My Blog

By Kyle Bouhana, D.D.S.
June 17, 2021
Category: Dental Procedures
Tags: veneers  
YourNewPorcelainVeneersCanLastandLookGreataLongTime

Dental veneers are a popular way to improve teeth with chips, stains, gaps or other defects. They're typically made of dental porcelain, ceramic-like materials prized for their ability to mimic the texture, color and translucency of natural teeth.

But dental porcelain doesn't come in one form—a dentist can utilize variations of it to better match a patient's need. For example, one patient may need a porcelain with added strength, while another may need one that provides better coverage of underlying discoloration.

The foundational materials for veneer porcelain are glass ceramics. Also used for crowns, glass ceramics have been the preferred choice of dentists for some time to achieve life-like results. In terms of veneers, dental technicians first mix the powdered form of the porcelain with water to create a paste. They then use the paste to build up the body of a veneer layer by layer.

But while the high degree of silica (glass) in this type of porcelain best resembles the translucence of natural teeth, early forms of it lacked strength. This changed in the 1990s when technicians began adding a material called leucite to the ceramic mixture that enhanced its strength and durability.

Today, you'll also find lithium disilicate used, which is twice as strong as leucite and is quite useful when creating thinner veneers. Both of these strength materials can be pressed and milled into shape, which helps achieve a more accurate fit. Along with the underlying glass ceramic, the result is a veneer that's both durable and incredibly life-like.

Although today's porcelain veneers are far superior in durability than earlier forms, they can be damaged when biting down on hard objects. To make sure your veneers last as long as possible, you should avoid biting down directly on hard-skinned fruit, or using your veneered teeth to crack nuts or crunch ice (or any other teeth, for that matter).

But with proper care, today's veneers have exceptional longevity. And, thanks to the superior dental materials that compose them, they'll look great for years.

If you would like more information on dental veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers: Your Smile—Better Than Ever.”

YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.

There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.

Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.

Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.

An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.

But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.

Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).

The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.

So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.

If you would like more information on diabetes and dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants & Diabetes.”

DontEatMotorizedCornontheCobandOtherDentalSafetyTips

We're all tempted occasionally to use our teeth in ways that might risk damage. Hopefully, though, you've never considered anything close to what singer, songwriter and now social media persona Jason Derulo recently tried in a TikTok video—attempting to eat corn on the cob spinning on a power drill. The end result seemed to be a couple of broken front teeth, although many of his followers suspected an elaborate prank.

Prank or not, subjecting your teeth to “motorized corn”—or a host of other less extreme actions or habits—is not a good thing, especially if you have veneers, crowns or other dental work. Although teeth can withstand a lot, they're not invincible.

Here, then, are four things you should do to help ensure your teeth stay healthy, functional and intact.

Clean your teeth daily. Strong teeth are healthy teeth, so you want to do all you can to prevent tooth decay or gum disease. Besides semi-annual dental cleanings, the most important thing you can do is to brush and floss your teeth daily. These hygiene tasks help remove dental plaque, a thin biofilm that is the biggest culprit in dental disease that could weaken teeth and make them more susceptible to injury.

Avoid biting on hard objects. Teeth's primary purpose is to break down food for digestion, not to break open nuts or perform similar tasks. You should also avoid habitual chewing on hard objects like pencils, nails or ice to relieve stress. And, you may need to be careful eating apples or other foods with hard surfaces if you have veneers or composite bonding on your teeth.

Wear a sports mouthguard. If you or a family member are regularly involved with sports like basketball, baseball/softball or football (even informally), you can protect your teeth from facial blows by wearing an athletic mouthguard. Although you can obtain a retail variety in most stores selling sporting goods, a custom-made guard by a dentist offers the best protection and comfort.

Visit your dentist regularly. As mentioned before, semi-annual dental cleanings help remove hidden plaque and tartar and further minimize your risk of disease. Regular dental visits also give us a chance to examine your mouth for any signs of decay or gum disease, and to check on your dental health overall. Optimizing your dental health plays a key part in preventing dental damage.

You should expect an unpleasant outcome involving your teeth with power tools. But a lot less could still damage them: To fully protect your dental health, be sure you practice daily oral care, avoid tooth contact with hard objects and wear a mouthguard for high-risk physical activities.

If you would like more information on caring for your cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “An Introduction to Sports Injuries & Dentistry.”

By Kyle Bouhana, D.D.S.
May 18, 2021
Category: Dental Procedures
Tags: aging  
KnowingHowtheMouthandFaceGrowCanImproveBiteTreatment

Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.

Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.

And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.

Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.

This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.

More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.

Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.

If you would like more information on orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Understanding Aging Makes Beauty Timeless.”

By Kyle Bouhana, D.D.S.
May 08, 2021
Category: Oral Health
Tags: tmj disorders  
WhatWeCanLearnFromThoseWithChronicJawPainandDiscomfort

Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.

But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.

A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.

Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.

Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.

The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.

These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.

If you would like more information on TMD management and treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”





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