This patient did not like the spaces between her front teeth. Her choices were to do Invisalign orthodontics
or to cover the issue with porcelain veneers. This patient decided on porcelain veneers and Dr. Gangwisch was
able to give her a stunningly beautiful smile.
This patient was born with front teeth that were malformed called peg lateral incisors. Lawrenceville dentist
Dr. Gangwisch placed porcelain laminates over those teeth and now they look just like his natural teeth.
This patient had taken an antibiotic called tetracycline when she was younger which darkened her teeth dramatically.
Lawrenceville dentist Dr. Gangwisch placed porcelain laminates over those teeth and now she isn't shy about
This patient was born missing her two lateral incisors. Lawrenceville dentist Dr. Gangwisch placed orthodontically
moved her teeth and built Maryland (bonded) bridges to replace her missing teeth giving her a beautiful smile.
04/11/15Read More3D Dental X-Rays We now have a piece of "Star Wars" technology at our disposal. 3D x-rays are now readily available to dentists. Called cone beam tomography, one can see jaw structures, tooth relationships and root canal anatomy. They are becoming the standard of care for implant surgery since it shows the relationship between the available bone and major structures such as nerves and sinuses. It's indispensable for making sure that a dental implant does not impinge on the nerve that controls the lower lip. It can also help find some hidden bone around the sinuses allowing for placement without doing expensive bone grafts. In orthodontics, the relationship between the upper and lower jaw in conjunction with the rest of the skull can be determined readily with these x-rays. The3D view can aid a dentist in search for an elusive root canal or an extremely curved root.
Although the amount of radiation needed to produce these x-rays is reasonably minimal, the general feeling at this time is to not make them a routine procedure, especially in children who will probably be exposed to multiple sources of radiation throughout their lifetime.
04/11/15Read MoreGum Disease and Heart Disease It is becoming more and more apparent that there's is a link between gum disease and heart disease. The link appears to have to do with inflammation. Chronic diseases such as diabetes, cardiovascular disease, Alzheimer's disease and periodontal (gum) disease all have an inflammatory component. The general feeling at this time is that inflammatory components of gum disease can worsen plaque buildup in the arteries leading to the heart. The plaque buildup narrows the inside of those arteries, thus, restricting the blood flow.
Another theory is that bacteria that is present in periodontal (gum) pockets gets into the blood stream and attaches to the coronary arterial plaques. This theory says that that could contribute to clot formation. Studies have shown that people with periodontal disease are more than twice as likely to have coronary artery disease.
Even though theses theories haven't been thoroughly proven, it is still a good idea to make sure that you are free of gum disease. A thorough periodontal exam by a dentist is necessary to be certain that gum disease is not present. This is because symptoms are not usually present until the later stages of the disease when irreversible bone damage occurs and the teeth start loosening. Read More
04/11/15Read MoreBisphosphonates and Osteonecrosis in the Mouth Medications to help reduce the effects of osteoporosis have been a great help to the sufferers of the disease. Unfortunately, as there is with most medications, there are side effects. The main oral concern of these side effects is a malady called bisphosphonate-related osteonecrosis,BON, which is essentially localized bone death. After oral or periodontal (gum) surgery, wound healing can be compromised to the point that raw, denuded bone can be present and continues to be a nagging problem for the sufferer. It was a condition that was common in cancer patients who received radiation treatment. However, with the advent of the osteoporosis medications, this affliction became more common. The good news is that those receiving oral medications versus intravenous were significantly less likely to be affected by BON. The most popular of these medications go under the brand names of Fosamax, Uredic, Boniva and Zometa. If any type of oral surgical procedure is contemplated, the dentist must be made aware that the patient is taking a bisphosphonate drug. Since there is no treatment available for BON, a decision must be made weighing the risk versus the benefits of doing the surgery. Read More
04/11/15Read MoreOrthodontic Retainers So you've spent a couple of years being metal mouth with your braces and the time has finally come to get them off. That's the good news-now-here's the bad. You have to wear a retainer for the rest of your life. Orthodontic retention is just as important as the actual treatment. This is because the muscle forces are always there trying to push the teeth back into their original position. It's a constant battle-the good guys against the bad guys-and the only way to win is by wearing the retainer regularly. When the braces are taken off, the bone that holds the teeth is in a state of flux. The teeth are quite loose because the pressure that is applied by the braces erodes the bone on the pressure side and stimulates new bone on the other side. However, the new bone growth is slow to catch up, therefore, loose teeth. The retainer must be worn full time until the bone can heal with the teeth in their new postion. The good news is that this full time period doesn't last forever. Once the orthodontist decides that the teeth are stable enough, you can go to the night time wear. But from that point on, you must sleep with it in forever, or risk undoing all of that time, effort and money to straighten them. Read More
04/11/15Read MorePeriapical X-Rays A periapical x-ray is a closeup of a particular tooth or teeth. If your dentist recommends one, by all means, have him take it. I recommend periapical x-rays to my patients anytime they say that they are having pain in a particular area, if there is deep decay in a tooth or if there is a problem or defect that is apparent on a bitewing x-ray (the x-ray that is used to detect cavities and gum disease) but cannot be seen in it's entirety. When viewing a periapical x-ray, the dentist will look at the bone around the root, the height of the bone for periodontal (gum) defects, intactness of the root and for any other pathology (disease process) that could be visible. If a darker area exists on the x-ray around the tip of the root, then that could mean that there is a dead nerve inside the tooth. Dark areas up the side of the root could mean a possible root fracture. Dark areas at the crest of the bone (the portion closest to the crown of the tooth, i.e. the part of the tooth that you see) is usually an indication of bone loss due to gum disease. Pathological conditions can show up as either light or dark areas. This could be indicative of a tumor or cyst. That's why it is so important to allow your dentist to take a periapical x-ray if he recommends it. Read More
04/11/15Read MorePulpitis Ever woken up to a toothache? Chances are it was caused by pulpitis, an inflammation of the dental pulp, a collection of nerves and blood vessels inside your tooth. A mild pulpitis can cause symptoms of cold sensitivity. If the condition is allowed to progress, then it can lead to lots of pain and suffering. The most common cause of pulpitis is decay. Bacteria can get down inside a cavity and form acids and toxins that can injure the pulp (nerve). If allowed to continue unchecked, it can lead to much discomfort and to pulpal death. Another cause of pulpitis can be exposed roots. Normally a tooth has an enamel coating, but if the gums begin to recede, then cementum and dentin can be exposed. Dentin has microscopic tubules that lead to the nerve. Bacteria can get into these tubules and can cause sensitivity. For temporary relief of pulpitis until you can get to a dentist, the best thing is an anti-inflammatory such as Ibuprofen. Pharmacies may have toothache drops which have oil of cloves in it or temporary filling material (zinc oxide and eugenol) to plug the hole. Once at the dental office, if decay is the cause of the pulpitis, then the dentist many times can simply remove it and place a filling. If the pulpitis is due to receded gums, then the dentist can apply a desensitizing agent on the root surface to help alleviate the pain. Read More
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