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Posts for: September, 2018

By Michael J. Tisdelle DDS
September 27, 2018
Category: Dental Procedures
Tags: crown lengthening  
CrownLengtheningOpensupNewTeethRestorationPossibilities

A crown — a life-like “cap” made of dental porcelain that permanently covers an existing tooth — is an effective way to restore a still-viable decayed or broken tooth’s appearance. Properly fitting the crown over the tooth requires some healthy tooth structure above the gum line.

But what if the tooth has broken down to the gum line? In this case, we would need to perform a common procedure known as crown lengthening to expose more of the tooth.

Crown lengthening is a minor surgical procedure performed with local anesthesia to numb the tooth, surrounding gum tissues and supporting bone. We first make tiny incisions inside the gum-line on both the cheek and tongue side of the tooth to expose the bone, and then carefully remove a small amount of bone from either side of the tooth; this will expose or “lengthen” the tooth. Once finished, we suture the gum tissue back into place with self-dissolving sutures against the bone and tooth.

Most procedures take only sixty to ninety minutes, and the mild discomfort afterward is usually managed with pain relievers like ibuprofen. While the gum tissues may appear to be healed after a week, we typically wait six to eight weeks to perform the final crown restoration to give the tissues time to fully mature.

Crown lengthening may not work in all situations, especially with a severely fractured tooth. In these cases, we may need to evaluate the long-term viability of the tooth and consider other restorative options. Depending on your bite, it may also be necessary to treat with orthodontics first: not only will the tooth move into a better position, but the treatment may move both the gum and bone down with the tooth. Subsequent crown lengthening will then only affect the intended tooth and not adjacent ones, resulting in a more even smile.

The first step is for us to decide after a thorough examination if you would benefit from crown lengthening. If so, this minor surgical procedure could pave the way for better mouth function and a more attractive smile.

If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation.


By Michael J. Tisdelle DDS
September 25, 2018
Category: Dental Procedures

Dental CrownCould your dental problem be improved by adding a crown to your tooth? Charlottesville, VA, dentist Dr. Michael Tisdelle helps his patients improve their smiles with versatile crowns.

What are crowns?

Crowns, also called caps, slip over the top of teeth after your Charlottesville dentist decreases the size of the teeth. The hollow restorations are usually made of strong materials that closely resemble tooth enamel, such as porcelain, porcelain-fused-to-metal, ceramic, or resin.

Before you receive a crown, your dentist will file down your tooth and make an impression of your mouth. In most cases, preparation of your new crown will take about two weeks. In the meantime, you'll wear a temporary crown. During your final crown appointment, your dentist will make any necessary adjustments, then attach the crown with dental cement.

Can a crown help me?

Crowns are used to protect weak teeth, restore damaged teeth, and conceal imperfections. Your dentist may recommend a crown if you have one or more of these issues:

  • A Cracked Tooth: Cracks increase the risk of a future fracture or break in your tooth. Adding a crown strengthens and protects the damaged tooth.
  • A Broken or Fractured Tooth: Crowns restore normal function to your tooth and improve its appearance. They also prevent injury to your lips and cheeks by covering ragged edges and eliminate pain that can occur if your tooth pulp is exposed to the air.
  • A Fragile Tooth: Fragile teeth run in some families but can also occur as a normal part of aging. If your dentist notices that a tooth is fragile or brittle, he may recommend a protective crown.
  • A Weak Tooth: Large cavities or root canal therapy are necessary for good oral health, but these treatments can weaken teeth. Crowns ensure that your treated tooth doesn't crack or break.
  • An Unattractive Tooth: Crowns offer an excellent option if you want to conceal a discolored tooth, lengthen a tooth that's shorter than other teeth or completely change the shape of a crooked, twisted, pointed, or oddly shaped tooth.
  • A Missing Tooth: Crowns also anchor artificial teeth in a bridge. Your dentist may recommend a bridge if you've lost one or more teeth.

Protect and improve your smile with dental crowns! Call Charlottesville, VA, dentist Dr. Michael Tisdelle at (434) 977-4101 to schedule an appointment.


By Michael J. Tisdelle DDS
September 17, 2018
Category: Dental Procedures
Tags: bone grafting  
WecanBuildupLostBoneBeforeYourImplant

The “magic” behind a dental implant’s durability is the special affinity its imbedded titanium post has with bone. Over time bone grows and attaches to the titanium surface to produce a strong and secure hold.

But there’s one important prerequisite for ultimate implant success—there must be an adequate amount of bone available initially to properly position the post during implantation. Otherwise, the implant may not have enough support to position it properly or cover the implant surface completely with bone.

Inadequate bone can be a problem for patients who lost teeth some time before and now desire to an implant restoration. This happens because when teeth are missing, so are the forces they generate during chewing. These forces stimulate new bone growth around the tooth root to replace older, dissolved bone at a healthy rate. If that replacement rate is too slow, the volume and density of bone may gradually diminish.

There is a way, though, to build up the bone for future implantation. Known as bone preservation procedure or a ridge augmentation, it’s a surgical procedure in which the dentist adds bone grafting material to the extraction socket or the bony ridge. The graft serves as a scaffold for new bone cells to grow and multiply. If successful, there will be enough new bone volume after several months of healing to support proper implant placement.

Bone grafting can add more time to the implant process. It may also mean you will not be able to undergo immediate crown placement after implantation (a “tooth in one day” procedure). Instead we would probably suture gum tissue over the implant to protect it and allow for full integration with the bone over a few more months. In the meantime, though, we could fit you with a temporary restoration like a removable partial denture (RPD) or a bonded bridge to improve the appearance of the space while the bone continues to heal.

After several months, your implant will have a better chance of a secure hold and we can then attach a life-like crown. Even if you’ve suffered bone loss, you’ll then have the benefit of not only a durable implant but also a new smile.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.


By Michael J. Tisdelle DDS
September 07, 2018
Category: Oral Health
Tags: teething  
EaseYourChildsTeethingDiscomfortwiththeseTips

Although it’s a natural part of dental development, teething is no picnic for your baby. This process in which each of their twenty primary teeth gradually erupt through the gums usually begins around their sixth to ninth month and may not end until around age three.

These periodic tooth eruptions can cause your baby to bite, gnaw, drool or rub their ears. Teething can also disrupt sleeping patterns, decrease appetite and cause gum swelling and pain that can turn your otherwise happy baby into an unhappy one.

Managing these teething episodes is one of the most common topics parents bring up with their dentists. Since teething is supposed to happen, there’s no need for medical intervention unless the child is also experiencing diarrhea, rashes, fever or prolonged irritability associated with teething episodes. In most cases, the best you can do is to make your child more comfortable. Here are a few things to help you do just that.

Provide cold items for gnawing.┬áRubber teething rings, wet wash cloths or pacifiers that have been chilled can give your child something to gnaw on and ease the pressure of sore gums while the chilled temperatures help numb pain. Be sure, though, that the items aren’t frozen because extremely cold temperatures can burn the skin.

Gum massage. You can massage your child’s gums with one of your fingers during a teething episode to counteract the throbbing pressure coming from the erupting tooth. Just be sure your finger is clean and don’t use any numbing agents unless advised by your dentist or pediatrician.

OTC medication. You can ease mild to moderate teething pain with over-the-counter pain relievers like acetaminophen or ibuprofen in dosages appropriate for your child’s age. But don’t apply rubbing alcohol to the gums or massage in any pain reliever—both practices can burn the skin. And, as mentioned before, only apply numbing agents like Benzocaine with the advice and supervision of a healthcare professional.

Besides these practices, be sure to keep up regular dental checkups to monitor the teething process and ensure all is going normally. And remember: though it may seem harrowing at times, the teething process won’t last forever.

If you would like more information on easing the effects of teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”