Dental Cleaning or Prophy FAQs


If you have a good hygiene, and you have been flossing your teeth, the cleaning will not hurt; but if you don’t floss; which dose 40% of the work, the hygienist has to do more, and get under your gum more, which might make it hurt.

 

Depending on the zip code, and local fees, the routine cleaning could cost from $80 to $200 X-rays and exam included. The scaling and root planning, costs about 150 – 300 per quadrant.

Brushing and flossing can only remove plaque which is soft. Once you get tarter, build up, or calculus, brushing and flossing would not remove them, and number one cause of tooth loss is periodontal problems which is caused by not taking care of your teeth.

Dental cleaning / prophy is not a substitute for teeth whitening; but it can remove superficial stains, and make them look whiter; or get it back to the original color.

You are probably sensitive because the cleaning instruments touch the inflamed gums, and areas that are not covered by enamel, like the roots.

Depending on your periodontal health, you might have to clean your teeth 2,3,4; or every 6 months. If you have a good oral hygiene, every 6 months is the norm.

Use soft tooth brush. Use desensitizing tooth paste. If you grind your teeth, get a night guard. Avoid acidic foods. Use fluoride mouth wash or tooth paste.

Dental hygienist specializes on professional dental cleaning; and even though your teeth should not be damaged, if you have really bad puffy gums or periodontal disease, your gum might shrink slightly as it gets healthier; and that might make you sensitive. Also when the tarter is cleaned off of your teeth, you could get sensitive because the tooth and the root is now exposed.

Brushing and flossing can only remove the plaque that is soft. Tartar and calculus is hard, and can only be removed by scaling and ultrasonic at a dental office.

Teeth will always gradually become yellow. The teeth cleaning / prophy can only remove the stain from your teeth. If you want white teeth, you showed get a teeth whitening appointment; or permanently cover them with veneers.

Tarter and build up, erodes the enamel which can not regenerate. But fluoride tooth paste, and fluoride rinses help to strengthen your enamel.

You can either use fluoride tooth pastes or rinses; or cover the sensitive teeth with a layer of porcelain ( veneers or crowns ).

You only need to wait 30 minutes if you either got fluoride treatment; or medication were applied in your gums.

If you are drinking apple cider vinegar or lemon juice for their health benefits, it could damage your teeth ( because its acidic ) if you don’t brush and rinse with water right after that. You can actually dip your tooth brush in apple cider vinegar and brush your teeth and remove the plaque; just make sure you rinse thoroughly with water.

Cavity can only be stopped sometimes on the early decalcification phase by using fluoride tooth pastes and fluoride rinses; other wise it needs to be removed and filled by your dentist.

You can stop chewing gums that have sugar, use soft tooth brush, use a night guard if you grind your teeth, avoid sugar and starch, improve your nutritional intake, and fix your gastrointestinal issues, and finally go to your dentist on regular ( 6 months ) basis for maintenance.

Mix a teaspoon of salt with tablespoon of baking soda; then dip your tooth brush in warm water and brush your teeth. You should take about 4-5 minutes brushing. Spit right after and rinse.

Mix baking soda with lemon juice to make a paste. Brush your teeth; then rinse after one minute. You can also use diluted hydrogen peroxide. Avoid drinking or eating items that stains your teeth; if you do, brush and rinse immediately.

Supposedly, Vitamin D, Vitamin A, Calcium, and  Phosphorus.

Even though some people believe that oil pulling with an edible oil like coconut is beneficial for your gums, and teeth; as it turns out, it has not been proven.

Dental Implants FAQs


Under normal conditions ( good bone quality and quantity ), Implants are supposed to last up to 25 years, compared to the alternatives that last about 5-10 years. But there are no expiration date on the implants, so with proper maintenance, it could last a lifetime.

 

The cost of dental implant depends on the type of the implants used, and the crown material. In our office, we use the best dental implant that is made by Nobel Biocare Company, the leading dental implant company. No matter where you are in the universe, Noble Biocare dental implants are well known, and most dentists have the wrenches that is used in case there was a problem. In our office the Noble Biocare dental implants costs around $1,800 – $2,000. Then The abutment that screws on top of the implant, and the Crown ( made by da Vinci lab in Beverly Hills ) that screws or cemented on top of the abutment costs between $1,150 – $ 1,400.

Most insurances do not pay for dental implants; but there are a few insurances that might help pay for a portion of the implant crown.

The success rate of dental implants are 95% – 98%.

If there are teeth surrounding the missing tooth, a fixed bridge is the alternative; other wise removable partials..

Pain comes from the nerve. The nerve comes out with the tooth that is removed. If there is a slight discomfort, it usually comes from pulling the tooth, or the gum surrounding the implant. But if you take the medication as directed, you should hardly feel any pain.

For regular implants, it depends how many implants is necessary. But the best treatment is normally All on 4 ( see the All on 4 section ), which could range between 40-50 thousands per jaw. Dr. Shojania is an expert in All on 4 procedure, and will give you a discount because he buys the implants in bulk.

Considering the patient has sufficient bone ( except for All on 4 procedure ), and there are no medical contradiction, almost every body can get dental implants.

If the tooth that is pulled has only one root, we can do the implant at the same time. If the tooth that was removed had more than one root ( upper and lower Molars ), it is advised to wait 4 months before placing the implant.

In average, for lower jaw, about 3 months; for upper jaw about 4-6 months because the bone is softer.

Since you lose bone after each extraction, it is necessary to place bone graft in most cases. It is optimal to have at least 1.5 mm bone all around the implant to assure sufficient blood flow.

Yes, if the dentist has the expertise, and the specific implant removal kit.

Yes, according to research, there is no increase gum disease with dental implants.

If the dentist is specialized in implant, nothing should go wrong. But if the dentist is novice, or in extreme cases, there could be pain,infection, tingling sensation, numbness, and nerve damage; but it is rare.

In most cases, you do not need to change your diet; but in some cases, the dentist might advise you to either chew on the other side; or go on a softer diet.

Dental implants could fail if there was infection at the site, severe bone loss, medically compromised patients, smoking, and most of all bad oral hygiene. Also, if the patient fail to mention that they have been taking bisphosphonate drugs like Fosomax, alendronate, etc.

As far as tooth appearance, they look the same; but implants do not have propioreception and shock absorption like natural teeth.

Yes, in rare situations, if the implant is failing, you will feel pain, swelling, gum recession, and it will feel like the implant is moving.

No, Dental implants do not make the alarm sound at the airport.

Yes, even though we prefer that you stop smoking few days before and after, you can still get implants. Smoking, bad oral hygiene, and bad nutrition can slightly increase the chance of implant failure.

There are a few absolute contraindications to dental implants like, recent myocardial infarction, cerebrovascular accidents, valvular prosthesis surgery, immunosuppression, active treatment of malignancy, I.V bisphosphonate use. There are also conditions that can lower the success rate of dental implants, like smoking, grinding, bad oral hygiene, etc.

Dental Veneers FAQs



Porcelain dental veneers cost between $925 – $2,500 depending on the expertise and the zip code of the dentist. They last between 7 to 15 years; but if you are very careful, they could last life time. Composite dental veneers cost between $250 – $1,500 depending on the expertise and the zip code of your dentist. They normally last between 3-7 years.Your dentist might not use this material anymore.

 

Dental veneers do not damage your teeth if it is done by an experienced dentist with proper training.

Porcelain dental veneers normally last between 7 to 15 years; but if you are very careful, they could last life time. Composite dental veneers normally last between 3-7 years.

Dental veneers can fall out if the bite is hitting hard on it; or the dentist missed a step in permanently cementing it to your teeth. If they fall out once, the dentist can recement it again and adjust your bite. If it they come out more than once, the dentist will have to modify the prep, and either place a ¾ crown; or full crown over the tooth for more retention.

Dental veneers can actually strengthen your tooth if done by a qualified and experienced dentist.

 Brush your teeth with nonabrasive toothpaste. Floss like its your natural teeth. Be careful biting on hard foods or candies.

The dental veneer itself can not get cavities; but your exposed tooth, and the margins can get cavity if you don’t brush and floss like you should.

Because dental veneers are normally done for cosmetic (elective and optional)reasons, most insurances do not cover the cost. But you should always check with your insurance.

Dental veneers can be expensive. If they fracture, they cannot be repaired; it has to be redone.  Once permanently cemented, it cannot be removed; so make sure you check the shape and the shade before the dentist starts the cementation process.

Dental veneers only cover the front of the tooth; but dental crowns either cover ¾ of the tooth or the whole tooth. After your dentist checks your bite, and desired outcome, he or she can advise you which would be better for you. Crowns usually last longer, and less chance of your tooth getting decay or cavity.

If the dentist decides to grind enough to get to the sensitive part of your tooth ( dentin ), he or she will make you numb through the whole procedure, so you will not feel any pain. After the numbness goes away, you either temporarily have slight pain that an Advil or Tylenol will make you feel good till the permanent veneers are cemented. Sometimes the dentist decides to do the veneers without grinding your teeth; or minimal grinding; which you will not even need to be numb during the procedure.

If your filling material almost covers half of the tooth, dental crown is a better choice for you. If the filling material is very small, Dental veneer can be done.

A good quality veneer that is sufficiently polished by a reputable dental lab, will not get stained like natural teeth, because unlike natural teeth, the dental veneer is not porous.

Normally, for best outcome, it takes two appointments; the first appointment the dentist prep your teeth, and gives you a nice temporary veneers; then in about 10 – 14 days, we will replace your temporary dental veneer with permanent ones.

People with different genetics, have different bacteria in their mouth, and some specific bacteria might leak behind the temporaries and stain them. But before the stain starts to bother you, your temporary dental veneer will be replaced with the permanent veneers that do not get stained.

At the initial visit, your bite is adjusted in a way that your veneers cannot wear down; but if your bite changes over time, and get imbalanced, they could wear down even though they are harder than your natural teeth. Your dentist might advise you to get a night guard to protect them.

Once your dental veneer is permanently cemented, you can not whiten them anymore; that’s why it is very important to mutually decide with your dentist the shade or color that you desire to have before the veneers are made.

Even though the veneer material is stronger than your natural teeth, because they are cemented on top of your teeth, we advise you to cut the apple or break the hard foods and chew them with your back teeth.

Once the dentist checks you teeth shape, bite, and if you are cavity prone, he or she will advise you if dental veneer is better for you, dental ¾ crown; or dental full crown. Because cosmetically, they can both give you the same smile; it is just the matter of how far in the back of your teeth dentist decides to cover with the porcelain.

Dental Crowns FAQs


For the best outcome, it normally takes 2 appointments to get dental crown. First appointment, Patient is numb ( unless it is a root canal tooth ), prepare and reshape the tooth, take mold of the tooth, and a temporary crown. Second appointment, temporary crown is replaced with a permanent crown.

 

Once you get numb, nothing will hurt; then the anesthetic ( normally lidocane ) will wear off; the sensitivity is minimal to none at that time.

Generally, dental crown cost between $800 – $1,600 depending on the type of the material used, and the location.

Depending on the type, and the habits of the patient, dental crown can last from 5-15 years; but if you maintain a good, there are no expiration on dental crown; it could last a life time.

Depending on the way and type of the temporary the dentists give you, you have different precautions. In most offices, they ask you not to chew sticky or chewy foods; but in our office we advise you to do whatever you want, except floss around the temporary.

There are so many different types of dental crowns; but in our office we only use top of the line, which is either:

  • Full zirconia for grinders, or if we want minimal tooth preparation on the biting surface.
  • Porcelain fused to Zirconia, for cosmetic areas, and dental implant crowns.

Once you get a root canal on a tooth, no more nutrition gets to the tooth, causing the tooth to be dry and brittle. Also, some teeth colors get darker after root canal therapy. Normally, you do need a dental crown after a root canal; but in rare cases, like lower front teeth, you might not need a dental crown after root canal. Your dentist will advise you on the best option.

Normally, if there is not a cheaper way ( like dental filling ), depending on your dental insurance, they cover a portion of the fee. Also, if you are getting a crown for cosmetic reasons, the insurance will not cover it at all.

Dental veneers can be expensive. If they fracture, they cannot be repaired; it has to be redone.  Once permanently cemented, it

There are usually 4 reasons a dental crown can fall out:

  • There is cavity underneath the crown which breaks the seal.
  • The dentist does not make all the 4 walls around your tooth parallel to each other.
  • The crown is too small, causing insufficent surface area for the cement to hold on to.
  • Patient is a severe grinder ( bruxer ); and the bite was not adjusted accordingly.

But if your dentist is experienced, there are ways to avoid above issues.

Depending on the cause of the crown falling out, there are different solutions. The dentist will normally recement the dental crown one more time (assuming there are no cavity), and adjust the bite. If it happens again, the dental crown needs to be redone, to correct the source of the problem.

You can temporarily cement the temporary dental crown with over the counter temporary cements; or just use tooth paste (dry the tooth); or use denture adhesives. No matter what you decide to do, consult your dentist first.

Normally, because in our office we use the most advanced cements, you can eat right away. But for some other crowns and cements used, it is advised not to eat chewy and sticky food for 24 hours.

In 95% of the cases, the dentist can do a root canal through a crown; but there might be some cavities underneath the crown, if it was done couple of years before.

Root canal is only done if the bacteria from the cavity is in or very close to the nerve; so you don’t need a root canal before every dental crown.

X-rays only show cavities if 30% of the density has been removed by the bacteria; also some crown or root fractures do not show on the x-rays. That’s why after getting a dental crown, your symptoms might show the dentist that root canal therapy is needed.

All on 4 FAQs


No, it is not experimental, the All-on-4 procedure (AO4) has been successfully performed in Europe for more than two decades and here in the U.S. from 2004. Approximately 14 years ago one of the world’s largest dental implant manufacturers, Nobel Biocare, began to study computer simulation and bio-mechanics and collected large amounts of data about this use of implants for the edentulous patient (most or all of the natural teeth missing). Dentists in USA have since studied with the developers of the AO4 procedure through AO4 seminars. Recent studies of large numbers of patients treated with this procedure show a success rate of nearly 99%.

 

For upper jaw, I will in 90% of cases place 4 implants ( because of bone quality and quantity, depending on the sizes of implants used, 8% of cases get 5 implants, and 2% get 6 implants ). For lower jaw, 98% of my cases get 4 implants as above; but in rare case 6 implants. Research studies have shown that if the back two implants are tilted slightly          ( usually 30 degree ), and the two front implants are straight or tilted 17 degree. This would render enough retention and support as multiple implants.

An implant-supported bridge attaches to these four specifically placed implants and is just as effective as being supported by many more implants using a non-AO4 technique. Think of this analogy: your teeth as a table that needs for legs ( implants ) to be stable. The results are less cost, less chair time, less healing time, hardly any bone graft, and most of all, no painful temporary stage with dentures needed.


Most dental clinicians do not have experience in the AO4 procedures and protocols and continue to use too many implants per jaw, increasing the cost to the patient, more trauma  and more treatment time. At Extreme Smile Makeover, dr. A, Shojania recommends the most cost effective denture replacement procedure that is customized and appropriate for you.

At Extreme Smile Makeover, after the initial examination, Dr. Shojania with his on site Lab takes total of about 5-6 hours, all in one day. Basically, Dr. Shojania takes about 2.5 hours to pull out all the teeth in one jaw ( if patient has teeth ), and place 4 – 6 ( mostly 4 ) implants, and close the gum; Then the lab person will take 2.5  hours to fabricate the temporary implant-supported bridge; lastly Dr. Shojania will take about ½ hour to srew the bridge to the implants, and adjust the bite. Patients will not need any bone graft procedure with the  ALL ON 4 procedure. Then patient will be walking away with a new smile. And new outlook on life. Patient can start eating food right away ( soft diet only ). We wait about 3-6 months; then we take a new mold of the implants in order to make the final permanent bridge; which not only has more teeth added in the back; but also has stronger base for the bridge to be attached to your implants. No temporary painful stages with dentures anymore; no waiting for the bone to be hardened around the implants.

Keep in mind that before the invention of  ALL ON 4  technique, using the traditional implants normally involved 6-8 implants per arch, risky and expensive and timely bone graft procedures ( usually involving the sinus ), several visits to different specialists in different locations, would normally took between 8 months to 2 years with patient being without teeth and temporary denture.

Knowledge is power. When I heard about this technique, I was skeptic also. But through hours of research, seminars, and post implantology courses, and seeing the results on live patients seminars, I can assure you that in rare cases, two things can go wrong:

1-     In the early stage, one of the implants might fail; which the problem can be resolved right away by:  a) replacing the failed implant with a larger diameter or longer implant     at the same location. b) replacing the failed implant with another implant in a different location, but close to the failed implant. In either case, I will modify your temporary implant-supported fixed bridge, so you can continue to have a fixed bridge until the new implant heals.

2-     Late failures,

We’ve heard this statement often, and can assure you it is not accurate. In fact there are even reports with pretty good results using only 3 implants. We don’t recommend this approach, for a variety of reasons, but it shows how silly the statements insulting the 4 implant design can be. We have met with and discussed the All-on-4 technique with some of these skeptical dentists and surprisingly these very dentists now understand the AO4 and how it can instantly give relief to their dentally exhausted patients. Even still, some of these same dentists are now resolute advocates of the AO4, advising their patients to see us for a complimentary consultation. We are experienced and will care for you. And we mean it.

When only 4 implants are inserted into each jaw ( optimal ), 20 year study shows that the All on 4 for the lower jaw is 98% successful; and for the upper jaw All on 4 is 98.2% successful. These success rates does not change if there are more implants ( 5,6 or more ) in the jaw bone. If in rare cases an implant fails, which will happen in the first 2 months, we will replace that implant, and fit it into the bridge accordingly.

There are different dentists practicing:

1-     Some dentists do not no how to do simple implant procedures, and unfortunately they would rather offer partials or dentures to their patients instead of losing their patients to a dentist that does implants and All on 4 procedures.

2-     Some dentists know how to do implants; but they haven’t gone through all the All on 4 classes and seminars to be able to do the All on 4 cases.

3-     Some dentists know how to do implants; and have taken some All on 4 courses; but because it is hard for them to do, they do not like to try it, and mess up someone’s jaw; and consequently, pay the price for it.

Fortunately, there are a few local general dentists that are highly educated, and have seen the benefits of All on 4 specially for edentulous patients with full or partial dentures, put the patient’s health a priority. These dentists frequently refer patients to us for single, a few implants; or full mouth ( All on 4 ) Implants. In our office, we do A-Z; meaning from pulling the tooth, bone graft, implant, and the restorative part which is implant crown, implant bridge; or All on 4 for the whole jaw.

Even though most patients are great candidates for All on 4 procedure, it is contraindicated if the patient has an uncontrolled medical condition like diabetic, severe immune deficiency, cancer, organ failures, etc. But even with above diseases, if it is controlled, the All on 4 treatment is acceptable. We will collaborate with the patient’s medical doctor to insure the patient’s safety.

Age is not an issue with the All on 4 treatment. The patient can be as old as 100 years, and still he/she is a good candidate for All on 4. Bone quality does not change much with age.

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Temporary bridge is screwed on the 4 implants on the same day that the implants are placed; so the patient can leave the office with a beautiful smile. It is made of acrylic, and composite resin. They are strong enough for patients to have a normal life before the final bridge is made. Because the implants are not fully integrated with the bone for about 4 months, the patient will be instructed to go on a soft diet for 3-5 months. Soft diet does not mean liquid diet; the patient can chew anything that the side of the fork can cut through. No chewy food like bread, steak, and pizza. No sharp, sticky, and hard food like peanut butter, popcorn, dried fruits & nuts, candy, chewing gum, seeds, spicy foods. Temporary bridge is made to last 6-12 months max, and then it will start to deteriorate and fracture. Temporary All on 4 bridge normally has no molars, to reduce the pressure exerted on the implants in the healing period.

 Final bridge is made after 3-5 months after the temporary bridge is made. It usually takes 3-4 appointments. It has a hard titanium framework for support, and has couple more teeth ( molars ) added to the All on 4 bridge. It is made with acrylic, composite or porcelain. Even though It is durable, and made to last long term, be extra careful the first 2 months, so the bone gets stimulated, and the bite totally adjusted. Before the final All on 4 bridge is made, the patient has a chance to change the shade, shape, and size of the teeth. Also, if there is some bone loss under the temporary bridge that food traps in there, we close it to avoid food collection under the All on 4 bridge. The final bridge will give you a great smile, and functions like your natural teeth. No more cavities, root canal. The only trip to the dental office is for keeping the gum healthy, and making sure that the patient is keeping the bridge clean.

1.      Get a good night’s rest the night before treatment.

2.      Eat a light, nutritious breakfast or lunch, but avoid coffee or other beverages that may increase your need to use the restroom during your procedure. No caffeine.

3.      Do not exercise or lift heavy objects for 2-3 days after the surgery.

4.      Take prescribed mediation as recommended by your physician, especially heart, blood pressure, or diabetic medication.

5.      Avoid aspirin 3 days prior to treatment.  If you take Coumadin, or any other blood thinners, you must be off the medication for at least three days prior to treatment.  Please check with your physician prior to discontinuing any medication.

6.      Have cold, soft foods in your home prior to your appointment so that they are available to you the day of your surgery.

7.      If you would like to listen to music during your treatment, please feel free to bring your own personal music and headphones.

8.      If you tend to become cool easily, please dress warmly.

Day of surgery:  for the first 24 hours, your diet should consist of cold, soft foods and drinks such as:

Iced tea                        Malts or Milk Shakes                              Chilled Canned Fruits

Fruit Juices                 Ice Cream or Frozen Yogurt              Milk

Cottage Cheese           Any Nutritional Drink                         Ensure Drink

Potato Salad               Apple sauce                                             Carnation Drink

After the first 24 hours you can return to a warmer diet such as:

Soups                                  Cooked Cereals                                        Eggs

Fish                                     Ground Beef, pork, Lamb or Turkey   Plenty of Fluids

Steamed Vegetables         Spaghetti                                                  Ensure Drink Mashed potato                                                                                                                                                                                      

While you are healing, you should only eat foods that you are able to cut it with the side of the fork; also no chewy, sharp or sticky foods; therefore AVOID:

Popcorn                             Candy, Chewing Gum                           Spicy Foods

Peanut Butter                   Sunflower or Sesame Seeds                 Pizza

Dried Fruits & Nuts        hard Crusted Breads                              Chips

Full & Partial Dentures FAQs


The price for each arch range between $300 – $2,500 depending on the type and the number of teeth missing.

 

The price for each arch range between $2,500 – $3,500 depending on the type and the number of teeth missing.

Even though it takes about 2 months for the swelling and gums to stabilize, you can get an immediate denture the same day; then replace it after 6 months with a new denture that fits better. Sometimes you need to reline your immediate denture to make it more comfortable till you get your final denture.

It is advised to take them out at night to allow the gum and the denture bearing tissue to rest, and be exposed to natural antibacterial agents that is present in saliva. Good analogy is like, it is a bad idea to wear your shoes while sleeping. Place them in a glass of water with or without a few drops of Scope or Listerine. If your denture or partial has metal attachments, the attachments could tarnish if placed in a soaking solution.

It depends on the type and location of the teeth being replaced by the partial; but normally You can chew with your partial denture in the back; but in some cases, it is not a good idea to bite with front teeth on the partial. Your dentist can advise you on chewing with your partial denture.

If the teeth are pulled at the same day, it is a good idea not to take your denture out for 3 days to control swelling. If you take it out too early, you might not be able to put it back till swelling goes down. Take out your denture at night before sleeping, and place it in a glass of water with or without a few drops of Listerine or Scope. You can also soak your denture in a mixture of ½ cup of 3 percent hydrogen peroxide and ½ cup water. Also, mixture of 2 teaspoon baking soda and enough warm water. There are also denture cleaning tablets ( constituents are dilute sodium hypochlorite which is a mild bleach, sodium bicarbonate,  baking soda, and sometimes citric acids for stain removal ) mixed with water. To remove tarter and build up, soak your denture in a mixture of equal parts of white distilled vinegar and warm water for 30 minutes or overnight, then brush it. If you could not remove the calculus or tarter from your denture, your dentist can remove it for you. Once a month, it is also a good idea to make a mixture of 1 part  house bleach with 11 parts water, and soak your denture in it for 30 minutes to get rid of stains, and disinfect. Brush your denture regularly and gently with denture tooth brush. Take small bites of soft foods, then gradually chew medium food. Chew your food slowly. Avoid sticky food. Once you eat normally, make sure you chew on both sides of the mouth to keep even pressure on both sides so the denture does not dislodge on the other side.

Once you get your denture, it takes about 30 days to get used to it, try to be patient during this time. Unfortunately, since your bone structure and gum gradually change throughout your life, the fit of the denture keeps changing, making it uncomfortable till you reline it; or get a new one. The first 6 months, you lose a lot of bone, then it slows down. Most people spend tons of denture adhesives to make their denture fit better. You are going to need to learn how to eat and speak with a denture.

Here are a few things you can try to relieve:

  • Apply topical gel or cream specifically made for oral pain relief to mthe sore spots in your mouth.
  • Take out your denture, then mix 1 teaspoon of salt with warm water, rinse your mouth for 30 seconds to reduce inflammation.
  • Apply smooth Aloe Vera Gel to the inside of your denture to soothe and alleviate gum soreness and irritation.
  • After the extraction sights heal ( about 2 months ), Massage your gums regularly to increase blood flow and circulation. This will reduce swelling, and your gums get healthy.
  • You can take over the counter pain medication like Advil ( consult your dentist about which medication suits you best ) to reduce inflammation and pain.
  • Remove your denture over night to allow your gums to rest. Brush your denture, then put your denture in a glass of water to avoid the denture from getting dry and brittle. You can put a few drops of Listerine or Scope to kill bacteria.
  • Ask your dentist to reline your denture for a better fit.
  • Use denture adhesive or Poligrip to help denture stay in place. Loose dentures are a major cause of sore gums.
  • Avoid spicy and sour foods till your mouth sores and ulcers heal.

Canker sores may hurt 7-10 days; but they heal completely in about 3-6 weeks.

Depending on the patient habits ( like grinding ), and wear of the denture material, the dentist will advise you when it is time for a new one. In average, most dentures need to be replaced between 3-8 years.

Leave your denture in cleaning solution made with equal parts of white distilled vinegar and warm water for 30 minutes or overnight to soften the tarter, then brush them out gently with denture tooth brush. If that doesn’t help, your dentist can remove and polish it for you. To avoid tarter and build up, you need to brush your denture with denture tooth brush regularly.

You can either use fluoride tooth pastes or rinses; or cover the sensitive teeth with a layer of porcelain ( veneers or crowns ).

For mouth ulcers, you can:

  • Warm water and salt rinses; you can also add baking soda to your rinse.
  • Cover the ulcers with baking soda paste.
  • Apply milk of magnesia on the mouth ulcer.
  • Use over the counter products like Orajel, Anbesol, and Benzocaine ( topical anesthetic ).
  • Ice will also help with canker sore.
  • Cold sores are contagious; but mouth ulcers are not.

Cold sores appear around the mouth, specially on the lips. It starts with tingling, itching or burning sensation. If you have several mouth ulcers, that could be a sign of hand, foot and mouth disease, followed by rash on the hands and feet. Your dentist can prescribe you lotion to rub on the cold sore; and Acyclovir pills that either prevents a cold sore, or lessen the time of duration. Cold sores are contagious; but mouth ulcers are not.

For upper denture removal, press your thumb against the inside of your front teeth and push up and outwards towards your nose. For lower denture removal, put your fingers around the edges of your denture on both sides, then slowly remove it with a rocking motion.

Full complete dentures stay in place by closely fitting to the underlying gum with a thin layer of saliva between your denture and the gum. The more surface area the denture has, the better the seal. Good analogy is: try to fit a wet glass inside an identical glass; you will see how hard it is to separate them, because it is a perfect fit.

Even though it is ideal to wait about 4-6 weeks for your mouth to heal before taking an impression or mold, because of cosmetic reasons, most dentists already have an immediate denture made to be delivered the same day. If patient has no teeth, once the impression is taken, it takes about 3-4 weeks to go through a teeth trying in wax, and verifying the correct bite, and finally making the final denture.

Mouth cancer rarely causes any pain. Abnormal cell growth usually appears as flat patches, usually red, white or red and white. Most often mouth cancer grows on the side of the tongue; or under the tongue, but it could happen anywhere. Other signs and symptoms of mouth cancer are:

  • A sore that doesn’t heal.
  • A growth, lump or thickening of the lining of your mouth.
  • A sore that bleeds.
  • Pain on the tongue.
  • Jaw pain or stiffness.
  • Loose teeth with no apparent reason.
  • Chewing becomes difficult or painful.
  • Denture not fitting.
  • There are other signs of mouth cancer that your medical doctor can tell you.

Your dentist can do a cancer screening exam on you, specially if you are at risk, like smokers. There are no blood tests that can diagnose cancer in the mouth cavity or oropharynx.

You can clean and take care of your denture in variety of ways by:

  • Take out your denture at night before sleeping, and place it in a glass of water with or without a few drops of Listerine or Scope mouth washes.
  • Soak your denture in a mixture of ½ cup of 3 percent hydrogen peroxide and ½ cup water.
  • Soak your denture in a mixture of 2 teaspoon baking soda and enough warm water.
  • There are also denture cleaning tablets ( constituents are dilute sodium hypochlorite which is a mild bleach, sodium bicarbonate, baking soda, and sometimes citric acids for stain removal ) mixed with water.
  • To remove tarter and build up, soak your denture in a mixture of equal parts of white distilled vinegar and warm water for 30 minutes or overnight, then brush it. If you could not remove the calculus or tarter from your denture, your dentist can remove it for you.
  • Once a month, it is also a good idea to make a mixture of 1 part house bleach with 11 parts water, and soak your denture in it for 30 minutes to get rid of stains, and disinfect. Brush your denture regularly and gently with denture tooth brush. It is a good idea to prevent the denture from falling and breaking by always brushing it over a sink that is filled with some water, just in case it slips out of your hand.

If you experience numbness, tingling, pain, weakness. Loss of sensation, loss of balance, paralysis, difficulty walking, they can be sign of high levels of zinc and copper in your blood caused by long term use of either Fixodent, super Poligrip, or other denture adhesives. You need to request a blood test for zinc and copper.

Full Mouth Reconstruction FAQs


The cost of full mouth reconstruction or full mouth rehabilitation can vary depending on the treatment. Cost can range from $3,000 to $30,000 per jaw ( arch ). A free consultation with Dr. Shojania can tell you how much it will cost.

 

Full mouth reconstruction can take 1 day to 9 months depending on the treatment. A free consultation with Dr. Shojania can tell you how long it will take.

There is a procedure called All on 4, which we make a full mouth bridge for you in advance; then it takes 5 hours to remove all your teeth, place 4 implants, and screw the pre made bridge to it. For more info, see the All on 4 section in my website; or A free consultation with Dr. Shojania can tell you all the details that you need to know.

Depending on the treatment you need, a full mouth rehabilitation can look, feel, and function almost as your natural teeth; in some instances, much better than your natural teeth.

Invisalign® Aligner FAQs


Once you accept the suggested treatment plan for Invisalign, dr. Shojania will:

  • Exam your gums, and take the necessary X-rays to make sure your gums and teeth are o.k.
  • Take a mold ( impression ) of your teeth.
  • Take a mold of your existing bite.
  • Take pictures of your teeth.
  • Will write down the existing problem, and the desired outcome.
  • All the above will be send to Invisalign factory.

 

You will get your Invisalign Aligner on your second appointment. It takes about 3-4 weeks after your first appointment, for Invisalign to email the doctor:

  • How many Invisalign Aligner it takes exactly to get to the desired outcome.
  • Video of the exact movements with each Invisalign Aligner till the final outcome.
  • Shojania can either request different movements with the Invisalign Aligner; or approve the existing one. Once he agrees with the suggested movements, the cast that is the exact replica of your teeth are scanned, and all of the Invisalign Aligner are sent to the doctor.
  • You will then get a call for your second appointment to wear your first Invisalign Aligner. In some cases, you might get more than one Invisalign Aligner.

 

Depending on the requested treatment, your dentist might have to:

  • If there is crowding issues, your dentist might have to use a thin strip between your teeth, to create room for your teeth to be able to turn and move. The amount of stripping is minimal, and not only will not damage your teeth; but also you will not be sensitive either.
  • If your teeth have to turn or move a lot, your dentist might have to put some tooth color attachments on some of your teeth, so the Invisalign Aligner can grab those teeth better. These attachments will be removed and polished after your treatment is over.

All of the Invisalign Aligners have numbers on them ( 1,2,3,.. ). Invisalign Aligners should be changed every 14-16 days. Invisalign Aligners should be worn 22 hours a day. Basically, the only time that you take them out, is when you are drinking ( unless its water ) or eating. Then brush your teeth and wear your Invisalign Aligner again.

You need to take care of your Invisalign Aligners as follow:

  • Do not drink any thing that is warm or hot when you are wearing your Invisalign Aligner. Because warm and hot temperature can soften and change the shape of the Invisalign Aligner.
  • Do not drink something that has sugar, because some will leak inside the Invisalign Aligner, and your teeth will be soaking all day in sugar, causing future cavity.
  • When you need to remove your Invisalign Aligner for any reason, do not pull on one part too hard, because you might cause a tear in the Invisalign Aligner. Your dentist will tell you how to remove your Invisalign Aligner.
  • Do not chew food with your Invisalign Aligner inside your mouth.
  • Brush your aligners with a gentle tooth brush.

In average, it takes Invisalign about 12 months to correct your bite; but some cases may take longer or shorter depending on how misaligned your teeth are. Dr. Shojania will inform you on the time it takes to correct your teeth alignment on your free consultation appointment.

Yes you do need a retainer once your Invisalign treatment is finished. However you might not have to wear it forever.

Normally, you wear your Invisalign Retainer for:

  • First 2-3 months, 22 hours a day ( just like your Aligners ). This will give a chance for the soft bone around the teeth that were moved to harden.
  • After 3 months, Nights only for another 3 months.
  • After the first 6 months, if the Invisalign Retainer is not comfortable, you can wear it every other night.
  • After the first 8 months, you can start weaning yourself off of it by wearing it less and less ( keep in mind that if teeth start moving slightly, you need to go back and wear it every day ).

The cost of Invisalign can range from $3,500 ( for minor movements ) to $6,000 depending on your case. The Average cost is $5,000. You will find out the cost on your initial free consultation appointment.

There are many advantages to get Invisalign instead of the traditional metal braces:

  • Comfort- There are no wires or brackets to wear, no sharp edges to get cuts from Invisalign Aligners.
  • Attractive- Invisalign Aligners are clear and more attractive. In most cases, people do not even know that you are wearing Invisalign Aligners.
  • Convenience- You do not need to deal with metal braces. you can remove your Invisalign Aligners to eat, floss, and brush to brush and floss, or eat.
  • More hygienic- because you can remove your Invisalign Aligners to eat, floss, and brush, it makes it more hygienic. Less risk of getting gum disease and periodontal problems. You don’t have to worry about food getting stuck to your teeth with your Invisalign Aligners, which happens with traditional metal braces.
  • Can be removed- You can remove your Invisalign Aligners to eat, floss, and brush; that is something that you cannot do with traditional metal braces.
  • Minimal maintenance- If your Invisalign Aligners get stained, all you have to do is wet your tooth brush in a mixture of ½ cup water and 2 drops of bleach; then brush your Invisalign Aligners gently every 2-3 days. Rinse your Invisalign Aligners before wearing them.

In some cases, every time that you wear a new Invisalign Aligners, there will be pressure on the teeth that the Invisalign Aligner is trying to move; that causes discomfort for 1-2 days. The more you are in your treatment with Invisalign Aligners, the less pain you will have. You can use a pain reliever for couple of days till you get used to your new Invisalign Aligner.

Invisalign® takes a modern approach to straightening teeth, using a custom-made series of aligners created for you and only you. These aligner trays are made of smooth, comfortable and virtually invisible plastic that you wear over your teeth. Wearing the aligners will gradually and gently shift your teeth into place, based on the exact movements your dentist plans out for you.

Root Canal FAQs


Depending on the cause, root canal may or may not be emergency. In most cases, there is an infection that needs to be taken care of immediately. The infection can move towards the heart ( from the lower teeth ); or move towards the sinus ( from upper teeth ).

In general, dental root canal takes one appointment to complete; but if there is a lot of infection, the dentist might take two appointment to complete dental root canal. Also if the roots have sharp curves, or are calcified, the dentist might decide to finish the dental root canal in two appointments.

Depending on the insurance, and the degree of difficulty, dental root canal can cost anywhere from $400 – $1,400. After the dental root canal, the access to the canal is closed with a temporary filling. If there are no more pain or infection, your dentist will remove the temporary, and build up the tooth; then prep the tooth for crown.

Once the dental root canal is finished, no more nutrition gets to the tooth, which causes the tooth to become very dry and brittle. Because of that, you need a crown to protect your dental root canal tooth. In rare cases, like lower small front teeth, you might not have to do a crown if there is not enough tooth structure.

Any untreated infection in the body ( including teeth ) can kill you.

During the dental root canal procedure, you will be numb, and you are not supposed to feel any pain. After the anesthetic wears off, minimal or no pain is the norm.

If you don’t do the root canal, the infection can spread to the surrounding tissue ( gum and bone ). The infection is acidic, and it will damage the bone, creating a canal that connects the infection to your soft tissue ( cheek and under the jaw bone ). This will lead to abcess ( swelling caused by infection ). Remember that any untreated infection in the body ( including teeth ) can kill you.

It is normal to feel mild to moderate pain for a few days after your root canal therapy; but in most cases, you should not have any pain.

In some cases, the root canal is needed because of the expected degradation of the dental nerve; or if the cavity or fracture is too close to a nerve, even if you have no pain. Your dentist can explain to you that why you need a root canal even when you are not experiencing any pain.

Yes it can. If your first root canal fails because either there is infection again; or there is a root fracture, if your first root canal was done by:

  • A general dentist, you need to be refered to an endodontist ( specialist for root canal ) to evaluate or redo the root canal.
  • An endodontist, then you probably need to remove the whole tooth, and either get an implant or a bridge.

Yes, you can go back to work after your root canal; but remember you will be numb 2-3 hours after your appointment. Just be careful eating while your cheek or lips are numb.

You can eat after your root canal; but remember you will be numb 2-3 hours after your appointment. Just be careful eating while your cheek or lips are numb. It will be wise not to chew on the root canaled tooth until the permanent crown is in place.

The success rate of the root canal therapy under normal circumstances are about 95%.

If you take care of your tooth, and do regular checkups, your root canal could last a life time.

After root canal therapy, the tooth might still be sensitive for couple of days. Also it is wise to chew on the other side till the permanent crown has covered your tooth.

Depending on the extent of your cavity and the infection, your dentist will advise you to save a tooth by root canal; or remove the tooth permanently.