Wednesday, December 18, 2013

Dental Crowns vs Veneers

In today's world, there are a lot of people out there that are looking to become more attractive in one way or another. One popular way to enhance a person's looks comes in the form of enhancing the look of their teeth.

The simplest form of tooth enhancement is by bleaching the teeth. This is the cheapest and easiest thing to do. If someone is looking for more then a mere color change however, simple tooth whitening may not be enough.

If someone does no like the way their teeth are turned, angled, aligned, or shaped in any way then crowns or veneers may be what is needed. As a side note, to use the word "porcelain" when referring to a veneer may no longer be correct. There are many materials that veneers can be made out of now a days. Porcelain is simply one of many. So by asking for porcelain veneers, you may be asking for something that is not best suited to your individual case. To say, veneers are sufficient. The same can also be said when referring to a crown.

So what is a crown and what is a veneer? Simply put a crown covers the entirety of the tooth. From biting surface all the way down (or up) to the gum line. A crown will, typically cover it all. A veneer will only cover the surface that is visible to an outside observer. A dentist with the ability to turn you upside down and use mirrors at just the right angle could see the exposed tooth, but no one else would ever be able to tell.

So what is right for you? This is a question that is dependent upon a lot of variables. How much change is shape, position, and angulation is the person attempting to achieve? Severe cases would tend to be more of a crown case. How much of your natural tooth structure do you want to maintain? If you want as little of your natural tooth taken away as possible then veneers are your route.  Are you a grinder? If so then veneers may reduce the wear on your natural teeth to a minimum. The list could go on and on. You really need to see a dentist to determine which is right for you.
The tipping factor may be longevity. A recent study by the JADA (Journal of the American Dental Association) shows that full coverage crowns do have a better longevity then the veneers.They are fairly comparable,and veneers are still a durable option, but in the end, full coverage crowns get the nod as far as a longer lasting restoration.;139/suppl_4/8S

There are also possible side effects that can occur from any kind of procedure that you may choose to go through in the dental office. You need to make sure that you are also aware of these. Nothing is ever without risks. Simply make sure that you go into your new smile with your eyes wide open as to things that may happen.

Barring any side effects the person who gets the new crowns, or the new veneers, will be unbelievably happy with the way they look. The technology of today's lab work is simply amazing.  Brighter, whiter, straighter teeth may only be a few appointments away.

Front View of Crown & Veneer
Side view of Crown & Veneer

Side View of Crown & Veneer
Side view of Crown & Veneer

Dr. Jim Ellis, DDS
1220 33rd Street Suite C
Ogden, UT 84403
(801) 783-3490


Tuesday, December 10, 2013

Ogden Dentist: What is Periodontitis?

Today, we are going to talk about Periodontitis. Most people are unfamiliar with that term. And it's not surprising since its rather technical in nature. Thus, we will back up a little but and discuss some simpler terms that will help us better understand the more difficult condition of periodontitis.

When you floss you have noticed that the floss will disappear underneath the gums slightly as you near the base of the teeth. That is a very good thing. There is supposed to be a 1-3 mm pocket that surround each and every tooth in your mouth. At that depth, the pocket is very cleanable with your toothbrush, mouth wash, and floss. Maintaining this pocket at this healthy depth will ensure that your gums will stay healthy. Trouble is that many people do not brush, rinse, or floss as often as they should. Thus food gets packed into this pocket, does not get removed in a timely manner, and begins to be a breading ground for bacteria.

Once the bacteria begin to reproduce, the gums start to show the effects. Swelling, redness and bleeding are all common signs of gingivitis. Most people have gingivitis to one extent or another. And as long as the bacteria gets cleaned from the pockets within a few weeks nothing much should happen. It is when weeks, months, and even in some cases, years go by without a person seeing the dentist that the real problems begin to manifest themselves.

As the bacteria builds and the gingivitis gets severe enough the jaw bone, that resides just under the gum tissue, begins to also have difficulties. The bone will start to feel the effects of the bacteria overload and begin to dissolve from around the tooth. This unhealthy, and deteriorating bone condition is what is known as Periodontitis. This condition becomes ever more dangerous as the bone moves further away from the chewing surface of the tooth and closer to the end of the root. As the tooth loses bone support, it begins to be more mobile. Thus every time you chew, the tooth begins to move ever so slightly in the bone.

If the periodontal condition is not corrected the bone continues to erode and the tooth gets looser and looser. Eventually, it becomes so loose that it must be extracted from the mouth. Teeth with absolutely no cavities, crowns, root canals, etc. can be deemed unsalvageable and will be lost. That is the saddest moment of a patient with severe periodontitis.

A patient who has done their very best to brush as often as they could but has been unable, or unwilling, to add flossing and regular dental visits to their brushing regime. Moral of the story is that brushing is only one variable in a far more complex equation of overall oral health care. Taking care of the teeth is one thing. But taking care of the gums and bone structure is another entirely. Please floss appropriately and see your dentist on a regular basis.

Below photos are before and after of a person who had not been to the dentist in 5 years. The crap behind their teeth is calculus build up that helped this patient attain sever periodontitis. The other picture is an after picture of when the teeth were cleaned off.

Dr. Jim Ellis, DDS
1220 33rd Street Suite C
Ogden, UT 84403
(801) 783-3490


Wednesday, December 4, 2013

New Crowns

Here is Jeff.
Jeff didn't like the way his bottom front teeth looked. 
The first picture is of the teeth during the prep stage.

This next picture is a picture of the final crown in place.
The alignment, color, shape and feel of the teeth are
now all much improved over what he had. 
Happy patient.

Monday, December 2, 2013

Peg Lateral.

This was an interesting case.
This patient's lateral incisors were what we call, pegged. 
When you have a Peg Lateral your lateral incisor 
is much small then it should be. 
We also had additional spacing issues with the canine. 

So we went ahead and did some bonding. 
This allowed us to close the space with minimal financial burden
and still left open the possibility of crowning the tooth later
on if the patient decided that bonding wasn't enough.

This procedure can be done with most any gap in the mouth
and is not simply limited to the fixing of peg laterals.

Tuesday, November 26, 2013

My canines look too sharp. What can I do?

Canines are unlike any other teeth in the mouth.
Every other tooth in the mouth is, almost, a copy of a another
tooth in the same corner of the mouth.
You typically have 2 incisors, 2 pre-molars, 
and 2 molars per quadrant but only 1 canine.

One problem that people have with their canines is that sometimes
they feel as if they are a bit too pointed.

They hide them when they smile for fear that they look too much like a vampire.

Well there has never been an easier fix for just about anything.

All you need to do is file those bad boys down just a bit.
You do not need to be numbed up and it will only take a moment to do.
You will have less enamel so the chances that you could get decay in the
future are slightly higher. But, with a little added attention to your home
care that should never end up being a problem.

Thursday, November 21, 2013

I chipped my tooth. How bad is it?

Okay so you, your child, your mom, your brother, etc. etc. just fell face first into something, over something, under something, etc. etc. and broke the corner of your/their front tooth off.

What do you do now?

Well, that depends. Lets break this down into 3 simplified categories.
The nerve of a tooth is in the middle of the tooth.

#1 If you just broke off a small corner of the tooth and it didn't reach the nerve then a simple filling is probably all you would need.

#2 If you broke off a larger corner but still didn't reach the nerve then you more then likely would need a crown.

#3 If you broke your tooth so severely that you got down into the nerve then you will need a root canal AND a crown.
And although all of this may be a traumatic experience don't worry. Your cracked and broken smile can be completely repaired and have you back to being the model you know you were born to be.

Monday, November 18, 2013

Body Modification. Lip Gauging.

That's right.
You have heard of tongue, ear and nose gauges.
Now we have lip gauges.

Lip gauges have famously been around for a long time
among some groups in Africa.

The big difference is that the older gauges simply extend
the lip outward. Meanwhile, the new gauges actually
go through the lips and from a path to the oral cavity.

Confused. Here are a couple of pictures. 

Older Gauges 

You can see that the lips are simply stretched out. 
The disk that is inserted into the lip can be removed and 
the mouth can be fully closed for eating.

That is the trouble I may have with the newer variety of gauges.

As you can see the hole is actually a communication into the oral cavity.
The issue I have with these newer style of gauges is how to keep
food in your mouth when you are eating and how to keep drool
in your mouth when you are not.

I don't know how to stop the drool thing but I would think that perhaps a 
plug could be inserted into the hole to prevent food from coming out
during eating. Either way, these may be more trouble then they are worth.

The good side to these is that if your partner also has one of these, 
you can do this.

I case you are confused, 
both of them have holes in their lower lips. 
They are touching tongues through the holes.

Friday, November 15, 2013

Wisdom teeth 101

Do I really need my wisdom teeth out?
More than likely you do.
There is only a small segment of the population that has enough room that would allow for all 4 wisdom teeth to erupt completely into the mouth. Wisdom teeth removal can range in difficulty from very simple to very complex. Which end of the spectrum your own personal wisdom tooth removal ends up being is dependent upon several factors. How far can you open your mouth, how far up, or down, into the jaw do your teeth sit, and at what angle do your teeth lie are just a few of the concerns that must be addressed by you and your doctor to determine what to expect from your own wisdom tooth surgery.

Artist rendering of different kinds of wisdom tooth positions.
Two actual patient x-rays of horizontally impacted wisdom teeth.

Tuesday, November 12, 2013

You are not fooling anyone.

Here at the old dental office we work on the mouth. 
We know what a healthy mouth looks like. 
We know what an unhealthy mouth looks like.

And we know what an unhealthy mouth looks like
when some one has brushed and flossed about 36 times
harder then they normally do because they have a dental 
appointment the next morning.

See these gums.
Someone thought they would makeup for not flossing for 6 months.
You aren't fooling anyone ; ) 

Thursday, November 7, 2013

My child has 2 teeth that looked they are stuck together. Help?!

I had this question yesterday in my office so I figured I 
would address it here today.

In the picture below you will see some arrows that are 
pointed to teeth that look like they are actually 2 teeth hooked together.

This is called a fusion.
2 teeth are, in fact, hooked together.
It usually happens in baby teeth.
And there is absolutely nothing wrong with it.

There is also another term called gemination (the above graph).
This is when 1 tooth appears to be splitting into 2.

With both fusions and geminations there is typically nothing to be concerned about.
The teeth should be noted and kept under observation over time.
But this would strictly be for the same precaution that 
any other teeth would be kept a watchful eye over.

Please inform your dentist when you notice anything that may seem
out of the ordinary, but this out of the ordinary isn't too bad.

Monday, November 4, 2013

What is that huge lump on the roof of your mouth?!

It's called a Tori.

Ever heard of the word?
A tori is a lump of bone that resides in the mouth.
Most people that have tori think nothing of it because they have always had it.
Well, not everyone does have it.
But even if you do have it it really not that big of a deal.
Its just bone and likely wont ever cause you any problems.
One of the only times that it may cause you problems is if you need a denture.
Dentures are very hard to fabricate over the top of tori.
It is only a minor problem however due to the fact that tori can be removed.
So if you have a hard boney lump that has been in your mouth forever,
it may not hurt to get it checked out, but more often then not its simply just a tori.

Tori in the floor of the mouth.

Tori in the roof of the mouth.

Wednesday, October 30, 2013

One of those days.

Patient came in today wanting to know why he felt a "little edge" on one of his teeth.
We then showed him this picture.

No cavity
No filling
Should have been no problem
The tooth had to be removed.

Some days you are the hammer and some days you are the nail.

Tuesday, October 29, 2013

1, and only 1, of my teeth are changing color.

I, and/or my child, have one tooth that is not the same color.
Should I be concerned?

Well, lets just say its a good idea to get it checked out.

Teeth discolor for a number of reasons.
If all of your teeth are discoloring at the same rate then it is more then likely due to staining
caused by foods you eat and/or oral habits you may have suck as smoking.
In that case there is not much to worry about.
Simple whitening can take care of that.

If you notice that one individual tooth is turning a different color then there is more cause for concern. One tooth discoloring on its own typically means that that tooth has moderate to severe nerve damage. This nerve damage can be caused by trauma, decay, or other causes. but regardless of the cause it is more then likely that the nerve is dead, or dying, and needs to be removed. This procedure is called a root canal. After the root canal is preformed then some sort of cosmetic procedure may be needed to restore the original color of the tooth. This may be a crown, veneer or cosmetic bonding.

Not many people realize it, but teeth are living organisms. They have blood coursing through the middle of them and just like any other living think they can die. If they do die then one of the number one signs of that death is a change in color.

Wednesday, October 23, 2013

Dentists and Halloween candy.

Every year I have people ask me if I give out Halloween candy?
Well of coarse I do!! It's Halloween.

Last thing on earth that I want to be is the house where kids end
up crying because they got a pencil, sticker, or some other lame treat.

Eating candy on Halloween is NOT a problem.
Eating candy every other day of year, all year long, IS.
Let the kids get the candy.
Let them pound it all down.
Let them have a tummy ache.
Brush and floss their teeth.
Great night had by all.
The End.

Tuesday, October 22, 2013

Spit, Saliva, Drool, etc. etc

Whatever you call it the wet stuff in your mouth ( I will call it saliva),
is a very important part of your overall health.

Saliva is produced from 3 major glands in your mouth and plays two major roles in the body.
#1 Saliva helps to lubricate food before it goes down your throat
so that harder foods will not damage your insides on the way to the stomach.

#2 Saliva helps to wash harmful sugars and bacteria off of you teeth.

One of the most damaging things to your teeth is a dry mouth.
Dry teeth are dead teeth.
A dry mouth can be caused by a number of things.
The largest cause of dry mouth that I see is from medications.
Specifically heart regulating and mood altering medications
have the greatest effect but it can be any medication.

Dry mouth can also be brought on by age.
Just as your eyes aren't as moist as they used to be, so to
may your mouth begin to dry out over time.

If you feel like your mouth is drier then it used to be please contact
your dentist right away. There are things you can do to help.

Tuesday, October 8, 2013

Tooth completely turned sideways.

This was one of the more challenging cosmetic bonding cases that I have done.
Some teeth that we bond are slightly tilted.
Some are slightly rotated.
Some are too long or too short.

This tooth is rotated 90 degrees.
Meaning the tooth is turned completely sideways.

The bonding was tough because the proportions are off due to the rotation.
However, The patient was very happy with the result.
She was told that expensive braces was her only option.
Turns out 30 minutes in the chair.....
no shots
no drilling
and the cost of a filling later she looked like this.

This is simply filling material and it can be done in lots and lots of cases.

Friday, October 4, 2013

And you think you hate the dentist.

As with most things, the first try is not always a success.

The same can be said about dentistry. The earliest writings we have on the subject are from about 5000 B.C. Way back then all we have are people's speculation on what in the world was the cause of a toothache.

Later on, about 300 B.C. we start to get treatments for toothaches. None of these treatments sounded very pleasant. Even such noted historical figures as
Hippocrates and Aristotle got in on the act.

In the old west it is recorded that the barber doubled as the local dentist. The word "dentist" being very loosely used as most of what the barber did was to simply take teeth that had gone bad.

Personally I can't imagine what it must have been like.
Tooth pain is one of the worst pains you can go through.
And to not have the anesthetics and equipment we have today must have been tough.

Well, 7,000 years after the first recorded ideas of dentistry we now have amazing new technologies that make going to the dentist a
whole lot better then it used to be.

Wednesday, October 2, 2013

I like to chew gum. Will that cause me any problems down the road?

We have all seen it in stores.
Rows and rows of gum. 
Bags, bottles, cans, and boxes filled with
sticks, cubes, and circles of gum.
It's everywhere.
But is it good for you?

The answer can be a little complicated.
First off if the gum is not sugar free then NO it wont be good for you.
The sugar on your teeth for the hour or so that you chew on the gum will help 
in causing the formation of cavities.
If the gum is sugar free then the is better but there are a couple of factors 
still left to consider.
Do you have any popping, clicking, or grinding in your jaw joint (tmj)?
If so then I would not recommend the gum. 
Working a piece of gum for an hour with a jaw that already is
a little tender could lead to even more joint problems.

So if its sugar free and you are free from any TMJ discomfort then it 
should be ok to go ahead and chew your gum.
And actually it may be beneficial as well. 
Gum will stimulate salivary flow.
Saliva helps to even out the pH in your mouth and prevent bacteria,
and the acids they produce, from hurting your teeth.

So if the conditions are right then not only is gum not bad, but
it can also be a good thing for you to do.

Monday, September 30, 2013

Acids could be eating your teeth.

Teeth are similar to most things, in they can be eroded by acid.

Acids can come from external or internal sources.

A good example of an internal acid source would be Acid Reflux. Most acid reflux will cause mild to moderate cases of heart burn. The stomach acid will travel up the esophagus toward the mouth. It usually makes it only as high as the level of the heart and this is what causes a sensation that the area around your heart is burning. If the Acid Reflux is more severe it the acid will make it all the way to the mouth. When in the mouth the acids will eat away at the enamel of the teeth.

Another example of internal acid is the condition known as Bulimia. This is where individuals will induce vomiting as a way of losing weight. After eating they want to rid themselves of the food they just ingested before it gets absorbed into the body. As they induce vomiting not only does the food come
 up but stomach acids will come up also.

An example of external acids would be sucking on things like lemons or other acidic foods. Many Carbonated beverages are also very high in acid. These acids may not be as strong as acids from the stomach but if the exposure is consistent over a long enough period of time the effects can be just as damaging.

This picture illustrates the effects of acid against your teeth over time.

The tooth should be covered in white. That is the protective layer of the tooth known as enamel. Where the teeth have a more yellow appearance is where the acids have eaten away the enamel. The yellow portion is the layer beneath the enamel which is much softer and much more susceptible to decay. These teeth will need to be crowned quickly to avoid decay from reaching the nerve and the need for root canals.

Acids are very dangerous to your teeth whether from internal or external sources.
Seeing your dentist often will help in diagnosing acidic problems early.