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Posts for: December, 2014

By John Sartorio, D.M.D.
December 29, 2014
Category: Oral Health
Tags: oral health   medications  
DoYouNeedAntibioticsBeforeHavingaDentalProcedure

Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.

First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.

At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:

  • An artificial heart valve, or a heart valve repaired with artificial material
  • A history of endocarditis
  • A heart transplant with abnormal heart valve function
  • Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
  • A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
  • Repaired congenital heart disease with residual defects, such as leakage or abnormal flow

In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.

The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.

If you have questions about premedication before dental treatment, please contact us or schedule an appointment for a consultation.


ForMichaelBubletheShowMustGoOnEvenWithouttheTooth

What happens if you’re right in the middle of a song, in front of an arena full of fans… and you knock out a tooth with your microphone? If you’re Michael Buble, you don’t stop the show — you just keep right on singing.

The Canadian song stylist was recently performing at the Allphones Arena in Sydney, Australia, when an ill-timed encounter with the mike resulted in the loss of one of his teeth. But he didn’t let on to his dental dilemma, and finished the concert without a pause. The next day, Buble revealed the injury to his fans on his Instagram page, with a picture of himself in the dentist’s chair, and a note: “Don’t worry, I’m at the dentist getting fixed up for my final show tonight.”

Buble’s not the only singer who has had a close encounter with a mike: Country chanteuse Taylor Swift and pop star Demi Lovato, among others, have injured their teeth on stage. Fortunately, contemporary dentistry can take care of problems like this quickly and painlessly. So when you’ve got to get back before the public eye, what’s the best (and speediest) way to fix a chipped or broken tooth?

It depends on exactly what’s wrong. If it’s a small chip, cosmetic bonding might be the answer. Bonding uses special tooth-colored resins that mimic the natural shade and luster of your teeth. The whole procedure is done right here in the dental office, usually in just one visit. However, bonding isn’t as long-lasting as some other tooth-restoration methods, and it can’t fix large chips or breaks.

If a tooth’s roots are intact, a crown (or cap) can be used to replace the entire visible part. The damaged tooth is fitted for a custom-fabricated replacement, which is usually made in a dental laboratory and then attached at a subsequent visit (though it can sometimes be fabricated with high-tech machinery right in the office).

If the roots aren’t viable, you may have the option of a bridge or a dental implant. With a fixed bridge, the prosthetic tooth is supported by crowns that are placed on healthy teeth on either side of the gap. The bridge itself is a one-piece unit consisting of the replacement tooth plus the adjacent crowns.

In contrast, a high-tech dental implant is a replacement tooth that’s supported not by your other teeth, but by a screw-like post of titanium metal, which is inserted into the jaw in a minor surgical procedure. Dental implants have the highest success rate of any tooth-replacement method (over 95 percent); they help preserve the quality of bone on the jaw; and they don’t result in weakening the adjacent, healthy teeth — which makes implants the treatment of choice for many people.

So whether you’re crooning for ten thousand adoring fans or just singing in the shower, there's no reason to let a broken tooth stop the show: Talk to us about your tooth-restoration options! If you would like additional information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Dental Implants vs. Bridgework.”


By John Sartorio, D.M.D.
December 05, 2014
Category: Dental Procedures

Smile ImageWhat’s the difference between these two popular cosmetic procedures?

 
When you are considering a dental makeover, you have to go through the list of cosmetic treatments to truly find out which one would be best for your smile. After all, there’s really no need to go through lengthy, more invasive procedures if all you’re looking for is a minor tweak.
 
If you’ve been trying to decide whether dental veneers or dental implants in Pittsburgh will give you the smile you’re looking for, here are the major differences between these two procedures to help make your decision process a bit easier.
 

What aesthetic problems do implants and veneers fix?

 
A dental implant is used to restore missing teeth and isn’t used to fix more minor dental flaws. Those with tooth loss should weigh the pros and cons of getting dental implants, as they are a long-term restorative treatment. Veneers, on the other hand, are thin tooth-like shells that go over the front of a tooth to cover minor imperfections like cracks, chips, small gaps, overcrowding and severe stains that whitening treatments can fix.
 

What is the dental implant procedure like?

 
Dental implants are used to mimic a tooth’s root; therefore, it is embedded into the jawbone to hold an artificial crown in place. This means that the procedure itself is more invasive than it would be for veneers. Before the crown is even placed on the implant, the patient’s mouth is given a few months to heal properly after the implant is inserted. Over time the gums and bones will fuse around the implant, making it a permanent structure within the mouth.
 

What should I expect from my veneer treatment?

 
Veneers don’t require much preparation and the procedure doesn’t take nearly as long. Before we put on the veneers, we will shave about ½ millimeter of your tooth’s enamel to accommodate the extra size of the veneers (you don’t want them to look bulky!). Then we will match the veneers to the rest of your smile before adhering them to the front of your teeth. A special laser is used to harden the resin that will permanently bond the veneers to your teeth. Since we do shave down some of your natural tooth, this procedure is considered irreversible.
 
Implants are used for more serious situations like tooth loss while veneers are more commonly used because they can fix a host of dental problems without surgery. If you want to find out which procedure would be best for your smile, call us so we can get you in for a consultation. We would be happy to further discuss your dental options with you!

DeterminingtheRightWhiteningApproachisKeytoBrighteningaDullSmile

Bright, naturally white teeth are a key component in a beautiful smile. But the opposite is also true: nothing diminishes an otherwise attractive smile more than stained or discolored teeth.

There is good news, however, about tooth staining: it can be greatly reduced with the right whitening technique. But before taking action we need to first uncover the cause for the staining — whether from the outside or inside of the tooth, or a combination of both.

If it’s an external cause — known as extrinsic staining — our diet is usually the source. Foods and beverages that contain tannins, like red wine, coffee or tea fall in this category, as do foods with pigments called carotenes as found in carrots and oranges. Besides limiting consumption of stain-causing foods and maintaining daily oral hygiene, you can also diminish extrinsic staining with a bleaching application.

There are two basic ways to approach this: with either a professional application at our office or with a home kit purchased at a pharmacy or retail store. Although both types use similar chemicals, the professional application is usually stronger and the whitening effect is obtained quicker and may last longer.

Discoloration can also occur within a tooth, known as intrinsic staining, and for various reasons. It can occur during tooth development, as with childhood overexposure to fluoride or from the antibiotic tetracycline. Poor development of enamel or dentin (the main sources of natural tooth color), tooth decay, root canal treatments or trauma are also common causes of intrinsic discoloration.

There are techniques to reduce the effects of intrinsic staining, such as placing a bleaching agent inside the tooth following a root canal treatment. In some cases, the best approach may be to restore the tooth with a crown or porcelain veneer. The latter choice is a thin layer of dental material that is permanently bonded to the outer, visible portion of the tooth: it’s life-like color and appearance covers the discoloration, effectively renewing the person’s smile.

If you’ve been embarrassed by stained teeth, visit us for a complete examination. We’ll recommend the right course of action to turn your dull smile into a bright, attractive one.

If you would like more information on treatments for teeth staining, 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 “Teeth Whitening.”