Gregory E. Oxford, DDS, MS, PhD  &  Isabell G. Oxford, DMD
100 Whetstone Place, Suite 308, St. Augustine, FL 32086  (904) 810-2345

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Posts for category: Dental Procedures

By Oxford Dental Associates
February 09, 2022
Category: Dental Procedures
Tags: dental implants  
BeforeReplacingYourMissingTeethYouMayNeedOtherDentalWork

Replacing missing teeth can do wonders for a smile. And you have solid options for doing so, from a partial denture to state-of-the-art dental implants. But there might be a roadblock to your restoration plan—literally. Some of your other teeth may be in the way.

When a tooth has been missing for a while, the teeth on either side of a tooth gap will naturally begin to move or “drift” into the space. This could result in an inadequate amount of available space for a prosthetic (false) tooth.

If that happens, we'll first need to move the errant teeth back to where they belong, either with traditional braces or removable clear aligners. If we're successful, we can then proceed with the missing tooth restoration.

But before starting orthodontic treatment, there may be another problem that needs our attention first. If your missing teeth are the result of periodontal (gum) disease, your gums and supporting bone may not be as healthy as they need to be. This can interfere with orthodontics, which often depends on the gums and bone around a tooth being healthy enough to reform as the tooth moves. That may not be possible if they're still infected with gum disease or you've suffered significant bone loss.

If that's the case, it may be necessary to first treat any gum disease present and rebuild the bone. The latter can often be done by grafting bone material to the area of loss. The graft then serves as a scaffold of sorts upon which new bone can grow and accumulate. And reducing gum disease, mainly by removing bacterial plaque, allows the gums to heal and regain attachment with the teeth.

Once your gums and bone are healthy again, we can then proceed with orthodontics. After the teeth are reasonably aligned, we can then complete the restoration for replacing your missing teeth, and any other cosmetic enhancements for your remaining teeth like veneers or crowns.

The entire process may take some time and multiple treatment visits. But gaining a more attractive smile in the end is well worth it.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.

YouCanMakeCosmeticDentalChangesWhileStillKeepingYourUniqueSmile

According to Dr. Suess, "Today you are You, that is truer than true. There is no one alive who is Youer than You." Indeed, you are different from everyone else on the planet. Your fingerprints, your DNA, even the shape of your outer ear, are all unique to you. And, in a society that pressures all of us to be alike, it's good to be reminded from time to time that it's okay to be different—including how your smile looks.

In fact, the thought has such a nice ring to it that some folks designate January as "It's OK to be Different Month," a good time to celebrate all the many ways we're unique from one another—and even in ways that might be considered imperfections.

For example, in terms of smiles, some people have a slight gap between their front teeth. Technically, it's a dental defect, and we can usually correct it with veneers or orthodontics. But a lot of people, including celebrities like Michael Strahan and Madonna, want to keep their gap—they consider it part of their personality, something that makes them, them.

The same could be said for other smile "quirks" like moderate dental misalignments (crooked teeth) or color variations—even a chipped tooth. If you consider it a comfortable part of who you are, then you do you, boo.

On the other hand, if there's something about your smile that you feel detracts from your appearance, you shouldn't have to live with it. And, fortunately, you don't.

Chipped tooth? Composite bonding could make it whole again. Misaligned teeth? Braces or clear aligners can straighten your smile. Missing teeth? You have numerous tooth-replacement options, with durable and life-like dental implants far and away the reigning champ of restorations.

More importantly, we can ensure that any cosmetic improvements you undergo enhance your uniqueness rather than diminish it. For example, we can fine-tune teeth whitening of dull and dingy teeth to achieve the level of brightness with which you're most comfortable—be it subtly natural or Hollywood dazzling.

The bottom line is that you can certainly undergo a complete smile makeover that radically transforms your appearance. Or, you can simply receive a few light cosmetic touches to make the smile you already like even better.

It's your decision—and it all begins with an exam to assess your current dental situation, followed by a discussion of your options. From there, you can choose just how much you want to change about your "Youer than you" smile.

If you would like more information about creating your own unique smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cosmetic Dentistry.”

By Oxford Dental Associates
January 10, 2022
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.”

AddressingTheseFactorsHelpsEnsureaSatisfyingExperienceWithImplants

Patients and dentists alike love dental implants. For one, they're unique among other dental restorations because they replace the tooth root as well as the visible crown. It's actually their role as a root replacement that makes them so durable and lifelike.

But it still falls to the dentist to create as natural an appearance as possible through proper implant placement. It requires extensive technical skill and artistry to surgically place an implant in the precise location inside the jawbone to gain the best outcome. It's even more critical when the tooth is a highly visible one within the "smile zone"—the teeth others see when we smile.

With a patient's smile appearance on the line, it's important that we carefully consider a number of factors that can impact implant success and address them as needed in our treatment plan.

The gums. The gums are to the teeth as a frame is to a masterpiece painting. If the gums don't correctly cover the new implant, the final outcome won't look natural. Positioning the implant precisely helps ensure the gums look attractive. It may also be necessary to augment the gums, such as grafting surgery to encourage growth of lost gum tissue, to achieve the most lifelike result.

The socket. For simple extractions (as opposed to surgical removals), a dentist deftly manipulates the ligament holding the tooth in place to loosen and remove it. It's important to do this carefully—if the tooth's bony socket becomes damaged in the process (or because of other trauma), it can complicate implant placement in the future.

The supporting bone. Likewise, the bone in which the implant is imbedded must be reasonably healthy and of adequate volume. Besides not providing enough support, inadequate bone also makes it difficult to place an implant for the most attractive result. Bone grafting at the time of extraction minimizes bone shrinkage. If bone shrinkage had occurred, the Inadequate bone may require grafting, particularly if there is a lag time between extraction and implantation. In extreme cases, though, a patient may need to choose a different restoration.

The usual process for implants—planning, surgical placement and the healing period after surgery—can take time. Paying attention to these and other factors will help ensure that time and the effort put into this process has a satisfying outcome—an attractive, natural and long lasting smile.

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 “Immediate Dental Implants.”

By Oxford Dental Associates
December 01, 2021
Category: Dental Procedures
Tags: oral surgery  
LikeJohnnyManzielYouMayNeedanOralSurgeonforaMajorDentalProblem

QB sensation Johnny Manziel has had a varied career in professional football. After playing two seasons for the NFL Cleveland Browns, he quarterbacked for a number of teams in the Canadian Football League. More recently, he joined the Zappers in the new Fan Controlled Football league (FCF). But then with only a few games under his belt, he was waylaid by an emergency dental situation.

It's unclear what the situation was, but it was serious enough to involve oral surgery. As a result, he was forced to miss the Zappers' final regular-season game. His experience is a reminder that some dental problems can't wait—you have to attend to them immediately or risk severe long-term consequences.

Manziel's recent dental problem also highlights a very important specialty of dentistry—oral surgery. Oral surgeons are uniquely trained and qualified to treat and correct a number of oral problems.

Tooth extraction. Although some teeth can be removed by a general dentist, some have complications like multiple roots or impaction that make regular extractions problematic. An oral surgeon may be needed to surgically remove these kinds of problem teeth.

Disease. Oral surgeons often intervene with diseases attacking areas involving the jaws or face. This includes serious infections that could become life-threatening if they're not promptly treated by surgical means.

Bite improvement. Some poor bites (malocclusions) arise from a mismatch in the sizes of the jaws.  An oral surgeon may be able to correct this through orthognathic surgery to reposition the jaw to the skull. This may compensate for the difference in jaw sizes and reduce the bite problem.

Implants. Dental implants are one of the best ways to replace teeth, either as a standalone tooth or as support for a fixed dental bridge or a removable denture.  In some cases, it may be better for an oral surgeon to place the implants into a patient's jawbone.

Reconstruction. Injuries or birth defects like a cleft lip or palate can alter the appearance and function of the face, jaws or mouth. An oral surgeon may be able to perform procedures that repair the damage and correct oral or facial deformities.

Sleep apnea. Obstructive sleep apnea is usually caused by the tongue relaxing against the back of the throat during sleep and blocking the airway. But other anatomical structures like tonsils or adenoids can do the same thing. An oral surgeon could address this situation by surgically altering obstructing tissues.

It's likely most of your dental care won't require the services of an oral surgeon. But when you do need surgical treatment, like Johnny Manziel, these dental specialists can make a big difference in your oral health.

If you would like more information about oral surgery, please contact us or schedule a consultation.