Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Your teeth face a hostile environment populated by disease-causing bacteria. But your teeth also have some “armor” against these microscopic foes: enamel. This hard outer tooth layer forms a barrier between harmful bacteria and the tooth’s more vulnerable layers of dentin and the inner pulp.
But although it’s tough stuff, enamel can erode when it comes into contact with high concentrations of mouth acid. Losing substantial amounts of enamel could leave your teeth exposed to disease.
So, here are 3 things you can do to help protect your enamel so it can keep on protecting you.
Careful on the brushing. Brushing removes dental plaque, a thin bacterial film on teeth most responsible for dental disease. But be careful not to brush too often, too hard and too quickly after eating. Brushing more than twice a day can cause gum recession and enamel wear; likewise, brushing too aggressively. You should also wait at least 30 minutes after eating to brush to give your saliva sufficient time to neutralize any acid. You could lose tiny bits of softened enamel brushing too soon.
Cut back on acidic foods and beverages. Spicy foods, sodas and, yes, sports and energy drinks all contain high amounts of acid that can increase your mouth’s acidity. It’s a good idea, then, to reduce acidic foods and beverages in your diet. Instead, eat less spicy foods and drink primarily water or milk. Also, look for foods and beverages with calcium, which helps increase your enamel’s ability to remineralize after acid contact.
Don’t eat right before bedtime. There are a lot of reasons not to eat just before you hit the hay—and one of them is for protecting your tooth enamel. Saliva normally neutralizes acid within a half hour to an hour after eating. While you’re sleeping, though, saliva production decreases significantly. This in turn slows its neutralizing effect, giving acid more contact time with enamel. So, end your eating a few hours before you turn in to avoid too much acid remaining on your teeth.
Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.
Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.
Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.
Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.
However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.
Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow. After several months, we may have enough regenerated bone to support an implant.
If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.
Bonjour! Hola! Shalom! December is National Learn a Foreign Language Month, and learning to say “Hello” in different tongues is a good place to start. You could then move on to another set of wonderful words like sonrisa, lächeln and sourire, the Spanish, German and French words for “smile.”
But then again, smiling itself doesn’t need a translation—it’s common to every culture on earth. It’s one of our best assets for interacting with people, both at home and abroad. So, make sure your smile is the best it can be by taking care of the “stars of the show”: your teeth and gums.
Here are a few tips for keeping your teeth and gums healthy and your “international” smile attractive.
Brush and floss daily. It takes just 5 minutes a day to perform one of the most important things you can do for your long-term oral health. Brushing and flossing clean away dental plaque, a sticky bacterial film that causes tooth decay and gum disease. A daily oral hygiene practice helps keep your teeth shiny and clean and your gums a healthy shade of pink.
Get regular dental cleanings. Even the most diligent hygiene habit may not clear away all plaque deposits, which can then harden into a calcified form called calculus. Also known as tartar, calculus is an ideal haven for disease-causing bacteria—and it can’t be removed by brushing and flossing alone. Dental cleanings at least twice a year remove stubborn plaque and calculus, further reducing your disease risk.
Don’t ignore dental problems. While your dentist will check your mouth for disease during your regular cleanings, you should also be on the lookout for signs of problems between visits. Watch for odd spots on the teeth and swollen, reddened or bleeding gums. If you see any abnormalities like these, don’t ignore it; make an exam appointment as soon as possible. The sooner we identify and begin treating a potential dental issue, the less your oral health—and your smile—will suffer.
Consider cosmetic improvements. Keeping teeth clean and healthy is one thing, but what can you do about existing dental blemishes that detract from your smile? Fortunately, there are numerous ways to cosmetically enhance teeth and gums, and many are quite affordable. Teeth whitening can brighten up yellow, dingy teeth; bonding can repair minor chips and other tooth defects; and veneers and other restorations can mask tooth chips, stains or misalignments.
Like the ability to speak another language, a confident, joyful smile can open doors to new cultures, places and friends. Let us partner with you to make your smile as attractive as possible.
If you would like more information about improving and maintaining your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “10 Tips for Daily Oral Care at Home.”
Miley Cyrus's rise to fame began when she was cast in the Disney series Hannah Montana. She played the title character, Hannah Montana, a famous singing star hiding her true identity, ordinary girl, Miley Stewart. In her real life at the time, Miley Cyrus had her own little secret—she was undergoing orthodontic treatment to straighten her smile.
Like many teenagers (as well as many adults), Cyrus's dental bite wasn't in proper alignment. She could have gone the traditional way by straightening her smile with braces fixed to the front of her teeth. It's an effective treatment, but the metallic hardware can overwhelm a person's appearance.
With her various roles in the public spotlight, Cyrus and her family wanted an effective but out-of-sight method for moving her teeth. They chose a relatively new one called lingual braces. Unlike traditional braces, the hardware for lingual braces is fixed on the back of the teeth (or the tongue side, hence the term “lingual”).
Lingual braces can correct any bite problem labial (“lip”) braces can, just through different mechanics of movement. Its main appeal is that the hardware is hidden behind the teeth, so only you and your orthodontist need know you're wearing braces.
There is also less risk of damage to the mouth or the braces themselves if you're in a sport or profession where you're at high risk for facial blows. And unlike patients with traditional braces, you'll have an unobstructed view of your progress over the course of treatment.
Lingual braces do tend to cost more than traditional braces. Some patients also have difficulty at first with speaking and tongue comfort, though most grow accustomed to the braces within a couple of weeks. Because lingual braces are relatively new, there's been a limited number of orthodontists offering it.
But lingual braces are just one of the ways to straighten teeth. Modern dentistry offers several ways to give you your dream smile. If you have dental problems or would like to improve the look of your smile, please contact us or schedule a consultation, and we can discuss your options. To learn more, read the Dear Doctor magazine articles “Lingual Braces” and “The Magic of Orthodontics.”
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