AirAbrasionAnAlternativetotheTraditionalDentalDrill

Drilling teeth is an essential part of repairing and restoring the damage caused by tooth decay. For generations dentists have relied on the dental drill with its rotating burr to remove decayed and damaged tooth material.

But while the dental drill is effective it also has its disadvantages. In the process of removing decayed material it inadvertently removes healthy structure near the target material. It often requires anesthesia to deaden the work area. And its noise and vibration are often unsettling to patients.

There is a growing alternative, though: air abrasion, a technology that's been around since the mid-20th Century. But recent advances in controlling the dust created by using abrasion, as well as new tooth-colored bonding materials to replace tooth structure, have sparked new interest among dentists and patients alike.

Also known as particle abrasion, this drill alternative uses a pressurized stream of fine particles to remove decayed material. Using a hand wand a dentist can precisely aim the stream of particles (usually aluminum oxide) to the specific areas of decay or softened material that need to be removed. As a result, it removes only a fraction of healthy tooth structure compared to traditional drilling. Air abrasion has also proven effective for removing staining without harming enamel.

Air abrasion also eliminates the sound and vibration associated with dental drills, and may not always require local anesthesia. On the other hand, it does have some limitations. For one, it's not as effective with larger cavities or working around older fillings. The tooth or teeth to be worked on must be carefully isolated from the rest of the mouth to keep the patient from swallowing the abrasive particles. And without a high-volume suction pump and good isolation protocols, the particles can produce something of a “sandstorm” in the treatment room.

But as air abrasion continues to advance, we may see improvements in these limitations. In a future time, the traditional dental drill may go the way of the horse and buggy.

If you would like more information on air abrasion as an alternative to drilling, 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 “Air Abrasion Technology.”

IfYourenotaGoodCandidateforDentalImplantsConsiderBridgework

Not long ago the dental bridge was the alternative treatment of choice to partial dentures for restoring lost teeth. Over the last few decades, however, dental implants have nudged bridgework out of this premier spot.

That doesn’t mean, though, that bridgework has gone the way of the horse and buggy. In fact, it may still be a solid restorative alternative to partial dentures for certain people.

A traditional bridge consists of a series of porcelain crowns affixed to each other like pickets in a fence. The end crowns are fitted onto the teeth on either side of the empty tooth space; known as abutment teeth, they support the bridge. The crowns in the middle, known as pontics (from the French for “bridge”), replace the teeth that have been lost.

Bridges have been an effective and cosmetically pleasing method for tooth replacement for nearly a century. To achieve those results, though, a good portion of the abutment teeth’s structure must be removed to accommodate the crowns. This permanently alters these teeth, so they’ll require a restoration from that point on.

Dental implants, on the other hand, can be installed in the missing space without impacting any neighboring teeth. What’s more, implants provide greater support to the underlying bone than can be achieved with bridgework.

But not everyone is a viable candidate for implants, and ironically the reason most often has to do with the bone. If a patient has suffered significant bone volume loss, either because of disease or the long-term absence of the natural teeth, there may not be enough bone to properly support an implant. Unless we can adequately restore this lost bone volume through grafting, we’ll need to consider another type of restoration.

That’s where bridgework could be a viable option for patients in this or similar situations. With continuing advances in materials and new applications, the traditional bridge still remains an effective and important means to restore a smile marred by missing teeth.

If you would like more information on dental restoration options, 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 “Crowns & Bridgework.”

DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

By George Salem and Associates, PC
May 24, 2018
Category: Dental Care
Tags: teeth whitening  

Teeth WhiteningIf you want a whiter smile fast then you should turn to our cosmetic dental team.

 

No matter whether your wedding day is fast approaching or you have a big job interview coming up, one thing is certain: you want a smile that will look vibrant and radiant rather than yellow and dull. This is where our Braintree, MA, cosmetic dentists come in. If you want a whiter smile fast, we can make that possible.

Why do people choose in-office teeth whitening?

While some people may not relish the idea of sitting in the dentist’s chair for an hour or coming into the dental office when they don’t need to, if you want to get a significantly brighter smile in one day then the only approach is our professional chairside teeth whitening system.

Before your whitening treatment begins we will use a shade guide to determine the current color of your teeth. Once the whitening treatment is over, we will pull out the shade guide again to show you just how much your smile changed after just one session. Depending on the severity of your stains, you may only need one whitening treatment; however, those with more deep-set or dark stains (e.g. smoking stains) may require more than one session in order to get the results they want.

How does professional teeth whitening work?

The goal of our Braintree, MA, dentists is to make sure that we remove yellowing and dental stains and to give you an evenly brilliant and whiter smile. Professional teeth whitening is the only system that removes dental stains while also altering the actual color of your teeth to make them whiter.

Whitening gels across the board contain either hydrogen peroxide or carbamide peroxide, the two most common active ingredients used to break up and destroy stain molecules within the hard outer layers of your teeth. The whitening gel that we use contains the highest percentage of active ingredient, which means that we don’t have to leave the whitening gel on your teeth nearly as long as over-the-counter whitening gels in order to achieve visible results. In just one trip to our office, we could get your smile up to seven shades whiter!

Do you want to find out if you are an ideal candidate for professional teeth whitening in Braintree, MA? If so, then it’s the perfect time to call our office today to schedule an appointment with one of our fantastic cosmetic dentists.

3PossibleTimingScenariosforGettingYourNewImplant

If you have a problem tooth we’ve recommended removing, those “Tooth in one day” ads—a tooth removed and an implant placed at the same time—might start to pique your interest. But there are a few factors we must consider first to determine if this procedure is right for you. Depending on your mouth’s health conditions, you may need to wait a little while between tooth extraction and implantation.

Here are 3 timing scenarios for receiving your implant after tooth removal, depending on your oral health.

Immediately. The “tooth in one day” scenario can be much to your liking, but it could also be tricky in achieving the best results. For one, the implant may fit too loosely—the bone around the socket might first need to heal and fill in or undergo grafting to stimulate regeneration. In other words, immediate implant placement usually requires enough supporting bone and an intact socket. Bone grafting around the implant is usually needed as well.

After gum healing.  Sufficient gum coverage is also necessary for a successful outcome even if the bone appears adequate. To guard against gum shrinkage that could unattractively expose too much of the implant, we may need to delay implant placement for about 4 to 8 weeks to allow sufficient gum healing and sealing of the extraction wound. Allowing the gums to heal can help ensure there’s enough gum tissue to cover and protect the implant once it’s placed.

After bone healing. As we’ve implied, implants need an adequate amount of supporting bone for best results. When there isn’t enough, we might place a bone graft (often immediately after tooth extraction) that will serve as a scaffold for new bone to grow upon. Depending on the degree of bone loss, we may wait until some of the bone has regenerated (about 2 to 4 months) and then allow the natural process of bone cells growing and adhering to the implant (osseointegration) to complete the needed bone growth. If bone loss is extensive, we may need to wait until full healing in 4 to 6 months to encourage the most stable outcome.

If you would like more information on the process of obtaining 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 “Implant Timelines for Replacing Missing Teeth.”





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Dr. George Salem and Associates, P.C.

Braintree, MA Dentist
Dr. George Salem and Associates, PC
60 Adams Street
Braintree, MA 02184
(781) 843-0660
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