tooth repair in one day

Dr. Raymond E. LaVigne practices dentistry in Palatine, Illinois. His specialties are cosmetic dentistry, dental implants, and patient education. This article focuses on the concept of repairing a tooth and/or dental implant in one day's worth of procedures. There are many pros and cons to this practice. 

While it may seem tempting to have all of your teeth problems fixed in one day, this may not be the healthiest reality.

For example, the procedure of placing 6 implants, allowing 4-6 months for healing and later delivering a full denture that is screwed down over the implants has been a successful treatment option for over 10 years.

Recently, the concept has been advanced to placement of the implants immediately after extracting remaining teeth and also placement of the denture attached to those implants in the same visit. In addition, reducing the number of implants to 4 has been used.

This works wonders for some patients who qualify for this major treatment. However. there are many who cannot have this same treatment regimen. In order for the "all on four, teeth in one day" to be realized, there are indications and prohibited conditions. In order for implants to be placed immediately following extractions in general:

The teeth being extracted must either be distant enough from the implant sites or the bone must be adequate to allow an implant wider and f or longer than the extraction site. There should be no active infection.

Although prosthetic teeth are placed immediately, there must be absolute compliance by the patient with regard to eating extremely softly for the recommended time frame. There must also be provision made to prevent the effect of bruxism (teeth grinding during sleep) from damage to and failure of the implants healing within the bone.

The total surgical and restorative procedure is at a fairly high cost in a short period of time. Even with zero percent financing, some patients find this difficult to fit into their overall budget.

The good news is that there are other options for patients to consider. Rather than make a quantum leap to a denture loaded upon 4 implants in one appointment, patients can elect to go much more gradually. As an example, teeth can be extracted one or a few at a time. Implants can be placed one or two at a time. Extraction sites can be allowed to heal and Implants can be left unloaded in the traditional fashion for at least 3 months. The patient is fitted with a temporary partial denture or temporary plastic fixed bridges. These can be modified as the treatment progresses. Implants that have been confirmed as integrated into bone can then be used as' anchors while additional teeth are extracted and more implants placed.

The above approach allows for treatment to be phased in over a much longer time frame. While the concept of everything done quickly is appealing to some, it is not for everyone.

The advantages of the gradual phase in method are as follows:

1) Conservatively allowing time for healing of extraction wounds, bone grafts, implants
and confirming this stability before relying on their support for chewing.

2) Extend financing even further by doing the treatment in smaller phases still possibly using zero percent financing.

3) Avoiding complications from infection, night clenching.
4) Give patient opportunity to gradually become acclimated to having implants and doing the necessary daily care before they invest in everything on 4 - 6 implants.

5) Allow more opportunity to make adjustments to the appearance and occlusion (bite) by a more gradual transition and ability to do more try in visits before the prosthesis is completed.

Thank you for reading,

Dr. Ray

Dr. Raymond E. LaVigne DDS is a practicing dentist in the Chicagoland area for over 30 years.

Please call our Palatine, IL dental office for an appointment: 847-359-1292.

Sedation dentistry

Dr. Raymond E. LaVigne practices dentistry in Palatine, Illinois. His specialties are cosmetic dentistry, dental implants, and patient education. This article highlights pros and cons of sedation dentistry as well as tips for easing dental-related anxiety.

Some patients have extreme anxiety about any type of medical / dental care.

They avoid treatment for so long that ultimately they need major procedures on one or more teeth or even extensive full mouth treatment.

They may build up their fear level so high that they feel the only way to get needed treatment is with general anesthesia - sleeping through it all.

We hear radio ads and see printed ads on every media including the internet that offer patients the alternative of sleep dentistry. Some make it sound easy to have everything done in one session including cosmetic treatment. While this sounds wonderful at first glance, there are significant reasons not to undergo general anesthesia for complete dental care:

1) Local Anesthetics are much safer.
2) Some procedures, especially cosmetic procedures and very large restorative cases require interaction with the patient. Patients need to open and close, smile, offer their opinions and approval.

3) Many restorative procedures - from simple fillings through complete bridges or dentures require that the bite be checked. This can only feasibly be done with an alert and co-operative patient.

4) Many dental procedures require water cooling, irrigation and rinsing. When patients are completely sleeping, this is difficult and very compromised.

5) Complex dental work requires much time making and fitting temporary restorations. This will greatly extend the amount of time a patient remains under general anesthesia.
While there are certainly indications for complete general anesthetics, I believe that its use should be limited. Perhaps a few procedures that are the most fearful should be performed under general anesthetic. Some patients may have a medical condition or handicap that necessitates having dental treatment done while completely sleeping.

Other patients may just not be aware of other alternatives and some may simply not be trying to deal with their anxiety. Perhaps they would benefit from some of the techniques that we use:

1) Gradually overcome anxiety by having a small procedure done comfortably in order to gain their trust and ease their fears.

2) Witness that gentle technique, generous use of topical and local anesthetics, testing the effectiveness of the local anesthetic and a gentle approach to the treatment itself will improve their outlook and ability to deal with treatment.

3) Rather than be completely asleep, undergo sedation. By having nitrous oxide (laughing gas) just prior to treatment and throughout the "scary" parts a patient can be relaxed. They will still be able to participate in checking the bite, having discussions, etc. when needed. An even greater level of sedation can be reached if Valium, Xanax or similar drug is taken roughly 30 - 60 minutes before treatment. Some patients may also benefit from having a sedative to get a good night's rest before. The best dental care is done carefully and with proper water cooling for instruments and rinsing for removal of bacteria, debris and having a clear area for use of impressions, adhesives and other materials. Most extensive dental treatment is not due to sudden trauma but rather the result of many months or years of not receiving care.

Thank you for reading,

Dr. Ray

Dr. Raymond E. LaVigne DDS is a practicing dentist in the Chicagoland area for over 30 years.
Please call our Palatine, IL dental office for an appointment: 847-359-1292.