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Posts for category: Dental Procedures

By Scott A. Allegretti, DDS Provincetown Dental Arts
October 20, 2021
Category: Dental Procedures
Tags: celebrity smiles   crown  
WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
October 10, 2021
Category: Dental Procedures
Tags: crowns  
WhatYouNeedToKnowToChoosetheRightDentalCrown

In the realm of dental restorations, not all crowns are alike. And, one type isn't necessarily superior to the others. One type of crown may work better for a particular tooth, while a different crown is better suited to another.

Therefore, knowing your options can help you make a more informed choice with your dentist regarding the best crown for your needs. Here, then, is a quick primer on the main types of dental crowns used today.

Metal crowns. Early in the last century, crowns made of gold, silver or other metals were the go-to dental restoration. Because of their strength and durability, metal crowns are still used today, mainly in back teeth that encounter heavy biting forces. Their drawback: They're decidedly not the color of natural teeth and so can stand out if they're placed in the visible "smile zone."

PFM crowns. The first crowns made with dental porcelain solved the appearance problem, but couldn't adequately handle biting forces as well as metal. Out of this came the porcelain fused to metal (PFM) crown, which contains an inner core of metal overlaid with tooth-colored porcelain. Providing both strength and life-likeness, PFM crowns were immensely popular until the mid-2000s.

All-Ceramic crowns. The development of porcelains more durable than earlier versions eventually dethroned the PFM (although the latter is still used today). Sixty percent of the crowns installed in recent years are all-ceramic, many reinforced with a strength material known as Lucite. Many all-ceramic crowns reaching the 15-year mark are still in place and functioning.

All of these crowns continue to be viable options for dental patients. The biggest factor in choosing one particular crown over another is the type of tooth involved and its location. As mentioned before, metal or PFM crowns are usually better for back teeth where durability is a higher priority than aesthetics. All-ceramics work well in high-visibility front teeth that normally encounter lighter biting forces than back teeth.

Regardless of which kind eventually caps your tooth, any of today's modern crowns will function as intended. But the best crown for you will be the one that both protects your tooth and enhances your smile.

If you would like more information on dental crown restorations, 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 Dental Crowns.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
September 20, 2021
Category: Dental Procedures
Tags: dental implants  
ImplantsCanProvideEffectiveOptionsforTotalToothReplacement

Losing all your teeth can dramatically impact your life for the worst. Fortunately, we can give you your "teeth" back. The most common way, at least until a few decades ago, is with custom dentures, which reasonably restore life-like appearance and dental function. But it does have one major drawback—it can't stop bone loss.

Loss of bone in the jaws often occurs with missing teeth. Normally, the bone continuously generates newer cells to replace older ones that have died. Chewing stimulates this growth as the force generated travels up through the teeth to the bone. But when teeth go missing, new bone growth slows, eventually causing the bone's volume and density to decrease.

Dentures can't reactivate this lost stimulation, and so bone loss may continue. Dentures even accelerate this loss as the compressive forces applied to the bony ridge are detrimental. This often leads to a "loosening" of a denture's fit that can make them uncomfortable and less secure to wear.

Today, however, patients with total tooth loss have another option that could alleviate the problem of bone loss—dental implants. Since their inception forty years ago, implants have become the preferred method of both dentists and patients for tooth replacement.

Implants consist of a titanium metal post that's surgically imbedded into the jawbone. Bone cells are attracted to this particular metal, readily multiplying and adhering to the implant's titanium surface. Because of this, an implant can slow or even stop bone loss.

Most people are familiar with the single tooth implant with an attached lifelike crown. Although this use of implants could be used to restore total tooth loss, it can be quite costly replacing over two dozen teeth individually.

But implants could still be part of the answer for someone with complete tooth loss, because they can also be used to support traditional restorations. A few implants strategically placed around the jaw can support either a removable denture or a fixed bridge.

Besides being a cost-effective way to add support to these traditional tooth replacements, the inclusion of implants will likely decrease continuing bone loss. Most importantly, it can give you back your dental function—and your smile to boot.

If you would like more information on dental implant options, 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 “New Teeth in One Day.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
August 31, 2021
Category: Dental Procedures
Tags: tooth pain  
OnlyaDentalExamcanIdentifytheRootCauseofYourToothPain

A toothache means you have tooth decay, right? Not necessarily — your pain could be signaling a number of potential causes. Determining where, how much and how often it hurts will help us find out the cause and apply the appropriate treatment.

A single symptom, for example, can mean many things. A twinge of tooth pain as you consume hot or cold foods might indicate localized tooth decay easily repaired by a filling. But it could also mean the tooth's root surface has been exposed as a result of periodontal (gum) disease — aggressive plaque removal and maybe even gum surgery might be necessary. Or it could be a sign of inner pulp decay: in this case you'll likely need a root canal treatment to save the tooth.

Pulp decay can also announce itself with a very sharp and constant pain radiating from one or more teeth. You shouldn't hesitate to see us for an examination — even if the pain goes away. Pain cessation most likely means the nerves in the pulp have died. The infection, however, still exists, so you'll still probably need a root canal treatment.

If you notice severe, continuous pain and pressure around a tooth, particularly about the gums, you may have a localized, inflamed area of infection called an abscess. An abscess can be the result of gum disease, but it might also stem from a foreign body like a popcorn husk, getting stuck below the gums. We'll need to conduct a complete dental examination to determine the cause and how to treat it.

Finally, a sharp pain when you bite down could mean many things such as a loose filling or a fractured (cracked) tooth. The latter especially requires immediate attention to save the tooth.

These are just a few of the possible causes behind mouth or facial pain. Although all of them are serious, a few are true dental emergencies and can't wait if we're going to save a tooth. The sooner you see us, the sooner we can help relieve the pain, minimize any damage and avert disaster.

If you would like more information on treating tooth pain, 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 “Tooth Pain? Don't Wait!

By Scott A. Allegretti, DDS Provincetown Dental Arts
August 11, 2021
Category: Dental Procedures
Tags: dental implants   crowns  
WhichImplantCrownAttachmentMethodisBestforYou

If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.

As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.

Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.

But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.

Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.

So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.

In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.

If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”