HOW TO CARE FOR YOUR TEETH
Oral Health and Overall Health
There is a strong correlation between poor oral health and the incidence of gum disease. In addition, some of the same bacteria that cause gum disease are related to heart disease. For this reason, proper dental care is critical in the prevention of other diseases throughout the body.
Practicing Good Oral Hygiene at Home
The best way to practice good oral hygiene at home is by brushing the teeth. Proper brushing involves the use of a soft toothbrush and brushing as instructed by your dentist or dental hygienist. We recommend brushing at least twice a day, and especially after eating, to remove the food debris that causes the issues with our teeth. Our office also advises our patients to floss at least once a day, and flossing at night is especially beneficial. At night, the mouth tends to dry out and bacteria are therefore much more detrimental to the oral tissues, so flossing before bed is particularly important.
Fluoride is a naturally occurring compound in most water systems. In the mouth, fluoride replaces the calcium ions in the enamel, making the enamel more resistant to breakdown by the acids produced by bacteria and the simple sugars that we consume in our diets.
Teach Dental Group recommends that our patients use a regular toothpaste with fluoride. Many toothpastes contain additives that can be detrimental to oral health. A few brands of toothpaste cause tissue sloughing, in which the outer layer of the oral tissues sheds, creating a “cotton mouth” feeling. Sloughing also makes individuals more susceptible to certain diseases. A plain, fluoridated toothpaste, as recommended by the ADA, is ideal for cleansing the teeth without causing any harmful side effects.
Reasons to Floss
A toothbrush will clean only three surfaces of the teeth: the top or bottom edge, the front, and the back. The proximal surfaces (the side edges of the teeth) are unable to be fully accessed by even the most advanced toothbrushes, and they are thus susceptible to decay. Dental floss is capable of fitting between the teeth and cleaning out the food debris that has accumulated in these gaps, reducing the chance of developing gum disease.
Mouthwash is an important tool in fighting gum disease, but using alcohol-based mouthwashes too frequently can become problematic. Excessive intake of alcohol is one of the predisposing factors to oral cancer, so it is important to monitor your alcohol consumption and to use mouthwash only as directed. Our office recommends the use of alcohol-free mouthwash, which is just as effective in freshening the breath as brands that contain alcohol are.
Frequency of Dentist Appointments
Regular visits to the dentist are important because early action is essential in combatting dental problems. Seeing your dentist on a regular basis will allow her or him to spot any oral issues earlier, making them simpler and much more affordable to treat. Systemic diseases can start when an infection in the mouth is left untreated, and direct attention from a dentist is the only way to ensure that these ailments can be stopped before they spread.
Signs that should prompt you to see your dentist include sensitivity in your teeth, bleeding, sores, and red gum tissue. Pain in chewing or yawning can be indicative of a jaw problem, which a dentist can help to diagnose and treat. In addition, crowded, loose, or malpositioned teeth should receive attention from a dentist as soon as possible.
What to Expect at Your Dental Appointment
Your dentist will first review your medical history and inspect your mouth to see if there is a need for dental x-rays. The dentist or the hygienist may also examine your mouth to determine if there is evidence of gum disease or related problems.
We recommend that a two- or three-year-old child be in attendance when a parent is having her or his teeth cleaned. We let the child sit with a toy or a book in a chair in the corner of our office, and the child can watch her or his mother or father in order to feel more comfortable. If the child is receptive, we put the child in the chair and count her or his teeth. Sometimes we even give the child a ride in the chair.
Despite the common recommendation by pediatricians that infants at the age of one year should begin to visit dentists on a regular basis, it is difficult for dentists to treat children that young. Our office advises parents to look at their children’s teeth and only schedule appointments with dental professionals if they see any issues. If parents closely monitor the amount of sugar that their children eat and do not provide bottles of milk at bedtime, the risk for children at these early ages to develop problems will be minimal.
Going to the Dentist While Pregnant
Pregnancy is usually not that great of an issue when going to the dentist. There is always a concern with dental x-rays, so we tend not to take x-rays when a woman is pregnant. If there is an emergency and we need to take an x-ray, we can “double drape.” We use lead aprons that will protect the fetus. In addition, most obstetricians tend to tell us not to use anesthetics in the first trimester, especially those that contain vasoconstrictors.
Visiting a Dentist While Managing Diabetes
People who live with diabetes are more prone to gum disease. The condition is a common cause of loss of teeth in adults who have diabetes, and it is important for the dentist to know this. Also, diabetic people have some reduced healing properties, so precaution must be taken if there are any surgical procedures that must be performed in the mouth. It is always beneficial to know these facts so that we can prepare and do what we can to help our patients.
It is not uncommon to find latex allergies among our patients. Though many aspects of the field of dentistry are based in latex, we have several latex-free alternatives to the products that we use in our office, and we ready and willing to accommodate patients with a variety of needs.
Dentistry has been changing greatly over the past decade, and more technology has become integrated into everyday dental treatments. At our practice, we use various forms of dental technology. First and foremost, we offer digital radiography, or digital x-rays, which uses an intraoral sensor and generates far less radiation. Unlike film, digital radiography immediately provides images once scans are completed, and this both reduces wait time and increases our ability to provide our patients with timely treatment.
Another dental technology device that we utilize is the soft tissue laser. Despite the common misconception that lasers are high-tech and intimidating, our soft tissue laser is important in the healing process after dental work. To illustrate, many of our patients present with small canker sores, and we can use the soft tissue laser to help them heal faster. The laser allows us to do a lot more in terms of healing and provide non-invasive ways to treat patients.
The intraoral scanner is a device that is used to take pictures of the teeth inside the mouth, sometimes eliminating the need to take a dental impression. The unit is moved around the teeth and gums, and scans of the mouth are sent to a computer. The computer then puts together the patient’s mouth on the computer screen. In addition to saving time, the intraoral scanner allows us to forego the time-consuming process of making an putty impression of the patient’s teeth and using that impression to form a plaster mold.
We also routinely incorporate the CAD/CAM, which stands for “computer-assisted design and computer-assisted milling.” When we use this machine, dental crowns can be made and fabricated right here in the office to eliminate the need for multiple appointments and enable us to deliver more personalized crowns. In a way, the CAD/CAM lets us take the middleman out of certain procedures and treatment options.
Safety of Dental x-rays
Dental x-rays are rather safe today, especially due to the advent of digital x-rays. This innovation in x-ray technology cuts the radiation level dramatically, and all our machines are collimated to prevent the scatter of x-rays. We drape our patients with lead aprons, and there is no risk of any complications.
Does Whitening Toothpaste Work?
Whitening toothpastes usually contain peroxide and abrasive agents. These toothpastes help to remove the surface stains, and they have no effect on the intrinsic stains within the teeth. In contrast, professional bleaching and certain take-home bleaching procedures will help to whiten the teeth better than a whitening toothpaste.
How Long Does Tooth Whitening Last?
The duration of tooth whitening depends on both the type of tooth whitening that is performed and an individual patient’s habits. Does the patient drink a lot of coffee? Does he or she drink red wine or other beverages things that stain the teeth? Whitening is far more effective on some people’s teeth than on others, and it does not work for everyone.
Does Tooth Whitening Damage the Enamel?
Just as with most things in life, overdoing anything can cause issues. If somebody were to bleach too often, her or his enamel would become weakened. The effective agent in teeth whitening is usually peroxide, which can decrease the strength of the enamel. If somebody were to excessively bleach, her or his teeth would develop a bluish or grayish tinge; they would become chalky-looking. Most dental whitening products require that users wait certain amounts of time between bleaching. Two tooth whitening treatments a year is the norm.
Does Tooth Whitening Affect Fillings, Veneers, or Crowns?
We always caution our patients who have fillings and similar treatments in their mouths that the bleach will lighten the tooth structure but will not have much of an effect on porcelain crowns or composite fillings. A lot of the time, if a patient wants to bleach and lighten her or his teeth, we must then redo either crowns or fillings to match the lighter teeth.
– PREVENTATIVE DENTISTRY –
THREATS TO ORAL HEALTH
What Is the Timetable for Losing Baby Teeth?
By the age of three, all of a child’s 20 baby teeth will have erupted, or grown in. Usually, when the child reaches around four or five years, the parent or the dentist will start to notice that the child’s lower front teeth have begun to loosen. The first tooth falls out when the child is somewhere between the ages of five and seven. The child will lose eight teeth—the four upper teeth and the four lower teeth—between the ages of seven and eight. There is then a pause before the child will lose the next 12 teeth. Between the ages of 10 and 14, most of the baby teeth will have fallen out.
Oral Piercing Dangers
Oral piercings can be dangerous to the patient. The mouth is full of bacteria, and when the structures inside the mouth are piercefld, bacteria can be introduced into the rest of the body. If you pierce your tongue, you could strike a nerve and cause issues such as loss of sensation. Some of our patients with oral piercings and have accidentally bitten the piercing and fractured their teeth. There is also the possibility of swallowing or dislodging the piercing.
Foods That Weaken Teeth
We are frequently asked about which foods are harmful to the teeth. Usually, any foods that contain high amounts of simple sugars—candy and desserts, for example—will cause the teeth to be weakened because these snacks increase the amount of acid in the mouth. The bacteria consume these products and break them down into acid, which then eats away at the tooth, causing decay and gum disease. Besides sweets, certain beverages can also be damaging. A lot of sodas and sport drinks are highly acidic. Other issues that could cause erosion of the teeth include sucking on citrus fruits and regurgitating acid due to gastrointestinal issues. It is best to avoid foods with high amounts of sugar as well as acidic sport drinks and sodas.
Is Smokeless Tobacco Harmful?
Yes, smokeless tobacco can be harmful because chewers usually put the tobacco in between the cheek and the gum. In many instances, when doing oral exams, we see the changes in the tissue to the exposure to the smokeless tobacco, which can ultimately lead to oral cancer, ulcerations, and oral infections.
Decay is a process. The bacteria in the mouth consume the simple sugars that we eat. To prevent decay, sugar must be eaten less frequently, and everyone should practice proper dental care. Daily brushing and flossing, plus fluoride treatments, dental cleanings, and receiving sealants, can all stave off the incidence of cavities.
Preventing Tooth Decay and Gingivitis
The one way to prevent tooth decay and gingivitis is through consistent, proper oral hygiene: brushing, flossing, and limiting the amount of simple sugars in the diet. Unfortunately, sugar is in nearly everything that we eat today. The amount of sugar, though, is less important than the frequency that it appears in one’s diet. If you were to eat a candy bar, it would be better to eat it all at once than to eat one piece every hour until the candy bar was gone. In the latter case, the sugars in the bar would keep the pH level in your mouth low, which would allow acids to cause decay and the inflammation of the gum tissue, which is the cause of gingivitis.
Available Fluoride Treatments
Fluoride is a mineral that occurs often in nature, and we have found that fluoride strengthens the enamel on the surface of the teeth. The substance replaces the calcium ions in the enamel and thus hardens the enamel crystal. Fluoride treatments are important, especially as children’s permanent teeth develop. We also use fluoride treatments in adults because, as people age, gums recede and expose the roots of the teeth. Root surfaces are not covered by enamel and they decay much more easily, and the fluoride also strengthens that part of the tooth structure. Fluoride also reduces hypersensitivity, and with receding gums exposing root surfaces, fluoride will help to diminish that sensitivity that the patient experiences.
Fluoride is available in many ways. Our office uses both fluoride varnishes and foam fluoride, the latter of which is placed in a tray that the patient briefly wears following a tooth cleaning. We also offer take-home, prescription fluoride toothpastes for when children have braces or when adults have a lot of decay. This fluoride toothpaste also aids in staving off sensitivity from receding gums, gum surgery, and procedures that expose the root surfaces of the teeth. We strongly recommend that children receive fluoride treatments, as the treatments strengthen the enamel and make the teeth more resistant to decay.
Fluoride is safe for the patient as long as it is properly used and administered. We never prescribe excessive fluoride, as too high a fluoride intake can cause damage to the teeth.
Dental sealant is a plastic coating that is usually placed on the posterior teeth, that is, the teeth in the back of the mouth. Those teeth have deep grooves and fissures, and when the sealant covers those areas of the teeth, it prevents the bacteria from getting in and causing decay. We prefer to seal the teeth as soon as they erupt (grow in), so sealants are often performed around age six, just after the baby teeth start to fall out, and again at age twelve, when the molars erupt.
Sometimes adults may need sealants; as time goes on, these grooves in the teeth start to become sticky, and a dentist can arrest the process of decay by placing a sealant. Our office has placed sealants that last up to 30 years. Regardless of age, though, coating teeth in dental sealants is a beneficial procedure.
TOOTH AND GUM CONDITIONS
What Causes Morning Breath?
Morning breath is a common problem, and it is usually caused by the bacteria that are in the mouth. The reason why it is not experienced during the day is because the saliva generally flows into the mouth and helps to wash away the bacteria and the compounds that the bacteria produce that cause the malodor. During the night, the saliva takes a rest, and with nothing to remove the bacteria, the malodor appears in the morning.
Tooth sensitivity caused by different factors, the most widespread of which is the recession of the gum tissue. The enamel covers the crown of the tooth, the part that is visible in the mouth. As we age, or with too vigorous of brushing, scrubbing side to side along the gum line will cause the gums to recede and expose the root surface of the tooth. The root surface is not covered with enamel and it has microscopic tubules that communicate from the surface to the pulp, causing the sensitivity.
Teeth will darken sometimes with age because the teeth receive their color from the dentin, which is the layer below the enamel. As we age, the dentin tends to yellow more and our teeth naturally darken. Other reasons for the darkening of teeth are stains, smoking, and drinking a lot of coffee, tea, or red wine. Sometimes those superficial stains can be removed with dental cleanings, but the changes and colors in the dentin are difficult to change without more invasive work inside the tooth.
The causes of receding gums are diverse. One common contributor is vigorous brushing; even with a soft brush, when a patient scrubs along the gum line back and forth with a lot of force on the brush, this can force the gums into recession. Another major reason for receding gums is gum disease. Occasionally, gums can even recede because of occlusal trauma: if a tooth is malpositioned and it is bitten with too much force, the tooth may shift in position and the gums may retreat.
Bleeding of the gums is usually caused by poor oral hygiene and the buildup of the deposits that form in the mouth, such as plaque and tartar. To take care of bleeding gums, the best thing would be to see a dentist or hygienist and receive a proper teeth cleaning. A dental health care professional can teach proper dental care and the correct use of a toothbrush and dental floss.
Canker sores still have uncertain causes, though there are several theories about contributing factors. Sometimes trauma may play a role. When people wear braces or a sudden force strikes the mouth, the trauma causes an opening in the tissue, which allows the tissue to ulcerate and cause a canker sore. The foods that we eat, particularly acidic food, may also contribute. Other reasons for canker sores include undue stress, certain medications, and infection from viruses or bacteria.
Periodontitis is a disease that affects the tissues that surround and support the teeth. It occurs when improper dental care results in gingivitis, a condition involving chronic inflammation of the gums, and that gingivitis is left untreated, allowing it to slowly progress and wear away at the bones of the jaw.
Saving a Knocked-Out Tooth
When teeth are avulsed, or knocked out of the mouth, they can sometimes be saved. However, it is important to seek treatment within 30 minutes of the avulsion, or it will be difficult, if not impossible, to restore the tooth. It is crucial to handle only the crown of the tooth, as the root of the tooth is sensitive and can be damaged at the slightest touch. If the tooth is dirty or has some debris on it, it is recommended that the tooth be rinsed with some water. If it is not possible to get to the dentist within about 30 minutes of the avulsion, there are options: the tooth can be placed in the cheek or a cup of milk, or a kit from a nearby drugstore may help to temporarily preserve the tooth.
– RESTORATIVE DENTISTRY –
The Basics of Root Canals
A root canal is a procedure that is done in a tooth when the pulp around the tooth becomes infected. Each tooth comprises enamel covering the surface and dentin underneath. Inside the dentin is the pulp, which consists of soft tissue, the dental nerve, and the blood supply to the tooth.
When the pulp is infected, a root canal procedure can be done to extract the pulp and eliminate the infection. The tooth is sealed internally, and though the tooth is now dead, the supporting structures to the tooth are still viable. The tooth can thus stay in the mouth as long as it is properly restored after the root canal procedure.
When Do You Need a Root Canal?
A root canal is usually necessary when a tooth becomes symptomatic. Sometimes the tooth can be sensitive to heat and cold. Sometimes there can be excruciating pain. Sometimes there is tenderness when biting or chewing. Sometimes the face swells. A root canal removes the pulp, and it stops the infection, the pain, and the sensitivity in their tracks.
Benefits of a Root Canal over Extraction
If the tooth is still intact, and it has strong bone support, a root canal is the best option. If the tooth is removed, then it has to be replaced either by a bridge or an implant. If the tooth is not replaced, changes in the bite will occur over time. Teeth will start shifting around, creating more problems. Keeping one’s own teeth is the ideal, provided that the affected tooth is strong enough to withstand the root canal and the restorative procedure.
Typical Root Canal Appointment
When a patient needs a root canal, there is telltale discomfort in a tooth. We do some testing to figure out which tooth is the problematic one. Using some local anesthesia, we numb the area. We can then open the tooth to relieve the pressure that is building up and causing the pain and discomfort. Further treatment is necessary to clean out the canals, eliminate the bacteria, and finally seal the tooth so that it can remain in place without further issues.
Time Length of a Root Canal Procedure
Depending on whether it is one of the anterior teeth, which usually have a single canal, or one of the posterior teeth, where there are more roots to the tooth and more canals, the root canal procedure will vary in length. Sometimes it is a single-visit procedure, but often it is two to three visits that are needed to complete a root canal.
A Previous Root Canal Did Not Heal Correctly
Patients come in on occasion with root canals that were done prior to seeking treatment from our office. Usually, if root canals are failing or not working out in the way that we would like, we usually will then refer the patients to an endodontist. An endodontist is a root canal specialist who would then treat that problem. Hopefully, the tooth can be either retreated or have another root removed. On occasion, though, the tooth is fractured and needs to be removed entirely.
Does a Root Canal Hurt?
Even with local anesthesia, it is difficult sometimes to totally numb the patient so that he or she does not feel anything. In certain instances, we must go into the tooth and numb the pulp directly only once we have accessed the pulp. Unfortunately, when a tooth has deteriorated enough, a little more discomfort is required to help the patient to be asymptomatic and pain-free.
How Long Do Root Canals Last?
A properly done root canal can last a lifetime. Again, it is dependent on the patient getting the tooth properly restored after the root canal. Many times, people have the root canal done and, once they are not in pain anymore, they do not have the tooth restored. The tooth then decays, and it must eventually be extracted.
Do Root Canals Hurt After the Procedure?
A root canal, like any other surgical procedure that is done in the body, sometimes causes some post-operative symptoms. We usually recommend that when people leave the office after having a root canal done, they take some ibuprofen before the anesthesia can wear off, after which point the medication will already be in the bloodstream and working. When the anesthesia wears off, these patients should not have any further pain or discomfort.
Driving After a Root Canal
Root canals done in the office with local anesthesia usually do not require that a patient ask a driver to take her or him home. Patients can drive and function quite normally. There will only be the numbness in the face, which is similar to the numbness that lingers after a filling.
What Are Fillings Made Of?
Our office uses composite and amalgam fillings with our patients. A composite is a tooth-colored filling that usually contains a resin and a glass filler, the latter of which is composed of many microscopic glass particles. This type of filling has many different shades so that we can match the shade of the patient’s tooth. Amalgam, also known as a silver filling, is usually about half-silver and half-mercury. The metals are mixed and then bound together, and once the amalgam hardens, it becomes a suitable filling material. Other substances exist that can be effectively used in fillings, but our office relies on composite and amalgam, which are the most popular and durable options.
Are Mercury Amalgam Fillings Safe?
Some patients are hesitant about the prospect of mercury amalgam fillings. They may read in the newspaper about exposure to mercury and the corresponding negative health effects on the body. However, no proven scientific literature that amalgam fillings containing mercury are unsafe, and the Food and Drug Administration has labeled these fillings as safe for use. Amalgam is still an efficient restorative material to use, and there are some times during which it is more appropriate to use amalgam than composite in fillings.
How Are Fillings Performed?
Fillings are placed in the teeth due to factors such as decay. The amount of decay and where the decay is usually dictate what type of filling is used and how much of the tooth’s structure requires repair. We use local anesthesia, which numbs the area of the mouth so that the patient has no sensitivity when we remove the decay from the tooth. Then, once the decay is removed, we properly clean the area in order to prepare for the filling. Using composite or amalgam, we place the filling material in the tooth and wait for the filling to harden.
Proper Care of Dental Fillings
Patients who receive new fillings or other restorative treatments often want to know how to take care of their mouths. Our hygienists typically review the recommended oral care procedures with these patients, but our dentists love talking to patients about optimal dental care habits when it is the patients’ first time receiving fillings.
Many times in restorative dentistry, we are required to place temporary fillings in order to access damaged teeth again at a later time, at which point we clean out the temporary filling and install a permanent filling. The use of temporary fillings is often related to root canal, crown, and bridge procedures, all of which require access to the interior of teeth over multiple appointments.
An indirect filling is a filling that is constructed outside of the mouth, which requires the dentist to prepare the tooth and somehow transmit that preparation to the laboratory to fabricate the indirect filling. This can be done with a physical impression, but video images of the preparation are becoming more frequent in usage, and the filling is developed based on that image. The filling is then brought back either at that same visit or at a subsequent visit, and it is bonded or cemented into the damaged tooth.
Is There Pain After a Filling?
Patients should expect some sort of sensitivity after a filling is installed, as it is a surgical procedure. There is sensitivity in the tooth because every tooth contains a nerve, and depending on the size and type of the filling used, patients should expect some sort of post-operative sensitivity. This sensation is usually short-lived and does not develop into a chronic issue.
How Long Do Fillings Last?
The life span of a filling is dictated by its size. Smaller cavities require smaller fillings, which have a lower chance of developing recurrent decay and breaking down. The larger the filling is, though, the more surface area is involved. Therefore, larger fillings have more stress placed on them due to the normal functions of chewing and eating. These larger fillings tend to have a greater chance requiring replacement sooner than smaller fillings in smaller cavities.
Good Candidates for Dental Bridges
Dental bridges can be used in the mouth as long as the adjacent teeth are strong enough to support the dental bridge. If the adjacent teeth are weak, fractured, or otherwise unable to provide support to a bridge, a dental implant is the state-of-the-art option to replace a single missing tooth, as it does not involve the adjacent teeth.
Fixed Dental Bridges
A fixed dental bridge is a bridge that is placed by reducing the adjacent teeth, taking an impression, making a metal framework, and then firing porcelain to the surface to make the porcelain tooth-colored. The dental bridge is then cemented in the mouth and cannot be removed by the patient.
Cantilever Dental Bridge
The difference between a regular fixed bridge and a cantilever bridge is that a cantilever bridge is only attached to one abutment tooth. These bridges are only used in certain limited situations where there cannot be too much stress on the pontic (the false tooth).
The benefit of a resin-bonded bridge is that the teeth adjacent to the missing tooth are not reduced to pegs; there is typically minimal or no reduction necessary. The difference between a resin-bonded and a fixed bridge thus lies in the support of the adjacent teeth.
How Long Do Bridges Last?
A dental bridge placed properly in the mouth can last for one to two decades, if not longer, as long as the patient takes proper care of the teeth. There is a persistent misunderstanding that a dental bridge cannot decay or break down. Proper home care, keeping the adjacent teeth clean, and flossing underneath the bridge are necessary to extend the length of that bridge.
A dental crown is a type of restoration that is placed when there is a significant amount of tooth structure that is lost due to previous decay and fillings, fracture of a tooth, or the completion of a root canal. It is highly recommended that a dental crown be placed over the tooth once one of these issues has occurred because the tooth becomes weakened with time, and adding the crown prevents further breakdown.
Dental crowns are analogous to wearing helmets. Just as we wear helmets on our heads for protection from potential biking-related injuries, dental crowns protect the teeth from infection. The only difference between the two is that the tooth needs to be reduced in size before a crown can be installed. Otherwise, closing the teeth will result in hitting the crown prematurely, and this can reduce the durability of the crown.
Types of Crowns
In the past, the primary type of crown in use was the full-cast crown, which was made entirely of metal such as gold, a gold alloy, or a base metal. Today, we have many other types of crowns available. There are porcelain-fused-to-metal crowns, in which a metal coping is made that fits over the tooth, and porcelain is then fired to the surface to match the shade of the adjacent teeth. There are also all-ceramic crowns, and there is no metal used at all in the fabrication of these crowns. This makes the crown look much more lifelike and real; the metal underneath the ceramic otherwise tends to give the crown a dead, dull look, even when the ceramic is tooth-colored.
Preparing a Tooth for a Crown
A crown fits over the tooth and encases the remaining tooth structure. In order to fabricate the crown properly, the tooth needs to be reduced in height and on the sides. The tooth then resembles a cone with the top cut off. Then, the crown is made based on the impression of the filed-down tooth. The crown is placed in the mouth, adjusted, and bonded or cemented into place.
A CEREC crown is a type of crown that is created in the office on the same day that the tooth is prepared. Instead of having a dental impression done, a camera captures the image of the prepared tooth in the mouth. The image is then sent to the computer, and the computer and the operator design the crown while the patients wait. The image and the subsequent design of the crown are sent to a milling unit that chisels the crown out of a ceramic block. The crown is tried in the mouth and adjusted where it touches the adjacent teeth. The CEREC crown is then polished and finally bonded into the tooth—all in the same visit.
How Long Do Dental Crowns Last?
The average shelf life of a dental crown is a decade, but crowns can last for as long as 30 years. This all depends on the patient and her or his oral habits and hygiene, how well the crown is maintained, and the frequency of dental visits.
Do Crowned Teeth Need Special Care?
Crowns, just like anything else in the mouth, need to be maintained through brushing and flossing. The crown fits over the tooth, but there is an area where the edge of the crown meets the edge of the tooth. We call this area the margin, and it is susceptible to decay if it is not properly cleaned, flossed, and checked by the dentist regularly.
Needing a Root Canal with a Crown
In order for a dental crown to be placed, a root canal is not usually required beforehand. Patients who receive root canal treatment do need crowns after the procedure, but one does not need to have had a root canal in order to be eligible for a crown.
Matching Veneers to Your Other Teeth
When veneers are placed in the mouth, the key to matching the teeth so that they all look uniform is to have a strong relationship between the dentist and his laboratory. The ceramist who makes veneers for our patients often comes to our office to meet each patient, take photos of the teeth, and make sketches. With his good eye and color technique, he is able to match the color of each patient’s teeth quite well.
How Long Do Porcelain Veneers Last?
Porcelain veneers, when placed properly in the mouth and depending on the patient’s habits, can last for a decade or two. If patients are bruxers, that is, if they grind or clench their teeth, they also tend to possess oral habits that require the use of their teeth for actions other than eating, such as opening plastic bags or biting into pencils or pens. Bad habits like these can cause the veneer to pop off the tooth. When veneers are placed, it is advisable to wear a night guard to prevent any grinding or clenching of the teeth during sleep. We caution our patients to never use their teeth for anything other than smiling and biting into softer foods.
Do Veneers Stain?
Porcelain veneers can get extrinsic stains just like your teeth can, but the veneers can be easily cleaned. Dentists must take care during the cleaning process to not use an abrasive tool or substance that will remove the shine or the glaze on the veneer. In our office, we have special toothpaste that we use to polish the veneer without creating any damage.
Will You Get Cavities with Veneers?
Veneers are usually placed on the teeth in order to hide discoloration, and they can form protective shells around the teeth, fending off bacteria and plaque. The teeth can still decay, however, because there is a fine edge between the veneer and the tooth. Without proper home care and dedication to thorough cleanings of the teeth, bacteria can slip under the veneers, and the teeth can decay just as those without veneers do.
There are many different types of dental implants, but those that are popular among dentists nowadays are the models that replace the roots of lost teeth. An implant contains three parts: the metal base, the post, and the crown or prosthesis. The base is screwed into the upper or lower jawbone, and after that is left to heal for a certain amount of time, we place a post inside the base. Eventually, we install a crown or some sort of prosthetic device on top of that post, completing the implant. The implant fills in the space formerly inhabited by the lost tooth, preventing the patient’s bite and surrounding teeth from changing. If the implant is planned and installed correctly, the implant and the restoring crown on top of that implant can be made to look just as natural as the tooth that was lost.
How Long Does It Take to Get Dental Implants?
The length of the dental implant installation process depends on whether the original tooth needs to be removed, a bone graft is required, and some healing must occur before the implant is placed. It is common nowadays for the implants to be placed immediately after the teeth are removed, which cuts the healing time in half. The majority of the time, if the implant can be placed at the same time the tooth is extracted, three to six months of healing need to occur before the tooth can be restored to function.
After we extract a tooth, what we sometimes need to do is place some bone graft material in order to preserve the volume and the architecture of the bone. This is the only effective way to stabilize this area so that it can bear an implant in the future. It is our office’s responsibility to help the patient to grow extra bone in these weakened areas before they diminish so significantly that they can no longer support any implants.
There are two different types of bone grafts: an autograft and an allograft. In an autograft, the patient’s own bone is used, and allografts use bone from an external source, such as a cadaver, a cow, or a pig. We prefer to perform allografts because autografts require a second surgical site, and this usually creates a lot more trauma for the patient.
Bone grafting is a safe procedure. Autografts pose little risk because the bone graft is derived from the patient’s own body, and all the sources for allografts come from a tissue bank and are sterilized multiple times prior to use.
Are Dental Implants Painful?
Pain is a common concern among patients who require implants for teeth that have been lost or will be lost in the future. At Teach Dental Group, we tell patients that the amount of pain depends on the situation. There are numerous factors, such as the number of implants and the removal of teeth, that directly influence how much pain will occur afterwards. Our office uses new technology and advanced implants in our minimally invasive procedures, and as a result, our patients are able return home and resume their daily activities with only a brief recovery period. We follow up with our patients after they receive implants, checking on how they are adjusting to their new implants. The day after surgery, there are typically no issues with pain, especially if there were no previous infections or complications in the surgery.
When your body is healing, just as with any kind of physical therapy, you are going to go through some sort of discomfort. However, this discomfort is typically minimal. We moderate any pain or that discomfort that does exist with mild medication such as ibuprofen, naproxen, or acetaminophen. Narcotics are usually not necessary for dealing with the pain.
Does the Body Reject Dental Implants?
The number one risk factor that prevents implants from working or being successful is smoking. We will still place implants in the mouths of patients who smoke, but we endeavor to convince these patients from ceasing to smoke. Our office likes to educate patients about the importance of quitting smoking and how this will affect their systemic health and their oral health in general. There are other elements that can complicate success of implants, and they can be discussed at future appointments with your dentist.
First Step with Dentures
If you want dentures, the best way to receive them is to schedule an exam with our office, sit through a total head and neck exam and an oral soft tissue screening for cancer, and have one of our dentists determine that your mouth is in the optimum healthy state. Only then will we be able to bring you back to function, give you teeth, and rebuild your smile. The first place to start is with that exam, after which we take impressions, molds, and diagnostic casts so that we can evaluate the condition of the jaws and the tissues. From there, we can develop a game plan and properly provide all the treatment options necessary to rebuild your smile.
Types of Dentures
There are many different types of dentures available for use. A popular choice entails regular dentures that stay in the mouth with nothing holding them in place. This option is ideal for many patients, as these dentures have great retention, the teeth can firmly stay together and in place. Other patients may require implants to retain their dentures better. Because there are so many options, the best way to know which type of dentures are going to be most appropriate for you and your mouth is to schedule that exam with our team of dentists. We will discuss all available treatment options so that you can make the best-informed decision about which route you would like to take.
Dentures Immediately After Teeth Extraction
Some candidates for dentures may require the extraction of additional teeth before they can receive dentures. This can be an intimidating prospect for many patients, who understandably will not want to have to lose any further teeth. No one wants to have every tooth extracted; it can cause feelings of embarrassment to be unable to eat and talk.
To receive a full set of dentures, it is an unfortunate fact that any lingering teeth on one jaw will have to be extracted. However, to spare our patients as much inconvenience as possible, our office endeavors to provide dentures to our patients on the same day as the extractions, allowing them to leave our office with a complete set of teeth in order to stave off any feelings of humiliation and to allow them to immediately return to chewing and speaking without impairment or delay.
The Pain Involved with Dentures
For a traditional set of dentures, with neither surgery nor implants involved, fitting and positioning the dentures is a painless procedure. Sometimes it is required for impressions to be taken of the inside of the mouth, and a few patients will need to overcome a gag reflex, but there is a low chance that patients will experience any pain.
After the dentures are delivered, some patients may experience sore spots in the mouth where the dentures are pressing too firmly against the tissue. This can be easily remedied, and because it is a regular occurrence, our office usually schedules a 24-hour follow-up appointment after dentures are installed. During this type of appointment, our team narrows down the sore spots before they can turn into ulcers or painful sores, and we lightly reshape the gum portion of the dentures for a better fit.
Caring for Dentures
Many of our patients believe, once they have dentures instead of their original teeth, that they can neglect their oral hygiene. That is not the right mentality to have. Dentures or not, everyone needs to take care of her or his mouth, tissues, and gums. It is important to schedule a dentist appointment every six months just to ensure that the teeth are in good condition. Systemic diseases such as cancer can show up in the mouth, so early identification and intervention through oral screenings is key.
There are certain oral hygiene practices that can preserve the integrity of the dentures. They need to be brushed, just as natural teeth are, and kept clean so that bacteria do not develop on their surface. It is advisable to soak them in water overnight, and your dentist can recommend which tablets and solutions available at any pharmacy are best suited for maintaining denture cleanliness.
Eating Normally with Dentures
Though they can restore much of the original functionality and appearance of a mouth ravaged by edentulism (tooth loss), dentures are not a replacement for natural teeth. As dentists, we want to save as many natural teeth as possible, so jumping right into dentures might not necessarily be the best decision. Once receiving dentures, it will not be possible to immediately eat and chew normally; it is going to take some time to fully adjust. When we deliver new dentures to patients, we make them aware that they will require a trial period of about five to six weeks before they start to feel comfortable with their dentures.
Sleeping in Dentures
It is not recommended to sleep while wearing dentures for multiple reasons. First, dentures pose a choking hazard. The last thing that anyone wants is to wake up in the middle of the night with a piece of denture lodged in the throat. Another reason is the fact that the mouth tends to dry out when dentures stay in overnight, allowing oral bacteria to accumulate and create issues that will cause pain and sensitivity in the gum tissues. A common complication is a condition called candidiasis, a yeast infection that creates unsightly white patches in the mouth. Leaving dentures to soak overnight and cleaning them carefully is necessary to prevent this potentially serious and painful situation.
Do You Need to See the Dentist When You Have Dentures?
It is important for patients wearing dentures to continue to visit our office on a regular basis, as we conduct an exam specifically for the detection of oral cancer and similar issues that can be caused by the denture. Dentures tend to wear out over time, which causes a collapse in a patient’s bite and can affect the jaws. Another problem that longtime denture wearers face is the degradation of the jawbones. The bone underneath the dentures, which helps support the dentures in the mouth, slowly tends to resorb and shrink, leading the dentures to not fit as well. This results in issues with the jaw and the bite, impairing functions relating to eating and speaking. Visits to our office allow our team to analyze all changes in the shapes of our patients’ mouths and refit their dentures accordingly.
Time to Realign Dentures
A common misconception among denture wearers is their dentures will continue to fit perfectly for years to come. Unfortunately, the tissues change and the bones thin over time, so the mold from which the denture was made is not applicable forever. Just as everything else in life, nothing is truly permanent. However, if we take proper care of things and schedule regular appointments, dentures can at least be maintained.
When dentures start to become loose and are not staying in place as well, we can perform a denture realignment to make them fit better. Assuming that the teeth portion of the dentures are not worn down and in need for replacement, we reshape the gum portion in order to match the contours of the jaw. As a rule of thumb, every seven to eight years, a new denture may need to be fabricated.
– PAYING FOR DENTAL CARE –
Are Payment Plans Available?
Depending on the amount of treatment and the cost, we can work out plans upfront that every patient can pay over time. We prefer to review these costs with the patients ahead of time before we get involved in any sort of treatment so the patients are aware of what they need to expect financially. If treatments are higher than the patients’ budgets, payment plans can make everything more affordable. All financial questions are discussed ahead of time so that we can properly review everything with our patients before we even get started with treatment options.
Costs of Dental Procedures and Treatments
The take-home trays that we dispense for tooth whitening run around $70. The cost of root canals varies based ogran the tooth for which the root canal is necessary, as front teeth have fewer roots and are easier to access. Root canals usually cost between $700 and $1,200. The charge of a dental crown in our office is consistent with the marketplace in the Western New York area. Most often, crowns are covered by dental insurance. Veneers are usually around the same cost as a crown because of the similar processes in designing and installing them. The cost of implants depends on the type of implant, what implant is going to placed, what function it is going to have in the mouth, and whether it is used to retain a tooth or a denture. When a bone graft is needed prior to receiving a dental implant, there is usually an added cost with that procedure. The extensiveness of the bone graft can determine how much the graft will cost and how many materials will be used. The cost of a bone graft ranges from $300 to $800 depending on the specifics of the patient’s situation and surgical needs.
Our office is a fee-for-service practice, which means that we have certain fees for the procedures that we do as highly qualified practitioners. We do not discount our treatments because of dental insurance, but we gladly file for dental insurance coverage, allowing our patients to only be responsible for the co-pays.
Does Insurance Cover Cosmetic Dentistry Treatments?
Most dental insurances do not cover cosmetic procedures and treatments, such as tooth whitening and veneers. If such a procedure were necessary due to a damaged tooth or another significant condition, the procedure would be covered. But because bleaching and veneers are considered to be cosmetic procedures, they are generally not covered by dental insurance.
Does Insurance Cover Restorative Dentistry Treatments?
Generally, most insurance companies cover root canal procedures. How much of the fee will be covered, though, depends on the benefit plan or the insurance company. Fillings are generally covered by dental insurance because the fillings are treatments to fix problems with teeth such as decay. To restore the tooth to good health, the placement of the filling is a covered dental procedure. Dental insurance plans will also often cover crowns because they constitute necessary dental procedures. How much of the crowns will be covered by the insurance depends on the patients’ plans and which types of insurance they have.
Insurance generally covers multiple procedures related to implants. Sometimes the companies will also cover bone grafting, but certain insurance companies do not. Insurance will usually cover dentures as well, though it is important to discuss and review this treatment with our office ahead of time so that no surprises occur later. Before any procedure, we can usually get a pre-authorization from a patient’s insurance to find out whether a specific treatment is going to be covered.