Nat Shain DDS (951) 788-4500
Dental Crowns & Bridges:
Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.
Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.
Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.
A tooth must usually be reduced in size to accommodate a crown. A cast is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In most cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.
Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
Caring For Your Crowns &/or Bridges:
With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.
Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.
Nat Shain, DDS General & Cosmetic Dentistry
Complete dentures - replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.
Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.
Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient's jaws during a preliminary visit.
An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.
An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.
Partial dentures - are often a solution when several teeth are missing.
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps.
How dentures are made
The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments.
First, an impression of your jaw is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The color or shade of your natural teeth will also be determined. The impression, bite and shade are given to the dental laboratory so a denture can be custom-made for your mouth.
The dental laboratory makes a mold or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Usually a "wax try-in" of the denture will be done at the dentist's office so any adjustments can be done before the denture is completed.
The denture is completed at the dental laboratory using the "lost wax" technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for wear.
Getting used to your denture
For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.
At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.
Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum. You may want to avoid chewing gum while you adjust to the denture.
Care of your denture
It's best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Look for denture cleansers with the American Dental Association (ADA) Seal of Acceptance. Pay special attention to cleaning teeth that fit under the denture's metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.
Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution.
Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.
Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted. Avoid using a do-it-yourself kit to adjust your dentures, as this can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture.
If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.
Over time, dentures will need to be relined, re-based, or re-made due to normal wear. To reline or re-base a denture, the dentist uses the existing denture teeth and refits the denture base or makes a new denture base. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.
Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.
Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.
Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing.
Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures "click" while you're talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.
Denture adhesives can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture, which causes constant irritation over a long period, may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose, or cause pronounced discomfort, consult with your dentist immediately.
Advanced gum disease sometime requires the dentist to clean below the gum line to remove stubborn, crusty deposits called tartar or calculus, and to remove damage near the tooth root. This is done to prevent further damage and restore and stabilize the tooth.
For some patients, a local anesthetic is administered to the affected area. Then, a small scaling instrument and/or ultrasonic cleaning device are used to remove the deposits.
After cleaning, the root may need to be smoothed, or planed, to restore it as much as possible to its original shape. Planing also allows your gum tissue to better attach itself and heal properly.
Did you know??...
According to research performed by the Mayo Clinic, tooth loss & gum disease can increase the risk of Alzheimers disease. And, people with gum disease are twice as likely to die from heart disease and three times as likely to die from a stroke!!
Harvard found that gum disease increases the risk of Pancreatic & Kidney cancer by 62%
The American Academy for Oral Systemic Health found that gum disease increases the risk for head & neck cancer. 93% of people with gum disease increase their risk of getting Diabetes. Diabetes and bleeding gums increase your risk for premature death by 400-700%. There is an association between gum disease and Rheumatoid arthritis.
Be careful who you kiss or share food with, you can receive a germ that can cause cavities. Bacteria that live in your mouth can cause heart disease, high blood pressure and stroke. Please remember to see your dentist regularly to help keep you healthy all over.
Root Canal Therapy:
Root canals are tiny passageways that branch off from beneath the top of the tooth, coursing their way vertically downward until they reach the tip of the root.
All teeth have between one and four canals.
Many tooth problems involve infections that spread to the pulp, which is the inner chamber of the tooth containing blood vessels, nerves and other tissues. When the infection becomes worse, it can begin affecting the roots. A traumatic injury to a tooth can also compromise the pulp, leading to similar problems.
A diseased inner tooth brings a host of problems. Pain and sensitivity are some of the first indications of a problem, while inside, a spreading infection can cause small pockets of pus to develop, leading to an abscess.
Root canal therapy is a remarkable treatment with a very high rate of success. It involves removing the diseased tissue, halting the spread of infection, and restoring the healthy portion of the tooth. In fact, root canal therapy is designed to save a problem tooth; before the procedure was developed and gained acceptance, the only alternative for treating a diseased tooth was extraction.
At Nat Shain DDS, we take care to provide our patients high quality services personalized for their unique needs.
We provide a variety of services including:
- Cosmetic & General Dentistry
- Root Canal Therapy - RCT's
- Composite Fillings, Bonding
- Extractions, Removal of teeth
- Root Planing, Gum Treatment
- Nitrous Oxide (Laughing gas)
When restoration procedures such as root canal therapy, crowns, or fillings are not enough to save a tooth, it may need to be pulled, or extracted.
Tooth extraction procedures today are far less painful than ever before, thanks to powerful anesthetics and sedatives. In many cases, a patient who has tooth pulled experiences little or no discomfort, and only minor bleeding.
Before a tooth is extracted, the area surrounding the tooth is numbed with a topical/and or injectable anesthetic such as Novocaine.
Patients with extracted teeth sometimes need to take an antibiotic, and at the very least, take precautions following the procedure to ensure that infection doesn't occur.
Smoking, vigorous brushing and rinsing, and drinking liquids through straws are discouraged during the post-operative period because they hinder healing and may cause the wound to open. Cold compresses applied to the outside cheek near the extraction area can help reduce any swelling and promote faster healing.
Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. Unfortunately, most people experience problems from wisdom teeth; in most cases, this is because the teeth erupt too close to existing permanent teeth, causing crowding, improper bites, and other problems.
If wisdom teeth are causing a problem and are not pulled, they can sometimes become impacted. Impacted wisdom teeth can be extremely painful, as well as harmful to your oral health. Symptoms are easy to spot: severe discomfort, inflammation, and some kinds of infections.
Many people need to have their wisdom teeth extracted to avoid future serious problems. In general, the lack of the four wisdom teeth does not hamper one's ability to properly bite down, speak or eat.
If you experience any of the following symptoms, you may have an impacted wisdom tooth:
•Facial swelling •Infection •Pain •Gum swelling
POST OP INSTRUCTIONS:
BLEEDING. Some oozing of blood may continue for a short time after the extraction and may even persist until the next day. However, if there is more than just oozing, place a wet tea-bag in the extraction site, close tightly for 30 minutes, repeat if necessary. Call the office if bleeding persists.
SWELLING. Ice bag or chopped ice wrapped in a towel should be applied to operated area—one-half hour on and one-half hour off for 4-5 hours.
PAIN. For mild to average pain use any medication you would normally take for a headache or other pain. If a prescription for medication has been given to you, fill it at the pharmacy and start taking immediately. Remember to always take antibiotics as prescribed & until they are gone. If there is prolonged or severe pain, swelling or bleeding, or if fever is present, you should get in touch with the dentist so that exact instructions for care may be given. In most cases, if the simple instructions are followed, healing will be prompt and complications will be avoided.
RINSING THE MOUTH. The blood clot should be given time to form and should not be disturbed. Therefore, the mouth should not be rinsed during the day of the extraction. After the first day, warm salt water (1/2 tsp. salt in a glass of warm water) may be used to rinse the mouth gently. The mouth should be cleaned and the teeth brushed as usual. It is important to maintain these habits of oral hygiene so the extraction wound may heal well and not become infected.
FOOD. To help the healing process, avoid missing a meal. A light diet is advisable during the first 24 hours. Soft nutritious foods such as soft boiled eggs, chopped meat, custards, Milk & soup may be eaten as they can be chewed comfortably. Stay away from spicy foods or acidic foods. It is important that no food particles get trapped in the extraction socket, which could cause infection, pain, swelling & delay the healing process.
BONY EDGES. Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying return to this office for their simple removal. If any unusual symptoms occur, call the office at once. The proper care following oral surgical procedures will hasten recovery and prevent complications