Nashua, NH Dentist
Nashua Smile Makers
76 Allds Street
Nashua, NH 03060
(603) 882-3727
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By Nashua Smile Makers
September 13, 2019
Category: Dental Procedures
Tags: dental implant  
YourQuestforaDentalImplantMightBeInterruptedbyBoneLoss

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

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 Implants After Previous Tooth Loss.”

AnchorageToolsHelpOrthodontistsCorrectComplexBiteProblems

While braces are often the stars for straightening smiles, they're not the only cast members in an orthodontic production. Orthodontists occasionally turn to other appliances if the bite problem is challenging. Whatever the tool, though, they usually have something in common—they use the principle of anchorage.

To understand anchorage, let's first consider the classic kid's game Tug of War. With teams on either end of a rope, the object is to pull the opposing team across the center line before they pull you. To maximize your pulling force, the player at the back of your rope, usually your stoutest member, holds steady or "anchors" the rest of the team.

Like a Tug of War team, braces exert force against the teeth. This stimulates the supporting periodontal ligament to remodel itself and allow the teeth to move. The braces use the teeth they are attached to as anchors, which in a lot of cases are the back teeth. By attaching a thin wire to the brackets or braces on the teeth, the orthodontist includes all the teeth on the arch, from one end to the other. Anchored in place, the wire can maintain a constant pressure against the teeth to move them.

But not all bite situations are this straightforward. Sometimes an orthodontist needs to influence jaw growth in addition to teeth movement. For this purpose, they often use orthodontic headgear, which runs around the back of the head or neck and attaches to orthodontic brackets on the teeth. It still involves an anchor but in this case it's the patient's own skull.

In some situations, an orthodontist may feel he or she needs more anchorage as the teeth alone may not be enough. For this, they might establish a separate or additional anchor point using a temporary anchorage device (TAD). A TAD resembles a tiny screw that's inserted into the jawbone near the tooth intended for movement. The orthodontist can then attach the TAD to braces hardware using some form of elastics. After treatment, they remove the TAD.

These are just a couple examples of specialized tools an orthodontist can use for bite correction. Thanks to them and similar devices, even the most complex bite problem can be overcome to create a healthier and more attractive smile.

If you would like more information on correcting a poor bite, 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 “Orthodontic Headgear & Other Anchorage Appliances.”

ToExtractornotExtractTheBigDecisionAboutYourChildsWisdomTeeth

Your child's permanent teeth come in gradually, starting just as they begin losing their primary ("baby") teeth and not ending until late adolescence or early adulthood. That's when the third molars or "wisdom teeth" close out the process.

Because of their late arrival, wisdom teeth have a high potential for dental problems. With a greater chance of crowding or obstruction by other teeth, wisdom teeth often get stuck fully or partially below the gums and bone (impaction) or erupt out of position. In one study, 7 in 10 people between the ages of 20 and 30 will have at least one impacted wisdom tooth at some time in their lives.

It's not surprising then that wisdom teeth are among the most extracted teeth, to the tune of about 10 million per year. Besides those already diseased or causing bite problems, many are removed preemptively in an attempt to avoid future problems.

But wisdom teeth usually require surgical extraction by an oral surgeon, which is much more involved than a simple extraction by a general dentist. Given the potential consequences of surgical extraction, is it really necessary to remove a wisdom tooth not creating immediate problems?

That's not an easy question to answer because it's often difficult to predict a wisdom tooth's developmental track. Early on it can be disease-free and not causing any problems to other teeth. But as some researchers have found, one in three wisdom teeth at this stage will later develop disease or create other issues.

For many dentists, the best approach is to consider extraction on a case by case basis. Those displaying definite signs of problems are prime for removal. But where there are no signs of disease or other issues, the more prudent action may be to keep a watchful eye on their development and decide on extraction at some later date.

More than likely, your dentist will continue to have an ongoing discussion with you about the state of your child's wisdom teeth. While extraction is always an option, wisdom teeth that aren't yet a problem to dental health may be best left alone.

If you would like more information on treating wisdom teeth issues, please contact us or schedule an appointment for a consultation.

By Nashua Smile Makers
July 03, 2019
Category: Dental Procedures
Tags: veneers  

Perfect is a relative term, especially when it comes to teeth. For some, the perfect smile may consist of whiter, brighter teeth, while dental-veneerssomeone else might long to change the shape of their teeth or close up some gaps and spaces. If you have mild to moderate cosmetic imperfections/damage or would like to make general aesthetic improvements to your smile, porcelain veneers may be a good option for you. Here at Nashua Smile Makers in Nashua, NH, Dr. Salvatore Guerriero and Dr. Salvatore Colletta offer a range of cosmetic and general dentistry services (including veneers) for the entire family—read on to learn more!

 

Issues Addressed by Veneers

Even healthy and well cared for teeth are vulnerable to cosmetic damage over time. If you drink coffee, tea, red wine, or eat certain foods like dark berries and tomato sauce, your teeth will gradually look less white over time, even if you brush and floss every day (pro tip: you should!)

In other situations, maybe you chipped a tooth and never got around to fixing it, or have a gap between one or more teeth that makes you feel self-conscious every time you smile. Maybe everything is generally fine, but you just wish your teeth were more even or a different shape.

For all of these cases, veneers may be the solution!

 

How Veneers Work

Veneers are custom designed to match tooth enamel for a natural and authentic looking result. Made of a razor-thin layer of translucent porcelain, the veneer is bonded onto the surface of the tooth and molded into the desired size and shape. in order to ensure a natural fit, your dentist will remove a thin layer of tooth enamel to fit the veneer.

Veneers are not appropriate in every situation, and if you have any oral health issues like gum disease or a cavity, the dentist will treat them first before applying your new restorations. Once in place, veneers are cared for just like your natural teeth and can last anywhere from five to ten years or longer in many cases.

 

Find a Dentist in Nashua, NH

For more information about veneers and other cosmetic dentistry options, contact our office by calling (603) 882-3727 to schedule an appointment with Dr. Guerriero or Dr. Colletta today.

ToothTypeandConditioncanAffectRootCanalTherapyEffectiveness

Root canal therapy is the unsung "hero" of dentistry. Although often falsely maligned as an unpleasant experience, millions of decayed teeth have been saved thanks to this routine treatment.

But although root canal therapy can save your tooth, we can't guarantee it won't be affected by another infection. There are other factors to consider how long a treated tooth will remain healthy.

Root canal therapy stops and limits the damage from tooth decay that has infected the inner pulp and root canals. A dentist or endodontist (a root canal specialist) drills into the tooth to gain access to the pulp. They remove the diseased pulp tissue and then fill the empty pulp chamber and root canals with a specialized filling called gutta percha. The tooth is then sealed and later crowned to protect it against future fracture or infection.

The probability of that occurring may depend on when a dentist performs the root canal in the disease progression—and the earlier the better. If decay has already infected the underlying bone, the tooth's long-term prognosis even with root canal therapy could be dim. That's why you should see a dentist as soon as possible for any tooth pain, even if it goes away.

The type of tooth could impact long-term health. Teeth with single roots are usually easier to treat. But those with multiple roots and an intricate root canal network can be more difficult to treat, and require specialized equipment and techniques.

Age can also impact root canal therapy longevity. The older a root canal-treated tooth is, the more brittle and susceptible to fracture it can become, which can pose complications. That's why we typically place crowns on treated teeth to protect them from both future infection and undue stress created while biting and chewing.

To help mitigate these possible factors, you should see your dentist regularly for checkups and at the first sign of pain or other abnormalities for the earliest treatment possible. And for more complex tooth issues, your dentist may refer you to an endodontist to perform your root canal. With early intervention and attentive care, your root canaled tooth could enjoy many years of life.

If you would like more information on root canal treatment, 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 “Root Canal Treatment: How Long Will It Last?