Implants, Crowns, and Bridges vs. Natural Teeth

Nothing can replace the natural teeth you were born with for chewing and function. However, very few people go through life without having teeth filled, crowns (caps) placed, or bridges and implants used to replace missing teeth. Crowns, bridges, and implants are the best answer and closest to your natural teeth, but they are not the same as healthy, natural teeth.

Crowns

Crowns are used to reconstruct a single tooth broken down by dental decay. Crowns are made of ceramic, resin, porcelain, porcelain plus metal, or resin plus metal materials. They are bonded or cemented onto the prepared tooth and cannot easily be removed from the tooth once placed. If the tooth was in good alignment before the crown was prepared, the crown will be in good alignment. If the tooth was misaligned before the crown, sometimes the crown may be made to obtain a more ideal shape and position. It is cleaned and flossed just like a natural tooth and is most like real teeth.

Bridges

Bridges are crowns that are attached together, suspending the crown portion of a false tooth in or over the space left by the missing tooth. A bridge can be used to replace one or several teeth. Sometimes a bridge is used to splint loose teeth together in order to make the teeth more stable. Bridges are usually made of metal covered with either porcelain or resin. Some of the newer bridges are made of all resin or all ceramic materials. They are cemented or bonded onto the existing prepared teeth and are not easily removed once placed. The bridge teeth can be brushed the same as natural teeth, but since they are attached together, must be flossed differently by using a floss threader or other device.

The teeth are generally the same shape as natural teeth. However, if the existing teeth (abutments) that are used to anchor the bridge have moved from their original position because a tooth or teeth have been missing for years, the added tooth (pontic) may be longer or shorter than the tooth that it is replacing. With a bridge, the false tooth will most often butt up against the soft tissue ridge where the removed tooth was.

The shape of the tongue side of the false tooth varies. It is usually smaller on the tongue side and completely fills the space. Food will have more of a tendency to collect in this area, so you must be prepared to clean it. If the missing tooth has been gone a long time, the ridge may have shrunk considerably, and the pontic tooth will be longer that the teeth on either side. If this is the case, there are several periodontal procedures that can be done prior to the construction of the bridge. These procedures will build up the tissue to its former height. The more your mouth has changed from its normal state, the harder it is to make new teeth look and feel natural.

Implant Crowns

Implant crowns are used to replace single or multiple missing teeth. They are either cemented or screwed-retained onto an implant fixture. The crowns are made of porcelain or resin and metal. But they have some significant differences from the natural teeth they replace. Teeth are supported by a root or roots that are irregular in shape. Implants are round. The cross-sectional of the implant will never match that of the tooth it is replacing. A multirooted tooth may be replaced by a single implant, so the manner in which an implant crown comes out of the soft tissue ridge will appear different from a natural tooth. There will be more space between the implant root and the adjacent teeth. Implant crowns are often cemented with temporary cement. This allows the dentist to easily take off the crown and evaluate how the implant is doing. Crowns on teeth are usually cemented with a final cement. Implant-supported crowns are wonderful, but not the same as natural teeth with crowns. Be prepared for some differences. Expect more maintenance on your part and in the dental office with crowns, bridges, and implants.

Smokers take note: There is a heightened risk of dental implant failures among smokers—as much as 20% greater failure rate!

Headaches: The Dental Connection

You probably remember the old song “…the knee bone’s connected to the leg bone; the leg bone’s connected to the hip bone…etc.” Your (lower) jaw bone actually is connected to your “head bone”—and it is connected by muscles, ligaments, and tendons. This area is known as the temporomandibular joint or the TMJ. When the lower jaw lines up perfectly with the upper jaw and everything functions normally, everything is fine. If the lower jaw does not line up properly or, perhaps more importantly, if there is abnormal stress present when the lower jaw contacts the upper jaw, problems can occur. The abnormal stress is usually clenching or grinding of the teeth and it can occur any time, day or night, awake or asleep. When this happens, a person can develop regular, chronic, or migraine headaches; muscle pain or tenderness in the jaw joint muscles; or the temporomandibular joint dysfunction (TMD). Forty-four million Americans suffer from chronic clenching and grinding, resulting in tooth damage and 23 million suffer from migraine headache pain.

While mouthguards have been used with some success to treat TMD patients, an FDA-approved device seems to offer a higher success rate in eliminating TMJ problems. This device has an additional advantage in that it was designed to reduce the clenching habits that often lead to chronic and migraine headaches. This device prevents the upper and lower teeth from coming into contact. By preventing high-intensity clenching (and the muscular irritation that leads to migraine pain, TMD, and chronic headaches), studies have shown that 82% of migraine and headache sufferers has a 77% reduction in the migraine incidents. In short, the frequency and intensity of headache episodes and muscle tenderness can be reduced with the use of a mouthguard.

A tension suppression system is another effective form of mouthguard that can treat TMD. This small removable device, made in the office, can be worn day and/or night and has been shown to reduce clenching intensity by 66%. It takes advantage of a naturally protective reflex that suppresses the powerful chewing muscles active in clenching. For those concerned about insurance coverage, the cost of this device is submitted first to medical insurance for evaluation of benefit coverage. Most insurance carriers do consider this device a payable benefit.

How important is the reduction of clenching stress? Try this simple demonstration. Put a pencil between the last top and bottom molars on one side and bite hard. Remember how hard you were biting. Then take the pencil and place it between the top and bottom front teeth and bite down hard again. You will not be able to bite down as hard when just biting on the front teeth. You should be able to detect a great difference between biting (clenching) on back teeth only and front teeth only. Try another test: lightly place your fingertips on either side of your head in the temporal area (above and in front of the ears). Clench your teeth and feel the muscles on either side of the head bulge out. Then take a pencil, place it between the top and bottom front teeth, and bite down again. You will easily feel that the temporal muscles do not (cannot) bulge out as much, meaning that not as much clenching compression is possible.

Source: Elsevier Mosby, Dental Practice Tool Kit: Patient Handouts, Forms, and Letters

10 Things You Should Know Before Going to the Dentist

Fortunately for parents and kids, there are ways to make the dentist appointment less stressful for everyone. Here are 10 things to know before visiting the dentist:

1. Find a dentist that suits you and your family. Seek recommendations or look online for reviews. Call ahead to ask if you can interview or speak with the dentist about any reservations you may have regarding your dentist appointment. If you are taking a child to the dentist, consider using a pediatric dentist.

2. Gather your dental records, x-rays, insurance information, and any other pertinent papers to bring with you to your appointment. If this is a child’s first appointment, consider letting them hand their records to the dentist themselves.

3. Know your water. Find out if your drinking water contains fluoride. If not, your doctor may suggest that you and your child use a fluoride mouth rinse in addition to regular brushing and flossing.

4. Write down any questions you may have, so you do not forget to leave without the answers you need. When taking children to their dentist appointment, encourage them to ask any questions they may have too.

5. Talk with your children about what they can expect to happen during their visit. Describe how their teeth will be cleaned and the dentist will check for cavities. Explaining the procedure beforehand may help to ease any nervousness and help them to feel more confident during their appointment.

6. Talk with your dentist. If your child is nervous about the visit, let your dentist and hygienist know. Some children may be nervous, while others may have difficulty sitting still, or even sensitivities to lights and sounds. Talk with the dental office beforehand to make sure they can accommodate your needs.

7. Practice full disclosure with both the dentist and the hygienist. It will be helpful to tell them about any health issues, even if you may not think it would be a concern during a regular dental appointment. Let the office know if there is a chance that you may be pregnant, if you or your child have any allergies (particularly to latex or medications), bleeding or clotting problems, or any other health issues. Women who are pregnant or nursing may need to avoid x-rays and certain dental procedures.

8. Request your favorite hygienist. If you find a hygienist who you or child respond well to, ask for that person’s name and have it added to your file. That way you can request that same hygienist for your next visit.

9. Remember to schedule your next appointment! (This is one sin that I am super guilty of committing, and then before I know it too much time has passed between appointments.) Dental exams are not merely to check for cavities. Your dentist will be looking for signs of decay, gum disease and even oral cancer, so do not skip an appointment simply because you or your child are not having any pain.

10. Keep proper dental care going all year long. According to the CDC, tooth decay affects children in the United States more than any other chronic infectious disease. Keep up with regular dental care, including brushing twice daily, flossing, and eating a healthy diet. You should also speak with your dentist about whether or not your child should be using a flouride mouth rinse. Encourage your children to take care of their teeth so they can avoid any issues in the future. The better you and your children care for your teeth between appointments, the more likely your appointments are to go smoothly.

By: Jessica Cohen, Babble
http://www.phillytrib.com/things-you-should-know-before-going-to-the-dentist/article_771dac6e-d24f-5c43-a0ae-0d28cc15eb4a.html

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

Dental Insurance Coverage

Your employer, management, or union has purchased dental insurance coverage from a selection of plans offered by an insurance company or broker. Each insurance company offers many different plans. 

What is covered?
The type of dental benefits that are covered relate to the dollar amount spent on the benefit package. Generally, the more money spent on a plan, the more services are covered. Most dental insurance covers only 50% to 80% of the cost of the treatment. Major services (crowns, bridges, etc.), which are the most expensive dental procedures, are usually only covered at a 50% rate. For example, some dental benefit packages will not cover the fees for porcelain (tooth-colored material) crowns on teeth that are not visible when you talk or smile; they will only pay for a metal crown. Under this type of plan, you must pay the full amount of the cost of the porcelain on those teeth. According to insurance companies, fillings in front teeth have both functional use and cosmetic components. They will pay for the functional part but not the full amount for the cosmetic restorations.

Who is responsible for payment?
The fees charged for dental treatment reflect the many different parts of a particular procedure or procedures. Treatment for your particular needs may or may not fall within the limits set by your particular dental plan. Many dental procedures may not even be listed in your insurance's procedure/payment schedule. If your dental procedure falls into this category, you may not receive any insurance reimbursement for that procedure. You are ultimately responsible for paying the entire fee for an accepted dental treatment, regardless of your insurance coverage.

Choosing Treatment Options
Our goal through your examination, diagnosis, and treatment phases is to provide you with the best possible oral health. We do not allow the insurance company to tell us how to treat you. We recommend to you those treatments that we believe you need and we will discuss alternative plans with you. Whether or not the recommended treatment is a covered dental benefit is between you and your employer and the insurance carrier.

Submitting the Claim
We are happy to help you receive the maximum benefits you are allowed from your dental coverage. In order for us to submit your insurance claim, we will need an insurance form with your portion completed and signed. We deal with dental insurance companies on a daily basis; therefore, we have a great deal of experience submitting these claims to insurance carriers. We take great care in submitting claims properly the first time. 

There are three things we cannot do: 
1) Alter the date of treatment; 
2) Submit a claim for more than the actual fee; 
3) Submit a claim for procedures that have not been performed. 

Because it is not at all uncommon for the insurance carriers to make a mistake, we would prefer to submit the claims ourselves, and then verify proper payment. Insurance carriers may respond to requests for payment of preauthorized treatment in as little as a week or as long as 45 days. Please be patient; we have no control over the post office or the speed with which the insurance carrier processes your claim.

Our office cannot negotiate with your insurance company for reimbursement of dental expenses. Only the purchaser of the plan (your employer) can negotiate better coverage. If you would like better or more coverage, you will need to talk with your plan purchaser about the features you want in your dental plan.

If you have any questions about your dental insurance coverage, please feel free to ask us.