Show the After, see what it looked like before in the blog post

Esthetic Correction of Failed Color Match

The patient presented with a discolored filling on the tip. The old filling was made partially translucent, which normally looks very nice and very natural. In this case, the patient's natural teeth are mostly opaque, which makes the filling look slightly darker. Separately, composites are known to slightly yellow in shade over time. So, the before picture shows an older filling that due to yellowing and translucency, now looks darker than the natural tooth. Before (#9) Central Tooth with discolored filling Before (#9) Central Tooth with discolored filling - view 2 After (#9) Central Tooth with completed replaced filling After (#9) Central Tooth with completed replaced filling - view 2 When replacing the filling, I chose a more opaque and very bright white filling to match the opacity of the tooth. It is not wrong… Read More »

Top 10 Ways to Prevent Cavities

Brush for 2-minutes in the morning and 2-minutes at night.Timing Matters - Brush after breakfast.Floss every day.Timing Matters - Floss at bedtime.Use a fluoridated toothpaste. We can write a prescription for a high fluoride toothpaste (for patients who are high risk for cavities.)When wearing an appliance (e.g. Invisible or clear braces,) take it out to eat or drink. Brush and floss before you put it back in.Avoid sugary foods.Timing Matters - if you eat a bag of Skittles, it is better to eat the whole bag in one sitting rather than eating one skittle every thirty minutes, which keeps the pH in your mouth below the critical pH of 5.5, below which your teeth dissolve away.Drink a lot of water to help wash away plaque.Don't drink energy drinks. They are terrible for your teeth and… Read More »
fractured tooth

Fractured Tooth – Before and After

When a patient fractures a premolar, it depends on the angulation of the fracture, whether it can be saved with a crown or not. If the angle of fracture is oblique, (and comes out at a 45° angle, or even vertically then turns 90°,) then, a block of tooth breaks off, and the tooth can be rebuilt with a build-up and a crown. I will often rebuild these with minim pins placed very carefully 1.5mm from the outer edge of the tooth, this prevents tooth fracture, and keeps it out of the pulp chamber. Then, I will cure composite back onto the tooth and into the space around the pin(s) that are intended to retain the build-up. Then, you can make a crown. For premolars and anteriors, I like the beauty and strength of Obsidian… Read More »
Internal Bleaching

How Does Internal Bleaching Work?

Let me set the stage for you. You are walking with your friends. Suddenly, you fall and hit your face against the ground. You feel shaken, and your nose has a small cut, with blood on your upper lip. Your friends ask you, "Are you alright?" You quickly assess yourself, and tell them, "I am fine. It's just a scrape. We're good, let's keep walking." Unfortunately, sometimes the damage is unseen. The front tooth took the brunt of that impact spontaneously dies and later either requires a root canal or undergoes a sterile necrosis. Fast forward 3 years, and now seemingly out of nowhere, the tooth has turned brown and looks like it has died. The tooth probably died shortly after the accident and started walling itself off internally. The remaining pulpal tissue (old blood… Read More »

What’s Maryland Bridge?

A Maryland Bridge is a minimal prep bridge that can be used as an alternative to a full bridge and as an alternative to a surgical dental implant. Posterior Maryland Bridge in place, replacing #3 Maryland Bridge Prep, shown without Maryland Bridge Maryland Bridge Shown being held adjacent to the Model Maryland Bridge shown in place on the model (view 1) Maryland Bridge shown in place on the model (view 2) Teeth showing Maryland Bridge Prep (mirror) Teeth with Maryland Bridge in place (lingual aspect) Teeth with Maryland Bridge in place (highlighting facial aspect) Teeth with Maryland Bridge in place. [The farthest back tooth visible in this picture is porcelain from the bridge.] This case allowed a minimal prep design Maryland Bridge to be used to replace the missing 1st molar. The patient was able… Read More »
Discs make all the difference

The Importance of Being Polished

I was working on fillings for my patient and I noticed some of her old composite work, which was completed by a different dentist at her old office, was starting to show it's age. Composites, the white resin fillings, often look impeccable the day that they are placed. Little by little composites tend to lose their beauty because they discolor around the margins, due to stains collecting at these areas. I use discs to polish the margins of my composites because it makes a meaningful difference in their finished appearance. So, in this case, I was looking at the old composites and I asked the patient if she would mind if I smoothed off the edges of the old composites. She said, "Oh, sure. I guess so." I went over the edge of the composite… Read More »

Incisal Chipping from Bike Accident

When you have a bike accident, you have options. Sometimes the fractured teeth require veneers or crowns. In this case, we were able to restore the teeth with composite. I wanted to try a brand new composite that claims it can match any tooth. So, we placed this as the first layer, but, it was too dark, although adequately translucent. So, I moved this initial composite toward the lingual side, and we blended in Filtek Supreme Plus 'B1' with Filtek Supreme XL Bleach shade. The three composites together acted to created a visual layering effect. Before and After: (left) showing result of fracture from bike accident (right) showing layered composite restoration. If you need an appointment, call us 512-454-2744, or Book Online. [instagram url=] Hope you like it, J. Russell McFarlane Read More »
Root Surface Care Options

Remineralization is Real: reversing bracket scars and discolored roots

Shows demineralized roots with and without intact root surfaces and treatment using a remineralization protocol and alternatively with a composite. This case epitomizes how many options we have as restorative dentists to repair, restore, and in this case remineralized root surfaces. The outcome may look similar to the naked eye, but, the long-term impact of our approach to treatment really matters. Let me explain it simply, the remineralized teeth did not require any cutting with a drill or any other cutting tool. The remineralized teeth were treated with topical applications, (which I will describe in technical details below.) The teeth that are eligible to be remineralized in the photo above meet the following criteria: 1. They have discolored and demineralized tooth structure (limited mostly to enamel,) **2. They have an intact outer surface without physical… Read More »

Saving an Otherwise Condemned Tooth

A patient presented after being told by another dentist that they could not save her tooth. I understand that some teeth are more difficult to save. But, the patient was not interested in getting an implant so we saved it. We placed 2 minim pins to retain the build-up in the area of the missing palatal cusp. I have successfully saved several teeth using the very small titanium minim pins. Because you carefully pilot the holes before placing them, when placed successfully, they do not significantly increase the risk of root fracture. [Note: if you complete a root canal and place a post in the root space, this is different than placing minim pins in the tooth, posts in the root space have been shown to increase the risk of root fracture. Luckily, we did… Read More »

Fractured Teeth – Conserve Tooth Structure with an Inlay

When a tooth fractures, an inlay can be a conservative option if a full crown is not required due to structural requirements. Inlay to restore a fractured tooth adjacent to an old amalgam In this case a tooth had a thin area of tooth along the MB of #14 (photo taken in patient mirror.) The thin remainder of tooth fractured vertically and horizontally immediately adjacent to the old amalgam. This fractured off box of tooth structure was small enough that by extension, using the old preparation of the amalgam, we were able to replace the amalgam with an all-ceramic inlay. This inlay was completed with Vita Enamic (a dual matrix ceramic) milled in-office on the TS150e, same day. This restoration was scanned into the computer and completed immediately, without having to temporize the tooth. We… Read More »