Passionate Artistry

Choices

dental crownsWhat if you could be guaranteed that you will have little or no drilling on your teeth during the last 20 years of your life? Would excellent dental health and minimal dental expense appeal to you? Most readers would be excited by this thought, but 30 years of experience demonstrates that fewer than 10 percent of dentists give their patients an opportunity to achieve a condition that makes this possible. Instead, dentists allow their patients to have ongoing breakdown of teeth as if it were a normal course of events.

Of course, you may be such a delightful patient that your return visits are eagerly anticipated! Your problems may provide the dentist with a steady stream of repair work, but this is not the dentist’s intent. Rather, most dentists are simply too busy to take the time or responsibility for their patients’ long term success, other than what can be covered by standard fees.

A well-respected orthodontist restores and collects classic cars. Once restored, he keeps these cars immaculate. He usually has six to eight cars in his garage at any one time. Anyone could see that the cars are spotless on the outside, but most of us could not tell the condition under the hood. The orthodontist would not panic if he had a tiny scratch in the paint…he knows how to fix that easily. But should he have gritty oil running through the engine, or rust starting in the frame, he might go into an asthmatic attack. He knows that a large part of his investment would be ruined if the engine or a hard-to-find part had to be completely replaced.

He rebuilt a Pierce Arrow from the late 1920’s. It took almost a year and finally he announced that he was finished. Surprisingly, where beautiful upholstery was expected, were a bunch of bent wires. The paint looked more like an army tank. What he meant was that he was finished with everything that was difficult in restoring an antique car to perfect condition. The easy part was putting the esthetics on the car, which must wait for the inside work to be done. In fact, for about $5000 he was having someone else do that, so in reality, he had finished his project.

The message here is that your work is pretty much done when you contribute your part to remove disease. Finding a talented dentist to provide great esthetics is the easy part if you read the Article “How to Select Your Dentist”.

Most of us look at our mouths much the way we would look at the Pierce Arrow. If we see a nice white smile, we think beauty. We are impressed by the outer appearance. Dentists can tell you that many beautiful smiles hide extreme disease conditions on the inside and mask a future of pain and expense.

Mouths are different from cars, of course. It is often possible to create a more attractive smile with bleaching, cosmetic crowns or veneers before addressing the harder stuff “under the hood”. Unlike cars, dentists won’t scratch up your “shine” during restoration of the back teeth. Once patients obtain the smile of their dreams, they trust dental professionals more, then they place more value in their teeth. The “outside first” approach can work, but might not the best choice if you are currently motivated to achieve a healthy mouth during your golden years. The following section describes some reasons why.

Your mouth as a whole

Your back teeth support your front teeth. Any changes in your bite in the back will affect the appearance and function of the front teeth. If you lose back teeth, the front teeth will receive greater biting forces and this may lead to bone breakdown, root fracture, unsightly spaces or excess wear. If your dentist rebuilds your back teeth after restoring your front teeth, you may be left with front teeth that don’t touch. You will be frustrated when trying to bite together with your front teeth. Without your front teeth touching, your back teeth will be under greater stress when you chew from side-to-side. This will lead to increased bone loss and breakage of teeth, especially those teeth with existing fillings.

PRO-TIP before your crowns or veneers

Dentists who use follow up x-rays and exams to check the quality of the fit of the restorations they have placed, demonstrate there demand for high quality workmanship.

Getting back to that Pierce Arrow, there are some ways in which your mouth is (or should be) very much like a finely tuned classic car. The tartar and plaque under your gums can destroy the bony support for your teeth, much like dirty oil contributes to engine wear. Just as a car must have a smooth engine, balanced tires and safety features all working together, your mouth must have your teeth, musculature, jawbone and joints working in harmony for your comfort during the 20 to 30 year drive through the golden years. Everything must work and fit perfectly for this to happen.

We know the reputation developed by Mercedes automobiles. It is common to run these cars 200,000 to 300,000 miles. Your mouth needs to be like a Mercedes before it hits the difficult years ahead. This means any defective restorations (a word that includes fillings, crowns, veneers, etc.) should be replaced with ones that have a precision fit. Any new restoration should be perfect. No sloppy parts! Now, this is the hard part. It is very difficult for most patients to judge the technical skills of a dentist. This subject will be covered later in the Article “How to Select Your Dentist”. For now, assume your dentist has exceptional skills, as many do. Then follow the PRO-TIPs…

Many dentists recommend long-term dental solutions, knowing that you have the right to choose to do the dentistry or not do the dentistry. If you want the benefits of a healthy mouth, but do not want more dental sessions for many years, then make these statements to your dentist:

“I want restorations that are the least likely to break down or leak in the next 20 years.” If you are bold, substitute “30”, for “20”, but realize that most dentists haven’t had 30 years experience watching restorations as they break down or leak.
“I am counting on your skills to help this work last until I die.” This statement has a flattery element that will encourage the dentist to do the best he or she could ever do.

PRO-TIP It’s your choice.

You are in charge of your dentistry. If you choose to do shorter-term dentistry, you will expect to have more replacements, greater tooth loss and more expenditure in the future. Most dentists understand this, and will work with you so you can have the dentistry you want as you can afford it.

Your investment in your mouth will pay you back many times over if it is done early and done well. One of the more difficult problems for a dentist is to have an 80 year-old come in needing major repairs. If the patient is treated like he or she has five years of life ahead, then treatment decisions may far underestimate what would keep the patient comfortable at 90 or 95. On the other hand, most dentists are sensitive to fixed incomes and the need to limit dentistry on the elderly. Everyone’s life is easier if dentistry is done early and done right.

Can things go wrong? Of course they can! Dentistry cannot be guaranteed for your lifetime. But, armed with the PRO-TIPs, you can have a beautiful and healthy smile throughout your golden years. Dental problems should be least of your worries.

If you would like to learn more about the dental procedures and treatments performed by cosmetic dentists Dr. Rob Strain, DDS  and Dr. Laura Wittenauer, DDS please call us at 760.568.9494 or click here. Serving new patients in Rancho Mirage, Palm Springs, Palm Desert and surrounding areas.


Next Chapter: Grinding Your Teeth to Smithereens


It was great. Each staff member greeted me and they walked me through the whole office. I highly recommend Studio Dentistry. They are great!!

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