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Posts for: November, 2019

AdvancesinPorcelainVeneersImproveBothStrengthandAppearance

One of the best restorative options for slightly deformed, misaligned or stained teeth is a porcelain veneer. Composed of thin, laminated layers of dental material, the veneer is bonded to the outside of the tooth to transform both its shape and color to blend with other natural teeth.

Veneers are more than a technical process — they’re works of art produced by skilled artisans known as dental lab technicians. They use their skills to shape veneers into forms so life-like they can’t be distinguished from other teeth.

How technicians produce veneers depends on the material used. The mainstay for many years was feldspathic porcelain, a powdered material mixed with water to form a paste, which technicians use to build up layers on top of each other. After curing or “firing” in an oven, the finished veneer can mimic both the color variations and translucency of natural teeth.

Although still in use today, feldspathic porcelain does have limitations. It has a tendency to shrink during firing, and because it’s built up in layers it’s not as strong and shatter-resistant as a single composed piece. To address these weaknesses, a different type of veneer material reinforced with leucite came into use in the 1990s. Adding this mineral to the ceramic base, the core of the veneer could be formed into one piece by pressing the heated material into a mold. But while increasing its strength, early leucite veneers were thicker than traditional porcelain and only worked where extra space allowed for them.

This has led to the newest and most advanced form that uses a stronger type of glass ceramic called lithium disilicate. These easily fabricated veneers can be pressed down to a thickness of three tenths of a millimeter, much thinner than leucite veneers with twice the strength.  And like leucite, lithium disilicate can be milled to increase the accuracy of the fit. It’s also possible to add a layer of feldspathic porcelain to enhance their appearance.

The science — and artistry — of porcelain veneers has come a long way over the last three decades. With more durable, pliable materials, you can have veneers that with proper care could continue to provide you an attractive smile for decades to come.

If you would like more information on dental veneers, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers.”


By Lafond & Tambini, DMD
November 14, 2019
Category: Oral Health
Tags: tmj disorders  
SeekCoordinatedTreatmentIfYouHaveBothTMDandFibromyalgia

Fibromyalgia is a chronic condition that produces widespread pain and stiffness in the muscles and joints. The pain, muscle spasms and tingling it causes can disrupt sleep, alter moods and impair memory function.

Dealing with just this one condition can be overwhelming. But did you know 3 out 4 fibromyalgia patients also develop chronic pain and dysfunction involving their jaw joints? Known collectively as temporomandibular joint disorders (TMD), these jaw joint problems cause pain, muscle spasms and difficulty moving the jaws that can interfere with eating and speaking. TMD can also contribute to headaches and earaches.

Many researchers believe this prevalence of TMD among fibromyalgia patients stems from both conditions originating from the same primary cause—a malfunction within the central nervous system. In both cases, the brain and spinal cord may not be able to process pain signals in a normal fashion. This malfunction could also be generating and amplifying pain signals even when nerves are receiving no stimulation.

For decades now, the most effective treatment strategy for TMD has been to manage the symptoms with physical therapy and exercises, thermal therapy or medications. Relief for fibromyalgia has depended on medication and relaxation techniques like biofeedback therapy. But with the evidence of some connection between the two conditions, it may be helpful to coordinate treatment for both with a team approach involving all your healthcare providers, rather than treat them separately.

To that end, make sure both your dentist or physician treating you for TMD and your physician treating your fibromyalgia each know about the other condition. Consulting together, your healthcare team may find treatments (like certain drugs that counteract neurotransmitter imbalances) that might help reduce symptoms in both conditions. And cognitive-behavioral therapy, meditation and other therapeutic pain management techniques can help you cope with the pain.

Continued research into these two debilitating conditions and the possible links between them may have an effect on how we treat both. A holistic approach to treating them could be the wave of the future.

If you would like more information on the links between TMD and other chronic pain conditions, 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 “Fibromyalgia and Temporomandibular Disorders.”


TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”