Expertise

4 Questions to Ask an Orthodontist

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If you have decided to take the leap and get braces, then there are a few questions that you need to ask your potential orthodontic specialist before choosing them.

1. What is your experience?

Before picking an orthodontic specialist, make sure that they are well versed in orthodontic treatment and have done it before. Ask if they are members of the AAO, which can only be joined after completing a required training course. Also ask them how many years of practical experience they have and if they would feel comfortable tackling your case.

Ask your friends and family for references when choosing an orthodontist. If your cousin’s son has braces then she may know a good orthodontic specialist. Don’t be afraid to ask for help, it is a big decision that you don’t want to make lightly.

2. What are your hours?

You are probably busy, and if your kids need braces, then your family is probably pretty busy. Between soccer practice, dance recital, and piano lessons, it might be hard to squeeze in an orthodontic appointment. Find an orthodontic office that is right for you. Choose an office with extended and flexible hours so that you can fit in your visits when it works best for you.

3. How long will treatment take?

Treatment typically varies by person when it comes to orthodontia. We all have different mouths and teeth alignments, so it makes sense that some of us need to keep our braces on for longer periods of time. Most orthodontic specialists say that it takes about two years to see results. Ask how many visits you will need to make each year so that you can get a feel for the amount of time you will be spending in the dental chair.

4. What’s the cost?

Cost might just be the one thing keeping you from getting braces, so shop around for an orthodontist that best fits your price range. Sometimes price has nothing to do with quality, so if you find an orthodontist who charges less, that doesn’t make him a bad dentist. Ask what is included in the quote and what additional charges might crop up.

http://www.colgate.com/en/us/oc/oral-health/cosmetic-dentistry/adult-orthodontics/article/sw-281474979295844

How to Choose a Prosthodontist?

A prosthodontist is a dental professional who is recognized by the American Dental Association as a dental specialist. After their general dentistry training, prosthodontists receive an extra three years of specialty training in an accredited graduate program offered by the American Dental Association.

Prosthodontists specialize in procedures and techniques to restore a person’s smile. Many people don’t realize how important maintaining their smile and teeth is to their self-esteem and confidence, and overall physical health. “Tooth loss creates both esthetic and functional problems” (ACP). “Simple pleasures – like smiling or going out to eat – become a source of stress or embarrassment” (University of Michigan).

The Role of the Prosthodontist

For many dental restorations, the prosthodontist is considered the “quarterback” of the dental planning process. While many general dentists can provide many of the basics in restorative dental care, there are cases where the expertise of a specialist can mean the difference between a successful result and an exceptional result.

“Prosthodontists are trained to manage the most complex dental restorations. From patients requiring rehabilitation after a traumatic injury to creating new smiles for those born with genetic facial deficits…” (University of Michigan).

Your prosthodontist is able to provide the following treatments (adapted from University of Michigan):

  • Dental implants
  • Cosmetic dentistry
  • Complete and removable partial dentures
  • Special needs of geriatric patients
  • Cleft lip/palate
  • Temporomandibular joint syndrome/disorder (TMD)
  • Traumatic injuries
  • Snoring and sleep disorders
  • Maxillofacial prosthetic treatment such as oral cancer reconstruction

Prosthodontist receive extensive training in veneers, crowns/caps, bridges, managing/treating extensive decay and/or periodontal disease, and dental implant placement. The goal of the prosthodontic treatment is to take advantage of state-of-the-art techniques to provide the most natural-looking restoration possible, thereby restoring self-esteem and confidence along with overall oral health.

Your Dental Treatment Team

As the “quarterback” of the dental treatment team, a prosthodontist must coordinate treatment needs and timing with other dentists and dental specialists. For most patients, the dental treatment team coordinates through phone calls, letters and emails because the various members of the team are in different locations, which also means that patients have to travel to different offices to have their treatment completed.

Wellesley Dental Arts, in Wellesely, Massachusetts, has brought together a highly-trained team of dental experts and specialists in one convenient location, which allows them to streamline treatment plans that require the input of more than one or more dental practitioner. When you need dental treatment, it’s always handy to have the dental specialties you need right at your fingertips. That’s the advantage of Wellesley Dental Arts.

Don’t settle for anything but the best for your smile!

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How to Choose a Periodontist?

What is a periodontist? A periodontist is a dental specialist who treats periodontal disease and related issues. All dentists receive training in preventing and treating periodontal issues, but severe or complex cases will usually be referred to a periodontist. “All periodontists must complete an additional two to three years of specialized training in periodontics following dental school” (American Academy of Periodontology).

Not only can a periodontist help treat severe periodontal disease, but he or she can also help restore a smile that’s been affected. Your general dentist and periodontist will work closely together to develop a treatment plan that is custom-made for your particular needs. Why do I need a periodontist?

“In many ways, the mouth can be seen as a mirror of the general condition of your body. In particular, our periodontal status can often tell us more than simply what is happening locally in our gums. Although periodontitis is always triggered by plaque accumulation on the teeth, diseases affecting the rest of the body …can weaken the supporting structures of the teeth. Also, some serious disorders are known to show themselves in the mouth before they are evident in any other part of the body…” (European Federation of Periodontology).

Gum disease and periodontal disease (periodontitis) is the most common dental problem affecting 7 out of every 10 Canadians according to the Canadian Dental Association (and similar numbers can be assumed for Americans). It is estimated that at least half of non-institutionalized people over the age of 55 have periodontitis, and periodontal disease and tooth decay are the leading reason why 1 in 4 people over the age of 65 have lost all of their teeth (AAP).

Methods for finding and choosing a periodontist.

If you require the expertise of a periodontist, your dentist will make a referral to the periodontal specialist whom he or she feels can best handle your case. Some patients may take advantage of the Internet age and “Google” it, but patients can also obtain information from their insurance company or by word of mouth.

With the recent trend in multi-disciplinary practices, such as Wellesley Dental Arts in Wellesely, Massachusetts, a periodontal patient doesn’t need to go through all that searching and doesn’t even need to go do a different location. Patients can get the specialized care and treatment they need right in the same building. Wellesley Dental Arts offer the convenience of providing general and specialized dental treatment in one stop, which not only makes it easier for their patients, but also makes coordinating, developing and implementing a comprehensive treatment plan much less hectic and time consuming.

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Invisalign: The Virtually Invisible Orthodontic Treatment Option

It used to be that only teens were considered for orthodontic alignment. It seemed that it was worth investing in the appearance of a teen’s smile, which usually meant “train track” braces. In the last few decades, however, more and more adults have sought orthodontic realignment of their teeth, as well. And now there is an option that can provide adult orthodontic realignment in many cases in a more esthetically pleasing, virtually invisible way (Invisalign). Why Should I have Orthodontic Treatment? The purpose of orthodontic treatment is to alter the position of the teeth to optimize a person’s appearance and smile, and function. Ideal tooth position can be affected by genetics (natural skeletal structure, eruption of teeth) and environment (oral hygiene, accidents, activities that can affect proper alignment of teeth).

Malaligned teeth can make a person’s smile look off-center and asymmetrical, while compromising a person’s ability to bite, chew and speak (impaired biting and chewing can lead to other digestive issues as the stomach needs to work harder to break down bigger pieces of food than it was originally designed to).

Orthodontic treatment is usually part of an overall comprehensive treatment plan, sometimes involving other dental practitioners such as general dentists and oral surgeons to try to get the best result possible. Each treatment plan is custom made for each individual patient, since each patient’s needs are different and respond to treatment in different ways. In all, a comprehensive orthodontic treatment plan can last between 1 and 3 years depending on the age of the patient (which affects the thickness of the bone, which in turn can make it more difficult to move teeth) and the extent of the treatment required to bring about the best results.

Orthodontic Treatment Options Obviously, “train track” braces are still available and many people still use them. Instead of straight black, however, many come with the option of colored bands to go around the brackets and even different colored or clear/transparent/white brackets.

Many of us are also familiar with retainers which are usually used to help “maintain” orthodontically repositioned teeth in their final position once the main braces come off.

Then, there’s Invisalign. Invisalign is actually a series of appliances called “aligners” made from clear plastic or acrylic and are custom-made for each individual patient. “Each aligner is designed to move the teeth a maximum of about .25 to .3 mm over a 2-week period, and is worn in a specific sequence…. Excellent compliance is mandatory since the appliance has to be worn a minimum of 20 to 22 hours a day and each aligner should be worn 400 hours to be effective” (JCDA).

Your dentist will take X-rays, photos and impressions of your teeth which will be used to create a 3D image of your teeth, which will then be used to determine and devise what kind of and how much movement is required. Regular follow-up with your dentist will be necessary to make sure that the teeth are moving as planned and that you are complying with the treatment requirements.

Invisalign Considerations Invisalign might be indicated as a treatment option in cases of:

  • Mild malaligned malocclusions (1 to 5 mm of crowding or spacing)
  • Deep overbites when simple moving the teeth inward will resolve the issue
  • Full arches where crowding is due to tipping of teeth and not due to a narrow skeletal formation
  • Mild orthodontic relapse following traditional orthodontic therapy treatment

Contraindications to Invisalign treatment include cases of:

  • Crowding and spacing more than 5 mm
  • Skeletal discrepancies between the front and back teeth greater than 2 mm
  • Discrepancies in the positioning of the front teeth along the midline
  • Teeth that are rotated greater than 20 degrees
  • Open bites – anterior where a clear line is visible into the mouth because the upper teeth don’t close down over the lower front teeth; or posterior – where the molars don’t touch
  • Teeth needing to be moved outward
  • Teeth that are tipped more than 45 degrees
  • Teeth that have short crowns
  • Arches where there are multiple missing teeth

As mentioned, each patient’s needs are unique and what will work for one patient will not necessarily work for another patient even if they present with the same or similar dental alignment challenge or issue. Your Wellesley Dental Arts orthodontist will be able to discuss orthodontic treatment options with you, including the possibility of including Invisalign, along with the associated costs and estimated time of completion.

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Advances in Cosmetic Dentistry

Smile and the world smiles with you, as the saying goes. And it’s really true. Studies show that smiling really is contagious and can change a person’s entire mood. Studies have also shown that the more intense the smile (ideally involving the eyes) the better. In addition, smiling:

  • Boosts the immune system
  • Reduces stress and depression by releasing serotonin
  • Lowers blood pressure
  • Makes other people think better things about you

So, if smiling can have this much effect on us and the people around us, it’s really important to have a great smile.

However, studies from the U.K. show that 18% of the population actually don’t show their teeth when they smile in photographs. Women think a nice smile indicates a warm personality, while men are more inclined to think a nice smile can bring them more success in life. Women also are more likely to undergo a cosmetic dental procedure and believe that cosmetic dentistry can improve quality of life. If you consider the above physiological effects of smiling on stress, blood pressure and depression, cosmetic dentistry could very well improve quality of life.

Wellesley Dental Arts believes strongly in the effects a great smile can have on a person’s life, and our team of dentists has been instrumental in transforming people’s lives by simply restoring their confidence in their smile. If you’re self-conscious about your smile, there are many restorative options available.

Cosmetic Dentists can Help

When most people think of “cosmetic dentistry”, they probably think of veneers and tooth whitening.  While whitening a smile is indeed beneficial,  cosmetic dentists can do so much more to help restore, repair or refresh your smile.

In addition to tooth whitening and veneers, cosmetic dentists can provide:

  • Bonding to fix chipped, broken, cracked or stained teeth, as well as gaps between teeth (diastema)
  • Enamel shaping or contouring which modifies the actual shape of the tooth
  • Bridges and crowns to replace missing teeth
  • Bone or soft tissue augmentation or crown lengthening to improve the appearance of the teeth relative to the gum (gummy smile or toothy grin)

Cosmetic dentistry offers patients a variety of dental materials including:

  • Ceramics or porcelain, which provides a strong, most natural-looking dental restoration possible.
  • Resin and resin cement, which allows dentists to bond crowns and fixed bridges
  • Cast gold or zirconia, which may be indicated in molars to provide a strong, but natural-looking restoration

For best results, your overall treatment plan may involve orthodontics or placement of implants. Each treatment plan is custom-designed for each patient depending on his/her needs, wishes and budget.

If you’re interested in finding out what advances in cosmetic dentistry can do for you, be sure to ask your Wellesley Dental Arts cosmetic dentist.

Stop hiding and start smiling :)

Do You Really Need Dentures?

Dentures Thirty years ago, it was a common dental practice for dentists to replace missing teeth with full or partial dentures. Dentists believed (and still do) that missing teeth needed to be replaced to ensure proper chewing function. They recognized that missing teeth could contribute to malnourishment, self-esteem issues and speech difficulties.

At the very least, you do need to replace missing teeth for just the reasons mentioned above.

Dentures are not the only option for replacing missing teeth (see our discussions of dental implants, dental bridges, and general dentistry for other options), but if you are debating whether to receive dentures, or forego replacing missing teeth at all, the answer to the above question is, yes…you do really need dentures.

Dentures are usually made out of plastic and the crowns out of porcelain. They are designed to sit on top of the gum, or can be supported by or suspended between existing teeth. There are several main downsides to dentures, however.

Because the dentures actually sit on top of the gum, over time the gum and supporting bone can wear away, leading to ill-fitting and ill-performing dentures and by extension the malnourishment issue mentioned earlier. And, while dentures were fabricated to look as much as possible like natural gum and teeth, it was in most cases very obvious that someone was wearing dentures, resulting in, by extension, associated self-esteem issues and speech issues, related to air being caught underneath the denture.

Also, in the case of partial dentures that are supported by adjacent teeth, the supporting teeth—even if there is nothing dentally wrong with them—must be root canaled and the crowns ground down so that the pontic can be attached. An artificial crown will then be placed.

But dentistry technology has come a long way in 30 years, particularly since the introduction of P.I. Bränemark’s titanium dental implant. Those patients who have had dentures or will be candidates for dentures in the future have the option of having an implant-based restoration. Implant-based restorations preserve bone and gum height, look and perform more like natural teeth, and can provide support for a partial denture or bridge.

So if you have had a denture for a long time, or are considering having your teeth replaced by a full or partial denture, come in an talk to us about an implant-based alternative. Properly integrated, implants have an over 95% success rate and can last 30 years or more, where as a conventional denture may last only 15 years and can ultimately undermine the health of dental structures like bone and gums.

Each patient will receive a custom-designed treatment plan that takes their individual dental circumstances into account. Dental implants have become the treatment of choice for dentists looking to replace missing teeth. Talk to one of the Wellesley Dental Arts to see if dental implants might be a treatment option in your case.

Are "Teeth In A Day" A Possibility?

Teeth In A Day Along with all the hoopla about dental implants and their advantages in replacing missing teeth comes the new promise of “teeth in a day”.

In fact, Wellesley Dental Arts does offer services of Teeth In One Visit and Teeth In An Hour Treatment!

Many patients are aware of the advantages of dental implants—95%+ success rate, 30+ year lifespan, preserved height and quality of bone and gum support, improved esthetics and function over a conventional denture. The one main disadvantage of implants is the fact that, depending on the patient, it can take up to 3 to 6 months to have a temporary restoration placed and up to 9 to 12 months for placement of the final, usable crowns or dentures. Much of this timeline involves healing of the extraction and/or bone graft site before placement of the implant, and then a period of integration for the implant before it is “loaded” with the chewing weight and stress of normal function. For some patients, this method may still be necessary to provide the best, long-term and esthetic results.

For many patients, though, who have adequate height and quality of bone and no extensive tooth decay or other periodontal issues, teeth in a day provides a convenient, two-step process that could see a permanent restoration placed within three months.

The first appointment involves the extraction (and perhaps light bone grafting), if necessary, and placement of the implant and a healing abutment. A temporary crown or bridge is then placed on this healing abutment, providing an esthetic finish to the potentially empty space. The patient walks out of the office with a crown in place and no-one is the wiser. In many cases, the permanent restoration can be placed in as little as 6 weeks.

It is important that patients who opt for this “teeth in a day” procedure follow their post-operative instructions to ensure proper integration of the implant. Proper oral hygiene practices need to be followed, and no chewing is allowed on the temporary crown. Not following these instructions can lead to food or bacteria compromising the health of the supporting gum and bone for the implant, and the stress of chewing could compromise the success of osseointegration (the process where the titanium implant actually fuses to the bone).

If you would like to find out if you’re a candidate for “teeth in day”, please talk to one of our Wellesley Dental Arts. One of our dental specialists must evaluate your mouth before providing any form of treatment suggestion or estimate of cost of treatment.

How Do You Know If You Need A Root Canal Or A Dental Implant?

Root Canal One of the most common decisions for dental patients who are faced with treating a decayed or fractured tooth is between a root canal and placement of a dental implant. Not every patient will be a candidate for root canal treatment and not every patient will be a candidate for an implant-based crown or bridge. Each treatment plan recommendation will be based on each patient’s needs and dental circumstances.

For those of you who are faced with this decision, where either a root canal or an implant are equally viable treatment options, here a couple of main things to consider when deciding which treatment to pursue.

The two main considerations are cost and long-term results.

Cost

A root canal is quite obviously less expensive than placement of an implant. A root canal can range from $600 in a front tooth to $1000 in a molar, while an implant can cost $1000 each or more. In both cases there is usually an extra charge for IV sedation if the patient so chooses (although placement of an implant is commonly done under IV sedation).

Results

The main advantage to an implant-based restoration over a root canal is the quality of the results. A root canaled tooth can predictably last about 10 years before needing to be permanently replaced (usually with an implant). This lifespan may be less if the root canaled tooth is being used to support a pontic (bridge) or crown. The lifespan also depends on the skill of the dental specialist performing the root canal treatment. Missed canals or inter-operative complications (eg: instrument separation) can compromise longevity. Sometimes tooth decay is found to be more extensive than anticipated or tooth fractures or perforations are discovered during the root canal, which can also affect long-term results. In some cases, the root canal may need to be redone or an apico-ectomy performed to fully resolve the issue, increasing the cost to beyond that of an implant-based restoration.

By contrast, once properly integrated, an implant can last 30 years or more, and performs and looks just like a natural, non-root-canaled tooth.

Success

For most patients the percentage of success in either a root canal or implant placement procedure is almost the same (95% versus 95-98% respectively), so the choice will ultimately (likely) come down to price, and the extent of the damage or rate of decay affecting the tooth or teeth being treated. It should be noted though that root canal treatment is generally viewed as an intermediate step. It is assumed that, at some point in the future, an implant-based restoration will be necessary.

Is it Worth Investing in Your Teeth?

One of the most common reasons people put off even basic dental cleanings is simply that they cost a lot of money. But here are three reasons that make your mouth worth the investment.

1. First impressions: Your smile is the first thing people see and will define people’s first impressions of you. Discolored or missing teeth affect how your smile looks (what dentists refer to as “esthetics”) and unfortunately human nature will make a judgment on what kind of person you are if your mouth doesn’t look well-cared-for. Not only that, but poor oral hygiene can result in build up of plaque and tartar leaving existing teeth unsightly and development of bad breath from the result of bacteria growing in the plaque and tartar, which will also affect those around you. If you are a mother with young children and are in the habit of sharing utensils, there is also the chance that bad-breath and cavity-inducing bacteria can be passed on to your children – even through the touching of the spoon to your lip to test the temperature.

2. Self-esteem: It’s unfortunate but true that impressions are usually made on appearances first, and whether they realize it or not, people with poorly maintained teeth or smiles are not as confident in themselves and in presenting themselves in public as those with a full smile or well-maintained dentition. They do not view themselves as pretty or presentable and will focus more on covering up their smile than on discovering and making new friends or new job opportunities.

3. Effect on other health systems: Several studies have shown that periodontal disease and other dental issues can affect other bodily systems. Studies have shown that, regardless of weight, those with periodontal disease have a higher level of insulin resistance than those with more minor or no periodontal disease. Additional studies have shown that “subjects with gum detachment that exceeded 2 mm had a 40 percent greater risk of developing lung disease than those with attachment loss of less than 2 mm” (www.sciencedaily.com). Missing teeth, particularly molars, can affect chewing and improperly or inadequately chewed food can make the stomach and digestive system work harder as it tries to process what we eat.

Your smile and overall oral health can affect how you view yourself, how others view you, and how your body deals with health issues. Taking care of your mouth with a proper oral hygiene routine including routine dental cleanings, and investing in restoration procedures such as fillings, dental implants, crowns and bridges can make the world of difference in a person’s life and improve a person’s quality of living.

Everyone knows that if you catch something early it is easier to treat. That is also true for teeth. Paying a smaller expense now is better than paying a bigger expense later to treat the resultant problem of neglect and procrastination.

A healthy smile really affects a lot of other things…it’s worth taking care of it.

Sources: Sciencedaily.com; American Academy of Periodontology

Dealing with Cracked Teeth

If you’ve ever bitten down on a crusty piece of bread or an unpopped popcorn kernel or suffered a blow to the upper or lower jaw during an accident, you may have experienced part of a crown chipping off and falling out into your hand. In these kinds of cases, it is pretty obvious that a tooth is cracked. But many people do not realize that a tooth can be cracked without coming completely apart.

Causes of Tooth Cracking

If a tooth has had restorative work done such as a filling or root canal, or has untreated tooth decay where the structural integrity of the tooth has been compromised, there is a greater chance that this tooth will crack, either as a result of trauma or function.

Parafunctional habits such as grinding and clenching, where the molar teeth in particular are put under additional biting stress, can also increase the chances of a tooth cracking.

In many cases, the crack isn’t visible on an X-ray.

Symptoms of Cracked Teeth

So if your dentist can’t see these cracks or fractures on an X-ray, how do he or she know the crack is there? The presence of biting, percussion (light tapping or touch), or temperature and sweet sensitivity will alert your dentist that there is a potential problem.

The severity or acuteness of the discomfort is determined by the position, depth and direction of the crack. If the crack is below the gumline, an infection may develop in the gum tissue or inside the tooth root (if the crack is deep enough) resulting in a “fistula” (a blister) on the gum surface. A fistula drains pus from an infected site and is a definite sign to a dentist that something is wrong.

A dentist may not be able to diagnose a crack right away even with the presence of these symptoms. In fact, an examination by an endodontist may be required. If the source of the pain is still unknown, then a root canal might be suggested to address a suspected root issue, and it is often during this procedure that the crack is discovered. At this point, it is at the dentist’s discretion whether he or she believes the tooth can be saved, and the root canal procedure can continue with appropriate fracture management methods, or whether he or she should stop the treatment and consider other restorative options.