Six Month Smiles® is a modern twist on tried-and-true orthodontics. There is little debate within the orthodontic community that braces are the most widely used and most effective method to give patients straight, healthy teeth and a beautiful smile. Six Month Smiles has taken the best aspects of braces and modified the treatment and the materials to give adults a common-sense, cosmetic solution that fits your lifestyle. Here is what makes Six Month Smiles so innovative.
Average treatment times of only six months
Six Month Smiles' clear brackets and tooth-colored wires are barely visible
Use of braces as opposed to appliances, aligner trays, or veneers provides optimal final result
Six Month Smiles Patient Tray Kits ensure that your appointments are fast and comfortable
Low forces and short overall treatment time increases safety and hygiene
Six Month Smiles is typically less expensive than traditional braces, Invisalign®, or veneers
Is Six Month Smiles® right for you?
The best way to find the answer to that question is to contact a Six Month Smiles certified provider Bensonhurst Dental Care and schedule a consultation. However, by answering the following questions related to your lifestyle and your expectations we can help you determine if you should consider taking that next step. Questions to ask the doctor during your six month smiles consultation:
After you take impressions of my teeth how long will it take to get my Six Month Smiles Patient Tray Kit™ back from the Six Month Smiles lab?
After my teeth are straight are there any other cosmetic treatments that you would recommend for me such as whitening, bonding, or veneers?
Based on your initial assessment, about how many months do you expect that I will wear Six Month Smiles braces? (average is six months)
What type of retention do you recommend after treatment?
I understand that Six Month Smiles will not correct a severe overbite or underbite. Do either of these factors exclude me as a candidate?
Can you explain to me the differences between Six Month Smiles and traditional or comprehensive orthodontics? Which option is best for my situation?
Do you have any "Before & After" photos that you can show me or photos of patients wearing Six Month Smiles braces?
What types of payment options or payment plans do you offer?
Can you check to see if my insurance plan will cover a portion of the cost?
How soon can I come in for a records appointment?
F.A.Q.
How can teeth be straightened in only six months?
The Six Month Smiles technique employs the latest technology and techniques in dentistry to move your teeth quickly and safely. The key components of the treatment are the use of special nickel titanium wires and a primary focus of moving the teeth that show when you smile.
Six months sounds good, but will I still have a mouth full of metal for the whole time?
No! Six Month Smiles dentists use tooth-colored braces that are barely visible. The wires are tooth-colored as well. These are nothing like metal braces!.
How are Six Month Smiles braces more comfortable than regular braces?
Six Month Smiles braces use low force to move teeth more comfortably. Many people think that the accelerated treatment means simply "tightening" regular braces to get the teeth moving, but that is not true. Six Month Smiles utilizes standard orthodontic mechanics, but with an emphasis on the cosmetic appearance of your teeth rather than the position of your bite.
Do Six Month Smiles braces damage the teeth, roots, or gums?
There are no more risks of root damage or other issues than those associated with traditional orthodontics. Since the forces used with Six Month Smiles braces are lighter and teeth are seldom extracted, there are actually even fewer risks involved with Six Month Smiles orthodontics.
Will I have to wear a retainer?
Yes, as with any teeth-straightening treatment a retainer is necessary to maintain the straighter position of your teeth. If you don't want to wear a removable retainer, you can have a bonded retainer placed. There are a variety of options that you can choose from according to your personal preference and situation.
What's the catch?
There is no catch. If you are an adult (15 years and older) with crooked or spaced teeth and you're not looking for a major alteration to your bite, this could be the solution for you! Most adults ARE candidates for Six Month Smiles.
Comparison Chart
How does it work?
Six Month Smiles
Six Month Smiles utilizes clear braces to gently align teeth in an average time of only six months. The shorter treatment times are achievable by focusing only on your teeth that show when you smile. It's a revolutionary cosmetic-focused treatment designed to correct what bothers you most about your smile.
Traditional Braces
Traditional braces usually involves metal braces to make major bite changes and align back teeth, not just the teeth that show.
Invisalign
Invisalign utilizes a series of clear aligner trays to move teeth. Some types of tooth movement are nearly impossible with this technology and the ability for the patient to remove the trays may prolong treatment
Average treatment time of only six months
Six Month Smiles
Available.
Traditional Braces
No. Avg treatment time is 2 to 3 years.
Invisalign
No. Avg treatment time is typically 12 to 18 months or possibly longer depending on the compliance of the patient.
Nearly Invisible
Six Month Smiles
Available.
Traditional Braces
No. Metal wires and brackets are typically used with traditional braces because they are more durable and able to withstand the long treatment times.
Invisalign
Available.
Affordable
Six Month Smiles
Available.
Traditional Braces
Typically 20% - 30% more expensive than Six Month Smiles.
Invisalign
Typically 20% - 30% more expensive than Six Month Smiles.
Most patients are candidates
Six Month Smiles
Available.
Traditional Braces
Available.
Invisalign
No. Aligner therapy is limited in the types of tooth movement it can achieve so fewer patients are ideal candidates.
Predictable final result
Six Month Smiles
Available.
Traditional Braces
Available.
Invisalign
No. Invisalign utilizes a series of trays that are fabricated by a computer at the beginning of your treament. Often times the computer's predicted results do not match how your teeth actually move resulting in inconsistent results and multiple refinement stages of treatment. Occasionally, Invisalign cases have to be "finished" with several months of braces.
Gum and Bone
Professional dental cleanings are needed at least twice a year to maintain good oral health. Many people require a routine cleaning three or four times a year because of the buildup of plaque and tartar that they accumulate.Periodontics is that specialty of dentistry that encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. If you have been told you have periodontal (gum) disease, you're not alone. An estimated 80 percent of American adults currently have some form of the disease. Periodontal diseases range from simple gum inflammation to serious diseases that result in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost. Gum disease is a threat to your oral health. Research is also pointing to possible health effects of periodontal diseases that go well beyond your mouth (more about this later). Whether it is stopped, slowed, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.
We are on the same team!
Dental health begins with good oral hygiene. This requires professional care and guidance provided by us, combined with proper care at home by you. When you follow our recommended home care routine and have regular professional care, you will be able to maintain healthier teeth and gums. When you do your part at home for 365 days a year, it makes the few visits to our office that much more enjoyable. Please see How to Brush and How to Floss for more information.
Why do I need a prophylaxis (professional cleaning)?
Professional cleaning removes plaque, calculus (tartar), and stain from your teeth. The cleaning is done by a dental professional in the dental office and we provide education in proper care of the teeth and gums.
What is plaque?
Plaque is a soft, sticky, colorless film of bacteria constantly forming on your teeth. It combines with sugar and other carbohydrates to form acids, which attack tooth enamel that can cause cavities. Plaque can also cause inflammation of the gums (gingivitis), which can result in swollen and bleeding gums. If not treated early, gingivitis can lead to periodontitis, a more serious condition that causes gums to recede and bone to deteriorate. As a result, the supporting structures are weakened and teeth become loose. Its easy to see why brushing and flossing to remove plaque is essential to keep your teeth and gums healthy.
What is calculus (tartar)?
Minerals in saliva combine with plaque at the tooth surface and harden into a rough, unsightly deposit called calculus (tartar). Calculus, which is mostly mineral, provides a rough surface to which more plaque can attach, and makes thorough plaque removal more difficult. Your toothbrush and floss can't remove calculus once it has formed and it can only be removed during a regular dental prophylaxis.
What does a professional cleaning do that I can't do for myself?
A prophylaxis is a professional cleaning procedure that can be done only by a dentist or hygienist. The prophylaxis not only helps prevent gum disease, but also improves the appearance of your teeth by making them look clean and bright. A prophylaxis is usually performed in two steps. Instruments called scalers are used to remove calculus from teeth above and below the gumline. Then polishing with a special paste, by means of a motorized instrument, removes the remaining plaque and surface stains caused by various foods, beverages, tobacco, etc. A polished tooth surface makes it more difficult for plaque and debris to accumulate. You can help improve your oral hygiene by making plaque control part of your daily routine. Proper brushing helps remove plaque from the outer, inner and chewing surfaces of your teeth. Flossing thoroughly helps remove plaque and debris form between the teeth, especially in hard-to-reach areas at and slightly under the gumline.
What causes periodontal disease?
Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless "plaque" on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form bacteria-harboring "tartar" that brushing doesn't clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.
Gingivitis
The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called "gingivitis." In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.
Periodontitis
When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth.") In periodontitis, gums pull away from the teeth and form "pockets" that are infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
Who gets periodontal disease?
People usually don't show signs of gum disease until they are in their 30s or 40s. Men are more likely to have periodontal disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to buildup along and under the gum line.
How is periodontal disease treated?
The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. Additionally, modifying certain behaviors, such as quitting tobacco use, might also be suggested as a way to improve treatment outcome.
How can I tell if I have gum disease?
Symptoms are often not noticeable until the disease is advanced. They include:
Bad breath that won't go away
Red or swollen gums
Tender or bleeding gums
Painful chewing
Loose teeth
Sensitive teeth
Symptoms May Signal a Serious Problem
Any of these symptoms may signal a serious problem, which should be checked by a dentist. At your dental visit:
We will ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to periodontal disease.
We will ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to periodontal disease.
We will examine your gums and note any signs of inflammation.
We will use a tiny ruler called a 'probe' to check for periodontal pockets and to measure any pockets.
In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters.
We may take an x-ray to see whether there is any bone loss.
We may refer you to a periodontist, a specialist who treats gum diseases.
What can I do to prevent gum disease?
Here are some things you can do to prevent periodontal diseases:
Brush your teeth twice a day (with a fluoride toothpaste)
Floss every day
Visit the dentist routinely for a check-up and professional cleaning
Eat a well balanced diet
Don't use tobacco products
What are the risk factors?
Smoking
Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of periodontists. Additionally, smoking can lower the chances of success of some treatments.
Hormonal changes in girls/women
These changes can make gums more sensitive and make it easier for gingivitis to develop.
Diabetes
People with diabetes are at higher risk for developing infections, including periodontal disease.
Stress
Research shows that stress can make it more difficult for our bodies to fight infection, including periodontal disease.
Medications
Some drugs, such as antidepressants and some heart medicines, can affect oral health because they lessen the flow of saliva. (Saliva has a protective effect on teeth and gums.)
Illnesses
Diseases like cancer or AIDS and their treatments can also affect the health of gums.
Genetic susceptibility
Some people are more prone to severe periodontal disease than others.
Invisalign
Invisalign
Invisalign straightens your teeth with a series of clear, virtually invisible custom-molded aligners. Invisalign. With breakthrough technology that lets you have the smile you've always wanted without the hassle of braces.
The clear alternative to metal braces
By using a series of clear, removable aligners, Invisalign straightens your teeth with results you'll notice sooner than you think. The course of treatment involves changing aligners approximately every two weeks, moving your teeth into straighter position step by step, until you have a more beautiful smile. And unlike braces, these clear aligners can be removed while you eat and brush your teeth as usual.
Less treatment time
An average Invisalign course of treatment takes about a year. You'll see us every 6 to 8 weeks for adjustments and to check progress. At regular intervals, you'll receive a new set of custom-molded clear aligners to continue the straightening process. The total number of clear aligners is specific to you, determined by us for your course of treatment.
Clear and comfortable
Since Invisalign is practically invisible, there's no unwarranted attention to your mouth. In fact, very few people will notice at all – unless you tell them. They're comfortable to wear and remove easily when you eat, brush, and floss.
Orthodontics
Orthodontic treatment corrects teeth and jaw alignment problems and involves the design and use of appliances such as braces, retainers, aligners, rubber bands and headgears. If you have crowded or overlapping teeth, it makes them harder to clean which increases your chances of tooth decay, gum disease and eventual tooth loss. With orthodontic treatment, you can improve the health of your teeth and start to smile with confidence!. Early intervention and treatment is preferred, since the process is usually quicker and easier. Treatment can begin as early as six or seven, which is when some habits that are formed as a baby can begin to cause unwanted tooth movement. Orthodontic treatment is also available for adults, who can be treated with both fixed and removable appliances.
Initial Planning
Once the problems are diagnosed, we create a step-by-step corrective plan. Any existing dental findings will likely need to be addressed before orthodontic treatment can begin. For instance, any decay must be treated and a dental cleaning must be performed. Also, teeth that are causing crowding may need to be removed before orthodontic treatment can be started.
Teeth Problems That Can Be Caused By A Bad Bite
Crooked, crowded and overlapping teeth can cause a wide range of problems, including:
Tooth decay and gum disease
Teeth that are not in proper alignment are hard to clean, particularly if they overlap. A build-up of plaque can cause tooth decay and gum disease.
Wear and tear
The teeth of the upper and lower jaw are meant to come together in a specific way, with the upper teeth slightly protruding over the lower teeth. If they are misaligned, the action of chewing may grind the teeth unevenly.
Jaw injury
The jaw joint is called the temporo-mandibular joint, which is also known as the TMJ. A bad bite may place stress and strain on this joint; this can cause localized problems such as pain, headaches as well as clicking or grinding noises when the jaw opens and closes.
Speech impediments
Many sounds are made with the tongue against or near the teeth. Misaligned teeth or jaws can interfere with speech.
Self-confidence
A person may be reluctant to smile due to misaligned teeth.
How We Diagnose Orthodontic Problems
Problems with teeth and jaw alignment are identified using a number of tests, including:
Dental X-rays both inside and outside the mouth
Photographs both inside and outside the mouth
Duplicate your bite in stone casts using impression materials
Types of Treatment Options
The range of corrective orthodontic devices includes:
Braces
Braces are the most efficient and accurate way of moving teeth. Brackets are cemented to each tooth that needs to be moved with special dental glue and are typically made of a clear ceramic material or stainless steel. These brackets act like a handle on the tooth so that it can be moved into its correct position when force is applied to the brackets. Visits to our office every few weeks are needed to adjust the forces on the teeth as the teeth are slowly moved into a desired position.
Elastics or rubber bands
Elastics or rubber bands are sometimes used in orthodontic treatment. Elastics are helpful in aligning the upper and lower jaws. When help is needed to move teeth, elastics may be stretched from these teeth and attached to a bracket on either the upper or lower teeth. It's important to wear the elastics as instructed or orthodontic treatment will take longer.
Headgear
If the teeth need extra pressure, headgear and bands may be worn. Basically, tensioned rubber bands are hooked to the braces and connected to a strap worn around the head, usually at night.
Risks of Orthodontic Treatment
Some of the risks of orthodontics include:
Dental hygiene problems
Braces and wires make cleaning the teeth more difficult. This can cause decay, discoloration and permanent marks.
Mouthguards
It is strongly recommended that you obtain a special mouthguard if you play sports involving contact with another player.
Relapse
Teeth have fibers attached to the roots and those fibers have memory, which can caused properly aligned teeth to rotate out of alignment once the force on the teeth are removed. When wisdom teeth appear, also known as third molars, this can also caused properly aligned teeth to relapse. It is important that you wear your retainers for the prescribed time after fixed treatment has ended.
Soft tissue injury
The braces may dig into the gums or cheeks.
Porcelain Veneers
The tooth with a base for support and prepared for a veneer. If the entire front of the tooth needs to either be repaired or cosmetically improved, one of the options is a porcelain veneer. A veneer, by definition, is an overlay with a thin layer of a fine or decorative material. We can change the color, shape, length, alignment and spacing of your teeth with porcelain veneers. Veneers typically require two appointments; the first visit is needed to prepare the teeth by removing a small amount of tooth structure from the front surface of the teeth and then an impression is taken so a model can be made. The amount of tooth structure that needs to be removed depends upon several factors such as the alignment, length, shape, spacing and any discolorations in your natural teeth. Your teeth might be temporized depending upon your case. The case is sent to the lab and at the second visit the veneers are tried in, cemented and adjusted to fit your looks, style and personality. We can achieve a natural look with porcelain veneers because they are thin and there is no metal to try to hide. If, and when, your gums recede in the future, you will not have a dark gray line as was common with the way porcelain crowns used to be made. We did our job well if no one notices our treatment.
Related Porcelain Veneer Articles
Smile Design Enhanced with Porcelain Veneers
Smile Design Enhanced with Porcelain Veneers In part two of the series on Smile Design, Dear Doctor takes an in-depth look at Porcelain Veneers, a superior yet minimally invasive technique for smile enhancement. We'll explain not only when they're appropriate, but also when they're not.
Porcelain Crowns & Veneers
A closer look at two innovative techniques and strategies to improve your smile. In many instances these two restorative techniques can produce nearly identical esthetic results, even though they are structurally different.
Porcelain Veneers - Without A Drill
Porcelain Veneers - Without A Drill No drilling - reality or ridiculous? A no-drill technique requires a second look, as new materials and concepts have created new esthetic possibilities. Reactions and opinions among dentists have ranged from absolute disbelief to moderate acceptance. This article gives hope and reasons for patients to get excited about this conservative drill-free cosmetic technique.
Teeth Whitening
The natural color of teeth is not white. They are typically a shade of either yellow or gray and tooth color varies from person to person.The procedure to whiten teeth is fairly simple but there are some rules that need to be followed to achieve and maintain good results.
How long will whitening last?
Since the results vary from patient to patient there is no firm answer. We do know that teeth tend to become darker as time passes, so touch-up treatments are occasionally needed to keep the teeth lightened. Your eating, drinking, smoking and home care habits definitely have an effect on how long the treatment lasts. Remember that the base shade of teeth is yellow or white and that we cannot whiten this base color. However, most patients are very satisfied with the results of whitening treatments.
What are the side effects?
Some patients report a temporary increase in sensitivity. Tender gums are also a known side effect especially if you are whitening at home and use too much of the whitening solution. Remember that a little is good, and a lot will not make your teeth any whiter.
Is everyone a candidate for whitening?
NO! There is no whitening solution for most dental work such as fillings, crowns, veneers, or partial or full dentures. If the color of your teeth matches the color of your dental work before whitening, the color of your teeth will most likely be different from the color of your dental work after whitening. You are making a commitment to replacing those restorations if you whiten your teeth. We typically wait a few weeks after any whitening treatment to replace these restorations since we want to match the new color and we want the color to stabilize before choosing a color for the new restorations. Your gums must also be healthy and any decay must be treated since both of these can be a cause of sensitivity during whitening treatments. Teeth whitening is not recommended for children whose teeth are still developing or for women who are pregnant or breastfeeding.
Why Teeth Get Discolored
There are many reasons why teeth can become discolored. The major reasons are:
Diet
Drinking tea, coffee, red wine or other food and drink with strong colorings.
Smoking
Smoking can result in teeth appearing a yellowish color.
Age
As people grow older their teeth can become darker naturally.
Tooth decay, fillings and tartar build-up can cause discoloration.
Trauma
Teeth have nerves and blood vessels inside them. If these nerves and blood vessels are damaged the tooth may become darker - even several years after the trauma.
Medication
Staining can be caused by diseases or medicines. Tetracycline, an antibiotic, will cause a distinct discoloration if given to a child whose adult teeth are still developing.
How to Whiten Teeth
There are many simple ways to improve the appearance of discolored teeth:
Regular cleaning to remove the plaque and tartar.
Regular tooth brushing.
Stop smoking.
Reducing the intake of food and drink that are strongly colored such as coffee, tea, red wine, etc.
Professional whitening.
Whitening toothpastes claim to whiten teeth
but they do so at an expense. They vary from slightly abrasive to very abrasive. They may appear to make your teeth whiter by removing stains, but some are abrasive enough to remove enamel, which makes these toothpastes a very poor long-term solution.
In-Office Whitening
There are a few different methods for whitening your teeth in the office. We can whiten them from the outside-in or the inside-out. The inside-out method, which is known as internal bleaching, is only an option for teeth that have previously had root canal treatment.
External Whitening
This means that the color of the teeth is lightened by placing a whitening solution on the outside of the teeth. This is also known as "laser" or "power" whitening. We will put a rubber seal around your teeth to protect your gums. Then, the whitening gel is painted onto your teeth and a special, bright light is pointed at them. This light speeds up the whitening process. The procedure takes one to two hours.
Internal Whitening
As stated above, this is only an option for teeth that have had root canal treatment. The gums are isolated from the teeth and an opening is made from the back side of the tooth. A strong whitening solution is placed on a cotton pellet and then the opening is temporarily sealed. This is left for about a week and then the color is checked. The tooth will usually take two or three visits to whiten in this manner.
At-Home Whitening
At-Home Whitening
This method requires an impression to be made of your mouth so that a custom tray, which holds the whitening gel against your teeth, can be made. The gel is typically worn for a few hours a day for a period of one to three weeks.
What are LUMINEERS®?
Discover your permanently white, straight, natural-looking, beautiful smile with pain-free LUMINEERS. With ultra-thin, custom-designed LUMINEERS, your LUMINEERS Dentist can give you the beautiful smile you've always dreamed of, and unlike traditional veneers, LUMINEERS are minimally invasive. LUMINEERS are proven to last over 20 years and are backed by a limited lifetime warranty-so your beautiful, new smile will be with you for years and years and years and years!
No shots, no pain
Individual cases may vary. Tooth contouring may be necessary.
No drilling of sensitive tooth structure
Individual cases may vary. Tooth contouring may be necessary.
Custom-designed for your smile
Proven to last over 20 years
Backed by a limited lifetime warranty
Reversible
LUMINEERS in LUMITray™
LUMINEERS in LUMITray™
In addition to LUMINEERS, we have LUMINEERS in LUMITray, advanced placement technology that allows us to place your LUMINEERS all at once, instead of individually. We can get you out of the dentist chair faster so you can start showing off your incredible, new smile sooner.
Transforming Your Smile
Transforming your smile has never been easier- it takes just 2 visits! Whether you choose LUMINEERS or LUMINEERS in LUMITray, it takes only two easy visits for us to bring out your beautiful smile:
Visit #1
A precision mold will be taken.
The right shade for your permanently white smile will be chosen.
Visit #2
Your custom-designed LUMINEERS are checked for fit and shade.
Preparations are made for the placement procedure.
Then, they're painlessly placed.
Crowns, Onlays and Inlays
The cusp is the pointed or rounded projection on the chewing surface of the tooth.
Molars typically have four cusps as shown by the four purple asterisks in the top image. Bicuspids, also called pre-molars, typically have two cusps as shown by the two blue asterisks in the top image. When we refer to crowns, onlays, and inlays, we are referring to whether we need to restore the cusp of the tooth, and if so, whether it is all of the cusps or some of the cusps. When a tooth has been severely weakened or fractured, we will usually place a crown, which covers all of the cusps. In the photo on the right, the closest tooth requires a crown to made in the lab and the result is shown in the bottom picture.
When a tooth has one or more cusps that are weakened or fractured but other cusps that are still strong
we can elect to do an onlay. An onlay can cover one or more cusps while retaining some of the tooth above the gumline. In the example on the right, the lower left cusp for the middle tooth was determined to be too weak. It was capped, but the remaining three cusps were healthy so they were left untouched. The porcelain restoration was made in the lab and the final result is in the bottom image.
When the cusps of the tooth are all healthy and structurally sound
we can elect to restore the surrounding structure but leave the cusps intact. This is called an inlay as shown by the tooth on the far right. The amalgam restoration needed to be replaced and it was restored with a porcelain inlay that was made in the lab. The final result is shown in the bottom image.
Implants
A dental implant is essentially an artificial tooth root that is surgically placed into the jawbone. One or more missing teeth can be replaced by attaching a crown, a fixed bridge, or a full set of dentures on top of the implants. The implant material, which is typically pure titanium, is extremely biocompatible and the bone treats the implant just as if it was made out of bone. The bone cells attach themselves to the implant in a process called osseointegration. After an initial healing period, during which the implant(s) is left undisturbed underneath the gum tissue, it is uncovered and connected to a small post that serves as the foundation for the tooth or teeth that the implant will be supporting.
Indications for Implants
Implants may be used to replace teeth in single-tooth spaces, groups of two or more missing teeth, or where the teeth are completely missing in one or both jaws. Once placed, the implants are used to support individual crowns, or bridges that are attached to the implants. Implants may also be used to help retain removable dentures more securely.
Candidates for Implants
Most patients who are healthy with no restrictions for undergoing minor dental surgical procedures and who also have good oral hygiene are good candidates for dental implants. Your dentist will assess the potential implant site to determine whether there is sufficient bone volume and gum thickness to allow placement of an implant. We begin by providing a clinical examination that will involve inspection, palpation, and gentle probing of the potential implant site and adjacent teeth. In straightforward cases, simple dental x-rays are usually sufficient to examine the bone. In more complex cases, specialized implant x-rays, known as tomograms, are usually required.
Implants Function Just Like Teeth
Just like teeth, implants are not made to come out. Implants are not the same as natural teeth but they function and feel very much like natural teeth. For patients that have lived with removable appliances, the implant will feel much more secure.
Implants Can Be Rejected
Some implants fail because the bone has not integrated sufficiently with the implant surface. Hence, implants are not "rejected" like an organ transplant; they simply fail to bond with the bone. This may occur if the bone is very soft at the time the implant is placed or if the implant is initially unstable. Other reasons include inadvertent loading of the implant via a removable denture or by the action of chewing hard food over the implant site during the early stages of healing. Infection may also cause an implant to be lost. Most modern implant systems report success rates of 85-95% over a 5 to 15 years period.
Smoking and Implants Do Not Mix
Smoking affects the healing of bone and soft tissue by reducing the nutrients and minerals in the tissues as well as reducing the blood supply. This means that smoking is one of the biggest risk factors in failure of dental implants. Recent studies estimate that the chances of failure increase by two to three fold in a smoker. Gum and bone like a warm, moist environment and smoking produces a hot, dry environment.
Treatment for Failed Implants
In most situations, an implant can be replaced if it fails to bond with the bone, provided that adequate bone and gum tissue is present. Failures do occur, but not very often.
Wearing Dental Appliances Following Surgery
In most cases, existing dentures and other temporary appliances can be worn immediately after implant surgery. There are exceptions, but our goal is too minimize any aesthetic concerns during the healing phase.
Procedures for Implant Placement
In most cases, implants can be placed using local anesthesia in our office. In more complex cases, we may recommend that the surgical phase be performed while you are under general anesthesia in a specialist's office or in hospital environment.
After the Surgery
In most situations, a healing period of between 3 to 6 months is required before teeth can be attached to the implants. A temporary appliance can usually be made to provide function and aesthetics during this period. After initial implant placement, regular follow-up visits are required to ensure that healing is progressing as we would like. After the teeth are attached to the implants, regular check-ups are needed every 6 to 12 months. At these check-up appointments, the implants are inspected and examined to ensure that the supporting gum and bone remains healthy. X-rays are taken to examine the bone structure around the implant.
Home Care for Dental Implants
For the implant to function well and to remain healthy, proper oral hygiene must be performed at home on a daily basis. Special cleaning aids (brushes, and floss) are widely available. We will provide instructions on the proper use of these cleaning aids. It is important to note that no metal scrapers should ever come in contact with the implants because metal scalers can scratch the surface of the implants.
Fillings
How Teeth Are Restored
After diagnosing the problem and devising a treatment plan
the next step to restore a tooth to health is to make you comfortable. We will give you a local anesthetic so that you do not feel any discomfort. After the decay is removed, the tooth is ready to receive either a direct restoration or an indirect restoration.
A direct restoration means
that the tooth can likely be restored in one visit and that there is sufficient tooth structure for the filling to go inside of the tooth. Examples of direct restorations are amalgam, which is silver-colored; and composite, which is tooth-colored. There have been more amalgam fillings placed worldwide than any other kind of filling, but tooth-colored fillings are being placed more frequently in recent years because they match the remaining teeth and look like the natural tooth.
An indirect filling means
that the restoration is made outside of your mouth, either by a lab or by a milling machine. An indirect filling also needs to be cemented into place. Examples of indirect restorations are crowns, inlays, and onlays. A crown covers the entire tooth, an inlay fits inside the tooth and can replace a wall of the tooth, and an onlay replaces at least one cusp of the tooth.
Most indirect restorations take two or more appointments to complete
with the exception of restorations that are milled by a machine in the office. Cast gold is the most durable indirect restoration material, but porcelain ceramics are gaining in popularity because of their superior esthetic qualities.
Gold
A gold restoration is made in the same way as a gold piece of jewelry, using the lost wax technique.
A wax pattern is made to fit your tooth and then it is cast, polished, and cemented. Gold restorations are a mixture of gold and other metals such as silver and copper. The addition of these other metals make gold fillings more durable.
You will need at least two visits for a gold restoration.
During the first visit, any decay or old filling material is removed, the tooth is prepared to accept a gold restoration, an impression is taken, and a temporary filling is placed.
The impression is then sent to the lab and a stone cast is made
which enables the lab to work on your tooth without your presence. The lab makes a wax pattern, which is then cast into a gold restoration. When you return for your second appointment, the gold restoration is cemented into place.
Advantages
Good resistance to further decay
Wears well as - almost the same hardness as enamel
Does not fracture under stress
Good longevity
Disadvantages
Expensive
Conducts hot and cold
Color
Multiple visits
Porcelain
Porcelain is the most natural looking of the choices we have to restore teeth.
It is used either by itself in veneers, inlays, onlays, and crowns, as well as combined with metal for crowns. Porcelain restorations require two visits or they can be milled in the office with a milling machine. After the porcelain is cemented to your tooth, it is very difficult to notice that the tooth had any treatment at all.
Advantages
Color
Resistance to surface wear
Long lasting
Wears well as it holds up to chewing force
Disadvantages
Expensive
Brittle material can fracture
Usually requires more than one visit
Dentures
Complete or partial dentures can replace your missing teeth and give you the confidence to smile. Dentures can be used to replace teeth that have been lost due to trauma, decay, or gum disease. It is important to replace missing teeth, not only because teeth help with eating food, but because they help support the facial muscles and are critical for speech.
Full Dentures
There are two different types of removable full dentures; immediate and conventional. Immediate dentures are typically made when the patient's existing natural teeth are being removed and the new dentures are delivered the day of the extractions. Conventional dentures are typically made when existing dentures are being replaced.
Partial Denture
A partial denture is a removable dental appliance that replaces multiple missing teeth. It can be attached to the teeth with clasps, which are like small metal "c" clamps that hug nearby teeth, or may be attached to teeth with crowns with precision attachments (hidden clasps). Both types typically have a metal framework and plastic teeth and gum areas. A temporary partial dental may have a plastic base with no metal.
Implant Option
Implants are an option in some cases. There needs to be sufficient bone for an implant. If there is not enough bone present, we may be able to add more bone through grafting. Instead of having a removable partial, implants are an option in many cases. In the case above, two implants are placed to create an implant bridge. After the implants are placed and the bone around them is allowed to heal, porcelain teeth are attached to the implants. In this case, a three tooth bridge is placed on top of the two implants. This stays in the mouth and is only removable by a dental professional if maintenance is necessary.
Crowns
When the structure of an entire tooth is compromised
a crown, which covers all of the surfaces of the tooth, will need to be placed. The example to the left illustrates a fractured front tooth.
The first step is to prepare the tooth for a crown
which requires reduction of the tooth so that the lab has enough room to produce a life-like crown. We then take an impression, select the proper color for the crown and make a temporary, at which time the first appointment is completed.
Your case is then sent to the lab to make the crown
which is then tried in and adjusted. Our job is to communicate what your wishes and desires are to the lab technicians so your new crown will be in harmony with the surrounding teeth.
Before your new crown is cemented
we check the fit, the contacts, the bite and the color to make sure it has the same characteristics of your natural teeth.
Bridges
When a tooth has been lost and healthy teeth are located on both sides of the newly missing tooth or teeth
then a fixed bridge is a treatment option. The other options are implants or a partial denture.
The procedure for having a fixed bridge made
is essentially the same as having a crown made except that a fixed bridge involves at least two supporting teeth. What can cause confusion is the number of teeth needed for a fixed bridge. To replace one missing tooth requires a three tooth bridge. This is because the teeth on both sides of the missing tooth must be part of the bridge to provide support.
Fixed bridges are typically made from porcelain
with a metal sub-structure and require at least two appointments to complete. The first appointment is used to prepare and temporize the teeth. The second appointment is the delivery appointment to adjust and cement the fixed bridge in place. Occasionally a third appointment is needed if the span of the bridge is long and the supporting framework for the bridge needs to be tried in before the porcelain is applied to the framework.
Even though all of the teeth of the bridge are physically connected
the final result makes it look like the teeth are individual and natural.
Implant Option
Implants are an option in some cases.
There needs to be sufficient bone for this procedure. If there is not enough bone present, we may be able to add more through grafting. Please read our Implants page and visit our Implants Gallery for more information.
An implant may be an alternative to a fixed bridge in some cases.
In the case above, one implant is placed. This means the adjacent teeth do not need to be part of the treatment plan.
After the implant is placed and the bone around them is allowed to heal
a porcelain tooth is attached to the implant. This stays in the mouth and is only removable by a dental professional if maintenance is necessary.
Bonding
Bonding is a cosmetic dentistry procedure
that enables the restoration of chipped, spotted, discolored or gapped teeth. We use modern materials that match the shade, translucency, and texture of your teeth. Our goal is to have the end result appear as if no treatment was performed. This can do wonders for your self-confidence, since smiling will come naturally to you with the improved appearance of your teeth.
Bonding is the material of choice when it comes to small defects in your teeth.
When the defect or end result requires covering the entire front of the tooth, a veneer or crown will probably provide superior aesthetic results.
Cosmetic Dentistry
There are many reasons why adult teeth may need restorative treatment.
The most common reason is decay, followed by fractured teeth, and old restorations needing replacement. If we recommend that a tooth with a cavity be treated and more than a few weeks pass after the initial diagnosis, the cavity will almost always get bigger and can cause pain. Once this happens, it will likely require more extensive and expensive treatment. The tooth may even have to be removed and replaced with a false (or artificial) tooth. If you have a cavity and it needs a restoration, there are different kinds of materials that may be used to restore the functionality of the tooth. Please remember that a tooth may need treatment before it causes pain. If a tooth causes pain, it may be able to be saved, but the treatment time and cost typically increase due to the complexity of the necessary procedures.
How a Cavity Forms
A cavity is a very small hole that forms on the surface, side, or root of a tooth.
Cavities are caused when sugars in the food you eat combine with the bacteria in your mouth. This combination produces a mild acid that eats away at the enamel, the hard outer layer of your tooth. Cavities can occur at any age, but most occur during childhood when dental hygiene may be less thorough. There is a genetic component to dental health, including teeth, gums, and the bone that holds the teeth. No matter how good your genes are, if you don't take good care of your teeth you may be prone to very serious consequences.
Babies tend to get cavities on the front teeth, especially if they are given a bottle to sleep with.
Even milk contains sugar that can harm teeth. This is referred to as baby bottle tooth decay. Children tend to get cavities on the chewing surfaces as well as in-between teeth. Adults can be at risk for both new and recurrent cavities.New cavities tend to form between teeth as well as on the root surfaces. The cavities that form between teeth are typically related to a lack of flossing. Cavities on the root surfaces of teeth generally occur because this area is not covered with enamel and is softer and more prone to cavities. The exposed root may be the result of hard brushing or bone loss related to gum disease. Cavities that reoccur form next to existing restorations such as fillings, crowns, bridges, etc. As restorations get old, the filling material can shrink or wear away, causing the possibility of a small space forming between the tooth and the restoration. This provides a prime area for bacteria to accumulate and breed decay. Click the link to do an experiment with fluoride to see how it helps fight cavities.
Cavities and Restoration Choices
As part of any visit to our office, we check all of your restorations
such as crowns, fillings, bridges, veneers, etc. for any sign of decay or old age and we may recommend x-rays so that we can see inside and between your teeth. If we spot any cavities, we will recommend different options for restoring the tooth to full function. If the cavity is in the very early stages, we may decide to keep an eye on it and recommend a home fluoride rinse to help the tooth fight the cavity and possibly prevent the need for a restoration.