Questions patients often ask

It depends on the bone available and the design of the bridge, and it is decided during planning rather than in advance. What matters more than the count is where they go: implants are positioned to support the finished bite, not simply placed where bone is easiest.

The number of appointments depends on your starting position, and 8 to 10 visits is a reasonable expectation for a fixed bridge from beginning to end. Many patients leave the surgical appointment with fixed provisional teeth rather than a removable denture.

For most patients who can have one, yes. A fixed bridge is anchored to the jaw, so it does not move when you eat or speak, and it transmits force into the bone, which helps preserve it. A conventional denture rests on the gum and does neither.

A well-made full-arch restoration is designed around your face, not just your jaw: lip support, tooth proportion, midline and the amount of tooth that shows when you smile are all planned deliberately. That design work is the part a Prosthodontist is specifically trained for.

A conventional bridge is supported by the teeth on either side of the gap, and preparing them means cutting down two healthy teeth to replace one missing one. An implant stands on its own and leaves the neighbors untouched.

A single-tooth implant normally involves about four visits. Most patients are able to work the day after the implant is placed.

That is the point of using all-ceramic rather than metal. Shade, translucency and surface texture are matched to the teeth beside it, which matters most at the front of the mouth where a single crown has to disappear next to a natural tooth.

The bone that held the root begins to resorb, and the teeth on either side tend to drift or tip into the space over time. Neither is quickly reversible, so the decision is worth making sooner rather than later.

Usually not. A bridge spanning several teeth can be supported on fewer implants than there are teeth, provided they are positioned to carry the load. How many, and where, is decided at planning.

After the initial examination, expect roughly 4 to 5 further visits before the fixed bridge is permanently attached.

Some minor bruising and swelling of the gum and soft tissue is normal, and is usually managed with ordinary painkillers. Most patients are back at work the following day.

A partial denture is cheaper and faster, and it clips to your remaining teeth, which puts stress on them and traps plaque against them. It also has to be taken out. A fixed bridge on implants stays in, and it preserves the bone underneath.

Your jaw is scanned in three dimensions and the implants are positioned in software, planned against the teeth you are going to end up with. A custom surgical guide is then made that reproduces that plan in the mouth, so the placement is executed rather than judged.

Conventional implant placement involves lifting the gum to see the bone directly. When the plan is accurate enough to be trusted, the implant can be placed through a small opening in the gum instead. Less surgical trauma generally means less swelling and a more comfortable recovery.

Fitting provisional teeth to the implants at the time of surgery rather than waiting months. It is not appropriate for every case, and it depends on how firmly the implants sit at placement. When it is appropriate, it means you do not go through treatment without teeth.

Guided-surgery software and equipment are widely available, and how cases are planned varies between practices. Dr. Lal has published on computer-generated surgical templates for implant planning.

Separate repairs treat teeth. A reconstruction treats the bite. When teeth are worn or have been rebuilt repeatedly, the way the jaw closes has usually changed, and restoring individual teeth into a collapsed bite tends to produce work that keeps breaking.

It varies widely with the starting point and cannot be quoted honestly without an examination. What can be promised is that the whole plan is designed before treatment starts, so you know the sequence, the stages and the destination in advance.

No. Reconstruction is carried out in provisional restorations, which let you and Dr. Lal test the new bite and the new appearance before anything permanent is made.

A well-made crown on a sound tooth commonly lasts a decade and often considerably longer. Lifespan depends much more on the health of the tooth underneath and how you bite than on the crown itself.

All-ceramic crowns look the most natural and are the default at the front of the mouth. Where a tooth carries heavy load, material choice is a judgement between strength and appearance, and it is made per tooth rather than per patient.

Usually not the crown. Decay at the margin, a fracture in the tooth beneath, or a bite that overloads it are the common causes. Replacing the crown without addressing the reason tends to produce the same result again.

They involve permanently removing a thin layer of enamel, so it is a commitment. How much is removed depends on the case, and conservative preparation is the aim. Anyone who tells you veneers are reversible is not being straight with you.

That comes down to design, and it is a decision, not an accident. Tooth proportion, edge shape, surface texture and how much tooth shows when you smile are all planned. A uniform, extremely white, perfectly straight set is a choice some patients want and others specifically do not.

No. Crowding is often better treated by moving the teeth than by covering them, and Invisalign clear aligners are one way to do that. Discoloration alone may only need whitening. Veneers are the answer when shape, color and position all need correcting at once.

If the teeth either side of the gap are already crowned or heavily filled, a bridge uses them without further loss. If they are healthy and untouched, an implant is usually better, because a bridge requires cutting them down.

A conventional bridge commonly lasts many years. It usually fails at a supporting tooth rather than in the bridge itself, which is why the condition of those teeth matters so much at the planning stage.

With floss threaders or interdental brushes designed for the purpose. A bridge is joined, so it cannot be flossed normally, and the area underneath is exactly where problems start.

A complete denture is held by suction, the shape of the ridge and the muscles around it. As the jawbone resorbs over the years, the shape it was made to fit changes, and the fit loosens. That is the bone changing, not the denture failing.

Yes. Even two implants can hold a lower denture firmly enough to change what a patient can eat. It is often the single most effective improvement available to a long-term denture wearer.

No, and it is worth saying that a denture is a set of teeth designed from scratch, so tooth shape, color, arrangement and the amount showing are all chosen. Slight irregularity is usually what makes them convincing.

A removable replacement for several missing teeth that clips to the remaining ones. It is a reasonable option, though it does load those teeth and traps plaque against them, which is why fixed alternatives are discussed first when they exist.

An in-office whitening appointment usually takes between 45 minutes and an hour.

No. Whitening works on natural tooth structure only. Existing crowns, veneers and white fillings keep their current shade, which is why any that show are usually replaced after whitening, not before.

Professionally supervised whitening at appropriate concentrations does not damage enamel. Temporary sensitivity is common and settles. The risk in whitening is usually poor technique and unsupervised overuse rather than the chemistry.

It depends almost entirely on what you drink and whether you smoke. Coffee, tea and red wine restain teeth steadily, and most patients top up periodically rather than whitening once.

No, and you should be cautious of anyone who says otherwise. Sleep apnea is diagnosed by a sleep physician, usually with a sleep study. We work with your physician: they diagnose, and if an oral appliance is appropriate, we make and fit it.

Obstructive sleep apnea happens when the airway is blocked during sleep, often by the tongue falling back or airway tissues collapsing. The appliance holds the jaw forward overnight to keep the airway open.

For some patients, and that is a medical decision made with your physician. Appliances are often considered where CPAP has not been tolerated. The right treatment is the one actually used every night.

Heavy snoring, extreme daytime drowsiness, difficulty staying asleep, waking with a very dry or sore throat, and frequent morning headaches. If those are familiar, ask your physician about a sleep study.

Close to invisible in normal conversation. They are clear, custom-made and removable, which is the reason most adults choose them over fixed braces.

It depends entirely on how far the teeth have to move, so it is quoted after an assessment rather than in advance. Minor corrections are considerably quicker than comprehensive cases.

Close to it. Aligners only move teeth while they are in, so results track how consistently they are worn. This is the one treatment where the outcome is genuinely in the patient's hands.

No. They handle a wide range of cases well, and some bites need fixed appliances or a different approach. An honest assessment up front is worth more than an optimistic one.

Every 4 to 6 months for most patients. The interval should reflect your gum health, your risk of decay and your history, not a single default applied to everybody.

Every few years for a routine patient, and more often where there is a specific reason. X-rays show what an examination cannot: decay between teeth, bone levels, and the condition of existing work below the surface.

Dental x-rays are among the smallest radiation-dose studies in modern medicine. A routine examination with four bitewings delivers about 0.005 mSv, comparable to the exposure of a one to two hour flight.

Because reconstruction only lasts if what surrounds it stays healthy. Implants and crowns fail through gum disease and decay at the margins, so maintenance is part of the treatment rather than an afterthought.

Often you do not. Decay usually causes no pain until it reaches the nerve, which is why it is normally found on an examination or an x-ray rather than because something hurt. Sensitivity to cold or sweet, a rough edge you catch with your tongue, or food packing into one spot are worth mentioning.

Composite is shaded and layered to the tooth it is repairing, and on front teeth the shade is usually chosen in natural light with the tooth hydrated. A well-placed composite is difficult to spot; a rushed one is obvious, and the difference is time rather than material.

The material is the same. A filling replaces tooth structure lost to decay or fracture; bonding reshapes a tooth that is sound but chipped, worn or uneven. Bonding is conservative and reversible in a way a veneer is not, which is often the reason to start there.

Not on appearance alone. A sound amalgam that seals well can be left. The reasons to replace one are decay underneath, a crack in the remaining tooth, or a filling so large that the tooth would be better served by an onlay or a crown.

An inlay sits inside the cusps of the tooth. An onlay covers one or more cusps. A crown covers the whole tooth. Each step removes more tooth structure than the one before, so the aim is the smallest restoration that will reliably hold.

A very large composite flexes under biting load and can split the tooth around it. An inlay or onlay is made outside the mouth and bonded in as a solid piece, so it supports the remaining tooth rather than wedging it apart.

With CEREC the restoration can be designed and milled in the practice, so many cases are completed in one visit. Some are still better made in a laboratory, and those take two.

For most single crowns, yes. It is milled from a solid ceramic block, which is consistent material with no layering flaws. Where a case needs custom shading across several front teeth, or unusual translucency to match a neighbor, a laboratory technician still does that better, and we say so rather than defaulting to the faster route.

Commonly around two hours from preparation to fitting, most of which is the milling and the final adjustment. It is one longer visit instead of two shorter ones, plus the fortnight between them.

There is not one. That matters more than it sounds: temporaries are the stage where crowns come loose, teeth become sensitive and margins leak, and skipping it removes that whole window.

Not with putty. The tooth is scanned digitally, which is more comfortable, and the scan can be reused later without bringing you back in.

The extraction itself should not: the area is fully numb before anything begins. Nitrous oxide is available if the anxiety rather than the pain is the problem. Afterwards there is usually soreness for a few days, managed with ordinary pain relief for most people.

This is the part worth deciding before the tooth comes out, not after. Bone in the socket begins to resorb once the tooth is gone, which affects what an implant will need later. Where an implant is likely, the socket can be grafted at the time of extraction to preserve the site.

Often, and it is the first question rather than an afterthought. Root canal treatment, a crown, or periodontal treatment save many teeth that look hopeless. Extraction is recommended when the tooth is fractured below the gum, too decayed to restore, or so periodontally involved that it is loose.

Most people are comfortable within two or three days for a simple extraction. Avoiding smoking, straws and vigorous rinsing in the first 24 hours matters, because disturbing the clot is what causes the painful complication people have heard about.

Most people do not, because it happens during sleep. The signs we look for are flattened or chipped edges, teeth that have become sensitive without decay, a jaw that aches in the morning, headaches at the temples, or a partner who has mentioned the noise.

A boil-and-bite guard is bulky, does not fit precisely, and can leave the bite unsupported in places, which some people find makes the clenching worse. A custom guard is made to your own scan and adjusted so the bite meets evenly across it.

It protects the teeth from it, which is the realistic goal. It does not cure the habit. Where there is an underlying cause such as stress, airway or an uneven bite, that is worth addressing separately rather than expecting the appliance to do it.

More than most. Ceramic is hard but brittle, and a night of clenching can chip a restoration that would have lasted years otherwise. A guard is routinely recommended after significant restorative work to protect the investment.

A conventional lower denture rests on the gum and is held by suction and muscle control, which on a lower jaw is often not much. An overdenture clips onto implants, so it does not lift when you eat or speak. It is still removed for cleaning.

A fixed full-arch restoration is screwed in and stays in; you clean around it. An overdenture clips on and comes out. Fixed usually costs more and needs more implants; an overdenture is removable, easier to clean and less expensive. Neither is automatically better.

Commonly two to four in the lower jaw and four or more in the upper, depending on bone and how the denture is designed. A cone beam CT scan shows what the bone will actually support, which is what the plan is built from.

Sometimes, if it fits and the teeth are in the right position. More often the denture is remade, because the position of the teeth in a successful overdenture is decided by the implants and the bite rather than by the old appliance.