Dear Dental Doc.,
I just had a physical exam and my Doctor heard a heart murmur. He asked me if I ever had rheumatic fever. I said I did as a kid. He then told me I had to take antibiotics before any dental appointments. How come? What should I do?
Dear Dr. John: I just had the last three teeth on my lower jaw pulled and a denture made. I have had an upper denture for twenty years and have had no trouble eating with it. This lower one is a different story. It moves all over the place! I’ve tried every denture adhesive on the market; nothing seems to help. Is there anything I can do to keep these teeth in place? I’m tired of eating bananas.
Dear Mr. Miller: Your complaint is not uncommon among people who wear full lower dentures. Upper dentures generally fit and stabilize well without the use of denture adhesives. The full lower denture tends to be a great deal more troublesome. The reasons for this lie in the anatomical differences between the upper and lower jaws.
The upper jaw, or maxilla, consists of one continuous area. It has a bony ridge that is shaped like a horseshoe, which is connected by bone called the hard palate . An upper denture fits over the ridge and hard palate creating suction. This suction is what keeps the upper denture in place.
The lower jaw or mandible, differs in several ways:
· The lower jaw is hinged and moves up and down, side to side and forward and back
· It has movable soft tissues that tend to dislodge the lower denture.
· The tongue is located between the ridge, preventing the solid surface area that creates suction in the upper denture.
These differences, account for the lack of stabilizing forces in the lower denture. Therefore the denture wearer must rely on the size of the ridge, gravity and the upper denture to stabilize a lower denture. The denture wearer must also learn to chew in an up and down motion. Often times there is very little bone height to the ridge that the denture is seated over. In these cases, the denture may slide around making it difficult to eat or talk. Denture adhesives are of little use on lower dentures and may actually make matters worse.
There is a solution to your problem, by placing two dental implants into your lower jawbone, and the corresponding attachments into your denture. These attachments hold your denture in place, acting like snaps on pants. When you place your denture in your mouth, the female portion of the attachment snaps over the male portion located on the implant. This stabilizes your denture allowing you to chew with confidence. The results are phenomenal!
The procedure is straightforward. First, the dental implants are surgically placed into your lower jawbone. After three to four months, the bone attaches to the surface of the implant securing it into your jawbone. Once this is accomplished, the male portion of attachment is screwed into the implant and the female portion is placed into your denture.
After some careful adjustments, you’ll be ready to get off bananas and onto apples!
Better smiles for all.
Dear Dental Doc,
I finally got the nerve to see a dentist after 12 years. I only needed a few fillings, but the dentist said I had gum disease. He said it wasn’t advanced and recommended I have scaling and root planning done. He also recommended placing something called Arestin in bad areas. What do you think?
Dear Dr. John: Every time I bite into something hard a get a sharp pain in my lower left tooth. It also hurts when I drink something really cold. I saw my dentist, he took an x-ray and did some tests and said he couldn’t find anything wrong. He adjusted my bite and gave me a bill for $200! The tooth still hurts; do you have any ideas?
Candy- Redwood City
Dr. John I have decided to obtain dental insurance for myself and my family, how do I decide which plan is best?
Without a doubt, there are a very large number of dental plans available. Many plans will only be available to groups and not individuals. Generally speaking, when researching dental plans you will find that the various products will fall into one of the following categories.
I have only touched on the generalities of dental insurance and suggest you contact an expert to help you with your selection.
Doc every time I get a cold or my allergies act up my upper teeth hurt. My husband says I am nuts. What can I do about this pain?
Dr. John I am fifty-five years old and can count the number of times I have been to the dentist on one hand. I have not seen a dentist in 15 years. Just thinking about going to the dentist causes me anxiety and fear. I have tried to ignore my dental pain for as long as I can, now I have several teeth that hurt. I saw dental advertisement in the paper stating that with just the administration of a pill I could sleep through my treatment, this sounds really good to me. Does it work, is it safe?
Nelson – Daly City
Dear Dr. John,
I am forty two years old and only have a few fillings and no crowns. I was transferred to California from Washington State by my employer, my new dentist informed me I have gum disease and will need root planing cleaning. When I asked her how much the cleaning would cost she told me $1050. I know the cost of living in California is high but that’s ridiculous, what is the going rate, will I lose my teeth if I don’t get it done?
Shawn- Redwood City
Dear Dr. John,
I have a PPO dental plan and just got assigned to a new dental office. My new dentist did an exam and showed me my silver fillings with his in-mouth camera. My silver fillings are black and cracked he wants to replace them with white fillings, but says my insurance company will only pay for amalgam, so I will have to pay the difference out of my pocket if I want the white fillings. Help what material should I opt for? Which lasts longer?
Dear Dr. John: My dentist says I am a bruxer and need a night guard? Can you explain what a night guard is, how they are made and how much they costs?
Dear Dr. John,
Every time I drink or eat something cold, my teeth hurt. My teeth even hurt when I breathe in cold air! Can you tell me why my teeth are so sensitive and what I can do about them?
I have been wearing full dentures for the past thirty years, for the past five years I have had trouble with my lower denture staying put. I have had three new sets made and was just informed that my problem wasn’t the denture but in fact my jawbone was dissolving? My dentist is sending me to a specialist, what should I expect?
The lower denture has much less surface area to rest upon. The upper denture for example utilizes the entire roof of your mouth to help stabilize the denture.
The lower denture comes in contact with more movable mouth surfaces than an upper denture. These movable surfaces tend to dislodge the lower denture.
Loss of the jawbone ridge, allows the lower denture to come into closer contact with tissue extension , which cause destabilizing forces.
I am a 35-year-old female, my front teeth are crooked, but I don’t want to wear braces. I want to avoid tin man grin. Are there any other options and how much to do they cost?
There are currently three options available to straighten your smile.
1. Instant orthodontics
2. Traditional orthodontics
Dear Dr. John,
Last weekend I purchased a teeth-whitening kit at my local drugstore. I followed the directions and everything was ok for the first two days. On the third day I woke-up in excruciating pain. It seemed that every tooth in my mouth and gums hurt. I thought bleaching was safe—?
Last week I went to see a new dentist. I basically just wanted a cleaning but they were advertising a special that included and exam and cleaning. When I got to the office I was informed I would be required to have x-rays taken in order to get my cleaning and exam. When I refused they told me that American Dental Association mandated it. I felt I was being scammed for an extra $75 so I left. Isn’t that a lot for x-rays? What’s the story; does the ADA require the dentist to take x=rays in order to have a cleaning and exam?
Dear Dr. John,
I currently have a removable partial denture. I hate the way it looks! Every time I smile, you can see the ugly wire clasps. At the time I had it done, it was all I could afford. Since I’m older, and have the finances, what options do I now have?
Dear Dr. Russo,
I just saw my MD for a physical. Everything was fine, but he noticed I had bad breath and asked me to see my dentist. He said I could have gum disease and if so, it could cause many health problems. Can you tell me what diseases it can cause and what I can do to prevent this from happening?
Jill I suspect your doctor may have noticed inflamed and infected gums, in addition to your halitosis. Most people will have bad breath from time to time; this condition in and of itself is not the prime indicator for severe gum disease. Given that you do in fact have severe periodontal disease I agree with your doctor. Oral bacterium not only affects the health of your mouth, but also can cause various medical problems elsewhere in your body. Patients with advanced gum disease release significantly higher levels of bacterial components such as endotoxins into the bloodstream. Once released into the bloodstream these toxins travel to other areas of the body.
Oral bacteria has been linked to cardiac disease, stroke, diabetes stomach ulcers and pneumonia. Another heart condition caused by oral bacteria is bacterial endocarditis. Patients who have a heart valve defect or mitral valve prolapse are at risk. Oral bacteria enter your bloodstream and congregate on your heart valves causing further valve damage. This condition can be life threatening, so make certain your dentist is aware of any heart problems so he can determine if you need to take antibiotics prior to your treatment.
Prevention is always easier than the cure. My recommendation is semi-annual checkups, and dental cleanings three times a year. Home care should include daily brushing, flossing and tongue scraping. This will keep the bacteria at acceptable levels. The benefits are healthier teeth, fresher breath and a periodontal disease free mouth.
Better smiles for all,
Dr. John J. Russo