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
June 17, 2014
Category: Dental Procedures
Tags: root canal   endodontics  
NeedaRootCanalFearNot

Perhaps you or someone you know has been told they will need root canal treatment. Maybe you're experiencing some unexplained tooth pain, and you think you might need to have this procedure done. Nervous? You shouldn't be! A good understanding of this common and relatively pain-free dental treatment can go a long way toward relieving your anxiety.

What's a root canal? It's the small, branching hollow space or canal, deep within the root of the tooth. Like an iceberg in the ocean, a tooth shows only part of its structure above the gum line: That's the part you see when you smile. But about two-thirds of the tooth — the part called the root — lies below the gum. A healthy root canal is filled with living pulp tissue, which contains tiny blood vessels, nerves and more.

A “root canal” is also shorthand for the endodontic treatment that's called for when problems develop with this tissue. For a variety of reasons — deep tooth decay or impact trauma, for example — the pulp tissue may become inflamed or infected. When this happens, the best solution is to remove the dead and dying tissue, disinfect the canals, and seal them up to prevent future infection.

How is this done? The start of the procedure is not unlike getting a filling. A local anesthetic is administered to numb the tooth and the nearby area. Then, a small opening is made through the chewing surface of the tooth, giving access to the pulp. A set of tiny instruments is used to remove the diseased tissue, and to re-shape and clean out the canals. Finally, the cleared canals are filled with a biocompatible material and sealed with strong adhesive cement.

After root canal treatment, it's important to get a final restoration or crown on the tooth. This will bring your tooth back to its full function, and protect it from further injury such as fracture. A tooth that has had a root canal followed by a proper restoration can last just as long as any other natural tooth. And that's a long time.

If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”

By Aaron A Leishman, DMD, PA
May 16, 2014
Category: Dental Procedures
FrequentlyAskedQuestionsAboutTooth-ColoredFillings

Are tooth-colored fillings safer than silver fillings?
No. Both are considered safe based on the most reliable and up-to-date scientific evidence. Still, tooth-colored fillings do have some definite advantages. Not only do they blend in with your smile far better than “silver” (dental amalgam) fillings, but they often require less removal of healthy tooth structure. That’s because in order to fill a tooth with amalgam, it is necessary to create indentations in the tooth called “undercuts” to hold the amalgam in; this requires the removal of some healthy tooth material. With a tooth-colored filling, we need only remove the decayed part of the tooth to place the filling.

Are there any disadvantages?
Yes, tooth-colored fillings don’t always wear as well as metal fillings — particularly on back molars where they are subjected to the most stress from chewing. They are also more expensive and less likely to be fully reimbursed under dental insurance plans.

Are there different types of tooth-colored fillings?
Yes, three different choices of tooth-colored fillings are available:

  • Composite — This mixture of plastic and glass is the most common type of tooth-colored filling. Newer materials can hold up almost as long as amalgam fillings and look very natural, though they can stain over time just as natural teeth do.
  • Porcelain — High-tech dental ceramics are considered the most aesthetic choice of filling material. They don’t stain as composites can, but their relatively high glass content can make them more brittle and prone to breakage. They may be more expensive than composites.
  • Glass Ionomer — Made of acrylic and glass powders, these inexpensive, translucent fillings blend in acceptably well with natural teeth and have the advantage of releasing small amounts of fluoride to help prevent decay. However, they generally don’t last as long as other restorative materials.

We would be happy to offer guidance on which choice would be best in your own unique situation.

If you have any questions about tooth-colored fillings, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”

FixingAdultTeethIsNoMissionImpossible-JustAskTomCruise

It's no surprise that plenty of teenagers go in for an orthodontic evaluation and come out wearing braces. But sometimes, an observant orthodontist may notice that an adult's smile could use a little bit of improvement, too. Even an adult like — Tom Cruise?

That's exactly what happened to the star of Top Gun, Rain Man and the Mission Impossible franchise. Cruise, then 39, was taking one of his children for orthodontic work when it was pointed out that the leading man's teeth were also out of alignment. So he opted for braces too.

“Yes, Tom Cruise has braces,” said his publicist when the star appeared, sporting his new orthodontic appliances. “To him, it's no big deal.” Cruise chose to get the relatively inconspicuous ceramic type, with only a thin wire visible in front of his teeth. He wore them for about a year and a half, having them temporarily removed when it was time to make a movie.

Ceramic braces are a popular choice among adult orthodontic patients, many of whom find that less noticeable orthodontic appliances fit in better with their personal or professional lifestyle. Clear aligners also provide a virtually invisible option. We can help you decide which appliance would best meet your needs. But the first step is a thorough evaluation of your periodontal health.

Is it Risky Business to get braces as an older adult? Not usually — but if you do show signs of periodontal disease, which is more prevalent in adults than teens, it's important to bring it under control before beginning your orthodontic treatment. There are also a few medical conditions, such as heart-valve disease, severe uncontrolled diabetes, and leukemia, which might preclude treatment.

For most people, however, orthodontics offers a great way to improve your appearance and boost your self-confidence — even if you're not a movie star. It is estimated that three-quarters of adults have some form of orthodontic problem; and studies have shown that orthodontic treatment can enhance an adult's career opportunities and social life.

So, if you're looking for a better smile at any age, don't hesitate to contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Orthodontics For The Older Adult.”

SolvingtheProblemofMissingTeethWithOrthodonticsandRestorations

Normally, teeth erupt and grow in a symmetrical alignment: on the top palate, for example, the two central incisors take center stage; on either side are the lateral incisors, and then beside these the canines (cuspids).

But what happens when teeth don’t grow in? The result can be a smile that just doesn’t quite look right; more importantly, normal function is impaired because the person can’t grasp and chew food correctly.

These missing teeth are the result of a congenital (“from birth”) defect. It’s estimated that almost a quarter of all people are missing one or more wisdom teeth, and more than 5% are missing one or more second premolars or upper lateral incisors.

In a normal arch (the upper or lower set of teeth), each tooth type performs a particular role during eating. A missing tooth causes the remaining teeth to compensate, but beyond their capacity. The remaining teeth also tend to move to fill in any gaps left by the missing teeth, as when the eye teeth move toward the central incisors in the absence of the lateral incisors. This puts them out of position, so they can’t cover (“occlude”) their counterparts on the other arch and grasp food properly.

To improve the smile and restore proper chewing function it’s necessary to first move these “out of position” teeth to their correct position through orthodontics. We would then fill the gaps that result with life-like restorations (preferably dental implants with crowns) that resemble the type of tooth that should be there.

The restoration needs to be timed carefully, especially for young patients whose jaw structure has not fully developed. If implants are installed before the jaw’s full maturity (usually late teens or early twenties), the implant crowns may not appear to be the right length as the jawbone continues to grow. Since bone growth depends on the normal pressures exerted by the teeth, there may also be insufficient bone mass in the gap area to support a dental implant. Growing bone with bone-grafting material may be necessary before installing implants.

The total process could take many months or even years, depending on age and other conditions. In the end, though, the results can be astounding — better function and a vibrant, new smile.

If you would like more information on developmental problems with teeth, 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 “When Permanent Teeth Don’t Grow.”

DidYouKnowMatineeIdolJamesDeanHadFalseFrontTeeth

Imagine how different things would have been for movie star James Dean, had he not managed to replace the front teeth he lost as a youngster. According to one biography of the 1950s heartthrob, Dean's teeth were knocked out while he was swinging around on a homemade trapeze. Because his smile was restored, Dean was able to land the plumb movie roles that catapulted him to stardom.

This is perhaps the ultimate example of how a smile makeover can create new opportunities for a person. But opinion polls confirm that nearly 90% of adults feel an attractive smile is an important social and career asset. And, an almost equal percentage of adults feel that their smile could use some improvement.

Are you unhappy with your smile? Is a smile makeover something you've ever thought about? Dear Doctor magazine has come up with a great list of questions you can ask yourself to figure out if you would benefit from this life-changing experience:

  1. Do you avoid smiling in photos?
  2. Are you conscious about spaces and gaps in your teeth?
  3. Are your teeth making you look older than you feel?
  4. Have you held back a smile?
  5. Do you feel that your teeth are stained or too yellow?
  6. Do you hold your hand up in front of your mouth when speaking or laughing?
  7. Do you notice areas of excessive tooth wear that make your smile look older?
  8. Do you have little teeth and a gummy smile?
  9. Are your teeth crooked, chipped or crowded?
  10. Do you wish you had someone else's smile?

If you answered “yes” to any of these questions, please come in and see us. We have an amazing array of cosmetic procedures available to us — far more than what was available to James Dean in the 1950s. These options range from relatively inexpensive teeth whitening treatments to more permanent cosmetic solutions such as porcelain crowns and veneers. Together we can come up with a plan to give you the smile you've always dreamed about.

If you would like more information about what a smile makeover could mean for you, please contact us or schedule an appointment. You can learn more about smile makeovers by reading the Dear Doctor magazine article “Beautiful Smiles by Design.” Dear Doctor also has more on “The Impact of a Smile Makeover.”



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