Aaron Leishman

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9500 Corkscrew Palms Circle Suite 4
Estero, FL 33928
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Posts for category: Dental Procedures

By Aaron A Leishman, DMD, PA
April 24, 2015
Category: Dental Procedures
Tags: bridge   partial denture  
ATeensMissingToothMayRequireaTemporaryReplacement

Besides reduced biting and chewing function, a missing tooth can cause an embarrassing inhibition to healthy social interaction. This can be especially so for teens who greatly value peer relationships and acceptance.

Be that as it may, we typically discourage a permanent replacement for teens with a missing tooth, particularly dental implants. While we value a patient’s psychological needs, the long-term effect on dental health may be too great to advise otherwise.

The effect we’re concerned with involves jaw growth and development. Although a person’s permanent teeth have usually all erupted by early adolescence, the jaws continue to grow until the late teens or early twenties. Natural teeth can adapt to this growth because the periodontal ligament that holds them in place allows for incremental tooth movement. The teeth move in response to jaw growth and are thus able to maintain their proper relationship and alignment in the jaw as growth occurs.

Dental implants, on the other hand, are imbedded into the jaw bone: they, therefore, can’t move like natural teeth and thus can’t adjust their position with jaw growth, particularly the upper jaw as it grows forward and down. This can result in the implants appearing as though they are left behind or retreat into the jaw. It can also affect the position of the gums and inhibit their growth around the implants.

It’s best then to hold off implants and other permanent restorations until the jaw has finished developing. That, however, isn’t always easy to determine: specialized x-ray diagnostics may help, but it’s not an exact science. Your input as a parent will also be helpful, such as whether you’ve noticed the end of growth spurts (not changing clothes or shoe sizes as often) or your child’s recent similarity in appearance to other adult members of your family. It thus becomes a judgment call, based on examination and experience, as to whether it’s safe to proceed with implants — and may require erring on the side of caution.

In the meantime, there are temporary restorations that can improve appearance while you wait for the appropriate time to undertake a permanent restoration. Two of the most useful are removable partial dentures (RPDs) or a bonded bridge, a less invasive form of the traditional bridge. With a proper assessment we can advise you on which option is your best choice.

If you would like more information on tooth restorations for teenagers, 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 “Teenagers & Dental Implants.”

By Aaron A Leishman, DMD, PA
April 09, 2015
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 Aaron A Leishman, DMD, PA
December 29, 2014
Category: Dental Procedures
HowtoGetWhatYouWantinYourSmileMakeover

When you begin a smile makeover in our office, you are embarking on an exciting partnership with my laboratory technician and me. You should be full of excitement and anticipation — if you have been dissatisfied with your current smile, and you have great expectations for the results of this project. You will really like what you see in your mirror.

Being completely satisfied with your new look depends upon successful communication — between you and me and also between my dental lab technician and me. As you might expect, your perceptions of how your teeth appear are different from a dentist's perceptions. My education leads me to think of factors that untrained individuals probably won't consider, such as crown (tooth) length, midlines (how the teeth line up with other facial features) and the distance from gum to lip.

It is helpful to be able to describe what you like and don't like about your current smile, and what changes you would like to see. Using visual aids is a good idea. Bring photos and magazine illustrations to show what you have in mind. (Remember that we cannot make you look exactly like a celebrity or anyone else. The pictures are guidelines.)

Things to think about:

  • The color, size, shape, alignment and spacing of your teeth.
  • How much of your teeth and gum tissues show when your lips are relaxed and when you smile.
  • Tooth color: bright “Hollywood” white or more natural looking off-white.

Your makeover is more likely to meet your expectations if you get an advanced view of the results. Computer imaging is one way to do this. Another is for us to make a mock-up of the proposed dental work in tooth-colored wax on models of your mouth.

Finally, a “Provisional Restoration” can be used as a test to make sure that what I envision is also what you, the patient, want to see. A provisional restoration, made from temporary materials, gives you a chance to test out the changes and make sure they work for you — that they not only look good, but they are also functional in terms of biting, chewing, speech, and gum health.

If the provisional restoration works, it is used as a blueprint to make durable and long lasting porcelains in the same design. We will take impressions of the provisional restoration and communicate the relevant information to a dental laboratory technician, who will make the final porcelain tooth replicas for your new smile.

Competent communication and a provisional restoration will put you on track to meet your expectations and obtain the most aesthetic and functional result in your Smile Makeover.

Contact us today to schedule an appointment to discuss your questions about Smile Makeovers. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

By Aaron A Leishman, DMD, PA
December 04, 2014
Category: Dental Procedures
Tags: partial denture  
TemporaryToothReplacementwithFlexiblePartialDentures

Modern dentistry offers several great ways to permanently replace missing teeth, including high-tech dental implants and traditional fixed bridgework. But sometimes, for one reason or another, it isn’t possible to have these treatments done right away. If you need an aesthetic way to temporarily replace missing teeth, a flexible partial denture could be the answer you’re looking for.

Certain kinds of removable partial dentures (RPDs) can be used as permanent tooth replacement systems, especially for people who aren’t candidates for dental implants or fixed bridges. But in the past, if you needed a temporary tooth replacement, one of the few alternatives was the type of rigid RPD often called a “flipper.” This consists of a firm, relatively thick acrylic base that supports one or more lifelike replacement teeth. It attaches to the “necks” of existing natural teeth via metal clasps, which gives it stability and strength.

However, the same rigidity and thickness that gives these rigid RPDs their durability can make them uncomfortable to wear, while the acrylic material they are made of is capable of staining or breaking. Over time, the RPDs are prone to coming loose — and they are also easy to flip in and out with the tongue, which gives them their nickname.

Flexible partial dentures, by contrast, are made of pliable polyamides (nylon-like plastics) that are thin, light and resistant to breakage. Instead of using metal wires to attach to the teeth, flexible RPDs are held securely in place by thin projections of their gum-colored bases, which fit tightly into the natural contours of the gumline. Their elasticity and light weight can make them more comfortable to wear. Plus, besides offering aesthetic replacements for missing teeth, their natural-looking bases can cover areas where gums have receded — making existing teeth look better as well.

All RPDs must be removed regularly for thorough cleaning — but it’s especially important for flexible RPD wearers to practice excellent oral hygiene. That’s because the projections that hold them in place can also trap food particles and bacteria, which can cause decay. And, like most dentures, RPDs should never be worn overnight. Yet with proper care, flexible RPDs offer an inexpensive and aesthetic way to temporarily replace missing teeth.

If you have questions about removable partial dentures, please contact us or schedule an appointment for a consultation.

By Aaron A Leishman, DMD, PA
November 19, 2014
Category: Dental Procedures
RealityStarKeptHisEyesonthePrizeNewTeeth

If you follow the hit TV reality show Amazing Race, you know that professional-hockey-playing brothers Bates and Anthony Battaglia won the $1 million prize in the latest globe-spanning competition. You may also have witnessed Anthony removing his false front teeth from time to time — like when he had to dive for pearls in Bora Bora. Since he plans to resume his sports career, Anthony wears a partial denture to fill the gap in his classic “hockey mouth.” He has said that when he finally hangs up his skates, he will use some of his Amazing Race prize money to get new, permanent teeth. When it's time to get that new smile, Anthony, like many people, will have to choose between two good options for permanent tooth replacement.

The preferred option for most people is dental implants. In this system, tiny titanium posts substitute for the root part of your missing tooth (or teeth). These are placed beneath your gum line in a minor surgical procedure we perform right here at the dental office. The amazing thing about dental implants is that they actually fuse to your jawbone, allowing your replacement teeth to last a lifetime.

The titanium implant itself is not visible in the mouth; the part of an implant tooth that you see is the lifelike crown. Virtually indistinguishable from your natural teeth, the crown is attached to the implant above the gum line. Dental implants can be used to replace a single tooth, multiple teeth, or even all your teeth. You don't necessarily need one implant for every tooth because implants can support bridgework or even a complete set of prosthetic teeth.

The second-best option is a natural-tooth fixed bridge. In this system, we use healthy natural teeth on either side of the empty space left by a missing tooth (or teeth) as supports for one or more of the prosthetic teeth that will fill the gap. The downside is that in order to turn these healthy teeth into supports (which are referred to in dentistry as “abutments”), we need to remove some enamel and then cap them. This procedure can leave those teeth more prone to decay than they were before. But with regular dental exams and good oral hygiene on your part, bridgework can last many years.

Which system is right for you? That's a question we would be happy to help you determine... even if you haven't won a large jackpot or gone pearl diving in Bora Bora. If you've been looking forward to the day when you can have permanent replacement teeth, why wait? Contact us or schedule an appointment for a consultation. We will help you find your ideal solution to the problem of missing teeth! For more information, please see the Dear Doctor magazine articles “Dental Implants vs. Bridgework” and “Dental Implants: Your Third Set of Teeth.”



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