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Like an orthodontist or a periodontist, a prosthodontist is a type of dentist who has received specialized training in a particular type of dentistry. After completing their education in general dentistry, a prosthodontist continues to train for three additional years in the repair or replacement of teeth and jaw structure restorations. Specially trained prosthodontists even work with head and neck deformities.
Prosthodontics is the dental specialty of dental prosthetics or prosthetic dentistry. In Greek, “prostho” means “replacement” or “addition,” and “dont” means “tooth.” So prosthodontists are specially trained in repairing your smile where teeth are damaged or missing.
You might visit a prosthodontist if you want to improve the esthetics of your smile. Prosthodontists can repair your smile with many different dental prosthetics, including, but not limited to:
Bridges are dental appliances that replace missing teeth and create a “bridge” between teeth. A prosthetic tooth, called a “pontic,” is attached to an existing tooth to fill a gap in your smile.
Crowns cover and support a tooth to protect the tooth from breaking or to restore an already broken tooth. They can also cover a discolored tooth and are a great way to make your teeth stronger and improve their appearance.
Dentures are a set of removable teeth that replace missing teeth. They can improve your smile and your overall dental health by making it easier to chew and eat and by preventing facial sagging.
Dental implants are prosthetic replacements for natural teeth. They are anchored in the jawbone and permanently secured in your mouth, and they look and act like natural teeth.
Inlays and onlays replace old fillings. An inlay is like a regular filling and fits inside of the cavity of the tooth. An onlay also fits inside the cavity, but it covers the tooth cusp as well.
Veneers are thin prosthetics that are placed over a tooth to improve its appearance or strengthen it.
Prosthodontists also work on TMJ/TMD problems in the jaw joint.
General dentists can do some of the treatments that prosthodontists do, but prosthodontists specialize in these tooth restoration procedures. They even regularly lead teams of dentists to solve your dental problems and focus on the diagnosis, treatment planning, rehabilitation and maintenance of your oral health, appearance and comfort.
Like every other part of our bodies, our mouths change as we age. As the carefree days of youth fade you may be faced with new challenges when it comes to your oral health, or you may start to pay for bad habits from your younger days. And even if you’ve taken good care of your teeth & treated problems as they arise, some old solutions may age as well and need to be repaired or replaced.
Perhaps the most notable change as we age is the color of our teeth. Over time, the hard outer layer of your teeth called enamel, gets thinner. Because enamel is semi-transparent, this makes it so the dentin underneath shows through, which makes teeth appear duller and yellow. A lifetime of teeth staining habits, such as smoking tobacco or drinking red wine, coffee or tea can also eventually lead to discolored teeth. A dentist may be able to help whiten your teeth with a professional teeth whitening treatment. Discuss your goals for brightening your teeth with your dentist so that we can recommend the best option based on your overall oral health.
While fillings are one of the most common procedures that dentists perform and patients receive, fillings don’t last forever. Over time tooth fillings can get worn down and no longer be properly seated on your tooth. This can lead to tooth decay as bacteria and other debris get in between the filling and your tooth. One of the first signs of a filling that’s gone bad is tooth sensitivity to hot or cold. If you experience any new or strange sensations with your fillings, tell the dentist so we can examine your fillings.
Chronic dry mouth is more common in seniors, especially those undergoing cancer treatments that use radiation. Hundreds of medications also have dry mouth as a side effect. Saliva naturally helps flush away food particles that can become food for tooth decay-causing bacteria and also helps reduce acids that can cause decay. If you mouth isn’t producing enough saliva, you are at a much higher risk for both tooth decay and bad breath. Don’t hesitate to talk to your dentist about your medications and your symptoms so you can find a solution before your dry mouth has a negative impact on your oral health.
In most cases, dentures are an affordable and natural-looking solution to missing teeth. However, many denture wearers will notice that while they have a perfect fit when they first get their false teeth, over time the dentures can start to feel loose or uncomfortable. This is due to bone loss in the jaw under your dentures, which causes the ridge under your gums to change shape. Most of the time, re-lining dentures can fix this problem. However, sometimes dentures need to be replaced. A permanent solution to this problem would be dental implants, either to support dentures or to support individual crowns. Dental implants can prevent the bone loss that makes dentures fit poorly and restore your mouth to its natural appearance and function. If you are having trouble with your dentures, bring this up to your dentist as soon as possible. We don’t want you to live in discomfort!
As dental care professionals, our ultimate goal is to ensure as many of our patients as possible keep all their teeth for a lifetime. We know that disease and accidents sometimes makes this impossible, but we want our senior patients to have beautiful and functional smiles even if they’ve lost teeth. The most common cause of tooth loss is gum disease or periodontitis, which weakens teeth, gums and the jawbone. Lack of teeth can affect your quality of life in many ways, including difficulty speaking clearly, trouble chewing and eating, and a reluctance to smile or show your teeth in social situations. All of these are problems that can be alleviated with the appropriate preventive and restorative care. If your missing teeth are affecting your quality of life, talk to the dentist about whether bridges, implants, or dentures can help.
Perhaps the earliest example of dental implants were seashells found in the jaw of an ancient Mayan skeleton from 1,300 years ago. While the Mayans were known for their surprisingly advanced dental knowledge, their seashell solution is a long way from today’s modern dental implants. And like many amazing, world-changing inventions, dental implants discovered practically by mistake.
It all started in Sweden in 1952. An orthopedic surgeon named Dr. Per-Ingvar Branemark conducted an experiment studying bone healing and blood flow that involved placing titanium rods in the legs of rabbits. At the end of his months-long experiment, he went to remove the rods from the rabbits’ legs and discovered they were totally fixed in place. The bone had fused to the titanium and grown around it.
This was remarkable because the human body (and the rabbit body for that matter) usually doesn’t like foreign objects being placed inside it. The body views the object as a threat and rejects it. Just think about how irritated and painful your skin becomes when you get a splinter.
Following his discovery, Dr. Branemark coined the term “osseointegration” to describe the process of bone adhering to metal. (“Osseo” comes from the Latin word for bone.) Using titanium as anchors for replacement teeth was on of the first applications that Dr. Branemark thought of for his discovery. He placed the first implants in a dental patient in the mid-1960s, however, it wasn’t until the 1980s that the use of titanium implants became accepted by the rest of the medical and dental community.
Since then, the technology has continued to advance as scientists and dentists strive create better versions of dental implants. Improvements have been made to the materials, shapes and installation techniques of dental implants, leading to shorter healing times and making the procedure available to a wider range of patients.
The difference between traditional techniques of tooth replacement and dental implants is like the difference between a peg leg and a high-tech bionic prosthetic leg. The development of dental implants allowed dentists, for the first time, to truly replace a tooth. Because implants have a root and a crown structure just like a real tooth, they function just like a real tooth and can last for decades, unlike bridges and dentures which often need to be adjusted and replaced.
While many patients have only heard of the dental implants procedure within the last few years, the truth is that the concept of dental implants has been around for centuries, and modern dental implants have been around for over 60 years. The success of implants in restoring missing teeth to patients’ mouths truly makes it feel like we’re in a golden age of dentistry. Dentists the world over are grateful to have this amazing technology at their disposal to restore patients’ smiles.
A periodontist is a fully trained dentist who specializes in treating periodontal disease (advanced gum disease) and the placement of dental implants. To put it more simply, you can think of a periodontist as a dentist who specializes in caring for your gums.
After completing dental school and earning their dental degree, a dentist must complete an additional three years of specialized training in order to become a periodontist. During this training the dentist becomes an expert in the gums and their underlying bone structures, the placement of dental implants and both the surgical and non-surgical treatments for gum disease.
The conditions that periodontists most commonly treat are gingivitis, periodontal disease (gum disease) and tooth loss. These conditions can also be thought of as a progression. Left unattended, gingivitis develops into periodontal disease, which can lead to tooth loss. The role of the periodontist is to intervene at whichever stage the patient is at and try to create the best possible outcome for their oral health.
The treatment that periodontists may be best known for is a deep cleaning, also called a scaling and root planing. This is a procedure specific to the treatment of periodontitis which involves removing debris and infection-causing bacteria from the pockets that develop between inflamed gums and the teeth. Repeated deep cleanings are essential to keeping periodontal disease from advancing to the point of tooth loss.
A periodontist’s specific knowledge of the gums and jawbone structures makes them the ideal specialists for replacing teeth with dental implants. Dental implants are artificial tooth roots that are inserted into the bone and gums. Periodontists also perform related procedures, such as bone grafting. In a patient with bone loss due to missing teeth or periodontal disease, bone grafting can be used to reinforce or “grow” more bone so that a dental implant can be placed securely.
Periodontists also perform some cosmetic treatments that involve the soft tissues of the mouth. Gum re-contouring can fix gums that have receded due to gum disease, giving the smile a healthier look. Crown lengthening can expose more of the hard tooth structure, giving teeth a longer appearance or fixing a “gummy” smile.
While all dentists are trained to care for your gums, periodontists offer care for advanced or complex cases, including those where additional health complications may be involved. That’s why it’s very important to see your periodontist regularly if your general dentist has referred you to one. The periodontist and your dentists will work together to ensure you are getting all the treatment you need to keep your smile as healthy and functional as possible.
The answer: Bone loss.
A common legend says that an astronaut who returned to Earth after an extended stay on a space station had bones so weak that he broke his arm lifting a tea cup. While this story may be an exaggeration, astronauts do lose bone density at a about ten times the rate of osteoporosis when in space (source) due to the absence of gravity.
What does gravity have to do with your bones? All the bones in your body get built up or broken down (resorbed) based on the amount of stress they’re under. For most of the bones in your body, their major stressor is gravity. However, for the bones of your jaw, their stress comes from biting and chewing. But when someone loses their teeth, this stress goes away, which can lead to jawbone being resorbed by the body.
While dentures are an aesthetic and functional replacement for teeth, they apply biting and chewing pressure to your gums, instead of directly to your jawbone like a natural tooth does. Because the roots of natural teeth are embedded in your bone, so when you bite or chew something, that force is transferred through your tooth into the bone of your jaw.
This bone loss explains why you can get a new set of dentures that fit perfectly right after they’ve been manufactured, but as time goes on, they fit more and more poorly, until they are loose and uncomfortable. The dentures themselves have not changed, but the shape of the bone under your gums has.
For this reason, many believe there is no such thing as truly affordable dentures. Even the best, highest quality dentures will eventually need to be replaced due to the biological reality of bone resorption. However, it’s important to note that bone loss in your jaw will happen even more rapidly if you don’t replace your teeth with anything at all. If you’re missing teeth, dentures can help you speak, eat and look normally again. Any dentures that allow you to get some of the normal function of your mouth back are affordable dentures!
For a permanent solution to bone loss after tooth loss, dental implants are the best option. That’s because implants act as an artificial tooth root that transfers biting and chewing force directly into your jawbone, just like a natural tooth. Because your bone is still under stress from the implant, it won’t be resorbed by your body. While dental implants are more of a financial investment at first, they’ll never have to be replaced like dentures, so you only have to pay for them once. Plus, they can be maintained just like real teeth, with daily brushing, flossing and semi-annual visits to the dental hygienist.
Dental implants have allowed for the invention of a new type of denture: the implant-supported denture. This type combines the affordability of dentures with the bone-stimulating qualities of implants to create a tooth replacement solution that is much more stable than traditional dentures that are held on with adhesives. This makes implant-supported dentures the most affordable dentures there are, both in terms of your wallet and your oral health!
Simply put, an orthodontist is a type of dentist. However, many people don’t know this because general dentistry and orthodontics are treated as two very separate kinds of dental care. While some dental practices have both general dentists and orthodontists under the same roof, sometimes your general or family dentist will refer you out to a separate orthodontist’s practice if you need braces or another kind of orthodontic treatment.
Just like a general dentist, an orthodontist has gone to dental school and earned a DDS or DMD degree (or BDS degree outside North America). So an orthodontist has all the same training as a general dentist (or a prosthodontist or a periodontist for that matter). The difference is that the orthodontist has gone on to take 2 additional years of training in the specialty of orthodontics.
So what do orthodontists do? To put it plainly, they look after the alignment of your teeth, your bite, and your jaw. If you have teeth that are crowded or too far apart, an orthodontist can diagnose the problem and create a treatment plan to fix it. If your bite is misaligned so your teeth don’t come together properly when you close your mouth or chew, an orthodontist can also diagnose the problem and plan your treatment. Orthodontists can also treat jaw problems, including problems with the temporomandibular joint (or TMJ).
If you already are pretty familiar with what an orthodontist does, chances are you had braces as a child. Braces are the most common treatment that orthodontists are known for. They can be used to both realign teeth and to realign your bite. Orthodontists can also realign teeth using invisible plastic aligners, such as Invisalign, though general dentists can also treat patients using most forms of dental aligners. Once your teeth are aligned, your dentist may also provide you with a retainer to help keep your teeth in their new position.
So while a orthodontist is a dentist with all the same training as a general dentist, they have chosen to restrict their practice to treating tooth alignment and facial development.
While we all experienced losing teeth as a right of passage through childhood, losing a tooth as an adult is no fun at all, especially when it’s the result of an accident. If you should ever be unfortunate enough to have a tooth knocked out, a little knowledge about what to do can go a long way in preventing longterm damage to your smile.
Of course, on of the first things you should do if your tooth gets knocked out is make an emergency dentist appointment. However, depending on where and when your accident happened, it may be hours before you’ll actually be in the dentist’s chair. There is a good chance that the dentist will be able to put it back in place regardless, but only if you follow a few vital steps between the accident and your arrival at the dentist’s office.
Your primary goal after your tooth has come out is to keep the tooth alive, which means making sure the tooth root remains moist and as undamaged as possible. The tooth root is the tissues that provide blood flow and nutrients to the tooth. If these tissues dry out they can die, which makes it much harder for for the dentist to put it back in its socket successfully.
First, you should try to immediately fit the tooth back in its socket. If you manage to get the tooth back in place, you can bite down on gauze or a wet tea bag to keep in there until you get to your emergency dentist appointment. If you can’t get the tooth back in its socket, you’ll need to use other means to keep it safe.
If the knocked out tooth as dirt or debris on it, rinse it off using tap water or bottled water. Always hold the tooth by the crown (opposite end as the root) and don’t touch the root, as this may damage it. Do not brush the tooth or try to sterilize or clean it with alcohol or hydrogen peroxide. These things will do more harm than good.
Next, to keep the tooth moist you need to put it either cow’s milk, or if milk isn’t available, put it in saliva. You can also keep the tooth in your mouth, either under your tongue or between your gums and your cheek. But be careful not to swallow it! Don’t put the tooth in water to keep it moist. Water is not as gentle as milk or saliva and can cause damage to the cells in the tooth root. Once you get to your emergency dentist appointment, the dentist will take care of sterilizing the tooth in a way that doesn’t risk damaging it.
The dentist will assess the damage to your tooth and your mouth and determine the best way to proceed. Usually this involves cleaning the area and the tooth and gently inserting it back into its socket. Sometimes the dentist will apply a splint to keep the tooth in position as it heals back into place. This splint resembles braces and will usually be in place for 1-2 weeks.
The biggest thing to remember when a tooth gets knocked out is that it can be put back if you follow the right steps! Be sure to call your dentist for an emergency dentist appointment right away and your smile should be back to normal in no time.
Please note: If you injuries could be life threatening, contact emergency medical services right away and worry about the dentist later!
Bonus fact: The clinical term for a knocked out tooth is an avulsed tooth.
Generally speaking, there are two types of wisdom tooth pain: the kind that indicates a problem and the kind that’s just part of growing up.
In case you don’t know, wisdom teeth are an additional set of adult molars that typically start coming in between ages 17 and 21. Most children finish getting their adult teeth at around age 12, so wisdom teeth get their name because they appear a few years later, when a person is older and wiser. However, because they come in so much later when most of the adult teeth are already in place, wisdom teeth can often cause problems.
The normal process of tooth eruption can cause wisdom tooth pain. Just like all the other teeth, wisdom teeth need to push up through the gums in order to come in, which can cause occasional aches and soreness. This pain should subside once the tooth has come in all the way, but in the meantime it can be alleviated with topical pain relieving medications, such as Orajel.
However, in a good amount of the population, wisdom teeth do not emerge properly. The teeth can come in a bad angle, get jammed up against the existing molars, and get stuck beneath the surface of the gums. This is what dentists call impacted wisdom teeth.
Impacted wisdom teeth pain is usually an ache that comes and goes over time. It can be irritating and uncomfortable, and often the only long-term solution is to have the impacted teeth extracted. It’s important to note that while extractions are referred to as oral surgery, they are a very routine procedure that usually only requires a day or two of recovery time.
Another cause of wisdom tooth pain is an abscess. This often happens when debris or bacteria get caught in the pockets or crevices caused by a partially erupted wisdom tooth (i.e. a tooth that has only come in part way through the gums). Trapped debris causes and infection, which leads to pain and swelling in the wisdom tooth area. In these cases, the wisdom tooth needs to be removed as soon as possible.
If you have any wisdom teeth pain, it’s a good idea to talk to your dentist about it right away.
Most patients, especially those in suburban areas near cities, have two choices for the types of dental practices they can go to. There are classic privately-owned practices, which are small businesses where the supervising dentist is also the owner. There are also corporate dental offices (also called DSOs) which are owned and run by corporations, and the dentists that practice within them are employees of the corporation.
Clinically speaking, the quality of care at a corporate dental center versus privately-owned dental practices will be roughly the same. Both types of dental practices are staffed by dentists and hygienists who were held to the same standards in order to earn their DDS/DMD degrees or RDH certifications. That being said, some dentists working in corporate dental practices have complained that they’ve felt pressured by their corporate employers to offer expensive care that the patient might not need, instead of basing treatment decisions on their patients’ individual health, insurance and financial situation (source).
While we hesitate to make generalizations for all such practices, the ethics of care at a corporate dental practice may be clouded by the pursuit of profits. After all, the owner of the practice is a distant corporation, not a dentist who lives down the street, shops at the same grocery store as you and whose children go to the same school as yours!
At dentist-owned dental practices, treatment decisions are between you and your dentist, with no outside influence. Your dentist knows you personally and has the chance to get to know your goals for your health and your appearance, and can take your financial situation into account when helping you weigh your choices. Dentist-owned offices can help you maximize your insurance in a way that’s best for your health and your wallet, as opposed to what’s best for a corporation’s bottom line.
Just because a dental practice has more than one location in your area doesn’t mean it’s corporately owned. Just like your favorite mom and pop sandwich place might have locations on both ends of town, so too can a local dentist have multiple dental practices. One of our aspirations as dental professionals is to provide accessible, compassionate dental care to as much of the local community as we can, and having multiple locations is a way to do that.
While corporate offices have traditionally had the buying power to acquire all the latest equipment, as technology has advanced, the most leading-edge equipment is also increasingly available to privately-owned practices. With all other aspects of your care being equal, would you rather have your smile cared for by local people that you know and trust, or a corporation?
There are many ways to replace missing teeth & restore your smile, & bridges are a good permanent solution. They can replace one or more missing teeth, including molars, & cannot be removed, unlike dentures.
Bridges are called bridges because they create a “bridge” between teeth. The false tooth, called a pontic, is connected to the surrounding existing teeth or implants. The teeth or implant where the bridge is attached is called an abutment.
There are four major types of bridges:
Traditional bridges are held in place by dental crowns placed over the two existing teeth on either side of the gap. That means that for this type of bridge, there must be natural teeth on both sides of the gap. Your dentist will file down the existing teeth to place a crown over them so that the bridge can be attached to these new crowns.
In cantilever bridges, the pontic is only supported by one crown, instead of two. These are not as popular because sometimes the bridge can act as a lever & can have complications, like fractured teeth or loosened crowns.
In Maryland bridges, the pontic is held in place by a metal or porcelain framework that is bonded to the back of the surrounding teeth, kind of like little wings. This type of bridge is nice because your surrounding teeth don’t need to be filed down.
These bridges are useful when more than one tooth is missing. An implant is placed for every missing tooth, & a bridge is attached to the new implants. If an implant can’t be placed for every tooth, then a pontic can be suspended between two surrounding implant crowns instead. These bridges take a bit longer, since implants can take up to five months to place.
Bridges are a long-lasting way to restore your smile & prevent other dental health problems, like bad bites, gum disease & TMJ disorders. Bridges can last up to 10 years with proper care, so practice good oral hygiene to keep your teeth & gum free of decay, & avoid eating hard foods & ice. Keep your bridges clean with proxy brushes, floss threaders & antibacterial mouthwash, & by flossing underneath the false tooth.
Talk to your dentist to find out if dental bridges are right for your smile!
