New Teeth While You Wait

Between work and family obligations, most individuals have very hectic and tight schedules. Often dental treatment is put off because of actual or perceived time commitments on the part of a patient. This office has invested in a hi-tech system called CEREC that allows us to fabricate a permanent all ceramic crown [cap], onlay or veneer in one single office visit. This means fewer injections, less drilling and less time taken away from your daily activities. This computerized system allows us to use strong, tooth-colored ceramic materials to restore your teeth to their natural strength, beauty and function. These materials closely match the composition of natural tooth structure. The significance of this fact means when you eat hot food and drink something cold, the restoration and tooth expand and contract at almost equal rates, minimizing the chance of your tooth cracking. Also, the ceramic restorations are chemically bonded to your teeth, so we can preserve as much healthy tooth structure as possible.

First, we examine the tooth or teeth to determine the appropriate treatment. It could be a simple filling, or a full crown, depending on how much healthy tooth structure is remaining in our clinical judgment. Next, we administer an anesthetic and prepare your tooth for the restoration, removing decayed and weakened tooth tissue. This preparation is just like we would do for many other restorative techniques.

Then, we take an Optical Impression of the prepared tooth. Instead of filling a tray with impression "goop" that you must bite into and hold in your mouth until it hardens, we coat the tooth with a non-toxic, tasteless powder. A camera is used to take a digital picture of your tooth. This whole Optical Impression process only takes a minute or two.

Next, the CEREC machine helps us create the restoration for your tooth. The CEREC 3D software takes the digital picture and converts it into a 3-dimensional virtual model on the computer screen. We use our dental expertise to design the restoration using the CEREC 3D computer program. Within a few minutes, with the click of a button, the restoration design data is sent to a separate milling machine in the office. A ceramic block that matches your tooth shade is placed in the milling machine. About 10 - 20 minutes later, your all-ceramic, tooth-colored restoration is finished and ready to bond in place. Finally, we try the restoration in your mouth to ensure proper fit and bite. The restoration is then polished and bonded to the prepared tooth. Your tooth is restored with no "temporary" or return trip necessary. Please call our office to see if you are a candidate for this procedure.

Use it or Lose it!

Did you know that if you don't use all of your dental insurance benefits or money in your flexible spending account (FSA) this year, you lose them forever? That's right - no dental benefit plan or FSA we know of allows you to carry unused benefits over to the following year. If you don't use them, you lose them!

You may have benefits remaining this year. Waiting until next year means that not only will you lose any unused benefits for this year, but also that you may have to first satisfy a new year's deductible before any benefits will be paid.

If you have been postponing dental treatment, call our office at (757) 229-1224 to see if you have benefits remaining this year. We also have various financing options to help with any portion not covered by dental insurance.

A beautiful Smile is Precious and Priceless

Did you know that the shape, shade, length and spacing of your teeth could significantly affect your smile? And our smiles can greatly affect our self-esteem and confidence. Common conditions that impact negatively on your smile include broken, cracked or worn teeth, discolored teeth, missing teeth, crooked teeth, decayed teeth, gaps between your teeth and/or "gummy smiles." The good news is that with modern technology and improved materials, these situations can be dramatically changed to create natural looking and long-lasting beautiful smiles. Each patient and each specific circumstance must be evaluated on its own merits. Factors such as occlusion [bite], oral habits, available space, health of the gum tissue, severity of the problem and patient expectation must be taken into consideration while planning your cosmetic makeover. Depending on the situation, there are a variety of choices that all result in excellent esthetic outcomes. For whiter natural teeth, in-office or at-home bleaching [whitening] techniques are available. Repairing teeth or closing spaces may be accomplished with tooth-colored composite resin bonding, porcelain veneers or porcelain crowns. These procedures vary in time and cost and have differences in longevity and appearance. If you're not satisfied with your smile or want to learn if you're a good candidate for any of these remarkable techniques, call our office for a cosmetic consultation at (757) 229-1224 or visit our website at www.SmilesOfWilliamsburg.com.

Help! I Broke my Tooth!

Almost every day we get a call from a patient who has broken a tooth, and generally it means that to save the tooth, we have to place a crown or permanent restoration over it to keep it from breaking further. Sometimes the tooth can't be saved and that is a real bummer!

What causes teeth to break? Well, there are several factors, one of which we see in almost all tooth fractures. The most common contributing factor is Silver amalgam fillings- these fillings have the unique property of enlarging as they age. So, there seems to be some outward pressure on the tooth and if someone bites just the right (or wrong) way, you hear that crack!

Now this tooth broke in several planes at once, and had to be removed; there wasn't enough sound tooth structure to save it! So an implant or bridge needed to be done.

This is a more common sort of fracture. The inside aspect of the tooth just shears away. Luckily, this tooth can be saved with a crown, after first making sure there is no decay present.

The second common factor is bruxism- the habit of grinding or clenching the teeth. Many bruxers break teeth that don't even have fillings in them, but they always have a higher percentage of broken teeth than people who don't brux or clench.

If you or someone you know does grind their teeth and are worried about a tooth or some teeth, don't hesitate to give us a call and we will be glad to check it out for you! Don't wait until it hurts!

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

Handling Dental Emergencies

Dental emergencies may be categorized as toothaches, injuries or broken appliances.

Toothache If a toothache develops, using a brush and floss, clean the suspected area. Rinse with warm salt water. Do not place an aspirin on the gums or tooth [this may cause a burn]. Apply a cold compress to any facial swelling. Take acetaminophen [Tylenol] and call us as soon as possible.

Avulsed Tooth If a permanent tooth is knocked completely out, time is of the essence. Immediately call us for an emergency appointment. It is critical to get the person and their tooth to us within one half hour. This makes it possible to re-implant the tooth with a high degree of success. Find the tooth, and holding it by its crown, gently rinse it to remove dirt and/or debris. Do not scrub the tooth. If possible, gently place the tooth back in its socket as a means of transport. Otherwise, transport the tooth in a cup of milk, saline [salt water], or saliva [place tooth between cheek and gum, unless child is too young]. If none of these are available, use a cup of plain water.

Extruded Teeth If a tooth is pushed either inward or outward, try to reposition the tooth using light finger pressure. Do not force the tooth into its socket. Try to get the injured person to us as soon as possible. The tooth may be stabilized and held in place with a moist tissue or gauze on the way over.

Fractured Teeth First rinse your mouth with warm water to keep it clean. Immediate dental care is necessary. The treatment will depend on the severity of the fracture and could range from smoothing out the chip to bonding with a resin [tooth colored] material to placing a crown [cap]. If there has been pulp [nerve] injury, root canal may be necessary at once or at a later date.

Soft Tissue Injury The tongue, lips or cheeks may be bitten, lacerated [cut] or punctured. If there is bleeding, apply firm pressure with a gauze or clean cloth. If bleeding doesn’t stop within 15 minutes, bring the person to our office or a hospital emergency room. Sutures [stitches] may be necessary. Otherwise, clean the area with warm water on a gauze or clean cloth. Apply an ice compress to the bruised or swollen area. Contact us for further instructions.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

"Here, use my toothbrush..."

Ever use someone else's toothbrush? You may think twice about doing it again after reading this: (1) Toothbrushes can be a source of repeated dental infections. (2) Toothbrushes can cause a bacteremia (bacteria entering the bloodstream) that may result in an endocarditis (a heart infection). (3) Toothbrushes can harbor and transmit viruses and bacteria. (4) Toothbrushes can retain 50% of the herpes simplex virus for one week. (5) Gingival [gum] inflammation can be reduced by changing toothbrushes biweekly.

Still think it's sexy to share a toothbrush? How about sharing food? Kissing? Certain bacteria can be transmitted from site to site in the mouth via dental instruments or from person to person sharing someone else's eating utensil. In juvenile periodontitis, virulent bacteria can move from an infected site to an uninfected site in the same mouth. Other bacteria can be transmitted between spouses. Some bacteria can be transmitted between parents and children. Still other bacteria can be transmitted from dogs to children.

So you see, bacteria once thought to be localized to specific sites in the mouth can be migratory. We're not advocating that you stop tasting a scrumptious morsel or two at a four-star restaurant; we are advocating that everyone maintain good dental health not only for themselves but for the sake of those they love.

As far as ridding toothbrushes of bacteria, soaking them in a mouthrinse containing essential oils for 20 minutes kills 100% of the bacteria on the bristles. Ultraviolet light also sanitizes toothbrushes. But when researchers* tested the efficacy of using a toothpaste containing a common disinfectant compound - triclosan - they found little benefit when it came to eliminating the offending bacteria attached to the toothbrush bristles.

So what can you do about bacterial contamination from toothbrushes? Soak them in a suitable mouthwash, expose them to ultraviolet light, or from a practical stance, change them frequently. As for kissing someone, the benefits may still outweigh the risks... as long as you have an inkling as to their periodontal status!

*Warren DP, Goldshmidt MC, Thompson MB, Adler-Storhz K, and Keene HJ: The effects of toothpastes on residual microbial contamination of toothbrushes. JADA 132:1241-1245, 2001.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

Setting Priorities for Good Dental Health

Many people have bleeding gums, and they don’t think twice about it. They view it as a minor inconvenience. If you were bleeding from any other part of your body, you wouldn’t hesitate to see a physician. If you lost a body part you wouldn’t hesitate to have it replaced. We have 32 teeth - they are all body parts.

While we may not need our teeth to live like one needs a heart, we need our mouth to be pain-free and functional to enjoy a good quality of life.

But like exercising, dieting or anything that requires a routine, many of us fall short of a sustained effort to accomplishing long-term results. Why do we run out of toothpaste, floss, toothbrushes, vitamins, etc. when we know their importance? Why do we have problems maintaining an oral hygiene regimen? Perhaps, we don’t make the answers priorities.

We in this dental office believe in the philosophy espoused by Dr. F. Harold Wirth who said, "The mouth in its entirety is an important and even wondrous part of our anatomy, our emotion, our life; it is the site of our very being. When an animal loses teeth, it cannot survive unless it is domesticated; its very existence is terminated; it dies. In the human, the mouth is the means of speaking, of expressing love, happiness and joy, anger, ill temper, or sorrow. It is the primary sex contact; hence it is of initial import to our regeneration and survival by food and propagation. It deserves the greatest care it can receive at any sacrifice."

This is our passion. Make it yours and the rest will fall into place. Call and ask us how we may help you achieve your oral hygiene and health goals and ensure a greater quality of life.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!