How long will my dental restorations last?
That question comes up all the time, as well it should. Our patients often make a large investment in restoring their teeth and improving their smile, and rightly want to know how long we expect it to last.
There are several factors that need to be considered. The materials themselves are capable of lasting a very long time in the mouth. Filling materials, whether silver amalgam (which isn't used nearly as often now as in the past) or tooth-colored composite resins, can easily last 10 years. Porcelain, used for crowns and veneers, can last twice that long. Gold fillings and crowns typically last the longest. It's not uncommon to see gold dentistry that is 20 or more years old still looking good and functioning well.
The other factors to be considered are, how well will it be cared for, and under what conditions will it be used. Good home care consists of brushing and flossing to keep the teeth and dental work free from plaque and calculus in order to keep the gums healthy and to prevent new cavities from forming. New cavities can form under crowns, fillings, wherever there is a tooth, and undermine even the best made dental work. Regular professional dental care is essential to maintain oral health and restorations.
The other issue relates to the habits and usage of the individual patient, both voluntary and involuntary. Specifically, biting and chewing on non-food objects like fingernails and ice, and bruxism. Bruxism is the term for clenching and grinding of the teeth. This is perhaps the most destructive habit and the biggest negative influence on longevity of teeth and dental treatments. It causes wear and breakage of natural teeth, fillings, and pretty much any dental restoration. It can be controlled and the teeth protected with the routine use of a night guard.
When looking for an answer to the question of longevity of new dental work, look at the past of your natural teeth. While we have gotten pretty good at mimicking nature, your natural teeth are hard to improve on. Ask yourself how they held up. If you're young and your natural teeth are in bad shape with frequent cavities, worn, chipped or broken teeth and fillings, chances are that the longevity of your dental work will be toward the lower end of the range. On the other hand, if you're older and your teeth have held up pretty well, then you can expect to enjoy your new dentistry for a long time.
It's impossible to put an exact number to the answer, but there are things you can do to help. Regular professional care and excellent care at home are the most important. If a night guard is recommended, take that recommendation seriously. Make sure to discuss your concerns with your dentist and hygienist. They are in the best position to assess your specific needs and give you more detailed recommendations.
Do you accept my insurance?
Regarding insurance plans, there are three levels of participation. How your insurance might work in this dental office is determined by the options of your plan:
- Your plan limits you to a dentist on a list
- Your plan has a list, but you have the right to see any dentist you want and still be covered
- There is no list, and you choose the dentist with full benefits
If your plan requires you to go to a dentist on a list in order for you to have any benefits, and we are on that list, then your plan information will spell out the specifics. If you tell us what plan you have, we will be able to give you that information. If your plan has a list but gives you the option of seeing a dentist not on the list, then there will certainly be a benefit for any treatment performed here. The level of benefit will depend on the specifics of the plan. We can provide you with that information if you tell us the name of the plan. If you have a traditional insurance plan where there is no list, then the benefits will be spelled out in your plan documents. We can help you determine what the benefit is for any course of treatment.
Dental offices are approached by insurance plans all the time and asked to sign a contract in order to be placed on the list of "preferred providers". The terms of these contracts determine whether or not it makes sense for us to sign on. An indication of the quality of the plan is the number of dental offices on the list. We cannot provide the quality of care that we dedicate ourselves to within the constraints of many insurance plans. We are very selective as to the plans we contract with.
Regardless of your plan or the level of coverage, you can be sure we will do our very best for you. We have only one level of care. If you are not yet a patient, give us a call and we can help you determine the level of insurance benefit you can obtain for the treatment we perform. Come in and meet us and see why many of our patients stay with us even if they might have less out-of-pocket expenses somewhere else.
Will I be charged if I miss an appointment?
Appointment time is reserved just for you. We don’t overbook, and we schedule each individual patient to have our undivided attention. Missed appointments or last-minute cancellations leave us with insufficient notice to offer that time to another patient who has been waiting to see us.
Yes, we do charge for missed appointments. However, we do realize that things happen, and we try to be reasonable. People get sick, cars break down, situations arise that interfere with your ability to keep your appointment. This should happen rarely, however. We do have a priority call service for those who have difficulty determining, in advance when they might be available for dental appointments or for whom last minute changes in their obligations prevent them from keeping their appointments.
What can you do for bad breath?
The first step to improving chronic bad breath, halitosis, is understanding the underlying cause. When patients express concerns with chronic bad breath, we’ll carefully examine patients’ mouths for signs of decay, infection, or gum disease that may cause bad breath. However, most frequently, bad breath is caused by a gap in at-home oral hygiene. When food particles remain in the mouth they break down and cause foul breath. We’ll carefully review patients’ at-home care routine to ensure they’re adequately removing food and other debris each day. In rare cases, patients experience chronic bad breath without an obvious underlying concern such as infection or lacking hygiene. In these situations, we may recommend special mouth rinses or prescription toothpastes to combat dry mouth and remove or reduce the amounts of specific bacteria that lead to halitosis.
Are white fillings as good as silver?
They are even better. White fillings are now the standard filling used in almost every situation.
Silver fillings just fill the hole in the tooth. If the hole (cavity) is large or near an edge of the tooth, the walls that are left can be thin and weak. With repeated use, thin and weak parts of teeth will crack and break.
White fillings do more than just fill the hole. They actually bond to the tooth structure. In this way, they make the tooth stronger. These bonded fillings can prevent teeth from cracking, and if they already have cracks starting, can prevent them from getting worse.
White fillings are more difficult to place, and the process takes a little longer than for silver fillings, but the results are worth it.
Caps, crowns, inlays, onlays…What's the difference?
All of these are forms of restorations for teeth that have been extensively damaged or decayed. Caps and crowns are synonyms for the same type of restoration. “Dental crowns” is the more accurate term, but caps have been used as shorthand for this restoration for years because these restorations sit over the top of a damaged tooth like a cap sits on a person’s head.
Inlays and onlays refer to more conservative treatments that allow us to repair a larger damaged area than is possible with traditional fillings while preserving a greater amount of natural tooth structure than is possible with dental crown restoration. Inlays refer to restorations that repair decay or damage between the cusps, raised areas on the surfaces of teeth. Onlays are used to repair one or more cusps or sides of teeth.
All three of these restorative services are custom crafted by skilled professionals in our trusted ceramics lab. In order to create these restorations in the lab, we first need to gather information from the patient that is used to design their crown, inlay, or onlay. That means patients will need to visit our dental office at least two times over the course of treatment.
During the initial visit, we prepare teeth by removing a small amount of dental structure. Then, we capture impressions of the prepared teeth, take photos, and may even need X-rays to ensure the lab has all the necessary information to create a flawless restoration. Finally, we place a temporary crown, inlay, or onlay to protect the prepared tooth while our lab crafts the custom restoration for high-quality, durable materials. Once we receive the restoration from our lab, patients return to exchange their temporary for a custom crown, inlay, or onlay. With proper care, these restorations last a decade or more.
Before beginning treatment, we’ll determine what material is best suited to patients’ needs. We typically use gold or ceramic. Gold fillings don’t look completely natural within the smile line, but they do provide optimal support and do not increase wear to opposing teeth. Ceramic fillings completely blend into patients’ smiles, making them an ideal option for teeth. However, they are not as strong as the gold restorations, and may cause more wear to opposing teeth.
How do I know if I have gum disease?
Gum disease is present in over 75% of adults. The classic signs of gum disease are red, tender, puffy, or bleeding gums, or bad breath. Healthy gums do not bleed when you brush your teeth, even at the gumline. Gum disease is treatable and preventable, but the worse it gets before treatment begins, the harder it is to treat and the greater the likelihood it will result in tooth loss. The best plan of action is regular professional teeth cleanings and examinations.
What's a root canal?
Root canal therapy is a way to save an infected tooth. It's the only alternative to taking out the tooth. To be more specific, it's necessary to understand the structure of a tooth.
Every tooth has a hollow space inside. That space runs inside the tooth (the chamber) along its length right to the tip of the root (the canal). Inside that space is soft tissue (nerves, blood vessels, and other tissue) called the pulp, but often referred to as "the nerve". This tissue has a very limited ability to heal. When injured, either from trauma or from infection, the pulp usually dies. Tooth decay is a bacterial infection of the tooth, and when the decay gets close to the pulp, bacteria can enter the pulp chamber and infect that tissue.
Root canal therapy cleans that space, disinfects it, and fills it with a specific material used only in root canals. Following root canal therapy, as long as the tooth is properly restored, the tooth should last as long as any other tooth in the mouth.
Does teeth whitening work?
Yes, it works very well. We've been whitening our patients’ teeth for many years. In fact, it’s the most requested cosmetic dental procedure because it’s a relatively simple, inexpensive treatment that is very reliable.
We constantly research and evaluate whitening products and systems. Our experience along with the shared experience of hundreds of dentists nationwide allow us to provide the most effective and impressive results to our patients. We offer a combination of at home and in-office systems that can be tailored to your preferences and priorities.
What can you do about snoring?
There are dental devices that can help reduce or eliminate snoring. That might sound strange, but here's how it works. When you sleep, your muscles relax. When the tongue relaxes, it can drop back very near the back wall of the throat. This is the space air passes through when you breathe. During inhalation, the air is drawn past that narrowed passageway. Just like the air that rushes out of a balloon when you let it go, the back of the tongue and the soft palate will vibrate. This vibration causes the sound we call snoring.
If the tongue gets very close to the back of the throat or actually touches it, the suction caused when you inhale will suck the airway closed; no air can get by. Breathing stops. After several seconds, an alarm goes off in the brain and you are aroused from deep sleep, which restores the muscle tone, and the tongue is pulled forward, opening the airway. There is usually a gasp with the first breath, then a relaxation back to sleep. The sleeper is unaware of what happened. This is called obstructive sleep apnea or OSA. There have been numerous studies linking OSA with serious medical conditions such as stroke, high blood pressure, heart attacks, and others.
There are specific dental appliances that can help snoring and OSA. They are worn in the mouth like a mouthguard or night guard. When you bite into it, the appliance causes the lower jaw to be positioned forward. This causes the tongue to come forward, away from the back of the throat, thereby opening the airway. This is so much simpler than the alternative treatments that involve a cumbersome facemask-like appliance with pressurized airflow, or surgery to the tongue, throat, or palate.
What do you do to ensure patient safety?
We not only meet these recommendations and requirements, but we take that extra step. We always wear gloves, we use disposable supplies whenever possible, and steam/heat sterilize (autoclave) all instruments and handpieces. We test our autoclaves on a regular basis to verify their efficacy. We take advantage of continuing education courses and professional publications to stay up-to-date in this crucial area. This is consistent with our goal of maintaining a 'state-of-the-art dental office in all regards. Our primary concern is the health and safety of our patients and staff. If you have any questions or concerns, please feel free to discuss them with any member of our staff.
Are silver amalgam fillings bad for your health?
No, they are not. There are some people who think that silver fillings cause a variety of health problems. However, there have been a number of well-done studies recently looking at large groups of people. There are, after all, hundreds of thousands of people who have silver fillings in their teeth. No link between silver fillings and health problems has ever been demonstrated in a well done, controlled study. A very small percentage of people are allergic to the material and react to silver fillings much the same as people who can't wear certain kinds of jewelry or eat certain foods. What has been alleged is that silver fillings cause a variety of health ailments. This has never been shown to be true.
We do not recommend replacing fillings for health reasons because there is no health benefit. If you don't like the way they look, or if you need a filling replaced for other reasons, there are alternatives to silver fillings. In fact, we use tooth-colored fillings almost exclusively because they work better than silver fillings and look great.
If you have any questions or would like to discuss this issue further, feel free to speak to any of our doctors or hygienists.
What are some of the different billing and payment options you provide?
We do request that patients pay their fee at the time of service unless prior arrangements have been made with our financial coordinator. For your convenience, we do accept MasterCard, Visa, American Express, and Discover credit cards, as well as cash and personal checks.
If you have a large treatment plan and wish to make monthly payments, we do offer a payment plan. Our financial coordinator will be happy to discuss the details with you.
If you have dental insurance and wish the benefits to be sent to this dental office, please bring insurance information (card, form, or other identification) with you to your first appointment. We can now estimate, in advance, what the anticipated insurance benefit will be. We will process and submit all insurance forms and accept assignment of benefits directly from those insurance companies who offer that option. When this assignment applies, patients are only requested to pay their deductible and copay at the time of service.
Thank you for your understanding and cooperation.