Hello again!

Thought I would help out everyone with some dental terminology.  I am asked very often what’s the difference between a veneer and a crown?

Veneers and Crowns have many similarities and differences, so it is understandable that they get confused.

Firstly, they both replace the front portion of the tooth so that when they are completed, your new tooth (or teeth) has a new shape and color as observed from the front.  However, the veneer typically wraps on the back of tooth only minimally (1-2mm), whereas the crown wraps on the back all the way down to the gumline.  I guess you can say that a crown is more like a thimble. A veneer is more like a press on fingernail.  Because of this it is more likely to “pop off” a veneer than a crown.  Better bonding systems now and proper veneer design will help minimize e this occurrence.  Even a crown can “pop off” if there is inadequate support beneath it, but it stands less of a chance compared to a veneer.

Second of all, they are both typically made of porcelain, so that colors can be placed to better blend in the veneer or crown.  Veneers are typically solid porcelain, so light can shine through the material and create “lifelike” shine and luster.  Crowns too can be made of only porcelain, as many of our current laboratories now have such high strength porcelains that they can be used on back teeth as well.  Other crowns have a core layer (usually zirconium oxide), and some are made entirely of gold.

Veneers offer very little protection to a vulnerable tooth.  Typically veneers are placed on teeth that are healthy and strong.  They are made for teeth that just want a color and shape face lift.  Whitening will only do so much, and if you want them whiter, then veneer porcelain will be your solution as they can be made as white as you desire.

Conversely crowns provide protective strength for vulnerable teeth that have been weakened by either large fillings or root canal procedures.  These teeth may fracture and not be saved afterwards, and the tooth may be lost.  Crowns protect the tooth against fracturing and subsequent loss.  Combined with beautiful porcelain, crowns will protect and beautify your smile.

So there you have it! (Of course there are other subtle similarities and differences, but I don’t want to bore you to death!!!)

When the time comes for you, the decision will be carefully based upon the health of your teeth, the quality and force of your bite,  and the end result that you wish for.  It is a decision made between dentist and patient together.

Ciao for now!

Hmmm…

So you’ve decided to invest in implant supported teeth. Excellent for you!  This will certainly change your life.  Many complete denture wearers are struggling with their teeth, and the stability of implant supported teeth will restore their confidence in eating and in talking.  The fear of their teeth slipping out at the wrong time is gone, and the ability to bite into foods without hesitation is back.  It’s a great feeling.

But will you invest in a set of teeth that cannot be removed, or will you invest in a set of teeth that are removable?  This is a key question that you will face, and this blog is geared to giving you some input into your decision making process.

I will refer to the cemented or screwed down, non removable teeth as “fixed”.  I will refer to the removable teeth as “fixed-removable”, meaning that when they are in your mouth they are fixed and do not move, but that you have the ability to remove them without the need of a dentist.

Let’s start with the fixed teeth.

Fixed teeth are great.  You don’t even think about them once they are in.  You brush them and keep them clean, and soon afterwards you even forget about them.  They feel very natural.  This is the biggest advantage with fixed teeth.  There are two main types: one that is permanently cemented onto the “abutments” of the implants, and one that is screwed into the abutments of the implants.  The screw type can be removed by a dentist, whereas the cemented ones can only be removed if the cement allows removal.

There are invariably a few pitfalls with fixed teeth.

Firstly, if the forces of chewing overpower the support of the implants, bone loss begins to occur.  If enough bone destruction is present, the teeth need to be removed, and if cemented with non retrievable cement, this usually means drilling and destroying the teeth (a lab bill of close to 5 thousand dollars!)  If they are screw retained, the teeth can be unscrewed easily.  However with screw retained teeth, sometimes the screws loosen and require a dental visit to re-tighten the screws.  If additional implants are needed to balance the forces of chewing, screw retained teeth may allow the integration of more implants, whereby cemented teeth usually cannot, and a new set must be made.

Second of all, if food becomes pinned between the teeth and the gums, it may be difficult to remove.  A proper set of fixed teeth usually takes this into account, but sometimes food still gets trapped.  This requires a visit to the dentist to remove the teeth if they are screwed, and cleaned underneath.  The cemented teeth will hopefully allow either floss or a Waterpik to dislodge trapped food particles.

Now let’s move over to the fixed-removable teeth.

The fixed removable teeth are typically held into a firm position through attachments that lock into place.  These attachments are on the underside of the teeth, and they fit precisely into the abutments of the implants.  Once seated, there is no movement of the teeth, and so they become “fixed” teeth.  There must be a sufficient number of implants for these teeth to be truly non mobile.  Typically there must be at least 4 implants.  It’s like a chair- 4 legs for stability.  These teeth are wonderful because they feel like natural teeth when they are locked in, and provide all the stability of fixed teeth when chewing and talking.  The added benefit is that because they are removable by the patient, should food get trapped underneath, the patient can simply remove the teeth, clean their mouth out, and snap their teeth back into place.

With fixed-removable teeth, if there is evidence of bone loss around the implants (once again due to the forces of chewing overpowering the strength of the implants), the teeth can be simply removed, additional implants can be placed in the mouth, and additional attachments can be placed into the underside of the teeth.  There is greater flexibility with the fixed-removables should something go wrong.

The pitfalls are typically psychological in nature.  I have found that patients investing in implant supported teeth are sometimes uncertain about the fixed-removable option, as they are excited about getting fixed teeth, but reluctant to the idea that they can still take them out.  Having said that, my patients that have invested in fixed-removables love their teeth, and they love the fact that they can easily clean them when food gets trapped.  They quickly get over the psychological issue once they begin to function with their new teeth and realize that they truly are fixed when locked into place.

In addition, the attachments are usually plastic inserts that become stiff over time and usually need to be changed every year or so.  While relatively inexpensive, it still warrants a trip to the dentist every so often to replace the inserts.

So….  which type will you invest in?  Whichever you decide, you will still be super excited with your investment.  I have to date not experienced one patient who wasn’t thrilled with their implant supported teeth, whether they are fixed or fixed-removable.

Life is a gamble.  All you can do is try to stack the odds in your favor.  Sometimes a pair of deuces wins the pot, and sometimes three of a kind loses.

I hope this info has helped you.

Hello again!  I was hoping to clarify a couple of items that seem to pop up again and again when dealing with our Braces for 6 Months treatment.

Firstly, we are located in beautiful Campbellford, Ontario.  We are close to Peterborough, relatively speaking, but we are in fact about 60 kilometers east of Peterborough, or about 1 hour by car.  So for all of our out of towners, the Peterborough dentist is in fact the Campbellford dentist.  It is worthy to mention here that Peterborough is an incredible city and worth the visit.

Second of all, Braces for 6 Months is a short term orthodontic treatment geared at creating a beautiful smile by straightening your own natural teeth.  This will only apply to your front teeth though.  Your back teeth aren’t going to be moved very much at all, and if you have a really bad bite then I will probably recommend comprehensive for you.  It just depends on what your goals are.  Either way, straighter teeth, not only gives a great smile, but also makes it tougher for food to get pinched and stuck between your teeth, only to be stranded for days (if your not a daily flosser …) allowing those lovely Streptococci to feast, leaving you with a cavity as their house warming gift.  Just jump on our web page to find out more.

Ok thanks for letting me clarify those couple of points.  All the best until next time.

Well, well, well. Sinus Lifting vs. All on 4. What am I possibly talking about? I’m talking about someone who has lost all of their teeth on the upper jaw and is looking to replace their denture with a fixed set of teeth. Like building a deck, there has to be enough of a foundation to support the deck you are planning to build. Increase the number of sonotubes, increase the support. Same with implants… or is it? Studies and clinical successes are now being seen with a new idea for the upper jaw for patients who want fixed implant supported teeth. Some doctors agree that support for a full set of upper teeth must have implants under the sinus area. For many this means grafting bone into the sinus, and then placing implants in this area. Other doctors say 4 implants, without any need for sinus grafting, is successful in the majority of cases. So why put your patient through the extra surgeries? In the end it all comes down to long term success. Are 4 implants enough support for a full set of fixed upper teeth? This will be a hot debate for the next 20 years. Noble Biocare (one of the world’s most prominent figures in Implant Dentistry) has sinked a bushel of money into this concept. Will it pay off???

While flipping back and forth between highlights of the Masters and watching Dental XP videos, I found an interesting new concept that is showing signs of success. In the past, if the jaw bone was too thin for an implant, bone would be added to the outside of it in an effort to widen the bone, and then 4 months later the implants could be placed. 2 surgeries. This new technique I just watched takes a thin ridge and carefully spreads it open into two halves painlessly, opening up the ridge in the middle and allowing placement of the implant at the same time. It is being coined a sandwich technique and will allow us to get the job done in 1 appointment with 1 surgery that used to take 2. That’s one less surgery for our patients!