Canine Substitutions

                   Some people are congenitally missing their upper lateral incisors. Meaning that, genetically those teeth never develop and when the baby teeth fall out they are left with two missing teeth. The lateral incisors are the small teeth next to the front central incisors.

                Once this condition is identified a plan needs to be formulated to assure an optimum outcome. There are two ways to handle this, the first is canine substitution. In canine substitution we use orthodontics to move the upper canines into the lateral positions. There are some compromises aesthetically and functionally with this approach.

 Aesthetically canines are much wider and more triangular shaped than laterals. So if moved as is the smile looks unusual unless the canines are altered. If treatment is coordinated properly with the restoring dentist and the orthodontist, the canines can be narrowed and reshaped with composite bonding and the position of the tooth moved to mimic a lateral.

The bite or occlusion can be compromised as well since you are left with fewer teeth in the upper arch compared to the lower arch. Most of the time, the occlusion can be compensated for as part of the orthodontic treatment and an acceptable bite can be established.

The other approach is to maintain or regain the space that would normally be present with the lateral incisors. In this case, orthodontics is needed to move or hold the canines in their normal positions, and then later restore the missing teeth with implants or bridgework.

There are numerous factors that guide us into selecting the proper treatment plan, and unfortunately there will be compromises in either case. But if detected early and planned properly both treatment options can finish with beautiful results.

Diastema: The Space Between Your Teeth

Diastema is the term for any space between two teeth.  The midline diastema (space between the two upper central incisors) is by far the most common. Some celebrities have embraced their diastemas and have become part of their persona. For example…

Many people have a diastema and in most cases it may give some character, but for some they feel it detracts from their smile. With the advent of new materials and techniques patients have very conservative options available to eliminate these spaces.

In order to determine the best treatment we need to establish the etiology or cause for the diastema. The most common cause is the shape of the teeth. If the central incisors are rectangular shaped rather than ovoid this will lead to formation of a space. This is also the most easily corrected. Simply adding composite bonding to the side of the teeth will establish proper contours and close the space, and this is done without any harm to the teeth

Another common reason for spaces is a tooth size discrepancy. Simply put this is when the teeth are too small for the size of the jaw. For these cases bonding can be done to make the teeth wider, but if the shape of the teeth is good then orthodontic treatment (braces) may be the treatment of choice. There are now many esthetic options for orthodontic treatment (Invisalign, Ceramic Brackets, Short Term Orthodontics), and in some cases treatment can be completed in a few months.

Any spaces between teeth that were not previously there or are getting worse can be a sign of a problem. Gum disease weakens the support for the teeth and they become mobile and eventually spread out from biting forces causing spacing. Gum disease needs to be treated early to prevent systemic illness and tooth loss.

If you love your space and want to remain in the gap tooth club with Madonna, David Letterman, Arnold Schwarzenegger, Anna Paquin and Woody Harrelson, it worked for them. But if you are looking for a change or think your smile will look better and give you more confidence without the space; see your dentist for a consultation.

                                                              Composite Veneers by Salvatore Lotardo DDS

The truth about dental X-rays

The risk of X-rays:

Did you know that the radiation received from 20 dental x-rays is equivalent to an entire day of unprotected exposure to the sun? How many times do you go to a little league game or a day at the park on a day that is not hot enough for you to remember to apply sunscreen. Dental X-rays started being used about 100 years ago and took 25 minutes to take. With new advances in technology, x-rays have become digital which cuts the time and exposure rate to a less than a minute to take and merely seconds to develop. A typical dental x-ray exposes you to only about .5-3 mrem. The average person is exposed to 120 times that every year from outside, background sources alone (http://www.new.ans.org/pi/resources/dosechart/ -check it for yourself).  The lower doses, like the ones in digital dental x-rays are not as harmful as the larger doses because your body has time to recover. At Nesconset Dental Associates, your well being is our number one priority which is why all of our x-ray equipment is the latest in digital x-rays. It allows us as dental care providers to proactively see any cavities or other issues that may be occurring before you can feel them, with the lowest dose of radiation allowable.
Here are a list of procedures that use radiation and the amount of radiation used in each. The following figures for comparison were taken from the publication "RADIATION",by radiologist Dr. Martin Ecker and the science writer Norton Bramesco and as you can see, dental x-rays are very low on the list in terms of the amount of radiation that they possess:
HIGH DOSE GROUP ............................ mrem
Barium enema: lower GI series .............. 875
Pelvimetry ................................. 595
Mammography: breast examination (per breast) 500
Lumbrosacral spine ......................... 450
Small bowel series ......................... 422
IV pyelogram (kidneys, ureter, and bladder . 420
Lumbar spine ............................... 347
Thoracic Spine ............................. 247
MEDIUM DOSE GROUP
Gallbladder ................................ 168
Abdomen .................................... 147
Ribs ....................................... 143
Pelvis ..................................... 133
Skull ...................................... 78
Hip ........................................ 72
LOW DOSE GROUP
Cervical spine (neck) ...................... 52
Femur (upper leg) .......................... 21
Dental (full mouth series) ................. 9
Dental (one x-ray) ......................... 0.5