Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

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 People who are self conscious about their smiles tend to appear timid, hesitant, withdrawn or even angry.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.

Dental Implants have changed the way we look at dentistry. Dental implants are not just for single tooth or multiple teeth replacement. They can also be used in support and stabilization

of removable dentures. Long time denture wearers will tell you that over time the bone remodels and resorbs resulting in loose and ill fitting dentures. When this happens patients used to be forced to grin and bear it using various denture adhesives. Now with the development of dental implant supported dentures those days can be a relic left in the past for many patients.

Dental Implant Overdenture – What is it?

A dental implant supported denture is also called an overdenture. A traditional removable denture rests directly on the gums, and is not supported by dental implants. This is because the denture sits over the dental implants. The dental implants give support and stability to the denture.

A dental implant supported denture is recommended when a person is missing all the teeth in the jaw. The patient needs to have enough bone in the jaw to support the dental implants. The denture is able to stay in place using special attachments that allow the denture to “snap” into place over the dental implants.

Implant supported removable dentures usually are fabricated for the lower jaw. This is because regular dentures tend to be less stable on the lower arch due to tongue and musculature present. Usually, a regular denture made to fit an upper jaw is much more stable and tolerable on its own and doesn’t need the extra support offered by implants. If the patient chooses they can receive a dental implant supported denture in either the upper or lower jaw.

Dental implant supported denture should be removed daily to clean the denture and gum area just like traditional dentures. Also, you should not sleep with the dental implant supported dentures at night. Some people prefer to have fixed (permanent) crown and bridgework in their mouths that can’t be removed but this is not always possible in every patient’s case. Your dentist will consider your particular needs and preferences when suggesting fixed or removable options.

Dental Implants with bar supporting denture

Dental Implants with Bar Supporting Denture

Types of Dental Implant Supported Dentures

 

There are two types of dental implant supported dentures:

1) Bar-retained dentures. Your dentist will have a thin metal bar custom fabricated for your mouth. This bar will follow the curve of your jaw and is attached to 2-5 dental implants that have been placed directly into your jawbone. Clips or other types of attachments are fitted to the bar, the denture or both. The denture is then designed to fit directly over the bar stabilized by the attachments. The dental implants along with the bar and attachments gives the denture support and stability.

2) Ball-retained dentures. The dental implants in the jawbone hold a metal attachment(ball) that fits into another attachment(socket) on the

Dental implant supported denture - Ball retained

Dental Implants – Ball Retained Denture

denture. In most cases, the attachments on the implants are ball-shaped (“male” attachments), and they fit into sockets (“female” attachments)

on the denture. In some cases, the situation is reversed and the male attachment is in the denture and female attachment is on the dental implant. This also gives the denture wearer increased stability and retention over the traditional removable denture without dental implants.

In both scenarios, the removable denture will be made of a custom fabricated acrylic base that will look like gingival tissue. The teeth can be made of porcelain or acrylic. These teeth will look very natural. Either type of denture needs a minimum of 2 dental implants to work properly over the long term.

Placement of Dental Implants

The prime location for placement of the dental implants is in the front of the mouth. The reason for this is due to the fact that there is

supporting denture with dental implants

Visualization of dental implants supporting dentures

generally more bone present in this area for the dental implants. This is the case even if the teeth have been missing for a long period of time. When teeth are lost, bone is lost in that surrounding area.  Anatomy plays a role as well. In the front of the mouth there are less nerves orother important structures that could interfere with he placement of the dental implants.

The time schedule to complete the dental implants can be complicated. The general time frame is approximately 5 months for the lower jaw and approximately 7 months in the upper jaw. The process can take much longer if the case is more complicated. Complications can include the need for bone grafting or even sinus lifts.

The procedure generally requires two surgeries. The first surgery is for placement of the dental implants in the jawbone under your gingival tissue. The second surgery is to remove the gingival tissue that has now covered the dental implants. The second procedure comes 3-6 after the first.

There has been increased use of a one stage procedure.

A one-stage procedure is now used sometimes. In this procedure, your dentist places the implants and the supporting bar all at same visit.  The success rate of this procedure is high. if properly treatment planned.

Dental Implant Supported Denture Care

The dentures need to be removed at at night and to clean them. The attachments and/or bar need to be cleaned as well. Your dentist will give you instructions on how to clean these as they can be delicate.

Your dentist will periodically check the parts of your new denture to ensure they are secure and in proper place. Your denture may seem stable but over time these attachments can loosen. If they loosen even slightly it will cause the denture to move when chewing. This movement of the denture can cause sore spots as the denture rubs against your gums. Your dentist will also check to make sure your bite is correct and make any adjustments as needed.

The clip or other attachments on the bar retained denture usually will need to be replaced every 6-12 months. They are made of a plastic material (nylon) and will wear after continued use.

Complications that may Arise

The actual dental implant surgery carries its own risks but so does a bar retained denture. The fabrication of a bar retained denture needs extra space inside the denture to allow for the bar to fit inside. This means there is less support for the teeth in the denture. Due to this, the teeth sometimes come loose. This is an easy fix but an inconvenience for the patient.

Another important item is that the denture fits on the bar passively. This means that the bar is evenly balanced across all implants. If the fit is not passive, the extra strain can cause the screws holding the bar down to loosen. A special note for teeth grinders or clenchers is that their parts are more likely to break due to the excessive force they are placing on the components and dental implants.

Dental Implant Overdenture Expectations

A denture supported by dental implants will be far more stable than a traditional removable denture. Patients will find everyday tasks easier. They will find speaking easier. They will also not be concerned that their denture may fall out or become loose. Patients report being able to eat foods they have not been able to eat in years. A word of caution is to avoid sticky or very hard foods as you can damage the denture with these types of food.

A big advantage to having dental implants support the upper denture is the dentist can make your denture much less bulky. A traditional denture covers your entire palate whereas a dental implant supported denture does not need that extra material for support.

A whole new world has opened up with dental implants for both patient and dentist. The old compromise and limitations are slowly being worn away. We are entering a new world of dentistry and dental implants are leading the way!

 

Benefits of Dental Implants with Removable Dentures
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Just about everyone will grind their teeth from time to time. Grinding of your teeth (bruxism is the medical term for this) on rare occasions generally does not cause any harm. But when teeth grinding and clenching occurs on a regular basis damage can occur to the teeth, surrounding tissues, and other oral health complications can present themselves.

What is Teeth Grinding?

teeth grinding

Bruxism is the term that refers to a constant grinding and clenching of the teeth and jaws, unintentionally, and at inappropriate times. Bruxers (people with bruxism) are often unaware that they have developed this terrible habit. They often do not know or realize that treatment is available until damage to the mouth and teeth has already been done. Bruxism damage can present itself in a variety of ways. Every individual may experience symptoms a little differently.

Stress and anxiety are often thought as the major culprits of grinding. But it often occurs during sleep and is just as likely to be caused by an abnormal bite alignment (occlusion) or missing or crooked teeth.

Bruxism is considered to be a habit rather than a normal reflexive chewing activity. Reflexive events are responses to various stimuli and always occur without you being able to stop them (like the little hammer on the knee which makes your leg kick). Chewing and clenching can be controlled either consciously or subconsciously by the brain. During sleep, and often during daytime awake hours when we are distracted, our subconscious can take over allowing teeth grinding to happen. Bruxism can be quite rhythmic in nature. Researchers have classified bruxism as a habitual behavior and a sleep disorder.

Signs and symptoms of bruxism or teeth grinding can include:

-Anxiety, stress, and/ or tension. This can include tense musculature of the face and jaws. Waking up with an ache in the jaws face or teeth, or a headache.

-Teeth appear worn down or loose. Wear occurs from the aggressive movement of the teeth against one another. Although all teeth may show this type wear, it is especially noticeable when a person has front teeth that appear having theteeth grinding same length, as if they were somehow filed down.

-Chipped or cracked teeth. As teeth become worn, the edges of front teeth and the cusps (or corners) of back teeth will begin to show tiny fractures or cracks. These cracks generally can not be visualized by x-rays. It takes magnified vision or use of a dental microscope to diagnose them. Teeth with these type of fractures may eventually require further extensive treatment to restore their function. This could include large fillings, crowns, or even root canal therapy. Root canal treatment would be needed if the nerve was so inflamed that it could no longer heal itself, or a fracture extended into the nerve or pulpal area of the tooth allowing bacteria to leak in.

-Tooth sensitivity that is quite pronounced. Can be a constant ache, sensitive to touch or chewing,  hot, cold, or even sweet sensitivity.

-Receding gums and/or teeth with notches in them at the gum line. Most people have been told or assume that receding gums occur because of age, aggressive brushing or the presence of periodontal disease. In the majority of cases this is wrong.Bruxism These are called abrasion areas. When teeth grind hard against each other over time, the teeth will flex at the gum line and the enamel (which becomes quite thin in this area) micro fractures away. You end up with an area at the gum line that you can catch your fingernail in and can get very sensitive to touch and/or cold due to exposure of the root and closeness to the nerve endings.

-Jaws falling out of normal position or locking.

-Wearing away of the tooth enamel, exposing the dentin under the enamel.

-A popping or clicking in the temporomandibular joint (TMJ).

-Damage to the inside of the cheek tissues and tongue. Sometimes a bruxer will actually bite themselves on inside of the cheeks and tongue, (especially in the back part of the molar area).

The symptoms of bruxism can resemble other conditions or medical problems.

How is Bruxism Diagnosed?Teeth grinding

During routine dental examinations, your dentist will examine the teeth for evidence of bruxism. This often noted by the damage to the teeth. If the signs are present, the dentist may ask you some follow up questions to see if you have any of the other symptoms, such as snoring.It has been found that patients who both snore and grind have a much higher chance of developing sleep apnea.

Treatment

The goals of treatment are to reduce or remove pain, prevent permanent damage to the teeth, and to decrease the actual clenching. Treatment generally includes a custom made nightguard. The night guard is made for you to hold your teeth in a better position and protect your teeth when you grind to absorb the force of biting. This guard may help to prevent future damage to the teeth and aid in changing the patient’s behavior over time.

As always maintain a regular schedule of visiting your dentist so that these issues can be diagnosed in a timely manner should they arise. Also, of note is that this can affect children as well.