Drilling teeth is an essential part of repairing and restoring the damage caused by tooth decay. For generations dentists have relied on the dental drill with its rotating burr to remove decayed and damaged tooth material.

But while the dental drill is effective it also has its disadvantages. In the process of removing decayed material it inadvertently removes healthy structure near the target material. It often requires anesthesia to deaden the work area. And its noise and vibration are often unsettling to patients.

There is a growing alternative, though: air abrasion, a technology that's been around since the mid-20th Century. But recent advances in controlling the dust created by using abrasion, as well as new tooth-colored bonding materials to replace tooth structure, have sparked new interest among dentists and patients alike.

Also known as particle abrasion, this drill alternative uses a pressurized stream of fine particles to remove decayed material. Using a hand wand a dentist can precisely aim the stream of particles (usually aluminum oxide) to the specific areas of decay or softened material that need to be removed. As a result, it removes only a fraction of healthy tooth structure compared to traditional drilling. Air abrasion has also proven effective for removing staining without harming enamel.

Air abrasion also eliminates the sound and vibration associated with dental drills, and may not always require local anesthesia. On the other hand, it does have some limitations. For one, it's not as effective with larger cavities or working around older fillings. The tooth or teeth to be worked on must be carefully isolated from the rest of the mouth to keep the patient from swallowing the abrasive particles. And without a high-volume suction pump and good isolation protocols, the particles can produce something of a “sandstorm” in the treatment room.

But as air abrasion continues to advance, we may see improvements in these limitations. In a future time, the traditional dental drill may go the way of the horse and buggy.

If you would like more information on air abrasion as an alternative to drilling, 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 “Air Abrasion Technology.”

Perhaps you’ve heard the old saying: “Take care of your dentures and your dentures will take care of you.” Well, maybe it’s not that old—but it’s still a sensible notion. Maintaining your dentures by routinely cleaning them and having them checked for fit will improve their longevity.

There’s one other thing you should include on your maintenance routine—avoid wearing your dentures 24/7, especially while you sleep. This bad habit could lead to some unpleasant consequences.

For one, wearing dentures continuously can accelerate bone loss in the jaw that eventually causes your dentures to lose their comfortable fit. Bone loss is a natural consequence of tooth loss because the bone no longer receives the stimulation to grow transmitted by the teeth during chewing. Dentures can’t transmit this stimulus; what’s more, the pressure they place on the gums and underlying bony ridges could make bone loss worse. You can relieve this gum pressure at night by taking them out.

Dentures can also become a breeding ground for bacteria and fungi that cause disease, irritation and unpleasant mouth odors. Taking dentures out at night deprives these microorganisms of a prime opportunity to carry on business as usual—and it’s also a great time to clean your dentures. People who sleep with their dentures in their mouth are more likely to have gum or oral yeast infections and higher levels of proteins produced by white cells that increase inflammation. That could contribute to other diseases throughout the body.

Besides taking your dentures out at night, you should also practice other daily hygiene tasks. Remove your dentures after eating and rinse them with clean water. Brush your dentures daily with a soft-bristled brush and dish or antibacterial soap or dental cleanser (no toothpaste—it’s too abrasive for denture surfaces). Be sure you clean your gums and tongue every day too. When your dentures are out, store them in clean water or preferably an alkaline peroxide-based solution.

Removing your dentures at night and these other good habits will help extend the life and fit of your dentures. It could also help keep the rest of you healthy.

If you would like more information on denture care, 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 “Sleeping in Dentures: A Habit that Can Cause Health Problems.”

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, 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.”