Getting a new crown for a front tooth is a standard procedure performed in thousands of dental offices around the country. But dental patients are sometimes surprised to find that the price of this routine treatment can vary by a substantial amount. What accounts for the difference? The answer tells us a lot about how crowns are made, and the value of aesthetics in dentistry.

Crowns may be made of several different materials. Gold, the most traditional restoration material, makes for a time-tested, functional and durable crown, lasting as long as 50 years. Gold is a precious (and expensive) metal, but considered over the lifetime of the restoration, it's an economical choice. Yet, even for back teeth, it's losing out in popularity to more aesthetically pleasing alternatives.

Porcelain-fused-to-metal (PFM) crowns and all-porcelain crowns replicate the look of natural teeth more accurately. The kind of porcelain used in restorations must have special strengtheners added, which enable it to stand up to wear and tear in the mouth. There are different porcelain materials used in dental restoration, each with a different look, quality and longevity. There are also new, high-tech ceramic materials. Each one has advantages and drawbacks, and each one's cost is different.

Besides the material, another large part of a crown's cost is the custom-fabrication of every piece. Since it must match the other teeth in form and function — and often in looks as well — every crown must be made to an individual's exact requirements. This includes the tooth's exact size and shape, its spacing, and (often) its particular color.

Making this happen is a multi-step process. First, a dentist carefully prepares a model of the affected tooth and its neighbors. Then, the fabrication work is normally performed by a highly skilled laboratory technician, at the dentist's direction. Finally, the dentist prepares the tooth for the restoration, performs final adjustments, and attaches the finished crown. When it's done, the restored tooth can be difficult to tell apart from any other.

The level of craftsmanship involved at the dental laboratory can vary — and along with it, the price. Dentists may even choose different technicians based on the quality level they're striving for. All of these factors affect the final cost of the crown, and its value to the patient.

It has been said that beauty is in the eye of the beholder, and this is certainly true in the case of dental restorations. The choice of a “best” crown is different for every person — more than one alternative may be available, and each comes with its own price. If you have more questions about your options for a crown restoration, don't hesitate to ask us!

If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Value of Quality Care,” “Porcelain Crowns & Veneers,” and “Gold or Porcelain Crowns.”

Lashinda Demus holds the U.S record in the 400 meter hurdles, with a time of 52.47 seconds, the third fastest ever recorded. While her twin 5-year-old boys cheered her on, she brought home a silver medal from the 2012 London Olympics. But when it comes to her full set of upper and lower braces, there's no silver to be seen!

Demus is a top-ranked competitor, a wife and a mom — and an adult who is currently in orthodontic treatment. With her orthodontist's approval, she chose clear ceramic braces. These are just one of the treatment options available to adult patients, many of whom prefer a less noticeable style of orthodontic appliance.

As many as three-quarters of adults are thought to have some form of orthodontic problem. Common issues include teeth that are crowded too closely together, or ones that have drifted too far apart after an extraction or other tooth loss. It is believed that straightened teeth are easier to clean and better for chewing — they can also improve an adult's social life, and even his or her career prospects!

Some grown-ups may hesitate to consider orthodontic treatment because they remember the “railroad tracks” they saw in junior high school. In fact, there have been many changes in orthodontic appliances in the past few years. Two popular choices for adults are colorless braces (the kind Demus wears) and clear orthodontic aligners.

Colorless ceramic braces are made of high-tech composite materials. They resist staining, and are less noticeable because their translucent appearance blends with the teeth. Often, a single wire is the only part that's plainly visible. Sometimes it's even possible to place them on the lingual (tongue) side of the teeth.

Clear aligners are an alternative to braces that are available to adults and teens. Instead of wires and attachments, these consist of a series of transparent, removable trays that are placed over the teeth and worn 20 hours per day. Over a period of six months to two years, the teeth are gradually straightened as you progress from one computer-designed tray to the next. Best of all, you can remove the trays completely to clean your teeth, and for important occasions.

Which one is right for you? It depends. While aligners have been successful in treating mild to moderate spacing issues, more difficult problems with the bite may require a more traditional form of braces. Also, there are a few health problems which might need to be attended to before orthodontic treatment is begun. The best way to learn about your options is to come in for a consultation. But remember: if you want a better smile, it's never too late.

If you would like more information about orthodontic choices, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Clear Orthodontic Aligners.”

Do you ever find yourself thinking, “My smile would be near perfect if only?” If your answer is yes, come and see us to discuss some of the most advanced cosmetic treatment procedures available to give you a more dazzling smile in the shortest amount of time. Almost anything is possible from simple whitening procedures to a complete smile makeover, which may include repositioning your teeth with orthodontics and changing tooth shape and color with porcelain laminate veneers, to name a few options.

Before your visit, make a list of all of the things that you would like changed or improved. Being able to effectively communicate your desires to us will help immensely as we work together on your smile makeover. Although we may have a different opinion on what may actually be possible based on your dental and oral health, simply knowing how you define “your” ideal smile can be a good starting point.

For example, have you thought about and answered the following questions:

• Do you think your teeth or gums show too much or too little when you smile?
• What do you like and dislike? Are you unhappy with the size, shape or position of your teeth?
• Do you have unsightly gaps between some or all of your teeth?
• Do you think your smile would be improved if your teeth were whiter?

Providing us with a clear picture of all the things you like or don't like about your current smile will help guide the process. Even a picture of a smile that you like of a younger you or even torn from the pages of a celebrity magazine could be helpful. During our initial consultation, we will take all the dental records necessary for a cosmetic evaluation and smile enhancement. We can then compare your actual results to your “wish list” to ascertain how close we can get to your ideal smile and even create a computer-generated image of what we can achieve.

If you think you are ready to change your smile, call us today. For further information on the importance of having a clear vision plan that both patient and dentist agree upon, read the Dear Doctor magazine article “Great Expectations: Is What You Get What You Want?”

Do you clench your jaw or grind your teeth? Bite your nails? Chew on pencils or toothpicks? Or, heaven forbid, unscrew hard-to-open bottle caps using your precious pearly whites?

Over time, habits such as these — referred to in dentistry as “parafunctional” (para – outside; functional – normal) or beyond the range of what nature intended — can inflict excessive wear and tear on your teeth. Besides the impact damaged teeth can have on your smile, so called “tooth to tooth” and “tooth to foreign object” behaviors can cause physical problems, such as jaw joint and muscle pain, headaches, earaches, and even neck and back pain.

Use of Excessive Force

Parafunctional behaviors exert an abnormal amount of force on your teeth — up to 10 times the amount used for biting and chewing. Tooth grinding or “bruxism” (from the Greek word brykein – “gnash the teeth”) is particularly detrimental and is commonly seen in individuals who are experiencing a stressful time in their life. Some medications can also trigger it. Since bruxism often occurs while people sleep, it's possible to be unaware of it unless a partner comments (it can be noisy!) or a dental professional points out the tell-tale signs of wear.

To counter the adverse effects of nocturnal tooth grinding our office can create a customized night or occlusal (bite) guard. Typically fashioned from a hard, clear “processed acrylic” (wear-resistant plastic), this type of guard is amazingly inconspicuous. It is made to fit over the biting surfaces of the upper teeth only and is thinner than a dime. When it is worn, the lower teeth easily glide over the upper teeth rather than chomping into and gnashing with them, which minimizes the likelihood of erosion, chipping and uneven or excessive wear of the biting surface of the teeth. The guard is so unobtrusive, that some people even wear it as they go about their daily activities.

Remember: In addition to proper dental hygiene, you can help keep your teeth healthy by using them wisely!

If you would like more information about parafunctional habits like bruxism and ways to protect your teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “How And Why Teeth Wear.”

Whether you think they're the height of fashion or the depth of “ice,” oral piercings like tongue bolts are a sign of our times. But along with these bodily adornments come a host of questions about risks to the wearer's health, both immediate and long-term. To help sort out these concerns, here are five facts everyone ought to know about oral piercings.

Oral piercings can cause acute health problems.

Rarely, nerve problems may result from an oral piercing. In at least one case, a teenager who had just gotten a tongue bolt developed severe facial pain and the feeling of electrical shocks. A neurologist traced these symptoms to an irritated nerve in the tongue, and the bolt's removal made the pain go away. More commonly, however, the immediate problems are soreness in the area of the piercing, bleeding in the mouth, and the risk of infection.

Oral piercings can lead to gum disease.

Periodontal problems associated with oral piercings include gum recession, inflammation, and even infection. Long-term bone loss may also be an issue. Over time, all of these conditions may affect a person's general health.

Oral piercings can lead to tooth problems.

Tooth pain and sensitivity are sometimes reported after the installation of an oral piercing. Chipping of the teeth is also a possibility, due to repeated contact with the metal of the ornament. People who decide to wear oral piercings should consult with us about increasing the frequency of their dental checkups.

Closing the hole left by a tongue piercing may require minor surgery.

As is the case with an ear piercing, the hole made for a tongue bolt often closes on its own. If it doesn't, a little surgery may be required to help it. In some cases, the tissue around the piercing may need to be removed before the hole itself can be sewn closed. Carried out under local anesthesia (a numbing shot), however, the procedure is usually simple and quick to heal.

Removing an oral piercing improves your oral health.

Losing the piercing reduces your risk factors, and thus improves your oral health. It's as simple as that. But any decision about oral piercings is ultimately yours to make. You should have a frank conversation about its risks and benefits with a knowledgeable health professional.

If you would like more information about oral piercings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”