Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.

A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.

When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.

The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).

Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.

If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.

Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.

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

The holidays have officially begun! Between Thanksgiving and New Year’s Eve, it’s fairly certain you’re going to be spending time with lots of folks. From family gatherings to neighborhood open houses to the office holiday party, you’ll find yourself rubbing elbows with all the in-laws and out-laws in your social orbit. And because it’s the season of cheer, you’ll probably smile—a lot.

So, before the festivities go full tilt, take a little time to freshen up that wonderful smile of yours. Here are a few suggestions for having a smile this holiday season that you’re confident to put on display.

Dental cleanings. While professional dental cleanings primarily remove any lingering disease-causing plaque and tartar, they can have the secondary benefit of improving your smile’s appearance. So, if it’s close to time for your regular dental visit or you would simply like to give your teeth a quick polish, schedule a cleaning appointment for a little extra holiday sparkle.

Teeth whitening. You can gain a noticeable increase in smile brightness with a professional whitening application. With our advanced bleaching solutions and techniques, we can precisely control the level of brightness you desire, from a more subdued natural white to a dazzling “Hollywood” shine. And with care, the effect could last for several months or even years with an occasional touch-up.

Bonding. A chipped tooth can stand out from your smile like a smudge on a masterpiece painting. In many cases, though, we can repair minor chips and other defects by bonding composite resin to the tooth in a single visit. The process is simple: We color-match the resin to the tooth, then apply, shape and cure it. Your tooth will look good as new.

Porcelain veneers. For a more durable and comprehensive solution, consider veneers for dental flaws you do not wish to live with. These thin wafers of porcelain are permanently bonded to the front of teeth to mask chips, heavy staining or slight misalignments. And they are quite affordable compared to more extensive cosmetic restorations.

All of these cosmetic options can fit into most people’s budgets and don’t take a lot of time in the dentist’s chair. Veneers are the one slight exception: These require more than one visit to the dental office because they are custom-made for you in a dental lab. Also note that veneers often require the permanent removal of tooth enamel, so the tooth will require a veneer or other restorative covering from then on.

All in all, though, it doesn’t take much to put some much-needed zing back into your smile. In most cases, it only takes one visit—just in time to brighten up your holiday season.

If you would like more information about smile enhancement, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers.”

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

Breathing: You hardly notice it unless you're consciously focused on it—or something's stopping it!

So, take a few seconds and pay attention to your breathing. Then ask yourself this question—are you breathing through your nose, or through your mouth? Unless we're exerting ourselves or have a nasal obstruction, we normally breathe through the nose. This is as nature intended it: The nasal passages act as a filter to remove allergens and other fine particles.

Some people, though, tend to breathe primarily through their mouths even when they're at rest or asleep. And for children, not only do they lose out on the filtering benefit of breathing through the nose, mouth breathing could affect their dental development.

People tend to breathe through their mouths if it's become uncomfortable to breathe through their noses, often because of swollen tonsils or adenoids pressing against the nasal cavity or chronic sinus congestion. Children born with a small band of tissue called a tongue or lip tie can also have difficulty closing the lips or keeping the tongue on the roof of the mouth, both of which encourage mouth breathing.

Chronic mouth breathing can also disrupt children's jaw development. The tongue normally rests against the roof of the mouth while breathing through the nose, which allows it to serve as a mold for the growing upper jaw and teeth to form around. Because the tongue can't be in this position during mouth breathing, it can disrupt normal jaw development and lead to a poor bite.

If you suspect your child chronically breathes through his or her mouth, your dentist may refer you to an ear, nose and throat (ENT) specialist to check for obstructions. In some cases, surgical procedures to remove the tonsils or adenoids may be necessary.

If there already appears to be problems brewing with the bite, your child may need orthodontic treatment. One example would be a palatal expander, a device that fits below the palate to put pressure on the upper jaw to grow outwardly if it appears to be developing too narrowly.

The main focus, though, is to treat or remove whatever may be causing this tendency to breathe through the mouth. Doing so will help improve a child's ongoing dental development.

If you would like more information on treating chronic mouth breathing, 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 Trouble With Mouth Breathing.”

One in 700 babies are born each year with a cleft lip, a cleft palate or both. Besides its devastating emotional and social impact, this common birth defect can also jeopardize a child's long-term health. Fortunately, incredible progress has occurred in the last half century repairing cleft defects. Today's children with these birth defects often enter adulthood with a normal appearance and better overall health.

A cleft is a gap in the mouth or face that typically forms during early pregnancy. It often affects the upper lip, the soft and hard palates, the nose or (rarely) the cheek and eye areas. Clefts can form in one or more structures, on one side of the face or on both. Why they form isn't fully understood, but they seem connected to a mother's vitamin deficiencies or to mother-fetus exposure to toxic substances or infections.

Before the 1950s there was little that could be done to repair clefts. That changed with a monumental discovery by Dr. Ralph Millard, a U.S. Navy surgeon stationed in Korea: Reviewing cleft photos, Dr. Millard realized the “missing” tissue wasn't missing—only misplaced. He developed the first technique to utilize this misplaced tissue to repair the cleft.

Today, skilled surgical teams have improved on Dr. Millard's efforts to not only repair the clefts but also restore balance and symmetry to the face. These teams are composed of various oral and dental specialties, including general dentists who care for the patient's teeth and prevent disease during the long repair process.

Cleft repairs are usually done in stages, beginning with initial lip repair around 3-6 months of age and, if necessary, palate repair around 6-12 months. Depending on the nature and degree of the cleft, subsequent surgeries might be needed throughout childhood to “polish” the original repairs, as well as cosmetic dental work like implants, crowns or bridgework.

In addition to the surgical team's skill and artistry, cleft repair also requires courage, strength and perseverance from patients and their parents, and support from extended family and friends. The end result, though, can be truly amazing and well worth the challenging road to get there.

If you would like more information on repairing cleft birth defects, 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 “Cleft Lip & Cleft Palate.”