Questions every patient should ask their dentist
Has your Dental office been visited by OSHA this year? This is a very important part of being a health care providing office. Regular visits from Occupational Safety & Health Administration was created to make sure that all medical offices are up to standard.
Is my hygienist cleaning below the gums? I often see patients who say that they have been regularly visiting their dentist 2-3 times per year and never miss a cleaning. Why do they have plaque below their gums or periodontal disease? It is important that at every hygiene appointment, your dentist or hygienist is checking your “periodontal probing depths” around 6 surfaces of each tooth and recording that measurement at least yearly. If you have periodontal pockets that are a 4mm and above along with some bleeding when being probed, most likely there is some plaque found under the gum tissue. Try a new hygienist in the office or get another opinion. It’s not supposed to be painful but if the cleaning is just on the surface, you are not getting the job done.
Ask your dentist who their lab technician is? So many people rant and rave about the esthetics of their teeth. “Look how great my veneers are, isn’t my dentist great?” It is very sweet that patients give the dentist credit but the real credit goes to the lab technician or in our case, the lab ceramist, who meticulously created those veneers by first using wax (done by hand) and then painting layers of porcelain on one another to create a piece of art. The dentist’s job is to create the proper foundation so that lab technician can place their work on a smooth surface. For lack of a better example, lets use construction of a new home kitchen. The dentist would be responsible for placing the concrete or wood foundation and the technician is responsible for those beautiful shiny kitchen cabinets. You should meet the lab technician your dentist works with and feel confident that your communication with them as well as their previous work is a good reflection of your desired results.
What do youthful teeth look like? People ask me how they can have a more youthful appearance when it comes to their smile. The best example of this is to look at teenagers’ teeth. They are a good example to see what length, translucency, and natural curvy teeth should look like. When we age, our teeth tend to get duller in color and more worn down. The edges of our teeth need to show some translucency and the anatomy of our teeth need some natural curves to allow light to reflect in a beautiful way. Anyone that wants all of his or her teeth to be the same length or size is not looking for a natural smile. A natural look comes with the two upper front central teeth being larger both in length and width then the two smaller side teeth and the canine teeth to show a sharper edge. This is called a natural smile curve. See the pictures below. From left to right you see the blue dotted lines in the illustration showing the natural smile curve, the flat curve, and the reverse curve.
Do I really need a crown? What is a partial coverage crown? In my practice, I try my very best not to have to do crowns on patients unless there is a defective crown already on that particular tooth. Crowns are full coverage restorations that require the natural tooth to be cut down significantly to fit the restoration. A partial crown is called an “onlay” or “inlay”. See picture below. We have the technology today to save as much tooth structure as possible while still giving the patient a predictably strong restoration. Many years ago, if there was a tiny part of the tooth that was affected, the dentist did a full coverage crown. Crowns result in a higher incidence of root canals, sensitivity, poor esthetics, and gum problems then partial coverage crowns. Both can be made of porcelain or gold but being aware that there is a choice is the most important part of this question. I have too many patients come to me from another dentist for a second opinion because they were told that they needed a crown and they wanted a more minimally invasive option.