The Secret to Saving Thousands on Implants, Veneers and Crowns

Are All Crowns, Implants and Veneers the Same?

There IS a secret to getting your cosmetic work done for less. And it’s simple. It’s getting it done right the first time.

Even high quality crowns, veneers and dental implants can fail in your mouth. They can feel unnatural and make it uncomfortable to chew. Done incorrectly, they can lead to popping and clicking in your jaw or head, neck and back pain.

The secret to saving thousands on your crowns, porcelain veneers and dental implants is to ensure that the cosmetic dentistry actually “fits” your head, neck and jaw. Consider that dentistry is engineering on a very tiny scale. Everything must fit together to function correctly. Often, patients come to me with a jaw joint imbalance that has led to a deteriorated dental condition. Once this imbalance is corrected, cosmetic dental work can be placed on a sound structure.

This is called orthopedic cosmetic dentistry . This is not a recognized specialty in dentistry, but a protocol I’ve followed based on thirty-five years of experience, training and research into the best ways to ensure that cosmetic dental work lasts, does not interfere with natural chewing function, or create a structural imbalance leading to pain.

If you’re over the age of forty and have considered getting veneers, implants or crowns, I apply the principles of orthopedic cosmetic dentistry to Midlife Dentistry. That’s a sequence of treatment to restore the health of your teeth and gums and enhance your smile and usually entails some procedures that are common in the midlife mouth, such as:

* Your head, neck and jaw are balanced so that your cosmetic dental work is sitting on a sound structure. This ensures that your cosmetic work will last and save you from redoing procedures.
* As you age your teeth wear down, often causing an uneven bite. This can lead to unexplained pain in the head and neck area. If not addressed, you may have to redo cosmetic dental work. Worse, you may seek medical treatment for pain that has been caused by your cosmetic work.

But whether you’re midlife or not, your teeth and gums are part of the interrelated structure of your head, neck and jaw. A comprehensive program ensures the outcome of natural chewing as well as the expected aesthetic outcome. If your primary concern is just looks, then you may not get the work done correctly the first time.

I regularly have patients come to me to correct cosmetic work that was done over misalignment of the head, neck or jaw. This often leads to unexplained headaches due to a basic malfunction that was only made worse by veneers or crowns.

Some signs you may be ready for orthopedic dentistry are:
1. Thinning of your lips.
2. Wrinkles or sagging around your mouth and jaw.
3. A wearing down of your teeth causing your chin to get closer to your nose.
4. You avoid chewing on one side of your mouth.
5. You have missing or cracked teeth.
6. You don’t smile for pictures anymore.
7. You noticed facial pain with increased pressure in your head and sinuses.
8. You put your hand over your mouth when you smile.
9. You notice your smile is getting crooked as teeth wear down unevenly.
10. You’ve had an increase in root canals, especially on one side of your mouth.
11. You have neck and low back pain that creates inactivity.

The primary role of dentistry is chewing. Whether you are getting simple fillings or implants and crowns, your dental work needs to function naturally. With this approach to your cosmetic dentistry, your work is performed so that it’s in alignment with your structure. It is also done in the correct sequence, since all procedures are done in my office. This leads to work that doesn’t have to be redone. And that’s the secret to saving thousands on your cosmetic work.

You can learn more in my free downloadable ebook: Lifetime Smile.

If you are interested in a Consultation for Implants, Veneers, Crowns or Bridges,
call our St Louis dentist office 314 576 3000.

Midlife Dentistry is a service mark owned by Dr. Peter J. Pagano, DDS PC

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Why I Favor Minimally-Invasive Dentistry

I usually recommend milder treatments to alleviate conditions before resorting to extractions, surgery or root canals.

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.

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What is Orthopedic Cosmetic Dentistry?

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 in Doc’s free downloadable ebook: Lifetime Smile
at www.stlouisdentistdrpete.com.

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.

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Do You Have Symptoms of Imbalance?

Headaches or migraines.
Neck aches.
Facial pain with increased pressure in your head and sinuses.
You wake up with headaches or develop them by midday.
You have pain behind your eyes for no apparent reason.
You have sounds in your ears, but your doctor can’t find anything wrong.
You notice your smile is getting crooked as teeth wear down unevenly.
You’ve had an increase in root canals, especially on one side of your
mouth.
You have neck and low back pain that creates stiffness and inability to
perform tasks.
Your bite isn’t the same since getting cosmetic dental work.
You have head pain since your orthodontics.

Correct the Problem and These Symptoms Go Away. That’s Done By Balancing Your Head, Neck and Jaw Before Doing Dental Work. That’s What Orthopedic Dentistry Is All About. It Also Ensures Your Cosmetic Enhancements Don’t Create An Imbalance.

In a perfectly constructed mouth, the teeth and jaw fit together to perform the function of chewing. The slightest adjustment to a tooth can throw this precise functioning off-balance. Even the replacement of a filling can make your bite feel different if it’s not balanced correctly and if not adjusted, can cause your jaw joints to move out of place.

If just a simple filling requires such precision, imagine the skill required in placing veneers or implants while ensuring they not only look great but are completely natural in their feel and fit.

Like a perfectly balanced bridge constructed to withstand the elements of weather and carry immense weight, your teeth and jaw are designed with a similar precision. The ability to work with the precision of an engineer and the talent of a master artisan ensures your dental outcome is both sound and beautiful.

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Have Your Teeth Shifted Position?

Did you know that your teeth position are constantly subjected to forces that cause them to shift? Those forces may be due to muscle tension, biting, chewing or uneven jaw joints. The teeth will move in response to those forces.As you age, your teeth wear down and get shorter. Your jaw joints can wear down. You lose a tooth and maybe decide to not replace it. Both of these factors create imbalances in your mouth.

When that occurs, instead of your teeth all sharing equally in the function of chewng, some are forced to work overtime to compensate for missing, broken or shorter teeth.

If you were driving your car with two bald tires and two new tires, it would create a rough ride.The analogy is comparable when it comes to your teeth. If you chew on an uneven surface a tooth can crack, resulting in more chewing force on the remaining teeth.

It’s not only for cosmetic reasons that you straighten your teeth position, get crowns or implants. These treatments improve the way your teeth mesh together. They also balance your bite. They can even enhance or even create entire body balance. You may not notice an immediate effect from imbalance and uneven chewing, but like the “perfect storm,” many health conditions are the result of long-term, non-optimum conditions that have been ignored.

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Designer Dentures?

Designer Dentures?
Rather Than Dread Dentures, Views 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.
*BLOG is short for “weblog,” a journal posted online.

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.

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Dr. Pete’s Top 5 Dental Health Trends

Trend #1. The explosion of implant dentistry will bring costs down. Like computer technology costs came down with demand, so it is with dental implants. The cost of materials that kept prices high for implants and crowns is coming down simply because more people are getting implants for missing teeth and instead of dentures. 

The American Academy of Implant Dentistry reports, “As the Baby Boomers begin filing for Social Security, they’re replacing teeth weakened from periodontal disease with dental implants instead of bridgework and removable dentures. Further incentive is that highly precise computer-guided dental implant surgery has made the procedure faster, highly predicable and long-lasting with a success rate of 97 percent.”

Trend #2: Teeth straightening will increasingly become the first step in a cosmetic makeover. It’s been a common practice to place porcelain veneers on crooked teeth. While this gives the appearance of straight teeth, it does nothing to address the health conditions caused by uneven teeth. These create uneven bite pressure which can lead to health problems, including headaches and migraines. With more dentists understanding the connection between the bite and jaw joints and head, neck and back pain, concern for health will lead to correcting the uneven bite rather than covering it up with veneers.

Trend #3: Gum Contouring Will Become More Popular. Just like lip plumping or botox improve appearance without surgery, contouring gum lines will become popular as more dentists investing in acquiring and learning how to use laser dental equipment. With laser technology being used in everything from skin care to knee replacement surgery, it was only a matter of time before it would be more routinely employed in your dental care. In addition to gum contouring which, by the way, is also great for men, lasers can disinfect diseased gum tissue. They can also cut into the teeth, making it faster and more comfortable to get fillings.

Trend #4: 3D x-rays will enable more precise dental treatment. Technology called “cone beam” takes two dimensional x-rays and makes them 3D. This allows your dentist to provide more precise dental treatment. For example, with a 3d picture, your dentist can see the nerve tissue surrounding impacted wisdom teeth. This allows for a better surgery. With implants, we’re able to determine more exactly their correct placement.

Trend #5: Teeth whitening will become part of a daily makeup routine for women. Whitening pens like Liquid Smile will make a professional in-offce whitening last a lot longer. Instead of bulky whitening trays sitting in your mouth for an hour with saliva coming out the side of your mouth, pens allow you to touch up the teeth that are visible.

 

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Is Your Dentist Keeping Secrets From You?

I don’t think so. But I did like much of the information contained in an article of this title from Dr. Mercola’s website. Here’s a few followed by my comments:

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

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Are Same Day Implants For Everyone?

I get asked a lot about same day implants. Implants are the best dental treatment for missing teeth. A titanium post is inserted into the bone where the tooth was and capped off with a crown. Since dental implants integrate into the structure of your bone, they prevent bone loss and gum recession that are common with bridgework and dentures. The stability is returned to the jaw and they look, feel and are maintained like your own teeth. For those who don’t want an unsightly gaping hole or for someone who doesn’t want to have to contend with dentures, implants are the most innovative dental alternative available.

That said, for about 80% of the patients who come into my St Louis office, dental implants can’t be done in a day. One reason is that bone erosion often accompanies a missing tooth. For proper placement of the implant there has to be enough bone, often requiring a bone graft. This means that the implant procedure is going to take more than one visit.

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Look Ma’ No Cavities!

For Boomers who grew up with this famous toothpaste commercial, I have a news flash: At your age, it’s no longer just about cavities!

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.

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