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With today’s techniques and materials, there is really no reason anyone should have to go without teeth any longer.

Solutions can be summed up in the “big three.”  Dentures, bridges, and implants can all be used to replace teeth gone MIA.  Even more exciting is the potential to use a combination of these three, giving literally endless options for patients depending on how many, and which teeth are missing.

When just a couple teeth are missing, the most likely candidates are either a bridge or individual implants. 

If a few teeth are missing, a bridge supported by implants is a great solution!

As more teeth need to be replaced, the options increase to include dentures or “plates.”  Don’t worry, these aren’t your dad’s dentures!  Using as few as two implants to anchor a denture adds stability and starts to make the dentures actually begin to function like normal teeth.  Of course they are still a poor replacement for natural teeth, but as we add more implants, they become dramatically more stable.  With enough implants, we can even remove the plastic that typically covers the roof of a denture patient’s mouth, which is often blamed for decreased taste sensation.

As you can see, today’s options for replacing missing teeth are vast.  The excuses for going through life without teeth are dwindling.  Thank goodness.

Dr. Crosby

Frequently the best way to restore a damaged tooth comes in the form of a crown, the workhorse of modern dentistry.  Usually it is a tooth that has had previous restorations like a filling or root canal and the fillings are aged or the tooth just needs more protection.

For decades this required two steps.  In the first step the dentist prepared the tooth for a crown like #2 in the picture above.  Once the tooth was prepared an impression was made and a temporary crown, usually made of aluminum or plastic, was glued in place to protect the tooth.  The second step needed a dental laboratory to make the crown using the impression the dentist made of the tooth.  The patient wore the temporary before the final crown could be glued in place at a second visit, generally two weeks later.

And then along comes technology, in the form of  CEREC…

Now the crown can be made in about ten minutes right in front of the patient so there’s no need for an impression, a temporary, or a second visit.  After preparing the tooth for the crown, a 3D scan is taken of the tooth and the doctor designs the crown using the sophisticated dental software.  Once the design is complete, a small block of ceramic material is placed in the milling unit and diamond bits mill the crown to fit the tooth exactly.

Once the porcelain is milled it can bonded in place to help support the tooth.

On occasion some teeth require custom shading which can easily be done in a few minutes in a small glazing oven.

The benefits that technology allows dentistry and therefore dental patients have never been better.  Cerec now adds the benefit of custom, single-visit crowns to save time for patients.

Dr. Crosby

Titanium dental implants have long been available and now they are even stronger and easier to place!

Dental implants consist of a titanium post placed in the jawbone with a porcelain crown attached.

Historically, the placement of implants has been challenged for two reasons, 1. because two professionals were responsible for one outcome, and 2. because  traditional 2-dimensional x-rays have their limitations. 

Often the job of an implant was done by two Doctors: an Oral Surgeon placed the implant post and the General Dentist placed the crown.  The Dentist knew where the crown should end up but the Surgeon knew where the bone was and often placed the implant independant of where the crown would go.  Neither Doctor was wrong but, because the process was divided, the implants were frequently compromised for one reason or another.

Because x-rays are only a 2-dimensional image, they required a certain degree of “interpretation.”  They are also notorious for distortion which is why a measurement on an x-ray – whether film or digital – can’t be used for anything more than a guide that must be confirmed on the patient.  “Confirmed on the patient” means that, at the time of your implant surgery, the gums were cut back from the bone to help verify the measurements.  This method was not only less accurate, it also meant significant post-op pain and healing.

Now comes the advent of the 3-dimensional, highly accurate, low-radiation CT scan dedicated to the dental office.  This gives Dentists the information necessary to be confident when placing the implant, knowing it will be in exactly the right spot for the future crown.

Using specialized software that maps vital structures like nerves, an implant can be “virtually placed” in the patient’s image.  From here, a laboratory can fabricate a guide or template that fits the patient’s mouth.

With an accurate template that fits in the patient’s mouth, now the implant procedure is as easy as drilling a small hole and placing the implant.  Our patients with these procedures are often in and out of the office  around 30 minutes because all the guesswork has been removed.  Even better is they rarely have to take any pain medicine because the procedure is so non-invasive.  Because the implant was planned on the computer, we can also ensure that it is aligned with the future crown placement.

This is what 3D implant planning is all about and why we use it at our office.

Dr. Crosby

Two choices: Pain or No Pain?

Which would you prefer?

Like it or not, pain is what many people think of when they think of coming to the dentist, but here more than ever dentistry is making huge advances.

A tool not many people know about is called the “Wand� or “Compudent.�  Essentially it is a computer-controlled dental injection. The flow rate of the local anesthetic is controlled by a computer. This means that the injection is guaranteed to be slow and steady and therefore comfortable.

Most people who have had a bad experience with injections think that needles sting because the skin is pierced, but this is usually not so! Most often, the sting was caused because the anesthetic was fired in too quickly. Obviously, it is possible for a dentist to control the speed with a standard syringe, but the idea of the Wand is to take out the “human error”. This can be very reassuring for people with previous bad experiences.

 

What does the Wand look like?

 

It doesn’t even look like a syringe! Welcome to the space age…

As you can see in the photo, the “hardware” looks similar to a miniature computer tower.

The handpiece device looks just like a ball point pen.

It is even held like a pen! Using the Wand is far easier to use because it is so light and easy to handle.  One of the reasons I like using the Wand is its accuracy.  As you can see, my hand is very close to the tip (yes, there is still a needle albeit a small one), unlike a traditional syringe where my thumb can be as much as 8-10 inches away from the “working end.�

Once I’m ready to dispense the anesthetic I have a small foot pedal to get started and that’s it!

Our patients routinely ask about the Wand and we find their friends that are new to the office are also asking about the Wand as well.

Dr. Crosby

 

Reggie had just returned from a tour in Iraq and wanted a new smile. His wife found us on line at www.crosbysmiles.com. The determining factor for choosing our office was the customer service they received. His wife felt very comfortable talking to Stefanie, our treatment coordinator, and was readily given answers to all of her questions.

Reggie’s treatment included eight veneers on his upper front teeth and whitening on his lower teeth. His new smile is remarkable. He describes our office on a scale of 1 to 10 as being, “off the charts�.

Reggie’s overall experience with us changed his life. He is happy, excited and always ready to show his new smile.

Gail is a genuinely happy person, but found herself holding back on her smile because her teeth were discolored. She found us on line at www.crosbysmiles.com.

Gail instantly felt at ease at our office. We made her feel relaxed. She could tell that we were genuinely concerned about what she wanted, which was a smile that matched her personality. So that’s what she got!

Gail’s treatment included veneers.

Gail said about her experience at our office, “It’s just not your typical dental experience – it’s really life changing.� She added, “A person can go from being really unhappy with their smile to having the prettiest, most perfect teeth. I literally went from not wanting to smile to receiving compliments on what beautiful teeth I have. I have always been a confident person, but my new smile has kicked it up a notch.�

Gail put off having her teeth done for years; she didn’t want to be selfish by spending the money on herself. Afterwards, her only regret was waiting so long.

Gail said, “My first appointment with Dr. Crosby was to be just that, one appointment. My intentions were to visit with other dentists and make my decision then based on how comfortable I felt and their qualifications. After meeting Dr. Crosby and his staff, I knew that he was the one I trusted with my smile. Dr. Crosby is passionate about what he does and is one of the best in his field. Professional, confident, accommodating… and he has a great sense of humor, which I really appreciate!�

Max came to see us because he was tired of the space between his two front teeth.

After a childhood bicycling accident, he lost one of his front teeth.

In the years since then, the tooth next to it had drifted into the space. Max was getting married and wanted to improve his smile. Max’s goal was not a Hollywood smile, but he did want to get rid of the space and make it less noticeable that he was missing his front tooth.

Some people want to look like they just walked off of a Hollywood movie set while others just want their teeth to “look natural.� Listening to what a patient wants is the most valuable first step in cosmetic dentistry.

The right cosmetic treatment for Max was to place a single porcelain veneer on the tooth that had drifted into the vacant spot and do some laser recontouring of his gums. This was a challenge for two reasons: #1 Matching the shade of a single front tooth can be one of the most difficult details in dentistry, and #2 We had to disguise the shape of the lateral incisor to make it look like a front tooth.

As you can see in the after photos, we achieved a great result! The color is almost a perfect match and the shape is ideal.

One benefit of today’s dentistry is that we have such a wide variety of materials to use. Pure porcelain materials without metal inside are now able to better match natural enamel and, as you can see, give a very life-like result.

Max was very pleased with his new smile and was looking forward to smiling in his wedding pictures!