I was in dental school in the early 1980's at the beginning of today's cosmetic dentistry. Bonding was coming into its own and porcelain veneers had just been conceived. The interesting thing to me is that most "truisms" of today are things that we learned in the class - Complete Dentures. Over the years I've often thought that complete dentures really are the ultimate in cosmetic dentistry because we can do virtually anything with the look without the limitation of where the teeth are located.
This then lead me to wonder why dentures, as a group, in this state don't look better. In fact most dentures are obvious to dentists in spite of what I said above and many dentures are obvious to most people that look rather than glance. So I thought I would put a few thoughts together for anyone that was considering a new denture.
Why do dentures look alike? I think that it comes down to money and time. A dentist charges a certain fee for a set of dentures and then he pays the lab a certain fee. But that fee increases each time the dentures is returned for "resetting" of the teeth. So if the patient teeth don't look nice the first time then they are returned to the lab with some new instructions. This is rather common and not a big deal. Quite often this "fixes" the problems and the denture proceeds in the expected manner. There remain many perfectly legitimate reasons for this to not be adequate so the steps are tweaked or repeated. How many times can this recur before it becomes irritating, untimely or expensive? It is important for the dentist and the patient to look at the bigger picture and persevere rather than rush or settle. It is also important for them at this point to reaffirm that they both are after the same goal.
Denture teeth are now arranged more often by lab technicians than dentists. Since the technician hasn't seen the patient they rarely get a feel for the patients face. Since models of jaws tend to look alike sets of teeth on jaw models tend to end up alike.
There are many disadvantages to dentures but they do offer patients a chance to be happy with the appearance of their teeth. If the patient knows what he or she wants whether it be bleach white teeth and a Hollywood smile or darker more natural looking teeth with spaces, "wear" areas, twists or any combination of these type things this should be communicated up front and if possible let the dentist know you're not in a big hurry. Another thing a patient could try would be to ask the dentist if he'll accept a lower fee say $50 off the price of the denture but that you'll pay for the second and third "reset" of the teeth. This might improve the financial dynamics and be a win/win.
At our office we have a lab technician and reset the teeth in a timely manner, sometimes when the patient waits. There are other dentists that do this, some denture clinics will do this with their more expensive dentures and certainly prosthodontists (denture specialists) will do this type of thing.
If your goal is to have a denture that doesn't look like a denture be assertive, shop for a dentist that likes dealing with dentures and persevere and you may be amazed at the results.
Endodontic Therapy
In today's column, I'd like to talk about one of my favorite subjects, root canals. Warren Zevon the late singer/songwriter summed it fairly well for most Americans. ... You know I just had a short vacation Roy. Spent it getting a root canal! "Oh? How'd you like it?" Well it ain't that pretty at all...
I'm sure that even today that is a rather diplomatic expression of how people feel. The name root canal just sounds bad. If it's something that a person is going to have done to them, that makes it that much worse! Who wants a canal dug in their jaw?
Well, I PROMISE that dentists do not in fact "dig" canals. The canals are already inside the tooth. A much better way of looking at this is that a root canal is a deep filling that has its own unique filling material.
Endodontic therapy, a.k.a. root canal, has come a very long way in the last 20 years. Technology and the application of that technology has made a procedure with a somewhat low success rate, maybe 90% or less, to a procedure with a high degree of success, 95-98%. The nickel titanium rotary instruments used today are very flexible and surprisingly durable. Care still has to be taken because they can break but normally a new instrument will not break on the first tooth it treats. Strategies have improved as far as getting access to the very tip of the root, the most important area for quality treatment to be attained. Many endodontists still use the same technique for filling root canals that I learned 20 years ago. I have no evidence that they should change but I do know that I feel much more confident with one of the newer warm gutta percha (read root canal filling material) technique.
Root canals can absolutely be done on senior citizens. There is no question that as teeth age the canals inside the teeth shrink but most endodontists have microscopes available now. If there is a canal present to treat then they will find it. You can even watch what the dentist does on video.! It really isn't even gross! Really!
If a senior has an abscessed tooth then there are many factors that need to be considered before deciding which course of action to take. If a partial denture is present then maybe the tooth should be extracted and added to the partial. If the tooth is structurally sound and the neighboring teeth are present then maybe a root canal is the right choice.
Crowns should be done on any molar that has a root canal. This definitely adds to the cost but I personally don't think that anybody should have a root canal on a molar if they do not intend to get the crown. Now front teeth are another story. Front teeth don't need crowns simply because they have had a root canal. If the need or have had a large filling in addition to a root canal then a crown may be in order.
But, "WHAT ABOUT THE PAIN?!?" If a tooth has endodontic therapy and the tooth is not hurting before the procedure then it likely will not hurt or only be slightly tender for a short period of time.
So what if the tooth IS hurting? I'm glad you asked that…this depends on the precise cause of the pain. Most dental pain is due to pressure building up inside or around a tooth. If the pressure is relieved then so is the pain. A clinical decision has to be made by the treating dentist as to whether the root canal therapy can or should be completed. A tooth with an acute infection can be left incomplete or left "open" so that pressure can be relieved through the tooth. This does usually work but it also means a return visit within the next couple of days. Completing the root canal in that tooth also can be done. If enough pressure is relieved then this can be relatively painless. The bottom line is that if the pain is eliminated before completing the root canal then the root canal procedure itself should not hurt or hurt only slightly.
Looking Forward
I'm not sure this is a strength for me because as a general dentist I sometimes have a hard time looking past what I'm doing.
The first thing I see for patients of Alabama is that I think that slowly and inexorably complete dentures will decline in number. I think that it would be faster but the people of our state seem to be convinced that they cannot afford to take care of their teeth without dental insurance. Let me not get too deep into this but simply say that the differences between medical and dental insurance are very large and that the average run of the mill Alabamian could keep their teeth without dental insurance if they valued their teeth enough.
The second thing I see in the future is that lower dentures will either be modified to stay down (e.g. Ultra-suction or another method) or even better implants will be the rule rather than the exception. I do not think that the denture adhesive market is going to fold but I do think it is going to shrink rather than grow.
A no brainer to predict is that cosmetic dentistry is going to grow. I see that on most of the dental literature that I read. There are a LOT of options in cosmetic dentistry. Bleaching may subside somewhat but I think Invisalign, the "invisible" braces for straightening teeth without wires is on the upswing. I believe that their experience as a company has improved them to acceptance by the dentists that provide the procedure. This is giving the dentists the confidence needed to promote its use.
I think that ultimately we will see ozone used to attack dental caries (tooth decay). This is being used in Europe with a certain amount of success. I do not expect this to be soon because of the stigma our country seems to have with ozone these days.
I think that laser dentistry will come into its own. The neat thing about lasers is that they can numb the tooth. This normally means "NO SHOT!" You hold the laser on the tooth, the tooth gets numb by some mechanism that Einstein understands, you then use the same laser to eliminate the decay. Fill the tooth and dare I say…painless dentistry?
The easy thing about this article is that by next year I can for the most part write the same thing but eventually most of this or even better things are in store.
Senior Living
I have never gotten over something that a young attractive woman once told me. No, it's not what you think! The woman was a social worker and my contact in a nursing home for which I did some consulting. What she told me was…"When I get old I am going to have all my teeth extracted!" She was quite serious and she might say the same thing today.
What would lead this person to feel this way? From her perspective the reasons were obvious, the inability of many of the patients to perform adequate oral hygiene, the failure of so many dental restorations in this population, gum disease, pain and halitosis
I still don't see things her way but her comments were very sobering.
As we get older our physical dexterity diminishes and our mental acuity decreases. This makes our ability to perform oral hygiene difficult or impossible. On the other hand, decreased salivary flow, recession of the gums exposing root surfaces which decay more easily and are more sensitive make oral hygiene even more critical than it already is.
I've always thought that the strategy is to take the absolute best care that you possibly can of your teeth for the first 70 years. If you do that and your teeth are healthy then as the quality of your home care diminishes then your teeth should remain healthy enough for the last part of your life. The truth is that that scenario will only truly play out for a small percentage of people.
The solutions are complex and varied. Topical Fluoride can help protect root surfaces of teeth from decay and also decrease sensitivity. Rotary or other mechanical toothbrushes can assist with oral hygiene in lieu of a certain degree of manual dexterity. For some
Possibly long term care insurance should include some dental coverage. Should nursing homes have hygienists on staff? Maybe people diagnosed with Alzheimer's Disease and those diseases which mimic Alzheimer's should have their teeth extracted?
Each patient needs to have their own plan and patient's need to continue to see their dentist as they age and especially for a while when their children or alternative caregivers are beginning to be the decision makers.
Dentures: An Alabama Tradition
I apologize. I love our state but at times I do get frustrated by the acceptance some people I treat have of becoming a "dental cripple". It is their very acceptance of it that often helps to bring it to reality. I hear so often "My parents lost their teeth when they were ____ so I am going to lose mine too." The blank being anywhere from 20 to 40 years old.
First, I admit that a very small minority of people will lose their teeth with the best of financing and effort. I also want to say that if financial difficulties require full mouth extraction rather than the high end treatment necessary to save the teeth, then that is a frustration out of sadness and helplessness and not really what I am trying to address in this column.
I am actually trying to reach the people that could afford it. I'm not talking about the rich. I mean the lower middle class and above. I am referring to Joe or Jane Average. I mean the parents that either need to instill the importance of teeth into their children and\or maybe ought to help them (financially) to take care of their teeth until they are TRULY independent and not just "out on their own".
Think about this: Children are "adults" at the age 18. Certainly they are considered adults at age 21. So from 18 to 22 or 23 children are beginning careers. They are establishing independence. They are renting places of their own. They are buying cars. They are dating. They are getting married. They are starting families of their own! What is going on in their mouths during this critical time? Well, I don't have research to back this up by do have 21 years of clinical experience in our state. The permanent teeth typically finish erupting from 11 to 14 years of age. It is about this age (often older for children with braces) that they teeth are in the position and the environment in which they are to reside. This is important because tooth decay takes time. The plaque that causes decay is just now day after day going to be in position to harm the areas between the teeth.
So if the average age of tooth eruption is 13 and young adults are independent at 18 then there is a five year window for the teeth to decay. If it takes longer than that and the parents don't insist on dental care this is when the dental care is neglected and this is the age where decisions are made by these young adults that eventually they will have to have dentures. They have so many new responsibilities and so little time and so little money.
One last point - I have hear so often, "I had great teeth until after I had my first child. The baby just took the calcium out of my teeth." This is just not true. Once teeth are erupted the body doesn't remove calcium from them, certainly not from the crowns of the teeth. This myth is the result of the same age related factors that I have just discussed.
Now to dentures - Why are dentures so acceptable? I'm not saying anybody wants dentures. I'm just saying that it really isn't considered that big of a deal. Not in the league of having a foot amputated. Why is this? I guess number one would be that more people lose their teeth than lose a foot. I think number two is that dentures often look better than the teeth that they are replacing. They almost always should look as good. After that I think since dentures are so common people think that they probably work pretty well. That could not be further from the truth. It is true that upper dentures usually do not require denture adhesive to stay up. But just think about eating with one. If you are having trouble visualizing then think about the prosthetic foot. Think about the part of your leg where the foot attaches. When you walk on a prosthetic foot the stump of your leg is bound to get sore. The same goes for a denture! Want to bite or chew something hard? Think about running on that same foot! I haven't even begun talking about lower dentures. Lower dentures are much much worse than upper dentures. They don't have the "suction" that upper dentures are able to develop due to the fact that they are adjacent to the tongue all the way around the lower arch.
In summary, if Alabama's young adults were to make their teeth an immediate priority they could prevent the loss of their teeth and with continued diligence they would be very likely to avoid a denture altogether.
Dental Implant
Do you remember the mid-90's when the general public was beginning to discover the internet? It was an exciting time and a time of constant change. There was a period one summer during that time that I was constantly being asked questions about dentistry. It was at this time that I have a vivid recollection of somebody telling me his dentist was studying and "getting into" dental implants. That night I thought that dentist was chasing a red herring and told this online stranger just that. I was really surprised that a general dentist would still be trying to do such a thing. I was still living in my 80's paradigm which was strongly affected by horror stories of the 70's.
WOW how things have changed since then. It took a few years and some prodding by one of my associates and mainly some eye opening but in 2000 I did see the light. I am so glad that I did. Dental Implants today are NOTHING like they were 35 years ago. They are probably the most successful dental restorations ever invented. Taking a back seat in my mind only to gold crowns.
Dental Implants today have many uses. One of them can be used to replace one tooth. Two of them can be used to retain (read "hold down") a lower denture. Five or more of them can be used to replace your denture entirely with something that doesn't have to be taken in and out.
In the past if a patient lost a tooth there were two choices. A removable partial denture or a fixed (cemented in) bridge. It is plain that a removable partial denture would take up a lot of room in one's mouth just to replace one tooth. These are usually successful only if the tooth that is missing is a front tooth. Most patients that are missing one back tooth would rather do without than to wear it.
A fixed bridge is a good restoration as far as the patient's comfort is concerned. A bridge is simply two crowns made with a false tooth connecting them. This is then cemented into place and usually the patient is very happy because no extra space is taken up by the restoration. The bridge stays in place and is very much like having a tooth "back". There are problems however. What if the two teeth that are crowned are perectly good teeth? It is a shame to "grind them to a nub" in order to replace a tooth. Add to this that the 5 year survival rate a fixed bridges is only in the 70% range and there is cause to be concerned indeed.
Enter the implant. With an implant there is no need to grind down any other teeth. A crown can then be placed on the implant and VOILA! It really is like having the tooth back. The 5 year survival rate of these restorations is much closer to 95% than it is to 70%.
The BIG Deal
In my opinion, the biggest lifestyle improvement in dentistry is the implant supported overdenture. Two implants placed in the lower jaw then attached to a lower denture will dramatically improve the function of that denture. Other benefits of this procedure are: prevention of the loss of bone in the lower jaw, improvement in speech due to the stability of the denture and improved confidence due to the decrease in movement of the lower denture. Maybe the best part of this procedure is that the price range of it is from about $3600 to $6200. When you think of all of the benefits of this procedure it is a value to the senior citizen and a bargain for younger patients.
There are many other scenarios that are possible. Three implants or four implants can stabilize the denture even farther. With five implants it is possible to have a fixed bridge that is completely supported and retained by the implants and does not require removal. Talk about having your teeth back!
There is no question about the excitement of the dental community about dental implants. I hope that if you have a missing tooth or teeth that you will consider dental implants. So often they are the best choice.
Dentures
I actually could write for hours on dentures. Now whether anyone else in the world would have any interest in what I write is a whole other story.
The first thing that one should realize about dentures is that they are a poor substitute for teeth. That being said about 70% of people who wear dentures become happy with them. Notice that I said "become". There is a rather large adjustment period when a patient receives their first set of dentures. Some of this is adjustments that need to be made by the dentist that made them and some of this is up to the patient to accommodate for the volume of plastic that is their new denture.
Difficulties:
The first one that comes to mind is "looseness". I put that in quotes because looseness is in the eye of the beholder. An upper denture should have some suction. I have found it rare to find a patient whose upper jaw is in such shape that a denture cannot be made to stay up. I find rather often somebody to whom I place an upper denture and the patient says: "It's loose". What we normally do at that point is evaluate the "occlusion" of the denture i.e. the way the teeth come together. Then I evaluate the amount of suction that I believe that it has initially. I can usually tell if it is going to have reasonable suction after a few hours or if it is just not likely to suction at all. I then will adjust the denture and see if I'm able to eliminate something that is keeping the denture from seating fully. If that does not work then I check and make sure the borders are adequate. The borders of the denture being the edges of it. If the borders of the denture are too long then it sometimes will not stay in place. Likewise if the borders are too short the denture will not suction.
At that point I shorten or extend the borders. If I extend the borders of a denture then I usually "reline" the denture. Relining is making an impression inside the denture so that it will fit the tissues better. Other reasons that a denture may need to be relined would be a warped impression or a problem in the lab that caused the denture to warp.
Nutrition
The subject of this months column has been weighing upon my mind for several months but especially this month. As that it is January at the time of this writing I, like so many others, am working at losing weight. I'm happy to report that I'm doing quite well with it SO FAR this year. I'm even happier because I feel like I'm going to keep the weight off and I'm going to be eating a healthy diet for some years to come. I say this because I have done it before. I do not pretend to be a doctor nor a nutritionist but I do believe that science is behind my "diet" which is really more of a lifestyle change with no end in sight. I believe this approach to be what healthy Americans should be doing.
About 10 years ago I attended a lecture on nutrition and the dental office by David Meinz most of the material in this column was either gotten or inspired by him. I am not necessarily trying to sell for him but I do feel I need to give credit where credit is due
Just to try to keep you interested I'll say that so far this year I have lost at least 10 pounds.
The first thing that I have done and it is the hardest things is I have eliminated soft drinks from my diet. I don't like coffee so this has been particularly hard.
As a dentist I can absolutely say that this would be a good thing for anybody.
The other thing I am doing and what I would love to see America doing is that I am holding my fat grams to 50 grams per day or less. This is not necessarily easy considering the fast food /fast lane life we lead but with research it can be done and done in a way that does not leave one starving for hours at time.
Most restaurant chains have websites and most of the websites have nutrition guides. If you will take about 30 minutes and print these out you can look at the menus and most of the time come up with combinations of items or items and condiments that well add up to 20 fat grams or less.
Some good examples: Grilled Chicken Sandwiches - if they are listed as higher than 20 grams of fat then it must have mayonnaise or some other dressing. If you ask for it without mayo and then ask for some barbeque sauce, then you have a healthy good tasting lunch.
Wendy's Chili has only 6 grams of fat, why not ask for a Plain Potato (no fat) and pour the Chili on the potato!
Combine two of the meals with a healthy breakfast of high fiber low fat cereal and you have done it!
A dentist talking about fat grams, shouldn't he be talking about sugars? No. Between meal sugars are what is wrong with sugar. Normal dietary Carbohydrates are good for you and fats (especially saturated fats) are what clog your heart and blood vessels. To me it makes more sense to reduce your fat intake than your sugar intake. What good are teeth if you aren't around to enjoy them?
Dental Crowns
Dental crowns, also known as "caps", are placed on teeth in order to preserve or protect them. Placement of crowns is indicated for broken, cracked teeth, teeth with excessive decay or after root canal therapy.
There are three main types of full coverage crowns:
PFM (porcelain-fused-to-metal) is a very strong, durable and esthetic option. One consideration is that with time the crowns may show the underlying metal at the gum line.
All-ceramic (all-porcelain) crowns are made with zirconia or other materials. The biggest benefit is extremely esthetic restoration. The consideration is that this kind of crowns is not recommended for long bridges to replace back teeth.
Gold crowns - used to be very popular restorations used for back or even front teeth. They are still recommended for patients with strong bite and patients who grind or clinch their teeth. Gold crowns offer good longevity, less tooth preparation and they are less abrasive to opposing teeth than PFM. The only consideration is esthetics.
Steps in fabricating crowns:
During first visit, the dentist takes X-rays to examine the tooth structure, roots and surrounding bone. If the tooth has lots of decay then the root canal therapy maybe recommended. The tooth receiving the crown is anesthetized (numb), then it is filed down and reshaped, if lots of tooth structure is missing than build up is placed. Impression is made of the tooth and an appropriate shade is chosen so the crown will match the neighboring teeth. The impression is sent to the professional lab to make a crown; it takes about 2 to 3 weeks. During the first appointment, the temporary crown is placed over the prepped tooth. When a temporary crown is placed, your dentist will suggest few precautiouns such as: avoiding sticky foods and hard foods, during flossing slide the floss out rather than lifting it out.
During the second visit the permanent crown is evaluated for a proper fit and color. If everything is correct, then it's cemented with a permanent cement.
In order to ensure that crowns stay in good condition and last for a long time, your dentist will recommend that you come for your biannual check-up when teeth will be clean of plaque and crowned teeth will be reevaluated for any recurrent decay.
Teeth Whitening
Everyone wants to feel and look good, and methods for improving appearance are increasingly available and varied in today's society. Statistically, 85-90% of our perception of others is based on our assessment of their smiles. A smile is, of course, closely associated with teeth. White teeth make people look younger, healthier and even happier (more self-confident). Unfortunately, with age our teeth get darker.
Two types of tooth discolorations are: extrinsic and intrinsic. Extrinsic (external) stains come from our ingesting dark-colored beverages and foods, using tobacco, and just from everyday wear. Intrinsic (internal) stains come from aging, trauma, drugs (i.e. tetracycline) or excessive fluoride ingestion.
Those stains can be removed by two major tooth whitening options: in-office or at-home whitening. In-office whitening is the most popular procedure in cosmetic dental offices. Advantages of this procedure are: it is the safest form of tooth bleaching, gives fastest results, and gum and tooth sensitivity is more controllable. Disadvantages: it is a more expensive method than take-home bleaching, it is difficult to predict results, and its effects are not permanent (after a year or two, small touch-ups are needed). Also, not everyone is a candidate for in-office bleaching. The dentist should assess a patient's candidacy, because this method is not suitable for the following conditions: tooth and gum hypersensitivity, deep staining or thin transparent teeth.
Steps involved in the in-office bleaching method: 1) a hardening resin is painted onto the gums for protection; 2) a bleaching gel is applied; 3) an intense light is focused on the teeth for up to one hour to activate bleaching; 4) the gel is washed away. The new whiter color will fully emerge after a couple of days.
At-home teeth whitening became popular in the early 1990s. Advantages are: convenience, because it can be done at any time, for short or long periods. It can be done at home, in the office, or on the go, and it is cost affordable. Disadvantages: if used incorrectly, damage to teeth and gums can occur. Over-bleaching can cause a bluish hue, a chalky whiteness, or uneven results. To avoid these problems, always consult your dentist before beginning your whitening program. If you decide to use take-home whitening trays from your dentist, the following procedures will be performed: 1) on the first visit, impressions of your teeth will be made; 2) on the second visit you will obtain custom-made trays and whitening gels that you will wear for several hours per day for several days.
To maintain your beautiful, bright smile, your dentist will recommend that you: 1) maintain at-home whitening once a year; 2) avoid dark-colored foods and beverages for at least a week after whitening; 3) sip dark-colored beverages with a straw; 4) brush and floss at least twice a day.
Some deeply stained teeth that are resistant to whitening can be corrected by dental bonding, crowns or veneers.
The Pell City Dental Clinic is open Monday through Thursday, and Dr. Barnett and staff are available for consultation. They provide a variety of treatments including general dental care, dental implants, whitening, periodontal treatments, and on-site denture manufacture and repair. Please call 205-884-2370 with questions or concerns.
The Pell City Dental Clinic is open Monday through Thursday, and Dr. Barnett and staff are available for consultation. They provide a variety of treatments including general dental care, dental implants, whitening, periodontal treatments, and on-site denture manufacture and repair. Please call 205-884-2370 with questions or concerns.
Cosmetic Dentistry
The focus of dentistry is prevention, diagnosis and treatment. It is recommended that patients visit their dentists biannually to ensure proper oral hygiene and functionality.
Cosmetic dentistry focuses on improving patients' gums, teeth and smile by providing elective services. Cosmetic dentistry treatments include: teeth whitening, composite bonding, veneers, crowns, implants and partials.
Teeth whitening is the most popular procedure among male and female patients. There are several factors causing staining of teeth, such as: age, eating habits (dark foods and drinks), smoking, medication and grinding. In order to whiten teeth, patients can choose one of the following treatments. In office procedure involves 1.5 - 2 hr chair site time, where special gel is applied to teeth and the light shine on teeth for 15 minutes, repeated 3 times. Take home kit consists of lab fabricated trays and the whitening gel that patients wear for couple hrs for several days. Both of those methods give good results, but they do not give permanent results, every couple years patients need to do touch-ups.
Composite bondings are used in dental offices to fill cavities, repair cracks, close gaps between teeth, repair worn edges. Composite bonding is applied to teeth surface and molded into desired shape. The chemical bonding between a filling and the tooth provides strength and lasts for several years. Composite bonding can also be used in fabricating chair side veneers. This procedure can be accomplished in one dental visit and there is no additional cost or time for lab processing.
Veneers are thin porcelain shells that are applied to teeth to correct color, shape, gaps, worn edges or misalignment. There are several types of veneers. According to used materials we can distinguish porcelain or composite veneers which are fabricated in a dental laboratory and cemented to teeth by a dentist in the office. Also some of composite veneers can be chairside made inside patient's mouth by a dentist. According to tooth structure, there are veneers that require tooth preparation and veneers that do not require any tooth preparation, therefore no anesthesia, no post-treatment sensitivity and no temporaries worn by patients. The dentist will diagnose which kind of veneers is recommended for the patient.
Crowns are typically recommended for teeth with large fillings, after root canal therapy, broken or misaligned teeth. Crowns will not only protect the remaining tooth structure but will improve overall look of patient's dentition.
Implants are replacements for lost teeth due to decay, root canal failure, periodontitis, trauma or congenital defects. The implant placement will contribute to the improvement of esthetics, function, nutrition and younger looks.
Another way of replacing missing teeth and therefore improving esthetics is using partials. There are several kinds of partials: standard one with metal clasps, Valplast which has a framework and clasps made of transparent pink acrylic or the precision partial with no visible clasps. The type of the prescribed partial is a combination of patient's desire and dentist's recommendations.
All of the above treatments contribute to the overall oral health and enhanced beautiful smile that is so desired by many patients.
