What is composite resin bonding?
This term refers to a kind of tooth-colored material that is a mixture of a plastic resin and a glass filler. The glass gives the mixture, or composite, strength and translucency that is similar to a natural tooth. The composite is bonded to the tooth by slightly abrading or roughening the tooth so that the resin fills in small cuts in the tooth surface and bonds with it. The end result functions and looks like part of the original tooth.

What is bonding used for?
This technique is a good way to restore chipped or stained teeth or to change a tooth's shape or color. It can also be used to restore parts of a tooth near the gum line where the gums have receded and left the root partially exposed.

What are the advantages of bonding?
Composite resin tooth restorations have several advantages.

• They take only a single dental visit because they are done right in the dental chair rather than having to be sent to a dental lab for preparation.
• They are less expensive than many other dental restorations.
• They leave most of the original tooth intact since little tooth preparation or drilling has to be done in order to make the composite material bond to the tooth.
• They can be made in a wide range of colors and can be matched well with the teeth around them.
• Because little of the original tooth has to be removed, they are a good choice for teens, whose dental arches (upper and lower jaws) are still developing.

What are the disadvantages of bonding?
The composite resin material is not as strong as the original tooth material, so the bonded restorations may not last over a long time. If it does last, the material may also stain as it ages.

When should you choose bonding?
Composite resin bonding is a good choice for a quick and attractive tooth restoration that may be replaced later by something more permanent, such as porcelain veneers.

Contact us today to schedule an appointment to discuss your questions about bonding. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”

Scientists don't know much about sleep even though it has been extensively studied. We do know that several hours of deep, restful sleep per night are essential for a healthy life.

Many people remain tired and unrefreshed, even after a full night's sleep. About a third of them are affected by sleep related breathing disorders (SRBD). Dentists can play a significant role in helping patients overcome these disorders, which range from frequent snoring to severe Obstructive Sleep Apnea (OSA). If you think you may have such a disorder, read on.

Under normal conditions, your upper airway is open, allowing air to flow from your nose, through your throat, and into your lungs. If you suffer from SRBD, you experience frequent reductions in the flow of air to your lungs during sleep. You may not be aware of it, but sometimes your breathing may even stop for brief periods. These reductions happen when your tongue and other soft tissues in the back of your throat collapse backwards and block your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stages of sleep your body needs.

The resulting reduced oxygen flow to your heart and to your brain can cause serious damage. You will also be tired during the day and experience a lack of energy, even if you sleep for seven or eight hours per night. This constant drowsiness puts you at greater risk for accidents.

Because dentists generally see their patients at six-month or other regular intervals, we are in a good position to screen and refer patients with suspected SRBD to physicians for diagnosis and treatment. Dentists can also treat SRBD in a number of ways.

• One of these is Oral Appliance Therapy (OAT), in which a device that looks something like an orthodontic retainer holds your lower jaw in a forward position relative to your upper jaw, preventing your tongue and soft tissue from collapsing into your airway.
• Another consists of breathing equipment called Continuous Positive Airway Pressure (CPAP). The CPAP is a mask connected to a machine that pushes air into your lungs.
• Other treatments include oral surgery or orthodontia. The goal of these techniques is to increase the volume of air passing through your upper airway by pushing your tongue forward.

Medical insurance usually covers the cost of much of these treatments.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine article “Sleep Disorders and Dentistry.”

We'd like to take a moment to clarify why it is so important to wear the retainer(s) given to you after your orthodontic treatment. These devices, which literally “retain” your teeth in their new and improved positions, are not just for kids. Anyone who has recently had their teeth moved through orthodontics needs to wear them for the prescribed length of time. Here's why:

Though your teeth may now look perfectly aligned, research has shown that there is no “right” position for your teeth to be in that can assure they don't move again — no matter what age you are when treated for malocclusion (“mal” – bad; “occlusion” – bite). In fact, most people will see changes to their bite and tooth alignment as they get older, with or without orthodontic treatment.

For one thing, there is a natural tendency for bottom front teeth to undergo a gradual “uprighting” with age. This can cause them to crowd as they move toward the tongue. And it happens regardless of whether wisdom teeth are present.

In the case of teeth that have been straightened recently, a type of “memory” of their original position may cause them to drift back to it. This tendency gradually lessens, but it may be a problem for up to 18 months.

That's why it's crucial to follow our instructions for wearing retainers. Keep in mind that the plan we have given you is designed to achieve the best possible results in your individual case. Some people will need to wear retainers 24 hours per day, some just at night, and still others on an as-needed basis. You may have received a removable retainer or one that is secured to the back of your teeth. The important thing is to secure the results you've worked so hard to achieve.

If you have any questions about orthodontic retainers, please contact us, or schedule an appointment for an orthodontic consultation.

You can read more about this topic in the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

Of all the teeth in the mouth, the ones receiving the most discussion and controversy would have to be the wisdom teeth or third molars. And this is not just a recent phenomenon, as people have been discussing them for centuries! See how much you really know about wisdom teeth by taking our quick and easy true/false self test.

1. Third molars received their name, “wisdom teeth,” because a moderate amount of wisdom is supposedly achieved in life about the time they appear.
   True or False
2. Wisdom teeth and all of their associated problems are commonplace in the practice of dentistry.
   True or False
3. Because wisdom teeth are so unpredictable, they typically make their appearance between the ages of 17 and 25.
   True or False
4. The most common consequence of impacted wisdom teeth is gum (periodontal) disease.
   True or False
5. If wisdom teeth are not removed, they will become impacted or cause crowding. This is why so many people require orthodontic treatment (braces).
   True or False
6. While most people have four wisdom teeth, having more (supernumerary teeth) or less (hypodontia) is possible.
   True or False
7. Through dental x-rays and routine check-ups, we can predict the timing and way in which wisdom teeth become visible (erupt).
   True or False
8. An impacted wisdom tooth, by definition, is a third molar that is colliding with or jammed against another important structure, such as an adjacent tooth, the gums or other important soft tissues in the mouth, or nerves and blood vessels.
   True or False
9. The primary symptom for indicating you have an impacted wisdom tooth is pain.
   True or False
10. If wisdom teeth need to be removed, it is best to remove them at a younger age rather than waiting until periodontal disease has started.
    True or False

Answers: 1) True. 2) True. 3) True. 4) True. 5) False. While wisdom teeth can be a factor in crowding, some people have no issues with these teeth. For them, they grow into proper position and are healthy teeth. 6) True. 7) False. Unfortunately, it is not possible to predict the way wisdom teeth will erupt. 8) True. 9) False. In some scenarios, impacted wisdom may cause no pain. 10) True.

To learn more about wisdom teeth and in particular, impacted wisdom teeth, continue reading the Dear Doctor magazine article “Wisdom Teeth.” Or you can contact us today to schedule an appointment to discuss your questions.

If you believe you need a crown or if we have already confirmed this fact, you need to understand that there are several options. The most common are gold crowns, porcelain-fused-to-metal crowns and all porcelain crowns. Each has both pros and cons; thus we will work with you to determine which will work best for your specific needs. However, to help you learn more now, here are some facts.

Gold Crowns

Made from cast gold, this type of crown has been around for over 100 years and is the most successful type of crown. It can last more than 50 years and thus many dentists prefer gold restorations for their own teeth, where cosmetics is not a concern.

All Porcelain Crowns

All porcelain crowns can produce an incredible, life-like appearance. However, because they are made purely from dental porcelain (a type of glass), they tend to be more fragile than gold crowns and may be more at risk with certain high biting forces. Thus they may not be as durable. Porcelain can also cause wear to the natural teeth they bite against. Therefore they are typically preferred for front teeth, rather than back teeth. They have an aesthetic longevity of about 10 years and a functional longevity of about 20 years.

Porcelain-Fused-To-Metal Crowns

As the name states, porcelain-fused-to-metal (PFM) crowns provide the best of both worlds. They are made of natural tooth-colored dental porcelain that is fused on top of a precious or noble metal (usually gold or platinum). They are stronger than porcelain alone and are a good option for back teeth because they offer a better cosmetic result than gold crowns. This is also true for front teeth, however the gold support beneath the porcelain can compromise its life-like qualities. These crowns also have a proven track record and have been used with excellent results for over 40 years.

Learn more about crowns when you read, “Gold or Porcelain Crowns.” Or you can contact us today to discuss your questions or to schedule a consultation.