My Blog

Posts for: December, 2018

By Mary V. Jaffarian, DMD
December 24, 2018
Category: Dental Procedures
Tags: fillings  
ItsanArtDeterminingToothColorinCompositeResinRestorations

It takes a lot of skill, experience, talent and artistry to create tooth restorations that look so natural that no one can tell them apart from the originals. To do so requires understanding of the normal anatomy of a tooth as well as of the interactions of light and color.

How the anatomy of a tooth determines color

The color that we perceive when looking at a tooth results from the combined appearance of the tooth’s center core (dentin layer) and its covering enamel. Going from the outside in, the enamel is made of tightly packed crystals of calcium, which cause it to be one of the hardest substances naturally produced by animals. The crystals are also responsible for a tooth’s brilliance and translucence. The dentin is more like bone, a porous living tissue composed of microscopic tubes, interspersed with more calcium crystals. In the very center of the tooth is a central chamber containing the pulp and nerves.

Each of these layers has its own physical and optical properties. Since the enamel is translucent and the dentin is more opaque, most of the tooth’s color comes from the dentin and is transmitted through the enamel layer. Factors that affect this transmission include the thickness and age of the enamel as well as external tooth whitening.

If the enamel is more translucent, more of the color of the dentin shows through. If it is more opaque, the enamel absorbs and reflects light so that less color is visible and the enamel looks brighter.

The language of color composition and reflected light

Color means the whole spectrum in the rainbow. The spectrum is made up of the three primary colors — red, blue, and green. When all are combined, they create white light.

Hue refers to the brightest forms of the colors. The color we perceive depends on the dominant wavelength of light that is reflected by an object.

Value refers to a color’s lightness or darkness. A brighter color has a higher value.

Chroma is the amount of identifiable hue in a color. An achromatic color (without hue) appears gray.

Saturation is a measure of a color’s intensity.

This terminology of color is used not only by dentists and dental technicians, but also by a wide range of artists. It implies expertise and understanding of how colors work, how they vary and change and affect one another.

Contact us today to schedule an appointment or to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor article, “Artistic Repair of Front Teeth with Composite Resin.”


By Mary V. Jaffarian, DMD
December 14, 2018
Category: Dental Procedures
Tags: dental implants  
WhattoExpectBeforeDuringandAfterImplantSurgery

People are choosing dental implants at an increasing rate to replace missing teeth, either as an individual tooth or as a support for other restorations. But unlike other replacement options, we must surgically install the titanium post at the heart of the system directly into the jawbone.

While the term “surgery” might make you nervous, there's nothing at all to worry about. Here's what you need to know about before, during and after this relatively minor procedure.

Before. While the actual procedure is no more complicated than a tooth extraction, it ultimately depends on careful planning beforehand. Using x-ray diagnostics, we prepare a precise surgical guide to help us locate the best position to place them for a successful outcome. We'll also need to check bone volume to make sure there's an adequate amount to securely anchor the implant. If the bone is insufficient you may need bone grafting to build up the site or another replacement option.

During. The actual procedure begins, of course, with local anesthesia to numb the site — you should feel no pain and very minimal discomfort. We access the bone through the gums; often using a surgical guide for alignment, we create a small channel or hole with a sequence of drills that gradually increase the size until it can accommodate the implant. We remove the implants from their sterile packaging and install them immediately into the channel. After confirming their proper positioning with x-rays, we can close the gum tissues over it for protection during healing or attach a healing abutment that extends through the gum tissue thereby avoiding a second surgical procedure.

After. Because we disrupt relatively little of the soft tissue and bone, there's only minimal discomfort afterward easily managed with aspirin, ibuprofen or similar anti-inflammatory medication. We may also prescribe antibiotics to guard against infection while the gums heal. During the next several weeks, the titanium post, which has an affinity to bone, will become more secure as bone cells grow and adhere to it. It's also during this time that a dental lab creates your permanent crown or other restoration that matches the color and tooth shape so it will blend with your other teeth.

This process is complete when we install the final restoration onto the implant. You'll have a new smile and better function.

If you would like more information on dental implants, 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 “Dental Implant Surgery.”


By Mary V. Jaffarian, DMD
December 04, 2018
Category: Dental Procedures
CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”