What do Veneer and Crown Temporaries look like?

October 16, 2010 alexnguyen

The temporaries are made to protect the underlying tooth structure as the final porcelain restorations are being fabricated in the ceramist's laboratory. Veneer and crown temporaries should look good. Finely made temporaries should have perfect marginal adaptation to the underlying teeth. The surface should be well polished to resist staining, since the material is simply an acrylic form. In our office we spend a significant amount of time on the temporaries because they should not affect the lifestyles and career demands of our patients. In other words, at the very least, no one should notice at conversational distance that your teeth are in temporaries.

Furthermore, well made temporaries will also allow the gum tissue to remain in perfect health. This clinical result will allow the dentist to ensure a perfect bond between the porcelain and the teeth at the final cementation process. If the gum is inflamed from improper fabrication of the temporaries, the end result may be compromised due to possible contamination of fluid and blood from bleeding gum around temporaries.

The term "temporaries" is misleading in a sense that they are only meant for short-term use. In fact, all details considered in the final restorations must be taken in to consideration with the ... "temporaries".

Here is a photo of a sample case of one of our patients, taken on the day she returns for her final porcelain restorations. Note that the four front teeth are bonded with acrylic temporaries.

All Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

Which Mouth Wash is good? Beware of advertisements when choosing consumer dental products !

October 8, 2010 alexnguyen

In a marketing driven country, consumer dental products are often pushed with claims to do wonders for your dental needs. Mouth rinses and toothpastes have been introduced with claims to help promote combinations of treatments. Here is a case where the FDA has contacted CVS to address inappropriate claims on the label of their CVS Complete Care Anticavity Mouth Wash. Apparently, we need to be cautious when choosing a product with the claim : “Helps prevent cavities, Kills germs that cause bad breath, Rebuilds enamel and strengthens teeth, and Promotes healthy gums.”

Which mouth wash and toothpaste are you using at home, and how did you make that choice?

Read the letter in the link below, and be careful when choosing your dental products.

Warning Letters CVS Pharmacy, Inc. 9/27/10.

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CT Scan and Dental Implant : High Standard of Care or Basic Requirement?

October 1, 2010 alexnguyen

In my practice, this "High Standard of Care" is a "Basic Requirement". Dental Implants have become the preferred standard of care when it comes to replacing missing teeth in the mouth. The advancement of technology has enabled dentists to accurately analyze the structure of the jaw and pre-plan for the implant work.

By using specialized software with images from a CT Scan of your dentition, I can analyze some important requirements which cannot be determined accurately with simple xrays alone:

1. Bone density

2. Bone thickness

3. Bone height

4. Proximity to nerve canals and the Sinus

5. Proximity to/ angulation of adjacent tooth root

With the above analysis, I can choose the right implant size before going into the surgery. The advanced treatment planning and analysis help prevent unexpected complications such as damage to vital nerves or impingement on the Sinus.

Here are some images of an analysis of a CT Scan for Dental Implants treatment:

One should never compromise a life-long restoration by choosing an implant treatment that has not been carefully planned out. This is particularly crucial in the esthetic zone such as your front teeth where lack of planning can produce an unfavorable esthetic result.

Thank you for viewing my post, and please let me know if you have any question.

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How to Choose an Orthodontist ?

September 24, 2010 alexnguyen

Often time, people get braces because they want straight teeth. However, straightening the teeth is only one aspect of an ideal orthodontic treatment plan. The best orthodontic treatment will also:

1. Balance the alignment of your teeth with the proper position of your jaw/joint.

2. Harmonize the esthetic of your smile with the esthetic of your face.

If an orthodontic treatment is done without considerations for the above two significant factors, the patient can come out of braces with:

1. Problems of teeth wear and joint pain over time.

2. Higher chances of teeth drifting back into malalignment.

3. A smile that may not fit the face.

4. A face that is not developed to its full potential.

Parents who choose to give their children orthodontic treatments should consider proper research to understand all treatment options. Children's orthodontic treatments revolve around complex growth phases. The orthodontist/dentist need to carefully monitor the development of not just the teeth but also of the jaw, joint, and face. The decision to start and end orthodontic treatments is based on science and clinical needs.

Here are some DO's to remember:

1. Consider more than 1 consultation with different orthodontists.

2. Ask the orthodontist to explain the treatment process of their sample cases. Ask Why, How, and What was done?

3. Look at the smile from the overall esthetic of the face.

Here are some DONOT's :

1. Choose an orthodontist based on price alone.

2. Automatically accept a treatment plan which suggests extractions of permanent teeth to create room. Instead, ask for multiple options.

3. Wait until all permanent teeth have erupted.

If you have had braces and are experiencing joint noise/pain. This is not normal, and further diagnostic testing and treatments should be considered in order to prevent long term damage.

Good luck in your quest for a beautiful and healthy smile !

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What Should Implant Crowns Look Like?

September 13, 2010 alexnguyen

I saw a patient last week for a consultation regarding implants to replace some missing teeth. As these teeth would be displayed in her smile, she was really concerned with whether the final crowns would look like real teeth. According to her. she has been putting off implant treatment because she has heard so many horror stories about complications and the "fake" look of implant crowns. My patient's concern is completely legitimate. Implant treatments carried out with improper planning and coordination between the implant placements and the final crowns can result in unattractive results. To avoid unfavorable outcomes, ask your dentists to show you their before and after cases of actual patients. Moreover, as a patient you should have a clear understanding of the necessary steps involved from beginning to end.

Beautiful crowns which mimic real teeth require a multi-dimensional construction of bone, gum, and teeth. When it comes to the esthetic of the anterior teeth, just remember one simple rule: Crowns, Bridges, Veneers, should all look like your real teeth.

Here is a case of front teeth that I have completed for one of my patients. Can you tell which one is a conventional crown, and which one is an implant crown? In reality, no one would ever look at your teeth at this close a magnification. Nonetheless, I would always choose to address all details in order for the restorations to come to life in your smile.

All Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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