Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Dentists would rather spare natural teeth than extract them. At McLean Dental Care, Dr. Cecilia Gyllenhoff or Dr. Samuel Cappiello adhere to this philosophy of care, and accordingly, they offer realistic porcelain crowns to shore up damaged teeth. Placed in their McLean, VA, office, crowns dramatically improve smile integrity and appearance.
What is a dental crown?
Reliable and durable, a dental crown is a tooth-shaped porcelain jacket or cap which completely covers a tooth directly to the gum line. A crown looks like the original tooth only better because the crown improves the tooth's shape, size, bite and color.
As determined by visual inspection and X-rays, your tooth is a candidate for a crown if it's basically healthy but requires support because of:
- Tooth decay
- Large and multiple fillings
- Root canal therapy removes the inflamed interior pulp and seals the tooth against further infection
- Traumatic injury and resultant missing or cracked enamel
- Odd shape, unusual color, and/or an improper bite
- Extreme enamel wear due to teeth clenching and grinding (bruxism)
Dr. Cappiello or Dr. Gyllenhoff may use dental crowns as anchor points for a multi-tooth bridge or to restore a dental implant.
Details on the treatment
To create and place a crown, Dr. Cappiello or Dr. Gyllenhoff will take oral impressions of your tooth and its neighbors. Then, the dentist will shape the tooth so it accepts the crown. A dental lab makes your restoration from high-grade ceramic which is color-matched to compliment the rest of your smile. Permanent cement holds the new crown in place.
Keeping that crown beautiful
The Cleveland Clinic reports that most dental crowns last up to 15 years. Good at-home and in-office care are must-haves. So, be sure to:
- Floss and brush carefully every day to remove plaque.
- See your dentist at our McLean, VA, office twice a year for a cleaning and check-up (including the condition of your crown).
- Do not bite your nails or eat extra-hard dietary choices, such as candy apples and peanut brittle.
- Wear an acrylic bite guard at night if you struggle with teeth grinding and clenching.
To learn more...
If you worry about a tooth's strength or longevity, call your friends at McLean Dental Care. Dr. Cappiello or Dr. Gyllenhoff will be happy to evaluate your tooth and outline treatment options. Often, dental crowns are great choices. Phone our McLean, VA, office at (703) 734-0100.
As part of the fight against COVID-19, many of us have been wearing some form of face mask in public for most of 2020. While it's intended for good, mask wear has had some unintended consequences. For one, it's inhibited the expression of one of our most important social abilities—smiling.
We're all hoping, though, that 2021 will be different—that our smiles will once more shine out from behind our masks. If and when that happens, you'll want to be ready: Here are a few things you can do in the new year to give your smile a nice upgrade.
Teeth whitening. Fighting teeth yellowing is an ongoing battle. Certain foods, staining beverages and habits like smoking can take the gleam from your smile in no time. But you can brighten up dull teeth with a professional whitening treatment. And because our bleaching solutions are stronger than you'll find in your local retail store, the shine could last for years with only an occasional touchup.
Orthodontics. Straightening teeth orthodontically not only can improve your dental health and function, it could revamp your smile (you might call it the original “smile makeover”). Even if you're well past your teens, an orthodontic correction may still be a viable option. And if you're concerned about your appearance during treatment, you might be able to take advantage of nearly invisible clear aligners.
Bonding. A chipped tooth can certainly detract from an otherwise attractive smile, but it may not take extensive means to repair it. Many chipped or disfigured teeth can be made whole through dental bonding. This technique bonds a color-matched dental material called composite resin directly to the tooth. Best of all, the treatment may only take one visit.
Veneers and crowns. For more extensive chipping or staining, you can step up to a custom-made porcelain veneer or crown. Veneers are thin layers of porcelain that are bonded to the face of teeth to mask imperfections. Crowns cover a damaged but otherwise viable tooth to protect it and give it a more attractive appearance.
Dental Implants. If you have a missing tooth—or one that's simply past saving—consider replacing it with a dental implant. A dental implant attached to a crown is the closest thing we have to a natural tooth in both appearance and function. In fact, most people with implant-supported replacement teeth forget they have dental implants. We can also merge implants with other restorations like dentures or bridges for a more secure, comfortable hold and a more natural smile.
These and other cosmetic enhancements could make a big difference in your smile. To find out how, see us for a complete dental examination and consultation. We want you to be ready for what we hope will soon be a “mask-free” 2021.
If you're intrigued by the strange and bizarre, here's one to pique your interest: geographic tongue. It's a rare condition that causes the appearance of red patches on the tongue surface, surrounded by grayish-white borders, and which look a lot like continents on a map (hence the name). But although it may look odd, geographic tongue won't harm your health.
The condition is also known as benign migratory glossitis, so named because it's not cancerous and the patches seem to move or “migrate” around the tongue surface. The most common causes are thought to be stress or hormonal disruptions in those predisposed to the condition. Many researchers believe zinc or vitamin B deficiencies in the body contribute to its occurrence. It also seems more prevalent among non-smokers and pregnant women, as well as occurring as a family trait.
The red patches are created by the temporary disappearance of some of the papillae, tiny bumps on the tongue's top surface. The patches can abruptly appear during a flareup and then disappear just as suddenly. But as “angry” as the patches may look, geographic tongue is not considered a health danger. It isn't normally painful, although people can experience stinging or numbing sensations emanating from the patches that can be mildly uncomfortable.
Because it's also rare, you're not likely to encounter it personally. But if you or a loved one does begin to notice red patches on the tongue, there are a few things you can do to lessen any accompanying irritation. For one, cut out foods like tomatoes, citrus fruits, eggplant, mint or highly spicy or acidic foods, all of which have been known to increase discomfort. You might also avoid astringents like alcohol or mouthwashes that likewise irritate the patches when they occur.
Although geographic tongue can't be cured, your dentist can help you manage symptoms when they arise with the help of prescribed anesthetic mouthwashes, antihistamines or steroid lozenges. These not only can help lower any discomfort or irritations, they may also lessen the duration of a flareup.
For the most part, geographic tongue usually causes more embarrassment than physical discomfort. But with a little help from your dentist, you can keep it to a minimum. Geographic tongue may be odd, but it's nothing to worry about.
If you would like more information on geographic tongue, 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 “Geographic Tongue: No Cause For Alarm.”
Although they can be expensive upfront, dental implants often prove to be a wise investment in the long-term. With a success rate that outperforms other teeth replacement restorations, dental implants could be the answer to a more attractive smile that could last for decades.
But while their success rate is high (95% still functioning after ten years), they can and do occasionally fail. Of those that do, two-thirds happen in patients who smoke.
This unfortunate situation stems from smoking's overall effect on dental health. The nicotine in tobacco constricts oral blood vessels, inhibiting the flow of nutrients and antibodies to the teeth and gums. Inhaled smoke can scald the inside skin of the mouth, thickening its surface layers and damaging salivary glands leading to dry mouth.
These and other effects increase the risk for tooth decay or gum disease, which in turn makes it more likely that a smoker will lose teeth than a non-smoker and require a restoration like dental implants. And blood flow restriction caused by nicotine in turn can complicate the implant process.
Long-term implant durability depends on bone growth around the imbedded implant in the ensuing weeks after implant surgery. Because of their affinity with the titanium used in implants, bone cells readily grow and adhere to the implant. This integration process anchors the implant securely in place. But because of restricted blood flow, the healing process involved in bone integration can be impaired in smokers. Less integration may result in less stability for the implant and its long-term durability.
To increase your chances of a successful implant installation, you should consider quitting smoking and other tobacco products altogether before implant surgery. If that's too difficult, then cease from smoking for at least one week before surgery and two weeks after to better your odds of implant success. And be as meticulous as possible with daily brushing and flossing, as well as regular dental visits, to reduce your risk of disease.
There are many good reasons to quit smoking. If nothing else, do it to improve your dental health.
If you would like more information on tobacco use and dental health, 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 & Smoking.”
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