Ask the Dental Experts

Partially Edentulous Arch

2010-03-10T21:13:00.000-08:00

When you are missing some of your teeth (a condition known as a partially edentulous arch), it is imperative that you do something. Delaying treatment is never a good idea, because the medical impact of doing nothing is worse than you probably assume. Missing teeth will cause other teeth to grow out of alignment. Cheek muscles will cave in and wrinkle. A person can start looking older than they really are, and the jaw bone will begin to deteriorate due to the absence of a tooth root to grow around. You do not want this to happen to you.

Fortunately, you have more than one option. These choices include the following:

· A bridge
· Implant-supported crowns or a bridge
· A partial denture

Bridges
There are several types of dental bridges you can have placed in your mouth to substitute for missing teeth. Before we look at these options, let’s first understand what a dental bridge is.

A dental bridge is an artificial tooth that is attached to the teeth on either side of the gap in your smile. These teeth work as anchors, holding the bridge in place and providing support. A bridge is fixed in the mouth and is therefore more stable and secure.

The problem, however, is the effect a bridge can have on surrounding teeth. In order to place the bridge in the first place, we have to reduce tooth surfaces in order to make it fit. This makes the teeth more vulnerable to decay. In severe cases, root canals eventually have to be done on some of these teeth.

However, getting a bridge requires us to reduce the size of the supporting teeth, and reducing teeth can sometimes lead to decay and the need for root canal therapy.

This type of dental bridge is called a fixed or non-removable bridge. It is commonly used as a restoration for an edentulous arch. A second type of bridge is supported by dental implants. This eliminates the need to use surrounding teeth as brackets. This is better for your teeth, although it is also more expensive.

Implants
You can also get dental implants as replacements for missing teeth. Implants use a titanium post to substitute for the tooth roots of missing teeth. The post supports a porcelain crown that is by all accounts the best possible and longest lasting tooth replacement. Not only does the crown act as a fully functional tooth, but it looks realistic. The post mimics a tooth root just enough to fool the jawbone into thinking a tooth root is still there, so bone recession is prevented.

Implants do require surgery, and recovery time can be several months. They are also expensive.

Partial dentures
Partial dentures can also works as missing tooth replacements. Of course, this is not the very best restoration for a partially edentulous arch, but it may be the most affordable option for you in the beginning. There are several types of partial dentures we can make for you. We can fit you with an all-acrylic flipper, which is a form of provisional partial denture. We can also fit you with a metal-based conventional partial denture if you prefer. For patients that need additional support for their restorations, implant supported dentures are also sometimes used.

Homecare Manual for Esthetic Dentistry

2010-03-09T17:26:00.000-08:00

Once you have receive an entirely new smile from your Houston cosmetic dentist, remember that it is going to take some time for you to get used to your new bite. Believe it or not, esthetic dentistry home care is simple. It is not about doing something difficult or laborious—it’s simply about doing a few basic things consistently. This will make your new adjustment comfortable for you, and it will ensure the success of your new smile.

Anytime your bit is altered by esthetic dentistry, the position of your teeth change. This causes them to feel different for a few days. The brain will need some time to get used to the changes. If you detect noticeable irregularities in your bite, call us to schedule another adjustment.

Otherwise, expect your teeth to be somewhat sensitive to cold, heat, and pressure for a short period of time. This is because tooth structure must be removed to place restoration materials on your teeth. After several days, this sensitivity should go away. If it does not, call us for another appointment.

You may also notice that your gums appear a bit swollen, and they may feel sore for a few days after esthetic dentistry. The best way to handle this is to rinse three times daily with warm salt water. Use one teaspoon of salt in one cup of water. This should be all it takes to relieve the pain and swelling.

If salt water is not enough, then talk to your dentist about over-the-counter pain medication. This should be enough to dispel the rest of the pain.

You might notice that your speech is affected after an esthetic dentistry treatment. Do not be alarmed, because this is normal. You will find that you will soon be speaking normally again. Salivation may also be affected. Again, this is simply a matter of the brain needing some time to adjust. Within a week, excessive saliva should be gone.

If you play sports, ask your dentist to make you a custom mouthguard to protect your new smile.

Keep in mind that anything you chew on or eat that can damage or crack natural teeth will also damage cosmetic teeth restorations. You should avoid sticky candies and hard substances. Avoid popcorn hulls, peanut brittle, ice, and chewing on your nails.

Try to quit smoking if you do. Any esthetic dental work can be undone in a short period of time if you smoke. Cola, berries, strong coffee, teas, and red wines can also stain your new restorations. Brush and rinse thoroughly after drinking them.

In order to ensure the long-term success of esthetic dentistry, remove daily place with brushing and flossing. Also, see us regularly for professional cleanings.

The Many Benefits of Indirect Resin Applications

2010-03-08T00:58:00.000-08:00

An indirect resin is a custom-made, white plastic restoration whose purpose is to bond to a damaged tooth and restore its cosmetic appearance and almost the full amount of its original strength.

One of the biggest advantages offered by an indirect resin is its ability to preserve much more of the original structure of a tooth compared to that of an ordinary filling.

The origin of the term “indirect resin” lies in the tact that this restoration must be manufactured in a dental laboratory instead of it being applied directly to your mouth. The laboratory must first harden the dental restoration through a special process. This involves curing the material with specific amounts of heat and pressure in order to make it much, much more durable.

The actual material used to make an indirect resin is made from either a special type of plastic or plastic material, mixed with glass. This material is tooth colored by nature, and is available in a variety of shades that allows us to closely match its color to the color of your existing, natural teeth.

In order to restore a tooth with an indirect resin, it takes multiple appointments. This first appointment focuses on removing decayed, damaged, or weakened portions of a tooth. We also have to remove old dental fillings if they are still present. We make this procedure very comfortable for you by numbing the around the tooth so that you will not feel pain while we are working.

We next take an impression of your teeth in order to create a working model of your mouth. The lab needs this model so it can accurately manufacture your indirect resin according to the parameters of both your existing teeth and the teeth we have prepared for treatment. By making a model of your entire mouth, we are able to restore the tooth both medically and cosmetically. By treating the tooth as one of many that exist in relationship to one another, we can better correct your natural bit.

We then send this model off to the lab. In the meantime, we must place a temporary restoration in your tooth in order to preserve the preparatory work we have done and to ensure that no further decay ensues in the meantime.

Meanwhile, at the dental laboratory, the resin material is carefully placed into the model. Your indirect resin is then individually designed and colored to match it to your teeth in as much of a lifelike manner as possible.

When you return to our office the second time, we remove the temporary filling and place a conditioning gel on your tooth in order to get it ready for the new resin filling. We then place the bonding agent in the tooth, and use a special, high-intensity light to bond your indirect resin restoration to the tooth.

After removing all excess cement, we adjust your bite, and then we polish the restoration to a high luster.

It is normal for you to have some sensitivity to hot or cold in the area, but this should soon go away after a few days. If you have any more problems, questions, or concerns, just call our office.

The Purposes and Goals of Esthetic Dentistry

2010-03-05T10:45:00.000-08:00

What is the goal of esthetic dentistry?
The goal of esthetic dentistry is to completely transform your average or damaged smile into an award-winning smile.

What is the value in paying for this service?
If you don’t think you can show your teeth when you smile, you may feel severely limited in personal encounters and professional settings. The debilitating effect this can have on your life can make you shy and withdrawn, even if you are an otherwise outgoing person.

I’m not so vain as to need a perfect smile.
This is not about vanity, nor have we ever billed a single client for perfection.

Esthetic dentistry is all about individual beauty beyond comparison and self confidence that comes from within. There is nothing vain or ego-driven about this. It is about you being your best and no one else’s.

The psychological impact of this service is only part of the equation, though. Real science goes into making something concrete out of a feeling of new confidence and performance.

In order to do this, we have to carefully examine every aspect of your smile and determine which. esthetic dentistry treatments must be implemented to correct the challenges that confront you.

What are some examples of what you can do to restore my teeth?
A few examples of the many esthetic dentistry services we offer include, but are not limited, to the following:

Crooked teeth that would otherwise need painful and embarrassing metal braces can now be corrected with painless invisible braces.

Teeth with gaps between them can be corrected with cosmetic dental braces, cosmetic dental bonding, or thin veneers placed on the sides of the teeth to fill in the gaps.

Discolored teeth that need to be whitened can be treated by cosmetic resin or professional teeth cleaning.

If your gums are uneven and extend over the tops of your teeth when you smile, we can use a technique called crown lengthening to make your teeth alone visible when you smile without your gums being visibly embarrassing to you.

If your teeth are too long, or too shore, they can be reshaped with special tools or dental bonding to make their edges smoothly follow the curve of the lower lip.

Esthetic dentistry employs a variety of tools, technology, and techniques that are not always used by general dentists. Many of its benefits are purely cosmetic, but others have real medical value as well. Because of this, practitioners of this highly specialized discipline must pursue credentials in licensing in general dentistry as well as cosmetic dentistry so that every patient gets the maximum benefits that any given procedure can provide.

Can Laser Dental Therapy Fix Gaps Between My Teeth?

2010-03-05T06:43:00.000-08:00

I am 36 yrs old. I had gum disease and gum recession a few years ago. I was treated professionally with antibiotics put inside the periodontal pocket. However, my both upper and lower front teeth now have a big gap between them. This looks unattractive when I smile, and it has affected my confidence deeply.

Does laser gum treatment close the gap between teeth? If not, is there any other option to help to close the gap between them?

Connie

Thanks for the enquiry. Most likely, we will be able to help you out. If you still have periodontal disease that needs to be treated and we can help you with that. As far as the gaps between your teeth that also can be treated depending on what is needed. We would be happy to help you out, please give us a call.

Dale J. Brant, DDS

Charles Campbell, DDS

713.795.5905

888.790.0309

Laminate Veneers

2010-03-03T21:39:00.001-08:00

Laminate Veneers cover and protect teeth. They are an excellent, affordable, and highly practical tooth restoration that can solve any number of dental problems. Teeth that are stained can be whitened by thin veneers. Chipped teeth can be smoothed and made to look whole and attractive once more. Misaligned teeth can be straightened without the need for orthodontics.

In light of the more complex and expensive alternatives, laminate veneers are often the best choice for the patient on a budget who wants a lasting solution without the complications and costs of multiple dental visits or dental surgery.

But what, exactly, is a laminate veneer?

It is actually a very thin sheet of porcelain that is designed to cover the front of the tooth. However, it can also be customized to fit the sides of a tooth in order to close a gap. Sometimes as well, a very small piece of laminate can be affixed to the end of a small tooth to increase its length. In some cases, misshapen teeth can be repaired this way as well by applying a smooth, thin veneer to their surface to cover up the asymmetry of the tooth.

The procedure itself is very simple and requires only two visits to the dentist. The first thing the dentist does is to examine your teeth and take x-rays of them. This lets the dentist know if any serious tooth decay or damage lies hidden inside the mouth that may require other corrective treatments or dental procedures.

If nothing is found, the next step is to prepare tooth surfaces in order to make the laminate veneers fit to form without looking thick or bulky. While this does involve removing a small amount of tooth surface, so little is removed that the majority of people do not need an anesthetic.

After the teeth have been prepared, the dentist next takes impressions of your teeth and makes a mold of your bit. This mold is then sent to a lab. Here, dental technicians will make your thin veneers custom-fitted to the exact dimensions of your teeth.

When your laminates arrive back in our office, we call you in to place them on your teeth to make sure they fit. After this, we bond them to the teeth and use a special, high-intensity to harden the cement.

Your bite will then be tested, and any minor adjustments that need to be made will be made. Thin veneers are extremely strong. With the right care, you can expect them to last anywhere from 10 to 15 years. Some even last longer.

It is important that you continue to practice brushing and flossing as always. Although your veneers are tougher than tooth enamel, take care of them as you would your natural teeth.

How Emergency Sports Dentistry Re-Implanted a Cheerleader's Teeth

2010-03-02T16:06:00.000-08:00

Consequently, we provide them with all sports dentistry services pertinent to the needs of their athletes. In particular, we make custom, protective mouthguards for football players. However, there are many other components to sports dentistry that we also provide to people associated with Rice Athletics.

One of the most important elements of our sports dentistry program is the effective management of emergency situations.

One story in particular comes to mind in regards to how vital this service is.

One afternoon 8 years ago, we received a contact from the trainer at Rice University. He explained that he would be brining one of the cheerleaders to our office for a dental emergency. This young lady was a “flyer” in their gymnastics routines. During the course of a practice session, she took a hard fall to the ground and knocked out several of her teeth.

In these situations, in order for emergency sports dentistry treatment to have any chance of saving the teeth, we have to see to it that several critical things are done:

The teeth need to be kept clean and moist. This can be done by the patient holding them in his or her mouth, or it can be done by immersing the teeth in a sanitary container filled with a saline water solution.
If teeth are exposed to open air out of the mouth for more than 30 minutes, the chances of re-implanting them slip away quickly
In most cases, immediate root canal procedures have to be performed.
After this, the teeth must be re-implanted and stabilized.

The cheerleader who came to us had a total of five front teeth knocked out. Some were upper teeth, and some were lower teeth. The trainer had been informed to keep the teeth moist and clean as noted above. We were able to get these back into her mouth before that critical 30 minutes was up.

Over the course of the next year, the management of these teeth was very successful overall. Only one was lost, and it was replaced by a dental implant.

Over the past 8 years later, the remaining four teeth have remained viable and stable. This lady is still a patient of ours since her graduation because of the treatment she received under our sports dentistry relationship with Rice University.

These same services are available to other universities, colleges, and school districts interested in protecting the safety and maximizing the performance of their athletes.

Tooth Bonding

2010-03-01T22:55:00.000-08:00

What is tooth bonding?
It is a cosmetic dental service used to repair the structure and appearance of damaged teeth. It can fix decay, chips, cracks, gaps, oddly shaped teeth, and teeth that are too long or too short. Sometimes it can even be used to whiten teeth that are stained. It is also the best way to replace lost dental fillings.

How many types of tooth bonding procedures?
There are two types of bonding. The type that you need will depend on your situation. It will depend on how small or how large of a correction you are going to require.

How long does the process take at the dentist's office?
Tooth bonding can be done in a single visit if all we need to do is replace fillings. When we do more complicated procedures, we may need more than one visit.

For small corrections like replacement fillings or repairs to surface damage can be done in one office visit.

These are one appointment fillings which are color-matched to the tooth and are bonded to the surface for added strength. These are most appropriate for small fillings and front fillings as they may not be as durable for large fillings.

For larger corrections that require dental lab work, we will need to make two appointments. This often happens when bonding is used in conjunction with a procedure like a post and core, or as filling beneath a cosmetic dental crown that has to be custom manufactured and placed

How is tooth bonding done?
A special composite resin is used to improve the condition or color of teeth. The process begins with the application of a special conditioning gel. This gel etches the tooth enamel so it will be easier for the resign to bond with its surface.

The composite is then applied and sculpted into the desired shape. The color of the resin will have been pre-mixed to match the color of healthy, natural teeth. The amount of resin applied depends upon the degree of damage we have to repair.

After we have finished the application and sculpting of the tooth bonding resin, we then harden it with a special high intensity light.

Who is a candidate for tooth bonding?
Anyone with small gaps between their teeth, chips in their teeth, or cracked teeth can benefit from cosmetic bonding. This restoration procedure is also very effective for patients who have discolored teeth, teeth of varying lengths, tooth decay, and even gum recession.

Tooth bonding is very strong and will last for a good long time, improving your teeth’s appearance and functionality. However, if you smoke, keep in mind that cosmetic dental resin is porous and can be stained by cigarette smoke very easily.

Houston Dental Implants

2010-03-01T05:07:00.000-08:00

I am very interested in the dental implants. I have had some work done on my mouth but would like for my teeth to be more natural. I also had gum surgery about 7 months ago, so I would really appreciate your opinion on whether or not I could be a candidate for implants.
Carolyn

Hello, Carolyn.

Most patients that are missing one or more teeth can benefit by the placement of dental implants. It is very dependent on how much bone you have remaining, but we have different sizes of implants to fit different width of residual bone support.

We will contact you and try to answer some of your questions by phone, but the best way for you to learn what your options are is to make an appointment for an implant consultation and come into the office. We will take photos and necessary x-rays and show you what is appropriate for your situation.

Thanks for the inquiry…

Chuck Campbell, DDS
Dale Brant, DDS
713-795-5905

How a custom mouthgaurd and splint therapy helped a rice university football player overcome concussions and pain to get back in the game.

2010-02-24T15:18:00.000-08:00

Sports Dentistry is a vital element of player safety and health. The Houston Medical Center Dental Group works in Partnership with Rice University to meet the dental needs of all the players on the Rice Football Team. We provide the full range of sports dental services to ensure the maximum possible safety of each player, thereby improving team spirit and furthering the pursuit of excellence and accomplishment.

These same services are available to other universities, colleges, and school districts interested in protecting the safety and maximizing the performance of their football team.

A recent case study from Rice illustrates how our combination of advanced sports dentistry and our knowledge of cosmetic dentistry solutions was able to help a wide receiver overcome constant pain and get back in the game.

Who was the patient?
He was a wide receiver for the Rice Football Team.

What brought the patient to the office?
Concussions and pain are what started the process. The knowledgeable trainers at Rice referred him to our office.

What were the specific problems that the player was facing?
The first problem he had was several concussions he had received over the years. Players, trainers, and coaches on the Rice Football Team were concerned that this could cause him additional problems if it wasn’t addressed.

The other problem that plagued him was temporal mandibular joint (TMJ) problems. These problems had surfaced over the years of playing football and they caused him to suffer a lot of pain. In particular, he had severe pain in his right TMJ.

What tests did you perform on the player?
We did a series of tests on his head to see the extent of previous concussions. We also did an analysis on his neck and a full set of X-rays.

What was the first thing you did for him?
The first thing we did for him was make him a custom mouthguard. We also performed splint therapy in order to help him with his discomfort and headaches. Thanks to the custom mouthguard, the player, to our knowledge, suffered no additional issues with concussions after that.

He will have to continue with splint therapy in order to control the condition of his right TMJ.

How did the procedure or device you issued the player improve player safety and performance?
The Rice Football Team trainers thought that the custom football guard helped prevent further concussions and the TMJ splint allowed him to have a pain free life.

In fact, the mouthguard worked so well that the Rice Football trainer asked us to make mouthguards for the entire team. We do this every August before the season starts.

Dental Insurance Question

2010-02-24T14:23:00.000-08:00

I need both upper and lower arches replaced. I also need extractions. I have MetLife dental insurance & phcs health thru my husband’s work.
I am 59 years old.
Would I qualify for any discount on the total cost of the procedure?
-Mary

Thanks for the note, Mary –

We will have to see you, take x-rays, take photos, etc. in order to answer your questions fairly. The cost will depend on how many teeth need to be taken out (we will look to see if in fact they all need to be taken out and give you options), and also the difficulty of the dentures. If you would like to have IV sedation, that is a separate cost that you can consider.

If indeed you need these teeth extracted, we will probably be making immediate dentures (made ahead of time and placed at the same time the teeth are taken out). We can also teach you about the possibility of dental implants if you are interested in those also.

Please call our office and make a denture consult appointment. You can speak with Mary, Debbie, or Maria. If you will give me your phone now, I can have one of those ladies call you and answer any further questions you might have. They can give you information related to your insurance and likely coverage.

Chuck Campbell, DDS

Dale J. Brant, DDS

How to Find a Good Oral Surgeon

2010-02-23T04:13:00.000-08:00

Is it easy to find a good oral surgeon?
It is not as easy as finding a general dentist. Oral surgeons are specialists that undergo advanced training and have to complete special residency and licensing requirements to perform the most complex of dental procedures and be qualified to use the most advanced of dental technology.

You must not only find a good oral surgeon, but you must research his or her credentials and references thoroughly.

What is the best way to find a good oral surgeon and to research his or her qualifications?
Begin by talking to your family doctor. Your doctor may be able to recommend a dentist who specializes in surgical work that is beyond the scope of general dentistry.

If not, then talk to people you know such as family, friends, coworkers, and a local area pharmacist. If any of them have gone to an oral surgeon, ask for candid feedback on the experience they had and the results of their treatment.

One excellent source may also be your insurance company. Most insurance companies have a list of dentists in your area.

Use the Internet as well. Some websites you find, though, may not have as much detailed content as ours and may only offer general information and standard contact information. Feel free to contact anyone who peaks your curiosity and ask questions directly.

However, we encourage you to check for references, both on ourselves, and on other dentists you may encounter in your search. If you want references on our professionals, ask and we will provide you with them.

What should make me feel good about an oral surgeon?
You want someone with a combination of advanced medical skill and expertise who is also compassionate and gentle with his patients. Avoid going to someone brand new at this business. Also, avoid anyone that makes you feel diminished or insults your intelligence or has a harsh personality.

We are not saying this to point fingers at any individuals here in our community, but to simply point out that there are such things as inexperienced oral surgeons and oral surgeons who are simply not nice people.

You have to draw your own conclusions about both at the end of the day.

Will a good oral surgeon be bothered by me asking for all this reassurance of reputation and experience?
No. People with integrity, experience, and healthy self-esteem do not hide things or engage in defensive posturing when patient’s whose lives they will be affecting ask realistic questions pertaining to their health and general welfare.

Good oral surgeons understand the importance of calming down anxiety that so many people have toward dental services and will not hesitate to answer your questions to do so.

That is why we have this blog called ASK THE DENTIST. We want you to ask us whatever is on your mind.

Oral Surgeons

2010-02-23T02:19:00.000-08:00

What is an Oral Surgeon?
Oral surgeons are dental specialists that must be certified by the American Board of Oral and Maxillofacial Surgery. He or she must have attended an accredited dental school and be licensed in the state he or she practices Maxillofacial Surgery. In addition to this, the oral surgeon must have also trained for four years or more in an accredited maxillofacial surgery residency at a hospital.

Why would I need to worry about an oral surgeon if all I need is cosmetic dental work?
Many cosmetic dental services depend heavily the structural integrity of bones and teeth. If these things have been damaged by trauma or disease, they must be repaired first before cosmetic tooth restorations can be effectively applied.

What types of procedures are performed by oral surgeons?
They remove wisdom teeth, treat TMJ, remove tumors and cysts, and replace missing teeth with dental implants. They can also do full mouth reconstruction where severe mouth trauma has resulted from an accident or blow to the head. Oral surgeons diagnose injuries and diseases of the mouth, jaw, neck, gums, and teeth.

I am afraid of oral surgery. What do I do?
Ask us about sedation dentistry. We have both oral and intravenous sedation programs that will make even the scariest procedures comfortable and painless.

Are oral surgeons trained in anesthesia?
Yes. However, we bring in an anesthesiologist for any type of anesthesia that is delivered intravenously. We prefer to have an his expertise focused exclusively on effectively monitoring the patient’s appropriate state while we focus our expertise on whatever general or cosmetic dentistry services we are performing.

What are several things to consider when selecting an oral surgeon?
You need to think about both training and clinical experience. How much coursework did your dentist receive in the particular procedures that he or she is recommending? Also, for how many years has he or she actually performed those procedures? Your dentist should be willing to provide you with as much information regarding this as possible.

It is also a good idea to know what professional dental societies your oral surgeon belongs to. Find out where he or she has received his or her credentials, and find out what awards or honors he or she has received.

Finally, continuing education should be the priority of every serious medical professional. None of us should ever stop learning. The American Dental Association, in fact, requires that oral surgeons regularly update their training with ongoing coursework on the latest technology and procedures in our field.

What else should I talk to my oral surgeon about?
Since most cosmetic dental procedures vary widely in cost due to differences in individuals and the severity of each individual case, you need to talk to you dentist about insurance and out of pocket costs for the procedures he or she recommends. You also need to talk to your insurance company and find out what is covered and what is not covered. If something we offer you is not covered by your plan, we have financing programs you can apply for.

Be sure to get a clear picture too on how to handle dental emergencies.

Ask the Dentist: Cosmetic Teeth Whitening

2010-02-22T23:31:00.000-08:00

What is tooth whitening?
Tooth whitening is an excellent way to restore the natural whiteness of stained teeth. Teeth whitening is safe and will produce results that can last anywhere from six months to over a year, depending on how willing you are to make appropriate dietary and lifestyle changes.

How Are Teeth Whitened?
The outer layer of your teeth is called the enamel. It is actually semi-translucent, or clear. Beneath the enamel is the dentin layer, which is most commonly yellow, although sometimes it can be gray, brown, or black.

When the dentin darkens, it shows through the enamel as discoloration. We have to use a peroxide solution that will penetrate the pores of the enamel down to the dentin. This will lighten the dentin and create whiter looking teeth.

How long does the entire procedure take?
The way we do cosmetic teeth whitening, it takes two appointments spaced between three and four weeks. During your first visit, we clean your teeth and apply the initial application of tooth bleaching gel. We harden this with a special high intensity light and take impressions of your teeth. Using these impressions, we make teeth whitening trays that you can take home with you.

For the next two weeks to one month, for 30 minutes or so each night, you will apply a special take-home version of our teeth whitening gel (made with a different kind of peroxide) and apply it for 30 minutes to 1 hour at a time.

When you return, we apply a final coating of gel and seal it with the high intensity light.

How much does tooth whitening cost?
This depends on the condition of your teeth. Some cosmetic dentists in Houston are more expensive than we are because they do tooth bleaching in a single office visit using a laser. We do not use the laser because it creates hypersensitivity in the teeth, and because the high intensity light achieves the same results as does the laser.

How long will my teeth stay whitened?
If you take really good care of them, they can stay white for as long as three years. On the average, however, we are looking at a little over a year with a person who eats a normal diet and does not drink a lot of coffee.

However, if you drink a lot of coffee and smoke cigarettes, you are re-staining your teeth and will need this treatment again in 4 to 6 months. It is therefore all up to you how you want this to work and how long you want this to last.

Are there occasions when tooth whitening might not work?
If you have porcelain onlays or cosmetic dental veneers, cosmetic tooth bleaching will not work on them because it is effective only on natural teeth. The same goes for dentures and crowns.

What is the most important consideration when it comes to whitening teeth?
You need to maintain a sense of realism. If your teeth are very badly stained, it may take several treatments to achieve a whiter smile. Also, remember that anything you eat, drink, or smoke after the treatment will have some kind of effect on the results. Dental hygiene is a must if you are going to retain a healthy, attractive smile.

Ask the Dentist: Cost of Getting Dentures

2010-02-22T08:58:00.000-08:00

I am looking to get dentures and I would like to know what it will cost. I am pretty sure all my other teeth will have to be pulled out. I want to know what the cost is without insurance.
Sheila

Thanks for the note, Sheila –

We will have to see you, take x-rays, take photos, etc. in order to answer your questions fairly. The cost will depend on how many teeth need to be taken out (we will look to see if in fact they all need to be taken out and give you options), and also the difficulty of the dentures. If you would like to have IV sedation, that is a separate cost that you can consider.

If indeed you need these teeth extracted, we will probably be making immediate dentures (made ahead of time and placed at the same time the teeth are taken out). We can also teach you about the possibility of dental implants if you are interested in those also.

Please call our office and make a denture consult appointment. You can speak with Mary, Debbie, or Maria. If you will give me your phone now, I can have one of those ladies call you and answer any further questions you might have.

Chuck Campbell, DDS
Dale J. Brant, DDS

Tooth Bleaching FAQ

2010-02-21T23:45:00.000-08:00

What is tooth bleaching?
It is a chemical process that dentists use to whiten teeth. It can be performed entirely in one visit, or it can be performed in two visits. The procedure may vary based upon the condition of the teeth. Your dentist may first perform a tooth cleaning before bleaching them. A special whitening gel is used for this process and is activated by a special light when the process is complete.

Why do teeth stain in the first place?
Anything including prescription medication, coffee, tea, and cigarettes can stain your teeth. You may also have a genetic predisposition to staining, or it can simply be the results of aging.

How is it done?
Tooth bleaching can be done with over the counter products. We do not recommend these products as a general rule. Their quality of their contents can vary. The gel may be of a low viscosity that allows the gel to leak onto the gums and cause irritation. If the tray fits poorly, you may also swallow some of the whitening gel. Without a dentist to supervise the process, you may traumatize your gums if the trays do not fit properly.
It is much better to have cosmetic tooth bleaching performed by a licensed cosmetic dentist. Your dentist will make molds of your teeth that precisely match your bite and use a gel that is much more suitable to whitening your teeth. You will wear these molds every night as prescribed by your dentist, then return to our office for the final application of tooth bleaching product and hardening of it with a laser light.

Are there side effects to cosmetic tooth bleaching?
Like we mentioned, the use of over-the-counter products can damage your gums if the trays to not fit you well. You really need to protect your gums during this process because damaging them can lead to other complications like gum recession or gum disease.

In a professional setting, tooth bleaching should only cause some temporary sensitivity in the teeth themselves. You may feel sensitivity to temperature, pressure, and touch. It is nothing to be alarmed about.

Is the tooth bleach that is used by cosmetic dentists different than the bleach used in home whitening kits?
Yes. The bleach we use of in-office whitening has a much higher hydrogen peroxide concentration than that which is found in over-the-counter kits. This concentration may range as low as 9 percent to as high as 40 percent depending on how badly your teeth are stained.

The tooth bleaching material used in at-home tooth whitening is a carbamide peroxide that becomes hydrogen peroxide after it breaks down.

How long do the results of tooth bleaching last?
The new white color of your teeth should last for about six months to a year. Sometimes it lasts longer. Of course, if you do not change your dietary, coffee drinking and smoking habits the results will probably not last more than six months at best.

Change is required to get the best results. Repeat therapy is needed if no significant lifestyle change is made on your part. The choice is yours.

Some Cosmetic Alternatives to Dental Crowns

2010-02-19T22:21:00.000-08:00

Should a dental crown ever be used as a means to improve the appearance of a tooth?
We do not recommend using a dental crown simply to restore the appearance of a tooth. While it is true that a crown does look like a natural tooth, an alternative to a dental crown should be used if only cosmetic improvements to the tooth are called for.

The reason for this is due to the fact that dentists have to reshape a tooth before crowning it. This involves grinding a portion of the tooth away. Many times, a significant amount of tooth mass must be removed in order to make the tooth suitable for crowning. This defeats the purpose of tooth repair in a way, because it is actually taking away a portion of the tooth only to make it look better.

If you simply want to improve the appearance of your teeth, there are alternatives to dental crowns that can be just as effective in upgrading their cosmetic appearance. Some examples of these alternatives to crowns include porcelain veneer, dental bonding, or professional teeth whitening services.

Could you describe briefly what each of these cosmetic dental restorations do? Yes.
Porcelain veneers are thin ceramic sheets that we bond to your front teeth. They do an excellent job of covering pits and discoloration in the tooth enamel.
Dental bonding can be used to treat teeth that have suffered minor decay or have been damaged by small cracks.
Professional tooth whitening is used to restore the color of stained teeth. This procedure is excellent for those who have smoked or drank a lot of coffee over the years and watched their teeth grow yellow.

Is a dental filling a good alternative to placing a dental crown?
We do not recommend using the traditional silver-mercury amalgam fillings. They are not biofriendly per se, and they will fall out after several years.

Small cavities can be filled with dental bonding. The determining factor here is the remaining amount of original tooth mass that exists after decay is removed. The tooth must be able to withstand normal chewing and biting.

Should I have the tooth extracted?
No. Removing a tooth will cause problems for surrounding teeth, which need it for support. Dental implants are the ideal cosmetic and functional solution for teeth that have been lost or that are too far gone to save, but they are not recommended options for those who simply want to improve the appearance of one or two teeth in the front of their mouth.

So when do I need a dental crown?
If the tooth is actually damaged and can no longer function as an implement of biting and chewing, or if decay threatens the root and a root canal has to be performed, that is when we crown the tooth to both seal it against future infection and improve its cosmetic virtue.

Restoring a Large Cavity

2010-02-19T14:31:00.000-08:00

When a tooth loses a large filling, the best way of restoring a large filling is to place a permanent crown over the tooth. Because the large cavity has already destroyed so much of the tooth, a filling alone will not be enough, generally, to give the tooth protection and strength.

Why is a filling not enough?
We are not saying it is not enough. Because we use cosmetic dental bonding resin, much can be done to fill in the cavity with a biofriendly material that is much better than silver mercury amalgam. However, there is a need to reshape the tooth and remove any decay that formed around the old cavity, and this is where we run into problems.

So much tooth matter gets lost in the cleaning and reshaping process that restoring a large cavity with even the best dental bonding resin may still not be enough. You see, the tooth must be able to handle normal biting and chewing pressure, and if only a thin shell of its outer surface has survived the decay and loss of a filling, there is no way we can provide this type of strength with a new filling alone.

The best course of action is to crown the tooth with a cosmetic tooth restoration of some kind. Normally, this is a porcelain crown.

What does the crown do for the tooth, then?
The crown first and foremost covers the tooth so that food debris cannot attach to its surface. This denies bacteria the opportunity to grow and form plaque. A crown’s hard surface can chew food like a normal tooth, and you can brush and floss it just like you can any other tooth.

The one thing you do have to be mindful of is the space between the edge of the ground and the gum. This is a very tiny space, but it is also a very dangerous space to ignore. It has to be brushed and flossed with extra care in order to keep bacteria from getting underneath the crown and attacking the tooth again.

How do you determine if a crown is the best way of restoring a large cavity?
We simply look at how big the cavity is and how much of your tooth is still standing. If it is clear to us that the tooth is not going to survive on its own, then it needs to be crowned.

We don’t just use guesswork or visual examination alone to determine this. We have all sorts of sophisticated equipment here at our office that can tell us the precise condition of your tooth and what it needs to be restored.

Homecare for Permanent Dental Crowns

2010-02-18T20:53:00.000-08:00

Is a permanent crown the best way to repair a tooth?
Short of a full dental implant, in most cases it is. You need to take care of it, however.

Will I see or feel a difference with the permanent crown?
Yes. The most noticeable thing will be that your permanent crown appears to be as natural as the surrounding teeth you have always had. It will also feel comfortable as well.

When should I call you office if necessary?

· Your bite feels uneven
· Your tooth with the permanent crown feels tight
· You have difficulty flossing around your crowned tooth
· You feel constant pain

Should a period of adjustment be expected?
After you receive a permanent crown, you will more than likely need a few days to adjust. It may feel a bit different when you bite down. Your mouth is simply getting used to things.

Is it normal for the crowned tooth to feel sensitive?
Yes. Temperature sensitivity is perfectly normal after getting a personal crown. During the healing process you may notice this from time to time, but it is nothing to be alarmed about.

What should I be especially mindful of in the homecare of my permanent crown?
If we have used an anesthetic, wait until the numbness wears off before chewing. Do not chew ice, hard candy, or chew on foreign objects like pencils or pens.

Do I brush my teeth as always?
Yes. In fact, home care for a permanent crown begins with proper brushing and flossing. You need to focus on keeping the edge of the crown along the gumline clean. This is because the tooth underneath the crown is still vulnerable to decay. You also need to watch your intake of sugar-containing foods.

What about medication?
If you were given any medication, take it as prescribed. If you want to take over the counter pain medication, please discuss it with us first. Normally there is no problem with over the counter pain medication, but we do need to consider personal, medical history.

If I can’t take, or do not want to take, pain medication, what else will stop discomfort?
It will help you reduce swelling in your mouth if you rinse out your mouth with warm salt water. You only need about one teaspoon of salt per glass of warm water. It is normal for your gums to be sore for several days, so if you rinse three times a day, this should reduce swelling and discomfort.

What if I follow all the home care steps for a permanent crown and none of them work?
If your pain continues, or if your bite feels uneven, call our office and share your concerns. We will either guide you over the phone or bring you in for a priority appointment.

Does Bone Grow Back After LANAP

2010-02-18T19:15:00.000-08:00

I am interested in LANAP. Will the bone grow back after this procedure.
-Deborah McCown

Thanks for your enquiry. LANAP procedure creates an environment for your body to re-grow bone in areas that you have lost it. There are several things that are necessary for this to happen. First of all, a strict protocol has to be followed by the dentist when they are treating you and by the patient (home care and post operative care). Also, a sufficient amount of tissue volume needs to be present in order for the bone to regenerate. If you have had gingival recession and bone loss bone will not grow back in these areas. The most important thing that you have to understand is that the LNAP procedure gets rid of the periodontal disease and this is the most important thing. Yes, bone can and will sometimes grow in areas that you have lost it, but the disease has been eliminated.

Dale J. Brant, DDS
Charles Campbell, DDS

Replacing a Failed Filling

2010-02-16T23:15:00.001-08:00

Many times, when we encounter a filling fails, we recommend restoring that failed filling with a dental crown. This is the often best way to protect a tooth. A filling is not going to protect and strengthen a tooth as much as a crown will.
Can you replace a filling with something else?
We can replace a filling with another filling. However, the constant refilling of teeth can weaken them. This is because more tooth structure must be removed each time a tooth is filled. The larger the filling is; the weaker your tooth becomes, and the more vulnerable it will be to cracking or breaking off.

Can’t you use composite dental resin?
Yes, but keep in mind that a very large hole in your tooth may need more than cosmetic dental resin can fix.

How do you know when replacing a failed filling can only be done with a crown?
If there is sufficient tooth mass to support normal biting and chewing, and if we do not have to remove a great deal of this to refill the tooth, we will use cosmetic dental resin. However, like we have already said, the danger here is no matter how good the resin does the trick, there will be insufficient tooth mass remaining to support normal biting and chewing.

In order to determine if we need to replace the filling with resin, or replace the filling with a crown, we have to thoroughly examine the tooth and make and accurate assessment of its current viability. A tooth that is clearly not going to make it with a new filling alone is going to need to be crowned.

This is not to say that cosmetic resin may not be used for a procedure such as a core buildup, but the exterior or the tooth will still be crowned to protect what is left of its enamel and dentin.

What other benefits does replacing a failed filling with a dental crown offer?
It seals the tooth. It keeps out plaque and bacteria. It also enhances cosmetic appeal by restoring the shape and the strength of the tooth.

What types of crowns do you use?
There are gold crowns still in use that many people like because they are very easy on opposing teeth (due to the softness of gold itself). There are also porcelain-fused-to-metal crowns which are very strong, but which are beginning to be phased out for newer forms of all porcelain crowns that look nearly identical to tooth enamel and are so hard they can handle all the normal pressures of daily chewing and biting without breaking or cracking.

How long does it take to replace a filling?
Normally, it takes two appointments to restore your tooth with a crown. During the first appointment, we have to remove what is left of the old filling and any decay that may have ensued since its failure. We also have to take impressions of your teeth to send to the dental lab that will make your new dental crown.

When the crown is ready, we will call you back to our office and fit your tooth with the crown.

What We can Do About Cracked Tooth Syndrome

2010-02-15T02:29:00.000-08:00

Why causes cracked tooth syndrome?
Teeth can crack for many reasons. They take a lot of pressure from biting and chewing each and every day. As they age, they lose much of their original strength. They can also be weakened by clenching and grinding.

Your teeth can also become weaker when they lose structure. This can happen with large fillings or from root canals. If you chew on ice, candy, popcorn kernels, or foreign objects, you can crack your teeth.

If you are in an accident or suffer an injury, this can crack your teeth too.

Does this occur in one place more than another?
Cracked tooth syndrome is more common in molars, usually lower molars, which take the brunt of chewing pressure.

Are some of us more prone to this condition than others?
Yes. If you have Bruxism, you are much more susceptible to cracked tooth syndrome. Also, if you have one cracked tooth, you probably have more than one. If you have been in an accident involving a blow to the mouth, you are vulnerable to your teeth cracking in the future.

Will I know right away if I crack a tooth?
No. You may have cracked tooth syndrome for several months and not have consistent symptoms.

What are the symptoms of cracked tooth syndrome?
One side of your mouth becomes uncomfortable to chew on.
Your teeth are sensitive to hot and cold.
You feel a sharp pain when you bite down.
Your pain is intermittent.

This intermittent pain is caused when the tooth flexes and microscopically stimulates the nerve in the tooth. Hairline cracks open and close. This is enough to put pressure on the tubules that run down the nerve. This, in turn, causes fluid to push and pull on the tooth’s nerve and cause pain. The nerve also becomes exposed to bacteria that are toxic, and this can make it inflamed enough to become very sensitive and for infection to spread to the nerve and bone tissue beneath the root.

If this happens, you are looking at a possible abscess. Part of the tooth can break off at this point, and a root canal will be needed to save it, or extraction will be the only other option.

How do you diagnose cracked tooth syndrome?
We run a series of tests on your mouth and teeth. Because many of these fractures are invisible to the naked eye, our examination will often include x-rays. Sometimes, though, even x-rays do not reveal a crack. We also have to analyze your bite to find small fractures.

After a thorough examination, and after we have located the fractures in your teeth, we then discuss treatment options with you. Treatment will depend on the location and direction of the crack. It also depends on how badly it has damaged your tooth.

If we find that the crack only affects your tooth enamel, we may just remove the affected portion and restore the tooth with a cosmetic dental onlay to stabilize it. Or, we may crown the tooth to protect it against future possible damage.
If we find, however, that the crack affects the underlying dentin or pulp layers of your tooth, we perform a root canal before placing a crown over the tooth.

Root Canal Crowns Cover Strengthen, and Protect Teeth

2010-02-14T04:14:00.000-08:00

How does root canal therapy affect a tooth?
A root canal will leave a tooth brittle and weak. We recommend a root canal crown that will strengthen, cover, and protect the tooth.

This is needed because the inner pulp layer of the tooth is where all the nerves and blood vessels are located. Much of the tooth’s blood supply is lost when we have to remove the infected tooth pulp during the root canal. There is also less support for the tooth because the center has been removed, and only the sides remain.

Your tooth is more likely to break when you bite down on food. Even when you are eating a normal diet, the pressure of biting and chewing place a tremendous amount of force on teeth. Already in weakened, state, brittle teeth are more likely to crack and break if they are not protected by a root canal crown.

What types of root canal crowns do you use?
We can make crowns out of gold, porcelain-fused-to-metal, and all porcelain. All porcelain crowns are the most popular because they look nearly identical to natural teeth.

Which teeth should receive a crown when root canal therapy is done?
Most root canal crowns are placed on back teeth. Some front teeth can be treated by a filling. This are general principles, however, not hard-fast guidelines.

Can a root canal and a crown placed on top be done during the same visit?
No. It can take a minimum of three visits to our office to finish a root canal and then later crown the tooth. There are normally many steps to this process, listed below, which illustrate why this process takes some time.

1. We first go through the crown of the tooth to access the infected pulp chamber.
2. We removed the tooth pulp.
3. We then clean, enlarge, and shape the root canals so they will accept the filling material.
4. If harmful bacteria are present, we will treat the root canal with medication.
5. Many times we place a temporary filling in the tooth we wait for the infection to clear up.
6. When you return to our office, we remove the temporary filling and the root canals are filled with permanent filling.
7. We take impression of your teeth, and we have a dental lab custom make a crown for your tooth.
8. When your crown is ready, we then shape and polish it.

How long do crowns last?
Crowns can last a very long time, depending on how well their owners treat them. Remember that a crown Closeup of crown covers a living tooth. This means that the tooth is still susceptible to decay. Plaque can form at the bottom of the crown and decay can work its way under the crown. Gum disease can just worsen this problem. The way to keep your crown as long as possible is to brush and floss the crown's base carefully. Getting periodic checkups helps make sure the crown, tooth and gum tissue around it stay in good shape, too.

CAD/CAM Restorations

2010-02-13T18:06:00.000-08:00

What is the history of CAD/CAM usage in Dentistry?
CAD/CAM was invented in the mid 1980s, but it was very cumbersome, and something of a luxury that took exorbitant expenses and time to produce results. It could only be used in select dental laboratories. Over time, the advances in computer technology and software made chair side CAD/CAM restorations possible. This new procedure lets dentists create dental prosthetic restorations in a matter of hours.

Many dentists feel it benefits the patient to have everything done in one dental visit. It does away with the need to fit the patient with a temporary crown and have to return for a second visit where the permanent crown is placed.

However, this can make a dental visit very expensive as well. If we were to have a CAD/CAM machine in our office, we would have to charge you more to cover the cost of maintaining it. We prefer to save you some money by doing what we can to lower your dental bills somewhat. We therefore outsource the actual CAD/CAM machining of your cosmetic dental restorations to a partner dental lab. True, you do have to come back for a second visit, but you get the superior results at a more affordable rate than you would if we did everything in-house.

What factors determine the cost?
The cost of CAD/CAM restoration depends on several factors:

· The type of restoration we are creating
· The material we use to create the restoration
· The cosmetic expectations of the dentist
· What your dental insurance is willing to cover and not cover

What type of cosmetic dental work can you do with CAD/CAM technology?
We can build cosmetic dental crowns, dental bridges, and dental implants. CAD/CAM is very useful in doing full mouth restorations that combine advanced dental bridgework with selective use of dental implants as anchor points for bridges.

Will the finished product be strong and cosmetic?
Yes. CAD/CAM restorations are normally all porcelain. They look like natural teeth, and they can withstand normal biting forces just like real teeth do. All-porcelain crowns do not have the metal core of previous generations of crowns, which makes them look practically identical to tooth enamel.

It is also healthier for your gums, because the crown sits just above the gum line with no metal to irritate the tissue.

How does the CAD/CAM restoration process done at the Houston Medical Center Dental Group?
We start by making you feel comfortable. Our standard procedure is to numb the area around your tooth so you will not feel any pain while we work on it. We also place a shield called a rubber dam across the back of your mouth that protects your esophagus and trachea from any dental debris that may fall into your throat during the removal of decay can the reshaping of your tooth surface.

Next, we remove decay and shape the tooth with a dental handpiece. We apply a reflective powder to the tooth and take a digital image of it. These images are then sent to the lab, where the CAD/CAM computer can see the most subtle of tooth surface contours and determine the dimensions of an exact replica of the tooth.

The lab feeds all this data into a milling machine that creates a custom-fitted restoration. When this is sent back to our office, we call you in and make sure you CAD/CAM restoration fits. We color it appropriately to match its appearance to surrounding teeth. We check your bite and make all necessary final adjustments, and then we bond your restoration permanently in place.

What Margin Decay is and What to Do About It

2010-02-13T15:16:00.000-08:00

What is margin decay?
It is tooth decay that begins where the tooth meets the crown. This is one of the hardest places for you to keep free of bacteria and plaque.

Why does it happen?
This can happen for many reasons. A crown does not completely cover the tooth. Bacteria can still affect the small margin of uncovered root surface at the bottom. This usually results from inadequate oral hygiene. Gum inflammation is common when this occurs.

Decay can also occur under the crown itself. Bacteria can enter under the margin and spread over the remainder of the tooth. The key to stopping this is to floss between teeth so all plaque is removed. Using a toothpick gently is a good way to get pieces of food out of crown margins as well.

There are times that decay starts because the cement bond deteriorates and saliva leaks in. This can carry bacteria under the surface of the crown and cause plaque to form on the tooth. This is a challenging situation, because even dental x-rays cannot always see the decay.

Does it need to be treated immediately?
Yes. This is not something you ever want to put off. If you do, the decay will grow under the crown. First, the decay will penetrate the outer layer of the tooth enamel and eat away at the tooth dentin. Bacteria will infect the dentin, which is much softer and more sensitive than tooth enamel. Once the decay completely moves through the dentin into the pulp chamber, the decay will attack the tooth’s root.

At this point you will need a root canal to save the tooth, or the tooth itself will be completely lost. Do not let this happen.

If margin decay occurs at the base of the crown or under the crown, how will I ever know if I have it?
If you feel tooth sensitivity, or if your crown feels lose, call us immediately for an appointment. If nothing appears out of the ordinary, you need to schedule periodic checkups and appointments for dental cleaning with us. Anyone with bridges or crowns needs to have professional checkups performed regularly because some things, like margin decay, can only be detected with a professional examination.

If margin decay is found, how do you treat it?
If the crown is located on the facial or lingual surface and is not extensive, we may can treat the tooth without removing the crown. A simple filling may be all that is necessary.

However, it is only the rare occasion where we are able to do this.

In most cases, we have to remove the crown and work on your tooth. Seldom can we preserve the crown for reuse. We have to have a new one made for you to make sure that any margin for future decay has been completely minimized.