It's not unusual for serious actors to go above and beyond for their roles. They gain weight (or lose it, like Matthew McConaughey for True Detective). They grow hair—or they shave it off. But perhaps nothing tops what Brad Pitt did to assume the character of Tyler Durden in the movie Fight Club—he had his dentist chip his teeth.
While a testament to his dedication to the acting craft, Pitt's move definitely falls into the category of "Kids, don't do this at home." Fortunately, people deliberately chipping their teeth isn't a big problem. On the other hand, accidentally chipping a tooth is.
Chipping a tooth can happen in various ways, like a hard blow to the jaw or biting down on something too hard. Chipping won't necessarily endanger a tooth, but the missing dental structure can put a damper on your smile.
But here's the good news: you don't have to live with a chipped tooth. We have ways to cosmetically repair the damage and upgrade your smile.
One way is to fit a chipped or otherwise flawed tooth with a dental veneer, a thin wafer of dental porcelain bonded to the front of a tooth to mask chips, discolorations, gaps or other defects. They're custom-made by a dental lab to closely match an individual tooth's shape and color.
Gaining a new smile via dental veneers can take a few weeks, as well as two or more dental visits. But if you only have slight to moderate chipping, there's another way that might only take one session in the dentist's chair. Known as composite bonding, it utilizes plastic-based materials known as composite resins that are intermixed with a form of glass.
The initial mixture, color-matched for your tooth, has a putty-like consistency that can be easily applied to the tooth surface. We apply the composite resin to the tooth layer by layer, allowing a bonding agent in the mixture to cure each layer before beginning the next one. After sculpting the composite layers into a life-like appearance, the end result is a "perfect" tooth without visible flaws.
Unlike Brad Pitt, it's pretty unlikely you'll ever find yourself in a situation requiring you to purposely damage your teeth. But chips do happen—and if it happens to you, we have more than one way to make your teeth as good as new.
If you would like more information about repairing dental flaws with veneers or composite bonding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”
Dentists extract millions of teeth each year, mostly because of disease. But sometimes a healthy tooth is removed to gain a more favorable, long-term dental health outcome.
An example of this is extracting teeth for the sake of orthodontic treatment. This is often beneficial when treating bite problems caused by crowding, a condition in which not enough space on the jaw exists to accommodate all of the teeth coming in. When this happens, the limited space can force teeth out of their proper alignment.
Crowding also complicates correcting the bite problem with braces: As with the eruption phase, there's no available room for orthodontic movement. One solution that may arise after a detailed examination is to open up space on the jaw by removing some of the teeth.
Planning this kind of tooth extrication requires careful forethought with the end in mind—ultimately, the dental providers involved want the resulting appearance after braces to look as natural as possible. For that reason, dentists usually choose teeth for extraction that are outside of the "smile zone" (the teeth visible while smiling) like premolars and molars.
Additionally, dentists are concerned about bone loss after extracting the teeth. Bone often diminishes around empty tooth sockets, especially if those sockets were damaged during extraction. This loss in bone can weaken the jaw structure and cause significant problems while moving teeth with braces.
To avoid this, dentists take great care during tooth removal not to damage the socket. Additionally, they may place a bone graft within the socket immediately after removing the tooth, especially if the space will remain vacant for a significant period of time. A bone graft serves as a scaffold upon which new bone cells can form and accumulate.
After the extractions, the orthodontist may then proceed with correcting the bite. Patients may also need some form of prosthetic teeth to fill in the spaces while wearing braces. Often prosthetic teeth can be incorporated with the braces for a more natural look. After braces, any remaining gaps may require further restoration, either with dentures, bridges or, later in adulthood, dental implants.
Complex bite problems like crowding pose unique challenges in correcting them. But using techniques like tooth extraction can help achieve a successful and satisfactory outcome.
If you would like more information on treatments for bite problems, 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 Removal for Orthodontic Reasons.”
More than one parent has wakened in the middle of the night to an unnerving sound emanating from their child's bedroom. Although it might seem like something from the latest horror flick is romping around in there, all that racket has a down-to-earth cause: teeth grinding.
Teeth grinding is the involuntary habit of gnashing the teeth together when not engaged in normal functions like eating or speaking. It can occur at any time, but frequently with children while they sleep. Adults may also grind their teeth, but it's more prevalent among children.
While stress seems to be the main reason for adult teeth grinding, many health providers believe the habit in children is most often caused by an overreactive response of the neuromuscular system for chewing, which may be immature. Other conditions like asthma, sleep apnea or drug use may also play a role.
Fortunately, there doesn't appear to be any lasting harm from young children grinding their teeth, although they may encounter problems like headaches, earaches or jaw pain in the short term. Most, though, will outgrow the habit and be no worse for wear.
But if it persists beyond childhood, problems can escalate. Adults run the risk of serious cumulative issues like chronic jaw pain, accelerated tooth wear or tooth fracturing. It's similar to finger sucking, a nearly universal habit among young children that poses no real harm unless it persists later in life.
And as with finger sucking, parents should follow a similar strategy of carefully monitoring their child's teeth grinding. If the habit continues into later childhood or adolescence, or noticeable problems like those mentioned previously begin to appear, it may be time to intervene.
Such intervention may initially include diagnosis and treatment for underlying problems like upper airway obstruction, asthma or stress. For short term protection against dental damage, your dentist can also fashion a custom mouthguard for your child to wear while they sleep. Made of pliable plastic, the guard prevents the teeth from making solid contact with each other during a grinding episode.
Outside of some lost sleep, there's little cause for alarm if your child grinds their teeth. But if it seems to go on longer than it should, you can take action to protect their long-term dental health.
If you would like more information on teeth grinding, 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 “When Children Grind Their Teeth.”
There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.
Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.
Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.
Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.
To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.
But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.
Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.
The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.
If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”
Performing for an awards show is a quite a feather in an entertainer's cap. So, up-and-coming country music star Carly Pearce was obviously excited when she gained a slot on last November's Country Music Awards. But an accident a couple of weeks before the event almost derailed her opportunity when she fell and knocked out two of her front teeth.
Fortunately, Pearce took quick action and, thanks to a skilled dental and medical team, was able to put her mouth back together before the show. Those watching her perform her hit single, “I Hope You're Happy Now,” as she smiled broadly would never have known otherwise about her traumatic emergency if she hadn't spilled the beans.
Orofacial injuries can happen to anyone, not just entertainers. You or someone you love could face such an injury from a motor vehicle accident, hard sports contact or, like Pearce, a simple slip and fall. But if you also act quickly like Pearce, you may be able to minimize the injury's long-term impact on dental health and appearance.
Here are some guidelines if you suffer a dental injury:
Collect any tooth fragments. Dental injuries can result in parts of teeth—or even a whole tooth—coming out of the mouth. It may be possible, though, to use those fragments to repair the tooth. Try to retrieve and save what you can, and after rinsing off any debris with cold water, place the fragments in a container with milk.
Re-insert a knocked-out tooth. You can often save a knocked-out tooth by putting it back in its socket as soon as possible. After cleaning off any debris, hold the tooth by its crown (never the root) and place it back in the empty socket. Don't fret over getting it in perfectly—your dentist will assist its placement later. Place a piece of clean cloth or cotton over the tooth and have the injured person bite down gently but firmly to hold it in place.
See the dentist ASAP. You should immediately see a dentist if any tooth structure has been damaged, or if a tooth is loose or has been moved out of place. If you're not sure, call your dentist to see if you should come on in or if you can wait. If a dentist is not available, go immediately to an emergency room or clinic. With many dental injuries, the longer you wait, the more likely the teeth involved won't survive long-term.
A dental injury could happen in a flash, with consequences that last a lifetime. But if, like Carly Pearce, you take prompt action and obtain necessary dental care, you could save an injured tooth—and the smile that goes with it.
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