Thursday, September 9, 2010

Sawdust Festival 2010





The staff took their annual field trip to the Sawdust Festival. Everyone had a very enjoyable day of shopping and having lunch together. It was a great day and a person could not ask for better weather.

Wednesday, September 8, 2010

Dr. Urban's Birthday Celebration



On August 4, 2010 the office staff gathered together as they usually do to celebrate Dr. Urban's birthday. We always look for reasons to celebrate and be together. It was similar to a 4th of July celebration with the sparkler style candles that lit up the cake. Fortunately the cake was large enough to accomodate the candles and fireworks. All of us had a great time and we now await the next birthday celebration.

Happy Birthday Dr. Urban!

Thursday, September 2, 2010

Fractured Teeth, Causes and Implications



During routine examinations I will often detect fractures in teeth. The most common areas are your back teeth (molars and bicuspids). These teeth are used to pulverize food, bite into hard candy, hit the occasion pit in pit less cherries, and chew ice. I do not recommend chewing ice-EVER! However, I can’t argue with the rest. Things just happen over time. Teeth fracture because of:
1. Burrowing decay
2. Root canal treatment for dying nerves
3. Unusual clenching or grinding
4. Overbites
5. Trauma and accidents
6. STPD (stupid things people do)
7. Ageing

As far as STPD I can think of things like opening bottles with teeth, opening chip bags with teeth, wearing some piece of jewelry in your tongue, chewing ice and hard candy.

Examinations will detect fractures when they get big enough to see with a magnifying lens or exhibit unusual light reflections. I use a bite stick or a wet cotton roll to see if there is any tenderness to biting. Hopefully, the tooth will not hurt and I will recommend a restoration to protect the underlying tooth structure. It is established by the root canal specialists that if a tooth is crowned (capped or covered) soon enough, only twenty percent will need future root canals. The percentages just go up the longer an untreated fracture exists.

Fractures never heal or go away. That is why your dentist checks your teeth very closely. Fractures often do not hurt until the break occurs. When the break occurs it can be a simple chip or a fatal shear fracture through the middle of the tooth. Fractures can injure the nerve in the root canal. That is why the root canal is treated, filled and sealed. It is a must for the tooth to be returned to normal function with a build-up and a crown. I have seen hundreds of rotting teeth with old root canals that were never restored with a crown.

Get your kids started early with dental visits. Today we fill cavities very conservatively with bonded resin (white) filling materials. This will keep the tooth stronger throughout one’s lifetime and may prevent fracturing from developing. As a kid I had average size silver/mercury fillings placed (everyone did at that time). They weren’t big, but as time wore on my teeth weakened and I eventually needed four crowns to repair the damaged teeth. This is very typical of people my age.

Finally, let’s talk about longevity. I am sure that prehistoric people did not worry about fractured teeth and aging. By the time they were 30 they were old and started dying. Teeth usually do not start fracturing until you about age 40. Today my practice enjoys treating hundreds of people in their seventies, eighties, and nineties. Their teeth become “work hardened” and brittle. Fracturing occurs more often. Fortunately, dentists can routinely repair these problems so we can continue to enjoy eating and socializing for years to come.

The Perils of Piercing


Dentists want to preserve, maintain, and if necessary restore teeth to full function and health. Therefore we preach prevention, encourage daily brushing and flossing, and recommend fillings and crowns to repair decayed teeth. Also, we inform people of harmful habits that lead to unnecessary dental problems. One of these is oral piercing.

I have not seen mature people (over thirty- something) succumb to this desire to poke a hole in their tongue and place a metal stud to show off. However, I have seen our teens and twenty year olds carry their body piercing habits onto the lips and into the mouth.

Let me tell you about the good things that happen when this is done. Nothing!
Now let me tell you about some of the adverse events that have occurred as a result of oral piercing. There have been several reports of severe infections and death as a result of bacterial infections. In fact a young British woman died of blood poisoning and pneumonia within 48 hours of tongue piercing this year. Although this is rare it can happen and would never have occurred if she declined to have the procedure.

Also some young people have experienced tooth movement as a result of pressing the metal ball of the tongue bar against the front teeth. Spaces and gaps are now appearing between the two front teeth. Teeth move when constant light forces are exerted against them. This principle is the basis for orthodontics. When random forces are applied random unpredictable events occur.
In my practice I have witnessed fractured teeth as a result of the metal banging against teeth. This has resulted in some expensive restorative work.-work that would have been unnecessary without piercing and tongue bars.

Lastly, I have observed severe recession of the gums around the lower front teeth. Tongue bars press against the gums on the back of the front teeth and the gums shrink away leaving bare root surfaces. Consequently these teeth become very sensitive and eventually get loose. Lip plugs bang against the front of the teeth causing recession on the front side. A lot of these defects cannot be repaired and will develop into major problems later on in life. Again these self induced dilemmas would never have occurred without piercing.
The ADA does not recommend piercing “because of its potential for numerous negative sequelae”. I am not aware of any dentist who approves of this trend. I can only encourage everyone to spread the word.

Tuesday, August 24, 2010

Dr. Urban on Today’s Dentistry/The Hollywood Smile


Have you ever looked in the mirror and wondered why your teeth aren’t as straight and bright as your favorite beautiful or gorgeous Hollywood actors? If not, then stop reading. For the rest us let me explain what goes into a great looking set of teeth and smile.

First, it starts when your parents take you to the dentist and orthodontist. Most bad bites and crooked teeth can be corrected with braces in two to three years. Take off the braces and bleach the teeth and Voila! You have a Hollywood smile.

Second (if you skipped the first step as a child), talk to your dentist about your smile. There are many types of beautiful smiles. They all have harmony and symmetry. Your dentist will evaluate your smile for lip line, tooth size, gum line, and color to develop an appropriate plan of action. Plans may include braces, bleaching, veneers, crowns, and cosmetic oral surgery.

I have many adults that have opted for braces. Yes, this takes a little longer, but it is often necessary for very badly positioned teeth. If the teeth are not too bad orthodontists can use the Invisalign clear tray method. Even with orthodontic correction your teeth may still be dark and worn.

Bleaching may be all that is needed. I use the “Sapphire” one-hour professional whitening. Other products such as Brite-Smile and Zoom are performed routinely. Take home tray bleaches are great and a little less expensive. The advantage is that you can bleach on your own quiet time and give yourself an occasional “booster” treatment when the teeth start returning to the original shade.

Veneers are thin porcelain shells that cover the front of the teeth. I try not to permanently alter healthy teeth for cosmetic work (sorry-it’s just me) so I use Lumineer veneers wherever justified. These are really thin (.3mm-.5mm) porcelain shells and are placed without the use of shots. I like them so much I have placed them on my staff and family to fill out the smile line and to permanently brighten teeth. Occasionally I must do a minor reduction of the tooth if it sticks out too far. The first veneers that were developed are thicker and require drilling back on the tooth to compensate for the added thickness.

When Lumineers cannot achieve your Hollywood smile many dentists are using ceramic fused to ceramic crowns. These crowns are brilliant and strong. They are more expensive than the old porcelain fused to metal crowns, but you will not get that dark line you see at the gum line when the tissues eventually shrink back.

Finally, oral cosmetic surgery may be required to correct gummy smiles and high lip lines.

So, if you want that “Hollywood Smile” a consultation with a dentist experienced in Cosmetic Dentistry might just start you on the road to the smile of your dreams!

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Wednesday, June 23, 2010

Snap On Smile



Snap-On Smile

The California Dental Association completed its annual spring scientific session in Anaheim. The lecture offerings were outstanding and very pertinent to your dental care. This week I want to report about an interesting innovative dental solution I discovered while “walking the floor”.

Dentists and patients have always been somewhat disappointed with temporary removable bridges while undergoing a long term dental solution. I think Snap-On Smile can happily offer people a beautiful temporary cosmetic solution for missing teeth, large gaps, and discolorations until they can get their dental work completed.

When a person goes to see the dentist about enhancements to their “smile profile” they will often get a mock up of what their teeth will look like after treatment. Unfortunately, the mock ups are fragile and have to be removed before they break. Recent improvements in acrylics now allow us to make a thin strong set of teeth that will snap over the existing teeth without shots and drilling.

Snap-On appliances are durable and do not stain. Some care must be taken when inserting and removing and they are not intended for a permanent fix for people’s dental problems. You can wear the appliance during the day and while eating. The appliance must be removed and cleaned when you brush your teeth. It is very difficult for anybody to tell if such an appliance is being worn.

These teeth-like appliances can be used to replace a missing front tooth, cover over crooked teeth, fill up spaces during implant placements, or for “photo shoots” and social engagements. Dentists can use these appliances to diagnose and change biting patterns to assist with more complicated problems. If porcelain veneers are not affordable the Snap-On Smile will certainly be a less costly substitute until porcelain veneers can be placed. Your teeth can be whiter and straighter until you have the ability to get your veneers.

The Snap-On Smile is made from an impression of your teeth. After the laboratory has completed the injection molding process the appliance is returned and fitted to your teeth. Your dentist will instruct you on handling and maintenance and some things you will have to do to get the maximum life expectancy from the teeth.

I am excited about the Snap-On Smile because it fills a time gap that some people require until they can get a permanent fix to their new smile.