For example if your tooth had a three surface cavity, many dentists would do a crown and build up. I might start with a three surface filling to see if that alleviates your problem. If the filling doesn’t hold up, you may need the crown in six months, but often times the less invasive — and less expensive –dental procedure will suffice.

The distance between your nose and chin is detemined by your back teeth. So your entire face, lips and smile is dependent on your back teeth.

The teeth in the back of your mouth serve a vital chewing function. If that function is compromised due to missing or broken down teeth that need to be capped or replaced, the entire chewing mechanism is compromised.

This sets the scene for more tooth loss in the future. Besides, it reduces the ability to chew up your food and puts the brunt of digestion on your stomach. This often results in gastointestinal problems.

So, replacing missing teeth or getting crowns in the back of your mouth is not a cosmetic decision — but a decision in favor of maintaining overall health.

This is not a recognized specialty in dentistry. Rather, it’s a term we use in our office to describe the Pagano Protocol – the sequence in which your teeth, gums and structure are treated which results in a dazzling smile that sits in a structurally sound foundation.

What do we mean by “orthopedic cosmetic dentistry?” Think of your teeth and gums as the inside of a house and your jaw and head bones as the structure and foundation. Once Doc ensures that the structure is balanced and stable – which often includes treatment that eliminates headaches,

teeth grinding and other unwanted conditions – then the restorative and cosmetic treatments on your teeth and gums can be performed on a stable foundation. This results in cosmetic treatment that lasts, a bite that feels natural, and eliminates redoing your work.

One patient with lifelong headaches experienced complete relief. Her treatment included straightening her teeth and getting a gorgeous smile.

You can read more about orthopedic dentistry in Doc’s free downloadable ebook: Lifetime Smile at www.stlouisdentistdrpete.com.

Rather Than Dread Dentures, View Them as a Chance to Design Your Own Smile

Morton came in as a new patient asking for a new set of dentures. In collaborating with him so we

could make him dentures he would be proud to wear, I asked him questions such as:

Do you want spaces between your front teeth?

What type of smiles do you like?

Who do you want to look like?

Do you want big teeth, little teeth, long teeth, wide teeth?

Do you want personalization, such as little character flaws built into your teeth?

Do you want perfect alignment?

Morton told me he’d never been consulted to that degree like when getting dentures made previously.

He said for the first time ever, he was excited to get his new denture appliance.

According to the Center for Disease Control, 1 out of every 4 adults over 60 have lost all of their natural teeth due to gum disease and tooth decay. Another CDC report says 1 out of every 5 adults over 65 have lost all of their teeth. Once that occurs, your choices are dentures or implants.

Although dental implants are an excellent alternative to dentures, not everyone can get them. This doesn’t mean you have to dread dentures. The biggest reason denture wearers switch to implants is:

• Their dentures are ill-fitting and uncomfortable;

• They don’t like how their dentures look.

You can dread dentures or view them as an opportunity to design your smile. If you want to pay $99 and get “teeth-on-a-plate” then the old adage “you get what you pay for” applies.

On the other hand, if you want someone to craft an appliance that feels and looks natural, you can spend the money and get something that will make you feel confident.

As an Art Minor in college, I see beyond the science of dentistry. Although an appliance needs to be engineered perfectly, the aesthetic appeal must also be present.

If you need a denture, view it as an opportunity to design the smile you’ve always wanted.

Do you want spaces between your front teeth?
What type of smiles do you like?
Who do you want to look like?
Do you want big teeth, little teeth, long teeth,wide teeth?
Do you want personalization, such as little character flaws built into your teeth?
Do you want perfect alignment?

According to the Center for Disease Control, 1 out of every 4 adults over 60 have lost all of their natural teeth due to gum disease and tooth decay. Another CDC report says 1 out of every 5 adults over 65 have lost all of their teeth. Once that occurs, your choices are dentures or implants. 

Although dental implants are an excellent alternative to dentures, not everyone can get them. This doesn’t mean you have to dread dentures. The biggest reason denture wearers switch to implants is: 

Their dentures are ill-fitting and uncomfortable; or
They don’t like how their dentures look. 

You can dread dentures or view them as an opportunity to design your smile. If you want to pay $99 and get “teeth-on-a-plate” then the old adage “you get what you pay for” applies.  

On the other hand, if you want someone to craft an appliance that feels and looks natural, you can spend the money and get something that will make you feel confident.

 I minored in Art Minor and I view dentistry as both an art and a science. Although an appliance needs to be engineered perfectly, there’s no reason it can’t also be an aesthetic expression of the smile you’ve always wanted.

Secret #1: Your dentist may not have the latest technology.

Digital x-ray: Dentists who do not have digital x-ray equipment are practicing in
the dark ages. Digital x-rays use less radiation than film. They are easier to read
and make diagnosis more accurate.

Ultrasonic Cleaning: Ultrasonic instruments vibrate plaque and calculus off your
teeth, even in areas below your gums. It is much more comfortable than oldfashioned
hand scraping.

Doc comment: I agree. Thats’ why our office has had this technology for years.

Secret #2: Your dentist may be using mercury.
Mercury is toxic. Norway and Sweden have banned the use of mercury fillings..
But mercury fillings are less expensive and easier for the dentist to use. If your
dentist does not use composite fillings, don’t go to that dentist any more. In the
US, the FDA is way behind the ball and not actively warning patients about this
like they have been mandated by the courts to do.

Doc’s comment: Very accurate. I haven’t used mercury in my office for years.

Secret #3: The lab may be more important than your dentist.

Dental labs create dentures, crowns, bridges, orthodontic appliances, and other
dental restorations like implant crowns. There is a huge difference in the quality
of these labs. You should be particularly wary if your dentist is using a lab in
China or Mexico. Some of the top labs in the U.S. are Aurum Ceramics,
MicroDental Laboratories, da Vinci Dental Studio, and Williams Dental Lab.

Doc’s comment: True. Aurum Ceramics is one of the labs we use a Artistic Dentistry.

Secret #4: There’s more to good dentistry than filling cavities.

A competent dentist screens for more than tooth decay. He or she should be
concerned about sleep apnea, jaw-related pain known as TMJ, oral cancer,
diabetes and hypertension.

Doc’s comment: All good points. I cover some of this in my free downloadable
electronic ebook found at http://stlouisdentistdrpete.com

If you’ve passed the age of forty, you really should have a mid-life diagnosis to evaluate the overall state of your oral health AND to plan a proper course of treatment that will enable you to keep your teeth for the remainder of your lifetime.

Patients over forty have often shortchanged their dental health or just barely maintained their teeth and gums. With the expense of family taking precedence through the previous two decades, Boomer-aged patients coming to me for the first time are often prepared to play catch-up with their own dental health.

Today you can plan a course of treatment that will ensure you’ve got your own teeth to chew with well into your senior years. In addition, nothing is more youthful than a natural-looking white smile. Unlike your parents, if you take care now you can have both.

Why do we neglect the role our mouths play in overall health? Why do we accept missing teeth and dentures as a “natural” course of aging?

My answer is the extreme lack of information on the subject. Look for my book coming out soon.

My dad, Dr. Sam Pagano, practiced dentistry in St Louis for over 50 years. Many of his techniques are lost today. Yet, his techniques resulted in quality dental work that lasts.

Case in point: My dad and I were having breakfast at Sunrise Café on 141 and Olive Blvd. A 91 year old woman by the name of Josephine came up to our table. She looked at my dad, waiting for him to recognize her. Turns out, he filled her teeth 40 years ago. She proudly announced that she still had those same fillings and that her current dentist wanted to know (and I quote): “Who did all of this beautiful work in your mouth?”

In another outing, my dad and I ran into a former patient of his who proudly displayed the dentures my dad had made for him – IN 1953! Over 50 years later, these dentures were still working for this patient.

In earlier times artisans and craftsmen spent years as apprentices in order to Master their skills. I was fortunate enough to get an apprenticeship fresh out of dental school, working with my dad for nearly ten years. I learned as much from him as I did in school, if not more. By mastering the fundamentals of dentistry and focusing on quality, I had a strong foundation on which to embrace the technological advancements that have been made in dentistry.

Despite my excitement at learning new procedures and acquiring the latest technology, I know that these aren’t substitutes for a firm grounding in the skills of providing quality dentistry that will last.

Nearly 3 out of 4 respondents were considering dental implants to replace their dentures.Two takeaway points from this poll:

1. Do everything you can to having to get dentures in the first place.
2. If you have them and find them uncomfortable to live with, find out how dental implants could be a solution.