Invisalign® has been around for a few years now and has proven to be a very effective solution for straightening teeth.
However, it does not take the place of all orthodontics by any means. There are many outcomes for optimal straightening of the teeth that can’t be accomplished with Invisalign®, in which case traditional orthodontics are the better option. Fortunately, for the great majority of people who once had orthodontics and it has relapsed, Invisalign® is an ideal procedure to get the teeth straight again. There are many situations where Invisalign® can get excellent results, even for someone who has not had orthodontics before.
In order to utilize Invisalign®, it is vital that the dentist has a full understanding of occlusion and the patient’s TMJ (joint of the jaw) health. Training in orthodontic movement and TMJ is ideal. The goal is not just straighter teeth, it is to get a healthy stable outcome for lasting results. Some outcomes with Inivisalign® can be less stable than they would be with traditional braces, which increases the need for fixed retention, such as wire bonding on the lower teeth or the use of retainers indefinitely.
Invisalign does allow business people to straighten their teeth and not have their image/business savvy interfered with because they can communicate well with Invisalign®, and most people can not even tell you have anything on your teeth. One of the big benefits we see from a dental standpoint is that you can straighten your teeth but still remove these things, brush and floss your teeth, and still keep them very healthy. With traditional braces you can not clean your teeth as well and it holds stuff against your gums. Many individuals with traditional braces end up with inflammation of the gums and discolored teeth from the pressure of the braces. Invisalign® has big advantages in that it uses the most modern Cad/Cam technology. This is where the dentist can view your individual case using a computer program that helps to guide how the movements in the teeth are made. An individual plan can be made that is tailored for optimal treatment for each patient.
For over 25 years dental implants have provided a natural looking solution for replacing missing teeth and for stabilizing or anchoring dentures. Before placing the dental implant into the jawbone, an analysis is taken to determine how the upper and lower jaw functions together. In addition, photographs, x-rays, and molds are taken of the teeth, smile, mouth, and jawbones.
Based on the analysis, we develop a plan that is in harmony with the patient’s goals and desired outcome. Most commonly, the patient’s goal is to replace their missing teeth, to use implants in place of their partial dentures, or for use with their dentures to create stability when chewing.
Some implants need time (four to six months) to fuse to the jawbone so that they will be strong enough to hold the crowns, bridges, or dentures. Implants usually require a surgical and restorative phase, but in some cases they can be used almost immediately after placement in the jawbone.
Typically, dental implants replace the roots of the missing teeth in the bone so that whatever attaches to it will be more stable. Individuals who have lost many of their teeth, if they have enough bone,have many options for stabilizing and making their dentures more functional with implants. Implants can also be used to build fixed bridges attached in part of the mouth, which is more like replacing teeth that the patient can really bite with. The advantages of putting in implants underneath the denture is, in addition to support, it stimulates the health of the bone and keeps it from resorbing as it does when it has a denture placed on top of it. One of the problems we have is that when the teeth are taken out, the bone begins to shrink down as it responds to the pressure of the dentures.
Over years of wearing dentures, the bone continues to shrink and eventually the dentures do not fit the mouth. Implants slow down this process dramatically by stimulating the bone to stay healthy and keep it from resorbing. The dentures will last longer because the underlying areas of the bone are healthier.
If you would like to learn more about implant dentistry to see if it is the best option for your goals for oral heath and beauty, please contact our office to schedule an evaluation.
Some symptoms of worn teeth include chipped teeth, your teeth do not show when you smile, or if you feel that your smile is flat and unattractive.
Veneers are not always the solution.
When a patient seeks out help for worn teeth, far too often the decision is to simply use veneers to lengthen the teeth back out. The problem with simply adding veneers onto the teeth is that it is important to find out why the teeth were shortened in the first place. Simply lengthening the teeth back to where they were may only treat the effect because it does not solve the underlying cause of why the teeth wore down in the first place. This sets the patient up to potentially wear down or break their veneers, just as they did with the teeth the first time. Often it is necessary to reposition the teeth or deal with another problem the patient may be having, such as grinding their teeth at night. If they have veneers placed, they may want to use a night guard to protect the teeth from damage as a result of grinding.
Addressing the Underlying Problem.
Before deciding to use veneers, your dentist should carefully examine the underlying problem. They should determine whether the problem is skeletal, just the teeth, or the bone that supports the teeth itself in order to truly solve the problem.Your dentist should give you the options that are available because veneers are a big investment and they are not really reversible. So if the patient has problems with them, they just have to keep replacing them. They should look and make sure that the patient’s gums are in the proper place and that they are not showing too much gums when they smile because their teeth have worn and they erupted down and brought the gums with them. They should make sure the gums are even to assist with a beautiful smile because putting veneers on them does not solve that problem if the gums are not addressed.
If their front teeth are tilted back and in, that is an abnormal relationship that leads to wear and if they put veneers on those type of teeth, the same wear will happen over again only now they will have to pay for the veneers over and over again.
Far too many times veneers are the answer that is given because the patient requests them or the dentist does not properly assess the entire situation. For example, sometimes veneers are put on when the answer really needed to be repositioning of the teeth prior to restoration. If the teeth are properly positioned, that makes room to ensure that the veneers are the appropriate size for the patient. If the teeth are restored in an abnormal position that has taken place because of wear the teeth, the veneers can not be the right width to length ratio for that patients smile…and may not be in the right place in that patient’s smile.
There are negative effects to getting veneers before restoring teeth. The patient may feel discomfort, such as jaw pain. In most cases, there will simply be a problem of maintenance. The patient may break off, chip, or wear down the veneers just like they did with their natural teeth.
A lasting Solution
If the teeth are restored correctly in the proper place, the patient can look forward to increased longevity, increased comfort, and a very beautiful smile as a result. Simply making teeth bigger with veneers often times does not solve the core problem and does not give the patient the best smile that is possible. Although it may offer improvement, it won’t give the final result that could have been accomplished. Far too many people get veneers and feel semi-happy with them because it is an improvement over where they were, but they are so far from where they could have been for the final outcome. Sometimes finding the right solution requires a comprehensive approach from a group of qualified, dental specialists who work together with the patient’s best interest in mind. The end result is rewarding: optimal aesthetics and longevity.
There has been a lot of progress made in the area of filling materials for teeth for small areas of decay. Previously, silver imogen was the major choice for dentists. One downside of these silver fillings is that they are held in mechanically so the dentist has to undercut the preparation to get it to lock in to the tooth, resulting in the removal of good tooth structure to get it to mechanically lock in to the tooth. Because they did have to make a larger opening to put in a silver filling, dentists were many times reluctant to fill the smaller cavities, waiting until the cavities were bigger to put in bigger fillings. The bigger a silver filling gets, the more discrepancy there is in the coefficient of expansion. This means the metallic filling will expand and contract more than the tooth structure it is in when making contact with hot and cold foods. When this happens over an extended period of time, often times the teeth will crack or the margin between the filling and tooth will break down, causing leakage. The biggest problem found with baby boomers who received these big silver fillings when they were young, is most of them needed crowns as they grew older. So now there is a push to perform less invasive dentistry and the composite resins have come a long way from previous generations. The composite tooth color restorations wear more like tooth structure now and they bond to the tooth so the dentist doesn’t need to rely on undercuts. This allows us to remove just the decayed area itself and bond the filling into the tooth, preserving more structural integrity to the tooth.
Because we are taking care of decay at an earlier stage and using filling that bond to the tooth that have a coefficient of expansion that is more similar to the tooth structure, there are fewer cracked teeth caused by the restoration, the fillings are smaller so they last longer, and cosmetically they blend to look more like part of the teeth.
When fillings get to be a certain size, regardless of the material, you are exceeding the limits of that material for it to be an effective restorative product. In this case, porcelain restorations can be shaped and cast to fit in or on the tooth and bond to the tooth. This solution can be effective for teeth that need full coverage to protect where they have been cracked or broken. Often times now we don’t have to do a full crown when we can do different shaped restorations that bond to the teeth and maintain more structural integrity to the tooth.
Bleaching and whitening is a popular service in dentistry. When done correctly, bleaching has evolved to be safe, effective, and to not damage the teeth. We caution patients about using some over-the-counter whitening products. While many are safe, most are not as strong as what we use at our office and some contain high levels of acid. Short term this will make the teeth whiter because it removes some of the minerals and reflects more light, but it is actually damaging to the teeth over long-term use. Some of these products also make the teeth more sensitive. We are careful to use products that cause less sensitivity and bleaching teeth is a routine service.
Patients who are considering restorations to their front teeth, whether composite fillings or crowns, should consider bleaching before the restorative work because bleaching can not be done afterwards.
A large segment of the population does not seek proper dental care because of fear. Today there are several options that make dentistry much more comfortable. For years nitrous oxide has been available, which is an analgesic gas that raises the pain threshold and alleviates anxiety. This is a good solution for many patients and the gas is out of the system within just a few minutes of breathing oxygen afterwards, so a designated driver is not necessary after treatment.
Some individuals are reluctant to even just have their teeth cleaned because of fear. For these individuals we have oral medication that can be taken 45 minutes to an hour before their appointment that will alleviate their anxiety. The medication is strong enough to really do an effective job so these patients will need a designated driver after treatment.
If we are going to be doing significant dentistry on an individual who is not comfortable sitting for an extended amount of time or has an extreme fear, IV sedation is available. This is a safe method of sedating the patient so that they will not have an unpleasant memory of the treatment. They will not be unconscious, as with general anesthesia, so there are not extreme dangers associated with this sedation. Patients can still respond and inform us if something is bothering them so that we can respond accordingly.
Sedation dentistry allows us to help individuals who have had years of neglect and sometimes get them back to good oral health in just one or two appointments. Once they are healthy, our goal is to keep them in good oral health.
A great number of people simply do not go to the dentist because they are afraid. It may be because they had a bad experience when they where a child and some people have no idea why they are afraid.Whatever the reason, we have seen MANY individuals wait until their teeth were almost killing them because of infections before they would come to the dentist.
In the old days we used to send patients to the hospital and give them general anesthesia to do anything.Now we have the capabilities to give general anesthesia in the luxury of our offices.
When I started getting into more comprehensive type dentistry, we needed to find a way to sedate those individuals who had a fear of dentistry to get them through the procedures, because the procedures they needed done could be perceived as “frightening”, not necessarily painful, but frightening. Sedation provides a solution for eliminating that fear.
Oral Sedation
Oral sedation is very popular in dentistry right now but I use it in a limited manner because it is not as predictable or as safe. You can’t predict how it is going to be absorbed or how it is going to affect one person versus another. and you can’t just keep giving them more medications one after another because it takes 30 minutes to an hour for that medication to be taken up in the stomach and to get in the bloodstream. So you could run the risk of over sedation if pills are given to close together.
IV Sedation
The IV is always much safer because once the patient has receive the medication through the IV, within 60 to 90 seconds you know exactly how it is going to affect that person and then you can titrate it (control concentration) so that you get the proper sedation without over sedation, making this sedation method totally safe.
If someone has been avoiding the dentist because of fear, IV sedation is an option because it allows us to do a lot of dentistry in 1 or 2 appointments. and get them back to good health. Fear of the dentist is based upon many things. One of them is lack of trust – so a patient has to come in and learn how they are going to react with that particular dentist to develop trust. We work with our patients on developing trust, especially those who are fearful because that alleviates a good portion of their fear- if they know they are working with someone who cares about them. You can’t get that kind of care in a clinical situation…where there are many patients waiting for that dental chair. For this reason we provide personalized, private, one-patient-at-a-time dental care.
In the right situation, veneers are a great answer for discoloration, worn teeth, and chipped teeth to revitalize or rejuvenate your smile. With the new bonding techniques that have been developed over the last several years, veneers are even better than they used to be because we can laminate them to the tooth, where they actually become part of the tooth. These are much stronger than porcelin veneers were in the past. We are also able to change the size length and shape of teeth, and even pull out the lip in some cases so that the lip looks fuller.
Many times people may have been born with teeth that are just a little bit too small for their mouth and, by using veneers you can enlarge their teeth, giving them that fullness to their smile. We want to make sure that we use a great artistic plan when we do veneers so that they look natural. Veneers can look very natural because of translucency and the shading, like a natural tooth instead of making them all one color.
Patients who are good candidates for veneers are people who have a reasonably good bite and have worn or chipped teeth, discolored teeth, or teeth that are not the proper size for their mouth.
As dentists, when we get the teeth to the right position in the facial structure, it purses the lips, makes them look fuller, and it gets rid of a lot of the initial wrinkles that form early in life around the mouth…And also the most important part of dentistry, as it relates to facial beauty, is in people who have a bad bite or have tmj problems. These individuals always have a tenseness in the muscles of the face because of chronic pain, or as they wear their teeth-their mouth over closes. If you restore health and comfort, the muscles relax and the face takes on a totally different youthful appearance.
In the teeth that are worn – that’s when you start getting the profile where the chin sticks out too far and the lower third of the face appears too short. This makes people look like they are wearing dentures even with their natural teeth. So for restoration done on the mouth, with a proper bite that opens right to the level where the muscles work best, tis will also add greatly in the facial beauty and rejuvenation of the face. We recommend for individuals who have a dental issue, to get that fixed before they consider doing a face lift or any cosmetic surgery. You can reduce the amount of surgery that is needed and, sometimes that eliminates the need for a face lift for some of the problems around the mouth.If there is someone who does need facial work, having a beautiful smile to go with it dramatically increases the effectiveness of the results.
When someone looks at a person for the first time, they notice their eyes, then they notice their smile, then they notice their other facial features. The smile is an incredible part of projecting beauty and youthfulness. For anyone who has had the misfortune of having to have gone to dentures, it’s important that those dentures get relined or replaced frequently enough to maintain the support of the lips and the height of the teeth to keep them from looking old before their time. In some cases you can tie that into implants because, to keep the dentures in the right place and to keep the gums from being sore, implants become necessary.
If you have an abscess tooth, and its not hurting too bad, it could be draining in to the sinus, causing chronic sinus irritation. When you look at an x-ray of the upper tooth, the roots are visible up there and the sinus comes down – usually following a pattern of that root. In other words, the roots are holding that up and when you take the tooth out, there is constant gentle pressure there inside the sinus. The bone reacts to pressure and the bone in the maxilla is softer bone. So it does what we call numatizes that area.: the sinus starts enlarging, getting bigger because it is gently pushing that bone and the bone is resorbing (losing substance).
We see a many individuals who, when their teeth are out, have paper thin bone between the ridge and the sinus. If it’s a denture, then that can be tender all the time when they have sinus problems, and the bone goes away so we don’t have a place to put the implants. If the teeth have been removed and left our for a long time, you can still get implants, but you have to go through a grafting procedure to raise the sinus floor and grow new bone to put implants in. The other thing that is particularly prominent when you have a tooth on the side but the middle teeth are missing, is the sinus comes down and now you have a low spot where the fluids are always sitting. This makes the individual more prone to get infections.
What are some symptoms that may indicate that the sinus problems you are having may be related to your teeth?If you had a tooth taken out and you want to have it replaced you should do it sooner rather than later so that the sinus doesn’t numatize and you don’t require an extra surgery.
