all you want, but if you do not spend the time to mechanically remove plaque with flossing and brushing then you are defying your home care effort.

The best prevention of decay and gum disease is flossing and brushing.  This has not changed since the invention of the tooth brush and the dental floss.  There is no such thing as a magical multi-purpose mouth rinse on the market today.

Restorations on the two front teeth are some of the most difficult treatments.  Not only do they have to look like real teeth, they also have to fit within the functional parameters of the patient’s bite.

I restored this case by eliminating interferences in his bite to stabilize it first. Then I restored the two front teeth with two new crowns which were done with complexity in color combination, contour, texture, and functional guidance.

The “after” photos were taken two days after delivery.  The gum will continue to adapt well around the teeth, and the restorations will continue to disappear into his dentition as if they were his own natural teeth.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

I did this case with a combination of bite adjustments, teeth whitening, porcelain veneers, and resin bonding.  Some of the detailed characteristics of the teeth were done specifically to the patient’s request.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

The sequence of treatment of a cad-cam fabricated crown would be:

1.  The dentist prepares the tooth for the crown.

2.  The tooth structure is scanned into the computer using a special camera.

3.  The computer activates the Cerec machine to mill out the crown.

4.  The dentist cements or bonds the crown onto the tooth.

This Xray shows a molar with a Cerec crown that crumbled during dinner one night… What went wrong?

Upon repairing the tooth I discovered some obvious problems:

1.  There was extensive decay in the tooth structure underneath the crown.  This could have severely compromise the strength of the bond and could have caused the crown to come loose over time.

2.  The existing root canal on the tooth was under-filled.

3.  The gum tissue around the remaining tooth structure was extremely inflamed.  This is a sign that the junction between the tooth and the crown was not properly sealed.

When choosing dental work, it is important to not base your decision on a “brand”.  Instead, it is crucial to find a dentist who delivers dentistry with strong emphasis on technique.

A crown on a tooth will only last if the following are handled properly:

1.  Proper technique in treating the tooth with a root canal when needed.

2.  Proper technique in building up the tooth structure underneath after the root canal.

3.  Proper technique in scanning the tooth structure.

Technique, technique, technique !

Good dentistry is all about good old-fashioned health care.  Treat brands with a grain of salt.  With a little bit of research you will discover your key to a long lasting dentition.

Color is not the only parameter required to match the two front teeth with the rest of the teeth in the smile.  Among other factors, we have to also match contour, surface texture, and shade variations of different areas of the teeth.  Matching the front teeth is like sculpting a portrait of what they used to look like. That is the only way they will blend in with the natural dentition. Furthermore, the two front teeth serve as a very important guidance for joint stability and function.  We must approach the front teeth in more than one dimension.

When done correctly,  restorations for the front teeth will disappear into the rest of the smile.  Here is a testimony from a recent case I delivered last week.

…………………..

Email dated 9/09/2011

Dear Dr. Alex,

I want to personally thank you for the wonderful job you did on my case. Although it took longer than I anticipated, it was worth the wait and I am very pleased with the end result. You definitely have the knack for how teeth should look and function. I really appreciate your thoughtfulness and professionalism. …Again, I want to thank you for a job well done.

P.S. you will soon have another positive review on Yelp

Sincerely,

K

Having straight teeth is not ALL about cosmetics.

The misalignment of teeth can cause a variety of problems ranging from TMJ issues, to bone loss, to excess fractures and wear facets on the teeth.  This type of break down in the dentition can take many years to manifest. Unfortunately, sometimes when the patient starts to notice the problems, the solutions may require a complex combination of orthodontics and restorative treatments.

Properly aligned teeth actually follow very scientific principles created by nature to establish the most stable functional foundation.  When teeth are properly aligned, certain functional movements of the jaw allow for optimum chewing, relaxed muscle state, and ideal joint health.  The cosmetics of the smile is automatically achieved secondarily when the functional foundation is established.  Finding the right orthodontist is key to successful treatment.

Hence, when you choose to have orthodontic treatment done, you are stabilizing the most important aspect of the dentition:  To allow you to sustain life by being able to chew effectively throughout the course of your life span.  As the human life span continues to lengthen, it is extremely important to make sure that you will continue to have a stable dentition for your chewing needs.

In the photos below you will find a smile with “crooked teeth”.  Whereas the patient was never concerned with the cosmetics of her smile before, she has lately been concerned with the fractures lines and wear facets indicated by the red arrows.  Her question to me at the last check-up was:  ”What would my teeth look like…say ten years down the line…”

My answer to her was:  ”They would look more broken down, and you will also notice problems with the back teeth as well.”

So as you can see… My recommendation for this patient to choose orthodontic treatment was based on achieving proper function, and not ALL about cosmetics.

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