When it comes to patient comfort, one of the most important developments of the 21st century has been sedation dentistry, which enables you to relax in both mind and body allowing you to focus on feeling peaceful rather than anxious. And the prescription medications we use are some of the safest on the “therapeutic index” (the scale pharmacists and health professionals use to measure the safety of medications.) However, it is critical that we are aware of any medications you are already taking and your medical health and history, so let us know all about you so that we can avoid adverse (negative) reactions. Please note that we will take a full history to gain this information prior to any treatment or sedation — our utmost concern is your safety. During this time, it is vital that you are honest and feel comfortable sharing your responses to our questions. It's also our way of getting to know you and the first stage in relieving your anxiety. We will need to know all about:

• All medical conditions for which you are currently being treated.
• All prescription medications you are taking.
• Over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. This even includes aspirin, St. John's Wort, and Kava Kava. (Why? If taken daily for good heart health, aspirin thins your blood and thus may interfere with blood coagulation. And St. John's Wort and Kava Kava may be beneficial in helping relieve depression, but they can negatively impact how oral sedation medications work.)
• Foods and drinks you consume, such as alcohol and even grapefruit (juice or the fruit), can negatively impact how your body responds to both your treatment and sedation medications.
• And lastly, we need to know if you are a tobacco user — especially if you are a smoker. In addition to increasing your risks for oral and other cancers, tobacco can negatively influence the effectiveness of sedation medications.

To learn more about this topic, read the article “Oral Sedation Dentistry.” Or you can contact us today to discuss your questions or to schedule an appointment.

An important consideration prior to having any cosmetic dentistry is to understand both the pros and the cons of each particular dental procedure. And while porcelain laminate veneers are among the most aesthetic means of creating a beautiful, more pleasing smile, they are permanent and non-reversible and should be maintained properly.

On average, you can expect porcelain veneers to last anywhere between 7 and 20+ years. However, much of that depends whether or not you care for them properly in addition to the quality of the dental porcelain, the craftsmanship, and placement of them. How long your veneers last can also depend to some extent upon how you age. This is because the gum tissues attached to the living tooth that your veneers are cemented to may shrink or pull away from the tooth exposing its root surface. If this occurs, you should see your dentist for an evaluation, as it may require veneer replacement. Or, the issue might be resolved through some minor periodontal (gum) plastic surgery.

Porcelain veneers are a low maintenance solution for solving a multitude of cosmetic dental challenges, but they do require that you protect them during sports or vigorous activity. You should also wear an oral appliance or mouthguard (nightguard) to protect them from grinding or any other involuntary damage during sleep.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Porcelain Veneers.” If you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.

It used to be that when it came to treating tooth decay (cavities), your primary option was to have the tooth decay removed and filled with a metal amalgam (silver-colored filling). This treatment sometimes requires a special shape cut called an “undercut” to be drilled into the tooth to hold it in. Unfortunately, it can also involve removal of some healthy tooth structure. Silver amalgam fillings still have limited applications and are still used in back teeth where they don't show in the smile. This is because they are strong and resist biting well; however, over time they can fatigue and fracture.

Older restorative concepts were based upon the development of strong and stiff materials such as gold, which tends to be unyielding and therefore contributed to failures of the remaining tooth substance around restorations (e.g., decay or cracking). Newer concepts tend to get away from the “stronger and stiffer is better” concept and have moved towards safety principles using materials that involve mimicking the properties of natural tooth structure. In fact, it is now clearly established that a new “biomimetic approach” (“bio” – life; “mimetic” – mimicking) to dentistry is possible through the use of tooth-like materials such as composite resins and porcelains. And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, which both stabilize and strengthen teeth.

These techniques are also suitable for children's teeth and can incorporate fluoride to reduce further decay. But perhaps best of all, using these materials and more modern technologies can restore proper tooth function and normal wear while producing results that appear indistinguishable from natural teeth.

To learn more, continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” You can also contact us today to schedule an appointment to discuss your specific questions about replacing your metal fillings with tooth-colored ones.

If you are insecure about your misaligned crooked teeth, then you may be a perfect candidate for clear orthodontic aligners. This system is an alternative to traditional braces that uses a sequence of individual, clear, removable “trays” that fit over your teeth to gradually straighten them. Each tray is completely clear and covers all the teeth thus making it virtually invisible. Each tray is designed to slightly move the teeth until the teeth are in proper alignment. Typically, each tray must be worn for 20 hours a day for 2 weeks before progressing to the next tray in the sequence with each tray moving you closer towards your goal — perfectly aligned teeth.

However, clear orthodontic aligners are not for everyone. If you are interested and wonder if they can benefit you, contact us so that we can schedule an appointment for a thorough evaluation to assess your specific situation. Below, we have briefly outlined some situations when they will and will not work.

Clear orthodontic aligners work if...

• You have mild to moderate crowding or spacing issues between teeth
• Back teeth fit together properly

They may not be the right choice if...

• You have moderate to severe crowding or spacing issues between teeth
• When your bite does not align properly (for example, if you have a large over-, under-, or cross-bite)
• When your teeth are “rotated” way out of position; such misaligned teeth will require special or complex techniques to rotate them back into position, or to pull them down into place or to fill the space left after pulling a tooth to resolve excessive crowding of teeth

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about this topic by reading the article “Clear Orthodontic Aligners.”

What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.

What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.

Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.

Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.

What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.

What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.

Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.

Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.

Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”