About Emergency Dental Care
What should I do if a porcelain veneer or crown pops off?
If your porcelain restoration comes off, carefully remove it from your mouth without damaging it further. If you have found only one piece then the veneer may not have broken but instead may have just become dislodged from your tooth, fully intact. If the veneer is whole, our doctor, your dentist may be able to re-bond it to your tooth so place it in a protective container. Even if the veneer is broken it’s not a bad idea to save the parts and show them to our doctor. They could possibly be of interest. Then, give us a call to schedule a repair.
What do I do if a temporary crown comes off?
If your temporary dental crown does happen to come off give our office a call so we can provide you with specific instructions and also make arrangements for you to come in and have it re-cemented. In regards to that time period before you can get in to see our doctor, we will usually suggest that you simply place the temporary crown right back on your tooth. Doing so will protect the tooth from irritating stimuli such as hot or cold foods and liquids. Wearing the temporary crown will also hold the tooth in place and keep it from shifting position (an important factor in how well or how easily your permanent dental crown can be fitted). If the bite on your temporary crown seems incorrect when it is placed back on your tooth then it might be advisable to leave the temporary crown off. If your temporary dental crown doesn’t seem to stay in place very well many dentists will suggest that you fill it with toothpaste, Vaseline, or denture adhesive before you place it over your tooth (this technique should only be used for a few days). You will need to be careful with your temporary crown in this state. So you don’t end up swallowing or biting on it unexpectedly, your temporary crown should be removed when you sleep and eat. Anytime your crown is not in your mouth you should keep it wet. Put it in a glass of water or close it up in a baggie containing a moist paper towel.
About Dental Implants
What is a dental implant?
This is a surgical procedure designed to replace a missing tooth. A dental implant is a titanium cylinder that is placed in the bone and replaces what was once the root of the tooth. A crown is attached to the implant to simulate an individual tooth.
How is a dental implant different from a dental bridge?
A dental implant literally replaces a missing tooth. A dental implant simulates the root of a tooth to which the cosmetic dentist attaches a cosmetic tooth. A dental bridge, on the other hand, is non-surgical and uses the adjacent teeth to support a new cosmetic tooth. A dental implant is not invasive to surrounding teeth (especially desirable if they are healthy and in good condition). By simulating the root, it engages the bone and keeps it healthy. Because a dental implant is an individual tooth it is also easier to floss. A dental bridge can be a good choice if the adjacent teeth are in need of restoration. However, there are other subtle factors such as age, timing and bone health that you should discuss with Dr. Dietrich when deciding which options may be best for you.
How long does the Dental Implant process take?
Once a person is deemed a good candidate for dental implants, then there is one visit to surgically place the implant. Some applications are ready for immediate restoration, others may be required to wait anywhere from 3 to 6 months for bone growth to solidify around the implant to anchor it. At this point the implant can be restored to completion.
Why can’t smokers undergo certain cosmetic dentistry procedures, such as dental implants?
Smoking is a leading cause of tooth loss. Smokers also have an increased risk for periodontal disease (gum disease), leukoplakia, loss of bone structure,inflammation of the salivary gland, and development of lung, throat, or oralvcancer. Smokers therefore face an additional set of considerations when exploring cosmetic dentistry treatment.
One restriction for smokers involves dental implants. Smoking increases the risk that a dental implant will fail to integrate with bone tissue (osseointegration). Smoking also affects gum health, and unhealthy gums can lead to dental implant failure. If you smoke, you need to quit before having an implant. Another restriction involves teeth whitening. If you whiten your teeth but continue to smoke, the whitening effect will not last as long, because smoking stains the teeth.
Are dental implants suitable for children?
Dentists indicate that implants cannot be considered until bone growth has completed. This typically occurs during adolescence, but may vary from one child to the next. Implants placed prior to bone growth completion may shift out of place and cause severe problems. If a child loses a tooth before bone growth has completed, an orthodontic device called a “space maintainer” may be used to prevent an abnormal growth of surrounding teeth. Once bone growth has completed, the space maintainer can be removed and the missing tooth restored using an implant or bridge.
About Restorative Dentistry
What is Restorative Dentistry?
Restorative dentistry repairs decayed teeth by caries, wear, or trauma.It can also servo for replacing old amalgam fillings, and old composites that have become discolored. Advanced restorative dentistry includes “indirect” restorations, which require the help of a dental laboratory to construct high quality, advanced restorations to repair damaged teeth or replace missing teeth.
Who would benefit from Restorative Dentistry?
Everybody with the above conditions benefit from restorative dentistry. Adults and children alike.
How long doe Restorative Dentistry take?
Restorative Dentistry is usually accomplished in one or two visits – each ranging from 2 to 4 hours depending on the procedure.
Can I still get tooth decay after?
Any place where there is an actual porcelain restoration – whether it is a veneer or a crown, will not be susceptible to decay. However, any uncovered area of the natural tooth structure (including the root surface and area under gum tissue) is vulnerable to decay. Continuing with regular dental/hygiene visits (as well as good home care) will help preserve the integrity and health of your teeth and preserve your investment.
About Dental Hygiene
Why do I need to have my teeth cleaned and how often?
There is more happening than just “cleaning your teeth” at an advanced dental office. The primary aspect of the visit is to remove tartar and calculus (hardened prolonged buildup) from around the teeth and under the gum where floss and a tooth brush do not reach. We measure the depth of the “pocket,” or space, between the tooth and gum. Up to three millimeters is considered healthy, as this is the barrier between the exposed part of your tooth and the inner workings of your body. Three millimeters is also the maximum depth that floss will reach. When people don’t floss as often as necessary, dental cleaning visits are even more important. A visit every six months is recommended for people in good oral health who floss and take good care of their teeth and gums. For some people, more frequent visits may be necessary as recommended by the doctor.
About Dental X-Rays
Are X-Rays really necessary?
X-rays are necessary to detect decay between teeth and areas not visible to the naked eye. Since gum and bone problems happen slowly over time, they are often not felt or detected from the surface. X rays are also necessary for detecting bone loss and infections at root surfaces. Dental X-Rays are a key element in a good diagnosis and hence, proper treatment of your teeth and surrounding areas.
How about radiation?
Many people are understandably concerned about excessive radiation. Dietrich Dental takes digital radiographs, which use approximately 80% less radiation than conventional techniques.
About Gum Disease (Periodontitis)
What is periodontal or gum disease?
Periodontal or gum disease is the leading cause of tooth loss in adults. Why? Because it occurs at an age when cavities are usually a thing of the past, and the initial symptoms often go unnoticed.
What causes gum disease? Does it hurt? Wouldn’t I know if I had it?
Gum disease is bacterial infection that attacks the gums and bone supporting the teeth. In its early stages gum disease is not apparent to the patient. Just as high blood pressure is called the silent killer, so is gum disease the silent killer of teeth. We’ve learned a great deal about gum disease in recent years. We are now able to diagnose it earlier and help patients get it under control much better than in the past. The earlier we detect it the sooner we can get it under control. If your gums are bleeding, even slightly, it is a sign of gum disease.
When patients wait until teeth are loose and painful and their gums are oozing it is much more difficult and costly, if at all possible, to get the disease under control.
What are the signs of gum disease?
You should watch for gums that bleed when brushing; red, swollen or tender gums; and/or persistent bad breath.
How can gum disease be prevented?
Gum disease can be prevented by brushing at least twice a day, flossing daily, eating a balanced diet, and visiting your dentist regularly — ideally every six months (or more if recommended) — for a preventive checkup and professional cleaning.
About Tooth Grinding (Bruxism/Clenching)
What is bruxism?
If you wake up with dull headaches or tension pain, you may be one of many people who grind their teeth at night. Many people are unaware they even have the disorder (called bruxism) because it often occurs at night during sleep. Your dentist can usually detect the telltale signs of wear on your teeth. Bruxism is the technical term for grinding and clenching that abrades teeth and may cause facial pain. People who grind and clench, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren’t diagnosed with bruxism until it is too late because so many people don’t realize they have the habit. Others mistakenly believe that their teeth must touch at all times. About one in four people suffer from bruxism, which may be able to be treated by our dentists.
Can bruxism cause harm?
Bruxism can either directly or indirectly cause many problems. Grinding can cause teeth to become painful or loose. Patients can literally grind away parts of their teeth, leaving them with worn surfaces or fractured enamel. People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive and they experience jaw pain and headaches. Forceful biting when not eating may cause the jaw to move out of proper balance.
What are the signs of bruxism?
Grinding is a common occurrence among many people at some time or another. If you develop facial pain, fatigue or other problems, treatment may be needed. Talk with your dentist if you suspect that you are grinding your teeth.
During regular dental visits, we usually check for physical signs of bruxism. If we notice signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy. When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth, which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ) -the jaw articulation- which may manifest itself as popping and clicking. Women, who are more susceptible to TMD, also have a higher prevalence of bruxism possibly because they are more likely to experience tissue alterations in the jaw resulting from clenching and grinding. Tongue indentations are another sign of clenching. Stress and certain personality types are at the root of bruxism. For as long as humans have existed, bruxism has affected people with nervous tension. Anger, pain and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at greater risk for bruxism.
What causes bruxism?
More research is needed to determine the exact cause of bruxism, but it is thought that both emotional and physical factors are involved. Some of the contributing factors may be stress or sleep disorders, an abnormal bite or crooked or missing teeth.
What can be done about bruxism?
There are a number of ways to treat bruxism. Our doctor will determine which single treatment or combination of treatments is right for you. When stress is the major cause of bruxism, people need to find ways to relax. People who have difficulty handling stress may need to seek counseling or our dentist may prescribe muscle relaxants to relax jaw muscles. We many times can prescribe a special type of night guard, which prevents grinding from occurring during sleep. To help alleviate muscle pain, physical therapy may be needed.
The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard that’s worn to absorb the force of biting which causes damage and pain and also helps to change patient behavior.
Why might a night guard or other protective appliance be advisable?
If designed correctly, protective bite appliances help keep teeth from moving, protect ceramic restorations, and protect teeth from wear damage caused by grinding or clenching. A night guard is a plastic mouth guard worn at night to prevent tooth grinding. A bite plate is a removable plastic device, which prevents teeth from coming together. In some cases, such as with an overbite, it may eventually improve the bite. A method used to treat the damage caused by more serious cases of grinding involves reshaping or reconstruction of the biting surfaces with crowns or inlays or a full mouth restoration. We do not recommend any over the counter device commonly found at drug stores to treat bruxism or TMJ problems. Use of this devices may worsen the condition.
About Root Canal Therapy
What Is It and Why Do I Need A Root Canal?
A badly infected tooth or one that just had significant decay or trauma which compromises the tooth nerve can be rescued most of the time through procedures utilized by both the general dentist and the root canal specialist, the endodontist. Extraction is truly our last resort!
How do I know if I need a root canal?
Some indications of the need for root canal treatment may be:
- Spontaneous pain or throbbing while biting.
- Sensitivity to hot and cold foods.
- Severe decay or an injury that creates an abscess (infection) in the bone.
Why should I spend a lot of money on a root canal? Why not just pull the tooth?
Losing a tooth can precipitate further teeth loss. Saving the tooth maintains space, keeps other teeth from shifting, and eliminates the need and cost of a bridge or implant and crown. Although seemingly expensive, it is actually quite cost effective. Remember, once your teeth are gone, they’re gone!
About Teeth Whitening
What is whitening?
Dental Whitening (sometimes called “bleaching”) is a popular dental procedure used to whiten teeth. Some people get their teeth bleached to make stains disappear, while other just want a whiter shade.
How does teeth whitening work?
The active ingredient in most of the whitening agents is 10 percent carbamide peroxide, also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.
What are the different ways to whiten teeth?
There are a number of different ways to whiten teeth. There are accelerated in-office approaches using a light activated technique with the peroxide gel. There are also at-home whitening kits used with a peroxide gel. Also, porcelain veneers can have the effect of whitening teeth to the shade determined by you and your cosmetic dentist.
Is whitening safe? Are there side effects?
A number of different studies have been performed over the years showing this method of whitening to be safe and effective. The American Dental Association has granted its seal of approval to a number of teeth whitening products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.
Why do teeth discolor?
Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. Discoloration also can be caused by your genetic make-up or simply getting older.
How is whitening performed?
Whitening can be performed by our cosmetic dentist in the office or, under dental supervision, at home. Many patients enjoy whitening at home because it is more convenient. Treatment in our office begins when we create a custom mouthpiece to ensure the correct amount of whitening solution (composed of carbamide peroxide) is used and that your teeth are properly exposed. Typically, whitening at home takes two or three weeks, depending on the desired shade you wish to achieve. Whitening in the office may call for one hour and ½ visit to our office.
How do I know if I am a candidate for whitening?
Generally, whitening is successful in at least 90 percent of patients though it may not be an option for everyone. Consider tooth whitening if your teeth are darkened from age, coffee, tea, or smoking. Teeth darkened with the color of yellow, brown, or orange respond better to whitening. Other types of gray stains caused by fluorosis, smoking or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, we may discourage whitening.
How long does whitening last?
Like skin tone, each person is different. In addition to genetics, it depends on how many cups of coffee, glasses of cola, red wine and other staining drinks and food you have cross your teeth. Many people can go from one to three years without significant need for touch-ups in whitening. The ultimate whitening is through porcelain veneers, which can last much longer.
What are realistic expectations with whitening?
No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist’s shade guide. The success rate depends upon the type of stain involved and your compliance. Whitening can only provide a shift in color from gray to a lighter shade of gray, for example. Whitening does not lighten artificial materials such as resin, composite, or porcelain.
What if I have tetracycline stained teeth?
The difficulty presented by staining that results from tetracycline use is that it is not uniform, but usually presents as horizontal light and dark bands. For such teeth, the banding effect will remain after whitening, albeit in a lighter color. The only practical way of eliminating the staining you describe is by covering it up. This can be done by the placement of crowns, or more conservatively by placing porcelain veneers.
My teeth have turned yellow. What can I do?
A good cleaning in our dental office with a prophy jet using baking soda spray is a good start. Professional in-office whitening using a light activated technique, especially when combined with take-home whitening can also help.
My teeth have really dark stains, what can be done?
First, get a hygienic cleaning with a prophy jet, which uses a baking soda spray followed by tooth polishing. This will help determine the type and amount of real discoloration present in the enamel of your teeth. Then, you can either opt for professional in-office whitening using a light activated approach, take-home whitening, or porcelain veneers to get a more permanent whiteness.
Do over-the-counter whitening products work?
Frequently, we hear from people who have not gotten the results they wanted through over-the-counter whiteners. Several factors can contribute to the darkening of teeth, including the effects of age, foods and drinks, smoking and some medications. Darkened teeth caused by oral supplements or medications pose more of a challenge. The whitening process involves placing a whitening solution in contact with the teeth, causing oxidation of stains and subsequent lightening. There are a variety of systems available, ranging from those done in the dental office to dentist supervised at-home systems.
About Dental Fillings
What are the different types of fillings?
The three most common types of filling materials are amalgam, composite, and porcelain.
- Amalgam Fillings – Amalgam fillings (sometimes called “silver fillings”) are a mixture of mercury liquid and small pieces of silver and other metals such as copper, tin and zinc.
- Composite Resin Fillings – A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth. Composite resin dental fillings were created as an alternative to traditional metal dental fillings. Tooth fillings colored to look like a natural tooth are known as composite resin fillings and are made of a plastic dental resin. Composite resin fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use. 3. Porcelain Inlays and Onlays — The real advances have been made in laboratory processed white porcelain fillings called “inlays” and “onlays”. They are beautiful, strong, and usually long lasting. The cost is similar to a gold “inlay” or “onlay”.
My old fillings in the front have turned dark. Can they be bleached?
Amalgam fillings, bonding and composite resin fillings do not bleach. If you are unhappy with the look, it is time to replace those. There are now many ways to restore teeth with materials that virtually disappear and blend with the natural color of your teeth. Remember, only replace these fillings and bonding after whitening in order to match the new improved color of your own natural tooth.
How are composite fillings placed?
Following preparation, we place the composite in layers using a light specialized to harden each layer. When the process is finished, we will shape the composite to fit the tooth. We then polish the composite to prevent staining and early wear.
Why are porcelain inlays/onlays used for larger cavities or restorations?
In cases with larger cavities or broken down areas, an inlay or onlay to cover more of the tooth’s surface may be indicated. These restorations are indirect because they require two visits and fabrication by our dental laboratory. The ceramic restorations are considerably more expensive and therefore simple, one-visit composite fillings are typically used instead for small fillings. Ceramic restorations are much more durable and will not stain. Naturally speaking, the final result with ceramics is spectacular. White inlays or onlays are actually glued into the tooth and there is now a body of research that claims that because of this the tooth ends up stronger after such a procedure, less prone to problems down the road.
Do cavity fillings need to be obvious?
New advances in tooth-colored porcelain and composite materials not only allow fillings to go unnoticed, but in many cases are stronger and more wearresistant than amalgam (silver fillings).
About Full Mouth Restoration
What is meant by a “full-mouth restoration”?
In short, a full-mouth restoration (or sometimes called reconstruction or rehabilitation) is the individual restructuring of each and every tooth in a mouth. FMR is called for where the teeth are worn down, broken down or missing, causing problems in both the bite and appearance of the mouth. The most common solutions to these problems are crown, veneers, onlays, and bridge work. FMR in the hands of a highly skilled dentist is usually so successful that others cannot discern the real teeth from the restoration. This technique involves some easy preliminary information gathering. Reconstruction is completed in just two appointments – a preparation appointment and a seating appointment. During the preparation appointment all old restorations and any decay are removed, impressions are made of the underlying healthy tooth structure and beautiful temporary teeth are made. These temporaries are worn until the seat appointment, about three weeks later. This appointment involves removing the temporaries and bonding on the final restorations.
My teeth are really broken down and worn. Can the youthful smile I had years ago be recreated?
In many cases, the answer is, “yes.” If you have teeth that are worn, shifted, missing, broken, or a combination of these, then FMR may be the answer. FMR is designed to restore your smile and, at the same time, make eating easier and more comfortable. Cosmetic dentistry has evolved dramatically in recent years. Many people have old dentistry that was done in bits and pieces. Much of it has worn resulting in collapsed bites and difficulty with chewing. This wear and patchwork quilt of old dental work creates an appearance that can age you beyond how you feel. Furthermore, a poor bite can cause jaw joint problems, muscle tenderness, and even headaches. Chewing and speech may be affected, as well.
How do I know whether I am a candidate for full-mouth restoration?
If you have teeth that are in very poor health or those who have worn them excessively over time, you should consider this procedure. You probably have lost vertical dimension if your teeth appear short, show signs of wear, or if your top teeth nearly or completely overlap your lower teeth. This “vertical dimension” is typically lost from decay or from teeth “grinding” (often from stress and/or misalignment of teeth). Other signs of lost vertical dimension are pains in the joints located near your ears, headaches, back pain, muscle pain, clicking and or popping of the jaw joints. Vertical dimension is restored by physically adding to the biting surfaces of all teeth. A material similar to porcelain is used to enhance the height of teeth in the form of a typical crown. It has been estimated that approximately 80% of the general population have lost some Vertical Dimension.
Why should you choose our office for Full Mouth Restoration?
Full mouth reconstruction is a demanding area of dentistry that often requires a combination of many disciplines. Most importantly, it requires planning and advanced skills on part of the cosmetic dentist. Our doctor has extensive training in Full Mouth Restoration.
About Crowns
What is a crown?
A crown is a restoration that covers, or “caps,” a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won’t solve the problem. If a tooth is cracked a crown holds the tooth together to seal the cracks so the damage doesn’t get worse. Crowns are also used to support a large filling when there isn’t enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.
How does a cosmetic dentist place a crown?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums are made and sent off to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown in made. On the next visit, the cosmetic dentist removes the temporary crown and cements the permanent crown onto the tooth.
I have seen people with crowns that look “fake” or that have a dark line at the gum line of the crowns. What causes that?
This is usually caused by the metal margin of a porcelain fused to metal (or PFM) crown. In the “old days,” many dentists used PFM crown, but now in most cases, cosmetic dentists use all porcelain crowns, which provide virtually the same strength but are highly superior in their aesthetic result.
Why would someone want an all-porcelain crown?
Some restorations are designed with a metal lining, covered with porcelain (porcelain- fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually look opaque or “flat” because they do not let light pass through like a natural tooth. There is often a noticeable dark line next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). All-porcelain restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).
Why would the cosmetic dentist recommend crowns instead of veneers?
Crowns require more tooth structure removal; hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
What can be done to replace a missing tooth?
Cosmetic dentistry now offers options beyond having a partial denture. One option is to have an implant and crown placed. An implant is a titanium cylinder that is placed in the bone (under the tissue) and functions to replace what was once the root of the tooth. After a period of 5–6 months a stress or load can be placed into this implant and then the crown is placed over the abutment. This tooth is now cared for like all the other teeth in your mouth. Another option is a bridge. A bridge is like a crown that is bonded to the teeth on either side of the missing tooth. Some people prefer to not go through the surgical procedure of having the implant placed. Others prefer to have a quick fix and to not go through the waiting period of 5–6 months before a crown can be placed on the implant.
What can I expect on my first visit for the crown procedure?
As soon as you are seated, we will numb the area to be worked on using a local anesthetic. Depending upon the type of local anesthetic used, you can expect to feel numb for one to four hours. If your anesthesia should last longer, do not be concerned. Individuals react differently to anesthesia. While the area is numb, please be careful not to bite your lip or tongue. You may want to consider a soft diet or no meal at all while until your sensation returns in the affected area. Once the appropriate area is numb, the doctor will prepare the tooth to maximize the function, retention and aesthetics of your new crown. After the tooth is fully prepared, we proceed to the impression stage where we create a model of your prepared tooth for our lab to custom-fabricate your crown. Should you experience any discomfort you can take a mild analgesic (Tylenol, Advil, or aspirin, etc.) as long as there is no medical contraindication based upon your medical history. Typically, you can take anything you would normally take for a headache. If the discomfort persists, please call our office.
How should I care for my crowns?
To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects – just like you should avoid for your natural teeth. You also want to avoid teeth grinding. Besides visiting our office, and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.
About Bridges
What is a bridge?
A dental bridge is a false tooth, known as a pontic, which is usually fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This cosmetic is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but can last as many ten years or more.
Is it possible to have a porcelain bridge affixed to your teeth without having any clasps or metal appearing?
Yes. If you are an appropriate candidate, a porcelain bridge can look as natural as (or in many cases better than) your own teeth, in color and shape, in proportion and alignment, with no clasps or metal appearance. Some bridges are designed with a metal support structure or a metal lining, covered with porcelain (porcelain-fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually can often look opaque or “flat” because they do not let light pass through like a natural tooth. There can also be a noticeable dark band showing through the teeth or showing next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). All-porcelain bridge restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are virtually as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).
Who is a candidate for a bridge?
If you have one or more missing teeth and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease.
How is a dental bridge placed?
We prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and then remove an area from each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help as a foundation for the crown. We will then make an impression, which will serve as the model from which the bridge, false tooth, and crowns will be made by our dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums. On your
second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted and checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth.
About Porcelain Veneers
What are porcelain veneers?
These are also called “porcelain laminates,” “porcelain laminate veneers,” and just “veneers,” For our purposes, we will just call them veneers. Veneers are formed porcelain shells that are used to create a new front surface to a tooth. These are thin sculpted pieces of tooth-shaped porcelain that fit over the front of the teeth and are the premier standard of care in cosmetic dentistry. Permanently bonded to the front surface of a tooth, to restore or improve position, shape and tooth color, they can make a dramatic, immediate difference to one’s smile and overall facial appearance. Veneers are wonderful for fixing common problems such as midline spaces (the gap-toothed look of the two front upper teeth) or chipped, crooked, missing, discolored, pitted, malformed or improperly positioned teeth. Once only accessible to the wealthy and top Hollywood stars and models, veneers are now a popular way for many people to obtain the smile of their dreams.
Is there really a difference between the porcelain veneers you can get from one cosmetic dental office and another?
Yes, there is a real blend of art and science behind high-end aesthetic dentistry. All veneers are not created equal. Our doctor has extensive training in the art of smile design, which determines the colors, line angles, shapes, thickness, translucency, occlusion, and many other factors that our doctor prescribe to our laboratory. Our lab then hand makes the veneers to our specifications. Veneers should be custom-designed to fit your face, smile, gender and personality. Done correctly, they look and feel like real teeth. You can be as much a part of the selection process as you wish, but part of why you select a cosmetic dentist is his or her experience and artistry in what looks great. Computer imaging as well as before and after photos of other cases will help you decide on the style, shape and color that work best for you. Veneers are bonded in place with a high intensity curing light. You can tell the quality by the photos of the work you see in our office.
How are porcelain veneers made?
Veneers are made from a thin shell of porcelain and are permanently bonded to the teeth. Our selected, world-class dental ceramists fabricate the veneers from our impressions and color mapping specifications. Each veneer is customdesigned to fit naturally and comfortably over each tooth like a ballet slipper. After placement, these veneers are designed to look like beautiful, natural teeth.
What are porcelain veneers used for?
Veneers can be used to correct the size, shape, color and alignment of teeth. So if your smile suffers from teeth that are stained, crooked or malformed for any reason (cracks, chips, fractures, spaces, smoking or tetracycline stains, etc.), then you may be a great candidate for porcelain veneers. Many people want straighter teeth without the hassle and time orthodontic braces require. Now teeth can be straightened with porcelain veneers and crowns. Most people can get the shape, length and degree of whiteness they want, and they don’t stain! But what many people don’t realize is that the shape of veneers in combination with occlusal adjustments, such as opening the bite, can also have profound impact on the entire face. This can result in giving the appearance of a face-lift or elimination of wrinkles without any plastic surgery. So in developing your personalized Smile Design, we take into account building out certain teeth or reduce others to achieve such desired objectives. This is why for a number of our quests, they actually look 10 years younger after our Smile Designs and just imagine their rejuvenated spirit!
What’s the difference between plastic veneers, bonding and porcelain veneers?
Composite bonding (also sometimes called “direct veneers” or “plastic veneers”) is a tooth-colored plastic resin material. Bonding can usually be placed in one visit and is used many times to repair a smaller chip in a tooth or to make aesthetic improvements in more than one tooth. Bonding usually requires little to no tooth reduction or anesthesia. Because they are made out of porcelain in a lab, porcelain veneers are usually more aesthetic in terms of the spectrum of colors, realism and translucency. Porcelain veneers are also more of a long-term solution than bonding, as they do not stain, discolor, and are stronger than bonding. Porcelain veneers usually require only a couple of office visits – the first visit to prepare the teeth and the second to seat the veneers.
How quick can porcelain veneers give me a gorgeous smile?
Our quests can usually get the smile of their dreams in a couple of visits. At the first veneer appointment, your teeth are prepared, impressions are taken, and you will walk out of the office with custom temporary veneers. In the second appointment, we permanently seat the veneers. Imagine getting a new smile within one month — one that actually fits your face and personality and gives you the confidence to express the real you!
I’m an adult, and don’t want to go through braces. Can veneers help correct my crooked teeth faster than orthodontics?
Porcelain veneers are a perfect alternative to braces for many adults. Veneers can correct the shape of teeth that are not aligned correctly, have gaps and spaces. Older patients, who have always wanted straighter teeth but no desire to undergo years of treatment with braces, usually love this new technique. Instead of months and years in braces, crooked teeth can usually be corrected in as little as two weeks with veneers. In fact, even if you have had braces in the past but the size and shape of your teeth is not pleasing to you, veneers may be the perfect solution. See our Before & After photo gallery for amazing examples of what “instant ortho” looks like.
What are the pros and cons of braces vs. veneers?
Braces are most desirable for people under the age of 18. At this stage in life, the bone is more malleable, teeth move easier and are more likely to stay once the bone “remodels” around the newly positioned teeth. Many adults also wear braces, but for a longer duration and almost always need a permanent retainer to hold the new positioning. There are numerous office visits in addition to the general hassles of wearing braces. Also, teeth may be repositioned, but continue to be the same shape and color which may or may not be desirable. Orthodontic braces, however, do not require the teeth to be reshaped or restructured in any way. Sometimes called, “instant ortho,” veneers can give the appearance of straightening teeth, closing gaps, and changing the shape of teeth to give a perfect smile. A veneer is a thin shell of porcelain. After the enamel on teeth is reduced, usually only slightly, the veneers are bonded in place covering the visible part of a tooth. Seated correctly, they are strong and should last a very long time. The bite is most often enhanced and veneers do not stain or discolor.
How are the teeth prepared for porcelain veneers?
Unlike crowns, usually only a thin layer of enamel is removed from the teeth to make room for the veneers. Usually, only about 5/10 to 8/10 of a millimeter is removed from the outer surface. This small amount of reduction is required to make room for the porcelain. This allows us to make the veneers to the proper contour without them appearing to be bulky or unnatural. Some teeth on some individuals may not need any tooth reduction, and some may require a lot.
How are porcelain veneers placed on the teeth?
New advances in bonding technology allow us to create an extremely strong bond between your teeth and the veneers. The teeth are first prepared with a bonding adhesive and special resin cement is used as the “glue.” The resin cement is available in a number of different colors to give the best possible aesthetic result. After approval, resins are then used to permanently bond the veneers to the teeth using a special dental curing light, which helps to create a stronger, longer-lasting bond between the veneer and your tooth. The durability, look and simplicity of application make it easy to see why veneers have become one of the most popular cosmetic dental treatments available today.
How many porcelain veneers are needed for a new Smile Design?
This depends entirely on the desired result. If there is only one tooth that is discolored or malformed, then a single veneer may be able to be used. To get a more balanced and even looking result, many times it is recommended that several veneers (from 4 to 8) be done at the same time. This allows us to get the most beautiful result possible. When closing large gaps between teeth, 6 to 10 veneers may be necessary to get a proper aesthetic result.
How long will porcelain veneers last?
There are no hard and fast rules about how long porcelain veneers will last. While you can certainly expect your veneers to last many years (some patients have had them for 20 or more years), it is unrealistic to expect them to last forever. With good home care and by exercising good judgment, it seems likely that a porcelain veneer could last well in excess of 10 to 15 years. Ask about our limited warranty.
Will my teeth be sensitive after I get porcelain veneers?
Some people experience sensitivity (to hot and cold or pressure, etc.) after the placement of veneers. Some sensitivity is absolutely normal and usually dissipates spontaneously from a day or so to a couple of weeks. The reason for the sensitivity can arise from the amount of enamel left on your tooth after preparation, the proximity of the nerve, as well as several other factors. If this sensitivity remains or concerns you at all, please contact your cosmetic dentist.
Will I need to change my diet after getting porcelain veneers?
Once placed, your veneers are very strong and will resist most of the forces placed upon them by a normal diet, so a normal diet should pose no problem at all. Porcelain has great crushing strength but poor tensile strength. Therefore, you should avoid anything that will bend or twist the veneers. As with your regular teeth, opening bottle caps with your teeth or crunching on hard candy or ice is not a good idea.
How do you maintain new porcelain veneers and what follow-up care is recommended?
With proper home care and scheduled dental visits, veneers can provide you with a beautiful smile for many years. A week or two after the placement of your veneers, we ask that you return to our office for a cosmetic polish and treatment evaluation. This visit is extremely important. It gives us the opportunity to evaluate the placement of the veneers, the tissue response and to answer any questions you might have regarding your new smile design. For example, if you grind or clench your teeth, please let us know. We can fabricate a soft night guard for you to wear to minimize the stresses placed upon your teeth while you sleep. The maintenance of your porcelain veneers is relatively simple. Brush and floss as you normally would to prevent oral hygiene problems. Once placed, veneers are typically the kindest restoration to the gum tissues that we currently have available. Don’t be afraid that you’ll damage your veneers by either flossing or brushing. Any non-abrasive toothpaste is acceptable. A good home care regimen will help ensure the aesthetic success of your veneers.
When would porcelain veneers maybe not be right for me?
- If you have unhealthy teeth. Porcelain veneers cannot be placed on teeth where there is decay or active periodontal disease (gum disease). These conditions must be treated by your dentist before porcelain veneers can be successfully fabricated and placed.
- If you have weakened teeth. If a significant amount of tooth structure has been lost as a result of decay or fracture, or else already replaced by a dental filling, the tooth may not be a good candidate for a porcelain veneer. Porcelain veneers do not significantly strengthen the teeth on which they are placed. Teeth that have, or have had, a history of a loss of a significant amount of tooth structure are usually better treated by placing a dental crown on them, not a porcelain veneer.
- If you have an inadequate amount of tooth structure. Some teeth, as a result of excessive wear or previous attempts at dental work, may have inadequate tooth structure. These teeth do not make good candidates for porcelain veneers.
- If you clench or grind your teeth. Persons who clench and grind their teeth can make poor candidates for porcelain veneers. The forces created by these activities, termed bruxism by dentists, can easily chip or break porcelain veneers. Possibly a person can successfully control their bruxing habits during their waking hours, but during sleep a bruxer has essentially no control over this activity. If a person who bruxes does have veneers placed, they must be committed to wearing an acrylic dental night guard when they sleep so to minimize the amount of stress placed on their veneers.
Are veneers my only option if I want a smile makeover?
Not necessarily. Our cosmetic dentist will determine the cosmetic dentistry procedures that would be the best for you and give your options. The dentist’s suggestions will be based on your desires and a thorough examination to determine the condition of your teeth and what problems, if any, may require dental treatment. Therefore, your smile makeover could involve teeth whitening, crowns, composite bonding, gingival sculpting, inlays and onlays or any other combination of cosmetic dental procedures that your dentist determines is right for your cosmetic treatment plan.
About Cosmetic Dentistry
What is cosmetic dentistry?
Cosmetic dentistry is dental treatment that improves the beauty and health of one’s smile. Nearly every dental procedure has 2 elements: Aesthetics and function. Quality cosmetic dentistry takes both of these elements into consideration; so that one may rest assured they will not only look great, but enjoy hassle free long-term results.
What are some examples of cosmetic dentistry procedures?
Cosmetic dentistry covers a multitude of procedures from smile teeth whitening to repairing, straightening, replacing or enhancing the appearance of one’s teeth and smile. Most common is the use of Cosmetic Veneers or Laminates. These thin, but durable restorations are much more conservative to the natural tooth than traditional crowns, and have become a very popular way to enhance a smile. In certain procedures dental bonding can be a way to shape teeth as well.
Why would someone need or be interested in cosmetic dentistry?
Cosmetic dentistry provides more than just a beautiful smile and a healthy mouth. According to the American Academy of Cosmetic Dentistry (AACD), cosmetic dentistry has also been shown to improve a person’s overall health and emotional well-being. An improved smile can boost a person’s self-image, making them more confident in their daily lives.
How has technology improved in cosmetic dentistry?
Cosmetic dental techniques have advanced dramatically over the last decade. The qualities of materials such as porcelain and composite resins have improved, giving a more lifelike appearance. And, where gum-tissue surgery and contouring was once performed with scalpels, lasers now provide fast, nonsurgical results.
How Do I Choose A Cosmetic Dentist?
A very important question. For the best results, it is important to know the qualifications and experience of the treating cosmetic dentist. The term “cosmetic dentistry” has become trendy and many dentists are promoting themselves as cosmetic dentists. At this time, cosmetic dentistry is not a recognized specialty (like orthodontics, for example). However, it is a discipline of dentistry that requires a thorough knowledge of science and an artistic eye. Ask your cosmetic dentist about his or her training, credentials, and experience in this area. A very effective way to understand your dentist’s skills is asking to see their portfolio of before and after photographs. Dentists who are dedicated to the art of cosmetic dentistry always take photographs of their cases.
Is there a standard beautiful smile for all people?
No. Each person is different and each case is different, and has to be planned very carefully. There are many differences between male and female teeth and between all people. The design of the teeth has to be in proportion with the gum line, the lips, and the construction of the face of each individual to achieve a beautiful and natural smile.
How white should I get my teeth?
In adolescence we generally have a white, bright smile but over the years our teeth pick up stain and become discolored. When undergoing cosmetic dental procedures the question then is how pearly white do we want to make your teeth? Many people are choosing shades that are whiter than in years past. Brilliantly white, opaque teeth on older individuals are a true sign they have undergone some type of cosmetic dentistry. In our office we strive to give your smile a sense of realism, we call it perfect imperfections. You will attain a beautiful white esthetic outcome, but there will still be a sense of realism.
How can I get an idea of how I would look with an improved smile?
The first thing we do is listen – to what your desires are for your smile. We then can perform computerized cosmetic imaging. We simply take a number of photos showing different views of your face with a digital camera. We then use graphic artist software to generate a computerized image showing you with various smile enhancements. We work with you to determine things like how white you would like your smile, the shape of your teeth, and other aspects of your smile. Cosmetic imaging, although an artificial rendering, can assist in giving you a better idea of what you can look like after cosmetic dental improvements. We also may want to have our dental lab perform a “wax-up” of your new smile, which would show in life-like, tangible form the proposed treatment.
How long do your cosmetic dental procedures take?
In most cases, bonding can be completed in one visit. Accelerated whitening can be completed in one visit. At-home whitening requires an initial visit to be fitted for the splint. You need to return in a few days to pick-up your splint and we make sure it is fitted properly. Then depending on how often you wear the splint, you should see results from the first wearing to a few weeks or more. Porcelain veneers require two visits, about 10 days apart for fitting and application. Since each person’s cosmetic dental needs are unique, the above time guidelines are only an estimate. When we develop your customized treatment plan, we can give you a more precise schedule based on your cosmetic dental needs.
How long will cosmetic dental treatment last?
There are too many factors to accurately predict how long any cosmetic dental treatment will last. The longevity of cosmetic treatment varies from procedure to procedure and person to person. The condition of the teeth prior to treatment influences the longevity of the restorations. Home care (hygiene) and eating habits are part of the equation. Of course, the quality of the treatment itself influences the long-term outcome as well. And, we do our best to deliver high-quality treatment that will last many years. Regular visits to the cosmetic dentist can help insure that your dental treatment is being maintained. While there is nothing we can do to render a tooth completely immune to future problems, preventive maintenance will prolong the life of your cosmetic dental treatment for many years. For estimated time frames for specific procedures, look at the treatment sections on this website or come in for a consultation for a more personalized estimate.
Are there cosmetic dentistry procedures that can be performed on children or teenagers?
There are many reasons why children and adolescents may want a better looking or prettier smile, such as for better socialization, enhanced self-esteem and greater confidence. Depending on your child’s age and where he or she is in the development of his or her teeth and dental arches, some cosmetic dental procedures may be suitable if there is a specific problem that needs correcting. For example, some children and adolescents may have severely discolored teeth as a result of taking certain medications. Or, the front teeth may have been fractured due to an accident or sports injury and require composite bonding or veneers. In other instances, there still may be slight gaps or spaces between the teeth even after orthodontics, so perhaps composite bonding would enhance the look of the smile. If your child or teenager is concerned about the appearance of his or her smile, make an appointment to see your dentist. He or she will suggest the most appropriate course of action based on your child’s age, oral condition and desires, as well as possibly refer you to a cosmetic dentist for consultation.
What is Cosmetic Dentistry?
Sometimes called aesthetic dentistry, cosmetic dentistry can be described as any one or more dental treatments that improve the beauty of your smile that vary from re-contouring the teeth or gums to placing porcelain veneers or crowns on a number of teeth. Although many general dentists may claim to practice cosmetic dentistry, it is truly an art form taking years of training, education and experience not taught in regular dental schools to master. It is grounded in the healthy enhancement, restoration and maintenance of a customized smile design. To obtain optimal results, it requires the application of advanced scientific techniques, skills, materials, and high tech equipment.
What to Expect on Your First Visit?
We believe that a comprehensive first exam is the best way to begin the process of obtaining a healthy, beautiful smile. Our goal is to give our clients the necessary information and education so that they may enjoy a beautiful, healthy smile for years to come. Here is what to expect:
- When you arrive, your treatment coordinator will help you fill out the necessary paperwork. We continue with a one-on-one discussion covering your pastdental history and present concerns.
- After that, your dental assistant will call you from the waiting room into one of our treatment rooms. There you will comfortably seat and have aprofessional dental cleaning, along with some X-Rays, if needed.
- While you have your cleaning, the doctor will be revising your records and radiographs so that when you are ready, he will finish with a comprehensiveexam and discuss his findings. He may recommend treatment and schedule an appointment, and determine your best time for a re-care visit and cleaning. If your
needs are more ample, he may take additional records and schedule for a complete treatment plan presentation.
- once you’re done, your assistant will escort you to the front desk, where you will be guided for your check-out and schedule your next visit.
Health and Safety
Radiation Safety
Are you concerned about the recent news on dental X-Rays? We are too! At Dietrich Dental, we use digital X-rays to minimize your radiation exposure.
Recently, there have been a number of media reports that have discussed a study that associates frequent dental X-Rays to an increased risk of developing a non-cancerous meningioma brain tumor. Here is some information to help ease any concerns you may have:
- Our office uses digital X-Rays that have 90% less radiation than traditional X-Rays.
- Most importantly, we want to ensure that radiation exposure is as low as reasonably achievable. As dentists, we must balance the small risk of dental X-Rays against the benefits of them. They are valuable because many oral diseases cannot be detected on the basis of a visual and physical examination alone.
- Such radiographs provide important diagnostic information about a patient’s oral health such as early-stage cavities, gum diseases, infections, and even some types of tumors.
- How often dental X-Rays should be taken depends on the patient’s oral health condition, age, risk for disease, and any signs and symptoms of oral diseasethat the patient may be experiencing.
What is a reasonably “safe” level of radiation?
It is important to note that you are going to receive a certain amount of radiation just by going through your normal daily activities. For example, you receive background radiation from concrete buildings, roads, and of course the sun. To put things in perspective, just standing around outside for several minutes, you receive more than three bitewing x-rays worth of radiation every day. Each time you fly from coast to coast on an airplane you receive radiation amounts equivalent to eight dental bitewing x-rays.
Dental Sterilization and Infection Control
Comfort comes in many forms. Our sanitary standards create a worry-free environment that extends comfort even after your visit.
All instruments connected to the water system that touch patients are heatsterilized after each patient’s use in a process called autoclaving. Items that are not heat-sterilized are disposed of and a new one is used for each patient.
Dietrich Dental meets or exceeds the safety and sterilization guidelines recommended by the American Dental Association, Georgia Dental Board and OSHA. We constantly upgrade our infection control techniques by attending frequent courses and holding regular staff meetings so as to insure your safety and peace of mind. Some of the measures we employ include:
- Wearing gloves, masks, and protective gowns during each patient examination and treatment.
- Sterilizing all instruments placed intra-orally in an autoclave or ultrasonic cleaner for germ free use.
- Cleaning and sanitizing each exam room between patients.
- Consistently using a contracted sterilization monitoring service to ensure the effectiveness of equipment
- Utilizing safety techniques to prevent cross-contamination by properly disposing of all products that are unable to be sterilized
- Sterilization of all dental hand-pieces (drills).
- Covering patient chairs, x-ray units, and light handles with disposable plastic wraps
- Using filtered water supplied to dental hand-pieces and air/water syringes
Does it cost a lot?
The question sometimes arises, “How much does dentistry cost?”
This is a broad question and the answer can vary as widely as the question, “How much does a car cost?” The answer is that the price varies depending on the quality, design, and workmanship that you want in the finished product as well as the care and attention that you receive along the way. Although sometimes inquiries are only about cost, that should not be the determining factor. Just as if you were selecting a brain surgeon, or even a restaurant or hotel for that matter, you wouldn’t want to make your selection based on price alone.
First, Ask Yourself:
- What is your smile worth to you?
- How having a healthy mouth and a confident smile it make you feel?
- How could a beautiful new smile change your life?
- Like all purchases, cost is relative to value. To some, a luxury vehicle is expensive, but to others, it’s a great value. No two patients are alike. Andin our practice, all dentistry is tailored to the individual needs and wants of the patient. The cost of our cosmetic procedures for any one patient can range from as little as a few hundred dollars to thousands. That’s because dental and cosmetic procedures can be from entry-level procedures such as tooth whitening to complex full-mouth restoration cases. We believe each patient should have the benefit of a prescribed combination of treatments best suited for each.
Cost Factors
Factors that influence our fees include our investment in top of the line materials, our dental technology, commitment to continuing education, the credentials of our dentist and staff, and our world-class service. These things, among many others, set our office apart.