Frequently Asked Questions

A bridge is a dental restoration that replaces missing teeth. It is made of a false tooth attached to crowns which fit over teeth on both sides of a space. A bridge is cemented in place and cannot be taken out.

Frequently Asked Questions

1. What material is in a Bridge?
   Bridges are made of three types of materials:
   • Porcelain
     – most like a natural tooth in color
   • Gold Alloy
     – strongest and most conservative in its preparation
   • Porcelain fused to an inner core
     of gold alloy (Porcelain Fused to Meta or “PFM”) – combines strength and aesthetics
2. What are the benefits of having a Bridge?
   
   • Bridges build back your smile and help you to speak and chew properly by restoring your teeth to their natural size, shape and – if using porcelain – color. They help maintain tooth, bite and jaw alignment by preventing remaining teeth from shifting out of position.
3. What are the risks of having a Bridge?
   In having an bridge, some inherent risks exist both to the tooth and to the bridge itself. The risks to the remaining teeth are:
   • Preparation for a bridge weakens tooth structure of the anchor teeth and permanently alters the teeth.
   • Preparing for and placing a bridge can irritate the anchor teeth and cause “post-operative” sensitivity which may last for up to 3 months.
   • Anchor teeth for bridges may need root canal treatment about 6% of the time during the lifetime of the tooth.
   • Anchor teeth may become mobile if there is bone loss around their roots.
   • If the cement seal at the edge of the crown over an anchor tooth is lost, decay may form at the juncture of the crown and tooth.

   The risks to the bridge are:

   • Porcelain may chip and metal may wear over time.
   • If a tooth needs a root canal after the bridge is permanently cemented the procedure may fracture the bridge and the bridge may need to be replaced.
   • The longer the bridge the shorter the lifespan; three tooth bridges last 10-15 years on average.
4. What are the alternatives to having a Bridge?
   
   Three alternatives to bridges exist:
   • Replace the missing tooth with an implant.
   • Replace the missing tooth with a removable partial denture.
   • Leave the space as is.
5. How can an existing bite affect a Bridge?
   
   • Excessive biting forces or untreated bite problems may lead to the anchor teeth breaking or loosening.
   • Excessive biting forces or untreated bite problems may lead to the bridge chipping, breaking or loosening.
6. Are there post-treatment restrictions once I have a Bridge?
   
   • As a bridge is made in one solid piece, it is not possible to floss in between the teeth; special dental aids must be used to maintain the health of the anchor teeth and gums around the bridge.
   • Porcelain on bridge may have a good color match with adjacent natural teeth when the bridge is placed but less of a match as your natural teeth age.
   • Food may become lodged under fixed bridges; gum recession over time may make food impaction unavoidable, even with the most ideal bridge contour.
   • Gum recession may lead to unsightly dark roots or bridge margins becoming visible.
   • A bridge may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

A build-up is the addition of a restorative material to a broken down or decayed tooth before a crown, bridge, inlay, onlay or veneer is placed.

Frequently Asked Questions

1. What material is in a Build-up?
   
   A build-up is made of:
   • A Tooth Colored “composite” filling material
   • A silver “amalgam” filling material.
2. What are the benefits of a Build-up?
   
   • A build-up restores a broken down or decayed tooth to the ideal shape needed to accommodate a crown, bridge, inlay, onlay or veneer.
3. What are the risks of a Build-up?
   
   • Preparing for and placing a build-up can irritate the tooth and cause “post-operative” sensitivity which may last for up to 3 months.
   • Teeth which have had build-ups may need a root canal treatment about 6% of the time during the lifetime of the tooth.
4. What are the alternatives to having a Build-up?
   
   • No treatment alternatives exist besides a build-up for broken down or decayed teeth which require a crown, bridge, inlay, onlay or veneer.
5. 
   How can an existing bite affect a Build-up?
   
   
   • Excessive biting forces or untreated bite problems may lead to the build-up breaking or loosening.
   • Excessive biting forces or untreated bite problems may lead to the tooth in which the build-up has been placed breaking.
6. 
   Are there post-treatment restrictions once I have a Build-up?
   
   
   • A build-up may break or loosen if chewing very hard or sticky foods.

A Complete Denture with Locator Attachments on a Bar is an appliance that replaces all of the teeth in one jaw. It is not cemented in the mouth and can be taken out. A Milled Bar or Cast Metal Bar is connected to 4 dental implants that are placed in the jawbone. Locator Attachments are placed in the Complete Denture and connect the denture to the bar.

Frequently Asked Questions

1. What material is in a Complete Denture with Locator Attachments on a Bar?
   
   • The base of a complete denture is made of pink acrylic. If the complete denture has a metal substructure, the substructure is made of a very strong metal alloy. The teeth are made of Tooth Colored acrylic or porcelain. The Bar may be milled titanium or cast metal. The locator attachments are plastic. The implants are titanium.
2. What are the benefits of a Complete Denture with Locator Attachments on a Bar?
   
   • A Complete Denture with Locator Attachments on a Bar is very stable. It greatly improves retention, stability and chewing ability over a traditional Complete Denture with or without Locator Attachments. Patients who have a dry mouth and/ or fragile tissue may have difficulty with retention and comfort of a traditional Complete Denture and benefit from Locator Attachments on a Bar. Lip support is better compared to an Implant Retained Fixed Restoration. A removable appliance is more easily repaired. Oral Hygiene is also easier. A Milled or Cast Metal Bar and Locator Attachments allow an Upper Complete Denture to be made without covering the roof of the mouth. The angulation of the implants is not an issue.
3. What are the risks of a Complete Denture with Locator Attachments on a Bar?
   
   • An implant may fail and need to be removed. If one implant fails the entire bar may fail, depending on the number and location of implants in the mouth. More space is needed to accommodate the Bar and Attachments than with other types of dentures. The acrylic base of the denture may fracture, especially if it doesn’t contain a metal substructure.
4. What are the alternatives to a Complete Denture with Locator Attachments on a Bar?
   
   • A traditional Complete Denture
   • A Complete Denture with Milled Bar Attachment
   • A Complete Denture with Locator Attachments
   • Crowns or bridges supported by dental implants
   • Leave your math as it is.
5. How can an existing bite affect a Complete Denture with Locator Attachments on a Bar?
   
   • Uneven or excessive bite forces may cause premature wear of denture teeth. Denture teeth may fracture or become loose from the denture. The denture base can also fracture. Unmanaged bite issues can also cause implants to loosen within the bone and break. Broken or loose implants must be surgically removed.
6. Are there any post treatment limitations once I have a Complete Denture with Locator Attachments on a Bar?
   
   • To keep the tissue under the appliance healthy and to prolong the life of the locator attachments, your denture should be left out of your mouth during sleep. The teeth in the denture are not as strong as your natural teeth and you will not be able to chew as heavily on them. The appliance will tend to get food trapped underneath it and you may have to remove and clean it after eating.

A complete denture is an appliance that replaces all the teeth in one jaw. It is not cemented in the mouth and can be taken out.

Frequently Asked Questions

1. What materials are in a Complete Denture?
   
   • The base of a complete denture is made of pink acrylic. The teeth are made of Tooth Colored acrylic or porcelain which attach into the base.
2. What are the benefits of a Complete Denture?
   
   • A complete denture restores function and appearance to a jaw with no teeth. It is the most cost effective way of replacing all the teeth in one jaw. A complete denture can also provide important support to facial structures such as the lips, helping to in maintain a more youthful appearance.
3. What are the risks of a Complete Denture?
   
   • Complete dentures, even under the best of circumstances, DO NOT have the same chewing efficiency as natural teeth. The ability to chew food depends on the stability, support and retention of the dentures. Stability, support and retention are affected by many factors, including the amount and type of bone, gums and saliva present in the patient’s mouth as well as the shape of the patient’s jaw and how it fits with the opposing teeth.
4. What are the alternatives to a Complete Denture?
   
   The alternatives to having a complete denture are:
   • Implants which attach to:
     • Crowns or bridges
     • A complete denture
   • Leave your mouth as it is
5. 
   How can an existing bite affect a Complete Denture?
   
   
   • Uneven or excessive bite forces may cause wear or fracture of the denture teeth or denture base. Chewing will make a complete denture rock slightly in the mouth; the more uneven the biting force, the more the complete denture will rock.
6. 
   Are there any post treatment limitations once I have a Complete Denture?
   
   
   • To keep the tissue under the appliance healthy your denture should be left out of your mouth during sleep. The teeth in the denture are not as strong as your natural teeth and you will not be able to chew as heavily on them. The appliance will tend to get food trapped underneath it and you may have to remove and clean it after eating. The fit between a complete denture and the gums is very important for retention and therefore must be re-established every 2-5 years as gums are constantly undergoing small changes.

A Complete Denture with Locator Attachments is an appliance that replaces all of the teeth in one jaw. It is not cemented in the mouth and can be taken out. Locator Attachments are connected to dental implants that are placed in the jawbone. The Locator Attachments connect the Complete Denture to the implants. Generally, 2 implants and attachments are used for a lower jaw Complete Denture, and 4 implants and attachments are used for an upper jaw Complete Denture.

Frequently Asked Questions

1. What material is in a Complete Denture with Locator Attachments?
   
   • The base of a Complete Denture with Locator Attachments is made of pink acrylic. The teeth are made of Tooth Colored acrylic or porcelain which attach into the base. Locator Attachments are plastic and the implants they attach to are titanium.
2. What are the benefits of a Complete Denture with Locator Attachments?
   
   • Locator attachments greatly improve the retention and chewing ability of a Complete Denture. Patients who have a dry mouth and/ or fragile tissue may have difficulty with retention and comfort of a traditional Complete Denture and benefit from locator attachments. Lip support is better compared to an Implant Retained Fixed Restoration. A removable appliance is more easily repaired. Oral Hygiene is also easier.
3. What are the risks of a Complete Denture with Locator Attachments?
   
   • Locator attachments wear out over time and need to be replaced. Denture acrylic covering the locator attachment may chip if it is thin due to a limited space in the mouth.
4. What are the alternatives to a Complete Denture with Locator Attachments?
   
   • A traditional Complete Denture
   • A Complete Denture with Milled Bar Attachment
   • A Complete Denture with Locator Attachments on a Bar
   • Crowns or bridges supported by dental implants
   • Leave your mouth as it is
5. How can an existing bite affect a Complete Denture with Locator Attachments?
   
   • Uneven or excessive bite forces may cause wear or fracture of the denture teeth, denture base or locator attachments. Unmanaged bite issues can also cause implants to loosen within the bone and break. Broken or loose implants must be surgically removed.
6. Are there any post treatment limitations once I have a Complete Denture with Locator Attachments?
   
   • To keep the tissue under the appliance healthy and to prolong the life of the locator attachments, your denture should be left out of your mouth during sleep. The teeth in the denture are not as strong as your natural teeth and you will not be able to chew as heavily on them. The appliance will tend to get food trapped underneath it and you may have to remove and clean it after eating.

A Complete Denture with a Milled Bar Attachment is an appliance that replaces all the teeth in one jaw. It is not cemented in the mouth and can be taken out. A Milled Bar Attachment is a metal bar that stays in the mouth and connects the Complete Denture to dental implants. The Milled Bar is usually attached to 4 dental implants that are placed in the jawbone. The Complete Denture has a metal substructure placed into it that connects it to the Milled Bar.

Frequently Asked Questions

1. What material is in a Complete Denture with a Milled Bar Attachment?
   
   • The base of a complete denture is made of pink acrylic. The metal substructure within the denture is made of a very strong metal alloy. The teeth are made of Tooth Colored acrylic or porcelain. Both the Milled Bar and the implants it is attached to are made of titanium.
2. What are the benefits of a Complete Denture with a Milled Bar Attachment?
   
   • A Complete Denture with a Milled Bar Attachment is the most stable of implant retained dentures. It greatly improves retention, stability and chewing ability over a traditional Complete Denture with or without Locator Attachments. Patients who have a dry mouth and/ or fragile tissue may have difficulty with retention and comfort of a traditional Complete Denture and benefit from a Milled Bar Attachment. Lip support is better compared to an Implant Retained Fixed Restoration. A removable appliance is more easily repaired. Oral Hygiene is also easier. A Milled Bar Attachment allows an Upper Complete Denture to be made without covering the roof of the mouth. The angulation of the implants is not an issue.
3. What are the risks of a Complete Denture with a Milled Bar Attachment?
   
   • An implant may fail and need to be removed. If one implant fails the entire Milled Bar may fail, depending on the number and location of implants in the mouth. More space is needed to accommodate the Milled Bar and Attachments than with other types of dentures. Dexterity of the patient may make insertion and removal of the denture difficult. The acrylic base of the denture may fracture.
4. What are the alternatives to a Complete Denture with a Milled Bar Attachment?
   
   • A traditional Complete Denture
   • A Complete Denture with Locator Attachments
   • A Complete Denture with Locator Attachments on a Bar
   • Crowns or bridges supported by dental implants
   • Leave your mouth as it is
5. How can an existing bite affect a Complete Denture with a Milled Bar Attachment?
   
   • Uneven or excessive bite forces may cause wear or fracture of the denture teeth or denture base. Unmanaged bite issues can also cause implants to loosen within the bone and break. Broken or loose implants must be surgically removed.
6. Are there any post treatment limitations once I have a Complete Denture with a Milled Bar Attachment?
   
   • To keep the tissue under the appliance healthy your denture should be left out of your mouth during sleep. The teeth in the denture are not as strong as your natural teeth and you will not be able to chew as heavily on them. The appliance will tend to get food trapped underneath it and you may have to remove and clean it after eating.

A crown is a dental restoration that covers up or caps a tooth. It is cemented into place and cannot be taken out.

Frequently Asked Questions

1. What materials are in a Crown?
   Crowns are made of three types of materials:
   
   
   • Porcelain
     – most like a natural tooth in color
   • Gold Alloy
     – strongest and most conservative in its preparation
   • Porcelain fused to an inner core of gold alloy (Porcelain Fused to Metal or “PFM”)
     – combines strength and aesthetics
2. What are the benefits of having a Crown?
   
   • Crowns restore a tooth to its natural size, shape and – if using porcelain – color. They improve the strength, function and appearance of a broken down tooth that may otherwise be lost. They may also be designed to decrease the risk of root decay.
3. What are the risks of having a Crown?
   In having a crown, some inherent risks exist both to the tooth and to the crown itself. The risks to the tooth are:
   • Preparation for a crown weakens tooth structure and permanently alters the tooth underneath the crown.
   • Preparing for and placing a crown can irritate the tooth and cause “post-operative” sensitivity, which may last up to 3 months.
   • The tooth underneath the crown may need root canal treatment about 6% of the time during the lifetime of the tooth.
   • If the cement seal at the edge of the crown is lost, decay may form at the juncture of the crown and tooth.

   The risks to the crown are:

   • Porcelain may chip and metal may wear over time.
   • If the tooth needs a root canal after the crown is permanently cemented, the procedure may fracture the crown and the crown may need to be replaced.
4. What are the alternatives to Crowns?
   
   • Having a silver filling or “amalgam” placed.
   • Having a gold or porcelain inlay/onlay restoration placed.
5. How can an existing bite affect a Crown?
   
   • Excessive bite forces may lead to the tooth under the crown breaking or loosening.
   • Excessive bite forces may lead to the crown chipping, breaking or loosening.
6. Are there any post treatment limitations once I have a Crown?
   
   • Porcelain on a crown may have a good color match with adjacent natural teeth when the crown is placed, but less of a match as your natural teeth age.
   • Gum recession may lead to unsightly dark roots or crown margins becoming visible.
   • A crown may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

A Tooth Colored Filling, or a “composite”, builds back missing tooth structure to its original form.

Frequently Asked Questions

1. What material is in a Tooth Colored Filling?
   
   • A tooth colored filling is a mixture of a tooth colored resin with clear glass particles that give it strength.
2. What are the benefits of a Tooth Colored Filling?
   
   • Tooth colored fillings come in many shades so they very closely match the color of natural teeth. They are bonded into place and require less removal of healthy tooth structure than silver fillings.
3. What are the risks of a Tooth Colored Filling?
   
   As with any filling, having a tooth colored filling involves some inherent risks both to the remaining tooth structure and to the tooth colored filling itself:
   • Tooth colored fillings are limited because they seal a tooth but do not prevent it from breaking.
   • Tooth colored fillings may fracture; the larger the tooth colored fillings, the greater the risk of fracture.
   • Tooth colored fillings may decay around the edge of the filling if your dentist is unable to keep the tooth clean and dry while placing the Tooth colored filling.
   • Preparing for and placing a tooth colored filling can irritate the tooth and cause “post-operative” sensitivity which may last for up to 3 months.
   • Teeth which have had tooth colored fillings may need a root canal treatment less than 1% of the time during the lifetime of the tooth.
4. What are the alternatives to having a Tooth Colored Filling?
   
   The alternatives to having a tooth colored filling are:
   • Having a silver filling or “amalgam” placed.
   • Having a gold or porcelain inlay/onlay restoration placed.
5. How can an existing bite affect a Tooth Colored Filling?
   
   • Excessive biting forces or untreated bite problems may lead to the bridge chipping, breaking or loosening.
6. Are there any post-treatment restrictions once I have a Tooth Colored Filling?
   
   • A Tooth colored filling may have a good color match with your natural tooth when it is placed but less of a match as your natural tooth ages.
   • Tooth colored fillings can collect stain over time from foods such as black tea, coffee and wine.
   • Tooth colored fillings may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

Fixed/detachable hybrids are fixed restorations supported by 4-6 implants with cantilevered metal attached to the implants and pink acrylic with denture teeth cured to it on top of that. This restoration is removable by your dentist.

Frequently Asked Questions

1. What material is in a Fixed/Detachable (Hybrid) Implant Supported Bridge?
   Bridges are usually made of four types of materials:
   • Porcelain
   • Gold Alloy (commonly gold, platinum, palladium)
   • Porcelain fused to an inner core of gold alloy
   • Zirconia metal oxide
     
     
     *
     
     Implants are made of titanium. The tooth and gum portion of the appliance has a base material that is made of acrylic. The teeth can be plastic or porcelain.
     
2. What are the benefits of a Fixed/Detachable (Hybrid) Implant Supported Bridge?
   
   • Bridges build back your smile and help you to speak and chew properly by restoring the natural size, shape and color of your teeth. They help maintain tooth, bite and jaw alignment by preventing remaining teeth from shifting out of position.
   • There is no need to drill down existing teeth in order to replace the missing teeth as occurs with conventional tooth supported bridges.
   • Long gaps where multiple teeth are missing can be treated effectively with implant supported bridges whereas long span natural tooth supported bridges have many negative consequences.
   • As the appliance is partially constructed from a removable acrylic base with denture teeth attached, making and repairing it is easier and more cost effective than other implant supported options.
3. What are the risks of a Fixed/Detachable (Hybrid) Implant Supported Bridge?
   
   • Due to the materials used for the restoration, treatment cost is relatively inexpensive compared to many other implant supported options.
   • Possible complications may be such things as food entrapment and challenges in matching adjacent tooth aesthetics.
   • There is a minimal risk of an implant not adhering to the jawbone and thus requiring removal and replacement.
   • Worn acrylic and plastic teeth or loose implant screws may require maintenance procedures, repair or replacement.
4. What are the alternatives to a Fixed/Detachable (Hybrid) Implant Supported Bridge?
   
   • Replace the missing teeth with another type of implant supported restoration.
   • Replace the missing teeth with an conventional tooth supported bridge.
   • Replace the missing teeth with a removable partial denture.
   • Leave the space as is.
5. How can an existing bite affect a Fixed/Detachable (Hybrid) Implant Supported Bridge?
   
   • Excessive or uneven bite forces may cause porcelain chipping, metal wear, implant screw loosening, or even gum and bone loss around the implant.
   • Severe bite issues such as habitual tooth grinding may cause premature failure of the dental prosthesis.
6. Are there any post treatment limitations once I have a Fixed/Detachable (Hybrid) Implant Supported Bridge?
   
   • Food may become lodged around the implant supported bridge; gum recession or minor bone loss around the top of the implant over time may make food impaction unavoidable, even with the most ideal bridge contour.
   • Gum recession may also lead to unsightly metallic implant margins becoming visible.
   • A bridge may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

An implant supported bridge superstructure with individually cemented crowns is a dental restoration that replaces missing teeth by inserting two or more artificial titanium roots into the jawbone and attaching artificial teeth to them. It is comprised of a substructure held in place by screws which attach to the implants. The substructure supports crowns which are cemented onto it.

Frequently Asked Questions

1. What material is in an Implant Supported Bridge Superstructure with Individually Cemented Crowns?
   Bridges are usually made of four types of materials:
   • Porcelain
   • Gold Alloy (commonly gold, platinum, palladium)
   • Porcelain fused to an inner core of gold alloy
   • Zirconia metal oxide
     
     
     * Implants are made of titanium. Superstructures are made of a gold alloy.
     
2. What are the benefits of an Implant Supported Bridge Superstructure with Individually Cemented Crowns?
   
   • Bridges build back your smile and help you to speak and chew properly by restoring the natural size, shape and color of your teeth. They help maintain tooth, bite and jaw alignment by preventing remaining teeth from shifting out of position.
   • There is no need to drill down existing teeth in order to replace the missing teeth as occurs with conventional tooth supported bridges.
   • Long gaps where multiple teeth are missing can be treated effectively with implant supported bridges whereas long span natural tooth supported bridges have many negative consequences.
   • If chipping of porcelain occurs, individual crowns may be repaired or replaced rather than replacing the entire superstructure restoration. This dramatically reduces treatment time and cost.
   • The superstructure fills in areas of deficient bone and tissue in addition to missing teeth, this allows for better aesthetic options than tooth replacement alone.
3. What are the risks of an Implant Supported Bridge Superstructure with Individually Cemented Crowns?
   
   • Due to the complexity of the restoration, treatment cost is relatively expensive compared to many other options.
   • Possible complications may be such things as food entrapment and challenges in matching adjacent tooth aesthetics.
   • There is a minimal risk of an implant not adhering to the jawbone and thus requiring removal and replacement.
   • Chipped porcelain, worn metal or loose implant screws may require maintenance procedures, repair or replacement.
4. What are the alternatives to an Implant Supported Bridge Superstructure with Individually Cemented Crowns?
   
   • Replace the missing teeth with another type of implant supported restoration.
   • Replace the missing teeth with an conventional tooth supported bridge.
   • Replace the missing teeth with a removable partial denture.
   • Leave the space as is.
5. How can an existing bite affect an Implant Supported Bridge Superstructure with Individually Cemented Crowns?
   
   • Excessive or uneven bite forces may cause porcelain chipping, metal wear, implant screw loosening, or even gum and bone loss around the implant.
   • Severe bite issues such as habitual tooth grinding may cause premature failure of the dental prosthesis.
6. Are there any post treatment limitations once I have an Implant Supported Bridge Superstructure with Individually Cemented Crowns?
   
   • Porcelain on the bridge may have a good color match with adjacent natural teeth when the bridge is placed but less of a match as your natural teeth age.
   • Food may become lodged around the implant supported bridge; gum recession or minor bone loss around the top of the implant over time may make food impaction unavoidable, even with ideal bridge contour.

An implant supported bridge is a dental restoration that replaces missing teeth by inserting two or more artificial titanium roots into the jaw bone and attaching artificial teeth to them. It is cemented in place and cannot easily be taken out.

Frequently Asked Questions

1. What material is in a Implant Supported Bridge?
   Bridges are usually made of four types of materials:
   • Porcelain
   • Gold Alloy (commonly gold, platinum, palladium)
   • Porcelain fused to an inner core of gold alloy
   • Zirconia metal oxide
     
     
     * Implants are made of titanium.
     * Implant Abutments which attach the implants to the bridge are made of titanium or zirconia metal oxide.
     
2. What are the benefits of a Implant Supported Bridge?
   
   • Bridges build back your smile and help you to speak and chew properly by restoring the natural size, shape and color of your teeth. They help maintain tooth, bite and jaw alignment by preventing remaining teeth from shifting out of position.
   • There is no need to drill down existing teeth in order to replace the missing teeth as occurs with conventional tooth supported bridges.
   • Long gaps where multiple teeth are missing can be treated effectively with implant supported bridges whereas long span natural tooth supported bridges have many negative consequences.
   • As it is a cemented restoration similar to tooth supported bridges, the restoration of the implants is more straightforward which simplifies the laboratory procedures and is less expensive compared to more complex screw retained implant supported bridges.
3. What are the risks of a Implant Supported Bridge?
   
   • If an implant screw loosens or any repair of the restoration becomes necessary, the restoration may be destroyed during the removal procedure if the cement seal cannot be easily broken.
   • Cementing restorations onto implants leads to challenges in removal of cement below gum line, possibly leading to tissue inflammation in the area.
   • Other possible complications may be such things as food entrapment and challenges in matching adjacent tooth aesthetics.
   • There is a minimal risk of an implant not adhering to the jawbone and thus requiring removal and replacement
   • Chipped porcelain, worn metal or loose implant screws may require maintenance procedures, repair or replacement.
4. What are the alternatives to a Implant Supported Bridge?
   
   • Replace the missing teeth with another type of implant supported restoration.
   • Replace the missing tooth with an conventional tooth supported bridge.
   • Replace the missing tooth with a removable partial denture.
   • Leave the space as is.
5. How can an existing bite affect a Implant Supported Bridge?
   
   • Excessive or uneven bite forces may cause porcelain chipping, metal wear, implant screw loosening, or even gum and bone loss around the implant.
   • Severe bite issues such as habitual tooth grinding may cause premature failure of the dental restoration.
6. Are there any post treatment limitations once I have a Implant Supported Bridge?
   
   • Porcelain on the bridge may have a good color match with adjacent natural teeth when the bridge is placed but less of a match as your natural teeth age.
   • Food may become lodged around the implant supported bridge; gum recession or minor bone loss around the top of the implant over time may make food impaction unavoidable, even with the most ideal bridge contour.
   • Gum recession may also lead to unsightly metallic implant margins becoming visible.
   • A bridge may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

An implant supported crown is a dental restoration that replaces a missing tooth by inserting an artificial titanium root into the jawbone and attaching an artificial tooth to it. It is cemented in place and cannot easily be taken out.

Frequently Asked Questions

1. What material is in an Implant Supported Crown?
   Crowns are usually made of four types of materials:
   • Porcelain
   • Gold Alloy (commonly gold, platinum, palladium)
   • Porcelain fused to an inner core of gold alloy
   • Zirconia metal oxide
     * Implants are made of titanium.
     
2. What are the benefits of an Implant Supported Crown?
   
   • It builds back your smile and helps you to speak and chew properly by restoring the natural size, shape and color of your teeth. It helps maintain tooth, bite and jaw alignment by preventing remaining teeth from shifting out of position.
   • There is no need to drill down existing teeth in order to replace the missing tooth as occurs with conventional tooth supported bridges.
3. What are the risks of an Implant Supported Crown?
   
   • If an implant screw loosens or any repair of the restoration becomes necessary, the restoration may be destroyed during the removal procedure if the cement seal cannot be easily broken.
   • Cementing restorations onto implants leads to challenges in removal of cement below gumline, possibly leading to tissue inflammation in the area.
   • There is a minimal risk of the implant not adhering to the jawbone and thus requiring removal and replacement.
   • Other possible complications may be such things as food entrapment, tissue irritation and challenges in matching adjacent tooth aesthetics.
   • Chipped porcelain, worn metal or loose implant screws may require maintenance procedures, repair or replacement.
4. What are the alternatives to an Implant Supported Crown?
   The alternative to having an implant supported crown is:
   • Replace the missing tooth with an conventional tooth supported bridge.
   • Replace the missing tooth with a removable partial denture.
   • Leave the space as is.
5. How can an existing bite affect an Implant Supported Crown?
   
   • Excessive or uneven bite forces may cause porcelain chipping, metal wear, implant screw loosening, or even gum and bone loss around the implant.
   • Severe bite issues such as habitual tooth grinding may cause premature failure of the dental prosthesis.
6. Are there any post treatment limitations once I have an Implant Supported Crown?
   
   • Porcelain on the crown may have a good color match with adjacent natural teeth when the crown is placed but less of a match as your natural teeth age.
   • Food may become lodged around the implant supported crown ; gum recession or minor bone loss around the top of the implant over time may make food impaction unavoidable, even with the most ideal crown contour.
   • Gum recession may also lead to unsightly metallic implant margins becoming visible.
   • A crown may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

Inlays and onlays are dental restorations that cover back teeth. The difference between an inlay and an onlay is that an inlay covers a fairly small part of the biting surface of a back tooth while an onlay extends over the biting surface and on to other parts of the tooth. Both of these restorations are cemented into place and cannot be taken off.

Frequently Asked Questions

1. What materials are in an Inlay/Onlay?
   Inlays are made of two types of materials:
   • Porcelain – most like a natural tooth in color
   • Gold Alloy – strongest and most conservative in its preparation
2. What are the benefits of having an Inlay/Onlay?
   
   • Inlays and Onlays restore a tooth to its natural size, shape and – if using porcelain – color. They improve the strength, function and appearance of a broken down tooth that may otherwise be lost.
3. What are the risks of having an Inlay/Onlay?
   In having an inlay/onlay, some inherent risks exist both to the tooth and to the restoration itself. The risks to the tooth are:
   • Preparation for an inlay/onlay weakens tooth structure and permanently alters the tooth underneath the restoration.
   • Preparing for and placing an inlay/onlay can irritate the tooth and cause “post-operative” sensitivity which may last for up to 3 months.
   • The tooth underneath the inlay/onlay may need root canal treatment about 5% of the time during the lifetime of the tooth.
   • If the cement seal at the edge of the inlay/onaly is lost, decay may form at the juncture of the restoration and tooth.

   The risks to the inlay/onlay are:

   • Porcelain may chip and metal may wear over time.
   • If the tooth needs a root canal after the inlay/onlay is permanently cemented, the procedure may fracture the restoration and the inlay/onlay may need to be replaced.
4. What are the alternatives to Inlays/Onlays?
   
   • Alternatives to placing an inlay/onlay are to either place a crown or a direct restoration such as tooth colored or silver fillings.
   • Crowns are less conservative in their preparation and therefore weaken remaining tooth structure more than inlays/onlays.
   • Composite and amalgam restorations remove decay and may restore teeth to their original form but are limited because they:
     • Do not improve the strength of broken down teeth.
     • Do not improve the long term function and aesthetics of broken down teeth as well as inlays/onlays.
5. How can an existing bite affect an Inlay/Onlay?
   
   • Excessive bite forces may lead to the restoration chipping or breaking.
6. Are there any post treatment limitations once I have an Inlay/Onlay?
   
   • Porcelain on an inlay/onlay may have a good color match with adjacent natural teeth when the restoration is placed but less of a match as your natural teeth age.
   • An inlay/onlay may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

The Kois Deprogrammer is a removable retainer-like appliance which allows your dentist to evaluate the stability of your bite. Every time you chew or swallow you must adapt your jaw to the best fit for your teeth. If this fit is not ideal for your jaw joint and muscles, you will be at higher risk for experiencing facial pain as well as worn, broken or loose teeth.

The Kois Deprogrammer removes the influence of your teeth from your chewing system by preventing them from interlocking and reinforcing the position of your existing bite. This allows your lower jaw to relax into a more comfortable position.

Once your lower jaw has fully relaxed, your dentist will be able to provide you with treatment options for maintaining your bite in this new, more comfortable position.

Frequently Asked Questions

1. How long do I need to wear my Kois Deprogrammer?
   
   • You can expect your dentist to recommend wearing the Kois Deprogrammer for up to one month. During this time it should only be taken out of your mouth while you are eating meals and cleaning your teeth.
2. How does my Kois Deprogrammer feel in my mouth?
   
   • The Kois Deprogrammer is designed to be as comfortable as possible. Within a few days you will likely have adapted to talking with it in your mouth. Some people initially experience soreness in their chewing muscles which resolves as those muscles relax.
3. How much will my bite change?
   
   • The change in your bite is usually very slight, although the improvement in the feel of your bite after wearing the Kois Deprogrammer can be dramatic.
4. If I decide not to proceed with treatment after wearing the Kois Deprogrammer, will my bite remain changed?
   
   • No, your chewing system will adapt back to your original bite after a few hours of leaving the Kois Deprogrammer out of your mouth.
5. How do I care for my Kois Deprogrammer?
   
   • Clean your Kois Deprogrammer every time you clean your teeth. Gently brush your appliance with a small amount of toothpaste on your toothbrush and rinse with warm water. Any time the Kois Deprogrammer is out of your mouth, keep it safe in its retainer box.

You must wear your Kois Deprogrammer to your dental appointments. If you have any further questions or concerns, Please contact your Dentist.

A post and core is a restoration that is cemented into the root canal chamber of a tooth and builds up the top of the tooth in order to hold a crown in place. It is cemented into place and cannot be removed.

Frequently Asked Questions

1. What material is in a Post and Core?
   Posts are made of three types of materials:
   • Porcelain
   • Metal
   • A fibrous resin material

   Cores are made of two types of materials:

   • A Tooth Colored “composite” filling material
   • A silver “amalgam” filling material

   Alternatively, the post and core can be made of one solid piece of:

   • Porcelain
   • Gold alloy
2. What are the benefits of a Post and Core?
   
   • A post and core holds a restoration on to a tooth which has too little remaining structure to retain the restoration itself.
3. What are the risks of a Post and Core?
   Having a post and core involves some inherent risks both to the remaining tooth structure and to the post and core itself:
   
   
   • The root of the tooth may be perforated when placing the post, necessitating the extraction of the tooth.
   • Under stress, the post may torque the root of the tooth and cause it to fracture, necessitating the extraction of the tooth.
   • Under stress, the cement holding the post and core on to the tooth can fail causing the post and core to leak, loosen or fall out.
4. What are the alternatives to having a Post and Core?
   The alternative to having a post and core is to have the tooth extracted and replaced with:
   • A dental implant
   • A bridge
   • A partial denture
5. How can an existing bite affect a Post and Core?
   
   • Excessive biting forces or untreated bite problems may lead to the post and core breaking, loosening or leaking.
   • Excessive biting forces or untreated bite problems may lead to the tooth in which the post and core has been placed breaking.
6. Are there any post-treatment restrictions once I have a Post and Core?
   
   • A post and core may break, loosen or cause the tooth to break if chewing very hard or sticky foods.

A Removable Partial Denture (RPD) with Locator Attachments is an appliance that replaces one or more missing teeth. It is not cemented in the mouth and can be taken out. A traditional RPD is retained in the mouth by metal clasps that clip onto existing teeth. An RPD with locator attachments is retained by snapping the appliance onto implants that have been placed in the jawbone. This greatly improves stability and retention of the RPD.

Frequently Asked Questions

1. What material is in an RPD with Locator Attachments?
   
   • The framework of an RPD is made of a metal alloy for strength. The teeth are made of Tooth Colored acrylic or porcelain. The teeth are attached to the metal framework by pink acrylic which simulates gums. Locator Attachments are plastic and the implants they attach to are titanium.
2. What are the benefits of an RPD with Locator Attachments?
   
   • Locator Attachments greatly improve retention and stability of an RPD. As well, they improve esthetics by reducing or eliminating the need for unsightly metal clasps.
3. What are the risks of an RPD with Locator Attachments?
   
   • Locator attachments wear out over time and need to be replaced. Denture acrylic covering the locator attachment may chip if it is thin due to a limited space in the mouth.
4. What are the alternatives to an RPD with Locator Attachments?
   
   • A traditional RPD
   • A bridge
   • A complete denture
   • Implants which attach to:
     • Crowns or bridges
     • A complete denture
   • Leave your mouth as it is
5. How can an existing bite affect an RPD with Locator Attachments?
   
   • Uneven or excessive bite forces may cause wear and fracture of the denture teeth, denture base, denture clasps, natural teeth and locator attachments. Unmanaged bite issues can also cause implants to loosen within the bone and break. Broken or loose implants must be surgically removed.
6. Are there any post treatment limitations once I have an RPD with Locator Attachments?
   
   • To keep the tissue under the appliance healthy and to prolong the life of the locator attachments, your RPD should be left out of your mouth during sleep. The teeth in the RPD are not as strong as your natural teeth and you will not be able to chew as heavily on them. The appliance will tend to get food trapped underneath it and you may have to remove and clean it after eating.

A removable partial denture (RPD) is an appliance that replaces one or more missing teeth. It is not cemented in the mouth and can be taken out.

Frequently Asked Questions

1. What material is in a Removable Partial Denture?
   
   • The framework of an RPD is made of a metal alloy for strength. The teeth are made of Tooth Colored acrylic or porcelain. The teeth are attached to the metal framework by pink acrylic which simulates gums.
2. What are the benefits of a Removable Partial Denture?
   
   • An RPD restores function and appearance to a broken down mouth. It is usually the most cost effective way of replacing teeth, especially in a mouth where many teeth are missing. An RPD can also provide important support to facial structures such as the lips; helping to in maintain a more youthful appearance.
3. What are the risks of a Removable Partial Denture?
   
   • RPD’s, even under the best of circumstances, DO NOT have the same chewing efficiency as natural teeth. The ability to chew food depends on the stability and retention of the dentures. Stability and retention are affected by many factors, including the attachment of the dentures to natural teeth as well as the amount and type of bone, gums and saliva present in the patient’s mouth.
4. What are the alternatives to having a Removable Partial Denture?
   
   • A bridge
   • A complete denture
   • Implants which attach to:
     • Crowns or bridges
     • An RPD
     • A complete denture
   • Leave your mouth as it is
5. How can an existing bite affect a Removable Partial Denture?
   
   • Uneven or excessive bite forces may cause wear and fracture of the denture teeth, denture base, denture clasps and natural teeth.
6. Are there any post treatment limitations once I have a Removable Partial Denture?
   
   • To keep the tissue under the appliance healthy your RPD should be left out of your mouth during sleep. The teeth in the RPD are not as strong as your natural teeth and you will not be able to chew as heavily on them. The appliance will tend to get food trapped underneath it and you may have to remove and clean it after eating.

A silver filling is an “amalgam” or metal filling that builds back missing tooth structure to its original form.

Frequently Asked Questions

1. What material is in a Silver Filling?
   
   • A silver filling is a mixture of silver, mercury, tin, copper and zinc. The mercury binds the other metals together to form a strong material once the silver filling has set.
2. What are the benefits of a Silver Filling?
   
   • Silver fillings have long-term durability, relative low cost and good strength once they have set. They are well suited for teeth that your dentist is unable to keep clean and dry as they set well even in a moist environment. Due to the material in them, amalgams are able to kill some decay causing bacteria.
3. What are the risks of a Silver Filling?
   As with any filling, having a silver filling involves some inherent risks both to the remaining tooth structure and to the silver filling itself:
   • Silver fillings are limited because they seal a tooth but do not protect it from breaking.
   • Silver fillings may fracture; the larger the silver filling, the greater the risk of fracture.
   • Silver fillings may decay around the edge of the filling if your dentist is unable to get a good seal between the tooth and the silver filling when placing the filling.
   • The edge of a silver filling may chip out over time, making the tooth more susceptible to fracture or decay
   • Preparing for and placing silver filling can irritate the tooth and cause “post-operative” sensitivity which may last for up to 3 months.
   • Teeth which have had silver fillings may need a root canal treatment less than 1% of the time during the lifetime of the tooth.
   • Silver fillings are silver in color and do not match the natural color of teeth; over time silver fillings may turn your natural tooth a gray color.
   • Although no proven health risks for silver fillings exist, controversy has surrounded the fact that they contain mercury which is a heavy metal.
4. What are the alternatives to having a Silver Filling?
   The alternatives to having a silver filling are:
   • Having a Tooth Colored filling or “composite” placed.
   • Having a gold or porcelain inlay/onlay restoration placed.
5. How can an existing bite affect a Silver Filling?
   
   • Bite problems may lead to the silver filling breaking or loosening.
   • Bite problems may lead to the tooth in which the silver filling has been placed breaking or loosening.
6. Are there post-treatment restrictions once I have a Silver Filling?
   
   • Silver fillings may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread or finger nails, opening bottles).

A veneer is an extremely natural looking dental restoration that covers the outside or visible surface of teeth. A veneer can change shape and color of a tooth as well as hide defects. It is bonded into place and cannot be taken off.

Frequently Asked Questions

1. What material is in a Veneer?
   
   • Veneers are made of very thin tooth-colored porcelain.
2. What are the benefits of having a Veneer?
   
   • Veneers can change the size, shape and color of teeth.
   • Veneers are porcelain and will not stain.
   • Veneers remove minimal tooth structure and are the most conservative porcelain restoration
3. What are the risks of having a Veneer?
   In having a veneer, some inherent risks exist both to the tooth and to the veneer itself.
   The risks to the tooth are:
   
   
   • Preparation for an veneer permanently alters the tooth underneath the veneer.
   • If the cement seal at the edge of the veneer is lost, decay may form at the juncture of the veneer and tooth.
   • Preparing for and placing a veneer can irritate the tooth and cause “post-operative” sensitivity which may last for up to 3 months.
   • Teeth which have had veneers may need root canal treatment less than 1% of the time during the lifetime of the tooth.

   The risks to the veneer are:

   • Porcelain may chip over time.
   • If the tooth needs a root canal after the veneer is permanently cemented, the procedure may fracture the veneer and the veneer may need to be replaced.
4. What are the alternatives to Veneers?
   
   • Alternatives to placing a veneer are to either leave the tooth as is or to place a composite restoration. Composite restorations remove decay but are limited because they will stain more and do not change the size and color of teeth as well as veneers.
5. How can an existing bite affect a Veneer?
   
   • Bite problems may lead to the veneer chipping or breaking.
6. Are there any post treatment limitations once I have a Veneer?
   
   • Porcelain on a veneer may have a good color match with adjacent natural teeth when the veneer is placed but less of a match as your natural teeth age.
   • A veneer may chip or break if used for abnormal activities (e.g. biting fishing line, sewing thread, biting finger nails, opening bottles).