This morning I attended a continuing education meeting that presented restoration techniques for esthetic dentistry in general and implants in particular. It was given by Dr. Rob Ritter of West Palm Beach, FL.
The program touched on esthetic dentistry techniques, materials and resources. Much of it was review but there were some interesting different perspectives which will help me refine my practice even further. The cosmetic dentistry discussion was helpful.
We then discussed the Biomet Encode system for restoring implants. This is something that results in faster and easier visits for the patient without compromising the results. Actually, it results in a more esthetic restoration through the use of a custom abutment [understructure] for the implant restoration. If you are interested in learning more about this please contact me. We are now offering this in our office.
It was a good meeting and fun!
Wednesday, June 24, 2009
Wednesday, June 17, 2009
"Diagnodent" helps find smaller cavities.
This is a relatively new piece of equipment. We have been using it for years. We use it for virtually all of our patients. It is a pretty costly piece of equipment but we feel that you are worth it.
The Diagnodent allows us to find decay when it is much smaller than can be found by other diagnostic methods. This means that instead of tiny areas of decay going undetected they can be found earlier and a much smaller filling will be needed or perhaps just a sealant to restore the tooth after the decay is removed.
When smaller fillings or sealants are needed it is much better for the patient. There is less tooth destroyed by the decay. There is less irritation to the nerve within the tooth. There is less of a need for anesthetic. The remaining tooth is stronger because there is more of it. The filling will last longer because it is smaller. All of this makes the use of this advanced diagnostic device very beneficial.
The Diagnodent uses a safe optical laser with a light sensor that detects the changes that decay causes in the light that it reflects back [technically: "laser fluorescence"]. Unfortunately it also reacts to calculus or tartar on the tooth and to healed [remineralized] very small areas that were once starting to decay. There are some significant false positives that your dentist [me!] needs to sort out.
We plan on using this wonderful piece of equipment for the foreseeable future!
The Diagnodent allows us to find decay when it is much smaller than can be found by other diagnostic methods. This means that instead of tiny areas of decay going undetected they can be found earlier and a much smaller filling will be needed or perhaps just a sealant to restore the tooth after the decay is removed.
When smaller fillings or sealants are needed it is much better for the patient. There is less tooth destroyed by the decay. There is less irritation to the nerve within the tooth. There is less of a need for anesthetic. The remaining tooth is stronger because there is more of it. The filling will last longer because it is smaller. All of this makes the use of this advanced diagnostic device very beneficial.
The Diagnodent uses a safe optical laser with a light sensor that detects the changes that decay causes in the light that it reflects back [technically: "laser fluorescence"]. Unfortunately it also reacts to calculus or tartar on the tooth and to healed [remineralized] very small areas that were once starting to decay. There are some significant false positives that your dentist [me!] needs to sort out.
We plan on using this wonderful piece of equipment for the foreseeable future!
Sunday, June 7, 2009
The Best Materials for White Fillings in Back Teeth
We use a special combination of materials when placing white fillings in one of our dental family member's teeth. There are a wide variety of tooth colored materials available for filling teeth. Most dentists use one of these materials to fill anterior teeth for appearance and another one of these materials to fill back teeth for wear resistance and secondarily, appearance.
I use a combination of materials to restore back teeth. There are materials which are quite wear resistant but they also contain, absorb and release fluoride to help minimize the possibility of decay occurring on areas adjacent to these fillings and on neighboring teeth. I use this type of material for the surfaces in between the teeth below more wear resistant materials on the chewing surfaces.
Fortunately, the more wear resistant materials placed over the high fluoride containing materials bond solidly to the underlying material as if it was one solid filling material. The wear resistant material wears in a similar manner as natural tooth enamel does. This material is very compatible with natural enamel.
This combination of filling materials leads to the most decay resistant, strongest, longest lasting fillings that I can place for you. There is the high fluoride content between the teeth and the wear resistance on the chewing surface. This technique has been recommended by one of the most respected 'dental gurus' in dentistry but is not done by most dentists. It does require a little extra effort.
I am doing the best I can for you when filling teeth for my dental family and helping you in other ways.
I use a combination of materials to restore back teeth. There are materials which are quite wear resistant but they also contain, absorb and release fluoride to help minimize the possibility of decay occurring on areas adjacent to these fillings and on neighboring teeth. I use this type of material for the surfaces in between the teeth below more wear resistant materials on the chewing surfaces.
Fortunately, the more wear resistant materials placed over the high fluoride containing materials bond solidly to the underlying material as if it was one solid filling material. The wear resistant material wears in a similar manner as natural tooth enamel does. This material is very compatible with natural enamel.
This combination of filling materials leads to the most decay resistant, strongest, longest lasting fillings that I can place for you. There is the high fluoride content between the teeth and the wear resistance on the chewing surface. This technique has been recommended by one of the most respected 'dental gurus' in dentistry but is not done by most dentists. It does require a little extra effort.
I am doing the best I can for you when filling teeth for my dental family and helping you in other ways.
Bonding Crowns, Implants, Bridges, Inlays, Overlays,....
In my office we very rarely have dental restorations come loose if we have placed them permanently in our office. We don't use conventional dental cements, everything that we place that is meant to stay in place long term is bonded, not cemented, to place. There are occasions when there is so little left of the tooth that we stretch the limits of the materials that we use in order to avoid the need to do root canals. Root canal treatment can allow rebuilding of teeth to allow for better retention of crowns and other restorations.
Many dentists still use dental cements. Most dental cements, even the so called permanent cements, are usually slightly soluble in saliva over a period of years. Restorations placed with these cements often will loosen and leak in about 5-10 years. Often these restorations can be recemented or bonded to place again if there hasn't been too much leakage of bacteria and food debris under the crown. At times there is too much decay and breakdown of the underlying tooth structure and the old restoration can't be used any longer. If you have bonded or cemented restorations in your mouth and you feel a change in these restorations contact us at your earliest convenience and we will be happy to assess the situation for you and help you with your problem.
I have been using bonding, resin materials rather than cements to place permanent restorations since graduating from dental school. Unfortunately many dentists are too conservative and most didn't change to the better bonding technology until years after I started doing this.
If you are in need of having permanent restorations placed and you are not one of my patients, ask to have these restorations bonded. Implant restorations, fixed bridges, crowns, ... should all be placed this way if they are meant to stay in place long term.
Please contact me if you have any dental related questions. It is always good to hear from you.
Many dentists still use dental cements. Most dental cements, even the so called permanent cements, are usually slightly soluble in saliva over a period of years. Restorations placed with these cements often will loosen and leak in about 5-10 years. Often these restorations can be recemented or bonded to place again if there hasn't been too much leakage of bacteria and food debris under the crown. At times there is too much decay and breakdown of the underlying tooth structure and the old restoration can't be used any longer. If you have bonded or cemented restorations in your mouth and you feel a change in these restorations contact us at your earliest convenience and we will be happy to assess the situation for you and help you with your problem.
I have been using bonding, resin materials rather than cements to place permanent restorations since graduating from dental school. Unfortunately many dentists are too conservative and most didn't change to the better bonding technology until years after I started doing this.
If you are in need of having permanent restorations placed and you are not one of my patients, ask to have these restorations bonded. Implant restorations, fixed bridges, crowns, ... should all be placed this way if they are meant to stay in place long term.
Please contact me if you have any dental related questions. It is always good to hear from you.
Fosamax, Jaw Surgery & Other Osteoporosis Drugs
Dr. Bob Bressman hosted a group of dental professionals at his office to review and discuss current research being done at the University of Southern California San Diego. I was happy to attend. Parish Sedghizadeh, DDS, MS, has been involved in multi-disciplinary research studying the effects of nitrogenous bisphosphonates on oral surgery. Fosamax is one of these drugs which is being used by many of our patients. We reviewed a video lecture of his during this meeting.
According to preliminary research being done at USCSD, there is about a 4% risk of developing osteo necrosis of the jaw [ONJ] when nitrogenous bisphosphonates have been taken for a long period of time [many months or years] when there is at least one other factor compromising the patient's health [diabetes, periodontal disease, ...]. Dental extractions are the primary procedures which can lead to ONJ. This seems to be a problem primarily associated with nitrogenous bisphosphonates and not with non-nitrogenous bisphosphonates.
I attended another meeting last October, sponsored by a drug company, which led me to believe that this was much less of a problem than the independent research noted above is now indicating.
If you are taking drugs to treat osteoporosis please let your dentist know.
According to preliminary research being done at USCSD, there is about a 4% risk of developing osteo necrosis of the jaw [ONJ] when nitrogenous bisphosphonates have been taken for a long period of time [many months or years] when there is at least one other factor compromising the patient's health [diabetes, periodontal disease, ...]. Dental extractions are the primary procedures which can lead to ONJ. This seems to be a problem primarily associated with nitrogenous bisphosphonates and not with non-nitrogenous bisphosphonates.
I attended another meeting last October, sponsored by a drug company, which led me to believe that this was much less of a problem than the independent research noted above is now indicating.
If you are taking drugs to treat osteoporosis please let your dentist know.
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