Frequently Asked Questions at Boldt Dental
|It is important to find a dentist that looks at your overall health and well-being as they approach your dental care needs. Quality of care, attention, respect and dignity should be the cornerstone of care at your dental practice.|
|Tooth decay and periodontal disease are the most common causes of tooth loss. Tooth decay takes place when most of the tooth’s mineral makeup has been dissolved away and a hole (cavity) has formed. While tooth decay primarily affects children, periodontal disease, or gum disease, affects mostly adults. Periodontal disease is an infection of the gums caused by the buildup of plaque, and its earliest stage is known as gingivitis.|
|Most dental professionals recommend that you brush your teeth at least twice a day. Brushing after every meal (and flossing at least once a day) is also a good way to maintain dental health.|
|A child should have his first dental appointment no later than his third birthday. Many dentists recommend a child have his first appointment when his first tooth comes in.|
|Tobacco (cigarettes, pipes, cigars, chewing tobacco, and snuff) is the most common cause of oral cancer. Combining tobacco use with heavy drinking can also foster the development of oral cancer. Bad hygiene, prolonged irritation of the oral cavity, and extended exposure to strong sunlight on the lips are among other causes of the disease. Many dentists believe vitamins A and E can help prevent the acquisition of oral cancer.|
|Early symptoms of oral cancer include: a sore on the lip, in the mouth, or in the throat that does not heal; a lump on the lip, in the mouth, or in the throat; a red or white patch found anywhere in the mouth; unusual pain or bleeding in the mouth; swelling of the mouth; and any difficulty or discomfort felt in chewing or swallowing.|
The most common causes of tooth loss include cavities (dental caries) and gum disease (periodontitis).
In the case of the tooth cavities, tooth structure is irreversibly lost as a result of oral bacteria producing acid on the surfaces of the teeth. As the cavity progresses in size the weakened tooth breaks and chips away. As the cavity process spreads deeper into the internal part of the tooth, bacteria and bacterial products can cause root canal infections and spread outside of the tooth into the surrounding bone.
In case of gum disease, the attachment between the tooth and the supporting gums and bone is destroyed as a result of inflammatory process that is triggered by the oral bacteria living on the tooth surfaces. As gum disease progresses the teeth become loose and mobile. Bacteria can also spread into the adjacent bone and soft tissue causing abscesses.
In most of the cases, dental caries and gum disease can be successfully treated and arrested using standard treatment protocols. However severe forms may not be amenable to the treatment thus requiring removal of the teeth.
Other less common causes of tooth loss include traumatic injuries, severe forms of tooth wear, tooth resorption, and tooth cracking as a result of chewing and grinding.
|Comparisons have been made between power-assisted (electric) toothbrushes and manual toothbrushes to look at the ability of each to remove plaque and prevent or reduce calculus (tartar) buildup, thus reducing gingivitis (gum disease). These research studies have shown both powered and manual toothbrushes to be equally effective when used correctly. So probably, in practical terms, which brush you use is not the critical factor, but how you use it. The ADHA Web site (http://www.adha.org)includes instructions for proper toothbrushing technique with a manual brush, and product packaging shows the best way to use powered brushes.|
|There are a lot of products to choose from, and much of the decision depends on individual preference. A fluoride toothpaste is essential for optimal oral health. Beyond that, your dental hygienist and dentist can alert you to any other features that make one product more suitable than another for you as an individual.|
|Most people have teeth that are naturally darker than “pure” white. If you want them whiter, the best thing you can do is talk to your professional oral health care provider about your options. Different people respond differently to different procedures used to whiten teeth, and it will take an in-person consultation with a professional to determine what is best for you. Sometimes all it takes is professional prophylaxis to remove stain and then abstinence from behaviors that stain teeth, such as drinking coffee or tea, or smoking tobacco. Some people respond well to the use of whitening toothpastes while some do not. Other options available include bleaching, at home or in the office, with chemicals or with lasers, as prescribed by a dentist. Sometimes a combination of options is used.|
|That depends on what is causing it. Often, bad breath results from less-than-optimal oral health, and sometimes people are not aware that they are not performing oral hygiene as effectively as they could be. A dental hygienist or dentist will be able to evaluate your oral health procedures and make recommendations for improvement; also, these professionals will be able to recognize any associated problems that might be contributing to an unpleasant mouth odor. In addition to evaluating and suggesting alterations to your brushing, flossing, and tongue deplaquing regimen, your dental hygienist may recommend products such as a mouthrinse that contains zinc. If it turns out that the problem isn’t in the mouth, a physician appointment is advisable. Sinus problems, stomach problems, certain foods and medications, and other factors can contribute to bad breath.|
Dentists in the United States either have the initials DMD or DDS after their name. A lot of people may wonder what the difference is between the two. But the truth is that the only difference is in the name: The dental degree and the education are the same. DMD stands for Doctor of Dental Medicine and DDS stands for Doctor of Dental Surgery. Some dental schools award the DMD degree while others award the DDS degree.
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|Implant dentistry is the branch of dentistry that involves installing an artificial tooth into a patient’s jaw in order to replace or restore a missing tooth.|
|Modern implantology began in the United States at the beginning of the 20th century. However, popularity really grew in the 1980’s with the increased success of the titanium cylinder. Since then, many brand name implants with minor variations have been approved.|
|Long-term success depends on multiple factors. Success will depend on the quality and quantity of bone. The better the bone and the more available, the greater the chance of long-term success. Second, the experience and ability of the dental surgeon will be a factor. As with any surgical procedure, there is no substitute for the experience and individual talent of the dentist. And finally, the quality of the restoration placed on top of the implant will play a big role in long-term success. If the design of the implant crowns or overdentures are poorly constructed, and biting forces are not balanced, even the best-placed dental implant will have a compromised survival rate.|
|No. Any person at any age can have dental implants as long as there is enough bone available in which to place the implants.|
|There are some medical factors that might prevent a person from being a good candidate for dental implants. Some of these may be uncontrolled diabetes, chemotherapy or radiation therapy, parathyroid disorders, blood disorders, rare bone disorders or bone marrow cancer. Some physical factors may include insufficient or poor quality bone, low sinuses or nerve bundles.|
|The success of your implants will depend greatly on how well you maintain them. They will need to be professionally cleaned and examined every three to four months. The hygienists are trained in the specific procedure of maintaining dental implants. Also, brushing and flossing daily is absolutely necessary for long-term success.|
|No. An effective local anesthetic is used during the surgery so that you do not have any discomfort during the placement of the implants. The mild discomfort you might experience after surgery can be controlled with medications.|
|You can go to work the next day, unless some particular surgical circumstance arises. We will discuss all postoperative instructions with you.|
A denture is an artificial prosthesis, which replaces missing teeth and gums in one or both jaws. The denture can be removed by the denture wearer and dentist for cleaning and servicing. When the denture replaces teeth in the top jaw it is called a top, upper, or maxillary denture. When the denture replaces teeth in the bottom jaw it is called bottom, lower or mandibular denture. There are several different types of dentures.
Full denture is fabricated for the replacement of all teeth in one jaw. When the denture replaces one or more but not all teeth in one jaw it is called a Partial denture.
Immediate denture is placed immediately following removal of the teeth. This type of denture allows immediate restoration of smile and function so the patient does not have to go without teeth for even one day.
Implant denture represents yet another type of denture treatment. In some situations gums or teeth do not anchor prosthesis well, thus making the denture wearer feel uncomfortable during chewing, speech, and swallowing. In such situations dental implants are used to anchor the denture.
Denture prosthesis is made of several different parts. Artificial denture teeth that are made of plastic or ceramic materials are used as a replacement of the natural teeth. The denture base is used for the replacement of the gums and usually made of plastic materials. When the denture is anchored to the teeth or implants additional anchoring metal or plastic parts are incorporated into the denture. It is also quite common to incorporate an additional strengthening element, usually made out of metal alloys, in order to reinforce the denture and prevent undesirable fractures.
Besides the denture, are there other options for the replacement of the teeth? What are the advantages and disadvantages of these options?
Two common options in the replacement of missing teeth include (1) fixed bridges and crowns and (2) removable dentures.
(1). Bridges and crowns can be supported by the natural teeth and dental implants. The most important characteristic of the bridge or crown is the fact that it is fixed and very stable during chewing and other oral functions.
Stability is the most important advantage of this type of tooth replacement. Performance of the fixed crowns and bridges is similar to the patient’s own natural teeth, and it is well appreciated by the patients. The disadvantage of the fixed crowns and bridges is a higher treatment cost, especially in situations where there is a need to replace several or all teeth. Treatment with fixed options may also add additional complexity and treatment time.
(2). Removable dentures are also used for the replacement of the missing teeth. Removable dentures can either be partial or full. Partial dentures are used for the replacement of one or several teeth in a jaw. The partial denture is designed in such a manner that it gets its stability from the remaining teeth and gums. Full dentures are used for replacement of all missing teeth in a jaw. Full denture gets its stability from the underlying gums of the jawbone. The main advantage of the denture treatment includes reduced cost. Denture treatment can also be less time consuming and less complex in comparison to the fixed treatment.
Dentures in comparison to the fixed bridges and crowns are usually less stable during normal functions such as chewing, speech and swallowing. The degree to which a denture moves in the mouth is extremely variable and depends on number factors. In many instances denture mobility can be a minor issue to the patient. However there are also many situations where a loose denture presents a considerable problem to the patient. The most common solution for loose dentures includes placement of dental implants that act as anchors.
Most of the time dentures can be placed immediately after removal of the teeth. This type of dentures is called “immediate dentures”. The biggest advantage of immediate dentures includes immediate restoration of smile and function so the patient does not have to go without teeth for even one day. Immediate dentures also help with the healing process by sealing the surgical wound which is present after tooth removal. Immediate dentures are made before the removal of the teeth. Measurements and impressions of the jaws are made in the dental office and sent to the dental laboratory where dentures are made.
Immediate dentures require additional servicing procedures. Bone and gums are always shrinking in the area of the removed teeth. The highest degree of bone shrinkage occurs in the first several months after the removal of the teeth. Upon gum shrinkage the immediate denture does not fit well anymore. In order to improve the fit of the denture, it is adjusted and relined as necessary. The number of reline and adjustment appointments depends on the clinical condition of the patient. It is common to have at least several adjustments and reline procedures done on the denture. Upon completion of the healing process the immediate denture is usually replaced with a new permanent denture.
It takes some practice, patience, and time to get used to your first dentures. On the other hand, adaptation to the new denture for patients with previous denture experience is usually a relatively straightforward task.
Patients who receive dentures for the first time may feel awkward or uncomfortable for the first several weeks. Dentures may feel loose, while the muscles of your cheeks and tongue learn to hold them in place. Salivary flow may also temporarily increase. Soft tissue irritation and soreness is not unusual especially when there is removal of the teeth and their replacement with an immediate denture. These problems disappear as your mouth becomes accustomed to the new dentures and your dentist makes necessary adjustments to the dentures.
For patients with immediate dentures we recommend soft diet for the first several weeks after removal of the teeth. Chewing slowly and using both sides of your mouth at the same time will prevent the dentures from moving out of place. Other types of foods can gradually be introduced until you resume your normal diet.
It is not advisable to wear dentures round the clock because gum tissues that are constantly covered with denture can become irritated. Patients are usually instructed to remove their dentures before bedtime. However for patients who receive immediate dentures, it is advisable to sleep with their dentures for first several nights after removal of the teeth.
Your existing denture does not fit well anymore. What can be done to improve its fit?
Changes in the denture fit most commonly occur as a result of the shrinkage in the bone and gums that support the denture. The degree to which bone and gums shrink depends on a number of factors as well as patient’s individual characteristics. When shrinkage of the supporting tissues reaches certain levels, the patient’s denture may not fit well anymore. Typically the patient will notice denture looseness, rocking, and denture sores. Potential solutions to this problem may include denture reline, denture rebase or fabrication of a new denture. Denture reline involves addition of a new material to the underside of the denture. In denture rebase, a new base is made and artificial teeth are added from the old denture.
Another common change that occurs with the denture over time is wear of the denture teeth. When tooth wear is significant, patient complaints may include unsatisfactory appearance, bite, and comfort. One potential solution to this problem may involve replacement of the old teeth with a new set. When denture presents with several problems such as poor fit and worn teeth it is best to replace the old denture with a new one.
Dental implants are the most advanced solution in the replacement of missing teeth and stabilization of removable dentures.
Dental implants are small titanium screws or cylinders. They are made of titanium and this material integrates well with the human body. Dental implants are placed into the jaw and after appropriate healing time they become permanently attached to it. Dental implants can be used to anchor a single tooth, multiple teeth or full dentures and partial dentures.
Dental implants have been used for several decades. Research indicates that dental implants have a very high success rate. Missing teeth that are replaced with implants can look and feel like natural teeth and allow patient to chew food comfortably. Another advantage of the dental implants is their ability to prevent further bone shrinkage.
Dental implants are very helpful for patients with loose dentures. Dental implants anchor the denture and help to eliminate denture sores and allow to chew food just like natural teeth. In today’s dental practice dental implants are routinely used for all types of tooth replacement.
Patients with loose dentures may experience gum discomfort and difficulties chewing food. Dental implants can be the best solution to these problems.
Dental implants are the best invention we have to date for loose and uncomfortable dentures. Usually two or more dental implants are placed in the jaw to help anchor the denture in place. The implants prevent the denture from flopping around thus making it more stable and comfortable. The advantages are many. They allow you to chew better and eat the foods you enjoy, speak more comfortably, smile confidently, enjoy your social life and overall improve the quality of your life. Patients who lose their teeth, experience continuous shrinkage of the jaw bone in the areas of the missing teeth. Another advantage of the dental implants is their ability to prevent further bone shrinkage.
For patients with loose dentures implants can be used in several possible ways. In one approach implants anchor the removable denture. In the other approach implants anchor a fixed bridge that is permanently attached to the implants. During planning stage of treatment, patient’s clinical condition is assessed for the feasibility of different treatment options.
Who is a good candidate for implant treatment? Patients in good general health, healthy gums, and adequate bone are good candidates for implant treatment. Patients who decide to have dental implants must be committed to thorough oral hygiene in order to keep their mouth healthy. In addition implant dentures and bridges require regular maintenance procedures in the dental office.
The mouth and oral tissues are subject to potentially serious deceases and should be examined on a routine basis.
Regular dental check-up and having your teeth, implants, and dentures professionally cleaned are important in order to keep your mouth healthy. Regular visits allow your dentist to check the soft tissues of your mouth, including the tongue and cheeks. These examinations are important so the dentist can spot any infections, mouth conditions or even mouth cancer at the earliest stages. Dentists recommend a dental check-up at least once a year even for patients who have no teeth. Professional dental cleaning intervals vary between the patients and depends on each patient’s condition. Professional cleaning for majority of the patients is usually performed once or twice a year.
Basic care of dentures include handling, cleaning, and storing.
The materials your denture are made of can well withstand chewing forces. However a denture may easily break if accidentally dropped on a hard surface. Handle your denture with care to prevent any accidental falling. When cleaning your denture, you can hold it over a towel or over a sink filled up with water.
Just like natural teeth, dentures accumulate food deposits, plaque, tartar, and stain. Removing food particles and plaque helps to eliminate undesirable microorganisms which can irritate your gums. Brushing also decreases staining of the denture. We recommend brushing your dentures at least twice a day. It is best to use a cleaning brush specifically designed for dentures, however you can also use a regular soft-bristle toothbrush. Dentures can be soaked in one of the specially developed commercial products. These products are helpful in removing microorganisms from the surface of the denture. We do not recommend household bleach for the soaking of the denture. Bleach can cause undesirable changes in color of the denture. It can also be harmful to the gums if not completely rinsed off the denture.
For denture storage we recommend to use a specially designed plastic storage container. For the overnight storage, a thoroughly clean and dry denture is placed into the storage container. There is no need to store your denture in water or wet environment. Moisture promotes growth of undesirable microorganisms.
A prosthodontist is a dentist who specializes in restoration and replacement of missing teeth.
Prosthodontist is a dentist who receives three years of additional training after dental school in the area of dentistry that is called prosthodontics. Prosthodontists deal with the restoration and replacement of missing teeth and associated oral structures, restoration of smile and restoration of oral functions. Prosthodontics is one of the nine dental specialties recognized by the American Dental Association. Dental specialties are recognized in those areas where advanced knowledge and skills are essential to maintain or restore oral health.
Training for prosthodontists is earned through a hospital or university program accredited by the American Dental Association. Specialty training includes didactic lectures and seminars, laboratory and clinical training in cosmetic dentistry, crowns, bridges, veneers, dental fillings, removable dentures, and dental implants. Upon completion of the training, prosthodontists receive certificate in their specialty and often times, a Master’s degree in dentistry (for research completed in the program).