Category Archives: Crowns

Inlays & Onlays Explained

Keeping natural teeth is important for reasons in addition to just creating an appealing smile. A natural tooth provides a number of advantages both above and below the gum line.

It has been shown that people who have their natural teeth live an average of ten years longer than people who wear dentures. And, it is a fact that, when a natural tooth is lost, the next to be lost will be one adjacent.

When most people think of having a cavity in a tooth repaired, a ‘filling’ is typically the anticipated procedure. However, large cavities of teeth that have an overload of decay or previous fillings are often crowned. A crown (or ‘cap’) covers the entire top and sides of the tooth to protect the remaining structure. This helps preserve the tooth along with its roots that are so beneficial to the health of the jaw bone that supports them.

In the past, many dentists used a silver ‘amalgam’ material to fill the portion of the tooth that was removed.  Because of the concerns surrounding the suspected hazards of amalgam’s mercury content, non-amalgam filling materials became the standard choice for most dentists.

Non-amalgam tooth-colored fillings contain no mercury and provide a more tooth-like appearance. Yet, there are times when a filling is not quite right and a crown may be more than is needed. This is where inlays and onlays are a better option.

Inlays and onlays are ideal when a large, biting surface area of a tooth needs repair. Inlays and onlays are like porcelain puzzle pieces. They are custom-designed to fit precisely into the tooth, similar to how a puzzle piece fits snugly into a jigsaw puzzle.

The procedure begins with removing the decayed area and preparing the tooth. You are fully numbed during the procedure. While you relax, a mold is made of the area to be replaced with the inlay or onlay. A temporary ‘restoration’ will be provided to protect the area while a dental lab creates your final porcelain inlay or onlay. Once the restoration is ready, you’ll return to our office to have it ‘seated’ into placed and secured with a special dental adhesive.

The porcelain used in inlay and onlay construction provides exceptional durability and provides a highly natural feel and function with exceptional longevity. During both appointments, your comfort is a priority. If desired, oral sedation can be added to treatment for added relaxation.

When a tooth needs repair beyond the adequacy of a simple filling (or less than the need for a full crown), an inlay or onlay may be the ideal remedy. If this is best for your individual situation, I’ll be happy to explain the procedure, comfort options, treatment time and estimated cost.

Call 586-739-2155 to request a no-cost, no obligation consultation.

Avoid Losing Teeth By Decisions You Make Now

Imagine standing on the side of the road, stranded beside a car that has stopped running. For most of us, there is a sense of dread for this type of situation since we know the time, expense and frustration that comes with correcting the problems involved.

Now, imagine learning that the car is stranded because you failed to add necessary fluids, fell behind on oil changes and ignored warning lights.

As a dentist, I see a fair number of patients who have lost teeth. While some have lost them due to an accident or injury, most have lost them because of inadequate oral hygiene, failing to have regular dental care, and poor health choices (such as smoking).

For those who have lost teeth due to these choices, any one of them will tell you if they could go back in time, they would have taken better care of their teeth.

A tooth lost must be replaced or else neighboring teeth will shift. This shifting can cause chipped, broken or worn teeth. As the fit of upper to lower teeth moves out of its proper position, it can lead to headaches, migraines, night-time grinding and clenching, dizziness, ear ringing and sore jaw joints.

With poor oral hygiene and lack of regular dental check-ups, continued tooth loss is almost assured. As each tooth is lost, the one adjacent to it is at the highest risk to be the next you’ll lose. It’s a vicious cycle.

Teeth are easy to take for granted, They are hard and strong, giving the appearance of being ‘rock solid.’ They can weather an enormous amount of force. Yet, teeth are a natural part of our overall makeup. and do have vulnerabilities. This is why cavities and breaks can occur.

The main reason we recommend crowns for teeth at risk is to save the tooth. While the portion of a tooth you can see is important, it’s the portion beneath the gum line that we are even more concerned about.

Tooth roots nurture and ‘feed’ not only the tooth, but the jaw bone that supports them. Without these roots in place, the bones begins to atrophy. In dentistry, this is known as resorption. Simply put, it’s a melting away of jaw bone where tooth roots were once held.

As the bone shrinks, a number of things begin to occur. The tooth roots adjacent to the area of resorption are more vulnerable. The tooth above or below elongates, creating risk for damage mentioned prior (chips, breaks, etc.).

Facial changes can be seen as the bone thins further. For example, when the mouth appears collapsed into the face and the chin points, this is referred to as a ‘granny look.’ This occurs due to severe resorption of someone who has lost all of their teeth.

Earlier facial changes can also be seen when someone is missing natural teeth. Deep wrinkles form around the mouth, the corners of the mouth turn downward even in a smile, jowls form from the detachment of facial muscles, and the nose moves closer to the chin.

As unfortunate as these changes in appearance are, trying to eat properly when the jaw bone has declined is worse. People who wear dentures or partials often struggle when chewing or biting when their denture lacks a high foundation on which to balance.

When the bone shrinks, the ‘arch’ where tooth roots were once held begins to flatten. This is a slow but continual process that gives a denture an ever-decreasing surface. After a while, even denture adhesives or pastes are of little help.

To replace missing teeth, we often recommend dental implants. Implants recreate stimulation to the jaw bone, halting the rate of bone loss. Because they are supported by the jaw, implants restore the same, dependable foundation your natural teeth once had.

Another advantage of dental implants is their ability to ‘stand alone.’ Since implants are held by the jaw bone, they do not rely on neighboring teeth for support, as with crown-&-bridge combinations. This means you won’t need to have otherwise natural, healthy teeth crowned for the mere purpose of supporting a bridge.

To correct a common misconception, an implant is NOT always needed for each missing tooth. In many cases, one implant can support a bridge of two or more teeth. When a full arch of teeth is needed, several strategically-placed implants can provide adequate support.

All-On-4 Dental Implant System is one example of several implants supporting a full arch of teeth.

If you’ve lost teeth, the best way to halt the process is to replace those you’ve lost (and the sooner, the better). Then, be ultra-committed to your oral health. Brush twice a day and floss daily. Drink plenty of water and limit snacking and your intake of sugar and carbs. If you have teeth at-risk, have them crowned or other necessary repairs.

In our office, we respect all patients. We pride ourselves on being a ‘lecture-free zone’ and are here to support each individual, regardless of what brought them here. For those who have lost natural teeth, our goal is to restore them to a healthy, confident smile they’ll feel good about.

Begin with a free consultation to discuss your oral health needs and the smile you’d like to have – and share, often! Call 586-739-2155 and ask to meet with me personally. I look forward to meeting you!

 

How To Make Dental Implants Last A Lifetime

Of all implant-in-bone procedures performed today, Dental Implants hold the highest success rate of all – over 94%. That includes hips and knees. However, like any medical procedure, Dental Implants can fail. How can you help to ensure an optimal result and enjoy a confident smile for your lifetime?

One of the keys to the lasting success of implants begins with the Doctor you choose. An experienced and skilled implant Doctor will make a proper diagnosis, selecting the best implant system for your needs. The Doctor will also provide precision placement so the implanted portions are to a proper depth and angle.

The highest risk of implant failure actually occurs after an implant patient leaves the office. The implant recipient has a significant role in the life of their implants.

Fortunately, removing a dental implant is a rare occurrence. Most often, an implant has to be removed because of the onset of an infection that cannot be adequately treated while the implant remains.

Infection typically occurs when oral bacteria amasses and creates an inflammatory state. Once this inflammation penetrates the gum tissues and bone surrounding the implant’s post, it becomes more difficult to treat. With prompt treatment, some infections can be resolved without complications. However, at a certain level the implant must be removed.

What leads to the problems associated with inflammation caused by oral bacteria? After all, we all have bacteria in our mouths, don’t we? Yes, oral bacteria is a normal part of any mouth. The problems begin when too much bacteria develop and are not sufficiently removed on a daily basis. While the most common cause is poor oral hygiene, smoking (which is drying to oral tissues) and diabetes contribute as well.

Another lesser-known but significant reason for failure is teeth grinding. Bruxing (clenching and grinding teeth during sleep) contributes to implant failure in more cases than many realize. One study of dental implant recipients noted that 29% of patients who were teeth grinders had failed implants. Nearly the same number of patients with diabetes experienced implant failure.

Bruxing is as much of a problem for natural teeth as for teeth held by implants. The force of grinding is often so much that it wears the tops of teeth down, referred to as worn teeth. Not to be outdone, the force of clenching can be hard enough to crack a walnut. Grinding and clenching can cause teeth to chip, crack, break and even tilt out of position. These actions can also lead to frequent headaches, migraines, sore jaw joints, ear ringing, dizziness, and sore facial and neck muscles.

Obviously, a newly-placed implant is not up for the challenges of bruxing. That’s why it is important to resolve the problem before implants are placed. However, bruxing should be corrected regardless of the situation.

Bruxing and clenching are the result of a misaligned bite in most cases. Once the misalignment has been pinpointed, mild cases may be corrected with simple reshaping of selected teeth. More severe misalignment may require the placement of crowns to adjust tooth height or even orthodontics.

Keeping a clean, healthy mouth and ensuring your teeth are in proper position will help in protecting the life of your implant, After placement, we will advise you on ways to avoid risks and potential failure. It is our goal for every patient to have a positive experience and successful outcome.

While not all aspects of after-treatment are within our control, I believe that thorough communication with patients is important. It is our belief that patients are able to increase their success potential when they understand the importance of their role.

To learn more about Dental Implants, call toll free 1-866-9-Smiles for a free consultation. During this time, I’ll answer your questions and make recommendations. If desired, we can also have our Financial Coordinator discuss easy payment options, most interest-free with no down payment required.

Position Of Each Tooth Can Effect More Than You May Realize

In dentistry, precision is everything. As a neuro-muscular dentist, I know just how true that is.

Good oral health relies upon a delicate balance of upper teeth to lower teeth as well as the unity of teeth on both sides. What occurs when a tooth is lost and not replaced is a perfect example of the the problems that can occur without each tooth in its proper position.

When a tooth is lost, the tooth above or below the open space is left without an opposing tooth. The opposing tooth helps to keep its upper or lower ‘neighbor’ at a proper length. Without it, the tooth grows longer. Additionally, the teeth adjacent to the open space are no longer held in their proper positions. These teeth can soon tilt into the open space and lean into range of the elongated tooth.

The longer tooth can now ‘hit’ the leaning teeth in chewing or speaking. Initially, this may cause a dull tooth ache. As the tooth grows longer and the others tilt further, chips, fractures or breaks can occur. The effects of bite misalignment don’t stop there, however.

Bite misalignment tends to put stress and strain on the jaw joints. These are the joints just in front of your ears that hinge the lower jaw to the skull. Stress on these joints is referred to as TMJ disorder.

When the bite is misaligned, the jaw joints become so as well. During sleep, there becomes a subconscious struggle as the jaw joints search for a proper relaxation point during sleep. As the jaws seek this out, clenching and grinding can occur. This can result in worn teeth, frequent headaches, migraines, soreness when opening the mouth, ear ringing, facial muscle pain and dizziness. Jaw Joint

Yet, you don’t have to be missing a tooth for these problems to occur. A crown that is placed at an improper height can just as easily disrupt the balance required for teeth and jaw joints to work together harmoniously.

My advanced training in neuromuscular dentistry and modern technology are ways I help our patients avoid the long list of problems that can easily occur when the delicate balance of occlusion is disrupted. Proper bite alignment is an important element in the overall skeletal alignment. Without it, a domino effect is set into motion.

If you are experiencing any of the problems related to bite misalignment or TMJ disorder (as mentioned above), call to arrange a no-cost consultation. During this time, I’ll discuss ways that we can determine if your bite is truly the source of your problems. If so, there are several options available to help restore the balance of a healthy bite.

If you are not experiencing these problems, you can rest assured that the work you have performed in our office will be done in a way to help you avoid them. It’s simply a perk of our commitment to exceptional care for each patient!

Call toll free 1-866-9-Smiles for a consultation time that works for you.

The Endless Value Of Dental Implants

We all like to be smart shoppers. And, we’re all aware that, in most cases, “you get what you pay for.” That’s as true in the dental office as it is in the appliance store.

There is a misconception that Dental Implants are expensive. Quite frankly, once the patient understands the long term benefits, they are seen as one of the best investments one can make. When truly understanding the benefits, the obstacle of cost (which is often the only obstacle) becomes less of a concern.

Implants may seem expensive because all treatment fees occur at once. The costs for the implants, placement and the restorations (attached teeth) are paid for as one fee. The true value of Dental Implants, and the actual savings they provide, occurs in the form of the many expenses Dental Implants help you avoid.

With proper care, Dental Implants are designed to last your lifetime. That, in itself, is a tremendous value. Additionally, they restore the ability to eat comfortably and laugh with confidence. This enhances your physical and emotional health.

Dental implants never decay, need root canals or compromise neighboring teeth or the bone structures that support teeth. Dental Implants are also beneficial for the jaw bones that support them.

Because Dental Implants are positioned in the jaw, they recreate the presence of tooth roots, which provides stimulation the jaw bones. This was one of the roles of natural tooth roots. When tooth roots are removed, a process known as resorption begins. This is a gradual but continual shrinking of bone mass.

Bone loss occurs when tooth roots are removed from jaw.
Bone loss occurs when tooth roots are removed from jaw.

For long-time denture wearers, this bone loss can be seen in their facial appearance, which creates an appearance that is far older than one’s actual age. Bone loss causes the mouth to turn downward (even in a smile) and deep wrinkles around the mouth. As facial muscles detach, jowls form. As bone loss progresses, the chin points and the nose moves closer to the chin. This creates what is referred to as a ‘granny look.’

For denture wearers, a new denture is designed to fit snugly. However, resorption is the reason that dentures eventually begin to move. This is because, as the bone mass declines, the ridge that holds the denture flattens out. This leaves the denture with an ever-shrinking foundation on which to balance. Eventually, adhesives and pastes do little and even relines are of only temporary help.

The treatment fees for Dental Implants are largely based on the number of implants placed. However, an implant is not always needed for each missing tooth. For those who are missing several teeth or even a full arch (all upper or lower), several strategically-placed implants can often provide sufficient support .

For example, when several teeth are missing in one area, one implant can often support a bridge of two or more teeth. An added bonus of using an implant to support a bridge is its ability to protect the integrity of neighboring teeth. With dental implants, it is not necessary to crown otherwise healthy teeth for the mere purpose of supporting a bridge.

While a traditional crown-&-bridge combination relies on adjacent teeth as support, an implant is supported by your jaw bone, providing the same dependable foundation as your natural teeth once had. You’ll be able to bite and chew without worries.

For those who are missing all upper or lower teeth, as few as 4 to 6 implants may be sufficient to support a full arch of teeth. With strategic placements and appropriate selection of implant systems, the force of biting and chewing can be distributed evenly. This is also possible for patients who have experienced a great deal of bone loss. Some implant systems are able to support non-removable teeth that are secured to several implants in a minimal amount of bone.

We believe that every patient CAN achieve the smile that makes them happy decades after their investment has been made. If the obstacle to achieving a confident smile is because of implant fees, start with a free, no obligation consultation. I’ll explain the options that may work best for you. If desired, we can also have you meet with our Financial Coordinator to discuss easy payment options. Most are interest-free with no down payment and break your costs down into affordable monthly payments.

Call toll free 1-866-9-Smiles for a no-cost, no obligation consultation..

Not All Crowns Are Created Equal (And Why Prices Vary)

Many of us are familiar with the phrase “a rose is a rose.” While the scent of a rose would be pleasant regardless of its name, this reminds us that comparisons aren’t always “apples to apples.” Roses can vary a great deal, just as crowns, bridges and other dental restorations.

As a dentist, I regularly see new patients who have aging crowns or bridges. Some of these restorations are breaking down rather soon, typically due to inferior quality or being placed improperly. For those who assume all crowns are the same, like roses, this is far from the case.

To begin, most crowns are made by a dental lab selected by the dentist and to specifications of that dentist. In order to trim expenses, the cheaper labs typically create results of lesser quality. Typically, the appearance won’t have the natural appearance that blends seamlessly with other teeth. And, the feel won’t provide the smooth finish that feels like a tooth surface. It will look and feel like a ‘fake tooth.’

Patient of Dr. Ban Barbat - Crowns That Look Natural, Of Exceptional Quality
Patient of Dr. Ban Barbat – Crowns That Look Natural, Of Exceptional Quality

In addition to a compromise in the look and feel of a crown, longevity is another area where cost cuts mean sacrifices in quality. The life of a crown is dependent on its materials (along with proper shaping and placement). Obviously, a crown made of lower grade materials won’t hold up as well over time.

Proper placement also has a tremendous effect on the life of a crown. When a tooth is prepared for a crown, the shape, shade and size of the crown is provided to the dental lab. There is no margin for error. The slightest misstep in height or shape can create conflict for the teeth above or below.

For example, a crown that is just a fraction of a millimeter too tall or short will hit incorrectly on the tooth that meets it in a bite. As a neuro-muscular dentist, I know how significant this can be on a patient’s overall oral structures. This minute disparity can result in bite misalignment that leads to headaches, migraines, sore jaw joints, ear ringing, dizziness, facial pain or pain in neck and shoulder muscles.

The same principles apply to a bridge. Bridges that look good, fit correctly, and last an exceptionally long time are worth “doing right the first time.” When a bridge is selected based on the lowest price, like anything, the repercussions of cutting corners will show up eventually.

Rather than think of a crown in terms of its cost, consider what it will provide to you for a fair price. Will it look as natural as your surrounding teeth? Will it feel like a tooth? Will it last for a long time because it was made of quality materials? Will it be placed so you avoid problems from bite misalignment in the future?

When it comes to what is spent on a smile, we all want to feel we have made a good investment. We believe our patients deserve the highest quality in crowns, bridges or veneers for a reasonable cost. Too, we want you to feel pleased with your investment long after it is made.

Let’s sit down together to discuss how you can achieve a healthy, confident smile and enjoy exceptional results in an affordable treatment plan. Call 586-739-2155 to schedule a cost-free, no-obligation consultation. We can also discuss easy payment options, some with no down payment and interest-free.

What To Do If A Crown Comes Off

surprised-cartoonIt’s Murphy’s Law — the worst things seem to happen at the worst times. While there is never a good time to lose a crown (also referred to as a ‘cap’), disasters tend to happen at the worst times, like the morning you’re leaving on vacation or the night before an important job interview. And, they always seem to happen on a weekend when waiting for a Monday dental visit seems an eternity.

A crown is a custom-designed ceramic shell made to cover a natural tooth. They are typically placed to protect the health of a tooth. A crown is often recommended when a tooth has developed cracks or has too much filling material for the tooth structure. Crowns are also placed for esthetic reasons or to correct bite alignment.

Porcelain crowns are ‘cemented’ in place with a special adhesive. This adhesive is designed to secure the crown for most normal functions, such as eating, biting and flossing. However, things like eating ice, an injury to the mouth, or night-time grinding may disrupt the adhesive and dislodge the crown.

If you lose a crown, don’t panic. There are simple measures you can take to protect the tooth structure and temporarily replace the crown until you are seen in our office.

As soon as the crown comes off, rinse it while holding carefully. Place the crown in a hard container (such as one that holds a retainer or mouth guard or even a clean pill bottle). Rinse the mouth gently with lukewarm water. Call our office immediately to schedule a time to have the crown re-cemented. If your crown comes off after our normal business hours, the recording will give you instructions on how to reach me.

Fortunately, you can temporarily secure the crown until it is re-cemented. Most drugs stores sell a putty-like dental cement made to temporarily hold crowns in place. Denture adhesives can also provide temporary grip. Follow the directions carefully and then avoid chewing in the area of the crown. Floss only in a downward motion to avoid dislodging the crown again.

If you cannot get to a drug store, apply petroleum jelly to the inside of the crown. This will provide some help in holding it in place, although for a brief time.

NEVER use household glue to reattach your crown! Most of these products contain highly-toxic ingredients which can leak into your mouth and get into your system. And, because glues like Super Glue and Gorilla Glue are ‘permanent’ glues, removing this material can be very difficult and even damage the tooth structure during attempts to remove it. Too, the crown can be damaged in the process of removing this type of glue.

If you’ve lost the crown, your remaining tooth structure may be sensitive to hot or cold until a new crown can be created and attached. If this occurs, the area should be covered until you can be seen in our office. For this, use a layer of the drug store dental cement on the tooth to fill it in and cover sensitive nerves. Again, avoid chewing in that area and floss downward only.

Regardless of what caused your crown to come off, our goal is to get you smiling comfortly and confidently again – and as soon as possible! Call us at 586-739-2155. We always welcome emergency patients who have experienced mishaps that result in a crown coming off or tooth loosening (or loss).

Beautiful Smiles Have Advantages That Go Beyond Appearance

While definitions of beauty vary, symmetry is a common component of how most assess a face as beautiful. A common standard used is a balanced eye alignment with both sides of the mouth, nose and cheeks mirroring one another. However, many beauty ‘experts’ agree that, regardless of meeting these standards, beauty exudes from those who possess an aura of confidence.

Being confident, however, requires one to feel confident. That sounds so simple, yet it’s not. When we stop and examine what creates confidence in a person, many say it’s feeling self-assured about the impression one makes. And, right or wrong, we know that a large part of this impression is created by what others see on the outside.

In my twenty years in dental practice, I’ve seen hundreds of patients who decided, after much contemplation, to have a smile makeover. And rightly so, since many surveys have shown that the first thing people often notice when meeting someone is their smile.DrB Pt Mirror copy

Modern cosmetic dentistry offers a number of durable, natural looking and long-lasting methods to create a smile that enhances one’s appearance and self-confidence. In some instances, for example, placing porcelain veneers on just the front six upper teeth can dramatically improve a smile’s appearance with a look and feel that is as natural as real teeth.

You may remember “Extreme Makeover,” a series on television that aired from 2002 to 2007. Each episode followed an individual who had been chosen for a total makeover. Typically, the individual was taken through weight loss and toning, plastic surgery, hair and makeup, and smile enhancement. What quickly became key criteria for the candidates selected was their need for cosmetic dentistry.  Why?

After the show began, it became very apparent to the producers that the most significant changes in appearance emerged from the smile enhancements. While losing weight, a nose job or breast lift were all beneficial, it was the smile that often had the most dramatic effect when it came to improving appearance.

When smile makeovers are completed in our office, I’ve had many patients break out in tears at the new smile they see in the mirror. And, even though the expenses associated with some smile enhancements can be a financial stretch, I’ve never had a patient who didn’t say their new smile was “worth every cent” with most adding, “I only wish I hadn’t waited so long to do this.”

Yet, it’s not what occurs in the moments after their new smile is completed as what emerges over time. I’ve seen a number of my smile makeover patients lose weight, pursue work promotions, get a new hairstyle, become more social, smile more often and seem more positive about life in general. It’s as if the new smiles released self-esteem that had been hiding behind smiles that kept their true self-confidence tucked beneath the surface.

Time and again, research has shown the dramatic effect a smile has on one’s overall demeanor. Apparently, the act of smiling causes the brain to release endorphins, which are the feel-good chemicals in the brain. Findings also show that even faking a smile causes the brain to react as a mood booster.

The simple act of smiling is good for you, inside and out! A smile that enhances our appearance tends to be shared more often. This sets off a domino effect. Since our mood is boosted from our brain’s chemical reactions, it makes us feel more positive. Feeling more positive makes us feel more confident. And so on.

Whether you need to replace missing teeth, old crowns or bridgework, need to realign crooked or crowded teeth or repair broken, chipped or worn teeth, today’s cosmetic dentistry offers excellent options. And, many are surprised at the affordability of achieving the smile they desire.

Begin with a no cost, no obligation consultation. We’ll talk about what may work best for your goals, comfort options, payment plans and anticipated treatment time.

When you consider the small amount of space that a smile has on our bodies, it amazing at how significantly it can transform our appearance and mindset one way or another. Yet, what nature may have denied, modern dentistry can give back!

Call toll free 1-866-9-Smiles to arrange a time convenient for you.