Dentures

One of the greatest aspects of modern dentistry is our ability to replace missing or extracted teeth. Today, patients typically seek out implant crowns and bridges as quick and safe methods of restoring their smiles. But what about dentures? The name alone might conjure up pictures of older relatives and seltzer tabs, but they are still an excellent way to fix a gap in your dentition. At Thousand Oaks Family Dentistry, we offer a number of denture options for patients needing everything from temporary single tooth replacement to permanent appliances for entire arches. No matter what your needs, there is likely a denture solution to fit it!

Patients who still have some existing teeth are typically eligible for partial dentures. These appliances bridge one or more empty spaces between teeth to recreate a natural smile. They usually require healthy molars or premolars to snap on to and give them rigidity. Some partial dentures are made entirely out of acrylic. These are commonly referred to as “flippers” and typically serve as temporary solutions until an implant can be placed or a permanent denture can be made. Because they are plastic, they need to be made thick for rigidity. Likewise, flippers can feel bulky and uncomfortable and are prone to becoming brittle. Still, they are an excellent interim esthetic solution for patients missing teeth.

a full acrylic partial denture or "flipper"

Partial dentures can also be made using a combination of acrylic and cast metal. These devices are stronger, thinner and typically more comfortable than flippers. When you smile or open your mouth, pink and enamel colored acrylic hide the metal framework beneath and the appliance looks like natural tissues. Rigid metal partial dentures are appropriate for long term use and are often the most comfortable option. If you have enough teeth to anchor the device, they can fit snugly and comfortably in your mouth.

A partial denture with metal framework

If you are missing all teeth on an entire arch, you are likely eligible for full dentures. Full dentures are made out of acrylic and stay in your mouth using the suction created between your gums and the denture base. Since they rest on your gum tissue, full dentures can take some time to get used to. Many patients will feel sore spots or an uneven “rocking” sensation until they become accustomed to the feeling of the appliance. Our office can make small adjustments to dentures to better accommodate your mouth, but they will never feel as natural as something anchored to your teeth. Still, they are a great alternative to smiling, chewing and speaking with no teeth.

a full upper and lower full denture

A final subset of dentures are implant supported dentures. Here, an acrylic appliance is mounted to 2 or more implants (depending on the number of teeth replaced) through rubber snaps. These are typically the most comfortable denture style for replacing whole arches of teeth. However, this treatment option is both costly and time consuming; Implant placement can take up to six months to become healed and sturdy enough to support a denture. Still, many patients are extremely satisfied with the resulting product, as the implants keep the appliance rigid and out of contact with gum tissue.

A diagram of how implant supported dentures are mounted

No matter what type of denture we are making, our office needs three types of impressions: one impression of the teeth (or gums) on which the dentures will be made, one of the opposing teeth and one of how the teeth come together when you bite down. Once we take these impressions, we send them off to a lab along with instructions on tooth color, transparency and brightness. From there, the lab will either fashion your permanent denture, make a wax try-in (a soft, denture lookalike used by our office to ensure fit and esthetics), or send us custom trays. Custom trays are impression trays that precisely fit the dimensions of your mouth. These instruments insure a perfect impression (and a better fit) for the final denture. Once we are ready to deliver your appliance, you will return to our office for a short fitting appointment where we can make minor adjustments.

The true scope of dentures extends into many different devices, materials and mounting styles. We like to have a lengthy discussion with every patient prior to taking impressions, to make sure they will satisfied with the final product. Only a consultation between you and Dr. Hong can show us what kind of denture is appropriate for your specific needs. If you would like to know more about dentures or any other type of appliance offered at our office, please give us a call. We are always happy to walk you through any and every procedure!

Eating Disorders and Oral Health

Anyone affected by an eating disorder can tell you about its tolls on whole body health. Whether overeating, binging eating or bulimia, these conditions have very tangible effects on the entire system. We would like to take a moment to highlight how some of these disorders affect oral health. Please understand that this information is not presented to to scare or shame anyone. Rather, we want our patients to understand what is happening to their mouths, and how to go forward and manage the diseases’ effects.

Eating disorders involving overeating can damage teeth by creating prolonged acidic events in the mouth. Every time we eat or drink, our mouth pH turns acidic for the duration of the meal and the following 30 minutes. If someone were to eat once every half hour, their mouth would spend the entire day in a state of acidity. As this acid sits on the teeth, it begins to break down the tooth enamel, causing decay. Thus, overeaters who graze throughout the day are particularly susceptible to poor oral health. In addition to problems with the amount of food, the type of food consumed presents problems as well. Binge eaters can gravitate towards sweet, sticky and carbohydrate heavy products (“comfort foods”). These foods are excellent at adhering to the teeth, causing a drop in mouth pH and fueling bacteria to colonize and produce further acid. This can lead to more decay, recession and gum disease. In total, overeating can take many of the problems associated with frequent snacking or poor diets, and amplify them.

No matter what your diet, sticky, sugary and carbohydrate heavy foods are excellent at causing tooth decay. Overeaters are particularly susceptible to these effects due to their high frequency of exposure. 

At the opposite end of the spectrum, bulimia can also be particularly damaging to the teeth. Purging can leave patterns of acid erosion across the entire mouth, causing extensive enamel degradation and gum inflammation. Stomach acid is much stronger than any pH drop induced by food consumption, and thus the effects of bulimia manifest themselves very rapidly. In comparison, each session of purging would be akin to rinsing your whole mouth with concentrated lemon juice. These effects can be further amplified if the acid isn’t rinsed off and allowed to sit on the teeth. Time is an important factor in tooth decay, and the longer the teeth are exposed to acid, the more extensive the decay will be.

A visualization of the affects of bulimia on teeth. From bulimiahelp.org

While this information may seem daunting, it is important to remember that there are ways to improve your oral health and stop the progression of decay. Fillings, crowns and root canals can halt existing cavities and pain while restoring the esthetics of your smile. For teeth in the early stages of decay, there are a number of products to help repair enamel. Rinses such as Carifree CTx3 offer remineralization through fluoride and xylitol exposure, while pastes like GC MI-Paste provide extra calcium phosphate for rebuilding enamel. Overall, the important thing to remember is there is always a solution to your current oral state.

Again, our office presents this information to help you better understand how a psychological disorder (eating) can affect your physical body (teeth). If you are affected by an eating disorder, we encourage you to seek professional help. We want all of our patients to lead healthy lives, and are happy to help you find inner wellness!

New Technology- The Isolite

Throughout the years, the practice of dentistry has certainly gone through many changes. New technologies have made the average appointment, quicker, more comfortable and more productive. At Thousand Oaks Family Dentistry, we stay at the forefront of the dental industry, always updating our equipment and techniques to the latest standards. One such instrument we are proud to utilize is the Isolite vacuum system.  

In the past, even simple dental work was clinically challenging to keep dry and clean.  An assistant would have to hold multiple suctions for the duration of your appointment, taking care to protect your tongue and cheeks. While effective, this process is cumbersome, difficult to use on certain teeth and ultimately less relaxing for the patient. The Isolite streamlines this entire process, while adding an extra dimension of comfort to your visit.

An Isolite handpiece. The clear, flexible plastic forms a mouthpiece that keeps you safe and comfortable. 

The Isolite is a specialized suction system mated to custom sized mouthpieces. It connects to the central vacuum line at our office and is installed in every one of our operatories. The mouthpieces provide a comfortable place for you to rest your mouth along with continuous suction and lighting. They have two flexible “wings” that wrap around your tongue and cheek, creating a safe barrier between our instruments and your soft tissue. The end result is a quicker, safer and more comfortable appointment. Additionally, since the Isolite provides more thorough suction, it keeps our work area cleaner and drier. This translates to more precise preparations and stronger cement bonds with better longevity. 

An example of the Isolite in use. 

On top of coming in five different sizes, the Isolite mouthpieces can be further trimmed and shaped in a matter of seconds. Most patients find the fit to be quite comfortable, often forgetting we are using it. Overall, we have had excellent results with this system and use it for nearly every (non-cleaning) appointment. If you would like to learn more about the Isolite and why we use it, please give us a call. We are always happy to educate our patients on the instruments and techniques used at our office!

Dental Library Review- Arthur Tricks the Tooth Fairy

Welcome to The Dental Library Review! In this feature, we will be reviewing and highlighting different children’s books we have collected at our office. Our staff have personally used these books with their own children and have had great reception. Today, we will be going over Arthur Tricks the Tooth Fairy by Marc Brown.

This book follows the characters and basic plot line of the popular Arthur books and TV show. In this story, Arthur looses a tooth and wakes up to some money from the Tooth Fairy. His sister, D.W., is both confused and jealous that she hasn't lost a tooth yet. After much deliberation (and a few attempts to prematurely remove teeth), she comes to the conclusion that she can trick the Tooth Fairy into visiting her. After catching wind of his sister's plan, Arthur decides to entertain D.W. by swapping her decoy tooth for a few dollars. 

In addition to being a great story, this book is a part of the Step into Reading learning program. This system categorizes books into five levels to encourage gradual development of reading skills. Being a "step 3" book, Arthur Tricks the Tooth Fairy is generally appropriate for first through third graders who can read on their own. It introduces some new vocabulary and has a fun set of stickers to match the words. A second set of stickers is also included, with instructions on writing your own story about Arthur and his friends. 

We love this book because it is an excellent story with fun additional content. We also feel this book would be great for younger siblings experiencing some "tooth fairy jealousy." As with all the stories we review, feel free to check it out at your next appointment. We are always happy to do anything we can to get your family excited and educated about dental health topics!

Dentistry Through The Ages- High School and College

Greetings and welcome to our on-going blog series, Dentistry Through the Ages. In these blog posts, we will cover age-group specific dental needs and concerns. Your life is constantly changing, and we want to equip you with the best information possible to keep your teeth healthy!

Today, we want to take a look at the special dental needs and concerns of high school and college students. Between classes, extracurriculars and socializing, this is no doubt a hectic time period. However, it is still important to remember the basics of dental care- brush twice a day, floss at night and schedule regular teeth cleanings. Bad habits and neglect developed during these times can last well into adulthood, causing irreversible damage to the teeth and gums.

For our patients in orthodontic treatment, please remember to work hard at keeping your brackets, wire and any appliances clean and debris free. Many young adults develop characteristic decay later in life as a result of poorly maintained teeth while in braces. Food stuck under brackets and wires can cause extensive erosion and demineralization that will eventually necessitate fillings. While the teeth may look and feel fine now, the weakened enamel will almost certainly become a problem. As always, take care to follow your orthodontist’s instructions. Some steps or recommendations may seem tedious, but they are all very important and can add months to treatment time if improperly followed.

During these more “studious” years, students often turn to brain food to keep themselves awake and alert during long hours at the library. Unfortunately, this type or prolonged snacking can create lengthy acidic environments in the mouth, leading to extensive tooth decay. For this reason, many patients return home from college and find themselves with their very first cavity. To counteract this, we recommend keeping snack sessions concise, ideally under 30 minutes. For those who need to “graze” to stay focused, we suggest avoiding sticky, processed foods and gravitating towards fresh vegetables, fruits or even cheeses. You can always follow up your snacks with xylitol mints or gum to assist in the remineralization process as well.

For better or worse, this time period is also hallmarked by many young adults experimenting with drugs and alcohol. We are here to remind you that almost every drug (prescription or illicit) will cause dry mouth to some degree. This is a surefire way to speed up the development of decay and cavities, above any other adverse interactions substance may cause. Alcohol is not exempt from this fact. Alcoholic beverages are carb-heavy and acidic, lending themselves to stimulating mouth bacteria and causing enamel erosion. Binge drinking can exacerbate this problem, through prolonged mouth acidity, vomiting, and “passing out” (going to sleep without brushing teeth/sleeping with a dry mouth). Overall, students who choose to party frequently may be faced with a host of oral problems later in life.

In total, many patients who developed good oral care as children will carry it through college and to adulthood. While there are some specific concerns to patients in this age group, most of their dental care extends from the basics of home maintenance. We wanted to highlight some special circumstances that could reverse years of great dental care- before it became a problem. As always, our office is here to guide you and your family towards optimum oral health!

Retainers and Space Maintainers

When most patients think of a “retainer,” they imagine a plastic and metal device that snaps across the upper or lower teeth. In reality, there are a whole array of products that assist in the retention and maintenance of tooth position. At our office, we offer a number of retainer solutions to keep your teeth beautiful and straight.

No matter what type of retainer, the general process for fabricating and delivering the appliance is the same. We typically need to take three types of impressions; one of the teeth that the appliance will fit on, one of the “opposing” set of teeth, and a final impression of how your teeth fit together when you bite down. The last two impressions help guarantee that the appliance doesn’t interfere with the occlusal surfaces (where the bottom and top teeth touch each other). Plastic and metal clasps covering these areas can potentially lead to an uneven bite, headaches and even jaw pain. After taking impressions, we need about two weeks for our lab to fabricate your appliance and send it back to us. When you return to our office, we will do some minor adjustments, check the fit and send you off with your brand new retainer!

At Thousand Oaks Family Dentistry, we frequently deliver three types of retainers. The first is the Hawley Retainer. This is the most recognizable “plastic and metal” type appliance. It is removable, easy to clean and usually very comfortable to wear. This type of retainer typically best fits the needs of our adult and teen patients. We also offer clear plastic retainers, known as Essix Retainers. While these appliances are not as noticeable while wearing (the entire device is made from thin clear plastic), the nature of their constructions requires material to cover the biting surfaces of the teeth. This can lead to a whole host of painful problems, particularly in patients who grind or clench.

Finally, we offer a specialized individual tooth retainer called a Space Maintainer for young children who lose a primary tooth prematurely. Decay, cracks and infection can all indicate that a primary tooth needs to be extracted before the adult tooth is ready to erupt. Once removed, the adjacent teeth will typically “move in” and try to fill in the leftover gap. Since the primary teeth serve as placeholders for their adult counterparts, this shift can result in uneven or improper eruption of the adult dentition. A Space Maintainer counteracts this by holding the space of the lost primary tooth. It is physically cemented to the more rearward tooth and butts up against the more forward one, bridging the gap. We recommend space maintainers to almost all of our young patients having primary teeth extracted. This small device can save time, money and headaches by preventing the need for extensive orthodontic work or surgery to correct the adult tooth’s position.

Hawley Retainer

Essix Retainer

Space Maintainer

On top of the retainers offered specifically at our office, there are a number of more complex devices aimed at maintaining tooth position. These appliances can be more discreet, maintain difficult cases or even provide mild repositioning or realignment. For our patients needing these devices, we will typically refer out to our network of wonderful orthodontists. They all have countless hours studying and fabricating these retainers, and can bring years of experience to your needs. After a consultation, we will gladly refer you out to a specialist to best suit your specific case.

As with any of the services offered at our office, a consultation and exam are necessary to determine the best type of retainer for your personal needs. If you are interested in having an appliance made, or have more questions about the process, please give us a call. We are happy to assist you with every step towards optimal oral health!

Video Blog on TMJ Pain and Night Guards

Greetings, my name is Dr. Kari Ann Hong and I have a family dentistry practice where I see patients from all age groups. In my practice, I see a number of patients that clench or grind their teeth at night.  This extra function at night can cause headaches, morning muscle pain when chewing, temporomandibular joint (TMJ) pain, tooth pain, and breakage of teeth.  The number one way to protect the teeth and muscle groups from the clenching and grinding is to wear a custom fitted night guard.

The first step in making a night guard is to take impressions of your teeth and to take an impression of how your teeth come together when your jaw is slightly open.  From the impressions, we make stone models that are used to fabricate a custom fitted acrylic night guard.  Usually we make the appliance for the lower arch.  During the one hour fitting appointment, we adjust the surface of the acrylic so that when the upper teeth touch the appliance, they all hit evenly.  Also, when you grind side to side or forward, the appliance is adjusted so that the majority of the force happens on the front off the appliance. This helps protect the facial muscle groups and the TMJ.

Due to concerns about the cost of a custom fitted night guard, sometimes patients will buy over the counter boil and bite type appliances.  The disadvantage of these boil and bite appliances, is that the opposing teeth don’t have freedom of movement, thereby potentially causing additional interferences for the TMJ and increased firing of the muscle groups that help our jaw open and close.  Depending on your medical and/or dental insurance plan, there usually is some coverage for a custom fitted night guard to treat TMJ pain.  If you would like to find out if a custom fitted night guard is right for you, and what your cost would be, please fill out the contact us page.

Viroxyn Cold Sore Treatment

Viroxyn is packaged in a convenient vial/swab combination and can be applied in a matter of seconds. Credit: Quadex Labs

Every year, millions of Americans develop one or more cold sores on their lips. These blisters are unsightly, painful and contagious- often causing us to avoid or limit socialization while they are inflamed. Fortunately, there is an excellent medical solution to this pain and embarrassment. Our office is proud to offer Viroxyn- a professional strength cold sore treatment.

Cold sores are caused by a viral infection that enters the body via the mucosal tissue (i.e. lips) or dry/cut skin. Once inside, it can lie dormant for months or years, until it becomes activated and begins to replicate. As the virus grows, your body’s immune system kicks in and begins to supply the area with white blood cells to combat the infection. This process causes the typical cycle of pain, irritation and appearance of blisters associated with cold sores.

Untreated, the entire biological process takes about 2 weeks to resolve itself. The virus then becomes dormant until reactivated, as it is never actually eradicated from your body. Typical cold sore sufferers receive an average of 1-3 outbreaks a year, often coinciding with times or stress or irritation to the lip tissue. Dry weather, hectic work schedules and even sunburns can cause the virus to engage and begin replicating.

Viroxyn helps minimize the hassle of these outbreaks through a combination of an effective pain reliever and antiseptic. One applied, the topical anesthetic begins to numb the pain, while the antiseptic helps the body target and eradicate the active virus. Many patients find their pain eliminated in one hour, with the visible outbreak minimized in as few as three days. Viroxyn works best when the outbreak is caught early on, and is typically administered as soon as you feel the first signs of a cold sore. The medicine is delivered in a convenient single use swab system and takes less than a minute to apply. 

If you suffer from cold sores, please let us know at your next visit. This product does an excellent job of stopping pain from cold sores and can drastically shorten your time spent suffering with an unsightly blister. If you have any further questions about this product, or would like to learn more about what causes cold sores, please call our office. We are here to help in every way that we can!

Dental Library Review- Tooth Fairy

Welcome to The Dental Library Review! In this feature, we will be reviewing and highlighting different children’s books we have collected at our office. Our staff have personally used these books with their own children and have had great reception. Today, we will be going over Tooth Fairy by Audrey Wood.

This story follows Matthew, who just lost a tooth, and his sister, Jessica. Jessica decides she can trick the Tooth Fairy into bringing her treats along with her brother by painting a kernel of corn white. She proceeds to have a vivid dream about the tooth fairy and her magic kingdom. As Matthew’s tooth is placed in the hall of perfect teeth, hers is outed as a fake. The story concludes with Jessica waking up to a loose tooth, excited to have her own (legitimate) visit from the tooth fairy.

Being a picture-heavy book with little wording, this story is likely best for preschool and kindergarten aged children. It would make a great bedtime story for a first lost or “wiggly” tooth before the toothfairy actually comes. Our office likes this book because it avoids the concept of “lost teeth = money.” Matthew receives “treasure” for his teeth, including an apple and a toy car. This could be useful for your household, if the tooth fairy decides to bring toys or snacks instead of cash.

As with all of the story books at our office, feel free to stop by and take a look. In addition to this book, we have a collection of toys, stories and gifts all geared towards children’s dentistry. We want to do everything possible to get your family excited and informed about dentistry and oral health!

Dentistry Through the Ages- Toddlers and Young Children

Greetings and welcome to our on-going blog series, Dentistry Through the Ages. In these blog posts, we will cover age-group specific dental needs and concerns. Your life is constantly changing, and we want to equip you with the best information possible to keep your teeth healthy!

Today, we want to take a look at the special dental needs and concerns of toddlers and young children. During this time period, your young one will undergo rapid growth and development, both physically and mentally. At Thousand Oaks Family Dentistry, we want to give you the best tools to keep up with their changing needs!

There are a number of milestones that can help you best gauge your child’s dental development. Typically, the first primary teeth to erupt will be the central lower incisors at around 8 months. These will be followed shortly after by opposing teeth, the upper central incisors at about 10 months. Likewise, the last primary teeth to be shed are the upper canines and second molars, which are lost as late as 12 years.

A chart showing the eruption and shedding ages for primary teeth. 

It becomes apparent that although the primary teeth will all be eventually be shed and replaced, they need to last a long time- from 5 to 10 years depending on the specific tooth. During this period, these teeth will serve as both mechanical tools for chewing and as placeholders for the adult teeth. It is important that primary teeth are lost naturally and not due to facial trauma or decay. If a tooth must be removed prematurely, we recommend placing a Space Maintainer retention device to hold spacing. Without this appliance, the adult teeth can come in crooked or unevenly, requiring extensive orthodontic intervention later in life.

A typical space maintainer on a model. The final appliance is gently cemented to the rearward tooth. 

Beyond the development of primary teeth and adult teeth, there are a number of ways you can give your young child the best start on their dental health. At 1 year of age, we recommend stopping the use of bottles and pacifiers. Studies show that the prolonged use of these products can cause improper oral development, including an open bite. You can limit pacifier use using the “snip” method, where a small amount of the pacifier base is cut off periodically, limiting your child’s ability to create satisfying suction with the device. Thumb sucking needs to be limited as well, although behavioral interventions required to stop this are usually unsuccessful until the age of 3.

We recommend brushing your child’s teeth as soon as the first teeth begin to erupt. You can brush with water, fluoride-free toothpaste or even xylitol wipes. However, avoid fluoridated toothpaste and supplements until age 2, as the fluoridated water in Southern California will provide enough remineralization power alone. Any extra dosage of the ion can cause a condition called fluorosis, where white spots of “over mineralization” arise on the still-developing adult teeth.

At about three years of age, adjacent teeth in your child’s mouth will begin to touch. At this time, it is crucial to start flossing once a day. Childhood diets are full of tooth decay causing foods and habits- constant snacking, sticky and carbohydrate heavy foods and milk instead of water for beverage. While brushing will manage the risk of decay on most tooth surfaces, only flossing can remove bacteria and food from in-between teeth, where 70% of childhood tooth decay occurs. Additionally, keep in mind that brushing and flossing can be difficult tasks for children. As a rule of thumb, children not possess the motor skills to brush their own teeth until they can tie their own shoes.

We typically recommend children come in for their first dental visit at 1 year of age or when their first tooth comes (around 6-12mos). This visit is less of a traditional exam, and more of a “primer” for future dental visits. We will introduce your child to our various tools and ease them into what can be a very stressful setting. Depending on patient compliance, we will do a quick check of the mouth, followed by a health history review and educational discussion (for parents). All this is conducted in our fun and imaginative children’s room!

Undoubtedly, your child’s specific developmental patterns, needs and concerns will vary from the information in this article. With this in mind, it is imperative that they come in for regular dental examinations and check-ups. Many problems- from tooth decay to some developmental issues, can be corrected easily if caught early on. We hope to see you and your loved ones at our office- to make sure everyone is on the right track for dental success!