My Blog

By Phillip S. Tully III DMD
February 15, 2019
Category: Dental Procedures
WemayNeedtoBuilduptheBoneinYourJawbeforeImplants

Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.

For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.

Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by  at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.

That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.

If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.

With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.

Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.

If you would like more information on dental implants, 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 “Dental Implants after Previous Tooth Loss.”

By Phillip S. Tully III DMD
February 05, 2019
Category: Dental Procedures
EdenSherandtheLostRetainer

Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!

If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.

If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?

As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.

And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!

If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?

By Phillip S. Tully III DMD
January 26, 2019
Category: Dental Procedures
Tags: porcelain veneers  
GetRidofThoseUnattractiveTeethwithPorcelainVeneers

Those unattractive teeth you see in the mirror are what are standing between you and a truly beautiful smile. If only you could make them go away.

In a way, you can do just that—with dental veneers. For the past three decades dentists have been covering the imperfections of problem teeth with these thin layers of porcelain. What's more, they're usually less involved and expensive than other restorations.

Veneers work best on teeth with moderate flaws like chipping, heavy staining or wearing, or slight misalignments like crookedness or gaps. The dental porcelain used is a ceramic material that so closely mimics the color and translucence of natural teeth it often takes a trained eye to notice any difference.

The first step to getting veneers is to plan your new look with a full examination and a diagnostic mock-up, a temporary application of tooth-colored filling materials applied directly to the teeth. This gives you and your dentist a better visual idea of how veneers will look on your teeth, and to make any adjustments ahead of time. A dental lab will use these findings to create your custom veneers.

In the meantime we'll prepare your teeth to accommodate your veneers. Although they're usually only 0.3 to 0.7 millimeters thick, veneers can still appear bulky when placed straight on the teeth. To adjust for their width we usually must remove some of the teeth's surface enamel so the veneers look more natural. Because enamel can't be replaced, the removal permanently alters the teeth and will require some form of restoration from then on.

When the veneers are ready we'll attach them with special cement so they'll form an almost seamless bond with the teeth. You'll then be able to use them just as before—but with a little caution. Although quite durable, veneers can break under too much force, so avoid biting on hard objects like ice, hard candy or nuts. And be sure you practice good dental care on your veneered teeth with daily brushing and regular dental cleanings and checkups.

The end result, though, is well worth the upkeep. Porcelain veneers can rejuvenate your smile and provide you a new level of confidence for years to come.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Your Smile—Better than Ever.”

By Phillip S. Tully III DMD
January 23, 2019
Category: Dental Procedures
Tags: cosmetic dentistry   crowns  

Dental Crowns & BridgesThinking about a crown for that tooth which has so many fillings? Avoid the hassle of gooey impressions and multiple visits to the dentist to discuss, create and fit your restoration. Ask Dr. Phillip Tully and Dr. W. Newton Sharp about what CEREC processes can do for you. Performed in just one visit to their Columbus, GA, office, CEREC crowns and partial crowns restore life, aesthetics and functionality to decayed, misshapen and otherwise damaged teeth. The results are nothing short of exceptional.

What is CEREC?

CEREC stands for Chairside Economical Restorations of Esthetic Ceramics. Translated, that long name means a patient gets a new crown, inlay, or onlay (inlays are partial crowns) in just one short visit to Dr. Tully's office in Columbus, GA. After determining that a tooth needs a crown or large filling, the dentist takes digital impressions of the tooth, inputs the information into the CEREC milling machine using CAD/CAM (computer-aided design/computer-aided manufacturing) and then creates the restoration out of a solid block of porcelain.

The milling process happens right in the treatment room in about 20 minutes. In fact, the patient can watch his or her crown being made! Then, the dentist bonds the restoration onto the prepared tooth, shading the crown to match the neighboring teeth.

CEREC crowns fit perfectly right away; so there's no need for multiple try-ons or adjustments to dental bite. Beginning to end, the process take about ninety minutes. Amazing!

Benefits of the CEREC process

The obvious benefit is a fully restored tooth which is spared from extraction. Whether you've had multiple fillings, a serious abscess, root canal therapy or need to restore a dental implant, a CEREC crown can be the right restoration for you.

Other benefits include:

  • Less time in the dental chair (under two hours)
  • One-appointment convenience (not three or four as with old-fashioned crowns)
  • No awkward temporaries or messy impressions
  • Natural shape, texture and color
  • All processes completed by your trusted dentist right on premises--no outside lab needed
  • A beautiful and durable restoration that can last for ten years or longer with good at-home and in-office care, reports ShareCare

Learn more
If you are concerned about the health of a tooth, please don't wait. Many times, tooth loss can be avoided with placement of a realistic porcelain crown, and CEREC manufacturing with Dr. Tully and Dr. Sharp in Columbus, GA, makes it all so easy. Please call us today for a CEREC consultation. Phone (706) 323-6491.

By Phillip S. Tully III DMD
January 16, 2019
Category: Uncategorized
Tags: pulp capping  
Less-InvasivePulpCappingCouldSaveYourTooth

There’s one sure thing about tooth decay: you can’t ignore it. In fact, the best outcomes result from finding it early and treating it before it enters the pulp in the center of the tooth, often a filling or similar treatment.

If it does advance to the pulp, you may need a root canal treatment to save the tooth. This is a moderately invasive procedure where we access the pulp and root canals, tiny passageways leading to the root and supporting bone. We then remove all the diseased tissue and fill the empty pulp chamber and root canals with a special filling. Later we’ll crown the tooth for added protection against future infection or fracture of the tooth.

But there’s also another less-invasive method than a root canal called pulp capping. It’s only appropriate to use, however, if the pulp has become exposed or almost exposed by decay, but hasn’t yet shown signs of disease.

Pulp capping can be either direct or indirect. We use direct pulp capping if the healthy pulp has been exposed by the disease process. We first isolate the tooth from the rest of the mouth to prevent contamination and then proceed to remove all of the tooth’s decayed dentin structure. We then apply a biocompatible material directly over the pulp to protect it from further decay and to facilitate healing. We then restore the tooth, usually with a filling, to its proper function and life-like appearance.

When the pulp is threatened by decay but not yet exposed, we may then use the indirect method. In this approach we first remove most of the decayed dentin, but leave a small amount next to the pulp to keep it covered. We then treat this remaining dentin with a material to help it heal and re-mineralize, followed by a temporary filling of the tooth. A few months later we’ll remove this filling and inspect the treated dentin. If it has regenerated sufficiently, we remove any remaining decay and permanently restore the tooth.

As we said, pulp capping is only used with patients with deep decay whose pulp tissue is healthy. But when we can use it we can avoid some of the permanent alterations that often come with a root canal treatment and still save the tooth.

If you would like more information on treatments for tooth decay, 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 “Pulp Capping: A Procedure that May Save a Decayed Tooth.”





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