My Blog

Posts for: November, 2014

By John Leitner DDS
November 19, 2014
Category: Dental Procedures
AvoidingtheJimCarreyChipped-ToothLook

Fans of the classic bumbling-buddies comic film “Dumb and Dumber” will surely remember the chipped front tooth that Jim Carrey sported as simpleminded former limo driver Lloyd Christmas. Carrey reportedly came up with the idea for this look when considering ways to make his character appear more “deranged.” He didn't need help from the make-up department, however… He simply had his dentist remove the dental bonding material on his left front tooth to reveal the chip he sustained in grade school!

Creating a Bond
A dental cosmetic bonding involves application of a composite filling material that our office can color and shape to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed. This is the quickest and lowest-cost option to repair a chip.

Alternatives
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.

A veneer can be used to hide smaller areas of missing tooth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface also may be necessary to fit a veneer.

A chipped tooth makes an impression, but generally not a flattering one. Nearly 20 years after “Dumb and Dumber” hit the theaters, the only thing Jim Carrey had to do recently to hint at a sequel for his nitwitted character was tweet a photo of that goofy grin!

If you would like more information about repairing a chipped tooth, 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 “Artistic Repair of Front Teeth With Composite Resin.”


TheTimeIntervaltoReplantaKnockedOutToothCanAffectitsLongevity

Contrary to what you might think, a knocked out tooth doesn’t inevitably mean tooth loss. Time is of the essence — the shorter the interval between injury and replanting the tooth, the better the tooth’s long-term survival. The longer the interval, on the other hand, the less likely the tooth can survive beyond a few years. That phenomenon is due to the mouth’s natural mechanism for holding teeth in place.

The tooth root maintains its attachment with the jaw bone through an intermediary tissue known as the periodontal ligament. Tiny fibers from one side of the ligament securely attach to the tooth root, while similar fibers attach to the bone on the opposite side of the ligament. This maintains stability between the teeth and bone while still allowing incremental tooth movement in response to mouth changes like tooth wear.

While the ligament fibers will attempt to reattach to a replanted tooth’s root, the longer the tooth is out of the socket the less likely the fibers will fully reattach. An “ankylosis” may instead form, in which the root attaches directly to the jaw bone without the periodontal ligament. In this situation the body no longer “recognizes” the tooth and begins to treat it like a foreign substance. In all but the rarest cases, the tooth root will begin to resorb (dissolve); at some point (which varies from patient to patient) the attachment becomes too weak for the tooth to remain in place and is lost.

Ideally, a knocked out tooth should be replanted within 5 minutes of the injury (for step-by-step instructions, refer to The Field-Side Guide to Dental Injuries available on-line at www.deardoctor.com/dental-injuries). Even if you pass the 5-minute window, however, it’s still advisable to attempt replanting. With a subsequent root canal treatment (to remove dead tissue from the inner tooth pulp and seal it from infection), it’s possible the tooth can survive for at least a few years, plenty of time to plan for a dental implant or similar tooth replacement.

If you would like more information on treatment for a knocked out tooth, 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 “Knocked Out Tooth.”