Dentures

The first thing to know about dentures is that you shouldn’t expect them to work like regular teeth. They really are two hunks of plastic with tooth-shaped pieces of acrylic or porcelain glued into them. If your healthy, natural teeth function like driving a well-tuned sports car, even the best dentures function like riding a tricycle.

That being said, a custom-fitted pair of complete dentures can serve as a great tool for people who no longer have the use of their natural teeth. It is best to think of them as a tool that takes some learning to use.

An upper complete denture is typically fairly easy for a patient to get accustomed to. The upper prosthesis (or “plate” as some people call it) has the advantage of being supported by the entire palate (roof of the mouth). The denture should have good suction for retention, and it is normally fairly comfortable.

A lower denture is a completely different animal. It relies on a relatively thin, narrow area of bone and gums for its support. The lower denture usually does not have very good suction. The movement of the tongue also serves to reduce the stability of the device. For this reason, we often recommend the addition of at least two implants beneath a lower denture to increase its retention and stability.

More to come….

-dr z

Dental Center of Deerwood

Just pull ‘em and give me dentures

As a dentist, I unfortunately hear this phrase on a semi-regular basis. It usually is followed by an explanation by the patient of how much his or her mother/uncle/sister/grandma/etc LOVES their dentures and has never had a problem with them.

My typical response is something like: “The only reason they love their dentures is because they don’t remember what it is like to have real teeth.” I don’t mean to sound negative about the denture-wearing population, but I think that sometimes patients begin to think that wearing dentures is just an inevitable future…. That nothing can be done to avoid losing all of one’s teeth.

That is simply not the case! Even starting with a less-than-ideal condition, you dentist can almost always work with you on a plan to save at least some (if not all) of your natural teeth.

All that being said, if you are beyond the point of saving any teeth, dentures can be a worthwhile alternative to having no teeth at all. Over the next few days, we will discuss the various options available for replacing teeth if you find yourself without any.

-dr z

Dental Center of Deerwood

Veneers – part 2

Aside from porcelain veneers, there are a few other veneer options available. First, there are indirect composite veneers. These are fabricated in the lab similarly to porcelain veneers. The procedure for the preparation of teeth and cementation is exactly the same as with porcelain. The only difference is the material from which they are made. This option is usually slightly less expensive than porcelain, but the drawback is that they normally have lower strength and it is possible they might not last as long as porcelain.

The other alternative to porcelain veneers is also a composite veneer, but one that is place directly on the tooth. Some people might refer to this simply as “bonding” on the front of the teeth. This option is even less expensive than indirect composite veneers, but it can be the most time consuming. The result is an improvement in the appearance of the teeth; however, because this technique relies completely on the “sculpting” by the dentist, it is very difficult to achieve the highest level of esthetics.

 

-dr z

Dental Center of Deerwood

Veneers – part one

Hi friendly readers. I’m back from a brief blog-sabbatical. Thanks for your patience! 

Let’s talk about dental veneers for a bit. Veneers are one of the most popular and effective ways to improve the appearance of a person’s smile. A dental veneer is a restoration that covers the front part of a tooth. Unlike a crown, a veneer does not add strength to a tooth; however, it can repair defects like chips or jagged edges.

There are two types of dental veneers. The first are porcelain, lab-fabricated veneers. The other type is direct composite veneers, which we will discuss in the next posting.

The reasons you might want veneers for your teeth are: dark or discolored teeth, uneven, mishaped, jagged, broken, chipped, or crooked teeth.

A porcelain veneer is a thin shell of porcelain that is custom-made in the appropriate shade/color and then bonded onto the front, visible surface of the tooth.

The procedure normally consists of two office visits. At the first, the dentist numbs the teeth to be treated. He/she then prepares the teeth for veneers by removing about 1/2 of a millimeter of the structure on the front surface of each tooth. Then, a very accurate impression is made and sent to the dental laboratory. Sometimes temporary veneers are made and temporarily bonded to the teeth, and sometimes this isn’t necessary. At the second visit, the dentist tries in the porcelain veneers and ensures that the fit and shape are perfect and that the shade matches the desired goal. If everything looks correct, the pieces are bonded to the teeth with a very strong cement.

Once the veneers are bonded on, they are very strong. They should last for many years, and they typically only need to be replaced if decay is present. So it is very important to keep up with routine dental cleanings and to take excellent care of your teeth at home.

Let me know if you have any questions about veneers!

-dr z

Dental Center of Deerwood

Oral Rinses Part 3

The final type of oral rinse I would like to discuss is available by prescription only. Its generic name is chlorhexidine gluconate, and it is available under the labels “Peridex”,  ”Perioguard,” and other brand names.

This type of rinse is an anti-microbial agent that kills a wide spectrum of oral bacteria. It may be prescribed by your dentist if you have signs of periodontal disease or gingivitis. Alternatively, it can be used after surgeries (gum surgery, extractions, etc.) to help prevent post-operative infections.

One disadvantage in the use of this rinse is that it can stain teeth. The residue left behind when bacteria are killed becomes colored and visible on the teeth. However, this staining is temporary and can be removed during your normal cleanings. Most of the time, the benefits of this rinse greatly outweigh the inconvenience of some minor staining.

-dr z

Dental Center of Deerwood

Interesting article

Let’s take a quick break from the topic of oral rinses. Check out this news article about today’s FDA finding concerning dental amalgam fillings.

http://www.msnbc.msn.com/id/32192895/ns/health-more_health_news/

Cheers,

-dr z

Dental Center of Deerwood

Oral rinses – two

The next type of oral rinses address problems with occasional or chronic bad breath (a.k.a. halitosis).

One of the most recognized brands of this type is Scope.  

Scope and similar rinses act like cologne for your breath. The do not claim to kill bacteria. Neither do they work to prevent cavities, gingivitis, or periodontal disease.

There is nothing wrong with using these rinses occasionally to “freshen up,” but that is about all they are good for.

For more serious protection against bad breath, there are a few lesser-known products that I like. One is called SmartMouth.

Its makers claim that if you use it twice per day, you can eliminate even the dreaded “morning breath.” SmartMouth has an unusual flavor and aftertaste, but it is not unpleasant, and you get used to it after a few uses. The supposed active ingredient in SmartMouth is zinc.

Another product I like is called CloSys. This rinse has almost no taste at all, which is nice. They also give you the option of adding peppermint flavor if you prefer. (The flavoring is included separately in the package so you can add your own.)

This product does help in other areas besides bad breath because its active ingredient, chlorine dioxide, does kill bacteria. It can help reduce gum bleeding and gingivitis.

Both SmartMouth and CloSys are available in the drugstore over-the-counter. Let me know if you’ve tried either of these and what you think about them!

-dr z

Dental Center of Deerwood

Oral rinses

For the next few days let’s talk about oral rinses (a.k.a. “mouthwash”).

There are a few different types of oral rinses – some over-the-counter and some are available by prescription only.

Let’s first discuss the most widely-recognized oral rinse, Listerine.

Listerine and generic equivalents have been around for many years and are known for their characteristic “BURN” sensation. The active ingredients in this type of rinse are organic compounds such as menthol. They also have high alcohol content; however, the alcohol is not considered an active ingredient – it is simply necessary to disolve the other active compounds.

Patients often ask if they should be using Listerine or other mouth rinses, in addition to brushing and flossing. I do not have a strong opinion about this topic. My usual response is “use it if you want to.”

Listerine has been shown to reduce the overall bacteria count in the mouth after rinsing. But bacteria returns rather quickly afterward. Contrary to some television ads from a few years ago, Listerine is NOT an acceptable replacement for flossing. The company that makes Listerine was actually forced to end that ad campaign by a judge who found their claims to be misleading.

Next: we’ll discuss Scope and other breath-fresheners.

-dr z

Dental Center of Deerwood

Whitening (part 2)

Hi friends. Sorry for the delay in this posting.

Where were we? Whitening materials…. The first thing I’d like to say is that the active ingredient in whitening systems is very similar across the board. Basically, hydrogen peroxide is what does the trick. The way it is delivered is where the differences are seen. Some products use actual hydrogen peroxide at varying strengths. Others use a chemical called carbamide peroxide. This is a more stable product (i.e., longer shelf-life) and it works by releasing hydrogen peroxide when it is activated in the mouth.

Now let’s talk about the method of using these chemicals to whiten teeth. Generally speaking, the process can be accomplished either in-office at one sitting in a dental office, or it can be done at-home using bleaching trays or other devices to deliver the product to your teeth. Products used for in-office bleaching normally have stronger concentrations of the active ingredient, while those used at home are weaker and to be used over a longer period of time.

Tooth bleaching works by penetrating the outer layers of tooth enamel and changing the chemical structure of stained particles to make them colorless. Do you remember the OxyClean commercials where the tub of clothes turns from red to white instantly when the product was added? (Rest in peace, Billy Mays.)

Tooth bleaching works the same way. It doesn’t actually remove the stain. It just takes away the color.

I know your next question. “Dr. Z, what about that bright light that they use for the Zoom! whitening system? Does that do anything?”  Short answer: Not really.  It does accelerate the chemical  reaction of the whitening product by heating it up, but the light itself doesn’t really do any bleaching.

Of course in-office and at-home bleaching each have their own advantages and disadvantages. With in-office bleaching, the obvious advantage is that the results happen very quickly (usually within about an hour). However, with the speedy process often comes increased tooth sensitivity. Teeth can become very sensitive after bleaching, and this can make drinking cold beverages uncomfortable. Fortunately this sensitivity generally only lasts a few days.

At-home bleaching does have some advantages. This process is usually accomplished with custom made bleaching trays that are worn for a specified amount of time each day until the desired results are achieved. This allows a patient to have more control over how white their teeth become. When the results are acceptable, the trays can be used from time to time to maintain the desired shade of the teeth. Also, if sensitivity occurs during bleaching, the person can just take a break from the process for a few days to let the sensitivity subside before continuing.

Finally, many people want to know why teeth whitening is so expensive. To be honest, a person is mainly paying for the time of the dentist and/or staff member who is performing either in-office whitening or fabricating the custom bleaching trays. And, yes, there is some profit built into whitening fees. But also, systems such as Zoom! (offered at the Dental Center of Deerwood) and other professional products are quite expensive, so the procedure is not 100% profit, as some may think.

Oh yeah, and about the drug store products. I usually tell people that it won’t hurt to try them. They usually aren’t as effective as products offered in a dental office just because they have lower levels of active ingredient. But I feel that they are generally safe.

Please let me know if you have any specific questions I didn’t answer here.

-dr z

Teeth whitening (part 1)

One of the dental topics that I get the most questions about is teeth whitening/bleaching. People want to know:

1) Is it safe for my teeth?

2) What is the difference between drug-store products, take-home products, and in-office bleaching?

3) Do those “white strips thingies” work?

4) Why does teeth whitening cost so much?

Unfortunately, the Dental Center of Deerwood is tired after a long day of improving its patients’ oral health. Stay tuned for tomorrow’s posting for the answers to these questions.

Thanks for reading!

-dr z