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Posts for category: Dental Procedures

By Courtney Camp Highsmith, DMD
April 15, 2019
Category: Dental Procedures
Tags: root resorption  
CatchRootResorptionEarlyforBestChancesofSavingYourTooth

As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.

Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb).  It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.

It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.

We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.

Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.

At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.

If you would like more information on diagnosing and treating root resorption, 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 “Root Resorption: An Unusual Phenomenon.”

By Courtney Camp Highsmith, DMD
March 16, 2019
Category: Dental Procedures
HowKathyBatesRetainsHerMovie-StarSmile

In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.

When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”

Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.

There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.

By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.

So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.

By Courtney Camp Highsmith, DMD
February 14, 2019
Category: Dental Procedures
Tags: composite resin  
CompositeResinCouldAmpupYourTeethsAttractivenessinJustOneVisit

It might not rise to the level of a miracle, but cosmetic dentistry can achieve some amazing outcomes with unattractive teeth. A skilled and experienced dentist can turn "ugly ducklings" into beautiful "swans." And that achievement might not be as in-depth or expensive as you might think, thanks to the increased use of dental materials called composite resins.

Composite resins are pliable, tooth-colored materials we apply directly to tooth surfaces. They're most often used with broken, chipped or misshapen front teeth—the composite material replaces the missing tooth structure.

Composite resins have been around for decades, but haven't been widely used because they didn't have the strength of dental porcelain. In recent years, though, dentists have perfected techniques for bonding and shaping composites to teeth that have increased their durability. With just the right skill and artistry, composites can look like natural teeth.

We can correct many tooth flaws using composite resins right in our office. After roughening up the outer enamel surface of the tooth and performing other steps to aid bonding, we begin applying liquid resins to form a base layer that we then harden with a special light source. We continue to add layers to increase the color depth and shape of the restoration, before finally polishing it to resemble natural teeth.

Composite restorations are ideal for moderate tooth structure loss, but may not be appropriate for heavily worn, previously root canal-treated or fractured teeth. These and other kinds of flaws may require a different solution such as a dental porcelain restoration with veneers or crowns. Where composites can be used, though, they provide an affordable option that doesn't require an outside dental lab for fabrication—we can often perform it in one visit.

If you'd like to consider a composite resin restoration for a less than perfect tooth, see us for a complete examination and consultation. If your situation appears to be compatible for using this particular technique, composite resins could change your smile for the better in just a few minutes.

If you would like more information on how we can improve your smile, 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.”

By Courtney Camp Highsmith, DMD
February 04, 2019
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Courtney Camp Highsmith, DMD
January 25, 2019
Category: Dental Procedures
Tags: veneers  
YourVeneersHaveStayingPower-ifCaredforProperly

Porcelain veneers are excellent for restoring otherwise sound teeth that are stained, chipped or slightly misaligned. But the question for many is, are they long-lasting?

Just as the term is used in building construction, a dental veneer is a thin covering of material that’s bonded to the outside of a tooth to conceal blemishes. Very thin layers of dental porcelain (a form of hardened glass colored to match a patient’s natural teeth) are created by a dental lab technician to achieve the preferred shape and size of the patient’s tooth. Unlike crowns or other restorations, veneers require very little tooth preparation to accommodate them.

As to their longevity: if cared for properly, a veneer could last for twenty years or more. While the veneer itself isn’t subject to the effects of dental disease, the tooth and the gums that support it are. Shrinking gum tissues as a result of periodontal (gum) disease, for example, could have a negative effect on the veneered tooth and subsequently the veneer. It’s important, then, that you properly practice daily brushing and flossing, along with keeping up regular office cleanings and checkups.

There’s one other important consideration: while porcelain veneers can withstand normal biting forces, if they’re subjected beyond their tolerance they could shatter. You should be careful not to subject your veneered teeth to an abnormal biting force, such as biting down on an extremely hard object. If you tend to grind your teeth at night, wearing a night guard can minimize the force created from the grinding.

It’s possible to repair and re-bond a loose or slightly chipped veneer. In some cases, though, severe damage may require a replacement. Still, by using common sense about what you bite down on and taking proper care of your teeth and gums, you can minimize the chances of damage and enjoy many years of a more attractive smile.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: How Long will Your Porcelain Veneers Last?.”



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