The Dental Topic Thread: I'd like to be a resource if needed

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Messages 21 - 40 of total 115 in this topic << First  |  < Previous  |  Show All  |  Next >  |  Last >>
Mungeclimber

Trad climber
the crowd MUST BE MOCKED...Mocked I tell you.
Nov 27, 2012 - 04:28pm PT
Dig this thread

Thx!
micronut

Trad climber
Topic Author's Reply - Nov 27, 2012 - 04:53pm PT
Spanky,
Here goes. Orthodontics has come a long way in the past 20 years, even the past five honestly. They used to use heavy wires, heavy forces, and often "did the best the could" to level and align teeth into proper esthetics and function. They also didn't know about how sneaky teeth are in their propensity to "go back home" or rotate, twist and settle back into the place they started. Now, orthodontists basically tell kids and adults, "retention/retainers for life."

Now, amazingly, they use much lighter wires, much lighter forces and better technology and science (no doubt from learning from the past), to more precisely align teeth and place the chewing and functioning forces where they are most needed and evenly distributed. I often recommend adult orthodontics (DONE ONLY BY A SELECT FEW ORTHODONTISTS WHO KNOW THE CRAFT WELL) to people who had it done in the past either without great results or with significant relapse. In some cases, Invisalign is a great option, in others, its the full monty. But, if done well, I've seen adult ortho change peoples lives and or create stability, without which, they would have faced a real and debilitating decline in the coming years. I have had two of my own staff treated in the past few years. One 40 one 52. Both looked my orthodontist friend in the eye and said, "you jack me up and I'll kill you." I recommend that approach. If he squirms, walk. If not, you might be in the right place. Its a big investment, but it can be great and much needed for lots of folks.
Gene

climber
Nov 27, 2012 - 05:09pm PT
Both looked my orthodontist friend in the eye and said, "you jack me up and I'll kill you." I recommend that approach.


Not much ambiguity in that advice. LOL.

Nice thread, Micro.

g
khanom

Trad climber
Greeley Hill
Nov 27, 2012 - 05:58pm PT
Ok, you are a saint, but I think you are crazy for posting this thread.


I have a question:

If I have a molar extracted can an implant be done at a later time, say several months to 2+ years?
Gal

Trad climber
a semi lucid consciousness
Nov 27, 2012 - 07:18pm PT
Awesome, THANKS THANKS... I may have a question later... I will take it offline. You are a kind hearted person!
strangeday

Trad climber
Brea ca.
Nov 27, 2012 - 07:23pm PT
Thanks for this thread micro....

Regarding extractions and implants, I have had multiple extractions, and need to have another done soon. The last time I had one done, they recommended a bone graft, which was quite a bit more money than I could afford, but i paid for it anyway. Is the graft to make it easier to add an implant later? Or is it for another reason? I'd never been told I needed one before, and was curious as to why I would need one now.
tooth

Trad climber
B.C.
Nov 27, 2012 - 07:35pm PT
Khanom,

you can have an implant if there is bone to put it in. Adding bone to a fresh hole in your jaw is the best/easiest/cheapest way to ensure there will be.



Things have changed recently and now we always recommend a bone graft in a location where an implant or even a partial denture could be used later. People change their minds, I want them to have that option.

MisterE

Social climber
Nov 27, 2012 - 07:41pm PT
OK, Micro: bridge or implant?

I got a couple that need it, and the bridge looks like a quick solution, but the implant seems like a better long-term solution requiring some money and time sacrifice out of the gate...

Thoughts?

Thanks again for being a resource for something that is difficult for many of us.

Erik Wolfe
rottingjohnny

Sport climber
mammoth lakes ca
Nov 27, 2012 - 07:55pm PT
I always wanted to look like Freddy Mercury....RJ
tooth

Trad climber
B.C.
Nov 27, 2012 - 08:35pm PT
Implants are normal to floss/live with.

If you get a bridge, what do you do with it if one of the teeth gets a cavity? The whole bridge (3 teeth) is affected. It happens a lot because bridges are a pain to floss under and get neglected. Plus, every time you drill a tooth, you chance killing the nerve and needing a root canal.
Why increase that risk to adjacent teeth with a bridge?

If you have no bone to put an implant in, or smoke, or have gum disease, not many dentists will jump at the chance to lower their 95% success rate record by putting an implant in that environment.

So then you could get a bridge with a very thin replacement tooth hanging between the other two so that you can clean/access the space between a lot easier. Makes it airy, almost can clean it out with your tongue, but it also would look funny if it is in a visible location.

Just some things to think about before you commit.

S.Leeper

Social climber
somewhere that doesnt have anything over 90'
Nov 27, 2012 - 09:12pm PT
Thanks for your offer! I just liked you on facebook.

I just had dental implants in Mexico and I heard that Mexicans are coming to the states now because implants are becoming more affordable here.
Is that true?
Ken M

Mountain climber
Los Angeles, Ca
Nov 27, 2012 - 10:46pm PT
Thanks, docs!

I've wondered over the years about waterpics....useful, or gimmick?
They seem to have stayed around.
Mighty Hiker

climber
Vancouver, B.C.
Nov 27, 2012 - 10:50pm PT
What about the various mechanized toothbrushes? Do they work well? Who should use them?
nature

climber
Boulder, CO
Nov 27, 2012 - 10:53pm PT
Ok. About once a year, a thread gets started by someone in need of dental advice

...raises guilty hand....
tooth

Trad climber
B.C.
Nov 27, 2012 - 10:55pm PT
I give waterpiks away to invisalign/ortho patients along with the newest sonicare toothbrushes when they start treatment.

Sonicare toothbrushes are amazing. You just hold it still over each tooth for 5 seconds per side (3) and angle it up into the gums a few degrees when you brush the front or back. I have seen big improvements with patients in 6-12 months when they start brushing - either they weren't brushing before, or that toothbrush is actually working better than not. I think that a lot of people act like they are sawing their teeth off with regular toothbrushes which isn't effective, so learning to use a new toothbrush that works properly - even if they don't brush more times per day - can actually make a difference.


Using waterpiks are better than doing nothing, but if I could only use that or floss, floss would be the best choice.



I just met a guy who has used a chewed up stick his whole life to clean his teeth. I gave removed 4 of his back teeth, then gave him a toothbrush.
micronut

Trad climber
Topic Author's Reply - Nov 30, 2012 - 08:41am PT
Mr E. I like this little video. It pretty much sums up my feelings.

There are RARE times a bridge is a better option. Usually when gum disease has undermined the bone and cosmetically an implant would be impossible. But with good bone and gum grafting, we can usually move people towrds implants.

Also, implants will not become prone to recurrent decay. If you do a bridge, and in five years one of those prepared/abutment teeth holding the bridge in gets decay, you have a real situation. This can mean re-making a new bridge, or losing a tooth and making an even longer, more expensive, weaker bridge.

micronut

Trad climber
Topic Author's Reply - Nov 30, 2012 - 08:47am PT
Good answers by Tooth on all the above questions.

The key is effectively removing the soft, filmy plaque (teeming with bacteria) every 18-36 hors. That's all you gotta do, you just have to do it gently and thoroughly and effectively. You can do it with a nice regular soft toothbrush........no need for all the expensive tentacles and curb feelers on some of these things these days............and some good old fashioned floss. Its what I do and I get all that stuff for free.

But, if you have kinda low motivation or sensitive gums or build up plaque quickly or just want the best thing with the least dexterity and skill needed, the Sonicare is awesome. Get one. Use it. You'll get good grades from your pretty hygienist at your next visit.

But with the Sonicare, just let it do the work. Just hold it gently with your fingers. Hold it with three fingers if you are an OCD scrubber and already dealing with recession.
micronut

Trad climber
Topic Author's Reply - Nov 30, 2012 - 08:56am PT
Strangeday,

If its at all possible, make sure you have the bone graft placed when the tooth comes out. Especially if the tooth is difficult to extract, resulting in some destruction or removal of the socket wall. It's expensive, I know (My surgical extraction fee is $195.00 and the bone graft is $500.00) but you maintain the integrity of the site for a nice implant or possibly a bridge down the road. If not, that "hole" will resorb a good bit, not always, but 90% of the time 20%-60% bone volume reduction is expected according to some studies.

If the bone "goes away", you may not be an implant candidate down the road. Or, you might, but will need the bone grafting before the implant, which can actually cost quite a bit more due to the complexity of grafting a skinny ridge vs. just filling the hole at the time of extraction. My "ridge graft fee" can creep up into the $1000.00 range for a one hour appointment, with graft material, collagen matrix/membrane and screws to hold the graft in place.

Talk to your dentist/surgeon and let him know you really want the graft. If its a financial burden, let him know you believe in the graft but just can't do it. I often give away/pay for people's grafting if they are really in need and are genuinely unable to pay for it since I believe in it so strongly.

PAUL SOUZA

Trad climber
Central Valley, CA
Nov 30, 2012 - 12:31pm PT
+2145154512151212510 for Micronut!

He's worked on my grill a couple times. Class act.
John M

climber
Nov 30, 2012 - 01:11pm PT
Just wanted to say.. Tooth and a few other dentists have answered questions for people for years now on the taco.

thanks Micronut and Tooth and all of you other dentists. This is way cool.
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