My Blog

Posts for: June, 2011

By Dr. Salzberg
June 26, 2011
Category: Dental Procedures

Quiz: What Is Smile Design?

All cultures worldwide recognize a smile as positive nonverbal communication. Yet many people are insecure about the way their smile looks. Modern cosmetic dentistry can completely change your smile through a comprehensive technique called Smile Design.

Take the following quiz to find out how much you know about your smile and smile design.

  1. What is the basic reason we consider straight, healthy teeth to be attractive?
    1. An article in a beauty magazine.
    2. An instinctive understanding of health and survival.
    3. Our first grade teacher said so.
    4. A talk show on television.
  2. What must we take into account in designing an attractive, balanced smile?
    1. The shape of your face.
    2. Your skin color and complexion.
    3. The form of your lips.
    4. All of the above.
  3. As your dentist, we consider each of the following in evaluating your current smile except:
    1. Your marital status.
    2. The health of your bone and gum tissues.
    3. How your jaw joints function.
    4. The stability of your bite.
  4. What do we use to evaluate your smile?
    1. X-rays and photographs.
    2. Models of your teeth and gums.
    3. Photographs and computer graphics.
    4. All of the above.
  5. Bonding is one method that may be used to test or enhance your smile. It is used as:
    1. A way of making friends with your dentist.
    2. A way of training secret agents.
    3. A method of repairing chipped, broken or decayed teeth and testing changes before they are made permanent.
    4. None of the above.

Answers

  1. b. What we consider an attractive smile is rooted in instinctive understanding of health and survival. We value straight, white, healthy teeth — only a few centuries ago, a person with few or no teeth was likely to starve.
  2. d. All of these factors must be taken into consideration in order to design a smile that is in balance with your face.
  3. a. While satisfaction with your life partner may make you smile, our priority in smile design is to make sure that the basic structures of your teeth are healthy and function properly.
  4. d. All of the above are used in evaluating your current condition to design a new smile.
  5. c. In bonding, a composite resin tooth colored material is shaped and physically bonded to a tooth or teeth that are chipped, broken, or decayed to restore both aesthetics and function.

After careful analysis and planning, a variety of techniques can be used to redesign an attractive and healthy new smile, so you can feel confident about smiling and sharing it with the world. To learn more about Smile Design, read “Beautiful Smiles by Design.” Or contact us to discuss your questions or to schedule an appointment.


Dental implants traditionally have a high success rate with numerous studies showing long-term success rates of over 95%. This is just one of the reasons they have been widely accepted as the best method for permanently replacing missing teeth. In fact, over-dentures, which are full dentures supported and stabilized by at least two dental implants, are now considered the standard of care by the American Dental Association (ADA) for people who have lost all of their teeth in one or both jaws. And while they have a high success rate, there are some factors that can compromise the success rates of implants.

These factors are generally divided into three categories: general health concerns, local factors, and maintenance issues.

  • General health concerns: Your general health, lifestyle, and habits can play a major role in the success of dental implants. For example, smoking, diabetes, osteoporosis (porous bone) or a compromised immune (resistance) system can all negatively impact implant healing and success. And if you have a history of radiation treatment to your jawbones, you are at a higher risk for complications.
  • Local factors: Some examples of local factors that can affect implant success include bone quality and quantity — having sufficient bone in the right place to accurately secure and locate the implants.
  • Maintenance issues: While implants are excellent high tech replacements for missing permanent teeth, they do require routine maintenance. This includes daily cleaning and continued professional care. Otherwise, implants are just like any other technically sophisticated devices — they may be susceptible to breakdown.

To learn more about dental implants, read “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.


FAQs About This New and Miraculous Procedure

How can sinus surgery contribute to the replacement of missing back teeth with dental implants?
Dental implants must be anchored the in bone to be successful. Maxillary sinus surgery can help regenerate bone that has been lost and is critically needed to anchor dental implants.

What are the maxillary air sinuses?
Inside the upper jaw, or “maxilla,” are structures known as the maxillary air sinuses, one on either side of the upper jaw. Each sinus is an air-filled space lined by a membrane. Upper back teeth are normally encased in the bone of the maxilla, below the sinuses.

Why is it important to replace missing back teeth?
Replacing back teeth restores the ability to eat, chew, and talk properly. The back teeth also provide facial and cheek support.

Why use dental implants?
Dental implants are the state-of-the-art method for replacing missing teeth.

Why does bone loss occur?
Unless special precautions are taken to prevent it, when teeth are lost, the bone supporting them is also lost.

If there is insufficient bone to anchor dental implants, what are the alternatives?
If all the back teeth are lost and dental implants cannot be placed, removable upper dentures may be the only alternative.

How do you determine whether a sinus surgical procedure is necessary?
The size, shape, and remaining bone of the maxillary sinuses influence whether you can have dental implants with or without a sinus surgical procedure.

How does surgery grow bone?
A small window is created in the sinus wall above where implants need to be placed. The sinus membrane is lifted and the space thus created filled with bone grafting and biologically active bone generating materials. The window is then closed and simply heals.

How is the surgery done?
The surgical procedures are performed from inside the mouth in the area just above the missing back teeth. They are generally carried out under local anesthesia (small shots, just like for a filling), sometimes with the addition of sedation or anti-anxiety medication.

How do bone grafts work?
Bone grafts act as scaffolds that the body replaces with its own bone. The most well researched bone substitute grafting material is currently bovine (cow) bone. All grafting materials are approved by the Food and Drug Administration. They are specially treated to render them completely sterile, non-contagious, and free of rejection factors.

What can I expect after surgery?
Moderate swelling and discomfort after surgery generally lasts for a few days to a week, about the same as having an upper impacted wisdom tooth removed. Supportive treatment usually includes a course of antibiotics to prevent infection and prescription strength medication of the aspirin or ibuprofen type. A decongestant may also be prescribed, if necessary. Healing is generally uneventful.

Who performs this surgery?
Maxillary sinus augmentations are usually carried out by oral surgeons, periodontists, or appropriately trained general dentists. Proper assessment of your situation and diagnosis are critical pre-requisites to the right procedure.

If you are missing upper back teeth, contact us today to schedule an appointment and discuss maxillary sinus augmentation. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery: Creating Bone for Dental Implants out of Thin Air.”


By Dr. Salzberg
June 05, 2011
Category: Dental Procedures

A dental crown is a tooth-shaped “cap” or cover that we place over a tooth that is badly damaged from trauma or decay to restore its shape, strength, size and functionality. We also use them for cosmetic reasons to improve a tooth's appearance with natural, life-like results. Crowns are generally handcrafted by dental laboratory technicians using high-quality dental porcelains (ceramic materials) that are made to fit on precise replicas (molds) of the prepared teeth. In our office, we generally make temporary crowns to protect the teeth to keep them comfortable and functional while the permanent crown(s) is being made. And once a crown is placed (cemented into position), it fully encases the entire visible portion of the tooth that lies at and above the gum line.

When Are They Necessary?

There are many reasons a crown may be needed. Some of these include:

  • To repair a tooth that is worn down, broken or badly damaged by decay or injury.
  • To restore a tooth so severely damaged by decay that the tooth's structure is no longer intact enough to place a filling or where a filling can't restore the tooth to its former strength.
  • To protect a tooth that has minor cracks or fractures from further damage.
  • To create a bridge to replace a missing tooth, in which the teeth on either side, known as abutments, must be “crowned” to attach to the “pontic” (from the French word, “pont” that means bridge).
  • To create the visible part of the tooth that sits atop a dental implant.
  • To improve the appearance of a tooth providing a more appealing shape and color.

To learn more on this topic, read the Dear Doctor article, “Porcelain Crowns & Veneers.” You can also contact us to discuss your questions or to schedule a consultation.