The way you feel about your appearance reflects the way you smile and greet those you meet every day.
Porcelain veneers are a minimally invasive and painless way to transform your teeth from discoloration, misshapen, and malalignment to a beautiful, bright and friendly smile. For over 20 years, Dr. A. J. Boyajian has been creating cosmetic masterpieces for his patients in Los Angeles, CA.

A malocclusion is a “bad bite.” Easy enough, right?

If a good occlusion is defined as a bite where all components of the chewing system work together harmoniously, then a bad occlusion — a malocclusion — means that the teeth do not match up and fit together when you bite down. One or more of the components involved in the chewing system may not be functioning properly, and is most likely what is causing the teeth to come down abnormally.

The funny thing is that most of us don’t realize that we have a malocclusion until we go in for an occlusal analysis. After a while, we unconsciously train our muscles to chew in a certain way, to move in a certain direction repeatedly, so that it does seem like our teeth fit together fine. But you can’t really tell the difference between what’s “normal” and what’s “really normal” until you’ve had adjustments made because you’ve been doing it a certain way for so long.

Having a malocclusion almost guarantees wear and tear on your teeth, facial muscle fatigue, and long-term damage and/or disease throughout your whole mouth and jaw area. Having your malocclusion corrected is absolutely necessary for your mouth’s health and ultimately your whole body.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

An occlusion is basically the noun form of the word “occlusal,” which we already know is a term describing your bite. An occlusion is the way your bite is uniquely designed, how your teeth come down on each other and fit into specific grooves to properly chew.

However, an occlusion does not merely describe how the teeth fit together because — what have we learned? — the chewing system involves the TMJ (temporo-mandibular joints… your jaw joints), jaw bones, muscles, ligaments, and all other soft tissues in your mouth. With the ideal occlusion, every one of these elements works with the others to create comfort, harmony, and efficiency in your chewing. If any of these elements is not functioning to its best potential, however, even the smallest hindrance can cause pain, injury, disease, and other problems. This is called a malocclusion and will be covered in tomorrow’s post.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

How is an occlusal analysis performed, exactly, and what is involved in the process?

Well, first, a mold of your teeth is taken so an accurate plaster or stone model of your bite can be examined. Using what’s called a facebow transfer, the dentist will find the center of your jaw joint’s rotation, and then take measurements to see how it relates to your upper jaw.

Imprints of your teeth are then taken for a bite registration. A bite registration shows the dentist how your teeth come together when you are biting down completely. Also, the pattern of your jaw’s movement when chewing is unique to every individual. This pattern is also recorded.

There is a device called an articulator that a dentist uses to view your exact bite without having to use your head (which translates into countless hours in a dentist’s chair for you, the patient). It looks like this. The models previously made of your teeth are installed into the articulator, along with all the measurements of your jaw’s exact movements and how your teeth come together when you bite down.

After some examination (and long after your appointment is finished and you’ve driven home in time for dinner, don’t worry), the dentist will do some analyzing and will determine what is causing problems with your bite. Is it a TMJ disorder? Are crowns that were formed years ago getting in the way of proper chewing? What needs to be done in order to make the next procedure(s) successful?

Your dentist will be able to tinker with the articulator and find the ideal form of chewing system for you. A wax model will be made, and your dentist will move towards making these changes before moving on to the aforesaid procedure(s).

And, voila! Not only will you have some super treatment coming your way, but you’ll be comfortable knowing that your entire chewing system will be working the way it is supposed to.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

The occlusal analysis, when getting ready to perform any kind of orthodontic surgery, is crucial for a dentist or orthodontist to make the best possible choices for your oral health; a substantial number of problems are avoided when we know to not move a tooth in a certain direction, or design a mouthguard that will tire the jaw in an unhealthy manner. This is comprehensive dentistry; everything works together, and everything is related! An occlusal analysis is absolutely necessary before any of the following procedures:

  • Crown, bridge, denture, or implant treatment
  • Fabrication of a bite guard
  • Orthodontic treatment (an occlusal analysis should be performed after this as well)
  • Any other time a poor bite is suspected. Pay attention to symptoms like worn, chipped, or broken teeth; gum sensitivity and/or recession; pain in facial muscles; and other symptoms similar to prolonged gum disease, such as loose teeth, bone loss, and even tooth loss.

As a small side note, gum disease can, in fact, be evidence of a poor bite. But that’s a topic for another day.

Dr. Boyajian, West Los Angeles

Ouch! This topic may not be so pleasant to visualize. But harm does come to folks’ teeth all too often, maybe because of a car accident, a sports or recreational accident, or some other dreadful mishap. Children are most apt to suffer much damage because of their activity levels and still-developing mouth.

When I say tooth damage, this does not always refer to the visible damage you might see on the surface (the crowns), such as an obviously chipped or broken tooth. A significant amount goes on beneath what can be seen without x-rays or probing about. If an injury causes a tooth to move from its original position, the tooth’s pulp (nerves, blood vessels, etc.), dentin, and the surrounding bone and gums could very well be damaged as well, and that’s where things can get tricky and painful.

We will cover a few kinds of injuries and how they may be fixed over the next few days.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Cosmetic dentistry is the artsy part of dentistry — where we get to give your teeth makeovers. But cosmetic dentistry is more than just making your teeth look good on the outside. The beauty must go further than skin deep (er… enamel-deep…?). What if a crown or restoration conflicts with the way the opposing teeth bite against it? That seems like an obvious problem, but if you are not aware of how much a tiny adjustment can impact your entire jaw/head, then it is, in fact, an issue that must be approached with special care and consideration.

In most cases, though, it will be the restoration that shows signs of deterioration first. Cracking, chipping, even falling off altogether… and this may harm whatever natural tooth or tissues are bonded to this restoration. Pankey takes great care in training its dentists to take careful measures to ensure cosmetic improvements will also be functional and long-lasting. A little extra time and effort may go into forming a nicely fitted restoration, but the longterm benefits outweigh the initial installation process.

Perfectly colored or straight-looking teeth are only the tip of the iceberg!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

A patient recently came into my office with severely worn-down teeth & an overbite. This was caused by several years’ worth of clenching & grinding. I informed her that she essentially had two choices for restorations. Either she can have several veneers for the ‘visible-when-smiling’ teeth in the front, or full crown restorations for just about the entire mouth.

It raises an important question. How does an individual choose the right dentist to treat her? Choosing the right dentist isn’t only about choosing the dentist who gives you the best price or even the whitest teeth on Day 1. It’s the one who takes all things into consideration including the health of your jaw joint. The importance of preserving an already-healthy bite or taking steps to achieve the ideal bite is of vital importance. Bioesthetic methods are low-maintenance, greatly cost-effective, and save a lot of headaches (literally). Because the initial care in case design will lead to longer lasting restorations

For patients whose bite needs slight adjustment, I usually end my treatment by designing a MAGO — a maxillary anterior guided orthotic. A MAGO is quite different than a mouthguard which is usually a rubber based separator that keeps you from grinding your teeth but does nothing for your poor overexerted jaw muscles.  The MAGO, on the other hand, will simultaneously protect the teeth from clenching/grinding at night (when we have the least control over our bruxing habits) and develop a healthy jaw alignment over time if worn consistently.

Dr. Boyajian, Los Angeles

www.dentalwellnessarts.com

See how many great uses ozone has in the office? And, behold! Another one! Ozone is great for every dental surgery, including dental implant surgery.

Implants are used to replace teeth that have been lost or extracted, possibly due to disease or injury. A new “root” is drilled directly through the gums into the upper or lower jaw bone (depending on where the implant is needed) and is secured there. This new “root” will serve as the anchor for an artificial replacement tooth.

As usual, it is important to keep the area sterilized while surgery is being performed. Dental implant surgery goes deeper, literally, than each individual tooth. After surgery, there is a healing period where the surrounding bone and gums must be monitored to ensure that the new teeth are properly integrated into healthy oral function (this includes avoiding gum recession, for example, or infections in the mandible). Ozone is wonderful because it sterilizes more effectively and safely than traditional chemical sterilizers; not only this, but it also stimulates healthy gum healing and helps infuse the bone structure with strengthening minerals.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Last fall, I was told that using ozone in my dentistry would bring major changes to my practice; more convenience, less occupied office space, and a one-solution-works-for-all ease of use really has upped our efficiency and, yes, quality, too, of dentistry. For one, you may look forward to a quicker visit. Ozone, in the gas form, can reach into the tiniest cracks and crannies in your tooth, and cleanliness is guaranteed during your root canal or gum disease treatment.

Also, this high sterilization, unlike drugs, medications, or other harmful ways of destroying bad bacteria in your mouth (AND the good bacteria, for that matter), is completely side-effect-free, causes no allergic reactions, and works at the same level of powerful decontamination for every single person.

Ozone is particularly wonderful in that it maintains aesthetic qualities; it does not damage any tooth surfaces, other hard tissues, or soft tissues. Past methods of removing an infected area of tooth included actually removing the bacteria-laden tooth structure itself with lasers, drills, air abrasion, etc., to remove the bacteria! Practicing holistic dentistry and restoring teeth with minimal invasion of the natural structure, ozone works great for us. It almost “washes out” the infection with no deterioration, damage, or discomfort.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Veneers, unlike crowns, inlays, or onlays, are used for a more cosmetic purpose. Veneers are not used primarily for cavities, tooth decay, etc. They are excellent remedies to discolored, chipped, worn, and/or mildly uneven teeth. Veneers are very thin and are applied to the tooth’s surface. They can be colorized, slightly textured, sized, angled, and even given a touch of translucency to look exactly like your natural teeth.

CEREC veneers do wonders for worn, tired teeth; they are strong, reliable, long-lasting, and they preserve their beauty. A whole set to drastically improve the attractiveness of your entire smile can be designed, milled, and bonded in a single visit!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com