Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Want to give your kids the best start possible for a lifetime of good dental health? The most important thing you can do is train them in effective brushing and flossing. It's more than having a nice smile and fresh breath: these hygiene tasks remove the daily buildup of bacterial plaque, the primary cause for both tooth decay and periodontal (gum) disease, which are most responsible for poor oral health.
But those aren't the only habits they should be cultivating. Here are 3 tips for helping your child develop great dental health habits.
Encourage healthy eating. Teeth and gums are like other parts of the body: they need the "building blocks" found in nutritious foods to help grow strong, healthy tissues. By focusing on a diet leaner on processed items and richer in whole, less-processed vegetables, meats and dairy products, you'll be helping your child build strong defenses against dental disease.
Keep sugary snacks under control. Of all the items in your child's diet, sugar could have the greatest impact on their teeth. Disease-causing bacteria thrive on this particular carbohydrate, multiplying and producing mouth acid—the main enemy of tooth enamel—as a byproduct. So, limit sugary snacks as much as possible, opting instead for more nutritional between-meal treats. In fact, try to make sure they only consume sugary treats at mealtime, not in between.
Encourage an end to thumb-sucking or pacifiers by age 3. Most infants and very young children suck their thumbs or, alternatively, a pacifier. There's no harm in this habit unless it extends into later childhood where it could affect their bite. You can avoid this outcome by encouraging your child with mainly positive reinforcement to stop sucking their thumbs or other objects before their third birthday. Your dentist can also help with tips and support in those efforts.
If you would like more information on dental care for your child, 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 “Help your Child Develop the Best Habits for Oral Health.”
Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.
First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.
At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:
- An artificial heart valve, or a heart valve repaired with artificial material
- A history of endocarditis
- A heart transplant with abnormal heart valve function
- Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
- A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
- Repaired congenital heart disease with residual defects, such as leakage or abnormal flow
In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.
The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.
A lot of people don’t like dental work because they believe it will be painful or uncomfortable. There’s an anatomical reason to back up that concern — the mouth with its dense network of nerves in the teeth and gums is one of the most sensitive parts of the human body.
But modern dentistry has helped solve much of the problem of pain with advances in local anesthesia. Using substances that temporarily block electrical impulses within the nerves of a selected area of oral tissues, there’s a good chance you’ll feel little to no discomfort even during moderately invasive procedures.
Unfortunately, you might have heard some complaints from others about local anesthesia that might make you wary of it. Many of these complaints, however, aren’t fully based on all the facts. So, let’s set the record straight about local anesthesia and what you can expect.
No need to be afraid of needles. Nobody enjoys the painful prick from an injection needle, and some people are highly fearful of them. But although it’s necessary to use a needle to deliver anesthesia to deeper levels of tissue, it’s possible you won’t feel it. That’s because we’ll typically apply a topical numbing agent to the skin surface that deadens the top layers where we insert the needle.
That numb feeling afterward won’t last long. One of the chief complaints in the past about local anesthesia was the irritating numbness that could long linger after a procedure. Today, however, with more advanced anesthetics and formulae, we’re better able to gauge the duration of the medication’s effect. This has greatly reduced the length of time afterward your mouth might have that awkward numbing sensation.
Anesthesia isn’t necessary for every procedure. Unless you have hypersensitive teeth, a lot of dental procedures don’t require anesthesia. Your enamel, for example, has no nerves and actually serves as a kind of “muffler” for sensations to lessen their effect. Cleaning your teeth or removing portions of the enamel can normally be performed without the need for numbing medication.
For procedures, though, where pain could be a factor, local anesthesia can make all the difference in the world. In these cases, anesthesia is your friend — it can help you receive the dental care you need without the discomfort.
If you would like more information on pain-free dentistry, 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 “Local Anesthesia for Pain-Free Dentistry.”
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
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