My Blog
By Mark Maher, DDS
March 29, 2020
Category: Dental Procedures
Tags: tooth extractions  
ExtractingaToothisaRoutineProcedure

Dentists around the world routinely remove diseased or damaged teeth every day. While some extractions require surgery, many don't: Your family dentist can perform these simple extractions, usually with little complication.

The term simple doesn't necessarily mean easy—as we'll note in a moment, it takes a deft and experienced hand to perform this type of extraction. The term in this case refers more to the type and condition of the tooth: The tooth roots are relatively straight and reside in the bone at an accessible angle. There are otherwise no meaningful impediments to removing it straight out.

The idea of “pulling a tooth” out of the jaw isn't the most accurate way to describe the procedure. A tooth is actually held in place within its bony socket by the periodontal ligament, a tough, elastic tissue between the tooth root and the bone that attaches to both through tiny fibrous extensions. The best method is to first loosen the tooth from the ligament's tiny attachments, for which experienced dentists can develop a certain feel. Once released from the ligament, the tooth will usually come free easily from its socket.

Not all teeth, though, can be removed in this manner. Teeth with multiple roots like back molars, and without a straight trajectory out of the socket, can have a complicated removal. Other dental conditions could also prove problematic for simple extraction, such as brittle roots that might fragment during removal.

For these and other complications, your general dentist may refer you to an oral surgeon for the tooth extraction. But even with the surgical component, these more complicated extractions are relatively minor and routine—millions of wisdom teeth, for example, are removed every year in this manner.

If you have a tooth that needs to be removed due to disease or injury, your dentist will first determine the best way to remove it and will refer you, if necessary, for surgical extraction. And whatever kind of extraction you undergo, the dentist performing it will make sure you remain pain-free during the procedure.

While tooth preservation is usually the best course for long-term dental health, it's sometimes best to remove a tooth. If that should happen, your dentist will make sure it's done with as little discomfort to you as possible.

If you would like more information on dental extraction methods, 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 “Simple Tooth Extraction?

PrimaryTeethareCriticaltoFutureDentalHealthandWorthPreserving

Ask any kid and they'll tell you just how valuable "baby" teeth really are—out of the mouth, of course, and under their pillow awaiting a transaction with the Tooth Fairy. But there's more to them than their value on the Fairy Exchange Market—they play a critical role in future dental health.

Primary teeth provide the same kind of dental function as their future replacements. Children weaned from nursing can now eat solid food. They provide contact points for the tongue as a child learns to speak. And they play a role socially, as children with a "toothsome" smile begin to look more like what they will become when they're fully mature.

But primary teeth also serve as guides for the permanent teeth that will follow. As a future tooth develops below the gum line, the primary tooth preserves the space in which it will erupt. Otherwise, the space can be taken over by other teeth. This crowds out the intended tooth, which may erupt out of position or remain impacted below the gum line.

In either case, the situation could create a poor bite (malocclusion) that can be quite costly to correct. But if we can preserve a primary tooth on the verge of premature loss, we may be able to reduce the impact of a developing malocclusion or even prevent it.

We can help primary teeth last for their intended lifespan by preventing tooth decay with daily oral hygiene or clinically-applied sealants and topical fluoride. If they do become infected, it may be worth the effort to preserve them using procedures similar to a root canal treatment.

If a tooth can't be preserved, then we can try to reserve the empty space for the future tooth. One way is a space maintainer, which is a stiff wire loop attached to metal band bonded around an adjacent tooth. This keeps other teeth from drifting into the space until the permanent tooth is ready to erupt, at which time we can remove the appliance.

Your child may be anxious to get another tooth to put under their pillow. But helping that primary tooth go the distance will be more than worth it for their future dental health.

If you would like more information on the care and treatment of baby 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 “Importance of Baby Teeth.”

DakotaJohnsonandHerMissingToothGapSparksOnlineDebate

Celebrities’ controversial actions and opinions frequently spark fiery debates on social media. But actress Dakota Johnson lit a match to online platforms in a seemingly innocent way—through orthodontics.

This summer she appeared at the premier of her film The Peanut Butter Falcon missing the trademark gap between her front teeth. Interestingly, it happened a little differently than you might think: Her orthodontist removed a permanent retainer attached to the back of her teeth, and the gap closed on its own.

Tooth gaps are otherwise routinely closed with braces or other forms of orthodontics. But, as the back and forth that ensued over Johnson’s new look shows, a number of people don’t think that’s a good idea: It’s not just a gap—it’s your gap, a part of your own uniqueness.

Someone who might be sympathetic to that viewpoint is Michael Strahan, a host on Good Morning America. Right after the former football star began his NFL career, he strongly considered closing the noticeable gap between his two front teeth. In the end, though, he opted to keep it, deciding it was a defining part of his appearance.

But consider another point of view: If it truly is your gap (or whatever other quirky smile “defect” you may have), you can do whatever you want with it—it really is your choice. And, on that score, you have options.

You can have a significant gap closed with orthodontics or, if it’s only a slight gap or other defect, you can improve your appearance with the help of porcelain veneers or crowns. You can also preserve a perceived flaw even while undergoing cosmetic enhancements or restorations. Implant-supported replacement teeth, for example, can be fashioned to retain unique features of your former smile like a tooth gap.

If you’re considering a “smile makeover,” we’ll blend your expectations and desires into the design plans for your future smile. In the case of something unique like a tooth gap, we’ll work closely with dental technicians to create restorations that either include or exclude the gap or other characteristics as you wish.

Regardless of the debate raging on social media, the final arbiter of what a smile should look like is the person wearing it. Our goal is to make sure your new smile reflects the real you.

If you would like more information about cosmetically enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Space Between Front Teeth” and “The Impact of a Smile Makeover.”

By Mark Maher, DDS
February 28, 2020
Category: Oral Health
Tags: oral health  
YouDontHavetoLiveWithUncomfortableCrackedMouthCorners

While a relatively minor health issue, cracked mouth corners (medically known as angular cheilitis) can certainly be irritating. Fortunately, you don't have to live with it—we can help reduce the discomfort and even make it less likely to happen in the future.

 Angular cheilitis is most characterized by redness and fissures (or cracks) in the skin at the corners of the lips. It commonly happens in younger ages (children to younger adults) because of drooling or complications from wearing braces. Older adults can also develop cracked mouth corners due to wrinkling around the mouth. The immediate causes are usually localized to the mouth and lip region, but it can sometimes arise from systemic conditions.

A case of angular cheilitis can also become infected, usually with a strain of yeast known as “candida albicans,” which then intensifies inflammation and discomfort. This is usually due to interaction between saliva and the open fissures, helped along by people's tendency to habitually lick these cracks (hence the other name for cracked mouth corners, perleche, from the French “to lick”).

The best way to treat angular cheilitis is with a series of applications of oral or topical antifungal medication. These may also be combined with steroid ointments that help retard redness and inflammation. If the infection involves the inside of the mouth, you may also need to use an antibacterial rinse until it clears up.

There are also things you can do to minimize future occurrences. Be sure to have missing teeth replaced or loose dentures refitted, and stay vigilant with daily brushing and flossing. You might also consult with a dermatologist about ways to treat wrinkling around the mouth. And easing those wrinkles could not only minimize your chances of developing angular cheilitis, but also give you a more youthful appearance.

Cracked mouth corners can be unnerving. But with a few simple steps we can help relieve any current discomfort and help you reduce the chances of another occurrence.

If you would like more information on cracked mouth corners and other oral irritations, 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 “Cracked Corners of the Mouth.”

By Mark Maher, DDS
February 20, 2020
Category: Dental Procedures
Tags: Dental Implants  

Dental implants provide unique benefits to patients missing one or more teeth. Placed into the jaw by your dentist, Dr. Mark Maher, in his Walnut Creek, CA, practice, titanium implants revive smiles in ways no other tooth replacements can. Would you like to know more? Read on to learn what dental implants could do for you.

What is a dental implant?

A dental implant is a titanium screw or cylinder which replaces a missing tooth root. Through an amazing process called osseointegration, bone cells in the jaw adhere right to the implant, forming a strong and durable bond.

Osseointegration takes many weeks to complete, but once the surgical site is fully healed, Dr. Maher can attach a metal alloy post and porcelain crown. This gives the patient a complete tooth which functions, looks and feels like a natural one. Multiple implants--typically, two, four, or six-- support fixed bridgework or full dentures, helping people with extensive tooth loss experience great smiles.

Qualifying for dental implants

When you come to Dr. Maher's office in Walnut Creek, CA, your dentist will examine your teeth and gums fully and go over your medical history. Specialized scans show if you have enough bone in your jaw to accept implant devices. Bone density is paramount to implant success. Also, you should be in good overall health.

The implant treatment

If you are a good candidate--and most teens and adults are--your oral surgery will take place in the office with local anesthetic. Your crown, bridge or denture will be custom-made according to your needs and attached to your implants within two to six months.

Benefits of dental implants

The biggest benefit of dental implants is complete restoration of a damaged smile. Implants look and act just like natural teeth, and they stay in your mouth 100 percent of the time. The American Academy of Implant Dentistry says that implants are more reliable and predictable than conventional tooth replacements, and implants last indefinitely--even a lifetime.

Furthermore, these artificial teeth exercise the jaw bone every time you eat. This action improves the jaw bone density and quality which is so quickly lost after dental extraction. With a solid jaw bone, your facial contours remain youthful and your oral function remains efficient.

Finally, your dental implants need only routine care--brushing twice a day, flossing and check-ups and cleanings every six months with Dr. Maher.

Ready for a renewed smile?

If you are, please contact Dr. Mark Maher and his team in Walnut Creek, CA, for a personalized implant consultation. Together, you'll make the best decision for your oral health. Phone us at (925) 934-8149.





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