Dr. Jeffrey Olson DDS
A smile is a kind gesture to a stranger passing by, an expression of one’s delight, a professional disposition in a place of business, or just a free feeling, to laugh without hesitation. Our smile can mean so many things to us and those around us.
But, not everyone has the confidence to smile freely and openly. Sometimes, that lack of confidence comes from embarrassment of your teeth, or smile line. Discoloration, worn and crooked teeth, and especially missing teeth, can rob you of the simple act of smiling without hesitation.
As a cosmetic dentist for over 25 years, nothing gives me more satisfaction than seeing a patient’s self-confidence change dramatically by improving their teeth.
There are many reasons for us to be self-conscious of our smile. But, the question is, “How can it be fixed?” You may have heard of porcelain veneers being able to produce that “Hollywood smile.” While veneers can certainly do that, they’re not always the best choice. If it is a simple case of crowding, darkened and misaligned teeth, the best choice would be to do orthodontic treatment, either with traditional brackets and arch wire or with invisible aligning retainers. The latter is a great choice as they can move teeth without anyone else even realizing you are wearing them.
We have been doing this type of orthodontics for our patients since the mid-1990s, and have seen great improvements in the ability to treat misaligned teeth. The nice thing about this is that there is no restoration place on the teeth, so there is no maintenance or lifespan that the restoration would have over the course of your life. You can even bleach and lighten your teeth using the aligner that moves your teeth. Note of caution after treatment is completed, however: you MUST wear a retainer overnight to ensure you maintain your desired results.
While orthodontic treatment can straighten your teeth, you may still end up with a smile that you want to enhance. There can be noticeable tooth structure worn unevenly, restorations here and there that cause shade discrepancies in the smile line, or possibly recession causing a black hole or triangle at the gum line between the teeth. If this is the case, then the best options to treat this problem would be all porcelain crowns (very aesthetic), all porcelain veneers (very aesthetic) and/or composite veneers (also very aesthetic). The porcelain requires more tooth structure to be removed, but provides an impervious substrate against staining over time! The advantage of choosing composite veneers is that in many situations there is no need to remove any tooth structure when placing the veneer. Composite veneers can provide very life-like restorations that have a lifespan of 10-15 years or more. To lengthen the lifespan of any restoration, wearing a night-guard while sleeping is recommended to avoid fracture or wear of the restorations.
Everyone’s smile is different. To improve one’s smile can require a combination of orthodontic and restorative treatment as well as gum (periodontal) treatment. In many dental offices, a “before” and “after’ “photoshop-like” portrait of your smile can be created to give you an idea of how your smile can be improved. Your dental professional, if trained in cosmetic dentistry, can you help you decide the best solution to improve your smile, giving you that confidence to bright up another’s day with a simple gesture. 🙂
More on Veneers soon to follow…..Aloha for now!
We are excited to be able to share with you Dr. Olson’s articles he has written in the past for The Neighbors of Wailea & Makena Magazine, tidbits of fun and useful information, and sometimes just appreciating living here on Maui! So be sure and check back from time to time to see what is new. Here is Dr. Olson’s article about getting a great nights sleep from the magazine….
WHAT WOULD YOU GIVE FOR A GOOD NIGHT’S SLEEP?
One of the most interesting continuing education courses that I’ve attended in recent years, was oddly enough, on Adult Sleep Disorder Syndrome. It’s not a very “sexy” subject in dentistry (but really, what is with dentistry?”, but the facts surrounding the disorder were very surprising. I’d like to give you a basic synopsis of what I’ve learned over the years with regard to sleep disorders, commonly called sleep apnea.
Sleep apnea (SA) and sleep disorder breathing (snorers) occur in about 30% of the populations and about 80-90% of that 30% are not diagnosed. Most people have no idea they have a sleep disorder. That is roughly about 30,000+ people on Maui alone.
Sleep apnea is usually determined at sleep centers, though some MDs and dentists have “take home” devices that can test for sleep apnea. An “apnea” occurrence is when a person stops breathing for 10 seconds or longer.
- Mild SA: 5-15 episodes per hour
- Moderate SA: 15-30 episodes per hour
- Severe SA: 30+ episodes per hour
Sleep Apnea has been linked to diabetes, depression, GERD (gastric reflux), heart disease, dementia, ischemic stroke, and obesity. When a person has severe sleep apnea going through 30+ episodes of not breathing for over 10+ seconds, this can deplete the blood of oxygen. The normal 02 saturation at sea level is around 97%, but a person with severe sleep apnea can decrease this to below 70%. We have a pulse oximeter in our office to measure O2saturation on our patients. To experiment myself, I’ve tried holding my breath as long as I can have only been able to get my O2 saturation to 94% before I feel like passing out. An individual suffering from sleep apnea can desaturate the oxygen from their blood to well below this during the course of the night. In severe sleep apnea, a person can stop breathing for so long that the body goes into flight or fight response, releasing corticosteroids and epinephrine in order to startle the body to start breathing again. Unfortunately, these hormones, over time, can have an adverse effect on the body.
A shocking statistic that helps you realize how serious Obstructive Sleep Disorder (OSD) or Sleep Apnea is, is the Myocardial Infarction (Heart Attack) Risk Factor Multiplier:
- Standard: 1.0X
- Overweight: 7.1X
- Hypertension: 7.8X
- Smoking: 11.1X
- Obstructive Sleep Disorder (OSD): 23.1X
If you think you may have some form of sleep disorder, it is best to speak with your MD as soon as possible. If your doctor decides that a proper medical evaluation is necessary to determine you have sleep apnea, you may be requested to participate in a sleep study to determine your level of RDI or respiratory disturbance index. From that point, you and your MD can develop a plan to help you sleep better. CPAP, BiPAP, AutoPAP, and VPAP are all FDA medically approved devices to help OSD. Oral appliance therapy, where the patient wears a dental appliance that brings the lower jaw forward slightly during sleep, has shown to have GREAT benefits in treating mild to moderate sleep apnea as well. However, the diagnosis of the severity of the sleep disorder is critical in order to get that good night sleep once again!
I hope this article did not put you to sleep midway through, but if so, I hope you had a restful slumber. if you have any questions or need a referral for a sleep evaluation, please don’t hesitate to call our office.
Mahalo and talk again soon!