Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

If you press your tongue against your teeth, unless something is badly wrong they won't budge. In fact, your teeth are subjected to a fair amount of pressure each day as you chew and eat, and yet they remain firmly in place.

But there's a deeper reality—your teeth do move! No, it's not a paradox—the gum and bone tissues that hold your teeth in place allow for slight, imperceptible changes in the teeth's position. Their natural ability to move is also the basis for orthodontics. Here are 3 more facts you may not know about your teeth's natural ability to move.

Teeth are always on the move. Teeth are held firmly within the jawbone by an elastic gum tissue called the periodontal ligament and a thin layer of bony-like material called cementum. In response to pressure changes, though, the bone dissolves on the side of the teeth in the direction of pressure and then rebuilds behind it, solidifying the teeth's new position, a process that happens quite slowly and incrementally. And it will happen for most of us—some studies indicate more than 70% of people will see significant changes in their bite as they age.

Orthodontics works with the process. Orthodontic appliances like braces or clear aligners apply targeted pressure in the direction the orthodontist intends the teeth to move—the natural movement process does the rest. In the case of braces, a thin metal wire is laced through brackets bonded to the front of the teeth and then anchored, typically to the back teeth. The orthodontist incrementally tightens the wire against its anchors over time, encouraging tooth movement in response to the pressure. Clear aligners are a series of removable trays worn in succession that gradually accomplish the same outcome.

Watch out for the rebound. That nice, straight smile you've gained through orthodontics might not stay that way. That's because the same mechanism for tooth movement could cause the teeth to move back to their former positions, especially right after treatment. To avoid this outcome, patients need to wear a retainer, an appliance that holds or "retains" the teeth in their new positions. Depending on their individual situations and age, patients may have to wear a retainer for a few months, years or from then on.

If you would like more information on orthodontic treatment, 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 “The Importance of Orthodontic Retainers.”

Fluoride is an important weapon in the fight against tooth decay. Fluoride consumption and other applications are especially beneficial during children's dental development for building strong teeth long-term.

But the truism "too much of a good thing" could aptly apply to fluoride. If a child consumes too much fluoride over an extended period of time, it could cause a condition called enamel fluorosis in which the enamel surface develops mottled or streaked staining. It's not harmful to the tooth's health, but it can greatly diminish a person's smile appearance.

To avoid fluorosis, it's important with the help of your dentist to know and regulate as much as possible the amount of fluoride your child receives. Here are 3 fluoride sources you should manage.

Toothpaste. Many manufacturers add fluoride to their toothpaste formula, usually an important way to receive this tooth-strengthening chemical. But younger children tend to swallow more toothpaste than older children or adults. Because the chemical builds up in the body over time, swallowing toothpaste every day could potentially elevate your child's fluoride levels. To avoid this, just use a "smear" of toothpaste on the brush for children under age 2, and a pea-sized amount for older children.

Your water system. About three-quarters of all public water utilities add fluoride to their water as an added measure for tooth decay prevention. The amount can vary from system to system, although the maximum amount recommended by the U.S. Government is 0.70 parts per million (PPM). You can ask your local water system how much fluoride, if any, is present or they add to your drinking water.

Bottled water. Any type of bottled beverage (water, juices, sodas, etc.) could contain various levels of fluoride. Unfortunately there are no labeling requirements regarding its presence, so the most prudent course is to carefully manage the beverages your child drinks, or stay with bottled water marked "de-ionized," "purified," "demineralized" or "distilled," which typically have lower fluoride levels. For babies feeding on milk, you can use the aforementioned bottled waters to mix powder, use ready-to-feed formula (also low in fluoride) or breast-feed.

If you would like more information on fluoride and your baby, 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 Development and Infant Formula.”

Tooth decay is one of the most common diseases in the world, nearly as prevalent as the common cold. It’s also one of the two major dental diseases—the other being periodontal (gum) disease—most responsible for tooth and bone loss.

Tooth decay begins with high levels of acid, the byproduct of oral bacteria feeding on food remnants like sugar. Acid can erode tooth enamel, leading to a cavity that will require removal of decayed material around it and then a filling.

Sometimes, though, decay can spread deeper into the tooth reaching all the way to its core: the pulp with its bundle of nerves and blood vessels. From there it can travel through the root canals to the bone. The continuing damage could eventually lead to the loss of the infected tooth.

If decay reaches the tooth interior, the best course of action is usually a root canal treatment. In this procedure we access the pulp through the crown, the visible part of the tooth, to remove all of the diseased and dead tissue in the pulp chamber.

We then reshape it and the root canals to receive a filling. The filling is normally a substance called gutta percha that’s easily manipulated to conform to the shape of the root canals and pulp chamber. After filling we seal the access hole and later cap the tooth with a crown to protect it from re-infection.

Root canal treatments have literally saved millions of teeth. Unfortunately, they’ve gained an undeserved reputation for pain. But root canals don’t cause pain—they relieve the pain caused by tooth decay. More importantly, your tooth can gain a new lease on life.

But we’ll need to act promptly. If you experience any kind of tooth pain (even if it goes away) you should see us as soon as possible for an examination. Depending on the level of decay and the type of tooth involved, we may be able to perform the procedure in our office. Some cases, though, may have complications that require the skills, procedures and equipment of an endodontist, a specialist in root canal treatment.

So, don’t delay and allow tooth decay to go too far. Your tooth’s survival could hang in the balance.

If you would like more information on tooth decay treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Root Canal Treatment: What You Need to Know.”

You might think David Copperfield leads a charmed life:  He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.

“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”

Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?

In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.

There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.  Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.

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 “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”