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Dr. Sheela Neral, DDS & Associates

 
38215 W 10 Mile Rd, Suite #5
Farmington Hills, MI 48335
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Sterling Heights, MI 48314
(586) 268-1040

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Posts for category: Dental Procedures

By Dr. Sheela Neral, DDS, PC
March 31, 2015
Category: Dental Procedures
Tags: root canal   root resorption  
RootResorptioninAdultTeethisaCauseforConcern

As a new permanent tooth develops, the roots undergo a process of breakdown and growth. As older cells dissolve (a process called resorption), they’re replaced by newer cells laid down (deposition) as the jaw develops. Once the jaw development ends in early adulthood, root resorption normally stops. It’s a concern, then, if it continues.

Abnormal root resorption most often begins outside of the tooth and works its way in, beginning usually around the neck-like (or cervical) region of the tooth. Also known as external cervical resorption (ECR), the condition usually shows first as pink spots where the enamel is being undermined. As these spots continue to erode, they develop into cavity-like areas.

While its causes haven’t been fully confirmed, ECR has been linked to excessive pressure on teeth during orthodontic treatment, periodontal ligament trauma, teeth-grinding or other excessive force habits, and bleaching techniques performed inside a tooth. Fortunately, ECR is a rare occurrence, and most people who’ve had these problems won’t experience it.

When it does occur, though, it must be treated as quickly as possible because the damage can progress swiftly. Treatment depends on the size and location of the resorption: a small site can often be treated by surgically accessing the tooth through the gum tissue and removing the offending tissue cells. This is often followed with tooth-colored dental material that’s bonded to the tooth to replace lost structure.

A root canal treatment may be necessary if the damage has extended to the pulp, the tooth’s interior. However, there’s a point where the resorption becomes too extensive to save the tooth. In these cases, it may be necessary to remove the tooth and replace it with a dental implant or similar tooth restoration.

In its early stages, ECR may be difficult to detect, and even in cases where it’s been diagnosed more advanced diagnostics like a CBCT scanner may be needed to gauge the extent of damage. In any case, it’s important that you have your teeth examined on a regular basis, at least twice a year. In the rare chance you’ve developed ECR, the quicker it’s found and treatment begun, the better your chances of preserving the tooth.

If you would like more information on root resorption, please contact us or schedule an appointment for a consultation.

By Dr. Sheela Neral, DDS, PC
January 28, 2015
Category: Dental Procedures
Tags: root canal  
ThreeThingsYouMayNotKnowAboutRootCanalTreatments

The term “root canal” is a part of our social lexicon, and not always with a positive meaning. But contrary to its negative reputation, a root canal treatment can make all the difference in your dental health.

Here are 3 things you may not know about this important procedure.

A root canal treatment is a “tooth” saver. Decay deep inside the tooth pulp puts the entire tooth at risk. The infection not only destroys nerves and tissue in the pulp, it has a direct path to the root through tiny passageways known as root canals. By cleaning out this infected tissue, then filling the empty pulp chamber and the root canals with a special filling, the procedure stops the disease from further harm and seals the tooth from future infection. Without it, it’s highly likely the tooth will be lost and other teeth threatened by the infection.

A root canal doesn’t cause pain — it relieves it. The biggest misconception about root canal treatments is their supposed painfulness. That’s just not true, thanks to anesthetic techniques that numb the teeth and gums — and any discomfort afterward is quite manageable with mild anti-inflammatory drugs like ibuprofen. The procedure actually stops the real pain, caused by the infection damaging and finally killing the tooth’s nerves, when it stops the infection.

Root canal treatments are even more effective thanks to recent advancements. Not all infected tooth situations are the same: some teeth have smaller offset passageways called accessory canals that grow off a larger root canal that can be quite difficult to detect and access. Missing them can leave the door open for re-infection. In recent years, though, endodontists, specialists in root canal disorders, have improved the way we address these complications using advanced technologies like specialized microscopic equipment and new filling techniques. The result: a lower risk of re-infection and a higher chance of long-term success.

Hopefully, you’ll continue to enjoy good dental health and won’t need a root canal treatment. But if you do, rest assured it won’t be the unpleasant experience you might have thought — and will be a welcomed solution to pain and threatening tooth loss.

If you would like more information on root canal treatments, 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 “A Step-By-Step Guide to Root Canal Treatment.”

AmericasDentistsGotTalent-forFixingDamagedorMissingTeeth

A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.

We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?

Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.

When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?

In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.

So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.

If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”

By Dr. Sheela Neral, DDS, PC
December 29, 2014
Category: Dental Procedures
WhatScientificStudiesRevealAboutSmileMakeovers

A generation ago, hearing the term, “smile makeover,” would most likely have resulted in questions and puzzled looks. However, through the power of both the media and celebrities, today it has become a common household term with over 70% of all inquiries coming from people in the 31 to 50 year old age group, according to the American Academy of Cosmetic Dentistry (AACD). While some people seek cosmetic dentistry purely to boost their self-esteem, others pursue it to improve first impressions during business and social interactions, as many studies have revealed that first impressions are the ones that typically last the longest.

The AACD study also revealed other interesting statistics that support why a smile makeover is a wise choice that can yield a life-changing return on your investment — you!

  • 99.7% of Americans believe a smile is an important social asset.
  • 74% feel an unattractive smile can hurt chances for career success.
  • 50% of all people polled were unsatisfied with their smile.

Another important study recently conducted by Beall Research & Training, Inc., an independent marketing research firm, used before and after photos of smile makeovers for polling purposes. The research found that people who have had a smile makeover are viewed by others as more attractive, intelligent, happy, successful in their career, friendly, interesting, kind, wealthy, and appealing to the opposite sex. This evidence clearly proves just how important a first impression can be as well as what it can silently communicate about you.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule a consultation. We look forward to meeting with you to learn about your specific concerns and to show you what we can do for you. You can also learn more by reading the Dear Doctor article, “The Impact Of A Smile Makeover.”

By Dr. Sheela Neral, DDS, PC
December 11, 2014
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and your oral health, 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 “Removing Wisdom Teeth.”