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Posts for category: Dental Procedures

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.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
August 01, 2021
Category: Dental Procedures
Tags: celebrity smiles   crowns  
HowCelineDionOvercameHerSmileObstacle

For over three decades, Celine Dion has amazed audiences and fans with her powerful singing voice. Best known for her recording of "My Heart Will Go On," the theme song for the movie Titanic, Dion has amassed global record sales topping 200 million. In her early singing days, though, she struggled with one particular career obstacle: an unattractive smile.

The Canadian-born performer had a number of dental defects including crooked and discolored teeth, and—most prominent of all—abnormally large cuspid or "canine" teeth (located on either side of the four front incisors). They were so noticeable that one Quebec celebrity magazine gave her the unflattering nickname "Canine Dion."

This isn't an unusual problem. Since human canines are already the longest teeth in the mouth, it doesn't take much for them to stand out. Our ancient hunter-gatherer ancestors needed these large, pointed teeth to survive. But with the evolution of agriculture and industry, canine teeth have become gradually smaller—so much so that when they're abnormally large, they don't look right in a smile.

So, what can be done if your canines embarrassingly stand out from the rest? Here are some of the options to consider.

Reduce their size. If your canines are just a tad too long, it may be possible to remove some of the enamel layer in a procedure called contouring. Using this technique, we can reduce a tooth's overall size, which we then re-shape by bonding composite resin to the tooth. It's only a good option, though, if your canines have an ample and healthy layer of enamel.

Repair other teeth. The problem of prominent canine teeth may actually be caused by neighboring teeth. When the teeth next to the canines are crooked, the canines can appear more prominent. Alternatively, other teeth around the canines may be abnormally small. Braces or clear aligners can correct crooked incisors, and applying porcelain veneers to smaller teeth could help normalize their length.

Apply dental crowns. In some instances, we can reduce the canines in size and then bond porcelain crowns to them. This is the option that Dion ultimately chose. The natural teeth are still intact, but the crowning process transforms them into properly proportioned, life-like teeth. There is, however, one caveat: The alteration to these teeth will be permanent, so they will need a crown from then on.

Besides crowning her canine teeth, Dion also underwent other dental work to straighten and whiten her other teeth. As a result, this superstar performer now has a superstar smile to match and so can you if your teeth are less than perfect. These or other cosmetic enhancements can give you the look you truly desire. All it takes is an initial visit with us to start you on the road to a transformed smile.

If you would like more information about various cosmetic solutions for your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
June 22, 2021
Category: Dental Procedures
YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
June 02, 2021
Category: Dental Procedures
Tags: smile makeover  
PlanYourSmileMakeovertoGettheMostSatisfyingResults

If you think your smile is beyond hope, you might be in for a happy surprise: Today's dental cosmetics can improve even the most forlorn dental situation. It could be a one-visit tooth whitening—or a total “smile makeover.”

If it's the latter, your transformation journey could take months or even years—so you need some idea of where this journey will take you. That will come through initial discussions with your dentist about your dreams and desires for a new smile.

But you'll also need to consider what your dental condition will practically allow: Although your goal is a more attractive appearance, the higher priority is your long-term dental health. There's also cost—dental enhancements can be expensive, so you may have to adjust your dream smile to match the reality of your finances.

With the big picture in focus, the next step is to refine the details of your makeover plan. Nothing does this better—for you and your dentist—than to “see” your proposed smile ahead of time. This is possible with computer technology: Your dentist can modify a digitized photo of your face and smile to show the proposed changes to your teeth and give you a reasonable view of your future smile.

Another way is to create a “trial smile.” Using composite dental material, your dentist fashions a temporary restoration that fits over your teeth. Unlike the digitally enhanced still photo, a trial smile let's you see what your new appearance will look like while moving, talking or smiling. Although it's removed before you leave the office, you can have photos taken to show friends and family.

You and your dentist can use these methods to make adjustments to your makeover plan before applying the real enhancements. It also eliminates any unpleasant surprises after all the work is done—you'll already know what your future smile will look like.

These initial steps are just as important as the actual procedures you'll undergo. Through careful planning, you'll gain a new smile that can improve your life.

If you would like more information on smile transformations, 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 “Beautiful Smiles by Design.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
May 13, 2021
Category: Dental Procedures
Tags: celebrity smiles   crowns   veneers  
HowGeorgeClooneyMadeOverHisSmileandHowYouCanToo

Since his breakout role as Dr. Doug Ross in the 90's TV drama ER, George Clooney has enjoyed a blockbuster career as an award-winning actor, director and producer. He's still going strong, as seen in the recent film The Midnight Sky, which Clooney directed and starred in. This sci-fi drama set a record as the most-watched movie on Netflix for the first five days after its late December release. And although now well into middle age, Clooney still possesses a winsome charm epitomized by his devil-may-care smile.

But he didn't always have his enigmatic grin. Early on, his struggles pursuing his burgeoning acting career triggered a stressful habit of grinding his teeth. This took a toll, as his teeth began to look worn and yellowed, giving his smile—and him—a prematurely aged appearance.

Clooney's not alone. For many of us, our fast-paced lives have created undue stress that we struggle to manage. This pent-up stress has to go somewhere, and for a number of individuals it's expressed through involuntary grinding or gritting of the teeth. This may not only lead to serious dental problems, but it can also diminish an otherwise attractive smile.

There are ways to minimize teeth grinding, the most important of which is to address the underlying stress fueling the habit. It's possible to get a handle on stress through professional counseling, biofeedback therapy, meditation or other relaxation techniques. You can also reduce the habit's effects with a custom-made oral device that prevents the teeth from making solid contact during a grinding episode.

But what if teeth grinding has already taken a toll on your teeth making them look worn down? Do what Clooney did—put a new “face” on your teeth with dental veneers. These thin layers of porcelain are bonded to teeth to mask all sorts of blemishes, including chips, heavy staining and, yes, teeth that appear shortened due to accelerated wearing. And they're custom-designed and fashioned to blend seamlessly with other teeth to transform your smile. Although they're not indestructible, they're quite durable and can last for years.

Veneers can correct many mild to moderate dental defects, but if your teeth are in worse shape, porcelain crowns may be the answer. A crown, which bonds to a prepared tooth to completely cover it, allows you the advantage of keeping your natural tooth while still enhancing its appearance.

Although different in degree, both veneers and crowns require permanently altering the teeth, such that they will require a dental restoration from then on. But if you're looking for an effective way to transform your worn or otherwise distressed teeth into a beautiful smile, it's a sound investment.

Just like George Clooney, your smile is an important part of who you are. We can help you make it as appealing as possible with veneers or other dental enhancements. Call us today to get started on the path to a more attractive smile.

If you would like more information about dental veneers and other smile enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers.”