These two patients today had badly broken down teeth. One option would have been to extract the teeth and place implants. I wanted to try to save the teeth by building them up and placing crowns. Here are the before and after photos.
This patient chipped his front tooth on a kitchen cabinet door. I quickly and painlessly repaired it with a bonded composite restoration. Here’s the before and after photos. Looks good as new.
This patient wanted me to give her a pretty smile in time for her sister’s wedding. Here’s the before and after pictures. Her smile looks beautiful.
This patient’s lower teeth were worn down from years of grinding and clenching. We discussed crowning all the lower teeth, but I wanted to try bonding composite to the tops of the teeth to build them back up. He will eventually wear this away, but it’s easy for me to add to and re-bond the teeth as he wears them down over the years. I also made him a nightguard to wear when he sleeps to protect the teeth.
The first two patients I saw today chipped the same front right central incisor biting into a chicken bone. The third one chipped her lower right incisor biting into a sandwich. The last patient grinds his teeth and fractured the edge off his upper left central incisor. I restored each these teeth in about a half hour, for each one, with bonded ceramic composite restorations. Here are the before and after photos taken 30 minutes apart.
Here’s a New Year’s Resolution You can Smile About! Ten Steps to Happy Teeth and a Happy You:
This patient was hit in the mouth with a tennis racquet and broke his front tooth. The tooth also required a root canal, and periodontal crown lengthening surgery. I placed a temporary crown on the tooth for 2 months while the gums healed and did a computerized custom shade match to obtain a perfect color match.
This patient had decay on her back upper first molar. I cleaned out the decay and placed a beautiful ceramic composite restoration. Here’s the before and after pictures. Looks great!
This patient’s upper front teeth and old fixed bridge broke off. We discussed treatment options. Since the teeth were decayed and badly broken down, I recommended extracting them and making an immediate provisional partial denture. Following healing we can do crown lengthening periodontal surgery and make a fixed bridge from canine to canine or make her a final partial denture. I extracted the teeth and delivered the immediate provisional partial denture during the same 1 hour visit this afternoon.
It’s true that sugar does cause cavities, but it’s not the sugar directly. The naturally occurring streptococcus bacteria that live in our mouths consume the sugar, ferment it, and produce acid such as lactic acid. It is these acids that cause demineralization of the teeth and the formation of cavities. So it’s actually the acid from the bacteria in plaque in our mouth that eats holes in our teeth and causes cavities.
Here’s the interesting part, it’s not the total amount of sugar we eat, but the total amount of time the sugar is in contact with our teeth. It’s preferable to have a piece of pumpkin pie with a scoop of ice cream for Thanksgiving dessert, than to sip on a soda all afternoon. It is better to have a few sugar cookies, or slice of Christmas apple pie, than to repeatedly sip coffee with sugar all morning long. One Altoids mint or cough drop per hour throughout the day is 10 times more cavity producing than one big piece of cake for dessert, even though the cake has much more sugar and calories.
The repeated cycles of eating sugar and acid formation is the key to the problem. It’s the frequency, or the amount of time the sugar is in the mouth, not the total amount of sugar. So enjoy a few nice (and quick) holiday desserts, just please make sure to brush and floss after every meal and visit your dentist regularly.
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