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By Bruce P. Mercado, DDS, PC
February 10, 2022
Category: Dental Procedures
Tags: dental implants  
BeforeReplacingYourMissingTeethYouMayNeedOtherDentalWork

Replacing missing teeth can do wonders for a smile. And you have solid options for doing so, from a partial denture to state-of-the-art dental implants. But there might be a roadblock to your restoration plan—literally. Some of your other teeth may be in the way.

When a tooth has been missing for a while, the teeth on either side of a tooth gap will naturally begin to move or “drift” into the space. This could result in an inadequate amount of available space for a prosthetic (false) tooth.

If that happens, we'll first need to move the errant teeth back to where they belong, either with traditional braces or removable clear aligners. If we're successful, we can then proceed with the missing tooth restoration.

But before starting orthodontic treatment, there may be another problem that needs our attention first. If your missing teeth are the result of periodontal (gum) disease, your gums and supporting bone may not be as healthy as they need to be. This can interfere with orthodontics, which often depends on the gums and bone around a tooth being healthy enough to reform as the tooth moves. That may not be possible if they're still infected with gum disease or you've suffered significant bone loss.

If that's the case, it may be necessary to first treat any gum disease present and rebuild the bone. The latter can often be done by grafting bone material to the area of loss. The graft then serves as a scaffold of sorts upon which new bone can grow and accumulate. And reducing gum disease, mainly by removing bacterial plaque, allows the gums to heal and regain attachment with the teeth.

Once your gums and bone are healthy again, we can then proceed with orthodontics. After the teeth are reasonably aligned, we can then complete the restoration for replacing your missing teeth, and any other cosmetic enhancements for your remaining teeth like veneers or crowns.

The entire process may take some time and multiple treatment visits. But gaining a more attractive smile in the end is well worth it.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.

By Bruce P. Mercado, DDS, PC
January 21, 2022
Category: Dental Procedures
Tags: celebrity smiles   crowns   veneers  
HowGeorgeClooneyMadeOverHisSmileandHowYouCanToo

Since his breakout role as Dr. Doug Ross in the 90's TV drama ER, George Clooney has enjoyed a blockbuster career as an award-winning actor, director and producer. He's still going strong, as seen in the recent film The Midnight Sky, which Clooney directed and starred in. This sci-fi drama set a record as the most-watched movie on Netflix for the first five days after its late December release. And although now well into middle age, Clooney still possesses a winsome charm epitomized by his devil-may-care smile.

But he didn't always have his enigmatic grin. Early on, his struggles pursuing his burgeoning acting career triggered a stressful habit of grinding his teeth. This took a toll, as his teeth began to look worn and yellowed, giving his smile—and him—a prematurely aged appearance.

Clooney's not alone. For many of us, our fast-paced lives have created undue stress that we struggle to manage. This pent-up stress has to go somewhere, and for a number of individuals it's expressed through involuntary grinding or gritting of the teeth. This may not only lead to serious dental problems, but it can also diminish an otherwise attractive smile.

There are ways to minimize teeth grinding, the most important of which is to address the underlying stress fueling the habit. It's possible to get a handle on stress through professional counseling, biofeedback therapy, meditation or other relaxation techniques. You can also reduce the habit's effects with a custom-made oral device that prevents the teeth from making solid contact during a grinding episode.

But what if teeth grinding has already taken a toll on your teeth making them look worn down? Do what Clooney did—put a new “face” on your teeth with dental veneers. These thin layers of porcelain are bonded to teeth to mask all sorts of blemishes, including chips, heavy staining and, yes, teeth that appear shortened due to accelerated wearing. And they're custom-designed and fashioned to blend seamlessly with other teeth to transform your smile. Although they're not indestructible, they're quite durable and can last for years.

Veneers can correct many mild to moderate dental defects, but if your teeth are in worse shape, porcelain crowns may be the answer. A crown, which bonds to a prepared tooth to completely cover it, allows you the advantage of keeping your natural tooth while still enhancing its appearance.

Although different in degree, both veneers and crowns require permanently altering the teeth, such that they will require a dental restoration from then on. But if you're looking for an effective way to transform your worn or otherwise distressed teeth into a beautiful smile, it's a sound investment.

Just like George Clooney, your smile is an important part of who you are. We can help you make it as appealing as possible with veneers or other dental enhancements. Call us today to get started on the path to a more attractive smile.

If you would like more information about dental veneers and other smile enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers.”

By Bruce P. Mercado, DDS, PC
December 22, 2021
Category: Dental Procedures
3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing teeth, 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 “When Permanent Teeth Don't Grow.”

AreYourTeethSensitivetoWhiteninglikeDrewBarrymoresHeresWhatYouCanDo

Best known for her roles in E.T. and Ever After, and more recently as a suburban mom/zombie on Netflix's Santa Clarita Diet, Drew Barrymore is now bringing her trademark quirky optimism to a new talk show, The Drew Barrymore Show on CBS. Her characteristic self-deprecating humor was also on display recently on Instagram, as she showed viewers how she keeps her teeth clean and looking great.

In typical Drew fashion, she invited viewers into her bathroom to witness her morning brushing ritual (complete with slurps and sloshes). She also let everyone in on a little insider Drew 411: She has extremely sensitive teeth, so although she would love to sport a Hollywood smile, this condition makes teeth whitening difficult.

Barrymore's sensitivity problem isn't unique. For some, bleaching agents can irritate the gums and tooth roots. It's usually a mild reaction that subsides in a day or two. But take heart if you count yourself among the tooth-sensitive: Professional whitening in the dental office may provide the solution you are looking for.

In the dental office, we take your specific needs into account when we treat you. We have more control over our bleaching solutions than those you may find in the store, allowing us to adjust the strength to match your dental needs and your smile expectations and we can monitor you during treatment to keep your teeth safe. Furthermore, professional whitening lasts longer, so you won't have to repeat it as often.

After treatment, you can minimize discomfort from sensitive teeth by avoiding hot or cold foods and beverages. You may also find it helpful to use a toothpaste or other hygiene product designed to reduce tooth sensitivity.

The best thing you can do is to schedule an appointment with us to fully explore your problems with sensitivity and how we may help. First and foremost, you should undergo an exam to ensure any sensitivity you're experiencing isn't related to a more serious issue like tooth decay or gum recession.

Having a bright smile isn't just advantageous to celebrities like Drew Barrymore—it can make a difference in your personal and professional relationships, as well as your own self-confidence. We can help you achieve that brighter smile while helping you avoid sensitivity afterward.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Important Teeth Whitening Questions Answered.”

By Bruce P. Mercado, DDS, PC
December 02, 2021
Category: Dental Procedures
Tags: veneers  
VeneersMayNotBeaGoodOptionforaTeenager

People love dental veneers—those thin, porcelain shells bonded to teeth to mask stains and blemishes. For a relatively modest price, they can vastly improve a smile.

But what if it's your teenager who needs a smile upgrade? Teens also experience dental flaws like adults—which, at their age especially, disrupt their self-image and social confidence.

So, can veneers work for teens? Technically, yes, but there's a possible snag, depending on the maturity level of their teeth.

The potential problem relates to the tooth preparation that precedes the bonding of the veneers. One option is no-prep veneers and they are a nice solution depending on the size and shape of the existing teeth. If the teeth are slight in size, no preparation is necessary. If the teeth are large, even though veneers are thin, they can still look unnaturally bulky when bonded to unprepared teeth. A dentist may need to remove some of the tooth's surface enamel before applying the veneers.

Although this alteration has little effect on an adult tooth (other than requiring a veneer or restoration from that time on), it could damage a less mature tooth and stunt its development. A younger tooth can have a larger pulp—the central tooth chamber containing blood vessels and nerves—that's closer to the enamel surface than an adult tooth.

Because of the pulp's proximity to the surface of an immature tooth, there's a risk of damaging it during the tooth preparation phase for veneers. If that happens, the tooth may need additional treatment to save it.

We don't depend on a teen's calendar age to determine whether or not it's safe to install veneers. Instead, we examine the teeth and measure how close the pulp may be to the surface, as well as the thickness of the middle layer of dentin. Veneers could be acceptable if it appears the teeth have reached a healthy level of maturity.

If not, though, we may need to consider less invasive ways to improve a teen's smile. For stains or other outer discolorations, whitening with a bleaching solution significantly brightens teeth. We can repair chips by bonding and sculpting color-matching dental material to the teeth. And, these or similar cosmetic measures won't endanger an immature tooth like a veneer application.

Once a young patient's teeth have matured, we can revisit the subject of veneers. That may take time, but the more attractive smile that results will be worth the wait.

If you would like more information on dental care for adolescents, 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 “Veneers for Teenagers.”