My Blog

Posts for: February, 2014

By John G. Fisher, DMD
February 24, 2014
Category: Dental Procedures
Tags: dental crowns  
GoldorPorcelainCrownsTheFactorstoConsider

Gold is more than a financial commodity or a symbol of wealth — it’s one of the best materials for restoring damaged tooth crowns, the visible portion above the gum line. It’s extremely durable and can last for several decades if properly maintained. It also causes minimal wear to adjacent teeth.

But as new, more life-like materials have come into prominence, gold restorations have diminished in popularity. Dental porcelain in particular, a type of fired ceramic glass that mimics the look and color of teeth, has increased in popularity for use in highly visible areas.

But unlike gold, all porcelain crowns lack strength, tend to be more brittle and can abrade other teeth during biting and chewing. If they break, they can shatter beyond repair. All porcelain crowns are improving dramatically as newer space age materials become available. Historically, though, they are thought of as more unpredictable when used for back teeth; the greater biting forces make them more susceptible to failure than with front teeth.

A Porcelain-Fused-To-Metal (PFM) crown is a hybrid of these two materials that seeks to impart the strengths of both — the aesthetic appeal of porcelain and the durability of gold or platinum. But a PFM crown also has drawbacks: the porcelain surface may still abrade opposing teeth; they can lose their aesthetic appeal if the metal collar becomes visible if gum tissues recede; and they can fail if the porcelain fractures or separates from the metal.

To address some of porcelain’s weaknesses, some PFM variations reduce the amount of porcelain by placing it only on the visible side of a cast gold crown. In addition, other porcelain materials are now coming into use that may be more durable yet just as life-like.

Choosing which material to use for a crown depends on many factors: cost, the location of the crown, and, of course, the patient’s desires for the resulting smile appearance. It all begins with a comprehensive exam: from there, we can advise you on your options and help you make a choice — gold, porcelain or something in between — that’s durable and pleasing to the eye.

If you would like more information on your options regarding dental 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 article “Gold or Porcelain Crowns?


By John G. Fisher, DMD
February 21, 2014
Category: Dental Procedures
PadmaLakshmisSmileARecipeforBeauty

Before she began hosting the long-running TV competition Top Chef, Padma Lakshmi was a well-known model and successful cookbook author. (Appropriately, she is said to have been “discovered” by a modeling agent while sitting in a café in Madrid.) Yet the Indian-born beauty's striking look — at once exotic and familiar — doesn't come from any cookie-cutter mold.

So when Lakshmi had cosmetic work done on her teeth, early in her career, her dentist didn't use a cookie-cutter approach either: Instead, her smile was carefully designed, using small amounts of bonding material to brighten her teeth and to bring their shape and spacing into harmony with her facial features.

Dentistry by Design
What exactly is smile design — and what could it do for you? Essentially, it's the process of evaluating your smile in concert with the appearance of your entire face, and visualizing the changes — some dramatic and some subtle — that will make it really shine. Some aspects we consider include the face's shape, the proportion or “balance” of facial features, the complexion, eye and lip color and form, and the overall dimensions of the smile.

Based on dental aesthetics and clinical experience, we will probably have a number of suggestions to make on how you can improve your smile. Your input will also be very important; while some individuals prefer perfectly even teeth and a sparkling “Hollywood white” smile, others are looking for a result that's more in keeping with a “natural” look: slight irregularities in tooth shape, spacing, and even color.

There's no right or wrong answer here: Having a “perfect” smile means what's perfect for you, so it's very important for dentists and patients to communicate openly during the smile design process. But sometimes, words alone just aren't enough to convey the subtle dimensions of beauty.

The Trial Smile
Fortunately, it's now possible to preview your “perfect” smile using a number of different techniques. Advances in computer imaging make this the first step in previewing your new smile — you can see the changes before a single tooth is touched! Still, many people find that having a more concrete picture is helpful. The next step is to make a 3-D mock-up the proposed dental work on an actual model of your mouth. That way, you can see a physical representation of the final results — and even turn it around and hold it in your hands.

There's still one more way to really experience the difference cosmetic treatments can make without committing to a permanent change: the provisional restoration. Here, tooth-colored bonding material and other techniques are used to actually create the new smile — temporarily. This gives you time to “live with it,” and see if the proposed changes work for you. If everything goes well with the provisional work, the permanent restoration is guaranteed to please.

So if you want holiday treats, get out the cookie cutter — but if you're looking for a smile that's uniquely yours, and one that enhances your own individual appearance… call our office and ask about a smile design consultation. You can learn more in the Dear Doctor magazine articles “Great Expectations — Perceptions in Smile Design” and “Beautiful Smiles by Design.”