Family & Cosmetic Dental Care in a Relaxed Environment.

Exceptional Dentistry Las Vegas and Henderson NV Since 1999.

Dental Implants, Teeth Whitening, Porcelain Veneers, &
Botox Cosmetic.

How do the science of dentistry and stem cells go together?  Stem cells have long been debated in the public forum, usually in regards to cloning an individual or animal, not generally thought of in regard to teeth. This type of science brings up both ethical concerns and advancements in research with clinical applications in a whole host of areas. Stem Cells are  unspecialized cells that have the capacity to replicate themselves as well as the ability to produce highly specific cells needed for different types of tissue formation. These stem cells have been harvested from bone marrow, umbilical cord blood cells, and adipose tissues.

Possible Use Of Stem Cells In Dentistry

Recent research has proven that the tissues that form teeth, (odontogenic tissue) are a viable source of  stem cells ( Mesenchymal stem cells or MSC’s). The research has shown that the very core of the tooth (the dental pulp) especially in third molars and baby teeth, (deciduous teeth) that are getting ready to fall out, are the preferred teeth for stem cells. At this time there are millions of these teeth being surgically removed or falling out on their own every year. The potential of these cells goes untapped as they are simply discarded. These stem calls might have the ability to help individuals suffering from diseases such as, type 1 diabetes, muscular dystrophy, parkinson’s disease, and possibly spinal cord injuries. The stem cells are also being studied to see which type of useful tissues can be grown and used in repair.

In dentistry, these stem cells have not yet been proven to develop new teeth but have given some hope to dentists offering regenerative medicine to their patients. This can include the following:

-Alveolar Bone Regeneration – Allows bone regrowth in areas where bone has been lost. This can give hope to patients who have lost teeth and bone. The ability to receive dental implants can restore lost function and esthetics.

-Periodontal Tissue Regeneration – This can allow the dentist the ability to replace lost diseased tissues with healthy natural tissues thus restoring an individuals periodontal state to a healthy one.

Regenerating lost teeth with stem cells is a very difficult proposition with many hurdles to overcome. These include a unique challenge for researchers because the stem cells must be stimulated to grow the proper mixture of hard tissue, dentin and enamel, while developing into the correct size and shape. The other issue is developing teeth that have proper nerve stimulation and blood supply.

Stem Cells Collection

The silver lining in stem cell use in dentistry might be the fact that  primary teeth, which simply fall out on their own, are a major source of stem cells for future use. So, these can simply be collected and saved when they fall out with little or no discomfort to the patient.  Since you could potentially save your own child’s teeth, there would be virtually no chance of genetic rejection of the cells if needed later in life by them.

At this time there are a few laboratories nationwide that are accredited with the collection and storage of teeth for possible use at a later date. These laboratories include StemSave, BioEden, and Store-A-Tooth.

Stem Cell Conclusion

While still in its infancy, research in stem cells is developing some real promise in the science of dentistry. Teeth have been regenerated in mice and monkeys but humans will take far more work and research. If research is allowed to continue at its current pace, in the decades to come we can see some real changes in how we deal with systemic diseases as well as tooth loss. The diseases that stem cells can potentially cure or place in remission can be truly limitless. These diseases may include, leukemia, cancer, and even possibly diabetes.

Dental implants have evolved over time and become an ideal replacement for a lost tooth or teeth. The long term success rate of dental implants is well over 95%. What once was a product offered to very few has now become a mainstream dental care service available to most.

Options For Dental Implants

Depending on each, unique, individual person, each dental implants case will be personalized. Depending on how many teeth are missing as well as the available quantity and quality of bone present. Below are some of the situations where dental implants can replace lost teeth:

-Loss Of A Single Tooth. At one time, this meant wearing a removable appliance (commonly called a “flipper”) or removing natural tooth structure from surrounding teeth to create a fixed bridge of dental crowns. The flipper tends to be uncomfortable to wear and may affect speech. The 3 unit bridge compromises the support teeth by having them do the work of the lost tooth, and by making them more susceptible to decay. The long term success rate is lowered due to difficulties in cleaning under and around the bridge. A single tooth dental implant, when completed properly, will last a lifetime and function just like a natural tooth.

-Loss Of Multiple Teeth. When missing multiple teeth in a single area, dental implants can be used to form a fixed bridge. The beauty of this arrangement is stability and the ability not to affect the natural teeth in any way.

-Replacing All Teeth. In the past, the only way to restore function was to fabricate a removable denture. With dental implants, dentists have the ability to restore natural function and esthetics.

Complementary Procedures To Dental Implants

There are times when other dental procedures are necessary to successfully complete the placement of dental implants. These include:

-Sinus Lift. When you have a large sinus area that impinges on available bone depth, the sinus lift is a common surgical procedure. Sinus lifts are needed to elevate the sinus membrane and thicken a part of the upper jaw with a bone graft. This helps give  a dental implant enough bone depth to place it properly in the area you need it. Dental implants need a good quantity of bone along with good, dense quality of bone to succeed. The upper jaw is known to have poorer quantity and quality bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

-Bone Grafting. When the bone is not 100% adequate for dental implant placement, dentists are able to add to it by performing a dental bone graft. A bone graft is the placement of bone or bone-like materials in the jaw to to build it up. This gives an excellent platform for dental implants. Modification of the bone in this fashion has been shown to improve both appearance and long term success of dental implants. Typically, dentists try to place implants at least as deeply into bone as the crown or tooth will be above the bone. This is called a 1:1 crown to root ratio. This ratio serves as a guide for bone grafting in most situations.

Can A Dental Implant Fail?

It is quite rare for a dental implant to fail but when it does the dental implant must be removed. Then re evaluated as to why the failure occurred and to see if a new dental implant may be placed. Some of the common reasons for dental implant failure include:

-Failed Integration of Dental Implants - This occurs when the bone does not grow and fuse between the threads of the implant. This fusion of bone to dental implant is called osseointegration. If this does not occur, the dental implants will not function properly,will become uncomfortable, become loose, or come out completely. To reduce this risk, your dental surgeon will evaluate the quality and density of the jaw bone prior to surgery. This will help to only place dental implants in areas where there is a highly predictable success rate. If osseointegration does not take place, the dental implants can be removed, and surgery can be attempted again once the area has fully healed.

-Infection –  This is the most common complication of dental implant surgery. The surrounding bone and gums can get infected during the surgical procedure. This can happen due to non-sterile technique, a contaminated implant, poor healing ability(diabetic, smoker, osteoporosis medications), or pre-existing infection. The most likely time for this to occur would be during the surgical placement of the dental implant into the bone. Implant infection can occur after placement as well. Poor hygiene, too much force placed on the implant, or excess cement can cause the support tissue to breakdown. Implant infection is a condition referred to as peri-implantitis. Peri-implantitis is characterized by inflammation or swelling of the tissues surrounding the implant area. Peri-implantitis can also present as a secondary infection later on is a form of periodontal disease that can lead to inflammation, bone loss and implant failure if not treated quickly and properly. Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the dental implants, an implant infection can occur months or years after surgery.

-Post Surgical Bleeding - Some bleeding following surgery is normal and should be expected for about 1-2 days. Biting gently on a gauze pad placed over the surgery area for 30 minutes should normally stop the bleeding. Excessive bleeding is not normal and you should notify your dentist immediately if you have concerns about your dental implants.

-Damage To Surrounding Tissues - Dental implant complications related with surgical errors affecting adjacent teeth, nerves or sinus are directly correlated with the experience and skills of the dentist or surgeon. An experienced and skilled implant dentist is able to identify potential problems by examining x-rays or CT scan (computer tomography), design the proper surgical plan for ideal location and angle, and execute it successfully without complications. Even with the most skilled implant dentist there is always a possibility of dental implant complications. The complications can be limited by choosing an implant dentist with the skills and experience necessary to handle any complications if they arise.

-Rejection – An extremely rare complication for dental implants but it has been noted in the research literature. The dental implants can sometimes be viewed as a foreign body.

-Unusable Dental Implants – An implant that has successfully integrated with bone, but the area or extreme angle of placement deem it unrestorable.

Dental Implants Conclusion

Dental implants have been the solution for many. They come with risks but with proper treatment planning from a well qualified dentist they can be a successful tooth replacement for a lifetime of smiles.

 

 

There are certain questions we all think about when we are told we need to wear orthodontic braces…..Will it hurt?….How will I be able to brush and floss?….Can I still eat my favorite foods?….How long will I have to wear them?

For millions of adults and children they might have a far different reaction……I have allergies to metals….Will I be able to have the orthodontic treatment without an allergic reaction?

Types Of Metal Used In Orthodontics

As many of us know, orthodontic braces are made up of brackets, wires, and bands. These orthodontic components are composed of various types of metal. This gives the orthodontic braces its inherent strength to do the job of moving your teeth into proper positioning over time. There are generally a few types of metal used in orthodontics and these can include:

-Stainless Steel

-Nickel Titanium

-Full Titanium

-Gold Plated Stainless Steel

What If I am allergic to certain metals? What choices will I have?

-Ceramic Braces – These are an excellent choice, not only for people with a nickel or metal allergy, but for people who are looking for a more esthetic orthodontic option. Ceramic braces are clear and are able to blend in with the teeth much more easily than traditional metal orthodontic braces. Ceramic braces allow for tooth movement without causing a reaction. Ceramic braces are not quite as strong as the traditional metal orthodontic braces so additional care is required as well as additional trips to the orthodontist for broken parts.

-Gold Plated Braces - These are especially comforting to many with a nickel allergy as they add extra security against an allergic reaction. The gold is able to form a stable bond between the teeth and the brackets and will also blend very nicely against ones teeth to soften the esthetics. These have become more popular for many simply becuase they feel they look better than traditional options but they do come with added cost.

-Titanium Braces - These appear very similar to the traditional stainless steel orthodontic braces. Titanium has an added advantage (besides being nickel free) that they are often considered to be more flexible than traditional stainless steel braces. This will allow them to be more flexible upon chewing and placing forces on them. This makes them a more durable option for many.

-Plastic (Polycarbonate) Braces - The main advantages to these are that they are completely metal free and can be made to be practically invisible on the teeth. This is a great option for allergy sufferers but also for many adults who do not want a mouth full of metal. The main disadvantage of these is they tend to not be as strong as traditional braces so added care is needed as well as allowance for extra visits when things break.

-Invisalign- This is a clear plastic removable appliance. It is changed periodically to slowly move teeth into position. It is nice because it is very cosmetic, and can be removed for photos.  The main negatives are, they are easy to lose, and movement is limited. Therefore, it takes more time to receive less results overall.

Other Potential Orthodontic Allergies

Other potential risks for allergies exist in the use of elastic ligatures (also called rubber bands) during orthodontic treatment. These rubber bands contain latex which might pose an issue for those with latex allergies. Luckily, in modern dentistry companies have developed latex free rubber bands using the same colors as the traditional ones.

Also, the metal used for a particular patient should be the same metal used throughout orthodontic treatment with no deviation. This ensures that there is no cross contamination as it would become quite difficult to pinpoint the exact issue when and if it arises further into treatment.

Orthodontic Allergies Conclusion

Communication is the key in dealing with any dental issue but especially for those with a history of allergies. If you suspect you have any type of allergy let the dentist know. It might be a good idea to get allergy tested prior to beginning orthodontic treatment if there is any doubt. Any allergy should not be taken lightly if there is any chance it could impact treatment. This will ensure a smooth transition and trouble free orthodontic treatment.

Women have known for years that different changes to their hair, makeup, or clothes can give them a whole new look. Makeup has been used for centuries by women trying to highlight

and define their individual facial features. While these techniques have long been known….Did you know that changing your teeth can give you similar results?

Some of us are born with teeth that complemnts our facial features. But not all of us are so lucky.

A bright, white, beautiful smile creates a first impression that poeple are sure to take note of. Without a spoken word, your smile can give off a confident, optimistic and friendly personality. An esthetically pleasing smile is an attractive quality that brings people to you, making them respond in a positive way towards you.

Physical characteristics aside, a winning smile can also have a major mental and emotional influence on you. People who are self conscious about their smiles tend to appear timid, hesitant, withdrawn or even angry. You may not feel as attractive as you can be.

Modern advances in cosmetic dentistry has allowed a growing number of people to benefit from smile makeoversCosmetic dentistry smile makeovers are capable of transforming a person’s smile to produce dramatic life changing results. A cosmetic dentist will examine your smile and make notes of the changes that need to be made.

Cosmetic Dentistry - smile makeover

Cosmetic Dentistry – smile makeover

Smile Design Principles or Smile Design for Cosmetic Dentistry

A smile design influences the overall cosmetic impact of an person’s smile. Smile design can be divided into four separate components:

-Facial Esthetics. A person’s facial esthetics varies greatly from patient to patient. A cosmetic dentist can evaluate this using a visual examination and the use of photography. Facial Esthetics will include not only the teeth but also the bone structure of the face and the musculature. It will also inlcude the way your lips frame your smile when you speak, smile, or laugh.

-Gingival (Gum) Tissue Esthetics. A smile with diseased gum tissue will never bo one that is considered attractive. Healthy gum tissue is an essential element in smile design. Common cosmetic dentistry complaints include a gummy smile, uneven gum tissue, and exposed root surfaces from recession. All of these things take away from a person’s smile appeal.

-Microesthetics. This component deals with the subtle attributes that make your teeth appear the way they do. This includes how they reflect light, any unique marks or colorations. This technique is applied when restoring a tooth from decay. Cosmetic dentistry will restore the tooth to give it qualities closely resembling the natural tooth. The anatomy and coloration of natural teeth is a unique quality that varies from patient to patient.

-Macroesthetics. This area allows the cosmetic dentist to analyze the relationship and proportions between a patient’s front teeth, surrounding tissues, and facial characteristics. Analyzing these characteristic will ensure the final result will be natural and attractive for the patient. Working together, your cosmetic dentist and dental laboratory technician combine their technical and artistic abilities to create a natural and esthetically pleasing appearance in which the shapes, sizes and arrangement of individual teeth blend with and complement your particular features.

Anatomy of a Smile in Cosmetic Dentistry

The following are the important anatomical structures or landmarks used in cosmetic dentistry:

-Lips. In cosmetic dentistry the lips are usually compared to a picture frame. The lips frame your smile, teeth, and gums. Lip enhancements correcting shape, fullness, and symmetry of your lips can make your smile seem broader and fuller.

For optimal cosmetic effect, your facial features should line up to your teeth and lip lines. When your lips form a broad smile, an imaginary line can be drawn through the corners of the mouth, from one side to the other. The amount of upper front (maxillary anterior) tooth revealed below this line helps create a vibrant, youthful image. In a youthful smile, the upper front teeth should fill between75-100% of the space between your upper and lower lips in a full smile.

-Midline. The facial midline is an important landmark in cosmetic dentistry. It is an imaginary vertical line drawn between the front two upper teeth. For optimum esthetics the facial midline should line up with the middle of the face.

Sometimes facial features can throw the midline off. These include the eyes, nose, and chin. A portion of the population has uneven eye levels or a nose that is slightly off center. If not taken into account this will throw the whole analysis off. Cosmetic Dentistry uses a more accurate landmark on the face. The point between the eyebrows and the cupid’s bow in the center of the upper lip is used. By using these two landmarks, cosmetic dentists can draw and locate the facial midline wile also determining its direction.

Whenever possible, the midline between the upper front teeth (central incisors) should coincide with the facial midline. In cases where this is not possible, the midline between the central incisors should be perpendicular to the imaginary line that could be drawn through the corners of the mouth.

-Smile Line. Your smile line is the line created by the top of your lower lip. In an ideal smile line, the edges of your upper teeth should be parallel to your lower lip when you smile. The bottom of your lower lip should have the same line as the gums of your lower jaw. This should always be a standard, regardless of the size or shape of your smile. Once your cosmetic dentist has determined the orientation of your smile line, they can design its curve, or shape, and determine the length of your new restorations for your smile makeover.

-Teeth. Smiles that tend to be considered attractive usually hve a few things in common. These features include white teeth, teeth that are unstained, and evenly spaced with no crowding.

Upon smiling, your top teeth show fully in a good proportion to your gums. The line where the gums and teeth meet is smooth and even. The smile line of the upper teeth follows the curve of the lower lip. The midline of the upper front teeth ideally is in the center of the face. Tooth reveal is a term that describes the amount of tooth structure that shows during smiling and various angles of your face.

Cosmetic Dentististry Variations

The impact of a smile cannot be judged just by the individual beauty of teeth and gums. Each and every patient has their own unique qualities, quirks, and traits. These include age, sex, personality traits, as well as cosmetic dentistry expectations.

When considering  person’s ideal smile, the cosmetic dentist will always consider an individuals personal traits. These include facial features, skin tones, hair color, as well as how your teethare framed by your overall appearance. Occlusal and functional considerations will also play a role in the final treatment.

Macroesthetic concepts provide only guidelines and reference points for beginning esthetic evaluation, planning and treatment. The artistic component can be applied and perfected in cosmetic dentistry by dentists who understand the rules, tools and strategies of smile design. In modern cosmetic dentistry there are tools such as digital imaging, lasers, teeth whitening procedures that allow a skilled cosmetic dentist to create smile makeovers.

The cosmetic dentistry procedures range from teeth whitening to dental bonding to porcelain veneers, crowns, and dental implants. Cosmetic dentists also have at their disposal the ability to augment soft tissues. The use of dermal fillers can correct certain facial feature such as thin lips or even facial asymmetry. Advances in cosmetic dentistry and sedation dentistry make it possible to do these procedures with less patient anxiety and pain.

Ultimately any cosmetic dentistry smile makeover is in the eye of the beholder. Just because certain procedures are possible it does not mean it should be done on each and every patient. Many patients embrace their uniqueness and are fine with the way they look. Others are looking for a change and thats where cosmetic dentistry can come in and make that happen for them.