What about small fractures? Or is there more to the story?

Enjoy the before and after!


Patient could tell something didn’t feel right, it hurt initially, and a small piece broke off, but, then, the pain temporarily subsided. There was meaningful decay into the dentin in the area where the chipping occured. We removed the old amalgam, the caries (decay), and restored with a composite. Recurrent decay with associated fracture: #19 – DOB

He wore through the cusp tips from grinding. I did not extend the outline of the filling into the areas of erosion on those cusp tips, as the patient’s grinding was largely historic from having very large tonsils in his youth. He did not have his tonsils out until 18 or 19-years-old. The airway disturbance, akin to Obstructive Sleep Apnea, caused associated bruxism. If we did extend the outline of the filling into those areas, the tooth would be very weak and would require a crown and would be at high risk of fracture.

Leaking Sealant

Before and After of Leaking interface between filling and sealant.
Before and After of Leaking interface between filling and sealant.

In this case, we have a classic example of a leaking sealant. The interface between filling and sealant at the occluso-lingual groove of #3 has broken apart and been seeping with each day getting into the dentin beneath the filling and the tooth. The interface between the sealant and the filling breaks and starts leaking. I identified a small area of grayness at the marginal interface. These types of failures rarely show up on a radiograph, but, MUST be visually identified by the dentist. By the time it shows up on an x-ray, it would be very deep and very large. Luckily in this case we were able to identify it early and simply replace the failing restoration with a new clean composite that should last for many years to come.

People have asked me in the past, ‘Why do you only seal some teeth, but, not others?’ Only teeth in high risk patients and high risk teeth should be sealed. (Factors which determine caries risk are: whether the mother of the patient has caries, caries in the primary teeth, homecare – if they are brushing 2x per day, using a fluoridated toothpaste, and whether the individual tooth has deep grooves, and socioeconomic status.)

In-Office Whitening Special 10-Year Anniversary

YEAR OF JUBILEE Special: Professional Whitening In-office $200 off

The normal $510 for 1-hour In-office Whitening, we are running a quarterly special celebrating 10-years in practice, for $310. We ran this as a CYBERWEEK special last year, so I brought it back by popular demand as a way to say thank you to patients.

  1. Use the Pay Now.
    • Enter the information for the person paying for it, under First Name Last Name Billing Address, City, State, Zip Code, Country, Phone Number, and Email, all of these top fields should match the credit card billing information.
    • In the space for Invoice Number/ Chart Number, type “JUBILEE” Under the space for PO Number/ Patient Name, type the name of the person who will be receiving the in-office whitening.
    • In the space for Amount, enter $310.

This can be gifted for any special occasion to a family member or friend.

If a friend or family member comes in who is not yet a patient, as long as they have a home office where they have been seen within the past 12 months, they are eligible to do in-office whitening. If a person does not have a home office, but, wishes to redeem the whitening, we would strongly encourage them to get a cleaning, x-rays, and exam before moving forward with whitening. Otherwise, a person would need to sign a waiver that states that they understand that we cannot be held responsible for underlying caries, periodontal disease, or any other conditions, without a comprehensive exam. If a person who is redeeming the gift would rather use the money toward a cleaning, x-rays, and exam, then, the $310 will spend like cash and would cover a new patient visit (including cleaning, x-rays, and exam) assuming that the patient does not have periodontal disease. If the person using the gift certificate would rather have bleach trays made for at home bleaching and whitening, they can apply their credit to that, which would normally be $510, and it will completely satisfy the cost for whitening trays with 3 tubes of whitening gel. They will not owe $200, but instead will receive the same consideration, and the $310 gift will serve as complete payment.

If you have any questions about this promotion, call our office at 512-454-2744

This promotion is valid from 11/1/18 through 1/31/19.

Minimally Invasive Dentistry


Patient presented with a small area of wear and chipping, and a microfracture on the incisal edge. In this case, a simple and conservative option is simply smoothing off the area with a very fine polishing disc. Because the reduction is less than 0.5mm, and the chipped tooth appears slightly longer, it makes a reductive approach the most minimal option.

The reduction was completed with no anesthetic and done with a very fine ortho disc, and polished with the blue Sof-Lex discs. The patient was very happy and the cost is very small, since this is a simple and inexpensive method to improve the look and feel of the incisal edges.

Case Study – Drink Beer Out of a Can instead of a Bottle

Drink beer out of a can instead of a bottle.

Click on the picture for the blown up view of today’s before and after for the chipped tooth.


I heard an all-to-familiar story today. A patient was relaxing with his friends and was enjoying a beer. But, he made the fateful mistake of drinking it out of a bottle.

I have been practicing for 10-years and anterior chipped teeth are frequently caused by drinking beer out of a bottle. I have great advice… drink your beer out of a can.


J. Russell McFarlane DDS