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Dental restorations, fillings, or composites:

This is done to a tooth that is missing a small piece or has decay caused by bacteria. The procedure involves removing the infected portion of the tooth, cleaning the cavity and placing a composite filling material (hard light activated plastic) in the cavity to seal the tooth.

Caution: Exercised caution in chewing with teeth that have been filled, especially during the first 24 hours to avoid breakage. Understand that a more extensive restorative procedure than originally diagnosed may be required due to additional or extensive decay, that may be revealed during the excavation of the cavity. Understand that significant sensitivity is a common after effect of newly placed fillings. Extensive pain/sensitivity may require additional treatments (sedative filling, root canal, extraction) at additional costs to patient.

More information can be found at:https://en.wikipedia.org/wiki/Dental_restoration

Dental extractions:

Dental extractions are performed to remove a tooth or a portion of a tooth that is in the bone. The procedure involves luxating (loosening) the tooth root with an elevator instrument. This may feel as pressure to the patient. Some crushing of the bone may also be experienced. Pain should not occur although there are patients that are difficult to anesthetize due to anatomical abnormalities or severe infection in the area.

Caution: Sometimes there are alternatives to removal of teeth (root canal therapy, crown and bridge procedures, periodontal therapy, etc.) I understand removing teeth does not always remove all of the infection, it may be necessary to have further treatment with an oral surgeon. I understand the risks involved in having teeth removed, some of which are pain, swelling, spread of infection, dry socket, loss of feeling in my teeth, lips, tongue and surrounding tissue (paresthesia) that can last for an indefinite period of time, or bone fracture. I understand I may need further treatment by a specialist if complications arise during or following treatment, the cost of which is at my own expense.

More information can be found at: https://en.wikipedia.org/wiki/Dental_extraction

 

Fixed Crowns and Bridges:

 

Fixed prosthodontics is used to replace missing, discolored or broken teeth with a more esthetic porcelain cover. If a tooth has a root canal and is discolored, covering it with a porcelain crown can restore the aesthetics of the tooth. A missing tooth between two healthy teeth can be replaced with a fixed bridge, although now a days a dental implant is preferred.

 

Caution: Sometimes it is not possible to match the color of natural teeth exactly with artificial teeth. Wearing temporary crowns, which come off easily and one must be careful to ensure that they are kept on until the permanent crown is delivered. Realize the final opportunity to make changes (shape of, fit, size and color) will be before cementation. The patient must sign a release that they accept the shape size and color of the restoration before the cement can be applied. It is the responsibility of the patient to return for permanent cementation within 20 days from tooth preparation. Excessive delays may allow for tooth movement. This may necessitate a remake of the crown or bridge at patients expense. If the tooth being prepared does not have a root canal, one may be necessary before or after due to sensitivity/pain.

More information on bridges can be found at: https://en.wikipedia.org/wiki/Bridge_(dentistry)

More information on crowns can be found at: https://en.wikipedia.org/wiki/Crown_(dentistry)

 

Partials And Full Dentures:

 

Partial dentures are made to replace missing teeth. Complete denture is for when all the teeth are missing. The partial denture is made either of resin acrylic or a combination of acrylic and metal. Complete dentures are made from acrylic and can be reinforced with a metal mesh in the palate to reinforce them. The upper denture generally stays up by the suction created between the palate and the denture. This is not always so depending on the quality of the patients saliva and the shape of the bone in the roof of their mouth.

 

Caution: Removable full and partial dentures include risks and possible failures associated with such dental treatment. Risks and possible failures associated with but not limited to the following: even though the utmost care and diligence is exercised in preparation for the fabrication of prosthetic appliance, there is the possibility of failure with patients not adapting to them.

LOWER DENTURES: It is recommended that the lower denture be secured with at least 2 dental implants. Without dental implant it is impossible to guarantee the stability and retention of the lower denture.

ADJUSTMENTS: Adjustments of the dentures may be necessary after delivery. Lobaina Dental provides up to 4 adjustment visits at no cost to the patient. Any adjustments after that have a fee.

FAILURE OF FULL DENTURES-There are many variables which may contribute to this possibility such as: A) gum tissues which cannot bear the pressures placed upon them resulting in excess tenderness and sore spots, B) jaw ridges which may not provide adequate support and/or retention, C) musculature in the tongue, floor of the mouth, cheeks, etc., which may not adapt to and be able to accommodate the artificial appliances, D) excessive gagging reflex, E) excessive saliva or excessive dryness of the mouth, F) general psychological and/or physical problems interfering with success.

FAILURE OF PARTIAL DENTURES-Many variables may contribute to unsuccessful utilizing of partial dentures. The variables may include those problems related to failure of full dentures, in addition to A) natural teeth to which partial dentures are anchored ( abutment teeth) may become tender, sore and/or mobile, B) abutment teeth may decay or erode around the clasps or attachments, C) tissues supporting the abutment teeth may fail.

BREAKAGE-Due to types of materials which are necessary in the construction of these appliances, breakage may occur even though the materials used were not defective. Factors which may contribute to breakage are, A) chewing on food or objects which are excessively hard, B) gum tissue shrinkage which causes excessive pressures to be exerted unevenly on the dentures, C) cracks which may be unnoticeable and which occurred previously in causes mentioned in A & B, or the dentures having been dropped or damaged previously. The above may also cause wear or chipping.

LOOSE DENTURES-Full dentures normally become looser when there are changes in the supporting gum tissue. Dentures themselves do not change unless subjected to extreme heat or dryness. When dentures become “loose”, relining the dentures may be necessary. Normally, it is necessary to charge for relining dentures. Partial dentures become loose for the listed reason in addition to clasps or other attachments loosening. Sometimes they feel loose for reasons listed in the first paragraph.

ALLERGIES TO DENTURE MATERIALS-Infrequently, the oral tissues may exhibit allergic symptoms to the materials used in construction of either partial dentures or full dentures over which we have no control.

FAILURE OF SUPPORTING TEETH AND/OR SOFT TISSUES-Natural teeth supporting partials may fail due to decay, excessive trauma, gum tissue or bony tissue problems. This may necessitate extraction. The supporting soft tissues may fail due to many problems including poor dental or general health. It is the patient’s responsibility to seek attention when problems occur and do not lessen in a reasonable amount of time, also to be examined regularly to evaluate the dentures, condition of the gums, and the patient’s oral health.

The nature and purpose of this treatment has been explained to me, and I have had an opportunity to have may questions answered. Understand that dentistry is not an exact science and success with treatment cannot be guaranteed.

Steps for completing a Prosthesis:

1-Primary impression; Alginate impressions are taken, alginate is a soft white gel like material. With these impressions custom trays are made for the next step.

2-Impression final ; In this visit, using the custom trays made previously, a final, more precise impression is taken using a harder rubber like material called impregum. From these impressions the prosthesis will be fabricated.

3-Bite registration; A bite block of wax is used to capture the relationship between the upper and lower jaws, color is selected, marks for the size and position of the teeth are made in the wax .

4-Wax try-in; The teeth come set in the wax and the patient has the opportunity to view the teeth before they are finished.

5-Delivery; The prosthesis are delivered and adjusted as required for a perfect fit.

**Up to 5 adjustment appointments are permissible at no cost. After that the patient is responsible for an adjustment fee.

 

Understand the wearing of partials/dentures is difficult. Sore spots, altered speech, and difficulty in eating are common problems. Immediate dentures (placement of dentures immediately after extractions) may be painful. Immediate dentures may require considerable adjusting and several relines. A permanent reline will be needed at a later date. This is not included in the denture fee. Understand that it is your responsibility to return for delivery of my partial/denture. Understand that failure to keep delivery appointment may result in poorly fitted dentures. If a remake is required due to your delays of more than 30 days, additional charges could be incurred. Up to 5 adjustments can be done at no cost.

 

For more information on dentures: https://en.wikipedia.org/wiki/Dentures

For more information on dentures: https://en.wikipedia.org/wiki/Removable_partial_denture

 

Root Canals

 

Root canals are performed in order to save a tooth's nerve has been compromised by bacteria or inflammation. Teeth have canals inside of them which keep the tooth's nerves (for sensation of hot and cold) as well as the tooth's blood supply (which help keep tooth moist, flexible, feed the nerves and help with some repair of the tooth). If inflammation from a trauma to the tooth or caries reaching close to the nerve set in, the pulp of the tooth dies and bacteria colonize the root canal system. The purpose of a root canal is to clean the root canal system and fill it with an inert rubber material called gutta-persha which seals it and prevents bacteria from growing in there again. However sometime more than one canal exist and accessory canals may be impossible to detect and clean which can lead to recurrent infections.

 

Cautions: Realize there is no guarantee that root canal treatment will save the tooth, and that complications can occur from the treatment, and that occasionally root canal filling material may extend through the root which does not necessarily affect the success of the treatment. Understand that endodontic files are very fine instruments and stresses can cause them to separate/break during use. These may be left in the canal or may need retrieval by a specialist at patients expense. Irrigation accidents can occur when irrigation liquid leaves the canal and irritates the tissue. This can cause severe pain, swelling and discomfort in the area. This may need a specialist's care. Understand that occasionally additional surgical procedures may be necessary following root canal treatment (apicoectomy). The tooth may be lost despite all efforts to restore it.

The Following are some complications associated with root canals:

A failure to completely eliminate the infection requiring retreatment, root surgery or removal of the tooth at a later date;

Post-operative pain, swelling, bruising, and/or limited jaw opening that may persist for several days;

Separation (breakage) of an instrument within the canal during treatment. Broken instrument tips are typically allowed to remain in the canal, and only rarely are they the cause of subsequent problems. If removal is indicated the patient may be referred to an endodontic specialist.

Perforation of the root from within the canal can occur requiring additional treatment by a specialist. Such complications will occasionally result in the loss of the tooth.

Damage to nerves supplying the teeth resulting in temporary or, in rare instances, permanent numbness or tingling of the lip, chin, or other areas of the jaws or face:

Inability to adequately clean the canal(s) due to unforeseen calcified obstructions or severely bent roots. Under certain circumstances the patient may be referred to a specialist for successful completion of the procedure. Loss of the tooth may occur:

A fracture of the treated tooth, occuring during or after endodontic treatment. Treated teeth sometimes break due to the tooth’s loss of strength resulting from the procedure. In most cases a crown is recommended after treatment to prevent such an occurrence.

Leakage of irrigation solution (NaOCL-Sodium Hypochlorite) out of the tooth, which cause immediate intense pain and bleeding, swelling and numbing of the face, which lasts 1-2 weeks and may require medical intervention.

 

For More information on root canals: https://en.wikipedia.org/wiki/Root_canal

 

Cleanings and Periodontal Disease:

 

Periodontal disease is the infection and subsequent inflammation of the gum around the teeth which causes bleeding and bone loss. It is the #1 cause of tooth loss in the world. The cause of the disease is bacterial infection around the teeth. We treat it by mechanically removing the bacteria using periodontal instruments and irrigation. Antibiotics can be used if the gum disease is severe enough.

Caution: The Dr. will advise you which type of cleaning is recommended for you. The cleaning is performed to remove bacterial plaque and calculus from the surface of the teeth. A deep cleaning may be necessary if the plaque/calculus is under the gum and bone loss is present. Sensitivity may occur after a cleanings. Understand that if I have been diagnosed with a serious condition, causing gum inflammation and/or loss of bone, it could lead to the loss of the teeth. Alternative treatments include gum surgery by a periodontal specialist.

 

For more information: https://en.wikipedia.org/wiki/Periodontal_pathology

 

Dental Implants

 

Description: Understand that dental implants are titanium post place into the jaw bone(s) to support

replacement teeth. These posts are just as susceptible to disease and bone loss as natural teeth. Thus, daily care and frequent visits to the dentist are necessary for the longevity of your dental implants. I understand that in most instances dental implants require two surgical procedures. The first surgical procedure (Phase I) will be to place the implant into the jawbone. At this time, in most instances, the gum tissue will be closed over the top of the implant. After a healing period of between 3 to 6 months a second surgical procedure (Phase II) will be necessary to remove the gum tissue overlying the top of the implant and to

insert a metal post into the top of the implant. This post will then extend up through the gum and into the mouth. Following healing of the gum tissue around this metal post a prosthetic phase will be started. During this phase of the dental implant treatment, the prosthesis (crown, bridge, denture, artificial teeth and/or appliance) will be made and attached to the implant(s). Occasionally, in conjunction with the making of the prosthesis, additional surgery may be necessary to establish a more ideal contour of the bone and/or gum surrounding the implant(s).

Cautions

1. I understand that dental implants are most desirable in my case, but when teeth are missing, one or more of the following treatment options are currently available:

A. Do nothing to replace the missing teeth.

B. Have a removable partial denture to replace the missing teeth. This partial denture or “partial palate” is an appliance or prosthesis which can be removed and replaced by the patient. If all of the teeth in one or both jaws are missing, a conventional complete (full) denture(s) can be made. This complete denture(s) can be removed and replaced by the patient.

C. Have a fixed partial denture or fixed bridge. This appliance or prosthesis is cemented to

adjacent teeth and is not removed.

D. Replace the missing teeth with one or more dental implants. Dental implants are attached

to the bone and cannot be removed. However, there are several options for attaching manufactured teeth to implants, by the way of an appliance or prosthesis. This prosthesis can either be: “removable” (can be removed and replaced by the patient): “fixed removable” (can be removed by a dentist), or “fixed” (can not routinely be removed).

2. While a period of between 4 and 6 months is usually needed for proper healing of the implants, the exact time will be determined by the operating surgeon.

3. It has been explained to me that there are certain inherent and potential risks in any treatment or

procedure, and that in this specific instance such operative risks include, but are not limited to:

swelling; pain; bruising; breakage of the jaw; stretching of the corners of the mouth which may

result in cracking and bruising of the mouth and facial tissues; restricted mouth opening or

discomfort in the jaw muscles or joint(s); possible nerve injury with resulting change in sensation

and/or numbness to the lip, chin, gum, teeth and/or tongue which may be temporary or permanent;

infection; damage to adjacent teeth, nasal cavity, sinuses; and failure of the implants to heal(integrate) with the surrounding bone; medical emergencies that may require life saving

procedures and/or admission to a designated hospital.

4. If any unforeseen condition(s) should arise in the course of the operation, which calls for the doctor’s judgment or for procedures in addition to or different from those now planned, I request

and authorize the doctor(s) to do whatever he/she may deem advisable under the circumstances,

including the decision not to proceed with the implant procedure.

5. While the predictability of this procedure has been scientifically established, I am aware that there is a risk that the implant(s) may not be successful and may require additional treatment and/or surgery that may involve removal of the implant.

6. I understand that there are a number of factors which may limit the success of my implants. These

include, but are not limited to: heavy biting on the implants, for example, grinding of the teeth (bruxism) or chewing ice or other hard substances; the use of tobacco or alcohol; some systemic diseases such as diabetes; and the use of certain medications such as systemic steroids or antineoplastic (cancer treating) agents. I understand that these are examples only and there may be other factors, conditions and/or agents which could also jeopardize the success of dental implants.

7. I understand that dental implants require routine maintenance therapy (cleaning and evaluation) at

3 months to yearly intervals, depending on the supervising dentist’s evaluation, for the life of the

implants there is no guarantee that the implants, its component parts and/or attached prosthesis

will last a specific period of time.

8. I agree to follow my doctor’s homecare instructions and to report to my doctor for regular

examinations as instructed. I also understand that in spite of good overall dental health , oral hygiene, dental evaluation and care, inflammation and/or infection of the gum and the bone surrounding a dental implant can still occur. This condition, even with treatment, may ultimately lead to failure of the implant.

9. I understand that any treatment of the implant, and/or the surrounding bone or gum tissue, after the

prosthesis has been placed, will be considered maintenance therapy and will be at an additional

charge.

10. I understand that there will be separate fees for the surgical, prosthetic (restorative) and

maintenance phases of my implant treatment.

11. I have been advised that there is a risk that the implant and/or prosthesis (crown, bridge, denture,

artificial teeth and/or appliance) which is attached to the implant, may wear, break and/or fail. If

this happens it will necessitate the replacement and/or repair of the worn, failed and/or broken part(s) and may also involve additional surgery. This replacement, repair, and/or surgery will be

at an additional charge and will be based on the fees at the time this additional treatment is

rendered.

12. I understand that certain anesthetic risks, which could involve serious bodily injury or death are

inherent in any procedure that requires a general anesthetic or intravenous sedation. If I am to

have a general anesthetic or intravenous sedation, I certify that I have not had anything to eat or

drink for the last 6(six) hours prior to the time of surgery and have complied with all special

preoperative instructions.

13. I understand that certain medications, drugs, anesthetics and prescriptions may cause drowsiness

and lack of awareness and coordination, which can be increased with the use of alcohol or other

drugs; thus, I have been advised not to operate any vehicle, automobile, or hazardous devices, or

work, while taking such medications, and/or drugs; or until fully recovered from the effects of

same. I agree not to drive myself home after surgery and I will have a responsible adult drive me

or accompany me home after my discharge from surgery, if I have been sedated or have received

nitrous oxide.

14. I have had an opportunity to discuss with my doctor my past medical and health history including any serious problems and/or medications taken.

15. I agree to cooperate completely with the recommendations of my doctor while under care,

realizing that failure to do so could compromise the results of this treatment. I also understand that regular follow-up including x-rays, is necessary in order to evaluate and maintain the implant(s) and prosthesis.

16. Warranty: Implants placed at Lobaina Dental carry a 5 year warranty if the patient follows a timely and proper cleaning routine at Lobaina Dental as prescribed by the Dr. You must keep your hygiene appointments and maintain proper home oral hygiene. If the implant fails within the 5 years after placement, Lobaina Dental will credit your account the amount you paid for the procedure for future use of yourself or a family member.

17.Tobacco use voids any warranty on the implants. Smokers beware, if your implants fail, you are responsible for any cost associated with their replacement. In no way or form can the Doctor or Lobaina Dental be held liable for this failure.

For More information: https://en.wikipedia.org/wiki/Dental_implant

 

Oral Cancer screening

We use the VELscope enhanced oral assesment system that uses natural fluorecense to discover tissue abnormalities. This screening is available upon request at any time. 

you can find more information about the system at http://www.velscope.com/velscope-products/velscope/