Understanding Dental Services, Descriptions and Questions to Ask

Your OPT-In Dental Advantage Dentist will Explain Your Needs and Options

Dentistry offers fairly standard care as well as more complex care with options. Below is a list of types of care offered for different reasons, what they mean, and questions you might want to ask. You will find answers about:

• Teeth Cleaning
• X-rays
• Fillings
• Crowns
• Fixed Bridges
• Cosmetic Dentistry (Including Whitening & Veneers)
• Removable Partial Dentures
• Complete Dentures
• Dental Implants
• Periodontal Surgery
• Arestin Therapy
• Root Canals
• TMJ & Sleep Apnea/Sleep Disorders
• A Word of Caution
• Your Options

Teeth Cleaning Everybody needs their teeth cleaned and checked on a regular basis. Cleaning removes debris that can attach to tooth surfaces, calicify (tartar or calculus), and lead to gum disease, infections, and teeth to be lost. Most need their teeth cleaned twice per year, some, every 3-4 months due to extra buildup. For the latter, make sure you take the advice of your dentist, even when low cost insurance refuses to cover the extra cleanings. Those naturally resistant to tartar might be fine with one cleaning and exam per year. Being seen regularly will save you money in the long run.

• What to Ask: Your teeth cleaning appointment should require 30 minutes minimum, and in some cases, be much longer.

X-rays Not everyone needs x-rays once per year, especially those without problems for long spans of time. Full series x-rays that show bone are important, and should be taken at least every 5 years. Oral cancers and cysts that are found by Full Series x-rays are very dangerous. Though rare, the risk is not worth delaying. When teeth, gums, and bone have problems, they almost always get worse over time, becoming more difficult and expensive to fix.

• What to Ask: Ask your previous dentist for a copy of your x-rays. Your OPT-In Dental Advantage Dentist will want to compare previous to current x-rays.

Fillings There are two main types of fillings used to replace areas of decay: silver, and, resin composite. Silver, a viable and inexpensive filling material, remains controversial due to its mercury content. Resin fillings are tooth colored, perform very well, but cost a little more. An advantage of silver is how well it seals and inhibits bacterial invasion. However, it can wedge teeth in ways that could lead to tooth fracture. Resin fillings, though more technique sensitive, have also done well, long term. Aside from being more esthetic, resins attach chemically to the tooth, tending to make everything stronger.

• What to Ask: Before considering a lesser expensive silver filling, make sure your tooth is not in danger of fracturing.

Crowns  Broken teeth, large amounts of decay, and failed older crowns, might need a crown that covers the entire tooth, or just a portion. If cost is a factor, it is possible for a very large filling will work. However, doing so might lead to failure in the near future, and end up being a waste of time and money. The traditional crown has always been porcelain fused over metal. These are sometimes the least esthetic, cause dark lines along the gums, and even attract more plaque than other materials. However, for an additional cost, there are ways to improve and avoid associated problems. The other worthwhile category includes a variety of esthetic, all-porcelain crowns. When it comes to deciding which type of crown is best for you, your OPT-In Dental Advantage Dentist will provide expert guidance in choosing the best material and the right dental laboratory for the results you need.

• What to Ask: Make sure you understand how the different types of crowns, and the range of fees, will affect esthetics and health.

Fixed Bridges These are a series of crowns that are all connected, with one or more crowns replacing a missing tooth or teeth. All the attributes and cautions for crowns also apply to permanent bridges. Your OPT-In Dental Advantage dentist will determine if your teeth are strong enough, if there is enough room, and the best material to use.

• What to Ask: Always consider an implant(s) instead of a fixed bridge whenever possible, especially when teeth that will support the bridge have no restorations.

Cosmetic Dentistry There is nothing more important to establishing a first impression than to offer a great smile. In fact, we know from research that most of us look at the mouth when listening to others. There are many ways to improve our smiles, including orthodontics, porcelain veneers (a thin layer of porcelain bonded on the front surface of teeth), porcelain crowns, implants, white bonded fillings, and bleaching teeth also called teeth whitening. Most general dentists and prosthodontists will perform these services. Just as some dentists have extra training in Cosmetic Dentistry, there are also dental laboratories that are better suited to provide the highest quality results.

• What to Ask: Make sure you know what you want when improving your smile, and ask to see photos of before and afters. This is one area of dentistry where you very often get what you pay for. But also take the time to fully understand the limitations that all dentists face.

Removable Partial Dentures When teeth are missing and a fixed bridge won't work or your budget won't alllow for it, a removable partial denture might be the answer. Instead of being cemented like crowns and fixed bridges, removable partial dentures can be taken out, cleaned, and reseated. They rely on denture teeth to replace missing teeth, and gum colored resin that rests on the gums. There is most often, but not always, a metal support structure that also has metal clasps (arms) that hug teeth to help keep the removable partial denture from dislodging. Patients with removable partial dentures will often complain about catching food, bulkiness, and esthetics. Also keep in mind, denture teeth wear or break over time and will need replacement. Your OPT-In Dental Advantage Dentist will thoroughly explain the many types of removable partial dentures,  variables in their wide range of costs, and how to avoid allowing insurance to limit your choices.

• What to Ask: Before deciding on a removable partial denture, ask about a lower cost all-resin type to test your comfort. Also ask about dental implants.

Complete Dentures Replacing all teeth with traditional dentures might be necessary, but should be avoided if possible because they erode jaw bone that can cause further complications. Essentially, the less bone, the less the support, the more difficult to keep them in place, speak, and chew. They also reduce taste and bite strength. With dentures to accomodate every budget, you can rely on your OPT-In Dental Advantage Dentist to explain differences.

• What to Ask: The best denture teeth cost more, last longer, and chew better. Also ask about the minimum number of implants that can be used to improve your function and comfort.

Dental Implants Today, titanium dental implants are highly successful and a first choice for replacing missing teeth. They can be used to replace single or multiple teeth with permanently cemented crowns, designed to increase support and comfort for a removable partial or full denture, or a hybrid of permanent and removable. They are a blessing with a wide variety of options that your OPT-In Dental Advantage dentist will devote a great deal of time explaining. Dental Implants can be placed by general dentists, prosthodontists, periodontists, oral surgeons, or endodontists.

• What to Ask: Dental Implants can greatly enhance esthetics, eating, comfort, and offer very high success rates over long periods of time. While there is always a minimum number of dental implants required for each situation, there is little to be gained by requesting the maximum possible.

Periodontal Surgery Hopefully, you never get a gum infection or suffer bone loss around a tooth. If you do, you might need periodontal surgery. In this kind of surgery, the gums might be incised or lasered by a periodontist and pulled back so the infected gum and bone can be repaired. Debris trapped between the tooth and gums can lead to painless bone loss, or a painful infection with swelling. This can happen from delaying teeth cleaning, or, an isolated incident of a trapped food particle.  Gum recession and bone loss, a different problem, can be caused by abrasive toothpaste, and by opposing teeth hitting each other in traumatic ways. The latter problem might require a bite adjustment by your dentist. Your OPT-In Dental Advantage Dentist monitors these problems during each exam. Have your teeth checked and cleaned regularly to help avoid the need for periodontal surgery.

• What to Ask: Gum disease is a major cause of tooth loss, while a traumatic bite can lead to broken fillings, crowns, and teeth. Always express your concerns and follow your dentist's advice in addressing these problems.

Arestin® Therapy  Arestin®, an antibiotic made by OraPharma, is a powder with minocycline HCL infused particles that is placed under the gums in areas of infection. While some dentists might suggest Arestin® therapy to correct an infection, others argue they have not seen the same benefits. It is possible that different patients respond differently, with some not finding the same improvements as others.

• What to Ask: Our suggestion is, if you have unanswered questions about the benefits of Arestin® therapy, consider seeking an opinion from an OPT-In Dental Advantage Dentist.

Root Canals A tooth that dies will need a root canal. All teeth have hollow spaces filled with blood vessels and nerves. If a cavity reaches this hollow section, or your tooth is overly traumatized from your bite, an infection can ensue. The general dentist or endodontist will drill a hole through the tooth's chewing surface to access the hollow spaces in the center of the tooth and of each root. The nerves and blood vesseles will be removed, and all hollow spaces filled. The chewing surface will be repaired by placing a filling in the hole that is sometimes supported by a post placed in a root. Most likely, the tooth will need a crown. Sometimes, missing tooth structure needs to be replaced at an extra charge before a crown can be made. Be seen regularly to help avoid the need for a root canal.

• What to Ask: It is possible that a root canal tooth will also require periodontal surgery prior to having a crown. Ask if a dental implant would be a better alternative.

TMJ & Sleep Apnea/Sleep Disorders A large portion of us have jaw and or sleep disorders that can be fairly simple to address or, very complex, even to the point of impossible to completely resolve. TMJ related teeth grinding can destroy our teeth and may be associated with gastric reflux (acid coming up from the stomach). This problem can cause our teeth to wear quickly and adversely affect our smile, facial esthetics, and chewing. Clenching might have the capacity to break teeth, crowns, bridges, and fillings, along with causing damage to our jaw joints (TMJ). Sleep apnea is often related to snoring and airway blockage. Most dentists can successfully address the simplest of these TMJ problems, but complex problems and Sleep Apnea might require extra training.

• What to Ask: Always be evaluated for these problems. Left unchecked, they can be bad for your health, and cause great damage to your teeth that can also be very expensive to correct.

Your Options Keep in mind that dental treatment normally has options. Most dentists and dental offices will explain your options and make a suggestion on which would be best and why. It is also possible you will be presented with options that are more costly, have questionable benefits, and are less affordable, such as extra crowns or more than necessary implants. If you feel uneasy about your treatment, seek a second opinion from an OPT-In Dental Advantage Dentist.

• What to Ask: You should always feel comfortable and never pressured, otherwise, ask for a written diagnosis and treatment plan, and visit an OPT-In Dental Advantage Dentist for a second opinion.