Wed

01

Jun

2016

Wondering why your front tooth broke?

Front teeth can break for many reasons. I will try to discuss here some of the most common ones I see in my office

Broken Crown on Front tooth
Crown "snapped off" on front tooth

Here is a quick photo of a patient that broke his front tooth. He had a crown on the tooth, but when he bit down on a piece of licorice the tooth broke. This is a particularly difficult situation because there isn't much tooth left to hold a new crown. We ended up having to do a root canal and a post to help retain the new crown. Even after all that, if this lasts 5 years it is a success. For a longer term fix we could have extracted the root and placed an implant or a bridge here. Replacing with a new crown was the least invasive (and least expensive) option at this time. That is what the patient wanted, so we did that. 

 

So what happened here? He bit down and pulled on licorice. When we bite AND PULL on our food (like licorice/candy or even worse JERKY) we put a force on the tooth that isn't in line with it's natural strength. Un-restored teeth can usually handle that kind of force, but a tooth that has been compromised may not be able to withstand the lateral force on the tooth.  Anytime a tooth has been fixed (restored) it IS compromised.

Tooth broken off inside crown

All the tooth is stuck in the broken off crown
Tooth broke off inside crown

Here is a quick photo of a tooth that has broken off inside the crown. Honestly this is a bad situation. These just can't be bonding back on with any sort of predictability. I have patients that ask to "just glue it back on" and we will do that if they ask us to, but we tell them we cannot guarantee how long it will stay on. I think the average amount of time they stay on in these situation is 1-2 weeks. If your crown broke off, and this is what you see, you will most likely need to have the root of the tooth extracted and a bridge or implant.  

My tooth didn't have a crown, but it still broke off. I am wondering why?

Acid wear or tooth grinding wear can break teeth too
Tooth Broke due to wear on the back side

This patient came to us with these 2 broken teeth.  His wife made him come in. He really wasn't too bothered by the appearance. 

 

So what happened here?  His tooth was weakened by wear on the back side.  Once it was weak (thin) enough a normal amount of force "snapped" the front of this tooth right off.  

 

His wear was from 2 sources.  

 

1.  Acid.  He has had years and years of acid reflux (often called GERD) that dissolved away the inside of his front teeth. This is very common in men (can occur in women too). Reflux is a silent assassin. Most people have no idea it is destroying their teeth.

 

2. Grinding his teeth. This patient does grind his teeth. Not as bad as some patients, but when combined with the acid reflux it was devastating.

 

Fixing this is also very difficult (read a lot of time and money to get back to a nice result). I can't just put a white filling in there, it will require several steps to fix it. 

1 Comments

Thu

03

Mar

2016

Am I grinding my teeth?

5 signs you might be grinding your teeth!

And what you really need to do about it.

Grinding my teeth
Worn Front teeth and broken crowns and porcelain

Every day I work, I see it. Tooth wear!  When I try to tell someone they have it, they get VERY defensive. I'm not really sure why.  I think the biggest reason is because they believe it will cost a lot of money to fix it.  So most just want to pretend like it isn't a big deal.  They want to ignore it. I used to argue with them, but it wouldn't get me anywhere. Now I just take photos and wait.....

 

"I used to grind my teeth, but I don't do it anymore"

"My last dentist ground my teeth down to look like that"

"I don't notice myself grinding my teeth"

 

I will say that the longer you wait, the more it will cost to fix it. That is pretty much the scenario for delaying most dental work. There are actually 3 main reasons people have tooth wear, and not all of them are because of grinding your teeth. 

grinding teeth
Broken porcelain and worn down front teeth

This patient came to me because his crown broke. If you look at the photo above and to the left you can see he has a crown that is  broken on one of his front teeth and the metal from under his crown is showing in his smile. He has almost no concerns about the rest of his teeth. He said a few times, "I know I have bad teeth.......".  When I asked him if he was concerned about the tooth wear, he wasn't sure what I was talking about.  The wear is what has destroyed his teeth, not genetics.

 

Look at the shape of his teeth.  They are short and wide, this is typical of someone that has been grinding their teeth for some time. He has the added bonus of have acidic tooth wear in addition to the physical grinding, that makes things progress at a faster pace. Acidic wear shows up as cupped out areas on the teeth (seen here as the brown areas on his front teeth).

 

This is a case that will cost more money to fix.  How much?  About the price of a car.  What kind of car?  That depends........could be a Chevy, could be a Mercedes. We would have to take some more photos and make some models of the teeth to find out.

5 common signs of tooth wear

veneers and cosmetic dentist in Spanish Fork
Un-even edges on front teeth.

Early signs of tooth wear can be seen in the photo to the left.  The most obvious sign is the un-even biting edge of the tooth.  Here are 5 signs of tooth wear, there are more than 5 for sure, but here are the first 5 that come to my mind:

 

1.  Un-even egdes of the front teeth

2.  Front tooth/teeth fillings that keep popping out

3.  Waking up with headaches or jaw muscle pain. 

4.  Wearing through/breaking your retainer

5.  Teeth look wider than they are long

 

This patient wanted his front teeth fixed, but he didn't want me to shorten them. TRICKY, but we did fix them to his satisfaction.

 

 

You broke what God made you, you will break what the dentist makes you too, UNLESS................

No room to lengthen the teeth.
No room to lengthen the teeth.

You can see why this is so tricky, there is no space between the teeth when he bites his front teeth together.  Often times when your teeth wear, they move into each other to close the space between them.  So when we try to build them back up they are too tall and the fillings keep popping off.  Then everyone gets frustrated.

 

Look at the bottom teeth too. Notice how they are not straight across either. like mountains and valleys.  The most aesthetic front teeth are flat on the cutting edges and contact evenly all the way across. 

 

Now even after showing this guy the same info I am showing you, he STILL was skeptical about whether or not he was grinding his teeth. Can you see the danger if I fix his teeth and he doesn't believe he is grinding them?  Every time they break he will think it is because I did poor dentistry. He destroyed what God gave him, i'm just a lowly dentist.  Nothing I put in there can resist his grinding, EXCEPT a night guard.  He's not doing this during the day (occasionally people do day-grind their teeth). If we protect the teeth at night, they will hold up a lot longer. 

The key with tooth grinding

Fix your smile at our office
If you wait, eventually they will break, or not be restorable

So what is the key?  The key is to catch it early, and wear a night guard. Yes, you will have to wear it for the rest of your life.  Many people think they USED to grind, but they don't now. All the research and literature on the subject says that just doesn't happen. People go thru cycles when they grind more and less, but pretty much once a grinder, always a grinder.  A night guard is basically a piece of plastic that you can grind on all night.  It won't hurt your teeth, it is just there to take the beating. Some people grind thru their night guard. Can you imaging what they would have done to their teeth!! It's scary!!

 

This poor guy ground his teeth thin, then one day......SNAP!!  Notice there is no room for me to put a crown on the tooth.  The bottom tooth is right up tight to the top. His teeth moved together as he ground them over the years. I tried to put some white filling material on the front to help the appearance, he was back at my office within a week with that filling broken off.  

 

Catch it early and prevent this stuff. 

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Thu

03

Sep

2015

Free Exam and X-rays.........Buyer beware!

Dentist Spanish Fork
If it looks too good to be true...it probably is...

It seems like more and more I am seeing advertisements from other dentists with the irresistible offer of "Free exam and X-rays" or even seemingly better "free x-rays for life"! Please beware!  I too am guilty of using this "offer" to get new patients into my office. I only did it for a short time, I felt I was forcing myself to do what everyone else was doing.  I was caught up in the race to the bottom. One major problem was I felt pressure to find something that needed to be fixed to make up for the loss. I never could do it, I guess i'm too honest (not a totally terrible trait to have). I would see people and their beautiful teeth, and I would send them on their way without diagnosing the need for any additional dentistry. 

 

Here is the catch.  The offer is made with the hope of finding a bunch of dentistry that needs to be done. You may not be paying for the exam and x-ray up front, but you will be paying for it on the back end with all the treatment you end up getting done.  Often the treatment fees are raised to compensate for the "freebies".  You see, there really is no such thing as a free ride. There are a lot of dentists that really make a lot of money by offering something for free. They are very good at finding treatment that "needs" to be done (at least in they think so). They are on the aggressive end of the dental treatment scale. 

 

So, find a dentist you can trust.  Ask around, check out websites, there are plenty of good dentists out there. There are also plenty of dentists that you need to watch out for.  Our office? YES, we are pretty dang awesome. We are part of a group of dentists that have agreed to hold a higher standard. It's called Opt-in dental. Just a group of private practice, non corporation, dentists. You can learn more about opt-in by clicking HERE.


 

0 Comments

Wed

10

Jun

2015

What Are No Prep Veneers?

Veneers, Cosmetic dentist spanish fork
Before - No Prep Veneers

Many of my patients want no prep veneers because that means no shots.  Really that is the #1 criteria, they want easy and no "pinch". Sometimes that works, other times the old saying is true, "pain is beauty" or is it "Beauty is painful"? I am not sure.  Some teeth need to be numbed to get a better, more aesthetic, result.

 

Here is a patient that came to me because she didn't like the shape of her front teeth.  She does have nice teeth, but the small black triangles near the edges of here teeth really bother her.  In my opinion this is a great case for no prep (or minimal prep) veneers.  

 

Here's what makes a good patient for no prep/minimal prep veneers

-The teeth do not already have fillings or cavities in them.

-The teeth are already a nice color/shade.

-The teeth are not crowded or overlapped.

-The patient doesn't grind their teeth more than normal.

 

If you are thinking you want to try no prep/minimal prep veneers the above 4 criteria need to be met, otherwise your veneers will have some compromises, or you will need to have your teeth prepped to get a better result. 

Cosmetic Dentist Spanish Fork, Veneers
After - No prep veneers

Here is her after photo.  It was taken with the nitrous nose on, so her lip looks a little bit weird.  Also, one of the front tooth veneers was slightly longer than the other.  It was an easy fix, we just shortened the veneer with a little disc. Took about 30 secs. See the pics below for the side by side before and after. 

 

These veneers were done with zero anesthetic and no temporaries. She came in, we cleaned up the teeth and took an impression. 2 weeks later the veneers were back from the lab. We cleaned up the teeth again and bonded the veneers to her front teeth. As easy as it gets.  

 

These veneers are very thin. Almost like contact lenses for the teeth. The are great at giving a better shape to the tooth, it is hard to get a "whiter" tooth with these veneers, but color can be changed a little. 

 

If you want to know if you are a candidate for no prep/minimal prep veneers come in and we can do a free consultation. 

Here are the before and after shots. It is a subtle change, but the patient was very happy.

0 Comments

Wed

15

Apr

2015

Do I really need a root canal?

Root Canal Dentist in Spanish Fork
Deep Cavity on tooth that needs a Root Canal

You may have been told you need a root canal by your dentist.  Well, hopefully, I can provide some information on why root canals are necessary. I posted this ugly picture to help illustrate some points. I hope it doesn't scare anyone away. I will try to keep all this information short and sweet, but still provide some understanding.  The last section below will address why you might need a root canal when you are not having any pain or problems with your tooth. It can be confusing.

 

1. The Painful tooth


-Some types of tooth pain will not go away without a root canal. In these cases the nerve of the tooth is under assault. This assault is usually from a cavity that has reached the nerve (pulp) of the tooth, or a crack that has reached the nerve (pulp). In the picture I have posted we have BOTH. The yellow arrows show a crack that has reached the nerve, and the light blue arrow shows one spot (there are many here) that the decay has reached the nerve. There is actually a hole where the light blue arrow is. 

 

-If you have a cavity that is "deep" or close to the nerve there is a good chance you will need a root canal. This is especially true if the tooth has been sensitive to cold or biting. That sensitivity means the nerve has become involved.

 

-If cold liquids, or cold air, make the tooth painful you will probably need a root canal.  If this is happening don't wait until it is so painful you can't survive. Your tooth is trying to tell you something is wrong. It will blow up eventually, usually on a weekend or during a vacation. 

 

-If your tooth wakes you up at night and continues to throb you will most likely need a root canal. 

Spanish Fork Dentist
Infected tooth needing a Root Canal

This tooth looks like it has a little broken corner on the filling (both yellow arrows).  The patient was cold sensitive for a while, then all of a sudden.............BOOM!  She was in severe pain. I'll show a picture of the tooth after I removed the old filling below.


2.  The Infected tooth


Sometimes a tooth will have a cavity reach the nerve and the patient will deal with the pain for a while and then it goes away. The patient is thinking "Finally, that tooth feels better".  Then, with a little bit of time, the tooth blows up.  This time the patient's face swells up. What happened?  When the pain went away the nerve (pulp) actually died. No nerve = no pain. That dead tissue inside the tooth sat there until some bacteria made their way into the nerve. Once the bacteria found the dead tissue there was nothing there to stop them.  They started devouring that dead tissue.  Eventually they multiplied so many times they started to venture out of the tooth and into the bone and gums. That is why the patient swelled up. Also bone and gums have nerves, and they will fire when bacteria are infecting them. Antibiotics work better on these types of infections, but only temporarily. The only way to solve this problem is to get the dead tissue out of the tooth. That means root canal or extraction, both will get rid of the dead tissue. 


The more time a tooth spends with dead tissue in it, the less predictable a root canal will be. That is because the bacteria are moving into all the small, hard to reach areas of the tooth. All those areas have to be cleaned out during the root canal.  Some are so small that only molecules of disinfectant can reach the area. It is much better to have the root canal done before the tooth becomes severely infected. The earlier the better. 

We can fix infected teeth, we take your insurance
Infected tooth, not very happy............

"But my tooth doesn't even hurt!  Why would I get a root canal when my tooth doesn't hurt?"

 

I think this is the question most people have about root canals. There are quite a few reasons.  I'll give you the 2 most common reasons.  

 

1.  The tooth is dead and abscessed, but it is draining.  Your body can make a "pipeline" for the infection to drain outside the body. The exit shows up as a "pimple" on the gums.  Sometimes on the roof of your mouth, sometimes on the outside.  Sometimes it is draining into your sinus and you won't even see the pimple. The drainage keeps the area from building up pressure, so you don't swell and you don't hurt. The problem is eventually that drainage will get blocked, and it will hurt/swell.  The dentist is just trying to get the tooth fixed before you have bigger problems.  Also, you have an active infection in your body. That is not good for a lot of reasons I won't go into right now. 

 

2.  The tooth has a deep cavity in it that is very close to the nerve. I usually inform my patients that the cavity is too close to the nerve and I recommend a root canal in addition to the filling. If you remove the decay and fill the cavity (Without doing the Root Canal) your nerve will become irritated. It happens, a lot, that patients want to "try the filling and not do the root canal" in these situations. 9 times out of 10 the tooth becomes symptomatic and then you have to come back and get numb again and treat the tooth. Usually this all starts on a Friday afternoon. It makes for a long weekend. Experience has shown it is better to treat these teeth before they start hurting you badly. We know when the decay is just too close to the nerve, we see it every day. 

0 Comments

Mon

06

Jun

2016

10 Signs and symptoms your newborn baby may have a tongue or lip tie.

We are providing laser tongue tie and lip tie corrections in Utah County, we can help you.

Read More 0 Comments

Thu

03

Mar

2016

Am I grinding my teeth?

5 signs you might be grinding your teeth!

Read More 1 Comments

Thu

03

Sep

2015

Free Exam and X-rays.........Buyer beware!

Dentist Spanish Fork
If it looks too good to be true...it probably is...

It seems like more and more I am seeing advertisements from other dentists with the irresistible offer of "Free exam and X-rays" or even seemingly better "free x-rays for life"! Please beware!  I too am guilty of using this "offer" to get new patients into my office. I only did it for a short time, I felt I was forcing myself to do what everyone else was doing.  I was caught up in the race to the bottom. One major problem was I felt pressure to find something that needed to be fixed to make up for the loss. I never could do it, I guess i'm too honest (not a totally terrible trait to have). I would see people and their beautiful teeth, and I would send them on their way without diagnosing the need for any additional dentistry. 

 

Here is the catch.  The offer is made with the hope of finding a bunch of dentistry that needs to be done. You may not be paying for the exam and x-ray up front, but you will be paying for it on the back end with all the treatment you end up getting done.  Often the treatment fees are raised to compensate for the "freebies".  You see, there really is no such thing as a free ride. There are a lot of dentists that really make a lot of money by offering something for free. They are very good at finding treatment that "needs" to be done (at least in they think so). They are on the aggressive end of the dental treatment scale. 

 

So, find a dentist you can trust.  Ask around, check out websites, there are plenty of good dentists out there. There are also plenty of dentists that you need to watch out for.  Our office? YES, we are pretty dang awesome. We are part of a group of dentists that have agreed to hold a higher standard. It's called Opt-in dental. Just a group of private practice, non corporation, dentists. You can learn more about opt-in by clicking HERE.


 

Read More 0 Comments

Wed

10

Jun

2015

What Are No Prep Veneers?

Veneers, Cosmetic dentist spanish fork
Before - No Prep Veneers

Many of my patients want no prep veneers because that means no shots.  Really that is the #1 criteria, they want easy and no "pinch". Sometimes that works, other times the old saying is true, "pain is beauty" or is it "Beauty is painful"? I am not sure.  Some teeth need to be numbed to get a better, more aesthetic, result.

 

Here is a patient that came to me because she didn't like the shape of her front teeth.  She does have nice teeth, but the small black triangles near the edges of here teeth really bother her.  In my opinion this is a great case for no prep (or minimal prep) veneers.  

 

Here's what makes a good patient for no prep/minimal prep veneers

-The teeth do not already have fillings or cavities in them.

-The teeth are already a nice color/shade.

-The teeth are not crowded or overlapped.

-The patient doesn't grind their teeth more than normal.

 

If you are thinking you want to try no prep/minimal prep veneers the above 4 criteria need to be met, otherwise your veneers will have some compromises, or you will need to have your teeth prepped to get a better result. 

Read More 0 Comments