Deformed Permanent Molar

Thomas, age 9, came in yesterday with what looked like an infected baby tooth. After looking closer, I decided to take an x-ray and was surprised to see that his lower right first PERMANENT molar tooth was infected. There was no apparent explanation for this other than it had developed abnormally.

I hadn't ever seen this before, so I thought it might be interesting to others. Below are his panoramic x-ray and a photo of the deformed, infected tooth removed. Time will tell what will happen on the other side, as the permanent molar tooth there also appears to be developing the same way.

Gummy Smile Solution with Lip Repositioning Surgery

There is new hope for gummy smiles with lip repositioning surgery. Below is our most recent patient just one week after her procedure. Smiling big! But . . . fortunately not as big as before her lip repositioning.


Just the right amount of change resulted from this procedure because of our use of a new technique developed by Dr. Paul Jacobs called the Reversible Lip RepositioningTM. Patients are able to preview their intended result and adjustments can be made for more or less change to the smile depending on the desires of the patient. This new technique is more predictable and controllable than other methods used in the past.

Dr. Jacobs can be consulted by patients and practitioners for more information on the Reversible Lip Repositioning procedure. He speaks in different locations throughout the United States and is available in his office in Escanaba, Michigan for one on one training. This exciting new procedure is making a difference in the lives of many people.

Reversible Lip Repositioning Surgery

World's first Reversible Lip RepositioningTM Surgery!

I continue to enjoy incredible interest in my lip repositioning procedure from all over the world. In response to the demand, I developed a technique where our patients can visualize the final result prior to the actual surgery. During this procedure, no cutting is done, and the patient can "trial" the lip repositioning for feel and appearance for a day or for five minutes before fully reversing the procedure.


Patients have control to decide whether to have more or less of their gums showing in the permanent procedure after they have seen the temporary, reversible procedure.

The photo above shows the Before and After of the Reversible Lip Repositioning. You can see that there is less of a gummy smile. There is also the added benefit of increasing the fullness of the upper lip for this young lady. The entire procedure including the permanent lip repositioning takes about 40 minutes.

Invisalign Colors Rock!

Invisalign Colors rock at the Jacobs Smile Center in Escanaba, Michigan!

Invisalign straightens teeth with a series of invisible, clear aligners, but what about teenagers who feel the need to express themselves with the colors of rubber bands on braces? Now Invisalign wearers can custom design any shape, size or color to wear on their teeth. The greatest thing about this awesome option is that every two weeks they can change it to something different or just go "wireless" again.



Above is an example of an Invisalign aligner with bling for the holidays using a permanent marker. Patients can even pretend they're wearing the old fashioned "wires" if they want to surprise their friends.

Twinsburg Dentistry

Recently, one of our patients presented with a unique request. He wanted his teeth fixed so they would look better, but was hesitant about finalizing plans for the treatment.

My wife Paula was reassuring him that he would get the smile he desired, but she sensed that there may be a barrier to his decision making. She asked if there was some unanswered questions that he had, or if there was some issue that she was not aware of that might be giving him cause for reticence.

He explained that, yes, there was a concern he had. He went on to tell Paula that he had a twin brother, and that they looked forward to attending a meeting of twins called Twins Days in Twinsburg, Ohio. He wanted to be sure that his teeth looked nice when they were fixed, but "not too different" so that it wouldn't affect his twinness with his brother.

Dental treatment was completed in short order, and he was elated to let us know that he actually looked more like his brother than he did before. We were graced by a visit from the twins a few days later at our office, and had the welcome opportunity to meet our patient's brother and to get the photo below. Uniquely, you will notice that they are "mirror image twins."

Cosmetic Dental Contouring

Cosmetic dental contouring can make a lackluster composite restoration lifelike and realistic. The most obvious feature corrected is the elimination of the mamelons, or the small bumps on the edges of the front teeth.





The feature in a smile that is the most overlooked, and the one which makes the teeth look so much more natural is the contour and surface texture of the front teeth. In the first photo, you can see the dull, round surface of the tooth just to the right of center (right on the photo.) In the second photo, the restoration has not been replaced, but only carved and recontoured so that the light reflection is similar to the tooth next to it. This improvement was done quickly, without anesthetic, and at very minimal time and cost.

Sturge-Weber Syndrome - Oral Manifestations

Sturge-Weber Syndrome (SWS), also known as encephalotrigeminal angiomatosis occurs in about 1 of 50,000 births as reported in Nelson's Textbook of Pediatrics.

SWS usually occurs at birth and sometimes is associated with seizures or mental retardation. It's visual characteristic is a facial port wine stain. Few intraoral photos are available of SWS, so I took the following images with permission from one of our patients at the Care Free Dental Clinic in Escanaba, Michigan:

Most apparent on the hard and soft palate are the bright red striations caused by oversized blood vessels.

He reports being told that he is very fortunate, because he has no mental retardation or seizures.

Caries, Decay, Cavities, Acid Erosion

Caries and acid erosion can be seen between these two teeth below:

I recently cared for a young woman who has had recurrent episodes of decay (caries) between her back teeth. She's a soda drinker, and admits that she isn't flossing enough. When I began to remove the decay from between her teeth, I saw what is in the image above. I showed the patient this area, and she remarked that she "would really start flossing and stop drinking pop."

I thought that if the image was helpful for her, perhaps others would benefit by seeing the damage caused by acid attack between teeth. These areas are usually invisible to the patient, and even to the dentist without an x-ray.

The photo is of the area between two teeth. The caries is in it's initial state, as it doesn't show a hole between the teeth yet. Decalcification occurs first, which is the whiter area in the photo. This is the outer layer of the enamel of the tooth that has been thinned or weekened. The next layer of the tooth as you proceed deeper is the dentin. The tooth on the right has begun to have caries form in the dentinal layer, while the tooth on the left has progressed much farther. This second layer of the tooth is much softer than the enamel, and decays and washes out much faster, even traveling laterally undermining sound enamel.

Acid erosion from lack of flossing or from too much soda or sports drinks can cause destruction in a tooth from the inside out. Seeing is believing in this case.

Tonsillolith

A tonsillolith is a semi-hard, cheesy yellow substance found in the side of the throat at the base of the tongue.


A patient reported to my office today with the complaint of a feeling of "something hard or lumpy in the back of my throat." He said that it was present for about a week, and didn't hurt, but he didn't know what it was. His concern was if it should be removed. After examining the area and taking this photo, I removed a small, yellow-white mass which felt like hard cottage cheese. The piece popped right out with a small curette. The most apparent quality of the tonsillolith was an extreme bad smell.

A tonsillolith is reported to be a calcareous mass that can accumulate in the tonsillar crypts in the lateral throat. It is believed that it is generated from an accumulation of food or bacteria in the area, possibly actinomyces bacteria. They are usually not harmful but can contribute to bad breath.

Proud Father and Mother

Last Saturday, Paula and I had the honor of attending a luncheon of the American College of Dentists in Boston at the Yankee Dental Congress Meeting. Our son Bryan Jacobs was presented with a distinguished student award for ethics and leadership in dentistry. The award was introduced by the Dean of Bryan's Harvard School of Dental Medicine, R. Bruce Donoff, DDS, MD.

In attendance were the deans of 4 dental schools, the president of the ACD, the executive director of the American Dental Association, past presidents of the ADA, among others.

Bryan has worked hard and persevered through the demands of dental school at Harvard. He has kept his sights on the goal of completing a quality education in dentistry. He is passionate about his profession and I know he will continue his lifelong quest for learning.

Bryan will soon be the fourth generation of dentists in our family. He will be the first Harvard grad. Paula and I are so proud of him - almost as much as we love him. His grandparents are so proud of him. All of his family, friends, cousins, neighbors, even Linda (soon to be Dr. Linda) are proud of him. What a great example. Way to go Bryan!

Perio-Pod

Perio-Pod TM Definition: (copyright 2010, Paul Jacobs, DDS)


A perio-pod TM is two or more people that share or potentially share similar oral bacteria, pathogens and/or periodontal risk factors. Inclusion in a perio-pod may affect the periodontal treatment decisions or outcomes for an individual based on the profile of the group.

Above are bacterial profiles from Hain-diagnostics showing the similarity in bacterial profiles between spouses and between parents and their children.