As far as your appearance goes, the most important teeth you have are those in the “smile zone.” These are the teeth most visible when you smile—and the ones that awkwardly stand out if they're chipped, worn or otherwise flawed. More than any other teeth, they determine how inviting your smile is to others.

You might think you'll need extensive cosmetic dental work to fix these kinds of dental defects. But that may not be necessary: We may be able to use a dental material known as composite resin to repair the defects in your “smile zone” teeth in one office visit.

Composite resins are a combination of ceramics and plastics that have been around for some time. They've only recently come into wide use, though, with the development of new techniques to bond them to tooth surfaces. They're ideal for chips, cracks, or decayed areas where front teeth make contact with one another. They may also be used occasionally to reshape irregular or misaligned teeth.

You'll first need a complete dental examination to determine if composite resin bonding is an appropriate approach for your situation. If so, we'll begin by preparing the tooth surface to better accept the resin material. We'll then apply the liquid form of the material in layers, along with other agents to increase the material's strength. Each layer is cured (hardened) before applying the next layer.

As the layers build up, we shape the material to achieve a normal tooth appearance. We'll also incorporate your individual color shadings, so that the prepared tooth blends well with surrounding natural teeth. In effect, the procedure requires as much artistry as technical skill to create a natural look.

Though not as strong as porcelain veneers or crowns, composite resins are durable if not subjected to heavy biting forces. And for a few hours in the dentist's chair with minimal tooth preparation, a composite resin treatment can create a dramatic and exciting change in your appearance.

If you would like more information on composite resin bonding, 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 “Artistic Repair of Front Teeth With Composite Resin.”

Brushing and flossing daily, and dental visits at least twice a year: These are the essential things you should be doing to protect your teeth and gums against dental disease. But you're also getting an automatic assist from your body through saliva, that humble fluid swishing around in your mouth, to protect your oral health.

It's more than simply “mouth water”: Without saliva and its various components, your risk for tooth decay or periodontal (gum) disease would be much higher. Here are 4 ways saliva helps you keep your teeth and gums healthy.

Cleansing. Chewing prepares your food for digestion, but in the process produces tiny particles of food debris. Settling on tooth surfaces, these bits become part of the dental plaque that forms on your teeth and develops the ideal breeding ground for disease-causing bacteria. Saliva helps rinse away much of this debris—particularly sugar, the primary food source for bacteria.

Protection. Saliva is the first line defense against disease-causing microorganisms entering the mouth. The primary source of this protection is a protein-based antibody called Immunoglobulin A (IgA), which directly fights infection-causing organisms. Another protein in saliva, lactoferrin (also found in tears), interferes with bacterial growth.

Buffering. The main enemy of tooth enamel is mouth acid, produced by oral bacteria and the foods that we eat. Saliva neutralizes acid to help the mouth maintain its normally neutral pH range. And it works fast: Saliva can buffer acid and restore balance within thirty minutes to an hour after eating.

Re-mineralization. It's normal for acid to build up after eating, and for it to quickly remove minerals from surface enamel, a process called de-mineralization that can soften and weaken the enamel. But saliva helps restore some of these lost minerals as it's neutralizing acid. This re-mineralization re-strengthens enamel against tooth decay.

Saliva is so important for maintaining a healthy mouth, it's worth your efforts to protect it. Diminished saliva production not only produces an unpleasant dry mouth, it may increase your risk for disease. If this is a constant problem, speak to your dentist about causes and remedies. You'll be doing your teeth and gums a favor.

If you would like more information on the role of saliva in maintaining oral health, 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 “Saliva: How it is Used to Diagnose Disease.”

One of the major signs that a young person's dental development is nearing completion is the eruption of the last four permanent teeth: the third molars, located rear-most on either side of both the upper and lower jaws. But the advent of these molars, also called wisdom teeth, isn't always a cause for celebration: They can give rise to serious dental problems.

Wisdom teeth often arrive on an already crowded jaw, making them subject to erupting out of position or becoming impacted, totally or partially submerged in the gums. This can cause harm not only to themselves, but also to other teeth: They can impinge on and damage the roots of their neighbors; impede brushing and flossing and increase the risk of disease; and skew the alignment of other teeth to create poor bites that affect dental health and function.

Wisdom teeth are considered so prone to these problems (an estimated 70% between ages 20 and 30 have at least one impacted molar) that it's been a common practice to remove them before they show signs of disease or poor bite development. As a result, third molar extractions are the most common surgical procedure performed by oral surgeons.

But the dental profession is now reevaluating this practice of early removal. On the whole, it's difficult to predict if the eruption of wisdom teeth in a particular person will actually lead to problems. It may be premature, then, to remove wisdom teeth before there's sufficient evidence of its necessity.

As a result, many dentists now follow a more nuanced approach to wisdom teeth management. An impacted wisdom tooth that's diseased or contributing to disease is an obvious candidate for removal. But if the eruption is proceeding without signs of impaction, disease or poor bite development, many providers recommend not removing them early. Instead, their development is allowed to continue, although monitored closely.

If signs of problems do begin to emerge, then removal may again be an option. Until then, a more long-term watchful approach toward wisdom teeth may be the best strategy for helping a young person achieve optimal dental health.

If you would like more information on managing wisdom teeth treatment, 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 “Wisdom Teeth: Coming of Age May Come With a Dilemma.”

Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.

Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.

Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.

Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.

While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.

That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.

Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.

With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.

The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.

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

Orthodontics, veneers and other cosmetic dental techniques can turn a less than perfect smile into a beautiful one—but not always very quickly. For example, porcelain veneers can take weeks from planning to installation, including the meticulous work of an outside dental lab to produce veneers that look natural as well as beautiful.

But you may be able to take advantage of another approach, one that often takes no more than a couple of dental visits. Called direct veneers, it's actually a process of bonding and sculpting life-like composite materials to teeth that are heavily stained, chipped or that contain tiny crevices called “craze lines.”

Unlike the similarly-named traditional method, direct veneers don't involve the creation of layered porcelain veneers fashioned by a dental lab. But this newer process is similar to the older one in that some of the enamel must be removed from the teeth in question to provide a suitable surface for the composite material to adhere. This alteration will be permanent, requiring a restorative covering on the treated teeth from then on.

Right before this preparation, though, a dentist typically makes an impression of the patient's mouth. This will be the basis for creating the procedural plan for the dental work, particularly a “trial smile” from similar composite material that can be applied to the patient's teeth before actual restoration work begins. This temporary application gives both patient and dentist an opportunity to visualize the final look, and make needed adjustments in color and shaping.

Once the work plan is finalized, the patient then returns for the actual restoration procedure. The dentist begins by applying and bonding the composite material to the prepared teeth. Then, using a drill and manual instruments, the dentist shapes and smooths the material into a tooth-like appearance that blends with other teeth. The procedure can take a few hours, but it can usually be completed during a single visit.

Although direct veneers may not last as long as porcelain veneers, the process is less costly and requires less time to complete. Direct veneers could be an economical solution for achieving a more attractive smile.

If you would like more information on direct veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic with a firsthand patient account by reading the Dear Doctor magazine article “A New Smile With Direct Veneers.”