Passionate Artistry

New Materials

composite dental fillings before after coral springsModern materials technology has completely changed the standards for dental care. Some of our tried and true materials are guaranteed to fail. New materials can provide substantially longer service. But some new materials could spell disaster for you, your dental health and your pocketbook. In this article you will learn what your risks are with the various materials that are popular today.

Anecdote of the Missing Teeth

The little lady sat quietly in the dental chair while her dentist went to the laboratory to polish her denture. When the dentist returned, he could see that she was still holding a tissue over her mouth. At the chair, he asked her if there had been a problem with her mouth.

“Oh, no!” she said. I never let anyone see me without my teeth in.“

“Surely your husband has seen you,” replied the dentist. “You have been married over 50 years and you have been wearing dentures the whole time.”

Her answer astonished the dentist. “No one has ever seen me without my teeth except my dentist.”

This story has occurred in countless dental offices throughout the country. Women, in particular, are prone to have nightmares about losing their teeth. Men seldom have such dreams. For women there are few occasions as humiliating as being seen without teeth. Few of life’s traumas can compare. A complete smile is a sign of beauty, health and financial well-being. Missing teeth is a sign of unattractiveness, disease and financial struggles.

Anecdote of the Sunken Teeth

A partygoer sneezed during cocktails, sending her drink and upper denture four feet away. Unfortunately the party was on a houseboat. There aren’t many places to hide on a houseboat when your teeth fly overboard! This lady faced her worst nightmare. Not only was she missing her teeth, there was no place to hide. She felt humiliated.

Occurrences such as these are less common today than they were 20 or 30 years ago. Fewer teeth are lost because of more regular dental visits, better home care and new gum treatment techniques. Newer bonded fillings and crowns help hold teeth together, so fewer teeth break down to the point of needing extraction. When teeth must be lost, dental implants provide a stronger attachment than the original teeth. We have come a long way in the last 50 years!

These true stories happened 25 years ago. They are much less likely to occur today, primarily due to 21 st century dental materials.

Composite Bonding – The Answer to Many Dental Needs

Bonding is a technique that combines a resin bonding agent (the glue) and composite resin filling material to restore teeth to their natural beauty and function. Bonding has several wonderful benefits over amalgam (silver and mercury) fillings:

  1. Bonding helps to hold teeth together, so they are less susceptible to fractures that require crowns for repair.
  2. Bonded fillings are stronger in the bite and do not get “work hardened” the way amalgams do.
    Work hardening weakens an amalgam, making it more susceptible fracture
  3. Less drilling is needed for bonded fillings.
  4. Bonded fillings look great!
  5. Some dentists and patients believe that removing mercury-laden amalgam fillings reduces the potential of mercury to contribute to autoimmune diseases.

With all these advantages, you would think that every dentist would only place composites. Many dentists still do place amalgam fillings, though. Amalgam fillings require less skill and are more profitable for a dentist with a busy schedule. Composites are in the best interest of your teeth when placed by a skilled dentist.

Laminate Veneers

Veneers are thin porcelain facings that go over the front of teeth to fill gaps, straighten, whiten or correct a discolored smile. Recent advances in porcelain technology are responsible for gorgeous results that are far superior to those possible from the veneers available ten or fifteen years ago. Advances in adhesive technology assure that veneers will stay bonded for years to come. The four biggest advantages of veneers over crowns are:

  1. They require very little or no tooth preparation.
  2. They can transmit light in a way that mimics natural teeth.
  3. Veneers do not show a dark line along the gum line.
  4. They form a very strong bond to teeth, strengthening weakened teeth.

Porcelain laminate veneers are a great alternative for many patients who have always wished for a nicer smile without orthodontics or extensive capping of the teeth. If you have these feelings, ask your dentist if porcelain veneers are possible for you.

All-Ceramic Crowns

There have been numerous advances in all-ceramic (porcelain without metal underneath) in the past 15 or 20 years. Milled crowns utilize CAD-CAM technology. Some dental practices offer these crowns with only a few hours turn-around time. More popular, however is a combination crown that has a milled zirconium ceramic undersurface and a custom ceramic outer surface. Both types now have excellent fit characteristics. The milled crowns are somewhat limited in shade selection, but this has improved recently. The patient can expect strength properties and great color matching, without the dark lines at the gum line that are common after porcelain-fused-to-metal crowns are in place for a number of years.

Dental Implants

Dental implants can be placed in the jaw as anchors for either cemented or removable teeth. Design changes, impeccable technique and patient selection is responsible for the success rate on dental implants, increasing from 50% ten years ago to over 95% today. Today, dental implants are recognized as being so successful that they are now the standard of care for replacement of missing teeth. Bridgework and unsupported partial or full dentures are no longer the first choice. With dental implants, a person who has lost teeth can have the security and comfort of non-moving, rock solid teeth to complete the smile.

General dentists, periodontists and oral surgeons may place dental implants. A healing period of three to six months prior to tooth placement is usually allowed while bone grows around the implant, a process known as osseointegration. Some recently developed implants allow teeth to be placed immediately so long as the bite is not heavy in the area of the implants.

A trained general dentist or prosthodontist places dentures or crowns on top of the implants. The most common uses for dental implants are:

  • Replacement of a single missing tooth, especially when adjacent teeth do not need dentistry.
  • As a substructure, when all the lower teeth are missing, to be fitted with a cemented bridge or removable lower denture
  • As a foundation for a bridge when all or most of the back teeth are missing on one side, especially when the patient wants to avoid a removable partial denture.

Millions of Americans have suffered from wearing full or partial removable dentures. Dental implants can end this suffering and restore oral health and a feeling of wholeness to those who are missing many teeth.

Extractions and Grafting

Extraction techniques have remained relatively unchanged for decades. Recently, there has been a move towards atraumatic extractions. The goal is to disturb the bone as little as possible to create more rapid healing following implant placement.

Whenever there is an extraction there is a loss of function in the bone that was surrounding the tooth. The stimulus from teeth in their sockets keeps bone in place. Once the bone loses this stimulus, resorption sets in, leaving a depression in jawbone where the tooth used to be. This loss of bone has three potential consequences:

  • Replacement teeth on bridgework in the back of the mouth have to be oversized to fill in the gap, or a large food trap will occur.
  • Replacement teeth on bridges in the front of the mouth have to be oversized, which results in an unattractively long tooth.
  • There is less bone available for placement of an implant.

New materials are available for bone grafts that will help maintain this bone and minimize resorption. These grafts are usually placed at the time of extraction, but can many times be placed even years after extractions. When bone is grafted to create extra bone for an implant, it is important that the implant is placed soon after the graft has healed, otherwise this bone may also resorb. The surgeon knows the appropriate timing based upon the type of graft material used.

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: What’s That You Are Putting in Your Mouth?

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