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A patient who has teeth that are damaged or missing, whether from disease, injury or other causes, is a candidate for restorative dentistry, which will restore overall mouth health and make teeth look aesthetically pleasing. Receiving proper treatment for damaged or missing teeth is essential in order to prevent further problems and eliminate difficulties with eating or speaking.
There are several restorative options available, and which ones are used depends upon the patient’s overall health and personal preference, and the doctor’s recommendation. Available restorative dental treatments include:
- Full and partial dentures
- Crowns and bridges
- Dental implants
- Mini dental implants
- Inlays and onlays
- Full-mouth reconstruction
Each type of dental restoration has its own benefits. To complete a full-mouth restoration, several treatments may be combined.
Cosmetic dentistry encompasses not only the health of the teeth, but also their aesthetic value. Various products and procedures exist within cosmetic dentistry with the goal of improving both the well-being and visual beauty of the teeth, giving the individual a higher level of self-confidence. Services provided by a cosmetic dentist include the following:
- Teeth bleaching
- Porcelain veneers
- Teeth-colored fillings
- Dental implants
Dentist supervised whitening is one of the safest and most conservative cosmetic dental treatments available. We offer both in-office Phillips ZOOM Whitening and at-home professional whitening systems.
Porcelain veneers are very thin, tooth-colored shells of ceramic that are custom-fit and bonded to the front of the teeth. They can create an attractively white and even smile. Veneers can address a variety of issues, including chipped, yellow, stained, misshapen or crooked teeth, or teeth with spaces between them. A veneer placed on top of a tooth can quickly and easily improve the look of a smile.
Cavities are painful and unsightly holes in the teeth that must be filled with inert material. Contemporary fillings, called dental composite resin, are much closer in hue to the natural color of teeth. This allows the teeth to be protected but still look untouched.
A dental implant is an artificial tooth replacement designed to fill the void created by a missing tooth. There are many types of dental implants, ranging from individual crowns to large scale dentures. A cosmetic dentist can ensure that not only will the most comfortable replacement be found, but it will be implanted in the most accurate and aesthetic manner possible.
There are numerous options available to improve the overall health and appearance of the teeth and smile. Patients should consult with their dentists to decide which option best suits their specific needs and will most effectively meet their expectations.
For people who are dissatisfied with their smiles but have not done anything about them because they are not interested in a mouthful of metal, Invisalign® “braces” may be a good option. They eliminate both the discomfort of metal wires and the inconvenience of adjustments. The Invisalign system uses virtually invisible aligners that straighten teeth without metal bands, brackets or wires. The custom-made trays are comfortable, and easy to remove for eating, brushing, flossing and special occasions. The clear-plastic Invisalign aligners are so inconspicuous that it is difficult to tell when someone is wearing them.
Invisalign aligners are nearly invisible, and do not draw attention to the mouth; most people cannot tell when someone is wearing them. Invisalign aligners offer many benefits over traditional metal braces inlcuding:
- More cosmetically appealing
- Lower cost
- Little-to-no impact on daily life
- Less painful
- Greater flexibility because aligners can be removed at any time
- Easier to keep teeth clean and healthy
- No dietary restrictions
With no metal or wires to irritate the mouth, an active, athletic lifestyle, free from worry about injury or bracket breakage, can be maintained.
Full Mouth Restoration
Full mouth restoration involves reconstructing all of the teeth in both the upper and lower jaws through the use of restorative materials like crowns, bridges, veneers and dentures. Full mouth reconstruction can be a necessary treatment performed to preserve the patient’s oral health.
Candidates for Full Mouth Restoration
This treatment may be performed on patients who have missing or severely damaged teeth caused by:
- Injury or fracture
- Acid erosion
- Tooth grinding
Missing teeth often leads to serious dental problems and can significantly inhibit a patient’s ability to eat and speak. It is important to seek restorative treatment for any missing teeth, but especially when most or all of the teeth are damaged.
Full Mouth Restoration Options
There are many different treatment options available for patients requiring reconstruction. Each type of dental restoration offers its own benefits and several treatments may be combined to complete a full mouth restoration.
There is a wide variety of prosthetic materials that are commonly used to replace damaged or missing teeth. These materials may be permanently implanted or glued to the mouth or can be removable and temporary. They may replace individual teeth, a few teeth or all of the teeth. Some of these options may include:
Dental crowns are individual prosthetic teeth used to replace missing or severely damaged teeth. Crowns are implanted into the jawbone with a titanium implant root or placed with cement as a cap over an existing tooth. The actual crown can be made from metal, porcelain or a combination of the two and provide a natural looking and feeling replacement. Crowns provide a strong, sturdy, aesthetically pleasing replacement that can withstand the same pressures as a regular tooth, letting patients enjoy the convenience of eating, speaking and smiling without any problems.
Dental bridges replace missing teeth with a short row of prosthetics that rely on the strength of surrounding teeth and help stabilize the bite. Bridges also help keep surrounding teeth from moving into the open space of the missing tooth. The surrounding teeth are prepared for the bridge, which is then attached to the teeth. Bridges can be permanent or removable and provide a restored function and appearance.
Veneers are shells made from composite or porcelain that fit over the natural teeth to provide a white, even, full smile and can cover up crooked, chipped or discolored teeth. They are bonded to the front of the tooth after the tooth has been buffed in preparation of the veneer, which is then bonded to the teeth with an etching solution and special light. Veneers typically last for 10 to 15 years and are more durable and less expensive than other materials. Veneers are a cosmetic enhancement and cannot replace missing teeth.
Dentures are for people who have lost many or all of their teeth and are usually used to replace an entire arch of teeth. Dentures can be removable or fixed, and partial or full, depending on each patient’s needs and preferences. Dentures can be treated just like natural teeth but require special care and adjustment when they are removable.
Dental implants are small titanium screws that are drilled into the jaw bone to replace missing teeth. The implant serves as the root of a replacement tooth and can be covered by a crown, bridge or dentures to provide a natural-looking replacement for the missing tooth. The implant is first placed into the jaw and then allowed to fuse with the bone before the prosthetic is placed on top. Implants provide long-lasting support that most closely replaces the individual strength and stability of the natural teeth.
Full mouth restoration is a complicated procedure that involves multiple office visits and can take up to a year or longer to complete, depending on each patient’s individual case. A customized treatment plan for each individual patient will be developed with the dentist, to help regain a healthy smile.
BOTOX® Cosmetic is a prescription drug that, when injected, temporarily paralyzes muscles. It contains a purified and safe form of botulinum toxin A, which is produced by the microbe that causes botulism. Manufactured by Allergan, Inc., it is used to treat permanent furrows and deep wrinkles in the skin that are formed by the continual contraction of facial muscles. In addition to its cosmetic applications, it is used to treat a number of medical problems, including excessive sweating, overactive bladder, neck spasms, crossed eyes, chronic back and jaw pain, and migraines.
Applications for BOTOX Cosmetic
Although originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, BOTOX Cosmetic was quickly recognized for its cosmetic value. Properly placed injections of BOTOX Cosmetic block nerve impulses sent to muscles, weakening them to the point where they cannot contract, and temporarily eliminating moderately severe furrows and lines. BOTOX Cosmetic is used to treat the following:
- Forehead furrows
- Frown lines
- Crow’s feet
- Skin bands on the neck
According to Allergan, BOTOX Cosmetic has been “extensively researched, with approximately 2500 studies.”
BOTOX Cosmetic Procedure and Results
Using a very fine needle, BOTOX Cosmetic is injected directly into facial muscles that are causing furrows and lines. Receiving the injections requires no anesthetic, but some doctors choose to numb the area to be injected with ice packs or a topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to four months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals.
Side Effects of BOTOX Cosmetic
Injection-site side effects of BOTOX Cosmetic are usually mild and temporary, and include the following:
JUVÉDERM® XC Injectable Gel
JUVÉDERM® XC injectable gel is a U.S. Food and Drug Administration-approved dermal filler that, according to its manufacturer, Allergan, Inc., is designed to "temporarily treat moderate to severe facial wrinkles and folds such as nasolabial folds" in people older than 21. Unlike the original JUVÉDERM injectable gel, JUVÉDERM XC is infused with lidocaine to make its injection more comfortable.
JUVÉDERM XC is a smooth-consistency gel that restores volume to the skin, and smooths away moderate-to-severe facial wrinkles and folds. It is made of hyaluronic acid (HA), a sugar that occurs naturally in the body. In terms of the skin, HA's role is to deliver nutrients and hydration, and act as a cushioning agent. Young, healthy skin contains a lot of HA, but factors that include aging and sun exposure reduce the amount, causing skin to lose structure and volume. JUVÉDERM XC is most effective in improving the appearance of nasolabial folds, the lines that run from the bottom of the nose to the corner of the mouth on both sides of the face.
JUVÉDERM XC Injectable Gel Procedure
JUVÉDERM XC injections take about 15 minutes to administer in a doctor's office. A fine needle is used for the injection, which is given under the skin in the targeted area to add volume or fill in wrinkles and folds. Because JUVÉDERM XC contains lidocaine to improve comfort, an anesthetic may not be needed. However, a doctor may still elect to use a topical anesthetic on the area to be treated before giving the injection. Afterword, the doctor may gently massage the treated area(s).
Once treatment is completed, patients can return, with virtually no downtime, to their regular activities. For the first 24 hours after treatment, to reduce the risk of complications, patients should avoid strenuous exercise, excessive sun or heat exposure, and alcohol consumption.
Results of JUVÉDERM XC Injectable Gel
The results of JUVÉDERM XC are visible immediately after injection; any swelling and bruising, to which ice can be applied, should subside during the next few days. Results can last 6 to 9 months, and, in some cases, up to year. However, according to its manufacturer, "Results from injectable dermal filler vary and correction is temporary. Supplemental 'touch up' treatments may be required to achieve and maintain optimal correction of . . . wrinkles and folds."
Risks of JUVÉDERM XC Injectable Gel
Although JUVÉDERM XC is considered safe, there is a risk of side effects. They are usually limited to the injection site, and include the following:
- Pain or tenderness
- Lumps or bumps
For customized treatment, Allergan, Inc., offers two types of JUVÉDERM XC: JUVÉDERM Ultra XC, which is suitable for superficial facial lines and folds, and JUVÉDERM Ultra Plus XC, a stronger formulation that is used for deeper facial folds and lines. JUVÉDERM XC is the first HA filler that is FDA-approved for use on people of color.
TEMPOROMANDIBULAR JOINT DISORDER
Temporomandibular joint disorder (TMD) refers to a group of related disorders that result from problems with the jaw or jaw joint, or the facial muscles involved in jaw movement. The temporomandibular joint (TMJ) is the small joint located in front of the ear where the skull and lower jaw meet; it enables the jaw to move and function normally, and is one of the body’s most frequently used joints. Talking, yawning, chewing and swallowing all involve the TMJ. For the TMJ to function properly, the muscles, ligaments and bones involved in its movement must be working properly; any conditions that prevent them from doing so may cause TMD. At Engelbrecht and Sikes, DDS, our doctors have extensive training in treating TMD through physiologic dentistry methods such as appliance therapy and/or full mouth reconstruction.