Extreme Good Looks North Carolina with Designer Dentures
One of the most common complaints, and there are only a few, that people have about dentures is that they obviously look like dentures.
It is the norm for new denture wearers have consists of getting several extractions. After that, a series of dental impressions need to be created, then a few visits to the office to going through a series of adjustments to get the gum tissues to reduce swelling, and eventually start healing.
Over a period of a few weeks to a few months, the new dentures will be lined and relined to accommodate the loss of gum tissue.
Denture products fabricated in high tech laboratories and dental techniques that promote quality over aesthetics will have the best amount of happy denture customers. High tech laboratories produce products that create beautiful new teeth based on a single visit with the dentist.
Common errors or anticipated adjustments are “handled” by denture relines which can become a frustrating experience for many patients.
Veteran Denture Wearers
There are, fortunately, a great number of denture wearers who have above average treatment results with their dentures. They fit snugly, don’t become loose, don’t affect speech and enable eating of most favorite foods.
These standard dentures (not implant retained or anchored) are created with attention to detail that denture clinics or high production denture dentists can’t provide.
Every imaginable detail is covered. Fit…. function… comfort and amazingly good looks. The final denture result is practically indistinguishable from normal teeth. The final cosmetic customization creates an appearance that is nearly identical to normal teeth provided by Mother Nature.
The Dunningham Process
A literal pioneer in denture prosthetics, Dr. Bill Dunningham developed a system of prosthodontic protocols that enable artistic denture dentists, like Dr. Frank, to create a denture product that is custom fit to a patient’s jaw structures.
Prosthodontic Makeover Cosmetics
Initial Training and Evaluation Denture
The first denture is designed to function as an assessment tool that is used, over time, to get everything “just right”. Fit, feel, comfort, perfect speech, effortless eating and chewing, fearless laughing and smiling, etc.
Re-linings for the initial denture create the data points used by Dr. Frank for modifying measurements for what he will create as a final denture. The patient provides feedback and input during this phase to assure every important patient need is satisfied.
Denture or Real? Designer Dentures
During the very last phase, denture cosmetics are implemented by Dr. Frank to create a final denture that looks like natural teeth…. NOT denture teeth.
Differences in texture, whiteness shading, opalescence, size, rotation, incisal edges, cosmetic gaps, maybe even a gold crown…. are used (according to patient interests) to eliminate the appearance of mass produced denture teeth.
Fleshy, tinted areas of the denture representing normal gum tissue are painstakingly stained by hand to convert what is supposed to be cold acrylic into something that looks like warm, live gum tissue.
The finished product is called a Dunningham Denture. There is no known fabrication process that can duplicate this process.
Call our office at (919) 851-6697to schedule a consult to learn how Dunningham prosthodontics can change the way you think about wearing dentures.
Patients with specific questions about cosmetic makeover dentures are invited to contact Dr. Frank directly with our on-line Ask The Dentist form. Dr. Frank will respond directly with the answers and information you are seeking.
We have four types of dental wear: abstraction, attrition, abrasion and erosion. In this article, we will talk about dental erosion.
WHAT IS DENTAL EROSION?
It is the progressive loss of tooth enamel associated with its contact with acids that do not involve bacterial action and produces defects in enamel and dentin that occur as wedge-shaped depressions in the vestibular and cervical areas of the teeth.
We can distinguish between two types of erosion: Intrinsic: can be produced from:
Gastroesophageal reflux:where the acid content of the stomach is regurgitated to the oral cavity, thus exposing the teeth to this acid content. Erosion for this cause is found mostly in posterior teeth and lingual faces of anterior teeth.
Vomiting:by alcoholism or bulimia. Gastric juices erode the dental surface after repeated episodes of vomiting, generally altering the lingual surfaces of the upper anterior teeth and less frequently on the lingual faces of the lower anterior teeth due to the presence of the tongue that acts as a protective barrier. A characteristic lesion that occurs in a person with bulimia is alterations and undercuts in the incisal edges.
Extrinsic: occurs when food-related acids, medications or drugs that consume contribute to the formation of a very acidic oral medium. A diet high in sugars, or the well-known carbonated drinks, juices of unnatural fruits, etc., they help create an acidic oral environment, and thus, generate dental erosion.
HOW DO WE DIAGNOSE DENTAL EROSION?
It is possible to suspect the presence of erosion when discolouration of dental parts, dental sensitivity is present when dentin is already affected or when tooth wear is observed.
In the first phase, the spots are white, and yet in more advanced stages, the enamel lesion becomes irreversible.
HOW DO WE PREVENT DENTAL EROSION?
Periodically go to the dentist.
Reduce consumption of acidic and carbonated beverages.
Avoid eating foods such as lemon, garlic, fried foodsthat help cause gastroesophageal reflux.
Daily dental hygienewith non-abrasive pastes and fluoridated mouthwashes
HOW DO WE TREAT DENTAL EROSION?
We will perform one treatment or another depending on the severity of the injury.
Incipient erosion: The patient will simply follow the prevention protocol and will go to the dentist for periodic check-ups.
Moderate erosion: at the time when almost all the enamel structure has been lost, a composite seal will be made.
Severe erosion: when there is a large exposure of dentin in one or several pieces, reconstruction must be reactivated, even in more severe cases it will be necessary to perform a root canal and crown placement or inlays.
As always, at Durham Dentistry, we believe that prevention is the best treatment. In our clinic, you will be advised how to maintain a high degree of dental hygiene so that the onset of dental erosion is avoided.
Tartar is the bacterial plaque that accumulates between the teeth and gums, creating a solid matter difficult to remove with brushing. Lack of hygiene and improper feeding are usually the main causes of tartar.
To eliminate dirt in the mouth that triggers the appearance of tartar, it is essential to know its specific causes, in order to know the steps to follow and try to proliferate.
What causes tartar on teeth?
Although it seems that the main cause of tartar accumulation should be cleaning, the truth is that food is the factor that most influences the bacterial plaque. Excess sugar, fats and saturated foods contribute to dirt accumulating between the gums and teeth, increasing, as a consequence, the unsightly tartar.
Tobacco is also a factor to consider in the appearance of tartar. Nicotine and smoke, in contact with the mouth, entail accumulation of bacteria that slowly solidify in the teeth creating a plaque that directly attacks dental defences.
As for cleaning, we are in a fundamental aspect that can make a difference in the appearance of tartar. Correct and regular cleaning will keep the mouth healthier and will be able to prevent the accumulation of bacterial plaque, but it will never be 100% effective if the above factors such as food care or smoking are not avoided.
How to remove tartar on teeth?
Once the main causes of the appearance of tartar on the teeth are exposed, it is easier to know how to act to prevent the accumulation of bacterial plaque.
Increase the intake of fruit and vegetables, so as to replace processed and sugary foods. Apples, for example, are an excellent natural cleanser. Including one piece a day will keep your teeth and gums in perfect hygienic condition.
Avoid snuff. Among the infinite list of negative aspects of tobacco, is its high capacity to damage both enamel and teeth and gums, so avoiding it will be a way to keep extra dirt at bay.
Brushing your teeth after each meal: it is essential for oral hygiene to eliminate any remaining food from the mouth after each intake. Brushing your mouth for at least 1 minute and ending with a specific mouthwash will help keep your mouth clean and without debris that can slowly become annoying tartar.
Professional periodic cleaning. Once a year it is advisable to have a deep professional dental cleaning. Although particular cleanings are essential, they are usually not enough to completely eliminate tartar. Dentists, with specific treatments, will be able to arrive with their tools where a toothbrush is unable to reach.
Although tartar seems harmless, bypassing it or not treating it properly, it can cause discomfort or major illnesses such as gingivitis or periodontitis. Before the minimum sign of tartar or dental dirt, going to the professional to obtain a specific diagnosis, it will be essential to not suffer serious damages that affect oral health.
Differences Between The Different Teeth Whitening Treatments
One of the most demanded treatments in our clinic due to the immediate aesthetic effects that it presents is tooth whitening. Within this treatment, there are several techniques that have different procedures and times.
We recommend two different treatments from which the same results are obtained. Once you have decided how to whiten your teeth, you just have to choose which is the right treatment for you.
Clinic teeth whitening:
The first teeth whitening that we are going to talk to you about is the one performed at the clinic. The patient, after making an appointment with the dentist specialized in dental aesthetics, goes to the clinic to be treated in a single session.
In it, the specialist applies the bleaching with a previous cleaning of the area. The main differences in teeth whitening in the clinic with which it is applied at home are:
Higher Product Concentration
In the clinic, the dentist can control and customize the dose of the agent in charge of teeth whitening. Depending on the state of the enamel and gums, the professional will control quantities and times in a personalized way.
The teeth whitening in the clinic will also have components responsible for treating the gums, something especially important in those who suffer from delicate gums.
A treatment performed at the dental clinic will always have more professional tools than the one performed at home. Activation of the bleaching component by LED light will help the treatment to be more effective in less time and contain extra durability.
Tooth whitening from the clinic offers the professional the possibility of influencing treatment in areas that have not initially presented the desired results.
Teeth Whitening From Home:
When a patient is in search of the best teeth whitening, he should consider not only the results but the demands of his day today.
Due to the current pace of life, going to the dentist can sometimes be a difficult task to achieve. Therefore, we have the teeth whitening that can be done from home. The duration is 16 days, and the bleaching effects usually last approximately two months.
Although its mode of application is not the same as the treatment performed from the clinic, it also has its advantages:
The Patient Chooses The Moment
Although we have an online appointment service that saves time, there are always patients who prefer to perform treatments from home, if they have the opportunity. Our teeth whitening at home helps to save maximum time being able to choose, each patient, the time of day or week in which you want to make use of whitening.
Despite not having the control of the professional who has teeth whitening in the clinic, home treatment contains a thermoplastic splint coupled to the maxillary teeth, which prevents the bleaching agent from coming into contact with the gingival tissues.
The bruxism is a disorder that involves grinding and clenching teeth involuntarily, both during the day and at night regularly, which can cause damage to your teeth and wear the enamel and even the dentin reaching Pulp exposure in very serious cases. In addition to these disorders, it can also cause other problems such as the jaw, ear pain and even frequent headaches or migraines.
At night, during sleep, the problem is more serious, since the patient is not aware of his action and, therefore, is even more difficult to control. This type of bruxism is considered one of the sleep disorders or parasomnia. However, even when awake many people do not realize that they are doing it, and it is those around them who warn.
WHAT ARE THE DETACHERS OF BRUXISM?
Specialists agree that its main trigger is situated on the psychological level due to stress or a state of emotional agitation, although the causes that trigger it can be diverse such as:
Problems in the mandibular musculature.
Inability to relax
Malocclusion or dental crowding.
TO WHOM DOES BRUXISM AFFECT?
I reached out to a Durham dentist to find an answer to this question and I was told it affects both sexes indistinctly and at any age, but usually occurs more frequently between 15 and 25 years. Depending on the way the teeth are pressed, bruxism can be:
Eccentric: the teeth make movements from front to back causing wear on the enamel, affecting the incisors to a greater extent.
Central: the teeth are clenched on a specific point, and the area that is most affected are the necks of the teeth.
WHAT ARE THE SYMPTOMS OF BRUXISM?
One of the main symptoms that bruxism can cause is to exert excessive overload on the muscles, tissues and structures surrounding the jaw. If it extends over time, it can become chronic and affect the temporomandibular joints (which are two joints, one on each side of the head, that join the jaw with the skull and allow us to chew). The main symptoms are:
Earache and tinnitus (acoustic sensations such as ringing or clinking, not caused by an external auditory stimulus)
Pain and inflammation of the temporomandibular joint
Sensitivity to sweet, cold and hot things.
HOW IS BRUXISM TREATED?
The ideal treatment will always be related to the cause since the objective is to treat it from the root. The dentist is the one who will determine the potential cause of bruxism and, depending on the dental damage and the trigger, possibly recommend the use of a night splint to prevent its negative effects, reduce the pain caused and try to prevent damage from occurring irreversible dental Other measures that can be taken to attack the underlying cause are:
Perform relaxation exercises to reduce stress.
Avoid hard foods.
Perform orthodontic treatment.
Sleep the recommended hours.
Refer a physiotherapist specialized in the temporomandibular joint.
They are resin devices, created from some molds of our own mouth, personal and non-transferable. These devices help release the tension accumulated during the day and protect dental structures during tightening. Although the splint is usually placed at night before bedtime, it can and should also be worn during the day in case of the most severe cases.
Since, as mentioned before, the splint does not suppress the patient’s habit of clenching the teeth, but avoids its pernicious effects and, when removed, can cause discomfort.
Once delivered and adjusted, a second visit to the dentist will be necessary a week to make the necessary adjustments and thus achieve the desired occlusal contact and avoid any unwanted dental interference.
CAUSES OF BRUXISM IN CHILDREN AND ADULTS
The causes that cause bruxism are not always clear, although, in a large percentage of patients, these reasons are related to some of the signs that we mentioned earlier. Thus, many times stress is the cause of its appearance. At other times it is due to a malocclusion, that is, bad alignment of the teeth.
In most cases, dental alignment and a reduction in stress level are recommended, but bruxism, its cause and its solution may occur in the long term. That is, without proper treatment, we can help reduce bruxism, but not solve it if we don’t find the root of the matter.
CONSEQUENCES OF ORAL BRUXISM
We talk about a disorder that can cause problems of various types. Those directly related to the teethand jaws are the following:
Dental wear, cracks and breakage of parts.
Hypersensitivity and dental pain.
Similarly, this pathology can lead to other side effects :
Headaches (even headaches).
In some more severe cases, bruxism can cause peripheral vertigo and dizziness.
Routine Dentistry becoming Anything BUT Routine
Most patients have heard horror stories about a complex and/or costly dental treatment failing.
The reasons seem to be almost infinite.
Stone Models – The First Step
We have also heard stories about how a simple treatment, perhaps the placement of a crown or a few fillings cause a cascade of new problems and treatment misery that didn’t exist before the simple treatment was obtained.
Tooth sensitivity, jaw and gum pain, aching jaw joints, biting – chewing pain, intolerance for cold foods, intolerance for hot foods, clicking noises, ear congestion and even tmj headaches are some of the common complaints and events patients experience unexpectedly from certain types of dental treatments.
Complex Surgery Rarely the Cause
Dental surgery procedures including for example, bone grafting, periodontal procedures, gum tissue grafting, bone leveling and dental implant surgery, rarely cause these types of symptoms.
Bite Height Measure Long Island
Occlusion – Attention to Detail
Vertical Dimension Precision
Surgery protocols are tightly defined and leave little to chance for a “surprise symptom”
Restorative Procedures Changing the Bite
Patients frequently become mystified (even some dentists) when they discover after weeks, months and even years of pain and discomfort, that a simple adjustment to a single tooth or a simple repositioning of a jaw relationship thrown out of whack by an oversized crown can relieve symptoms within minutes.
Cosmetic Procedures causing Unwanted Cosmetics
Cosmetic Implant Dentistry with Hal Smithington
Initial Consult – Cosmetics and Function:
Gum inflammation, bleeding gums, swollen gums, changing colors and cosmetic treatments (veneers, crowns, bridgework) that seem to fall off soon after leaving the dentist’s office are most commonly related to unrealized technical errors related to “the bite.”
Biting Forces: The Basics
The average biting force during chewing is around 68 lbs per square inch for males, less for females. Intentional teeth clenching can increase the force to about 150 lbs per square inch.
Nocturnal or night time teeth clenching however, can subject our teeth and jaws to pressures of up to 1200 lbs per square inch.
It doesn’t require much imagination to consider what can happen to our teeth, jaws and soft tissues when something like a routine crown, filling or a few veneers causes a disturbance that fails to distribute our biting forces evenly along the entire occlusal plane (alignment of upper and lower jaw when closed).
Analysis: Attention to Detail
Stone Models and Diagnostic Waxup activities are a critical component for complex reconstructive or cosmetic dentistry. Precision instruments enable the accomplished dentist to evaluate all physical properties of jaw and dental function.
Accomplished reconstructive and cosmetic dentists who rarely have a treatment failure tend to have a history of incorporating occlusal studies in all but the simplest of treatment plans.
Articulation analysis assures the dentist of being able to maintain or correct the best upper and lower jaw relationships while providing patients the ability to design the cosmetic aspects of their treatment.
Waxup Modeling and Temporaries
Treatment plans that focus on multiple tooth replacements via crowns, implants, bridgework or denture prosthetics typically include detailed assessments of physical features and dental function dynamics that are required for recreating a bite that once existed.
Once the physical attributes of reconstructive or restorative dentistry are determined, the waxup process begins. Creating new tooth shapes, tooth positioning, color shading, harmonizing the smile line and otherwise making everything “look just right” involves the dentist AND the patient.
Temporaries are created for veneers, fixed bridges or new crowns that are actually worn by the patient for a few days… to several weeks.
Critical Procedure Component Often Omitted
In complex reconstructive dentistry treatment plans the use of Temporaries is assured by most accomplished dentists.
It is within the less complex treatment plans that the common stories of cosmetic disappointments or complete failures often are due to the omission of temporaries.
Patients and even some dentists believe that with small numbers of crowns, veneers or short span bridgework (and other prosthetics) the diagnostic waxup process is an unnecessary and perhaps wasteful expense.
In some metropolitan areas, some dental practices may create attractive pricing for popular cosmetic procedures (placing or replacing crowns, veneer makeovers) by eliminating various costs that frequently include Stone Models (made from impressions) and the waxup process that is built upon these models.
Last Chance for Perfection
The implementation of stone modeling and waxup activities guarantees the patient (and dentist) the opportunity to check and recheck all technical and aesthetic factors that make any treatment a treatment success.
Occlusion and bite, even for the smallest number of restorative products, is evaluated and reconfirmed. For the patient, the feel, fit, values of natural appearance and degree of cosmetic balance is evaluated repeatedly until the patient obtains the goal he/she wants from treatment.
Point of No Return?
When the dentist and patient are in agreement or consensus that everything is perfect as can be…. the last sets of occlusal and aesthetic data are sent to the dental lab for final fabrication. This is the step that creates the final restorative products.
Diagnostic waxup activities commonly guarantees:
– the fabrication and fitting of crowns that don’t need to be “adjusted” via grinding down porcelain
– crowns that look “just right” in color, texture and match with other teeth (natural or otherwise)
– smile line changes that match text book definitions
– bridgework or prosthetics that don’t look like prosthetics or fake teeth
– a veneer makeover experience that meets or exceeds a patient’s original goal
– cosmetic and/or structural changes in dental function that include NO unwanted surprises
– the opportunity to create dramatic changes that change the way we think and feel about ourselves
Once fabricated, the color and shade characteristics of veneers, crowns, bridgework and other prosthetics cannot be changed. New layers of porcelain cannot be “added” to a new crown that is poorly shaped or poorly shaded. Veneers cannot be remade, lengthened or shortened be shading is wrong. Fat looking teeth cannot be re-prepped to make a veneer look more natural.
The waxup example pictured here amply demonstrates the structural and cosmetic effects this female patient will experience as she designs her new smile line. In this treatment plan, strict adherence to the Rules of Golden Proportion are followed.
With only one half (1/2) of the 10 unit veneer temporary in place, the patient IMMEDIATELY becomes aware of the different properties of her teeth that will be modified to create the cosmetic result desired.
Especially noteworthy is how an unwanted color is bleeding through one particular tooth structure. Veneer fabrication and lamination “adjustments” for this particular tooth resolves this problem.
The mathematically derived new smile line is perfect (as defined by the patient) that includes new tooth sizings to overcome the appearance of her natural teeth… as seen on the left side of the upper arch.
Our second photo shows the entire veneer temporary placed on the upper arch. Notice how the unwanted color shading “incident” is repeated on the left side of the arch. Idiopathic properties of these two teeth cause a discoloring event when the teeth are fully prepped for veneers.
As indicated above, attention to detail (required) will resolve this cosmetic issue.
This special need would not have been discovered without the use of temporaries.
After documenting the special fabrication and lamination needs for these teeth, the patient continues to wear the temporaries for several days, monitoring the fit, feel, changes to bite or incisal relationships with the lower jaw, speech characteristics and any changes in color shading in different types of light (incandescent, fluorescent, sunlight, etc.).
The very last step is the final fitting of the new veneers that will reproduce, minus any chance of unwanted surprise, the veneer makeover result achieved with the temporaries.
Waxup Modeling Summary
Patients undergoing nearly any dental treatment where function and/or appearance is critical (in either the patient’s opinion or dentist’s opinion) should always evaluate the importance of using stone models and waxup services.
Temporaries of nearly any restorative or reconstructive dental component enables precision dentistry that meets the standard of care requirements defined by the dentist and meets the aesthetic and basic dental function desires of the patient ….. without the need for retreatment caused by technical errors.
Questions – Suspicions?
Treatment failures, both cosmetic and functional are most often related to the inadequate or poor controls over the analysis and planned treatment of a particular need. In comprehensive dentistry many patients discover that poor attention to detail or the failure of following a treatment standard can cause immense dissatisfaction or unhappiness with new treatment that doesn’t look right, feel right or is creating even more unplanned treatment needs.
Patients seeking details about the material discussed on this page or seeking information that is not discussed here are invited to contact Dr. Smithington directly with our on-line Ask The Dentist form.
Or, call our office at (919) 625-5584 to schedule a complimentary consult with Dr. Smithington. For convenience, an appointment can be arranged with our Free Consult form.
The Reconstructive Cosmetic and Long Beach Dental Implant Dentist
Reconstructive Dentistry is probably the broadest and most inclusive term used to describe the concept of replacing, rebuilding or creating, for the first time, the elements and relationships between teeth, the upper and lower jaws and overall facial structures.
Our practice has been involved in celebrity style cosmetic dentistry since it became popular. Long Beach Dental Implants Dentist, Dr. Smithington, years ago, was a co-founder of the International Medical and Dental Spa Association, in an effort to establish a comfortable and relaxed atmosphere within the dental setting and to offer our patients the widest range of cosmetic change or outcomes imaginable for nearly any dental need.
Elements of Change
Although reconstructive treatment plans typically involve units of replacement or reparative dentistry (replacing a crown, a filling, an implant, bridge, etc.), the terms are not interchangeable.
Rather, Dental Reconstruction refers to the elements of change introduced by treating and/or replacing tooth structures and … most importantly.. the process of assuring an optimization of bite that maintains dental function for each and every unique patient.
Reconstruction: Creating What Mother Nature Forgot
In general terms… it is rare that any given individual will have picture perfect teeth and a smile that compliments a person’s features in every possible way. Typically, for many of us… the reconstructive treatments can begin at a very early age.
Orthodontists specialize in moving things around, up and down, to create a good solid bite that functions and looks the way it should.
Developmental issues are first encountered during the early years and in significant cases can involve surgery to achieve something that we expect nature to provide…. jaw structures that match.
Reconstruction: ReCreating What is Missing
Creating or recreating components of a great looking smile takes on more importance as we move into adulthood. Careers and social activities have a tremendous impact on how we want to look. Bite problems, if not treated or corrected during our developmental years can, well, they usually do come into full bloom as we move through adulthood.
Eating habits, oral health care histories, trauma, delayed or forestalled treatments for routine restorations make up a larger part of all the things that can require a reconstructive effort… rather than just restorative.
Endurance of course becomes a significant issue for any restorative treatment but when a complete smile makeover is the desired result… Long Beach Dental Implants Dentist, Dr. Smithington’s patients can select from a virtual menu of reconstructive components that can promise long term endurance.