Dr. Benanti, my husband has started snoring and it keeps me up all night to no end. Is thre anything that we can do about it? Wow he really sounds like a train huh? Yes there is, there is a dental device that helps to alleviate snoring. It has also been shown to help people that have sleep apnea. Does your husband have sleep apnea?
I’m not sure that is the next step.
That would be really good. There is an excellent sleep clinic near hear and we would be happy to refer you over there for evaluation. If everything comes back normal and he is just snoring like crazy, we have something that can really help you out.
So, what is it exactly that we can do?
Let me get one and i can show you. So Amelia, this is what the device looks like. It has a top piece and a bottom piece and it similar to an orthodontic retainer and it’s made out of clear acrylic. There is a little rubber band on each side, and what that rubber band does is these each snap on and then the rubber band pulls the lower jaw forward. If you stick your lower jaw out it opens your airway in the back so air can get through.
It’s an easy device to make, painless, all we do is make a couple of impressions a record of your bite and get you a box of rubber bands and you’ll be sleeping well.
So remember Amelia we talked about the options for a smile makeover? One of the options we discussed was the snap on smile. So I thought I would show you what one looked like. So this is a model, and this person is missing a few teeth. So the snap on smile is just exactly what it sounds like, it covers all of the teeth and it snaps into place. It is a highly cosmetic appliance and is made out of an acrylic material – so it’s not meant to last a lifetime. In general you will get 3-5 years out of a snap on smile. They are quite nice aesthetically and we have quite a few patients that just love their snap on smiles. Do patients ever complain about them staying snapped on or food getting underneath them? Actually with snap on smiles that’s not really an issue. They snap on really tight and they tend to stay that way. You might notice that this one has holes on this side while the other side does not. There are two types of snap on smiles, there’s one where because of the way the person’s bite is we have to open up the so the teeth would be completely covered. Most cases we leave the bite the same so where the teeth hit is left open, while all of the teeth are covered in the front to get the pleasing smile.
Thank you for explaining that, it’s probably something that I would be much more interested in.
Dr. Benanti, I was on your website and I saw that you were having a promotion for smile makeovers on your website. Can you tell me what that’s about? Thank you for visiting our website www.fdadentist.com. We do have several promotions on our website and one of the options of course is smile makeovers. For smile makeovers we have two options and one of the reason for having a couple options is we wanted to be able to offer something to fit into everyone’s budget. I don’t know what your budget is, but I’ll go over all of the options so you can see what’s right for you.
The first and probably most popular option is just regular tooth bonding. That is where we take tooth colored fillings and apply it to the front of the teeth and bond it on there.
The next step up from that is snap on smile. You may have seen them, they ran a big ad promotion a couple years ago, they were running their ads on television. We are a snap on smile provider one of the few in the area. In just a moment I’ll show you what that’s all about.
The next step up, and that is the top of the line is thin porcelain veneers. They are highly aesthetic and we can talk about those more if you wish.
Dr. Benanti, one thing that does bother me is I have my partial, and it has the metal on it, but when I smile you can see it in pictures. Is there any way that we can make a new one or does it always have to have the metal in it? Actually we do have an alternative for that the newest partial dentures are made out of a flexible material. I have one here that I can show you. Would you like to see what it looks like. So this is a new material, it is a special acrylic and it’s flexible. This is actually an older version of it. You can see here on the front of it, that instead of having those metal clasp like you have, we can make these either tooth colored or we can make them gum colored like this one is, or we can make them clear plastic. So depending on the case and what blends in best, you can have your partial denture which will stay in very nice with the flexible attachment to it and no one will ever know you have it in your mouth. That sounds great!
OK, it was your first permanent molar that was removed. The first permanent molar is one of the most important teeth in your mouth. Even though no one can see it, it is the foundation of your bite. Most people don’t know that we do about 80% of our chewing off our first permanganate molars. What happens when you lose a molar like that you tend to chew on the other side of your mouth. The tooth really is a ‘key’ or important tooth so you really should consider replacing it.
So, would you replace it with an implant or what would you suggest?
There are 2-3 ways that you could replace that tooth. The first would be an implant, the second would be a fixed bridge. Both of those would get your tooth back – it’s something that you don’t remove from your mouth it’s just like having your tooth back again. The third option is a removable replacement for the tooth. It’s something that you take in and out of your mouth, it’s not as stable and you have to take it out to clean it. Implant by far is probably the best option for you in this situation. Because the implant doesn’t involve doing anything to the teeth on either side of the space.
So Dr. Benanti when they removed my back tooth, my molar, they didn’t really tell me of any long term affects from it. Is there anything that I should be concerned about?
Yes, there are a couple things that you should be concerned with. One thing that could happen and has already begun to happen, I saw this when I took a look inside your mouth, the tooth behind the space has started to tip forward into that space and the tooth above it has started to drop down. So over a long period of time the tooth behind it will fall over so much that it will have a poor prognosis and may need to be removed in the future.
The other thing that happens is when those teeth fall over they begin to cause interferences in your bite. When you have interference in your bite, that causes you to clench or brux (grind) your teeth together which causes excessive wear of your front teeth. And just looking at you, when you smile I am seeing some wear on your front teeth. So yes, it would be really important for you to get that tooth replaced.
So Dr. Benanti, if I decide to go with dental veneers, what is the typical life time of them? The veneers themselves will last indefinitely, but as we grow older – something that we all do our smiles change and the colors of the other teeth around the veneers change. Sometimes the gums recede a little bit. So generally speaking, every ten years or so we’ll have patients come back and say that “these don’t look right now” so we’ll replace them at that time.
Is there any type of special care for veneers so you can eliminate things happening like that or to prolong the life of them?
Once veneers are bonded onto your teeth – they are just like your natural teeth, so it’s just routine brushing and flossing just like you do with your regular teeth.
If I get my teeth whitened, they will not whiten correct? No they will not. That is usually the biggest reason people change their veneers out. It’s because the other teeth around them have darkened – they don’t whiten with teeth whitening and then the veneers stand out a little more, so that when we change those.
Alright Amelia we are just wrapping up your oral exam here today. There are a couple of things that I wanted to discuss with you. One of the thins is that your gums are receding a bit. Were you aware of that at all? Yeah I feel whenever I drink something cold or eat something cold it really affects my teeth. You’re feeling a little sensitivity? Yes. OK, I’ll have my assistant come in and take some photos, and we’ll talk a little about that.
So Amelia remember when we were talking a little bit about gum recession and that your were beginning to recede a little bit and that you were having sensitivity to cold. We are seeing that quite often these days – so I took a photograph so you could take a look at it and see exactly what we are talking about.
So here’s the photograph and these are your front 6 teeth. Up here you can see how you have pretty white teeth, but down here you can see the yellowish areas. These are actually the roots of your teeth. Oh Wow.
When the roots of your teeth become exposed in your mouth, that is when you begin to get tooth sensitivity and hyper sensitivity to cold. So I want to explain a little bit about gums to you. You may have watched the recent episode on the doctors where they talked about a gum lift. Well this is pretty much what they were talking about. So what’s going on is there are two different types of gum tissue. There is this type right here and this is firm, spongy gum tissue and it is attached to bone and it is designed to resist the forces of food when we are chewing eating. Then there is another type of gum tissue down here, and it is loose and then and it is not designed to resist those forces. So what’s happened along your front six teeth here, you’ve lost your attached gum tissue. It used to be here, and now it’s down here. It used to be here, and now it’s down here. You can see on this tooth that it’s getting really close to being all the way down to the lose gum tissue.
Left untreated this march will continue and the gum tissue will continue to recede until it gets down to the loose gum tissue. Once it gets down to the loose gum tissue we can expect that the whole root of that tooth will become exposed, and you will lose that tooth. You don’t want that to happen?
No, that sounds really serious.
So, there is a relatively simple procedure to get this gum tissue back up where it belongs. And that’s where the term gum lift comes from. Instead of it being down here, we’re going to bring it up here, and cover the roots of those teeth up.
Is that something that you would be interested in?
Yes, can you tell me a little bit about the procedure?
Yes, with that procedure is now a micro surgical procedure. We make a couple of small incisions and we make a little tunnel – a little tunnel underneath that loose gum tissue and we loosen that gum tissue up and we can bring that up to cover the roots of those teeth and suture it in place. Sometimes we put a little graft underneath there to make it thicker to resist so it won’t happen again. It doesn’t sound to pleasant, but it really is a minimally invasive procedure – mild discomfort for 24 hours and you’ll have stitches for a week. All in all it is a pretty simply procedure and it will help you keep your teeth a lifetime.
Does it all take place in one sitting? Do I come in and have the gum lift done and then come back a week later and have the stitches removed?
I’ve been coming here for 10-12 years – I appreciate the staff and everything that they do for me and how friendly this place is and all of the knowledge that they partake on me. I just wanted to tell him that I appreciated that. I just think the friendliness and the knowledge that everyone seems to have. I been to 3-4 dentist in my time here and at least that many assistants and they are all knowledgeable and very friendly.
So Amelia, what I’ve done is taken a little dental cement and I put it on a veneer. Now obviously it doesn’t match the normal size and shape of your teeth but it gives you some idea of the difference and in your case you can see that it’s a rather dramatic difference you still have some darkening that is left from the tooth whitening that will disappear. You have some square edges on your natural teeth that aren’t typical of a feminine smile. But we can create nice round line angles and we can really make you have a Hollywood beautiful smile.