Friday, April 30, 2010

Removing Wisdom Teeth

Removing wisdom becomes necessary when the health of your mouth is threatened. Other teeth in your mouth can be pushed out of alignment when wisdom teeth come in. Pain and discomfort almost always accompany the emergence of wisdom teeth.

Thanks to modern technology and advanced dental techniques, removing wisdom teeth can now be done with complete effectiveness and total comfort. Gone are the days when going to the dentist for this procedure was one of the most dreaded events of one’s early adult life.

Before the actual extraction procedure begins, however, certain preparatory steps have to be taken. The first thing we have to do is making certain you are relaxed and comfortable. If nitrous oxide works well for you, we will administer that before giving you an appropriate local anesthetic to numb the area around the tooth. We wait several minutes and thoroughly check the area for complete numbness before removing your wisdom teeth.

Please understand that it is normal for you to feel pressure from the procedure while we are working in the back of your mouth. However, if at any point you feel pain, you need to let us know so we can administer more anesthetic. Pain should not be a part of this procedure at any point in time.

Removing wisdom teeth is done several ways, depending on where the teeth are position in relation to other teeth. If they have not completely come in yet, we have to cut them out of your gums. These days, we do not have to do very much cutting at all. Only a small incision is needed to give us enough room to work with.

Next, we will place an instrument next to the tooth called an elevator. It is used to gently loosen the tooth before we actually pull it out using forceps.

If the roots of the tooth have curved around the jawbone, we have to remove the wisdom tooth by cutting it into sections. Again, we do this with minimum invasiveness to your gums. As cosmetic dentists, we are very conscious of the need to preserve as much existing tooth matter as possible in your adjacent teeth, and of the need to keep your gums in as good a shape as possible.

All incisions made during these procedures are immediately sutured and sanitized to minimize the risk of infection.

In addition to these measures, we also send you home with a very detailed list of instructions on post-operative care. These instructions emphasize how important it is to take care of yourself, particularly during the first 24 hours, and include strategies for controlling bleeding, swelling, and also dietary guidelines.

Removing wisdom teeth is never fun, but it is necessary in most adults because impacted wisdom teeth can affect your entire bite and cause future problems with tooth decay, gum disease, and jawbone cysts.

Thursday, April 29, 2010

Extracting a Single Tooth

As cosmetic dentists we recommend treatments that save teeth. There are times, though, when a tooth is so badly damaged that it cannot be saved and a single tooth extraction is the only choice.

Examples of these times include:

· Teeth fractured below the gumline
· Severe tooth decay
· Advanced gum disease
· Impacted wisdom tooth

Before the procedure, we might give you nitrous oxide as a relaxant. We also numb the area around the tooth with anesthetic so as to make the procedure painless. We want you to be as comfortable as possible. We will make sure that the area is completely numb before we begin extracting the tooth.

During the tooth extraction, you will feel pressure, but you should not feel any pain. If you do feel pain, we stop and give you more anesthetic.

The procedure varies per location and condition of the tooth. For instance, if the tooth has not emerged through the gums, we begin by making a small incision in the gum. We then use an instrument called an elevator, which is placed next to your tooth, to gently loosen it.

After the tooth is loose, we then use forceps to grip the tooth and carefully pull out the tooth with as little bleeding as possible.

Single tooth extractions procedures are more complicated if tooth roots are curved. If we find this, we often have to cut the tooth into sections to remove it.

In any event, any time we make an incision during a procedure, we always close it up with a few stitches after completing the extraction.

It is mandatory that you take care of yourself after a tooth extraction. We want you to minimize all potential problems after your tooth has been removed. The most critical time to be on guard is during the first 24 hours after the procedure, when bleeding and infection are most likely to occur

To help you do this, we give you detailed post-operative instructions which we advise you to follow implicitly. These post-operative instructions include information on how to control bleeding, how to minimize pain, and how to reduce swelling.

We also give you instructions on the prevention of dry sockets, and we give you a list of recommended foods you should eat, and foods you should avoid.

As cosmetic dentists, we are not here to promote the benefits of extracting teeth as the first option for any of our patients. However, we do admit that there are those times when it becomes necessary as a last resort. Single tooth extraction is sometimes the only way to reduce the risk of infection, the spread of periodontal disease, jawbone cysts, or severely crowded and misaligned teeth.

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Wednesday, April 28, 2010

Ridge Preservation

Ridge preservation is one of many bone grafting techniques. At times, bone grafting techniques are needed to preserve the ridge of the jawbone after one or more teeth have been extracted. This is because the jawbone shrinks after a tooth has been lost. Unless restorative measures are taken, permanent disfigurement will result.

The procedure will vary to some degree on a case by case basis. In some instances, a ridge preservation procedure can be done at the same time the tooth is extracted. The dentist begins by numbing the entire area to prevent the patient from feeling any pain. If at any point the patient begins to feel uncomfortable, or experiences noticeable pain, the dentist will give him or her additional anesthetic. Sensitive patients may also qualify for sedation dentistry at the dentist’s discretion.

The bone grafting material will then be prepared. Bone could be taken from another part of the patient’s body, or it can be taken from another source. The tooth socket is then rinsed and cleaned to remove all debris and any resident bacteria that could cause infection. At this point, the socket is filled with the grafting material.

In some cases, dentists will place a special membrane over the graft to ensure that the bone and gum tissues heal properly. The socket is closed, usually with only a few stitches.

Ridge preservation offers a number of benefits to patients who have lost teeth. First and foremost, it preserves the shape and strength of the jawbone. This is important for more than one reason. Not only does the integrity of the bone itself need to be preserved, but the contour of the cheeks and lips, which are directly impacted by the shape of the jawbone, must also be preserved.

Secondly, this procedure fills the empty socket left by the missing tooth. Bone tends to grow better when it is in contact with other bone, so this actually helps the existing jaw grow a portion of its original mass back, eventually fusing with the bone graft material.

As a result, the shrinkage that will otherwise result from missing teeth is slowed down significantly. Without tooth roots, the jaw will begin to recede because it will not have the normal vibrations that are normally transmitted through tooth roots during biting and chewing.

Keep in mind, however, that this is not going to stop jawbone recession completely. Bone graft material will provide sufficient surface area for the recession to occur at a slower rate, but the only thing that stops bone recession altogether is a cosmetic dental implant.

Nevertheless, is still a procedure that is worth investing in for the sake of maintaining a healthy appearance and making future tooth replacement options less complicated and more comfortable.

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Tuesday, April 27, 2010

What Would Four Dental Implants Cost

What is the cost for 4 implants in the front of my mouth?
I have a removable bridge at the present time, which I hate.


Wow --- what a loaded question. There are many variables on this question. Anterior esthetics are important and are a prime consideration in how to handle this situation. When there is ample bone present, it is much easier to place implants and restore them esthetically. Oftentimes the cause of anterior tooth loss is traumatic – a blow or fall – or periodontal - and this often compromises the amount of bone present. With inadequate bone, there are options of adding bone by grafting, placing smaller implants, or not placing implants at all…it just varies.

The only way that we can give you any kind of answer as to what we advise is to see you personally and get proper photos, x-rays and visual exam. Even with adequate bone present, there are times that we place 4 implants, as you envision, and there are times that you can get a more esthetic result with less than 4 implants. You don’t necessarily place one implant for each tooth lost. We will also have to evaluate the rest of your mouth to see what is appropriate and logical for you.

Please consider making an appointment for an implant consultation so that we can give you our opinion of what is the best advice for YOU.

Chuck Campbell, DDS
Dale Brant, DDS
(713) 795-5905

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Thursday, April 22, 2010

Regular Denture Care

Summarized From:
Patient Instructions for Immediate Dentures
Randy F. Huffines, D.D.S.  2008


Regular denture care after the first 24 Hours
When you remove your denture for the first time, rinse it after every meal and snack and put it back in your mouth. Keep your denture in at all times except to clean it. Do not use mouthwash for five days unless told to do so by your dentist. You can, however, use a salt water rinse.

Cleaning is a very important part of regular denture care.
To clean your denture, partially fill the sink with water. Use a liquid dishwashing detergent and denture brush to clean the inside and outside of the denture. Do not use a regular toothbrush; it is too abrasive. After your gums have healed, you can use a soft bristle toothbrush to clean them. You should also clean your tongue to remove germs that cause bad breath.

Take your denture out every night, beginning the sixth day after receiving your immediate denture. Soak it in denture cleanser and let your gums relax while you sleep. If you have to leave your dentures in due to mitigating circumstances, be aware you are at a higher risk for oral yeast infections. You should discuss with your dentist additional ways to keep oral tissues healthy if this is the case.

Standard dental care is essential to regular denture care.
Many people think that after losing natural teeth, they don’t have to go to the dentist anymore. This is a dangerous myth. Supporting tissues that are under your denture will change over the course of your lifetime. You’ll notice the greatest change during the first 6 months-1 year after the removal of your natural teeth.

If the change is very significant, your dentist may call your immediate denture a temporary denture. This means that you will get a totally new denture after the healing process is complete.

At other times, your denture will need to be relined. Relinement involves adding new material to the denture so it maintains contact with the gums and conforms to the shape of your mouth.

Your dentist may also place a tissue conditioner, which is a temporary soft liner, in your denture. This will remain until healing is complete. It can be changed from time to time as the gums shrink so you stay comfortable throughout the healing process.

Gums will shrink over the course of a lifetime. You will probably not notice this until great damage has been done, and you may require surgery. This is why it is so important to see a dentist regularly so he or she can examine your gums and detect problems early on.

Your dentist will also closely observe your tissues for signs of oral cancer. Nearly half of the oral cancers diagnosed in North America occur in people that have dentures.

Myths about regular denture care abound.
Although well meaning, friends and relatives may give you advice that can be damaging to your new dentures and your mouth. Each individual is very different, and what might work for some may create problems for others. Never adjust your denture yourself; a minor alteration might be very expensive to correct. Your dental staff is trained to give you the best advice based on your unique needs. Ask questions – they want to help!

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Talk to Your Dentist about Denture Adhesives and Denture Care

Summarized from:
Denture Adhesives: A Guide for Patients
Randy F. Huffines, D.D.S. Ó 2008


What are denture adhesives?
They are powders, creams, and liquids that can stick to both dentures and gums and increase denture retention.

If my new denture has been made correctly, why might I need an adhesive?
It can improve retention and chewing. It also helps with conditions such as dry mouth. If you have had a stroke or have suffered bone loss beneath the gums, a denture adhesive will certainly help.

Which denture adhesive should I use?
Avoid pads and cushions because they can alter denture bite. Powders do not last as long as creams, but they are easier to clean off your gums and dentures. Follow your dentists advice on which is best for you.

How should the denture adhesive be applied?
Powders: The mouth and denture should both be cleansed and kept wet. Tap a thin layer of powder over the entire tissue side of the denture. Gently shake off the excess. Insert the denture and press in place for 5 seconds. Close your teeth together, swallow, and clench your teeth together tightly for 10 seconds. If you have a dry mouth, it may help to first coat your mouth with saliva substitute or water before placing the denture on your gums.

Creams: Clean your mouth and denture well. Dry the denture. For the upper denture apply 5 pea-sized dabs of adhesive equally spaced to the side of the denture that contacts your gums. For the lower denture apply 3 pea-sized dabs. If you have a dry mouth, immerse the denture in cool water for 30 seconds to let the adhesive soak up moisture. Insert the dentures and press in place for 5 seconds with your fingers. Close your teeth together, swallow, and clench your teeth together tightly for 10 seconds. If you have used the right amount, only a little should ooze out from under the denture borders. Over time you will find out just how much cream you need.

How should I clean out the adhesive?
You can brush out powder denture adhesives from your dentures with warm water. You can also brush powders away from the gums. Creams are harder to remove. You have to scrub under the denture with very warm water like a denture brush. If it is hard to remove the adhesive, soak it overnight and then brush it. You can also scrub the denture with an electric toothbrush while the denture is immersed in a sink of warm water. Remove the cream from your gums by holding hot water in your mouth to soften the adhesive and scrub with a moistened washcloth that is wrapped around a finger.

Why are regular checkups still important?
If you no longer have natural teeth, you may assume that you do not need to see your dentist. This is a dangerous misconception. Dentists work on more than teeth. The supporting tissues beneath your dentures, for one, will continue to change throughout your life. As your gums shrink, your dentures and gums will become mismatched. Many people do not notice this is happening until the mismatch becomes so severe that it requires surgery to rectify. The dentist can find these problems early on and deal with them. Your dentist can also check for oral cancer, which threatens 50 percent of people with dentures.

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Adjusting to Dentures

Summarized From:
Patient Instructions For Immediate Dentures
Randy F. Huffines, D.D.S. Ó 2008

More than likely, you will have a harder time than you expected adjusting to dentures.
Your mouth detects even the smallest foreign object, so something as large as a denture is bound to be noticeable. It takes a while for you to feel like it belongs in your mouth, and it takes longer for you to adjust to the lower denture than it does for you to adjust to the upper denture. In most cases, a lower denture will cause more problems than an upper denture. The lower denture often feels lose, so you many need to get a denture adhesive to hold it in place. Ask your dentist which one is best for you.

You may also feel like gagging because the upper denture creates a feeling of fullness in the mouth. This will decrease as the mouth gets used to it.

Sore spots can occur even in a denture with a “perfect fit.”
This is due to the fact that the tissue the denture rests upon varies from place to place. Some areas are very thick and tough; others are thin and easily injured. You should contact your dentist as soon as a sore develops so an adjustment can be made; trying to “tough it out” can lead to a larger sore that is harder to treat. You can buy ointments to numb the area until you can get to the dentist, but these can mask the problem area and lead to larger sores if used too long. Never attempt to adjust the denture yourself.

Dry mouth
If you suffer from dry mouth, adjusting to dentures is going to be more difficult because you have less saliva to help hold your dentures in place. Ask your dentist about products that are made for this condition that you can use to make your denture more comfortable.

Eating during the first week
It is very important to maintain good nutrition while you are adjusting to dentures. It is necessary to drink plenty of fluids. During the first 24-36 hours you must eat food that does not require chewing. We recommend the following food groups:

Bread/cereal group: thin oatmeal or Cream of Wheat
Vegetable group: juices, thin soups
Fruit group: juices, blended drinks and shakes
Milk group: Milk, cheese soup, yogurt, Carnation Instant Breakfast, Ensure, Sustacal (these last two products are nutritionally complete, lactose free drinks)
Meat group: Pasteurized eggnogs, meat broths or soups, pureed meats

After the first or second day you can slowly increase the consistency of the food. In addition to the foods above, consider soft foods like small pastas, well-cooked carrots and green beans, mashed potatoes, creamed vegetables, soups, well-cooked fruits (no seeds), canned fruits, scrambled or soft-boiled eggs, and chopped meats.

It is best to cut your food into small pieces and eat it slowly. Eating with dentures is very different from eating with natural teeth. It helps to put food on both sides of your back teeth and chew straight up and down. It is better to bite food off at the corners of the mouth rather than the very front because is common with natural teeth. Nevertheless, it is hard to predict exactly what biting and chewing movements will work best for you because they vary widely from person to person. Experiment and find what is right for you, and be kind and patient to yourself.

You may have problems speaking while you are first adjusting to dentures.
To overcome this, read out loud in private to retrain your mouth. Over time your speech will return to normal.

Cosmetic Dentistry Procedures

Cosmetic dentistry procedures help to restore a brighter, whiter smile. New technology and better methods have lowered the cost of many of these treatments. Three options you might want to consider are tooth reshaping, dental bridges, and tooth whitening.

Tooth Reshaping

If you have all of your teeth, but if some are longer than the others, you are a candidate for tooth reshaping, also known as contouring. This procedure literally alters the lengths of your teeth. It is not very time consuming, and it if relatively simple.

Tooth matter is either added or removed until all of the teeth extend to the desired length and are in alignment with one another. Contouring is considered a very safe cosmetic dentistry procedure because the dentist only needs to remove (or add) a thin layer of enamel from your teeth. It takes only one or two dental visits to complete.

Tooth Whitening
Tooth Whitening is a cosmetic dentistry procedure that restores the natural color of teeth.

So many things we ingest can stain our teeth. Things like coffee, tea, carbonated beverages, certain medications, and smoking can all turn teeth yellow or brown.

Many stores now carry do-it-yourself kits for tooth whitening. However, nothing beats professional tooth whitening procedures performed by a dentist who has access to superior whitening agents.

The results you get will be much better, and the results will also last much longer than the over-the-counter kits ever can.

There are many types of cosmetic tooth whitening. There is laser whitening, air abrasion, acid, and chemical whitening. Our office uses a bleaching gel during the appointment, and then sends you home for two or three weeks to apply certain whitening agents we give you each night.

Over the years, cosmetic dentistry procedures have become so sophisticated that the costs are now within the reach of the average American. Tools and materials are so much better than they were in the past.

Dental Bridges
If you lose a tooth, you need to replace it right away. One cosmetic dentistry procedure that can do this is an implant or a dental bridge. If you do not replace the tooth, your other teeth will start shifting and you will end up with alignment problems.

A bridge is made from an artificial tooth called a pontic that has a crown on either side of it. So the dentist can install your bridge, he or she has remove enamel from the two teeth next to your missing tooth. After the appropriate amount of enamel has been removed, the dentist will craft a mold of your teeth and send it to a dental lab.

During the time it takes for the lab to manufacture your dental bridge you will wear a temporary one. When the lab sends back your custom bridge, you will return to your dentist’s office, and the new permanent bridge will be cemented in place.

Dental Implants
This is the best form of tooth replacement because it replaces both the natural tooth root and the crown of the tooth.

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Immediate Denture Care: First 24 Hours

Summarized From:
Patient Instructions For Immediate dentures
Randy F. Huffines, D.D.S.  2008


The first 24 hours

1. Do not remove your immediate denture during the first 24 hours. If you do, your gums may swell and you will have a hard time refitting your denture.
2. Take your pain medication as directed.
3. Do not take other medications or herbal supplements unless directed by your dentist or physician.
4. It helps to apply an ice pack over the area during the first few hours: on for 20 minutes, off for 20 minutes.
5. If you follow these directions, usually after the first 36 hours all you will need is mild pain medication.
6. Some bleeding during the first 2-3 days is normal.
7. When you notice bleeding, close your teeth together tightly for 10 minutes and the pressure from the immediate denture will slow down the bleeding.
8. Do not rapidly clench and release your teeth. This only agitates the site and can increase the bleeding.
9. Contact your dentist immediately if you bleed too much.
10. Do not spit forcefully during this time, or the immediate denture could become dislodged.
11. If you must remove liquid from your mouth, let it drool out gently over a sink.
12. Avoid using any kind of mouthwash for the first 24 hours unless so directed by your dentist.


At the end of 24 hours remove the denture

1. Mix ½ teaspoon of salt with a cup of warm water and place some in your mouth.
2. With your lips tightly closed, force the water under the denture to loosen it.
3. The lower denture is easier to remove, and lifts straight up.
4. The upper may be harder to remove, especially the first time. It comes out bets in a downward and forward direction.
5. If it is stubborn, take your index finger and place it between your denture and cheek moving up and back until you feel the back upper corner of the denture.
6. Move your finger onto the top of the denture border in this area and pull down gently, increasing the force until the denture is dislodged.
7. The way our denture comes out most easily depends our mouth’s unique shape.
8. After a couple of times, you will know just what to do. There may be very dark blood inside your immediate denture. This is normal.
9. You may also develop ecchymosis, or dark spots, either in your mouth or on your face over the area of the surgery. It goes away in a couple of days. Brush your denture inside and out with dishwashing liquid and rinse well with warm water.
10. Do not spit; let the salt-water drool out of your mouth into the sink.
11. Put your immediate denture back in place and press it on to your gums for 10 seconds.
12. Close together, swallow, and hold together an additional 10 seconds to correctly seat the denture.

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Problems with Dentures Caused by Xerostomia, or Dry Mouth

Summarized from “Dry mouth and Dentures”
By Randy F. Huffines, DDS Ó 2009


Saliva and oral health:
Dry mouth (also called Xerostomia) in most people is usually a side-effect of medications. Chemotherapy, radiation therapy, and some diseases can also cause a decrease in saliva production. It is necessary to have your dentist find the cause of your dry mouth so you can be treated properly. Most people with Xerostomia do not even know they have the condition until they have lost 50 percent of their saliva.

Saliva may appear to be only water, but this is not the case. Saliva actually works as part of your body’s immune system and contains hundreds of chemicals that make it possible to speak, chew, and swallow your food more comfortably. It also helps inhibit the germs that cause oral infections.

Oral lubricants:
There are medical products you can take to replace saliva. Some pharmacists call them “artificial saliva,” but a better term for them is “oral lubricants.” However, science to date has not been able to produce a substance that can replace all of the functions of saliva. Nevertheless, many people feel that oral lubricants make their mouth feel more comfortable. Many of these lubricants can be purchased in spray bottles. Some people even use water. Let your dentist recommend which oral lubricant it best for you.

Eating with a dry mouth:
If you wear dentures, you may have a number of problems if you do not produce enough saliva. Due to inadequate lubrication, it will be difficult to chew and swallow foods—especially dry foods. You can alleviate some of this with gravies and sauces and taking frequent sips of water. You can also use take an oral lubricant a few minutes before you eat. You must remove your dentures prior to using the lubricant so it can coat the parts of the gums that support the dentures. Then place the dentures back in your mouth.

Dry mouth and denture "fit":
Saliva is needed to hold your dentures to your gums. Dentists call this retention. When your mouth is dry, your denture will feel loose. This gets worse when supporting tissues under your dentures continue to shrink through the rest of your life. The amount of shrinkage varies from person to person. As your gums shrink, the denture and the gums become mismatched. This happens a little at a time, but even a small change in denture fit becomes more noticeable when your mouth is dry.

Most people notice this more often with the lower denture. It is easier to wear dentures on the upper arch because of the size and shape of the gums. As shrinkage occurs, you many h ave to have your denture remade or relined more often than someone who has normal amounts of saliva. A relinement is a procedure where additional denture material is added to the part of the denture that contacts the gums. This makes the denture fit closely and conform to the shape of the mouth.

However, even if you have a “perfect fit,” you may still experience some looseness because you lack enough saliva to hold the denture in place. You may need a denture adhesive to help in this case. There are many types available. Your dentist can offer advice on which one will best fit your needs.

Not only may you feel an increasing sensation of looseness, but you may also have sore spots underneath your denture because you have less saliva. Without the natural lubrication it provides, there is an increase in friction between the dry denture and the gum, which results in a sore spot. Your dentist should check denture fit is as close as possible. Then, if no adjustment needs to be made to the denture, you can use an oral lubricant or a denture adhesive.

Continued problems will require additional consultation with your dentist. You may need dental implants. It has been shown that replacing dentures with implants has greatly improved the quality of life for thousands of people. Dental implants are almost identical to natural teeth in both function and appearance.

Dry mouth and oral infections:
Because saliva controls germs in your mouth, dry mouth will make you more prone to mouth infections. Candida, a yeast-like fungus, often infects the mouths of people who wear dentures. One such infection is denture stomatitis. It occurs more commonly under the upper denture, particularly in those who have dry mouth and wear their dentures while they sleep. Most cases do not cause enough pain for people to notice, and may go on for years before finally being detected.

When it is detected, it must be eliminated before new dentures are made. Your dentist may have to treat your mouth with both tissue conditioners and antifungal medications.

There is also angular cheilitis, another problem caused by Candida. It causes sores to form at the corners of the mouth. It is treated with antifungal medications. Be careful how you use these medicines because they are often used incorrectly. Talk to your dentist before use.

If you have some natural teeth, you are more likely to have tooth decay resulting in tooth loss if you have dry mouth. Without saliva to regulate germs that cause decay, bacteria can grow more and cause greater damage. Ask your dentist for ways to prevent and reduce tooth decay.

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Wednesday, April 21, 2010

Fixing a Gummy Smile

I have a gummy smile and can't find a doctor here in the Rio Grande valley. Who does this type of correction?
I really want to fix my smile.


Thanks for your enquiry. We would be more than happy to help you out. In most instances, gummy smiles can be corrected very easily. The first we have to do is to do a comprehensive dental exam that includes digital radiographs, digital photos, a neuromuscular exam and an oral cancer screen. We will also do the consultation on the dame day. We will have our patient coordinator call you to set up an appointment.

Dale J. Brant, DDS
Charles Campbell, DDS
713.795.5905
888.790.0309

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Tuesday, April 20, 2010

Root Caries: An FAQ Guide

Summarized from an essay by
Randy F. Huffines, D.D.S. "Root Caries"
© 2007
Republished and Condensed with Consent from the Author


What is root caries?
It is form of tooth decay which attacks tooth roots. It is also known as root decay or root cavities. It becomes more of a problem for us as we age. Unlike typical tooth decay, which happens at the top of a tooth, root decay happens to tooth roots that have been exposed by receding gums.

What causes root caries?
It is caused by bacteria, like all other forms of tooth decay. Poor dental hygiene leads to buildup of bacteria that cause plaque. Also, gum recession, which exposes the tooth root, is another contributing cause. The root is made of dentin, which is much more sensitive than enamel, and which decays much easier.

Root decay can also result from changes in the amount of saliva in your mouth because saliva contains many chemicals that keep your teeth and mouth healthy. Many medications, chemotherapy, radiation treatments, and some diseases can cause your glands not to make enough saliva and therefore make cavities and other mouth problems more likely to occur.


How do I know if I have root caries?
Many people that have them do not know it. Because they occurs at or even below the gum line, the warning signs that often accompany tooth decay, such as sensitivity to cold or sweets, may not be present. In addition, as teeth age, they lose their sensitivity and may not warn us that the tooth is damaged.

Root cavities are most commonly found by a dentist or dental hygienist during a professional cleaning or exam, when they show up as soft spots in the tooth. X-rays and radiographs are also used to systematically check for root caries.

What can be done to repair the damage to the tooth?
Root caries is a deceitful condition. Even if you can see the cavity with your naked eye, you will probably dismiss it as small and harmless. This is not the case. Teeth are much like trees that blow over in moderate winds due to rotten or dying roots. Even minor damage is to the foundation of the tooth will weaken the entire tooth and put it at risk for breaking off to the gum line.

Damage may reach all the way to the pulp of the tooth and may require endodontic therapy (root canal) to prevent pain and infection. At times, so much damage occurs that the tooth must be extracted. That is why it is so important to have frequent exams so that the condition can be found early.

What can be done to prevent this condition?
Because root cavities are caused from bacteria, it is paramount that you keep your teeth clean every day. If your gums have receded, cleaning can be more difficult. Come see us if this is the case, because we have special teeth cleaning methods that we can teeth you to do at home.

Fluoride has also proven to be highly effective in the prevention of root caries. There are now many ways to be sure you receive the proper amount of fluoride depending on your unique needs. We will customize a fluoride treatment plan just for you.

Diet is also a very important factor because certain foods and snacks can greatly increase the number of bacteria that forms the decay-causing plaque.

Finally, frequent professional cleanings and through exams can help prevent root caries, or find it early when it can be more easily repaired. We are here to help you keep your teeth for a lifetime!

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Do you Offer Zoom Teeth Whitening?

I am interested in the Zoom teeth whitening procedure and was wondering if your office offered it. If not, what other options do you offer for teeth whitening?
Thanks for your time,
James


Thanks you for your enquiry. We do not offer Zoom teeth whitening. We do however have an in-office teeth whitening procedure that is very similar to Zoom.

In our office we offer 3 different types of teeth whitening procedures.

1. In-office teeth whitening with at home bleaching trays.
2. At home bleaching trays.
3. In-office bleaching.

The combination of in-office bleaching with at home tray bleaching is the most comprehensive and we find that this duo teeth whitening protocol with get your teeth the lightest that they possibly can get.

One thing to keep in mind is that different people teeth will bleach lighter than another person. In most of our cases most people are extremely pleased with their results.

Would you like for one of our patient coordinators to cal you to set up a consultation appointment?

Thanks,

Dale J. Brant, DDS
Charles Campbell, DDS
713.795.5905
888.790.0309

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Monday, April 19, 2010

Cost of Dental Implants

I have had all my top teeth pulled due to periodontal disease, and now my bottom ones need to be out as well. I am so ashamed I don't go out anywhere and I can't even get a job because no one will hire me. I cry everyday because I look like a monster. How much would it cost me to get implants? I tried to wear dentures but I can't.

It is so upsetting my grandkids ask me, “Nana why don't you come to see us. Is it because you don't have any teeth?” and I just don't know what to tell them. So please let me know.


I don't have insurance and no job but I will try to come up with the money somehow because my son will be leaving for Japan for 2 years in the Air Force and I would like to go and see him, but since I look like this I can't embarrass him. So please let me know if you can help me.
-Karen


Hi Karen,

You tell a tale that is not uncommon in dentistry. For some people, it is very difficult to get along well after having their teeth taken out. Most patients do OK with upper denture, but it is common to struggle with the lower denture. The only way that we can tell you what would be appropriate for you is to see you and get photos, x-rays, etc. to evaluate your options. Please consider making an appointment for implant consult with us.

Chuck Campbell, DDS
Dale Brant, DDS

Thursday, April 15, 2010

There are More Problems with Dentures Than you Might Think

There are those who assume that all of their dental problems will be over after they have their teeth extracted and replaced with dentures. What they do not realize is that while there are genuine medical and cosmetic benefits derived from dentures, there are also just as many problems with dentures.

One of the first problems with dentures that people notice is difficulty eating. Eating will take much longer sue to the fact that you can only bite down with about 15% to 20% of normal force when eating with dentures.

There are also many foods that you will have difficulty eating. This is especially true for fruits and vegetables, which are very important to your overall nutrition and health.

The taste of food is also altered by upper dentures, especially, because they cover the taste buds on the roof of your mouth.

Two other problems with dentures include gagging and sore spots. Some people with a strong and active gag reflex often find it impossible to wear upper dentures. Even without an active gag reflex, dentures can cause sore spots to develop in the mouth because the tissues here were never intended to have plastic continually rubbing against them.

The most serious problem with dentures is the loss of the jawbone. The jawbone depends on vibrations that come through the tooth roots to maintain its vitality, shape, and overall health. When teeth are missing, the jawbone does not get the stimulation it needs from chewing, and the bone begins to shrink. This will cause your dentures to become loose. After a few months, you will have to come back to our office to have it reline, and every so often, we have to make an entirely new set of dentures to maintain a proper fit.

This is really a bad problem with lower dentures. The base for the denture is smaller to begin with, and as the loss of bone flattens the jaw, there is very little to hold it in place. Even worse, the shrinkage can expose nerves that pass through the lower jaw, so the jaw hurts and can go numb every time you bite down.

The loss of jawbone also changes your appearance. Your nose gets closer to your chin and your lips collapse. This causes wrinkles, gives you less lip support, and makes you look older.

The expense is an unforeseen, but nevertheless very unpleasant problem with dentures. Relinement and readjustment costs money, as do denture replacements. Your tooth replacements that you thought would be cheap turn out to be more expensive in the long run if you use them for anything other than a temporary solution to missing teeth while you wait to be ready for dental implants.

Honestly, dental implants are by far the best way to go if you can afford them, qualify for financial assistance, and if you are in proper health to receive them.

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What is a partial denture?
It is a denture that replaces one or more missing teeth when you have lost some, but not all, of the teeth in your upper or lower arch. A partial denture will not prevent bone loss, so we do not recommend it as the very best possible cosmetic tooth restoration. However, it is a viable stop-gap measure to consider if you cannot receive or afford implants at this time.

Partial dentures, in spite of their inability to stop bone recession, prevent a number of other problems that result from missing teeth.

Missing teeth change the biting forces on teeth around the space. This will cause neighboring teeth to shift, and the opposing teeth begin to extrude out of their sockets and grow longer than they should be.

This in turn creates areas around the teeth that are very difficult to keep clean; so plaque and bacteria being to rapidly accumulate. This accumulation will cause tooth decay and very often also result in periodontal disease.

Changes in the bite will also place unequal chewing pressure on teeth that have shifted. This will often lead to bruxism, clenching, and very painful problems with the temporal mandibular joint (the TMJ). Uneven chewing will then make it hard to chew and enjoy food.

In order to prevent these problems, a partial denture can be used to keep teeth in alignment and to maintain normal functionality of biting and chewing. Partial dentures also will retain the shape of the cheeks and lips and prevent premature wrinkling.

Diagnosis and treatment:
In order to determine if we should recommend a partial denture, we perform a thorough examination of your teeth and gums. We typically take x-rays of your jawbone to determine its current health and size. If bone loss has already set in, we want to know at what stage it is at. As noted previously, partials will not stop recession, so determining the condition of your jaw will help us recommend to you implant options that you may qualify for in the future, and at what time it will be best to pursue them.

In the meantime, it is necessary to make a mold of your mouth that will enable us to create partial dentures that will closely match your existing natural teeth in both size and color. We do this by taking impressions of your teeth.

The dental lab will make your partial dentures, and periodic adjustments and relinements will be scheduled to keep them fitting properly and in good working order for you.

The aesthetic and medical benefits of partial dentures:
Partial dentures replace missing teeth, so you will forego the embarrassment of smiling with a noticeable gap in your arch. You will be able to eat most of the foods you normally eat, and the newer denture types that are now available on the market are much easier to clean. They also do not make clicking noises like the old generic dentures did, and they make it easier for you to speak clearly as well.


Cosmetic Tooth Restoration Options

Cosmetic tooth restorations offer you medical as well as aesthetic benefit. It is never good to have even so much as one tooth missing in your mouth. As we will see in a moment, delaying treatment has some very serious consequences that can make your life miserable if you procrastinate seeking treatment. The good news is that if you are missing one or more teeth, there are several options available for you to consider. Regardless of your finances or current state of dental health, one of them is ideal for you.

Procrastination: Why Not to Do It.
If you are thinking about putting off treatment, you need to know that without teeth and tooth roots, the jawbone in that area gradually shrinks. Jawbones have nerves just like all other tissues in the body. As tooth roots vibrate during the course of chewing, these nerves are stimulated and cause the bone cells to remain active, rejuvenated, and healthy. Without roots to carry this stimulus, however, the jaw atrophies, weakens, and begins to deteriorate.

This will change your appearance in a number of ways. It will alter the shape of your upper and lower arches, which will have a visible impact on your cheeks and mouth. You will wrinkle and look older than you are. Waiting on treatment will make future corrections more complicated and expensive.

Without some sort of cosmetic tooth restoration, you will also have difficulty chewing, and you may repeatedly bite your lips and cheeks. This is because teeth rely upon each other for support. When even one is lost, every tooth around it shifts. This will cause a chain reaction of dental problems, including increased risk for tooth decay and periodontal disease, changes to your bite, and even TMJ problems.

One option is to wear an implant-supported crown or bridge.
Unlike partial dentures and bridges, an implant replaces the roots of missing teeth. This will ensure that the jaw continues to get the necessary stimulation it needs for the bone to stay healthy and retain its natural shape. Once the healing process following implantation is complete, a porcelain crown, partial dentures, or implant-supported dental bridge can be placed over it.

Provided you are a viable candidate for dental implantation and can afford the cost, we recommend this as the very best possible cosmetic tooth restoration. However, if you cannot afford it at this time, or if other mitigating factors prohibit implantation, we have two alternatives we can provide to you.

You can wear a standard dental bridge.
There are several types of standard dental bridges that can be used as effective and very attractive cosmetic tooth restorations. All of them anchor permanently to neighboring teeth. This requires us to reduce the size anchoring teeth and reshape them, even if they are healthy. This is not always good for every patient, because in some people, it can lead to decay and root canal therapy.

If nothing else, for the time being, you can wear a partial denture as a cosmetic tooth restoration.
A partial is held in place by clasps or special attachments, and it is removable for sleeping and cleaning. Today’s partials look much more natural and can be relined and readjusted to maintain comfort and functionality. However, they will not prevent bone loss, so we recommend this only as a last ditch effort or a stop gap, temporary measure until such time as you can qualify for a superior cosmetic tooth restoration.

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Diagnosing Bone Loss

In order to be a candidate for dental implants, you have to have a healthy jaw bone. When bone loss has occurred, its nature and degree of severity must first be determined and corrected before any attempts at implantation are made.

Diagnosing the health of your jawbone is an important step in planning for stable, secure implants and maintaining a beautiful smile.

Causes of bone loss
Bone in the jaw can be lost for a number of reasons.

Periodontal disease destroys the jawbone around the affected teeth. Many people are not aware that something that affects gum tissue can also cause bone loss. The reason for this is bone is living tissue like everything else in the body. Although its calcium content is much higher, bone is made of cells, is nourished by blood, and is tied to the brain’s neural network. Infections can happen in bone just like every other part of the body as a result.

Development of a cyst or abscess creates a hole in the jawbone. This is very serious; because bone loss will occur at even more rapid rate once a hole is form. Also, the risk of disease is also further increased.

Removal or accidental loss of teeth sometimes can cause bone loss. A bone graft may be necessary to restore the integrity of the jaw if this occurs.

Missing teeth do not stimulate the jawbone through chewing, causing the jawbone to shrink. The jawbone needs teeth to stimulate it. Every time you bite down on food, the roots of your teeth send vibrations into the jaw, which the nerve endings sense, and which in turn stimulate the jaw to vitality and regeneration. However, once tooth roots are lost, bone loss always occurs—100 percent of the time—when the vibrations it the jaw is used to cease to be transmitted.

Diagnosis and treatment
Medical history is the first thing we look at. We need to know if you have diabetes or a history of gum disease. We also need to know if you smoke, because this can interfere with the healing process essential to dental implantation. We also want to perform a standard oral cancer exam regardless of whether or not you have ever smoked or used smokeless tobacco.

To check your jaw itself, we take x-rays and sometimes a CT scan to see how much bone injury and bone loss you have suffered. This allows us to actually study the nerves and blood vessels in your jaw and make a precise diagnosis of its health.


When we perform a visual exam to look at the shape of the jawbone, we will periodontal probe to check the height of bone around any neighboring teeth. Sometimes, we may also find defects in the jawbone while we are performing implant surgery. If necessary, a bone graft may be performed to reverse bone loss (if possible) and improve your chances of successful dental implant surgery.

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Implant Retained Partial Dentures

What is an implant retained partial denture?
It is a partial denture supported by dental implants that can be removed from the mouth at will. Unlike conventional dentures, which simply slip into place, these partials have fixed anchor points that work like artificial tooth roots that are surgically embedded in the gums. They are much better for you than conventional partials because the implants keep the jawbone stimulated, thus preventing bone recession that will result when natural teeth are lost.

Implant retained partial dentures are designed to evenly chewing forces over all of your remaining teeth and soft tissues. This makes them work like natural teeth and act in harmony with your remaining teeth, so you can enjoy daily life and normal eating without stress, discomfort, or embarrassment.

When would I need implant retained partial dentures?
If you were to lose some of your teeth through an accident, tooth decay, gum disease, or barbaric fisticuffs (i.e.: a fight), you would need to get these missing teeth replaced. Leaving a gap in your upper or lower arch is never good for you. Teeth depend on one another for alignment, so even one missing tooth creates enough of a gap to shift the entire arch out of place. You will end up biting your lip or cheek, and over time, you may even have time closing your mouth because opposing teeth end up growing at different lengths.

You will also experience jawbone loss because the bone no longer has tooth roots to stimulate it. When teeth shift out of alignment, there is also an increased risk of tooth decay because portions of the teeth become more exposed to bacteria and plaque, and many of these areas are very hard to brush and floss. Periodontal disease also results from this buildup.

Bruxism, or tooth grinding, can also be a result of neglecting missing teeth. Improper forces placed on shifting teeth will not only wear down the enamel over time, it can also start to affect the TMJ, or jawbone joint itself.

Implant retained partials can prevent many, if not all of these problems, from happening to you. They definitely will stop bone loss because the implants will carry chewing vibrations into the bone and keep it stimulated enough that it will retain its natural shape and mass.

Diagnosis and treatment
To see if implants are right for you, we perform a complete oral examination. We check your previous medical history and discuss any condition that could interfere with healing. We check for oral cancer, and we perform a visual examination to determine the precise health of your teeth and gums. We also check on the health of the jawbone itself by taking panographic x-rays and, if necessary, computerized tomography scans. Finally, we make a model of your mouth by taking impressions and bite registrations.

Benefits of implant retained partial dentures
Partials are less expensive than the porcelain crowns used to make dental bridges and cosmetic tooth restorations. They also can be removed and cleaned, or taken out during sleep. However, you have the benefit of a viable tooth root replacement that keeps your jawbone at normal size and better retains the shape of your mouth than other types of dentures are able to do.

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Implant supported dentures





When you are missing a full arch of teeth on the upper or lower jaw, you have to do something. There are several choices you can make.

If you are already wearing a denture, you can have it modified.
You can get a new conventional denture.
You can invest in an implant supported denture, which is the best possible kind of denture.
You can do nothing, which is not a good idea.

Delaying treatment
If you do nothing, your jawbone will continue to shrink because you are missing teeth. This will make future treatment more difficult and costly.

Wearing an implant supported denture
An implant supported denture is also called a fixed denture. The implant is embedded in the jawbone, but the denture itself can be removed for cleaning or during sleep.

Depending on your situation, an implant denture may not work for you.

If you smoke, this may prevent you from being a candidate for dental implants. Implantation involves surgery and a 3-6 month healing process. Smoking interferes with this healing process.

If you are diabetic or have severe gum disease, you may also not be able to wear implant supported dentures.

If you have lost a significant amount of bone mass, we will possibly have to do a bone graft to rebuild the jaw enough to support implantation. If you have Periodontal disease, we would have to perform LANAP treatment first so your gums can handle the surgery. This can be a long, drawn out, and costly process.

Financial complications can also arise if your dental insurance does not cover implants. Again, we strongly believe that implants are the best road to take, but if they are not possible or practical for you at this time, there are other things we can do for you.

Modifying a current denture
Your denture may not be fitting very well due to the changes that inevitably occur in a mouth with missing teeth. Many times, a simple relinement and adjustment is all that is needed to restore a proper fit that is comfortable and functional. On some occasions we can make a better-fitting denture base as well, so that we can reuse the teeth in your current denture.

Wearing a conventional denture
A conventional denture is custom-made for you 6-8 weeks after you have lost your teeth. It is made after the immediate denture that was initially placed no longer fits because the shape of your mouth changes.

Conventional dentures are used to replace either an upper or lower arch of missing teeth. They work well in the beginning, but over time the jawbone shrinks because tooth roots are now gone. This shrinkage will change the shape of your mouth, cheeks, and lips. This is why we recommend implant supported dentures as a better alternative to conventional dentures if you are a candidate for implantation.

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Dental Implant Supported Cosmetic Tooth Restorations

A dental implant is the best possible cosmetic tooth replacement. The most common form of implant is a root form implant, which is a titanium post that screws into the jawbone. This artificial tooth root can then support any number of restorations that both work and look like natural teeth.

What are the benefits of dental implants?
An implant has several benefits. Like the roots of natural teeth, it stimulates the jawbone when you chew. Jawbones are naturally stimulated by tooth roots when people bite down on food. The vibrations keep the bone stimulated and growing. When a tooth is lost, the jawbone will recede when this stimulus ceases. However, an implant restores this stimulus and keeps the tooth healthy.

An implant is strong, comfortable, and secure. When the restoration is in place, the implant looks and feels much like natural teeth.

With careful homecare and regular checkups and cleanings here in our office, an implant can be an excellent long-term solution for missing teeth.

How can an implant do for me?
An implant can support a variety of cosmetic tooth restorations, such as

A single crown
This restoration is almost always an all-porcelain crown. The newer types of porcelain that are now used to make implant retained tooth restorations look like natural teeth and are extremely durable. You will be able to chew all of the foods you normally eat.

A multi-unit bridge
This type of bridge anchors to an implant rather than to natural teeth. This prevents wear and tear that will result if the bridge is anchored to the teeth themselves. Bridges are non-removable, so for some people full-arch dentures supported by dental implants are a preferred option.

Full-arch dentures
These are removable tooth replacements for people who have lost natural teeth. Full-arch dentures can be manufactured to give you the match the characteristics of natural teeth the patient lost. New developments in cosmetic dentistry have made it possible to use materials that create much better dentures than the stereotypical false teeth of the past.

Dental implants can be used to support dentures that are anchored to the jawbone through the implant, but can also be snapped out and removed during sleep. The advantage to this system is it prevents bone loss because the implants emulate tooth roots and keep the jaw continuously stimulated.

Diagnosis and treatment
Depending on the situation, placing a dental implant is a process that takes several appointments over a period of months. Surgery is involved, so we use sedation dentistry with a trained anesthesiologist to keep you from feeling any pain.

Before this happens, however, we check your medical history and make certain you’re a candidate for implants. If the health of your gums and jawbone has deteriorated, we may need to perform bone grafting or gum surgery before we install implants.

When we are ready to install them, a channel is shaped in the jawbone, and then the implant is inserted into the prepared space. We may use a temporary restoration to cover the implant over the next few months as the bone grows around it. Once this has happened, we place your cosmetic restoration over the dental implant.

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Tuesday, April 13, 2010

Post Op Homecare for Dental Implants



After you have received dental implants, we strongly recommend that you follow these very important guidelines in order to ensure their long-term success.

General Care
Control any minor bleeding you experience with moderate pressure using gauze pads or a clean, moist tea bag wrapped in a gauze pad.

Limit yourself to calm activities for 3-5 days to keep your blood pressure stable and to minimize bleeding.

If you normally wear a removable denture or partial denture, follow any additional instructions we give you about wearing it during the healing process.

Tobacco use
Don't use tobacco products for a minimum of 24 hours. Avoid tobacco as much as possible for several months. Tobacco is the leading cause of dental implant failure because it slows healing and increases the chance that your body will reject the implants.


When to call us
Call us immediately if you experience increased or heavy bleeding, if you have pain or swelling that increases and continues beyond two or three days, or you experience a reaction to the medication.

Call us also if your dental implants gradually show through the gums. We will need to check them at once.

Chewing and eating
Avoid chewing until all numbness has worn off. If we have placed a temporary restoration, avoid chewing for one half-hour in order to allow the temporary cement to set.

For the first 24 hours, drink plenty of liquids and eat soft, nutritious foods. Chew on the opposite side of your mouth.

After the first 24 hours, you can return to your usual diet. However, you should continue to chew on the opposite side of your mouth. Do not eat hot or spicy foods until your gums are healed. We'll evaluate your situation to determine how soon you can chew on the dental implant.

Brushing and flossing
For the first 14 days, gently wipe the dental implant site with gauze or a cotton swab. After that, brush the area gently with a soft toothbrush.

Avoid flossing the area for four weeks. We will evaluate the healing and adjust your brushing and flossing timetable as necessary.

In the meantime, though, brush and floss your other teeth normally.

If we have recommended a mouth rinse, use it as directed.


Medication and discomfort
If any antibiotics or other medicines were prescribed, you should continue to take them for the prescribed period of time. Do not stop taking them even if all symptoms and signs of infection are gone.

To control discomfort, take pain medication before the anesthetic has worn off completely, or as specifically instructed. It's normal to experience some discomfort for several days after surgery.

To reduce discomfort or swelling for the first 24 hours following surgery, use ice packs, 20 minutes on and 20 minutes off.

To reduce discomfort after the first 24 hours, apply moist heat.

To further reduce discomfort after the first 24 hours, you can rinse your mouth very gently three times a day with warm salt water. Use about one teaspoon of salt per glass of warm water.

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Monday, April 12, 2010

Single-Tooth Implant



When a tooth is lost, a single tooth implant is the best way to replace it. A single tooth implant is a great way to keep your jawbone healthy, to stop neighboring teeth from shifting, and to maintain a stable bite.

It is never a good idea to do nothing about a missing tooth, because there are too many problems associated with the gap it creates. One of these is shifting teeth. When a tooth is lost, the biting forces on neighboring teeth change and they move out of place

This causes new areas of your teeth to become exposed to plaque and bacteria. These areas are harder to keep clean, and you face a buildup of cavity causing agents as a result. You also increase your risk of periodontal disease.

You may also start grinding and clenching your teeth as a result of the shift in your bite. This will make your jaw sore, and it could lead to problems with your jaw joint, the TMJ

Of all the problems that result from a missing tooth, though, bone loss is the worst. This is because teeth transmit chewing forces through their roots to the jawbone. This provides the stimulation bone needs to stay healthy, so when a tooth is missing, the jawbone around the area begins to shrink, along with the surrounding gums.

To see if a single tooth implant is right for you, we perform a thorough dental examination. This examination includes a thorough review of your medical history and an in depth discussion of any condition that may interfere with healing.

We also use our intraoral camera to perform a complete visual examination of your mouth. This allows us to check the health of your teeth and gums. We also do a standard oral cancer screen. In order to determine the health of your jawbone, we also take panographic x-rays. We may also do a CT (computerized tomography) scans.

We then take impressions and bite registrations to create an accurate model of your mouth. This is needed to create a single tooth implant that will match the surrounding teeth and work effectively to retain the shape and position of the opposing tooth.

The benefits of a single tooth implant cannot be understated. To begin with, an implant fitted with a crown effectively replaces a missing tooth. Both the base and the porcelain provide a functioning replacement for a natural tooth.

The single tooth implant is held firmly in the jawbone, so it feels much like your natural teeth when you talk and chew. The crown is custom crafted to match or enhance your smile, so no one but you will know that you have a tooth replacement.

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Tuesday, April 6, 2010

Anterior Tooth Breakdown

Hi,
I'm 30 and just had two crowns down on my top front teeth. The reason for the crown was one of the teeth keeps chipping off because the way I bite. My dentist recommend that I get that tooth crowned instead of bonding it every few months, but keep in mind this tooth is in good condition and never had any filling. He also recommended that I get the tooth beside the chipped tooth crowned as well. I listened to his advice and did so.

The reason for my email is I'm unhappy of the outcome because my smile changed and I feel crown looks false. I didn't understand whether I need a crown because the teeth are in good condition. My question is there a better option than crowning them, or was this a long term solution for the chipped tooth and was crowning the teeth necessary? Please advise, thank you.

Thanks for the question,

Linda

Anterior tooth breakdown is very common and a challenge to manage. Many times the reason for tooth fracture and weakness is either trauma from a blow or fall (maybe long ago), or the daily trauma of someone who clenches their teeth and bruxes on their front teeth….this also tears things up. If you look in a mirror, push your lower jaw slowly forward until the upper and lower teeth are end-to-end. Many times this is the protrusive position that you get into during sleep that causes the repeated breakdown of your teeth or bonding that has been placed. Sometimes when you repeatedly break off composite and more strength needed, crowns are often the best solution. In our practice you would also have a nighttime guard to protect those front teeth from further breakdown in the future. These dominant habits can be very destructive.

But you should work with your dentist first to get the crowns to the satisfaction of both you. It is a challenge getting teeth to look natural sometimes…. But definitely you should be able to work this out with your dentist. Both of you need to communicate about what you both like and don’t like and what is possible (or not possible) with the planned dental work.

Chuck Campbell, DDS
Dale Brant, DDS

713-795-5905

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Monday, April 5, 2010

How Much Does LANAP Cost?

I am trying to get a ballpark figure on the cost of LANAP. I know every case is different, but I need an estimate.
THANKS
Chris



Chris,

You have a very good question, on how much LANAP costs. The fee range can be anywhere from $4,000.00 to $10,000.00. This is for the 1st year of treatment. The fee depends on the severity of your periodontal disease. The only way that we can determine the type of periodontal disease that you have is to do a comprehensive dental exam. This includes a full series of x-rays, digital photos, periodontal exam, oral cancer screen and a head and neck exam. Once we have all of this information then we can determine the severity of your disease and give you the fees for your treatment. Please let me know if you need any additional information.




Thanks,

Dale J. Brant, DDS
Charles Campbell, DDS
713.795.5905
888.790.0309

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Saturday, April 3, 2010

All-Porcelain Bridges

A tooth-colored bridge can either be made from porcelain and metal, or, thanks to newly developed technology, it can be an all-porcelain bridge.

Metal-and-porcelain bridges
Porcelain bridges in the past have always been built upon a metal core. That was the only way to make them strong enough to withstand the tremendous biting forces that are exerted on all of your teeth. The metal core was what created the dark blue line at the edge of many bridges.

The benefits of all-porcelain bridges
Recent developments in adhesives, combined with the creation of stronger porcelain materials, allow us to now make bridges entirely out of porcelain. All-porcelain bridges maintain a translucency that makes them hard to tell from natural teeth. Without metal, the problem of a dark line at the edge of the gums is eliminated. This allows us to place the edge of the bridge above the gumline, and that’s healthier for your teeth and gums.

Why do I need an all-porcelain bridge?
A bridge restores your ability to eat normally, and it supports your lips and cheeks. The loss of a back tooth often causes your mouth to sink and your face to look older. Teeth were designed to work in relationship to one another. When teeth are missing, there is a tremendous amount of stress placed on gums and other surrounding tissues because of the gap. This can cause teeth to shift out of alignment, and it can increase the risk of gum disease. You may also have problems speaking as a result of missing teeth, and that, combined with a gap in your smile, can be very embarrassing, to say the least.

How is a bridge attached?
It normally takes two or three appointments to attach an all-porcelain bridge. During the first appointment, we prepare the teeth on either side of the gap by removing some of the enamel and dentin.
The bridge itself must be made in a dental laboratory to precisely match the size and shape of teeth and to maintain the bite of opposing teeth. This requires us to make impressions of your teeth that can then be used to make a mold of your mouth. The lab will use this mold to make the bridge.

We will fit you with a temporary bridge while we wait for the lab to finish its work, then call you back to our office when the permanent bridge is ready. When you return for the second appointment, we will remove your temporary bridge and trial fit the permanent bridge. We will test your bite and make certain that everything is in order. Once all these things are confirmed, we will permanently cement your bridge in place.

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Thursday, April 1, 2010

Denture Problems

Denture problems are something that few people who invest in the cheaper solution of dentures ever consider until after the fact.

You may have grown up with a relative who told you that the best way to fix a dental problem was to simply have bad teeth pulled and replaced with dentures. If you remember correctly, however, you’ll recall that this person probably never wore dentures themselves. People who actually wear dentures will tell you that they are very problematic at times.

Problems with eating are the first denture problem you will notice.
Eating takes longer because you can only apply about 15% to 20% of normal force when you chew with dentures. This makes it hard to enjoy many foods you normally eat. This is especially true for fruits and vegetables, which are crucial for your overall health.

Tasting food is harder too, especially with upper dentures, because they cover the taste buds on the roof of your mouth.

Another denture problem you will face is gagging and sore spots. If you have an active gag reflex, dentures may trigger it. If you have a severe gag reflex, you may not be able to wear them at all.

Sore spots can also develop in your mouth because of plastic continually rubbing against them.

A shrinking jawbone is the most serious of denture problems.
The most serious problem is the loss of jawbone. When tooth roots are missing, the jawbone does not get the stimulation it needs from chewing. The bone starts to shrink. This causes the denture to become loose and floppy. Jawbone recession also changes your appearance. It makes your nose get closer to your chin and makes your lips collapse. You will have less lip support and more wrinkles that make you look older.

After a few months, you will have to have your denture relined, and every few years, it needs to be remade completely to keep it fitting properly. Recession also exposes nerves passing through the lower jaw, so the jaw hurts and can go numb every time you bite down.

This is particularly true for lower dentures. The base for the denture is smaller to begin with, and as the loss of bone flattens the jaw, there is very little to hold it in place.

The compounded cost of dentures is another denture problem that adds sooner than you think as you continually have to return to the dentist for relinement and periodic replacements. As cosmetic dentists who are also skilled in all manner of general dentistry practices, we recommend instead that you invest in quality treatments that will save your natural teeth and restore their natural appearance. You will look better, feel better, enjoy your food more, and have more confidence.

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