Dr. Guy Mangia: Comprehensive Dental Examination is a service we provide for all new patients and for our adult patients of record every 2 years. Similar to a complete medical examination with your physician, this examination  process is considered the current Standard of Care with the American Dental Association.  During this examination we are able to document and compare the findings that are significant to your oral health.  Being able to compare these findings at a two year interval allows us to detect changes in your dental health that may be subtle to the human eye, resulting in early detection and correction of oral problems.  Of course, we will continue to provide updated examinations at the time of your  periodontal maintenance visit in between your comprehensive dental evaluations.

The Comprehensive Examination and Evaluation consists of six areas of your oral health:

• Head and neck oral cancer examination
• Temporal mandibular joint (TMJ) evaluation
• Evaluation of your occlusion( how your upper and lower teeth relate to each other in function)
• Periodontal examination and evaluation of the supporting bone and tissue around the teeth
• Evaluation of current dental restorations, detection of new decay and fractured teeth
• Esthetic evaluation of your smile

We use several diagnostic aids in the comprehensive examination to assist us in our findings and treatment decisions.

• Full  mouth radiographs (as needed)
• A series of digital photographs of your smile and teeth
• Study model casts of your teeth (as needed)
• A current medical history and blood pressure reading
• ViziLite Plus oral cancer screening system

We will take time to listen to your concerns, considerations and desires when it comes to the correction of your oral health problems.  Treatment plan options will be developed and discussed as a result of our clinical findings, our professional judgment and your wants and needs.

At the end of your examination, our treatment coordinator will provide you with your examination results, including a copy of your treatment plan, your periodontal charting, your dental photographs and any support brochures we feel would help you better understand our discussion.  We invite you to visit our web site for further information concerning the dental procedures as well as information about our practice.

www.guymangiadds.com

We feel open communication is vital to the patient/professional relationship.  If you ever have had any questions or concerns about your examination visit, the treatment discussed, the fees presented your estimated insurance benefits or our practice procedures, please call and ask for assistance.  Our mission is to assist you in obtaining optimum oral health.  We know that this mission is dependent on a team of people (including you the patient) working toward a common goal.  We look forward to continuing to assist you in  your mission toward optimum oral health.

Click here to view the embedded video.

PatientFYI: The most common type of tooth implant (dental implant) that is placed today is the “endosseous root form implant.” These objects are cylindrical or screw shaped devices that are positioned into a person’s jawbone. In essence, a dental implant acts as an “artificial root” on top of which a dental crown or one end of dental bridgework can be secured.The term “endosseous” refers to the fact that the implant is embedded in the jawbone and penetrates through the gum tissue. The term “root form” refers to the fact that this type of implant is somewhat similar in shape as the root of a natural tooth. (This isn’t precisely accurate in the sense that some teeth have multiple roots.)

Root form endosseous tooth implants are also described as “osseointegrated (osteointegrated) implants.” The term osseointegration refers to the fact that there is a direct fixed connection between the dental implant and living bone.

PatientFYI: Bisphosphonates, (also known as disphosphonates) are a class of drugs that prevent the loss of bone mass, used for treatment ranging from osteoporosis to cancer related conditions. Bisphosphonate has become a prevalent drug in our society and is a potent suppressor of osteoclastic (bone resorbing) activities, thus bone remodeling and healing are being affected.To clarify, bone has constant turnover, and is kept in balance (homeostasis) by “osteoblasts” which are responsible for creating bone and “osteoclasts” which digest bone. Bisphosphonate inhibits osteoclastic activities in bone, in other words, it inhibits the digestion of bone by osteoclasts. Surgeons are often faced with the dreaded possibility of bisphosphonate related osteonecrosis (bone death) of the jaw with patients who have been taking this class of medication, as the possibility of a successful outcome reduces.

Due to recent developments we now use a serum C-terminal telopeptide (CTX) test as a guide to predict the outcome of our reconstructive surgery. This helps us select the appropriate patient for surgery and increases the rate of a successful surgical outcome.

Dr. Tau on Digital Impressions: We all know that no one actually wants to go to the dentist, and some people downright dread it. Patients assume that all dental procedures are going to be uncomfortable or even painful. In an effort to make going to see the dentist a more pleasant experience, many dental offices look more like health spas. Gone are the horrible sounds and smells, replaced by the sound of rock fountains, massage chairs, paraffin wax treatments, iPods and most importantly virtually painless dentistry. Dentists are embracing new technology that greatly enhances the patient experience and eases anxiety about dental treatments. Laser scanners allow your dentist to find decay that normally can’t be seen or felt until they are much bigger. Computerized anesthesia machines allow only the tooth being treated to be numb instead of your entire face. And now a common dental procedure known as a dental impression has an amazing new technology behind it.

Fig 1 – Conventional Putty Dental Impression

Every year millions of people need crowns and bridges to replace broken, decayed, heavily filled or missing teeth. More and more people are now requesting cosmetic porcelain veneers to improve their smile. In order to fabricate the crown (cap), bridge or veneer, a physical impression must be taken of the tooth being restored. Most patients cringe at the thought of having a mold of their mouth taken. The putty is messy, tastes extremely unpleasant, and in many patients can cause gagging. (Fig. 1) This is far from a perfect science and if the impression has an air bubble or other imperfection, it may not be suitable and unfortunately the dentist may have to repeat the process again. The crown, bridge or veneer created from the physical impression often requires additional time to seat, may require numerous adjustments and may eventually need replacing. Sometimes the crown does not even fit and the impression needs to be retaken and the lengthy process started all over. Dentists now have another option when it comes to taking a dental impression.

Fig 2 – Dr. Tau Taking an iTero Digital Impression

Cadent’s iTero is a new groundbreaking digital technology that eliminates the need for a gooey physical impression. This device enables the dentist to create an exact replica of what is in the mouth using only a laser scanner. (Fig. 2) The only thing that touches the mouth is the tip of the handheld wand. Guided by voice prompts, the dentist takes several scans of the teeth and the patient’s bite until a complete digital image is captured. With each scan, Itero software captures 100,000 data points in the patient’s mouth. Once the dentist begins the scanning process it can be stopped and started as many times as necessary, unlike the physical impression that must set for 5 or more minutes before it is removed from your mouth. Never again will patients be stuck with a mouth full of goop. Each scan takes only a few seconds.

Fig 3 – iTero 3-D Impression

After the scanning process is completed a 3-D digital model of the mouth is magnified and displayed on the computer screen right in front of the patient. (Fig. 3) This allows the dentist to review the scan and make any necessary changes or take additional scans if some information was missed. Seeing this information allows for better communication between the dentist , the dental assistant, the laboratory, and most importantly the patient. It also allows the dentist to head off potential issues that may have gone unnoticed until the seating appointment. Itero technology all but guarantees a perfect fit for the new crown or bridge, so patients spend less time at the dentist’s office and more time enjoying their new smile!
Going to the dentist still may not be at the top of a patient’s priority list but if and when a patient needs a crown or wants a veneer, the Cadent iTero digital impression will allow for a much more comfortable visit, and more importantly, a better fitting restoration.

Want to avoid the messy, gagging traditional method of taking impressions?

Call Dr. Leonard Tau and ask about the Cadent iTero digital impression system.

Crowns in a Single Visit

Dr. Sorkin on Same-Day Dentistry: Welcome to dentistry in the 21st century! We are pleased to offer crowns made with CEREC 3D™, a highly precise computer milling machine that makes crowns right in the office, in one visit. No more temporaries, additional visits, or crowns that don’t seem to fit right.

CEREC 3D crowns are convenient, aesthetically desirable, and you do not have to give up function. Due to the custom design and precise fit, CEREC 3D restorations are bonded to the tooth with the optimum strength available. We are pleased to be one of the first in our community to offer crowns with the CEREC 3D machine. If you have ever had a crown placed the traditional way, we are sure you will notice the difference!

Central Jersey Dental on PatientFYI

Dr. Bodak on Missing Teeth: Many adults have missing permanent teeth that have been lost due to injury, disease or decay. Not only do missing teeth make you look older than you are, they can also be detrimental to both your health and well-being. If you have teeth that are missing, replacing them can dramatically improve your appearance by improving your smile. This will also improve how you feel about yourself.

In our grandparents’ day, there was often little opportunity for quality dental care. As a result, people expected to lose at least some of their teeth by their mid-adult years. As they began to lose teeth, their faces started to age prematurely. Losing a permanent tooth is similar to losing other parts of your body. Would you be content to lose a finger, even though you had nine others? Of course not. You could still use your hand, but you know that your hand works best when no parts are missing. Your mouth and jaw also function best when you have all 28 permanent adult teeth. Many people have lost all four wisdom teeth without any loss of function, but the other 28 adult teeth are a different story.

Each tooth functions both individually and also as part of your bite. When you lose a tooth, there is an empty space or gap left behind that affects each of the opposing teeth. If one or more missing permanent adult teeth are not replaced, the spaces or gaps will cause your remaining teeth to shift to a new spot. As these teeth shift, your bite will be disturbed and you may develop TMJ (temporomandibular joint) symptoms with jaw clicking or soreness. The gaps also become the perfect place for food to become trapped, which increases your risk of gum disease and tooth decay. If you lose enough teeth, you will also be unable to chew your food effectively.

Avoid future TMJ problems and collapse of your bite. Replacing missing teeth promptly can help prevent movement of your remaining teeth and can help preserve your bite. When a tooth is lost, the supporting bone in the jaw begins to dissolve. This is known as bone resorption. Bone resorption is an ongoing, continual and permanent process; it never stops throughout your lifetime until you replace the missing tooth. The longer the tooth is missing, the more bone is lost to resorption. This makes it more difficult to do dental restoration to replace the missing teeth.

If you have dentures, you are already experiencing ongoing bone loss and premature facial aging, as you lose more and more of your bone from your  jaw . Your profile and facial appearance starts to age more rapidly.  Loose dentures accelerate the rate of bone loss even more. Even if one or more teeth were lost long ago, replacing them with dental implants now can stabilize your bite and bone tissue, reduce TMJ stress, improve your ability to eat a variety of foods and enhance your smile and facial appaearance.

So replacing a tooth as soon as possible after it is lost is key to maintaining proper oral health and maintaining your facial proportions. Restoring missing teeth will reduce the shifting of teeth due to gaps and will also help prevent bone loss.

Your oral health and dental care is important to me.

Dr. L. Z. Bodak-G
www.MediaPADentist.com

PatientFYI: No more plastic trays or bad tasting putty at the dentist’s office –  a digital dental impression system captures continuous 3D video images to create precise 3D dental models. When used by dentists and hygienists, it eliminates the discomfort of traditional methods and improves communication between patients and dentists by allowing immediate chair-side review.

Find a Chairside Oral Scanner Dentist near you today!

Chairside Oral Scanners provide digital impressions that are comfortable, fast & precise.

To create a digital impression, the dentist positions the wand in the patient’s mouth and glides the tip over the teeth to capture surface data. The 3D data is collected and reviewed in real-time on the display.

Click here to view the embedded video.

Snap-on Smile is a patented, revolutionary dental appliance that requires no prepping, no injections, and no adhesives. It snaps right over your natural teeth. Snap-On Smile is easily removable, completely reversible and is an excellent option for patients looking for a non-invasive, affordable approach to restorative and cosmetic dentistry. You can even eat while wearing the Snap-On Smile appliance.

Find a Snap-On Smile Dentist near you today!

Patients looking for a non-invasive & affordable approach to restorative/cosmetic dentistry are excellent candidates for Snap-On Smile. It’s an easy, quick and affordable solution for patients who want to feel better, look better, and function better. Patients using Snap-On Smile report an immediate boost to confidence and self esteem. Most are impressed with the natural look and feel of Snap-On Smile and are grateful for the brief time investment – about two weeks – to achieve such life changing results. All it takes is a brief consultation in your dentist’s office. The process is quick and painless. Your dentist will take photos and impressions of your teeth. You choose from different smile shapes and shades for your Snap-On Smile. In about two weeks, the exclusive lab at Snap-On Smile will create and send your dentist your new appliance for final insertion. Snap it in and wear it home.

Click here to view the embedded video.

While a General Dentist’s main focus in on your overall oral health, which includes the prevention of tooth decay and restoration when needed, a Cosmetic Dentist will focus on improving your smile’s appearance & function through a variety of advancements in technology; such as teeth whitening, orthodontics, veneers and other reconstructive dental methodologies.

Find the best Cosmetic Dentists in your City & State! 

PatientFYI enables you to quickly learn about almost every Cosmetic Dentist in your city – so you can easily: compare their services & strengths, find out which advanced technologies they use, see any payment specials they are offering, read reviews from their patients that received the same service you want, make sure they accept your dental insurance; and much more! 

Many Technological Advancements in Cosmetic Dentistry

There have been many advancements which empower Cosmetic Dentists to complete intricate dental designs, all while preserving as much of your original tooth structure as possible. While incorporating the patient’s existing tooth structure, cosmetic dentists create the ideal shape according to each patient’s unique physiological make-up. Patient’s often times enhance their appearance and look younger due to the dramatic results of cosmetic dentistry.

Some of the typically methodologies used by cosmetic dentists in optimizing a patient’s smile include the following:

• Teeth Whitening or Bleaching: Significant color change in a short period of time is the major benefit of teeth whitening performed in our Dentist’s office. This protocol involves the carefully controlled use of a relatively high-concentration peroxide gel, applied to the teeth by the dentist or trained technician after the gums have been protected with a paint-on rubber dam. Generally, the peroxide remains on the teeth for several 15 to 20 minute intervals that add up to an hour (at most).

• Composite or Resin Fillings: If you have a cavity in a tooth, broken fillings, mercury fillings, or amalgam fillings, this type of dental filling is well worth discussing with your dentist. Mercury fillings or amalgam fillings can easily be removed and replaced with far more attractive colored fillings. These fillings actually strengthen your tooth beyond the level it had with the amalgam fillings.

• Inlays or Onlays: These are Porcelain fillings that cover an area too large for a filling


• Veneers: Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth to improve your appearance. These shells are bonded to the front of the teeth changing their color, shape, size, or length.

• Dental Implants: Dental implants combine the best of modern science and technology – a successful implant requires that all parties involved – the patient; the restorative dentist, who makes the crown for the implant; and the oral and maxillofacial surgeon, who surgically places the implant, follow a careful plan of treatment. All members of the implant team stay in close contact with each other to make sure everyone clearly understands what needs to be done to meet the patient’s expectations.

• Laser Dentistry: If you consider yourself somewhat of an anxious dental patient and are seeking extreme safety and comfort, you might consider looking for dentists who have incorporated laser dentistry techniques into their practices and treatments.

• Invisible Braces: Having a confident smile can change everything. And invisible braces make the decision easy, because you can get a stunning smile without most people even noticing you’re going through treatment.

• Dynamic Braces: Conventional orthodontic braces are tied with elastics, which cause friction and pressure, making treatment slower and less comfortable. Dynamic braces have a unique slide mechanism that reduces pressure on teeth and allows them to move more comfortably to their correct positions. This new approach to orthodontics ensures greater comfort with these braces throughout the treatment.

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Dental Implants:
So you are thinking about having dental implants huh? We are here to make your job easy in this process. There is quite that you and your dentist need to know about this procedure. And if everyone involved is well informed and prepared, the process is very simple and you will enjoy your brand new teeth for a very long time.

I am going to throw in a monkey in the wrench for you first however. Imagine Dr. Average. He has never done or placed any implants. The last time he had taken a course in anatomy was way back in the first year of dental school, and he has been out of school for a good 20 years. Let’s make him one of the doctors who has never done any surgery, meaning, he has never cut the gums, nor has he ever had to put any stitches on anyone. Dr. Average decides that he wants to start doing implants. So he finds an online course for dental implants, or a one day course if he is slightly more motivated, and Monday morning, he is an implantologist and unbeknownst to you, you are his first patient!

So what are the things you must know and learn before you have dental implants. The first thing is are you a good candidate for dental implants? People who suffer from medical conditions that has an effect on the immune system of the body, or inflammatory system, would need to be further evaluated. This is why a thorough, updated medical history is needed. At time, blood lab work up need to be done prior to having dental implants done. Anti inflammatory medications, steroids, pain medications and antibiotics are some of the medications that maybe prescribed to you before and after this procedure.

What else? Well, the big question is why do you need dental implants? Is it because you have broken your tooth? Then the cause of this needs to be evaluated. If not, you can do the same damage to the implants. What if you lost your tooth or teeth due to periodontal or gum disease? Did you know that you could lose the implants due to the same reason as well? Your diet, the PH of your mouth, your stress level, how you eat, chew, how the muscles of your head and neck function, all play a role in determining if you are a good candidate for dental implants or not. And if not, what are some alternatives, and or things that you can do to make you a good candidate for it now?

So what else does your dentist need to evaluate? Your dentist must evaluate the quality of your bone. Some implant companies even provide different types of implants for different types of bone. I will give you an example. Let’s say, you just bought a 2 beautiful 42 inch flat screen TV’s to be mounted on the wall in your house. One, you would like it to go on your living room wall (dry wall). The other, you would like it to go on a thick, old Oak entertainment center. Do you use the same screws or even number of screws for mounting these TVs? The same concept applies to dentistry. There are different types of quality and denseness of bone in the mouth. First of all, without taking CT scans, the only other way that a dentist can evaluate the quality of the bone is when they start to place the implant in your mouth, purely by the way the bone feels. Is this really scientific? You be the judge of that. CT scans today are an important piece of the puzzle to evaluate patients and also to treatment plan dental implants. The next thing is planning the implants. Where should it go and at what angle? These are the questions that the dentist who is going to be placing the crown over the implant (or the denture) will determine. If there are two dentists, a surgeon and a restorative, they must collaborate. Who is the quarter back? The restorative or the dentist who places the crown, not the surgeon.

Unfortunately, this does not happen often. Many times, the surgeons are the ones who determine where they would like the implant to go and then the restorative dentist ends up having to restore a positionally and esthetically compromised implant.

Why do you have to know these things? Because these steps are not followed properly most often.
So where do you start? 
1. Have your medical history be checked thoroughly by your dentist or dentists. Make sure no lab works are needed. Make sure you are a good candidate for dental implants, get rid of all existing causes of damage and pathology, correct bite issues, get gum disease and bite disease and dietary issues under control.
2. Consult the Restorative Dentist first. They must take models of your mouth, determine where they want the crowns to go, have special stents made by the lab.
3. You will wear these stents and have a CT scan of your jaw done.
4. The restorative dentist determines, the position and angulation of the crown that needs to be positioned in your mouth.
5. The surgeon determines if there is adequate bone to position the implant in the proper position and angulation that the restorative dentist had requested. If not, then bone grafting, sinus grafting or other procedures will be needed. The surgeon will evaluate the thickness of your gums as well.
6. The number of implants, type (based on the preference of both dentists and also based on your bone quality), the size and length of implant are all determined by both dentists.
7. The procedure is performed on the CT scan once virtually to make sure not complications in terms of positioning and anatomical structure (such as nerve damage) will happen. The CT scan will be sent to special labs to have a surgical stent fabricated so that the surgeon will duplicate with much accuracy the placement of the implant in your mouth in comparison to the CT scan or virtual version.
8. Once the surgical stent is available, then, you will be scheduled to have your implant(s) placed.

Follow the post op instructions, ice your face and take the proper medications. Very simple….. or is it?

How do you now determine who has the experience? And what does their training mean? I would recommend going to www.PatientFYI.com to evaluate the dentists’ training, to evaluate the courses they have taken, their accolades and educating yourself as to what each course means to you. I would start with a Full Mouth Rejuvenation Dentist first and then you can look for an IMPLANT DENTIST if the first dentist did not place their own implants. Again, make sure they have the same level of expertise in the surgical aspect as they have in the restorative aspect of dental implantology. A thorough examination, treatment planning is the key to success. Do not underestimate the power of preparation.