Question: Dr.Glasmeier,

If there is no plaque, what are the chances of getting only gum diseases. Also, how does floride toothpastes help,if any, to avoid gum swelling or minor gum problems like gum bleeding?

Answer: Great question! That is complicated question because plaque is only

factor that can contribute to gum disease. There are many other things that can contribute to gum disease such as:

1. Poorly fitting dental restorations

2. Medical History (Smoking, diabetes, autoimmune diseases)

3. Genetics

4. Grinding and clenching teeth, etc.

These are only a few of factors that can promote gum disease. The big misconception is that your hygiene is the only thing that determines gum disease and this is simply not true! Regarding fluoride toothpaste and its effects on gums--the fluoride is more geared for preventing cavities and minimizing thermal sensitivity that can develop on the teeth. The abrasive additives in the toothpaste in combination with brushing is what helps reduce plaque/tartar from forming on the teeth than can setup problems with gum disease. So to answer your question, the fluoride is more for the teeth than the gums. There are prescription mouthrinses that made to help prevent and/or control gum disease but most of them are prescription.

Hope this helps!

Dr.G

Question: Dr. Glasmeier,

I had composite fillings done 2 weeks ago. Soon after, I was put on amoxicillin for an infection on the top tooth that was filled. Now that I have finished the medication, I still have aching in not only the top but also the bottom teeth that were filled. Is this normal? I've never even had to take OTC pain meds after a filling in the past, and now that I no longer need Vicodin for the terrible infection pain, I am still taking ibuprofen for the aching. Is this normal? Should I go back to see my doctor? Thank you!

Answer: Hi there, yes if it has been two weeks then you should return to your dentist for further evaluation. Typically composite fillings, aka "tooth colored fillings" can present with some localized soreness to biting along with some brief cold/sweet sensitivity. However, this type of sensitivity should resolve typically within 7-10 days. I am a little confused why an antibiotic was given for a tooth that received a filling unless that tooth has become infected. If this is the case, then you will need additional treatment beyond an antibiotic, such as a root canal.

Re: pain on top and bottom teeth..is it possible your bite could be "off" or "high" from the new filling. Sometimes if the bite is changed by a "high" filling, it can cause biting sensitivity that can progress to thermal sensitivity. I would go back to the dentist and have them evaluate the bite but also rule out that you are developing an infection around that tooth.

Good luck!

Dr.Glasmeier

Question: Hi there, I am a 51 year old woman in pretty good health. In 2004 I had my 4 front teeth removed and porcelain crowns put in. It has become apparent that they were not sealed well enough, so over time decay has set in behind the crowns. They must now be removed and new ones inserted. My financial situation has changed considerably since then and the insurance I have now only covers porcelain infused over metal crowns. It would cost me another $600 per tooth if I want porcelain. I had never heard of these other ones so I would like your input on the aesthetics and longevity of the porcelain infused over metal.Thank you for your time and opinion

Answer: The porcelain fused to metal(PFM) crowns have been around much longer than all porcelain crowns. They are known for strength and I typically do these on back teeth. They do work well on front teeth but can be more challenging to make them look esthetic. I would talk with your dentist about doing the PFM crowns but it will be much more difficult to match the esthetics that you had with all porcelain crowns. I like the all porcelain better but if done correctly the PFM crown can be acceptable as well. My biggest concern is that if they are designed corrected or even if your gums even slightly recede, you can possibly see dark line or metal hue around where the gum has receded. If you have ever seen someone smile and you see a dark color or gray hue around the gum, it is likely it is PFM crown. With an all porcelain crown, even with recession it is not as visible. All porcelain is typically my choice, if and only if your bite will allow it.

Dr.G

Hello,

I have no idea what to do. After receiving a cosmetic dentist referral from Lumineers, ten months ago I had eight top teeth done for about $8500.00. Three days after the Lumineers were applied, one fell off. Since then I've had all but one of the original set of eight replaced, mostly due to the Lumineer breaking. I pretty much expect that last one will also fracture before long. I have been in the dentist chair 17 times and never known a single month in the last ten months - not once - when I had all eight Lumineers on at one time. I have always been waiting for a replacement or I was on my way into the office to get a mold taken to get the replacement.

I've nearly lost my job for all the time I had to take to accommodate the dentist's schedule, I've suffered unbelievable embarrassment when one will break and fall into someone else's drink or plate of food while out in public and I've always had a gap of one tooth or another while it was on order. The dentist tries to be nice, but he has reminded me a million times that "something like this has never happened before." A member of his office staff says he's only done 10 sets thus far (he told me hundreds during the consultation.) I know I am stuck with this office as far as the Lumineers warranty goes, and thus far none of the second set have cracked or popped off. I have absolutely no faith in this product and know I have no recourse, if the first set of Lumineers was defective as Lumineers keeps an ironclad "no compensation for anything" policy after 30 days. But this has gone on for ten months and will continue for another one (at least) as I have another replacement to get a mold taken and ordered yet. I could not be more unhappy with the whole Lumineers experience.Do you have any advice for me? Any at all? I would be so grateful, you just don't know.

First Lumineers, or also known as "no prep or no drill veneers" are a nice conservative way of reshaping and correcting color and esthetic issues with teeth that are in otherwise healthy condition. They require little to no drilling and no injections/anesthesia.

Answer: Sounds like there are some bite issues that are preventing the Lumineers from being successful. I don't do many Lumineers unless the conditions are right. You have to have a certain bite to be able to do those. There are other things that can cause them to fail, but they are fairly foolproof since there is no tooth preparation and the procedure for cementing them in very easy. I doubt its the Lumineers as much as you not necessarily being a good candidate for Lumineers. I would get a second opinion before you have them redone and would investigate whether or not you grind your teeth as this could be contributing to the problem as well. Not everyone is a candidate for no prep veneers and the dentist should be evaluating not only the physical appearance of the teeth but also analyzing your bite and ruling out that you grind or clench your teeth.

Good luck!

Dr.Glasmeier

What are mini implants and how are they used in dentures?

They are miniature titanium screws/anchors that are placed into the jawbone to help with various dental procedures such as:

1. Improving the fit of dentures

2. Help replace small, missing teeth.

3. Assist in orthodontics to move teeth into more favorable positions.

The implant simulates a root of a tooth and has a ball that sits on the top of implant that articulates with a denture or a crown. It works similar to a ball and socket joint that provides excellent retention and resistance form. It is most useful in denture applications to help provide resistance against lifting forces.

Mini implants are placed under local anesthesia and are quite pain free when compared to something like a root canal or an extraction of a tooth. There are not incisions, no cutting of the bone, and no long healing times. After placement, the ball of the implant will be sticking out of the gum tissue and will be the only visible portion of the implant. Because they are minimally invasive, there is very little healing period and dentures can be stabilized the same day the implants are placed. Depending on the situation, sometimes a new denture is made against the new implants or the existing denture can be refit ("retrofitted") to the new implants.

So who is a candidate for mini implants?

-Ill-fitting or poor fitting dentures

-Patients that cannot eat foods like corn, apples, steak, crackers, etc.

-Someone who is afraid to laugh, smile or speak for fear of their denture

coming out.

-Patients that want pain-free, immediate results and not long healing times.

Ask Dr.Glasmeier about mini implants and how they can help make your dentures better!!