Ultimate Smiles Orange County Dentistry

Questions and Answers about cosmetic and dental procedures:

First impressions can open or quickly close many doors. And nothing impacts that first impression, as does your smile. The beauty of your smile is determined by many factors. Jaw relationships, the size and shape of teeth, and tooth color can have pervading influence on your smile. For those wishing to enhance their smile, all of the above mentioned should be evaluated by the dentist. The following is a brief discussion of how each affects your smile.

Jaw relationship is most commonly what people notice first. The term "jaw relationship" means the size and shape of the lower jaw (mandible), the size and shape of the upper jaw (maxilla), and the relationship of each jaw to each other, as well as their relationship to the rest of the face.

If the upper jaw is too large as compared to the lower jaw, or if the lower jaw is too small, an "overbite" appearance occurs. If the upper jaw is smaller than the lower jaw, an "under bite" exists.

If the upper jaw is too small as compared to the face, the nose may appear too large, and the upper lip may appear too narrow. If the lower jaw is too large as compared to the rest of the face, the face can appear too long, and conversely, if the lower jaw is too small, the face will appear short.

Jaw relationship problems are most easily managed with childhood orthodontics (braces). However, adult jaw relationship issues can be managed by orthodontics and/or surgery. The cosmetic dentist should recognize jaw relationship problems in the child and the adult, and be able to discuss treatment options.

Size and shape of teeth are major factors that affect your smile. Teeth have an average size. If that size becomes smaller, many changes to your smile occur. The most common cause of changing tooth size is the loss of tooth structure due to excessive grinding (bruxism). This grinding of teeth, usually done at night, causes the teeth to become shorter. As the teeth shorten, the face collapses, resulting in the skin sagging under the eyes, around the mouth, and on the chin. As the teeth shorten, they do not show as much when you smile. Furthermore, wear on the front teeth can cause the front teeth to appear flat and squat, rather than the more youthful appearance of longer and more graceful teeth. Inordinate wear is destructive to teeth.

Restoring teeth to their proper size can be accomplished by the use of bonding, veneers, crowns, braces and/or surgery. Perhaps more important is the prevention of excessive tooth wear. The cosmetic dentist should recognize early signs of tooth wear, and inform the patient of this, and present prevention treatment possibilities.

Color is probably the component of a smile that is most often asked by patients to be changed. White teeth are the rage. Teeth darken as you age. Foods, tobacco, and fluids, stain teeth. The easiest method to lighten teeth is by teeth bleaching. This can be accomplished by bleaching under dental supervision, or in the dental office. Lighter and brighter teeth enhance a smile. It is important to remember that all issues of your smile need to be evaluated. Dr. Schlott can discuss these with you.

Teeth Bleaching

Teeth bleaching lightens the color of your teeth. Its brightening effects can last for years. It is usually the least expensive method to enhance your smile. Results vary depending on whether your teeth are stained from foods or smoking, or from taking certain medications or trauma. Generally, yellow teeth lighten more than gray teeth. However, all teeth benefit from bleaching.

Teeth bleaching will not change the color of existing dental work such as filling or crowns. If you are pregnant or nursing, bleaching should be postponed. Overly sensitive teeth may be a contraindication for teeth bleaching.

Some bleaching methods are performed in the office, and others are used in your home. All bleaching products lighten your teeth by use of peroxide. In-office products use a higher concentration of peroxide than those used in your home. Hence in-office bleach may lighten your teeth more than a single use of a home product. However, most dentists recommended that an in-office product be followed by a home-use bleach.

Dental supervised home bleaching is generally provides superior results to in-office bleaching, and is less expensive than in office bleaching. It is the most popular method of teeth bleaching. Acceptable results are achieved in about a week.

At home bleaching requires custom made trays to be manufactured by the dentist. These trays will be used to comfortably hold the bleach against your teeth. The bleach given to you by the dentist is stronger than over-the-counter bleach and must be used according to instructions.

Extensive studies have shown that bleaching is safe and effective. The only side effect, in a few individuals, is tooth sensitivity. If this occurs, it can be successfully treated with fluoride or by simply waiting a day or two for the sensitivity to decrease.

Spaces and Misshaped Teeth

Spaces between your teeth or teeth that are misshaped may make you feel self-conscious, and desirous of a new smile. However, before the dentist can create a new smile for you, a diagnosis of why you have a problem must be found.

Spaces between teeth occur for many reasons. Many times the teeth are plainly too small for the size of the jaw, and even distribution of the teeth creates gaps. Mouth breathing because of respiratory problems, tongue thrusting, and other habits during childhood can create spaces between teeth. Gum disease can cause the teeth to fan out creating unsightly spaces.

Misshapen teeth can be the result of genetics, accidents, grinding one's teeth, or stem from habits such as holding a pipe, or sewing needle between your teeth.

Correcting the spaces or misshapen teeth requires identifying the cause of the problem. Once that has occurred, treatment options can include orthodontics, bonding, veneers, and/or crowns.

Bad Breath

Few dental problems are as embarrassing as bad breath. (Halitosis) Its presence can hinder. Luckily, its causes and treatment are well understood.

Bad breath occurs when cells die and release volatile sulfur compounds. These dead cells may be from your body, bacteria, or from foods. These sulfur compounds are what gives rotten eggs their peculiar odor.

In a healthy mouth saliva bathes the teeth, cheeks, and tongue washing dead cells away. Therefore, if salivary flow is decreased by sleep, disease, or medications, dead cells accumulate and bad breath results. Diseases, such as gum disease or sinus infections, can overwhelm salivary flow and cause halitosis. Poor oral hygiene can lead to an accumulation of bacteria on the back of the tongue and be a source of bad breath. Unpleasant breath can also indicate more serious diseases such as diabetes, liver, and respiratory problems. A proper diagnosis of the cause of bad breath can lead to proper treatment.

The vast majority of bad breath can be eliminated with proper brushing and flossing. Mouthwashes containing chlorine dioxide can neutralize volatile sulfur compounds and sweeten breath for hours. Other mouthwashes, toothpastes, mints, and gum can mask bad breath for short periods of time. If more serious disease is the cause of bad breath, that disease must be treated.

Veneers or Lumineers

Veneers, or dental laminates, are thin pieces of porcelain that are bonded on to the tooth much like artificial nails are bonded on fingers. Veneers are probably the prettiest of dental restorations used to repair broken teeth, close spaces, change the shape of teeth, or to alter the color of teeth.

Placing veneers or lumineers may or may not require the removal of a small amount of enamel from the front of the tooth. An impression of the prepared tooth is taken and is sent to the dental laboratory where the veneers are manufactured according to the dentist's instructions. The veneers or lumineers are then bonded to the patient's tooth (teeth) creating a better smile that should last decades.

Tooth Colored Fillings

Decayed or broken teeth have long been fixed with silver or gold fillings. Recently, these materials have fallen out of favor and have been replaced with tooth colored materials made of composite or porcelain.

Composite filling material is made from resin and porcelain chips. It is placed directly into the tooth according to manufacturer's directions. Hence, only one dental visit is necessary. This material has replaced "silver fillings". It is best used for small and moderate sized cavities. The material can match the tooth color quite well and last for years.

For larger repairs, porcelain inlays and onlays can be used. The dentist must first prepare the tooth, and then take an impression. The impression is sent to the lab and the inlay or onlay is manufactured to fit the tooth. At a second visit the inlay or onlay is bonded to the tooth. These restorations look life-like and can last longer than composite fillings.

Crowns

Made of acrylic, or metal such as gold, porcelain, or a combination of metal and porcelain, crowns are restorations placed on teeth that are so badly decayed or fractured that a filling cannot restore them. Crowns can also be used to hide crooked or worn teeth. Porcelain crowns are generally more cosmetic than metal crowns, but metal crowns are generally more durable. However, both metal and porcelain crowns can last decades.

Crowns take two visits to the dentist. The first visit requires the dentist to prepare the tooth and take an impression, which is sent to the dental laboratory. The lab creates a crown that perfectly fits your tooth. At the second visit, the dentist cements the crown to your tooth.

Bridges

A bridge is a dental prosthesis utilizing crowns to replace missing teeth. The bridge consists of abutments (crowns on the existing teeth) and pontics (crowns which replace the missing teeth). The abutments and pontics are manufactured as one piece. The bridge is cemented on to your teeth and is considered a permanent restoration that can last decades. The procedure for bridges is identical to that for crowns.

Bridges are used to replace missing teeth for cosmetic reasons, and more importantly, to prevent other teeth from shifting and perhaps altering the patient's bite. Alternative choices for replacing missing teeth include implants and partial dentures.

Dentures

Dentures are used to replace missing teeth. If all teeth are missing, a "complete denture" is needed. A " partial denture" can be utilized to replace teeth if some teeth remain in the jaw.

Dentures are custom made from impressions of the individual's mouth, and usually take several visits to insure proper fit and cosmetics. Dentures should last years, but do require periodic relines to maintain proper comfort. Sometimes a person has problems wearing even the best-made denture. Dentures are always considered a compromise treatment. For those who have trouble with dentures, problems can be mitigated by using dental implants to fasten down the denture.

Toothpastes and Mouthwashes

A frequently asked question is "What is the best toothpaste and/or mouthwash?" The answer is ...it depends.

All toothpastes are similar. The major ingredient of all toothpastes is water. The next major component is a material that holds the water, flavoring, any abrasives, and other ingredients together. For the most part. Toothpastes do little to clean the teeth. Your toothbrush and dental floss are your best weapons against dental disease. Toothpastes mostly make your mouth taste good. However, those with fluoride, do strengthen the teeth against decay; and most dentist recommend a toothpaste containing fluoride. Other toothpastes possess herbs or chemicals that may or may not fight dental disease. Ask the dentist for specifics. On the other hand, some toothpastes fight tooth sensitivity, and can be effective if used properly. If tooth sensitivity is a problem, ask the dentist for some recommendations.

Mouthwashes generally mask bad breath, and some may be slightly effective in treating dental disease. Mouthwashes containing chlorine dioxide can eliminate bad breath for several hours. The most popular of these are Oxy fresh and Closys. Prescription mouth rinses contain Chlorhexidine and are effective in treating gingivitis.

Implants

Dental implants are used to replace missing teeth and as anchorage for orthodontics (braces). Dental implants generally have three components. The first part is the implant, per se, which is placed in the jawbone. Made of titanium, the implant fuses to the jawbone in 3-6 months. Once the implant is fused to the bone, an "abutment" is placed. The abutment connects the implant to the third piece of the implant complex, the implant crown or denture. Together the three parts mimic a natural tooth (teeth). Implants are cared for by brushing and flossing and with proper care can last a lifetime.

Root Canals

A root canal is a dental procedure that is performed when bacteria have or have the potential to infect the nerve of the tooth. The procedure allows the dentist to "save" as opposed to extract teeth.

A root canal begins with an access hole being placed in the tooth. The nerve(s) of the tooth is then removed. The remaining "canal", a tube in which the nerve and blood vessels of the tooth lived, is then filled with a material that prevents bacteria from re-infecting the tooth. Once the root canal is completed, the tooth will need to be restored with either a crown or filling.

TMJ

Strictly speaking, TMJ stands for temporomandibular joint. This is the jaw joint. However, TMJ is also a nebulous term used by many to describe a host of facial pains. Like other joints in the body, the TMJ consists of bones, discs, cartilage, tendons, muscles, joint fluids, nerves, and other tissues. If there is damage to any of these, pain results. TMJ pain frequently occurs in the TMJ joints and muscles of the face, mostly during chewing. However, headaches, earaches, and vague facial pain are also common complaints. Noises such as clicking or popping in the joint when chewing or talking may or may not be significant. Injury to the joint can be caused by frank trauma such as a blow to the head, or it can be the result of more obscure issues. Excessive grinding or clenching of your teeth is a common cause of TMJ disorders. Other diseases such as arthritis can also be culprits. If the pain exists in the muscles of the head and neck, stress may be implicated. The key to treating TMJ is a correct diagnosis. Discovering the cause leads to the correct treatment. However, the cause may have many origins, and thus treatment might be multi faceted. Treatment can include a splint (biteplate), occlusal or bite adjustment, orthodontics, physical therapy, nonsteroidal anti-inflammatory medication, biofeedback training, psychological counseling, and/or surgery. The dentist is best able to diagnosis and treat TMJ disorders. Dr. Schlott is well versed in TMJ and occlusion issues.

Gum Disease

Gum Disease, also know as periodontal disease, is one of the most common diseases to affect man. More than half of all people over the age of 18 have at least the early stage of some type of gum disease. After the age of 35, almost 75% of adults are infected with some form of gum disease. While, mainly a disease of adults, children can also be affected by gum disease. Gum disease has been implicated in aggravating heart and cardiovascular disease, diabetes, premature low birth weight. It is also the major cause of tooth loss. Gum Disease is alarming because the progression of the disease is often painless. Most often, pain only occurs after damage has occurred.

In its early stages gum disease can be treated with procedures known as "deep, quad, or perio scaling," prescription mouthwashes, and/or antibiotics. Severe gum disease may require additional treatment consisting of gum surgery and bone grafting. Gum disease can be prevented with good tooth brushing, flossing, and regular dental checkups.