My Blog

Posts for: November, 2016

By Michael J. Tisdelle DDS
November 28, 2016
Category: Dental Procedures
NeilPatrickHarrisWhattheOscarsHostTreasuresMost

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


By Michael J. Tisdelle DDS
November 20, 2016
Category: Dental Procedures
Tags: braces   tooth extraction  
ExtractingCertainTeethcanBoostOrthodonticEffectiveness

We treat most malocclusions (bad bites) with braces or clear aligners. But not all malocclusions are alike — some can require extra procedures to achieve successful results.

One such example is when incoming teeth crowd other teeth and cause them to erupt abnormally. The crowding also reduces the space needed to move the misaligned teeth to better positions. To make more room we'll often remove some of the teeth before undertaking orthodontics.

The key is to extract the right teeth. The best candidates are those whose absence will have minimal effect on both appearance and dental function. That's commonly the bicuspids, located right on the edge of the “smile zone” (the teeth most visible when we smile) between the cuspid (eye) teeth and the back molars.

Once we choose and remove the teeth our next concern is to protect the bone at the extraction site. The bone in our jaws benefits from the pressure created when we bite or chew. This stimulates new bone cells to form and replace older cells. Without it, as when we have a missing tooth, the amount of bone can diminish over time and affect the success of any future orthodontics.

To prevent this, we take care not to damage the gums and bone removing the tooth. We may also install a graft under the empty socket to encourage bone growth.

If we've removed teeth outside the smile zone, the resulting orthodontics will move teeth into the opened space. In the end, you won't even notice they're gone. Teeth lost or congenitally missing in the smile zone, though, may eventually require a replacement tooth. A dental implant is the best choice, but it should be put on hold for a younger person until their jaw has fully developed.

In the meantime, we can install a spacer or a temporary restoration to hold the empty space and prevent other teeth from drifting into it. This can be incorporated into braces or aligners, or with a removable partial denture or a temporary modified bridge.

Extracting teeth to aid orthodontics first requires a well-laid plan that could encompass several years. The end result, though, can be well worth the time and effort — better function and a new, attractive smile.

If you would like more information on the process of straightening 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 article “Tooth Removal for Orthodontic Reasons.”


By Michael J. Tisdelle DDS
November 16, 2016
Category: Dental Procedures
Tags: Veneers   cosmetic dentistry  

Thought there was only one type of dental veneer? You were wrong!

When it comes to getting cosmetic dentistry, there are certainly a lot of options out there. If you are looking to hide small chips in your veneersteeth or you want to cover up the gap between your two front teeth, then you may be considering whether dental veneers can help you. Our Charlottesville, VA dentist, Dr. Michael Tisdelle, is here to provide you with more information to help with your decision-making process.

What are dental veneers?

Also called porcelain veneers, these thin tooth-colored shells are custom-designed to bond to the front portion of your natural teeth to cover a host of dental flaws that don’t affect the overall function of your smile but certainly affect its aesthetics.

What kinds of flaws do veneers cover?

While dental veneers aren’t designed to fix major malocclusions (bad bites) they can be used to hide discolorations that don’t respond to whitening, cracks, chips, small gaps between teeth and minor crookedness, misshapen teeth, uneven teeth or teeth that are too small. In essence, getting dental veneers is a great way to alter the color, shape or length of your teeth.

But I thought there was only one kind of dental veneers?

While many people do opt for traditional dental veneers, some people are still a little concerned about the tooth preparation that goes into it. While shaving a very small amount of enamel from teeth can certainly make anyone a little nervous, this step is painless and can usually be performed without even needing anesthesia. Of course, since enamel can’t grow back, traditional veneers are forever. For those with severe dental flaws, the idea of having veneers forever is a great option.

However, for those who aren’t quite sure how they feel about veneers or just like the idea of being able to change their minds, it’s time you talked to your Charlottesville cosmetic dentist about no-prep dental veneers. These veneers are even thinner than traditional veneers so that no tooth enamel has to be removed. If you have your veneers bonded to your teeth but decide you aren’t happy with how your new smile looks, you can have them removed without the procedure ever affecting how your natural teeth.

If you are interested in getting dental veneers in Charlottesville, VA then it’s time you scheduled a visit with Dr. Tisdelle. We can examine your smile and make sure that you are a great candidate for veneers!


By Michael J. Tisdelle DDS
November 05, 2016
Category: Dental Procedures
JimmyFallonCanrsquotCatchaBreak-ExceptinHisTooth

Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.

What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!

Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.

If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.

For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.

Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.

Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.

So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.

If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”